Jupiter Medical Center Foundation Pinnacle Fall 2020

Pinnacle

FALL 2020

WORLD-CLASS HEALTH CARE IN PALM BEACH COUNTY

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ORAL REPRESENTATIONS CANNOT BE RELIED UPON AS CORRECTLY STATING REPRESENTATIONS OF THE SELLER. FOR CORRECT REPRESENTATIONS, MAKE REFERENCE TO THIS BROCHURE AND TO THE DOCUMENTS REQUIRED BY SECTION 718.503, FLORIDA STATUTES, TO BE FURNISHED BY A SELLER TO A BUYER OR LESSEE. This project has been filed in the State of Florida and no other state. This is not an offer to sell or solicitation of offers to buy the condominium units in states where such offer or solicitation cannot be made. Prices and availability are subject to change at any time without notice. This is a limited time offer. Developer may withdraw offering at any time. We are pledged to the letter and spirit of the US Policy for achievement of equal housing opportunity throughout the nation. We encourage and support an affirmative advertising and marketing program in which there are no

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barriers to obtaining housing because of race, color, religion, sex, handicap, familial status or national origin. All real estate advertised herein is subject to the US Federal Fair Housing Act of 1968 which makes it illegal to make or publish any advertisement that indicates any preference, limitation, or discrimination based on race, color, religion, sex, handicap, familial status, or national origin. Please check with your local government agency for more information. The sketches, renderings, pictures and illustrations are proposals only and the developer reserves the right to modify, revise or withdraw any or all of the same at its sole discretion without notice. The renderings illustrate and depict a lifestyle, however, amenities, features and specifications are subject to change without notice. All information is deemed reliable but is not guaranteed and should be independently verified.

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We will never be able to thank you enough, but we will work to protect you.

If you can help, please donate to Jupiter Medical Center Foundation’s COVID-19 Relief Fund. The Fund will allow the medical center to continue to meet the healthcare needs of our patients and community, despite the long-term financial implications of the coronavirus.

As an independent, not-for-profit healthcare system, we greatly appreciate your support and generosity during this challenging time.

Donate today at jmcfoundation.org

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CONTENTS 50

FIT FROM HOME Expert tips for making the most of your at-home workouts

By Jana Soeldner Danger

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UNDERNEATH IT ALL Jupiter Medical Center health care providers step out from behind the front lines Photography by Tracey Benson

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PORCH SESSIONS PROJECT A photographer captures the spirit of local families during quarantine Photography by Christy Burke

Departments 10

WELCOME

Features

Greetings from Jupiter Medical Center Foundation

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44

12

Immunity-boosting strategies to fight off disease and promote well-being

By Judy Martel

Maintaining the four core areas of fitness makes it easier to get back in the game

By Judy Martel

Dr. Amit Rastogi reflects upon his first year as president and CEO of Jupiter Medical Center, and shares thoughts on what the future holds

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46

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Insight into how to stay healthy while traveling during a pandemic

By Skye Sherman

High-tech tools help in the early diagnosis and treatment of a variety of cancers

By Judy Martel

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48

DONOR PROFILE

Knee replacement patient Marjorie Odeen hails JMC staff and safety protocols

The benefits and improved outcomes of off-pump bypass surgery

By K.S. Meyer

Joe and Barbara Charles have gifted JMC with a key piece of diagnostic technology

By Michele Meyer

ON THE COVER Photographer: Nadine Greeff / Stocksy United

READY FOR ANYTHING

TAKING FLIGHT DURING FLU SEASON

REPAIRING THE BEATING HEART

EXERCISE AFTER QUARANTINE

LEVERAGING TECHNOLOGY IN ONCOLOGY

MEET THE CEO

PULSE

Well-Being | Ask the Expert | Health Report | Nutrition

64

IN HER WORDS

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1210 S. Old Dixie Highway Jupiter, Florida 33458 561.263.2234 jupitermed.com

Amit Rastogi, MD, MHCM President and Chief Executive Officer, Jupiter Medical Center JUPITER MEDICAL CENTER FOUNDATION, INC. OFFICERS AND TRUSTEES 2020 Liv E. Vesely, MA, MPH President, Jupiter Medical Center Foundation Joseph C. Kempe, JD, LL.M., Chairman Donald H. McCree, Jr., Secretary Salvatore A. Tiano, Treasurer William C. Mattison, Jr. Jane F. Napier David J. S. Nicholson James E. Perrella Joseph M. Petri Katharine F. Plum M. Jude Reyes Mary E. Roff Burton M. Tansky Dennis K. Williams

Leonard Abramson Edward L. Babington Douglas S. Brown George H. Damman Lodewijk J. de Vink Neil S. Devlin Martin A. Dytrych John P. Healy Richard J. Katz, Jr. Peter A. Lund Emeritus: Peter O. Crisp

JUPITER MEDICAL CENTER OFFICERS AND TRUSTEES 2020 Martin A. Dytrych, Chairman Robert J. Stilley, Vice Chairman Jack Waterman, DO, Secretary Rosanne M. Duane, Esq., Treasurer Martin A. Dytrych Mark L. Corry, MD Henri J. DesPlaines Michele D. Deverich Rosanne M. Duane, Esq Harvey Golub Joseph C. Kempe Peter A. Lund

Simie Platt, MD, Chief of Staff Mary Roff, Ex-Officio Anthony P. Shaya, MD Ryan Simovitch, MD Robert J. Stilley Andres Suarez, MD Jack Waterman, DO

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Pinnacle

WORLD-CLASS HEALTH CARE IN PALM BEACH COUNTY

Publisher Terry Duffy Editorial Director Daphne Nikolopoulos Creative Director Olga M. Gustine Executive Editor Mary Murray Senior Art Director Jenny Fernandez-Prieto CONTRIBUTING WRITERS Alexa Becker, Judy Martel, Linda Marx, K.S. Meyer, Michele Meyer, Skye Sherman, Jana Soeldner Danger CONTRIBUTING PHOTOGRAPHERS Christy Burke, Tracey Benson, Jerry Rabinowitz, Libby Volgyes DIGITAL IMAGING SPECIALIST Leonor Alvarez Maza ADVERTISING Publisher, Naples Kaleigh Grover Advertising Manager Dina Turner Senior Account Manager Deidre Wade Account Managers Kathleen Beuttel, Melissa Zolin Schwartz, Meegan Wyatt Advertising Service Coordinator Ashley Fleak PRODUCTION Production Director Selene M. Ceballo Production Manager Brian Beach Digital Pre-Press Specialist George Davis Advertising Design Coordinators Anaely J. Perez Vargas, Jeffrey Rey Digital Production Coordinator Kassandre Kallen

OPERATIONS Chief Operating Officer Todd Schmidt Process Integration Manager Sue Martel Digital Operations Manager Bill Fleak Circulation/Subscriptions Administrator Marjorie Leiva Distribution Manager Judy Heflin Accounting Specialist Lourdes Linares Accounts Receivable Specialist Ana Coronel

In Memoriam Ronald J. Woods (1935-2013) HOUR MEDIA, LLC CEO Stefan Wanczyk President John Balardo PUBLISHERS OF: Palm Beach Illustrated • Naples Illustrated • Fort Lauderdale Illustrated Palm Beach Charity Register • Naples Charity Register • Florida Design • Florida Design Naples • Florida Design Miami • Florida Design Sourcebook Palm Beach Relocation Guide • Fifth Avenue South • South Florida Baby and Beyond • The Jewel of Palm Beach: The Mar-a-Lago Club • Traditions: The Breakers Salut!: Naples Winter Wine Festival • Palm Beach 100 • Naples 100 • Art & Culture: Cultural Council for Palm Beach County Pinnacle: Jupiter Medical Center Foundation • Waypoints: Naples Yacht Club • Naples on the Gulf: Naples Chamber of Commerce • Jupiter • Stuart • Aventura Community Foundation of Collier County Community Report Published by Palm Beach Media Group North P.O. Box 3344, Palm Beach, FL 33480 Telephone: 561.659.0210 • Fax: 561.659.1736 www.palmbeachmedia.com Copyright 2020 Palm Beach Media Group North Inc. All rights reserved.

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WELCOME

Road to Recovery In this new normal, our thoughts frequently turn to COVID-19. At Jupiter Medical Center, we understand the need for clear and concise health- and wellness-related information. It’s one of the things we do best, and one of the reasons this issue of Pinnacle is a must-read. We know your top priority is not only protecting yourself and your family, but also understanding how best to navigate our temporary new way of life.

Pinnacle’s fall issue could be considered a resource guide with answers to questions about protection from the coronavirus, how to stay well at home, and cutting-edge medicine. We’ve covered everything from herd immunity to ways to protect yourself if you have to travel during flu season. Since steering clear of the flu and the coronavirus are probably at the top of your list, we explore the dos and don’ts of proper hygiene with Lorrie Ingram, RN, JMC Infection Control. We’ve also asked Andres Suarez, MD, an infectious disease specialist, about herd immunity and vaccines, and how important they are to the health of our community.

Since COVID-19 attacks the immune system, we’ve called on Nichole Corry, MD, internist and JMC concierge physician, and Neal Nay, director of the JMC Sleep Center, to explain the necessary lifestyle changes we may need to make—diet, exercise, sleep, stress reduction—to prevent or fight the virus. Plus, Laura Molner, director of Urgent Care, and Harry Romero, MD, medical director of Urgent Care, comment on why telehealth has become a welcome necessity that protects doctors and patients while keeping medical costs down.

There’s so much more to investigate in this issue. We tackle how to build a home gym and how to stay fit at home. And since our lives extend beyond combating the coronavirus, we’ve added content on genetic screening, elective surgery, and revolutionary techniques in open-heart surgery.

We hope you find this issue helpful and informative.

Be well,

Liv E. Vesely President Jupiter Medical Center Foundation

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Q&A WITH DR. AMIT RASTOGI

By Michele Meyer

Meet the CEO Dr. Amit Rastogi, MD, MHCM, reflects upon his first year as president and CEO of Jupiter Medical Center, his background in medicine, and what the future holds Talk about a trial by fire. Just months after Dr. Amit Rastogi joined Jupiter Medical Center as president and chief executive officer, COVID-19 changed the medical landscape worldwide. However, the New Jersey native was poised to lead his team through this health crisis, having earned his master’s in health care management at Harvard University and having previously served various executive roles at Yale New Haven Health. Prior to a career shift into health care management, Rastogi, who is a board-certified internal medicine physician, amassed nearly 20 years of clinical experience. Here, he shares insights into his career and JMC’s response to the pandemic.

How has Jupiter Medical Center tackled the COVID-19 pandemic?

Since early January, when we recognized that COVID-19 would inevitably spread to the United States and affect our community, we were among the first medical centers in the state of Florida to initiate CDC guidelines. We also implemented a series of our own multidisciplinary measures to protect our patients, medical staff, and team members.

We carefully segmented the two distinct patient populations. COVID and non-COVID patients receive care in separate wings of our hospital and are treated by their own dedicated teams. It is likely COVID-19

will be with us for the foreseeable future and we have adjusted accordingly to successfully perform elective surgeries while also treating the most severe of our COVID-affected patients.

Has any good come out of this crisis?

The pandemic has reaffirmed how incredibly supportive the community has been. The philanthropic support we have received has been amazing and our community has rallied, donating equipment, services, and time. We have also learned a lot about our team members and medical staff who have demonstrated remarkable poise, courage, and dedication during this crisis. Our community should be very proud of their service.

What are your long-range plans for JMC? Despite the pandemic, we continue to stay focused on our vision of evolving into a regional medical center. We are building on our already well-established reputation as the leader in safety, quality, and patient satisfaction. We continue to expand the breadth and depth of our cardiac, oncology, orthopedics, pediatrics, and diagnostic imaging capabilities. We also continue to make significant investments in technologies made possible by the generosity of our donors, trustees, and corporate board members.

In February, we announced a partnership with the University of Miami’s Sylvester Comprehensive Cancer Center, South Florida’s only NCI-designated cancer program.

This relationship enables us to tap into groundbreaking clinical research to improve the quality of cancer treatment we provide right here in Jupiter, while also allowing us to collaborate with academics and world-class specialists at the University of Miami.

Our $80 million surgical institute, set to open in 2023, will have “smart” operating rooms for minimally invasive and robotic surgery for cardiovascular, orthopedic, and various other procedures.

When did you decide to become a doctor?

I’ve always been interested in science. I enjoyed biology, chemistry, and mathematics in high school and gravitated to medicine because I wanted to make an impact on helping people. Medicine also fed my intellectual curiosity.

Are there other doctors in your family?

My father is a chemical engineer, but everyone else in our family is a doctor, including my wife of 21 years, Dr. Priya Rastogi, who is a radiologist. We have two teenage daughters, one of whom aspires to enter the health care field.

How has being a doctor helped you in your role as CEO? As a physician and businessperson, I recognize a broad range of considerations that affect how we can improve patient care, the patient experience, and our outcomes, and solve many of the challenges and opportunities we encounter.

Why did you decide to transition into hospital administration?

I loved practicing medicine but realized that I could also make a significant impact, not just on each of my individual patients, but on entire communities.

You start your day at 3:30 a.m. How do you wind down?

For me, swimming is a form of meditation. The serenity of swimming laps allows me to wind down while also getting the exercise needed for me to bring a fresh perspective each day. «

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Introducing the For the Life Changing Best Heart Surgeon Best Orthopedic in Treatment South Florida Shouldn't Care in Florida Wait for a Pandemic to Pass.

Quality. Safety. Outcomes. These are just a few of the most important measures by which all heart surgeons are judged. And when it comes to issues of the heart, you only want the absolute best.

There is Medical only one hospital Center in is proud to welcome Dr. Arthur Jupiter Florida with two Blue board-certified cardiac Katz, aawarded nationally recognized Distinction Certifications from of Cardiac Surgery at the surgeon, as Medical Director Robson &Blue Vascular The Blue Heart Cross & ShieldInstitute and Timothy & Jayne Donahue Cardiac Surgery Association and three Gold Program at Jupiter Medical Center. from The Seals of Approval Joint Commission for Hip, byand his Spine peers as a “Top Doctor,” Considered Knee, Shoulder Kn Dr. Katz is known as theuncertainty cardiac surgeon COVID is causing for all of us. What is certain, however, is that diseases like Surgery.

that other cardiac would choose cancer, heartsurgeons disease and diabetes will continue to go undetected, undiagnosed, or for their heart surgeries. untreated. That’s why it’s critical not to delay the care you or your loved ones may need

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renowned experts are right here in Palm Beach County and the Treasure Coast region with Jupiter, closer to home.

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PULSE Well-Being Elective Surgeries

Ask the Expert

Herd Immunity and Vaccines Healthy Environments The New Age of Telehealth

Health Report Genetic Screening

Nutrition Elixirs for Vitality

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9/18/20 10:57 AM

PULSE WELL-BEING

By Judy Martel

When ‘Elective’ Procedures are More Essential than ‘Elective’ What to consider when scheduling an elective surgery or procedure during a pandemic

The year 2020 will long be remembered for the COVID-19 pandemic that turned the world upside down. As the ripple effect from the highly contagious disease changed every aspect of daily life, many Americans who were scheduled to have necessary, but nonlife-threatening procedures, such as hip replacements and cataract surgery, had to put their surgical plans on pause.

On March 20, when it appeared that hospitals could become overwhelmed with COVID-19 patients, Florida Governor Ron DeSantis signed an executive order banning “non-essential, elective medical procedures” to allow hospitals to reallocate resources and staff to focus on fighting the coronavirus. On May 8, the ban was lifted; however, lingering concerns about hospital safety prevented many who had put off nonessential procedures to further delay their rescheduling. Delaying a health condition could put some at unnecessary risk for complications or life-threatening cases that could have been prevented if treated early-on, according to Steve Seeley, vice president and chief operating officer of Jupiter Medical Center.

“We understand this pandemic has marked an unprecedented time in everyone’s lives and people’s anxiety is at an all-time high,” Seeley says. “But people shouldn’t wait to address their health in fear of contracting the virus.” Jupiter Medical Center has invested heavily in several innovative safety technologies, including disinfecting robots and UV light filters in addition to regular, aggressive cleaning, to sanitize the hospital often three times per day in order to reduce the likelihood of patients, medical staff, and team members being exposed to deadly pathogens. Additionally, at Jupiter Medical Center all COVID-19 patients are cared for in a separate area of the hospital, and there are dedicated teams of clinicians caring only for patients who are being treated for the virus.

“We have continued to make significant investments in the procurement of personal

protective equipment (PPE), multiple testing capabilities, treatment modalities, and state-ofthe-art safety technologies,” adds Seeley. “The safety measures we have implemented are consistent with the recommended CDC guidelines.

Even before the COVID-19 health pandemic, Jupiter Medical Center has been recognized for its excellent reputation for low infection risk, and we continue to work diligently to extend our leadership as the safest, highest quality medical center in Palm Beach County and the Treasure Coast.”

Even with the surge in South Florida over the summer, Jupiter Medical Center had the capacity to support the volume of COVID patients while also successfully managing increases in demand for cardiac, orthopedics, pediatrics, diagnostic imaging, urgent care, and telehealth services.

It is likely that this pandemic and COVID-19 will be with us for the foreseeable future so it is important that we continue to adjust to our new reality, which includes taking care of our health first and foremost.

Certain regular screenings, such as colonos-

copies and mammograms, should not be put off and could be the difference of being diagnosed in early, treatable stages versus life-threatening stages or, worse, terminal. Critical surgeries such as joint replacement and spinal can be scheduled safely so patients can start living an improved quality of life now and not later.

Critical symptoms such as severe abdominal or chest pain, sudden numbness or tingling of legs or arms or along one side of the body, loss of vision, and confusion could signal that something serious has occurred. These are symptoms that should not be ignored or put off. It is important to address these symptoms immediately and go to the emergency room right away.

“We want people to understand the importance of not waiting and potentially jeopardizing their health because of fears of getting the virus,” Seeley says. “It’s something to be cautious of, but people shouldn’t live in fear. We have made significant investments and implemented rigorous procedures to provide the safest possible environment for all of our patients, medical staff, and team members.” «

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9/22/20 9:43 AM

Introducing the Life Changing Best Heart Surgeon in Treatment South Florida Shouldn't

Wait for a Pandemic to Pass.

Quality. Safety. Outcomes. These are just a few of the most important measures by which all heart surgeons are judged. And when it comes to issues of the heart, you only want the absolute best.

Jupiter Medical Center is proud to welcome Dr. Arthur Katz, a nationally recognized board-certified cardiac surgeon, as Medical Director of Cardiac Surgery at the Robson Heart & Vascular Institute and Timothy & Jayne Donahue Cardiac Surgery Program at Jupiter Medical Center.

Considered by his peers as a “Top Doctor,” Dr. Katz is known as theuncertainty cardiac surgeon COVID is causing for all of us. What is certain, however, is that diseases like that other cardiac surgeons would choose cancer, heart disease and diabetes will continue to go undetected, undiagnosed, or for their heart surgeries. untreated. That’s why it’s critical not to delay the care you or your loved ones may need during this pandemic.

His appointment culminates

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Get a checkup.

See yourH. doctor.

By identifying symptoms early Arthur Katz, MD its cardiac expertise, capabilities and and more quickly initiating life saving treatment, the odds Medical Director Cardiothoracic Surgeonof living a long and healthy life resources. So now you don’t have to Cardiac Medical Surgery Director much in your or favor. go to are New York,more Cleveland, Cardiac Surgery Rochester to get the nation’s best Through it all, the #HealthcareHeroes at Jupiter Medical cardiac care because worldCenter stand ready to serve renowned experts are right here and in will continue providing Palm Beach County and the Treasure Coast region with Jupiter, closer to home.

Ju This is the safest, highest quality healthcare.

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PULSE ASK THE EXPERT

By K.S. Meyer

Responding to the Pandemic Weighing the inherent risks and rewards in vaccine development and achieving herd immunity In 1918, a curious change occurred in what until then had been an unremarkable virus. Its ancestors and cousins made yearly sweeps of the population, disproportionately affecting the very old, the very young, and the infirm. But something new in this one’s genome gave it the upper hand over even the strongest of its hosts’ immune systems.

By the end of that decade, this novel strain had resulted in more than 50 million deaths, more than twice the lives lost in the World War whose conclusion coincided with its emergence. Society ground to a halt. Funeral homes were overwhelmed. People in large cities wore

face masks in public to protect themselves and their loved ones.

Then, somehow, the deaths subsided. Slowly, things returned to normal. What we now call the Spanish influenza pandemic had run its course. How did this happen? How, in an era before rapid widespread testing, contact tracing, and vaccines, did this seemingly unstoppable scourge relent? Dr. Andres Suarez, an infectious disease specialist at Jupiter Medical Center, notes that one such mechanism behind the sudden disappearance was herd immunity.

“There is a number called the ‘basic reproduction number’ that guides this calculation,” he explains. “It indicates the number of people who are likely to get infected by every individual who acquires the infection.” For example, a basic reproduction number of two or three would mean that every infected person would, on average, spread the infection to two or three others. “Based on that number,” continues Suarez, “the proportion of the population that needs to be immune to achieve what we call ‘herd immunity’ is anywhere from 65 to 70 percent. That means that once 70 percent of the population is immune, then it’s very unlikely that those who are not will encounter the opportunity to be infected.”

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In other words, a virus is in constant search for available hosts, and as the number of available hosts in a population diminishes, so do its chances for propagation. Achieving herd immunity is thus desirable when an outbreak occurs, but the methods by which this can be done differ greatly in their efficacy and ethical implications.

An opinion widely voiced amid the ongoing COVID-19 pandemic has been, “We should all just get it and be done with it.” In other words, everyone should deliberately get sick so that we might reach herd immunity naturally. Suarez explains why this is very far from a good idea: “The mortality of COVID-19 is probably about 10 times that of the flu. For the flu, about one in every thousand people who acquire it will die as a result. For COVID-19 … it is believed that about one out of every hundred people who acquire the infection will die. If you calculate for herd immunity in our country, which is [roughly] 300 million in population, 70 percent would be 210 million. So, we need to have 210 million who are immune to the virus to achieve herd immunity, but if you do that by means of letting people get infected, and one out of every hundred persons infected will die, that translates to about 2.1 million deaths.”

A widespread vaccination program, on the other hand, can enable a population to achieve herd immunity at a level of risk infinitesimal by comparison, and at a far quicker rate. “Vaccines are the only way to fight these epidemics that carry high mortality,” confirms Suarez, who goes on to explain the differences between attenuated, or “live virus,” vaccines, and non-attenuated ones, including their mechanisms of action and the relative risks involved.

“One of the important aspects regarding attenuated live vaccines is that you cannot use them on people who are immunocompromised,” he says. “Since it is a live virus, in reality, what you’re doing is creating a lowgrade infection, which carries with it an increased risk of side effects.”

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Although the risk may be higher, the immunity granted by attenuated vaccines tends to be stronger and longer lasting.

Non-attenuated vaccines typically give immunity for shorter periods and thus require booster shots at intervals, but they are less dangerous for the broader population. “Vaccines that contain viral particles that aren’t alive are obviously safer, and you can give them to people who are immunocompromised,” says Suarez.

To those skeptical of the safety of vaccines, he is quick to note that while there are potential side effects to some, “the benefits so greatly outweigh the risks, that the risks are justified.” For example, the scientifically verifiable one-in-a-million chance of developing Guillain-Barré syndrome in response to the flu vaccine appears minuscule when compared to the one-in-a-thousand chance of dying from the contracted flu itself.

Future COVID-19 vaccines will be as novel as the disease itself and will likely carry risks of side effects, some of which may be severe; however, it is unlikely that such risks will outweigh the benefits.

Naturally, no one wants to be the one who develops a side effect, but to enjoy the reward of herd immunity—open businesses, open schools, fully functional hospitals and public services, not to mention the ability to sleep better at night—it is a comparatively small risk to assume. «

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PULSE ASK THE EXPERT

By Mary Murray

Healthier Environments, Healthier You Expert insight into proper hygiene and cleaning practices to prevent the spread of coronavirus While there’s much we don’t yet know about the novel coronavirus, we do have a good understanding of how it is transmitted from one host to another. Much like other coronavirus strains, it is a droplet-type virus that can travel through the air. If an infected person sneezes, for example, infectious droplets can both fall to surfaces or propel forward at a distance of about 6 feet. Someone either within that sneeze zone or who touches a contaminated surface would then be at risk of contracting the virus.

Given the nature of this transmission process, it is vital that everyone does their part to break the chain of infection, notes Lorrie Ingram, an infection control nurse at Jupiter Medical Center. In addition to wearing a mask, she identifies four key steps to discourage the spread of coronavirus: Practice good, frequent hand hygiene by washing with soap and water for at least 20 to 25 seconds every time or using alcohol gel/hand sanitizer; employ proper cough and sneeze etiquette, using a tissue and washing hands immediately after; socially distance whenever possible; and maintain reasonable environmental controls, including frequently

cleaning and disinfecting hightouch surfaces. Here, Ingram offers advice for killing viruses and staying healthy.

What best practices should we be following when it comes to household decontamination?

When you do your cleaning and disinfecting, remember that the cleaning process is as important as the disinfecting. We want to make sure we clean all surfaces and high-touch areas that we utilize often.

That is, to make sure you remove any type of gross contamination or dirt with the first step of cleaning, so that when you go over the areas again with your disinfectant, there’s nothing that can trap or block the disinfectant from fully contacting and covering the surface to destroy any organisms.

Commonly touched areas, such as tables, chairs, doorknobs, light switches, phones, tablets, computers, TV screens, remotes, keyboards, handles on cabinets, desks, and any sinks and bathroom fixtures and bowls should have a good daily wipe down with an approved cleaner or

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DISINFECTING 101 Ingram suggests consulting the Environmental Protection Agency’s “N” list when searching for products that kill COVID-19. It’s vital to follow the directions for use with any chemical, including how many minutes a product needs to be in contact with a surface in order to be effective.

You can also create a disinfectant at home using common ingredients such as bleach, isopropyl alcohol, or hydrogen peroxide, all of which need to be diluted with water. You can find instruction for utilizing and diluting these items on the CDC and Florida Department of Health websites.

disinfectant. An everyday deep cleaning is not always possible nor is it an achievable goal, but it’s more of making sure that the high-touch areas— especially those in the kitchen and bathrooms—are tended to, as those are the surfaces that would be most vulnerable for anyone in the home.

For those who have to work in traditional offices, what behaviors should they practice in order to mitigate the spread of viruses?

What we have to remember is at any given time someone could be exposed out in the community or at home and bring it into the workplace.

They could be asymptomatic themselves or a very mild symptom carrier.

We want to social distance or try to keep at least 6 feet between our desks or immediate personal workspace. Wear masks in the workplace as much as you can when in common areas, such as lounges, kitchens, bathrooms, and places with shared equipment, such as fax machines and printers. Some workplaces are using Plexiglas to increase the amount of environmental separation between workers [to block] anything that could become aerosolized during talking, coughing, sneezing, or heavy exhalation. We should also be cognizant of the cleaning and disinfecting we’re doing and how often we’re doing it. We should encourage and solicit the help of everybody in our common work areas to clean and disinfect their high-touch surfaces or those common areas that everybody may have contact with.

What is proper mask-wearing etiquette?

Always perform hand hygiene prior to putting on a mask. It is also important to wear it correctly to where it is covering both the nose and the mouth completely. Because a lot of people do tend to touch the outside of the mask, frequent hand hygiene is important. When you put a mask on, use the ear loops, ties, or the very end/outer edge of the mask so that you’re not touching the inside material that is touching your face. It is also important to avoid touching the outside of the mask after you put it on so that you do not contaminate your hands with anything that has come in contact with the outer material of the mask.

What about gloves?

We have to be careful with gloves. They can give us a false sense of security if we do not wear them appropriately, contaminate them, or do not remove them before moving on to other activities after they have

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potentially become contaminated. Certainly, if you’re using chemicals for home disinfection and cleaning, or if you have a loved one at home who is ill and for whom you have to surface clean and disinfect, then it’s appropriate and prudent to have and wear some gloves, either disposable gloves or [rubber] gloves that can be cleaned. But for most other activities, if we perform frequent and consistent hand hygiene, that is enough. We don’t have to utilize gloves on a consistent or frequent basis.

For the instances that you mention above, what’s the proper way to remove gloves once we’re done using them?

Let’s say I’m right-handed. I’m going to remove my gloves by taking my right hand and pinching into the palm of the glove on my left hand.

As I pinch it, I’m going to pull it back on itself and take it off to where it’s turned inside out and then drop it into the trash can. Then you’re going to take that hand that now has no glove on it, go to your right hand that still has the glove on it, and go underneath the cuff. Don’t touch the glove but go underneath the cuff as best as possible, and then peel it off, turning it inside out as well, and then throw it in the trash. And then, of course, you’re going to do good hand hygiene immediately after because it’s easy to contaminate your wrist or hands when removing gloves. «

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9/18/20 11:06 AM

PULSE ASK THE EXPERT

By Linda Marx

Patient Care from Anywhere Those delaying trips to the doctor can get an accurate telehealth diagnosis from home A combination of concerns can postpone a needed visit to the doctor’s office.

Whether the apprehension is due to safety issues over the spread of COVID-19 or convenience because of a patient’s active lifestyle, telehealth is quickly becoming a popular alternative to in-person care.

The distribution of health-related services and information via electronic means and telecommunication technologies allows for long-distance patient and doctor contact. According to the Centers for Disease Control and Prevention, telehealth consultations are an ideal option in the age of coronavirus as they can help to reduce medical personnel exposure to sick patients, preserve personal protective equipment, and decrease the strain that patient surges can have on facilities.

Beyond the pandemic, telehealth is becoming an integrated component of medical care, one that can give a patient access to comfort, advice, education, and diagnosis without ever leaving home.

“An encounter between the patient and the medical professional on video conference can be extremely effective,” says Dr. Harry Romero, medical director of the Jupiter Medical Center Urgent Care system, who has seen great results with this service. “We run surveys after such encounters and ask how patients liked the

session. All have been overwhelmingly positive because they felt the experience was personal, private, and thorough with minimal disruption to their daily lives.”

Telehealth programs are growing across the country, with medical professionals offering services and consultations to make life easier for themselves and their patients. In fact, national health care groups have estimated that by the end of 2020 there will be more than 160 million telehealth cases, a 700 percent increase from 2015. Furthermore, according to a study conducted by the research firm Software Advice, 77 percent of patients surveyed indicated they would choose a doctor who offers telehealth over one who does not use the technology.

“Patients are receptive to virtual care,” says Laura Molner, director of urgent care at Jupiter Medical Center. “We discuss their symptoms and provide education or direction with a treatment plan, and patients have been satisfied with the level of care we are able to provide virtually. They like that it is convenient for their schedules. We have had more requests than ever because of the coronavirus.”

In May, Jupiter Medical Center revamped and relaunched its Care Anywhere telehealth

system and now offers a dedicated phone line for requesting such visits. Once patients call and connect, they are registered for the session and sent a link to access it at the scheduled time. While patients are not required to fill out online forms, they will answer questions with a representative regarding the reason for their visit, insurance information, and other necessary details, all of which is entered into an electronic record just as if the patient were seated in the doctor’s office.

During telehealth sessions, doctors can diagnose, connect patients with specialists, provide and review treatment plans, and check in on recovery.

However, there are certain limitations. For example, there are no hands-on checks; a doctor cannot touch a patient's abdomen, hear the heartbeat, or listen to the status of the lungs. A patient is encouraged to use common sense before selecting telehealth, depending on the ailment. Common issues that can be evaluated and treated virtually or assessed for further evaluation include COVID-19 screenings and antibody testing, fever, congestion, headaches, and allergies. Through video calls, doctors can even look at rashes and minor cuts and wounds before discussing the situation.

Also, if a patient needs medications refilled, a solution for a simple respiratory symptom, or an evaluation to see if there is a need for follow-up treatment, then telehealth is fine. “If the session is about a chronic or acute illness, and the patient has a blood pressure cuff or thermometer, that can help the medical provider make even more informed evaluations,” Romero says. “But if I feel the patient needs face-to-face time, I will recommend their primary care doctor or a visit to the Urgent Care Center or, if needed, to the emergency room.”

Both Romero and Molner agree that the Jupiter Medical Center Urgent Care telehealth system is a fast-moving operation that does not make patients wait. Care Anywhere virtual visits take place Monday through Saturday from 8 a.m. to 6 p.m., and Sundays from 9 a.m. to 5 p.m.

Patients can either pay with insurance or out of pocket at a rate of $49 for a 15- to 20-minute consultation. And, as Romero notes, Jupiter Medical Center is staffed to handle the increase in virtual care requests it has seen as a result of COVID-19 and will continue to add providers as needed. “We have adapted well and are not backed up,” he adds. « For more information, please call 561.263.7080 or visit jupitermed.com/telehealth

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9/18/20 11:09 AM

Chairs: Lee Ann & Jeffrey H. Alderton

SATURDAY, APRIL 10, 2021 | 6:30 — 11 P.M.

1 S. COUNTY ROAD | PALM BEACH, FL Honorary Chairs: Tesa & Martin A. Dytrych Sponsors include Lee Ann and Jeffrey Alderton, Black Diamond General Contracting, Stephen Boruff/A1A Architects + Planners, Inc., Cerner Corporation, Knight Corporation, Palm Beach Illustrated and TD Bank.

Proceeds from this event will benefit the new Surgical Institute at Jupiter Medical Center.

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PULSE HEALTH REPORT

By Linda Marx

The More You Know Genetic testing can predict your risk of developing a disease like cancer—and help you prevent it Ever since the first draft of the human genome became widely available in 2000, the role of voluntary genetic testing to prevent or manage a challenging disease, like cancer, has grown exponentially. This process, which identifies changes, mutations, or variants in DNA, allows medical professionals to confirm or rule out a suspected genetic condition, and also determine a patient’s chance of developing certain ailments.

“It is good to know the risks so a patient can implement lifestyle modifications, enhance cancer surveillance, consider risk-reducing medications or surgery, and have at-risk family members identified and screened,” says Constance “Conni” Murphy, ARNP, a genetics counselor at Jupiter Medical Center, whose practice is devoted to providing cancer-risk assessment and testing to high-risk families.

The Jupiter Medical Center Anderson Family Cancer Institute opened in March and includes a Genetics Screening Clinic, the first of its kind in the country. Today, genetic screening conducted in medical settings such as these is integral to

health care. However, it’s also become a big business online, with around 250 companies offering direct-to-consumer testing. Prominent ones include 23andMe, which looks at ancestry, traits, and health, and Everlywell, which performs an array of mail-in medical tests.

While convenient, there are downsides to using such services. In addition to the potential privacy issues involved in submitting your DNA, the information these companies send in return is often limited, and users are left to decipher the results on their own, a task they should be undertaking with a medical professional.

“Many direct-to-consumer labs are not certified to provide information designed to be used for clinical decision-making,” says Murphy.

“Sometimes the consumer doesn’t understand the lack of depth in the testing, or they may be provided with inaccurate or incomplete information.” By going to a facility such as the Anderson Family Cancer Institute instead, patients can participate in counseling sessions to address medical concerns and the stress they may be feeling.

At Jupiter Medical Center, patients begin by filling out a packet detailing their family medical background, which Murphy then reviews. Afterward, she consults with the patient and determines if he or she wants to pursue gene panel testing. “As recently as six years ago, it cost thousands of dollars to do this,” she says. “Now a panel of 87 genes costs only $250. It takes about three to four weeks for results, then I bring [the patient] back to discuss the interpretation of the results.”

As Murphy is examining the report, she consults databases to ensure its accuracy. She uses National Comprehensive Cancer Network guidelines and writes up a management plan specifically for that patient, which can include lifestyle changes, more screening and surveillance, medicines to reduce cancer risk, and preventive surgery.

“Most of my patients are gene normal yet carry a high risk for cancer,” says Murphy. “The goal is for them to see me once a year so we can update their personal and family medical information while I confirm who else in the family is at risk for carrying a cancer-predisposing gene mutation.

It can be quite involved to have so many family members in need of counseling and testing.”

Because genetic testing has limitations and risks as well as benefits, the decision of whether or not to be tested is a personal one. Given that the technology and information is constantly evolving, it is important to discuss genetics with a trained medical counselor. “The field of cancer genetics has been expanding rapidly,” Murphy says. “We have discovered a lot of new and emerging genes. It is a moving feast.” «

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PULSE NUTRITION

By Alexa Becker

Elixirs for Vitality Sip and savor smoothies, juices, and mocktails packed with beneficial ingredients Photography by Libby Volgyes

«

MERMAID COOLADA, JULES ARON Mixologist and author Jules Aron is an involved contributor to Fresh Rx, a farm-tohospital initiative that allows Jupiter Medical Center physicians to prescribe fresh produce to patients who need to follow a healthier diet as part of their treatment plan. Lox Farms provides these patients with a free bag of organic vegetables every week and has also hosted dinners to benefit the program. Aron has participated in these events, whipping up an array of creative elixirs. This Mermaid Coolada, made with blue spirulina powder, pineapple juice, and coconut water, is as healthy as it is beautiful. “Blue spirulina is a freshwater, blue-green algae that gets its stunning blue pigment from phycocyanin, a photosynthetic compound in the algae with immune-boosting, antioxidant, and antiinflammatory powers,” explains Aron. julesaron.com, freshrx.org

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« PASSION, GINGER-AID, AND CLARITY JUICES, MERAKI JUICE KITCHEN At its three locations across Palm Beach County, including one in Jupiter Medical Center, Meraki offers organic plant-based cuisine, cold-pressed juices, and other beverages with superior nutritional value. The all-greens Clarity is rich in potassium and chlorophyll, an electrolyte that has been found to help deodorize the body, increase energy, and reduce inflammation. Passion’s high-magnesium content from its star ingredient, pineapple, plays a vital role in the metabolism and utilization of nutrients. The antioxidant properties of ginger combined with the vitamin C in lemon juice make Ginger-Aid a powerful drink that can support the immune system, aid in digestion, and soothe upset stomachs. merakijuicekitchen.com

«

PURPLE DRANK, CELIS PRODUCE The trio of brothers behind Celis Produce work to provide the community with healthy choices at their West Palm Beach and Palm Beach outposts. The Purple Drank, which consists of almond milk, almond butter, blueberries, spinach, and pea sprout vanilla protein, makes for a great post-workout refresher. In addition to its protein punch, this smoothie contains a lot of antioxidants, which numerous studies have shown to protect cells against damage caused by free radicals. celis-produce.com

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The Collection PUBLISHER OF: Naples Illustrated Palm Beach Illustrated Naples Charity Register Palm Beach Charity Register Southwest Florida Relocation Guide Waypoints: Naples Yacht Club Palm Beach Relocation Guide Traditions: The Breakers The Jewel of Palm Beach: The Mar-a-Lago Club Jupiter Magazine South Florida Baby and Beyond Magazine Stuart Magazine Fort Lauderdale Illustrated Aventura Magazine Naples 100 5th Avenue South: 5th Avenue South Business Improvement District Palm Beach 100 Go561 Community Report: Community Foundation of Collier County Pinnacle: Jupiter Medical Center Foundation art&culture: Cultural Council for Palm Beach County Florida Design Florida Design Naples Edition Florida Design Miami Edition Florida Design Annual Sourcebook Naples on the Gulf: Greater Naples Chamber

561.659.0210 • palmbeachmedia.com

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Ready For Anything Employ these immunity-boosting strategies to fight off disease and promote overall well-being

By Judy Martel

W

hen your parents told you to eat your vegetables and go to sleep early, they probably didn’t justify those requests by saying: “It’s good for your immune system.” But among the many lessons learned from the COVID-19 pandemic, one of the most important is how critical that complex network of cells and organs is to the function of a healthy body. While our genes have some influence on our immune systems, lifestyle changes—including proper diet, exercise, sleep, and stress relief—can have a big impact on how efficiently and effectively our bodies fight a variety of diseases and illnesses.

“I describe the immune system as the part of our being that protects us

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from ourselves and the outside environment, the defense system for our body,” says Dr. Nichole Corry, an internist with Jupiter Medical Center.

There are basically two components, she adds. One is the innate, which, on a day-to-day basis, fights off the bacteria and viruses we come in contact with and “cleans up” abnormal cells that may cause disease. The other part is adaptive, which is what most people associate with the immune system.

It evolves over time and “has a memory.” This is the part that vaccines and past infections stimulate to develop defense mechanisms by producing antibodies.

“The immune system is always functioning,” Corry explains, but the level of performance is what we strive to optimize. One of the keys to proper

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functioning is inflammation, which is the body’s healing response to short-term injury or illness. When a threat, such as an injury or virus, occurs, white blood cells, cytokines, and nutrients flood the site of the problem to fix it. But if inflammation happens over a long period of time or is an overreaction, the white blood cells may attack healthy parts of the body, potentially leading to a variety of chronic inflammatory conditions such as

heart disease, some types of cancer, and rheumatoid arthritis. The lifestyle changes we make can either help or harm the body’s inflammation response.

According to Corry, all exercise is beneficial to the immune system, whether it’s cardiovascular or strength training. Moderate daily exercise—about 30 to 40 minutes of mild huffing and puffing—is all it takes to reduce stress hormones and release positive hormones, she

says. Excessive exercise can actually weaken the immune system. “We do see that in elite athletes or some weekend warriors who overtrain,” Corry adds. “Overdoing exercise can do damage because the body is flooded with toxins that cause inflammation, and it doesn’t have time to recover.”

Diet also plays a part in both reducing the body’s inflammatory response and improving the gut’s microbiome, which is a delicate balance of beneficial bacteria that lives in our gut. Some foods create a healthier immune system, while others contribute to chronic inflammation. Corry recommends a colorful, vegetable-based, lean-meat diet and healthy fats, such as fish, olive oil, nuts, and avocado.

This approach closely resembles the Mediterranean diet and is sometimes called the antiinflammatory diet. “That’s going to get you pretty much everything you need for cells to function optimally,” she notes.

Simple carbohydrates and shelf-stable foods, including many of the comfort foods we

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“

When you make all of these beneficial changes in lifestyle, over time you’ll feel the changes.” —Dr. Nichole Corry

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A deep-sleep stage unleashes proteins and “killer cells” that target infection and inflammation. crave, such as pasta, chips, cookies, and crackers, feed the brain’s dopamine receptors and make us feel better immediately, but over time they can cause chronic inflammation by flooding the body with glucose and stimulating the inflammatory hormones. “We see that over and over,” says Corry. Furthermore, she believes that unless your doctor recommends specific

vitamins or supplements, you should be able to ingest sufficient amounts of most nutrients and micronutrients through a healthful eating plan.

“The body recognizes nutrients in their natural state, and if you can absorb them through diet, you’ll use them much more efficiently.”

While regular exercise and proper nutrition will quickly provide an overall feeling of wellbeing on their own, the amount and quality of sleep, healthy relationships, and low stress levels are other major contributors to a strong immune system. Chronic stress and depression release hormones and trigger cortisol, causing inflammation. “It does have a physical effect,” Corry says. (See Pinnacle’s sidebar on stress for more information.)

The coronavirus pandemic has proven to be a collective trauma for society. The quarantine alone has resulted in such

stressors as forced isolation and altered lifestyles that may have made sleep difficult or impossible for many. But Neal Nay, manager of the Jupiter Medical Center Sleep Center, says that quality shut-eye, or lack of it, has a direct impact on the immune system.

The minimum amount for optimal health is about seven hours and, because we cycle through different stages of sleep four or five times during the night, it’s important that those hours be uninterrupted. The stages range from light to deep, and while all are important, the deep stages impact the immune system the most. A deep-sleep stage that Nay describes as “almost like a coma” unleashes proteins and “killer cells” that target infection and inflammation. “These killer cells do what their name implies,” Nay says. “They are kind of like Secret Service agents. They identify foreign bacteria and viruses and kill them, so you want robust and virile killer cells working for you. If you reduce your sleep to four hours for just one night, there is a 70-percent drop in killer-cell activity.”

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Lack of sleep and the immune system’s response to it can lead to ailments such as diabetes and heart disease, and can also leave us more susceptible to contracting a virus. While most people can “rebound” from a rough night by sleeping well the next, when the problem lasts for several nights, it is more difficult to recover. Typically, older adults tend to sleep fewer hours or wake up more frequently. Children need more sleep than adults, and teenagers need more than middle-schoolers.

Women are more prone to insomnia, and men are more inclined to have sleep apnea, a breathing disorder that can disrupt them during the night and impact their quality of sleep.

It takes dedication to develop good sleeping habits, which can be dependent on age, overall health, and external factors, explains Nay, but he has some advice. “Light plays a big role. Before the electric light was invented, people slept about an hour longer per night.” Blue light is not only present in sunlight, but it is also emitted in high concentrations in televisions, smartphones, and computers. Nay recommends turning off devices two hours before bedtime and avoiding them in the bedroom, if possible.

Nighttime rituals—going to bed at the same time each night and performing a routine in the same order—work well for adults and particularly well for children. Those rituals might include listening to music, reading a book, and circulating through the house to lock windows and doors. While the actions themselves may vary, the end result is that you become relaxed and condition the brain to know that sleep is coming. For those who wake up in the middle of the night and can’t fall back asleep, Nay recommends getting out of bed and doing something “really boring,” like reading a technical manual. Getting involved in a favorite activity or hobby only rewards the mind for waking up.

These four factors—sleep, diet, exercise, and stress management—work in concert to support a healthy immune system. “When you make all these beneficial changes in lifestyle, over time you’ll feel the changes,” says Corry. “You will become ill less often, get fewer colds, and have fewer days of feeling groggy or run down. The growth [in overall health] is exponential.” «

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Stress Less Months of juggling children, school, loss of income, work-at-home boundaries, healthy meal preparation, and restricted mobility, not to mention fears about contracting the coronavirus—all within the constrained limits of a house or apartment—are enough to try the patience of the most even-keeled person. But chronic stress is one of the most hazardous threats to a healthy immune system.

“We have not adapted to handle constant stress, which is when your mind is telling you there is some sort of danger and indicates a fight-or-flight response,” says Corry. “If the stress goes on for days or years, it wears down the immune system and increases inflammation.”

The solution is to develop some sort of management system to recognize stress and reduce or eliminate it by retraining the mind; this system might involve meditation, slow breathing, or regular exercise, including movement that focuses on the mind-body connection, such as tai chi and yoga. The goal is to reduce harmful stress hormones and release endorphins, the chemicals our bodies secrete to diminish pain and send positive sensations to the brain.

Adequate sleep, for at least seven hours a night, is one of the most important stress reducers, but many find it difficult to achieve. “Chronic stress is bad for sleep, but paradoxically, sleep is one of the best cures for stress,” says Nay. “The most

frequent complaint I hear from patients is, ‘I can’t turn off my mind.’”

Meditation techniques can help quiet the noise in our heads, particularly if it is mindful meditation. In this approach, a person concentrates on one relaxing thing, often the breath, rather than trying to empty the mind completely, a particularly hard task for some. Nay explains that the goal is to be present in the moment, “instead of letting your mind wander until your thoughts become louder and louder and you lose control of them.”

In times of short-term stress, when you can feel your blood pressure rising, it helps to practice calming breathing techniques: Breathe in for four counts, hold for seven, and breathe out for eight.

“It turns off the fight-or-flight response and is very effective,” Nay says. “It’s literally a physiologic response that you can practice anywhere and anytime—in line at the grocery store or when you’re on I-95 and someone cuts you off.”

Controlling stress can be tricky, but the key is not to ignore it. “You can’t just say you’ll deal with it later, or the hopelessness will be overwhelming,” says Corry.

“You have to have a plan of action that will give you some sort of relief.” Whether it’s through diet, exercise, meditation, better sleep habits, or, ideally, a combination of all four, you’ll not only reduce stress but also boost your immune system and improve your sense of well-being, providing the best defense against potential threats like the coronavirus.

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Taking Flight

During Flu Season When faced with essential travel, practice these smart strategies to limit viral exposure

By Skye Sherman

W

hile influenza viruses can be detected yearround in the United States, they’re most common during fall and winter, a period commonly known as flu season. Exact timing and duration of flu season varies, but flu activity tends to increase in October, peak between December and February, and last as late as May. This year, with the added burden of the COVID-19 pandemic weighing on society, flu season will be more complicated than ever. The two viruses have some similarities and some differences, but both can spread through droplets in

the air from an infected person coughing, sneezing, or talking, and both cause similar symptoms, such as fever, cough, body aches, fatigue, congestion or runny nose, and sometimes vomiting and diarrhea. However, one can significantly decrease the risk of catching either through frequent and thorough hand washing, wearing a mask, limiting contact with others, and staying home.

But what if staying home is not an option? How will this double-whammy of contagious respiratory illnesses in circulation affect travel during flu season? And what measures can travelers take to protect themselves?

“It will likely be riskier to travel than during a time without COVID-19,” acknowledges Thomas

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TRAVEL SAFET Y DO S AND DON’T S

• Wear a mask any time you’re around others.

• Disinfect all high-touch surfaces in transit and upon arrival.

• Gravitate toward outdoor activities.

• Cancel your trip if you feel unwell.

• Touch your face, nose, eyes, or mouth.

• Eat from buffets as they abound with high-touch communal surfaces.

• Enter crowded locations where maintaining a safe distance is impossible.

• Forget to wash and sanitize your hands regularly.

Cleare, PhD, MBA, assistant vice president of planning and community engagement at the Health Care District of Palm Beach County. “Air travel involves being in very close quarters with a lot of people in a closed environment for a long period of time. Airlines are taking a lot of precautions and passengers are wearing masks during flights, but it’s still a much higher risk to travel than it would be for someone to stay home.”

Don’t be caught off guard by long security lines at the airport, crowded airplanes, and close seating on buses and trains, Cleare adds.

“It’s very difficult to stay 6 feet apart from others in those situations.” Postponing travel may be best if you’re not comfortable with the dicey circumstances—and if you feel sick even in the slightest, it’s your civic duty to stay home.

Before committing to a trip, do your research.

According to Cleare, travelers should check their destination for COVID-19 activity. “COVID-19 hot spots seem to develop in new areas while other areas might be seeing a leveling-off or decline in the number of cases,” he says.

Investigate not only the prevalence of COVID-19 in the region where you plan to travel, but also the specific protocols your intended airline, accommodations, and destination have in place, and decide if you’re comfortable with those measures. Some cities, states, and countries require visitors to self-quarantine for 14 days, and

Reusable fabric masks need to be washed in hot water on a regular basis, so be sure to stock up on to-go detergent packs. upon return, some local governments require the same of any citizen who has traveled.

While most establishments from sea to shining sea have enacted preventative measures such as ramped-up cleaning efforts and staff health screenings, ultimately, it’s up to individual travelers to protect themselves. Wearing a proper facial covering, keeping distance from others, and practicing proactive hygiene remain three of the most important steps travelers can take to minimize their exposure to any kind of virus.

Beware that if you contract COVID-19 while away from home, you will be responsible for all costs associated with your isolation or quarantine, including transportation, lodging, food, medical care, and any other expenses. Consider

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Suitcase Essentials Beyond now-routine items like face masks, disinfecting wipes, and hand sanitizer containing at least 60 percent alcohol, pack a travel kit with the below gear to safeguard against both the flu and COVID-19

1

You may be subject to a temperature check at the airport and other establishments—don’t let your results come as a surprise. Self-monitor with a touchless travel thermometer. The Withings Thermo smart thermometer ($100) offers color-coded fever indicators and syncs with an app to track readings. withings.com

2

Convenience stores and vending machines aren’t worth undue exposure. Limit pit stops and person-to-person exchanges by packing your own snacks, straws, and cutlery in reusable silicone or fabric bags from One World Zero Waste.

The Tequesta-based company offers individual bags (starting at $9) as well as lunch sets with a hard-wood spork and stainless-steel straw ($22). oneworld-zerowaste.com

purchasing a travel health insurance policy if your existing insurance doesn’t cover services performed outside of your home region.

In addition, one of the best precautions for travel during flu season is to get the flu vaccine.

The Centers for Disease Control and Prevention (CDC) recommends an annual flu vaccine for everyone 6 months and older. Since it can take two weeks for immunity to develop after receiving the vaccine, travelers should time the vaccination properly. Keep in mind that flu season varies around the world: In the Southern Hemisphere, like in Australia and most of South America, for example, it runs April through September.

Because there is no vaccine yet available for COVID-19, travelers must exercise extreme caution and avoid exposure. It also wouldn’t

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hurt to boost your immune system with healthy eating, ample sleep, exercise, and vitamins as recommended by a physician before your trip.

If you are in a high-risk category, begin to feel unwell, have had contact with a sick person within 14 days, or exhibit symptoms of illness, flu-like or otherwise, scrap your travel plans. Otherwise, monitor official reports to watch for lockdowns or spikes in COVID-19 activity in the area where you plan to travel.

If your destination closes to visitors, you’ll need to make other arrangements or cancel your trip. As of press time, the U.S. Department of State continues to advise Americans to avoid all international travel and the CDC recommends deferring cruise travel for the foreseeable future. «

3

Smartphones collect bacteria all day long and putting them to our face is second nature. Clean and charge on the go with the PhoneSoap Go portable UV phone sanitizer ($100), which can sustain 45 sanitizing cycles on a single charge. phonesoap.com

4

Low blood-oxygen saturation levels can be a sign of COVID-19.

A digital pulse oximeter like the Wellue O2Ring ($179) provides continuous monitoring and vibrates if your oxygen levels fall below 94 percent. getwellue.com

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Repairing the

Beating Heart For those with severe coronary artery disease, off-pump bypass surgery can lead to improved outcomes

By K.S. Meyer

A

s population and life expectancy continue to climb and more people than ever find themselves achieving advanced age, physicians and patients are increasingly shifting their attention to illnesses associated with the elderly, such as Alzheimer’s, diabetes, and cancer. In recent decades, so much of the national conversation has surrounded these conditions that it can be easy to forget that the leading cause of death among Americans is still the same as it’s been for almost a century: heart disease.

Its most common form, coronary artery disease, tends to be insidious in its presentation, developing quietly over decades and presenting in subtle early warning signs that can be mistaken for relatively harmless conditions. Many will not discover they have coronary artery disease until it has done significant damage to the heart muscle, by which point avoiding medical treatment or choosing to ignore it will not be options.

Fortunately, surgical interventions to revascularize the heart have come a long way.

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ILLUSTRATION: BRUCE BLAUS

“Coronary artery disease results when blockages occur in the arteries that supply the heart muscle with blood,” explains Dr. Arthur Katz, medical director of cardiac surgery at Jupiter Medical Center. “This can lead to damage of the heart, kidneys, lungs, and brain, including stroke and neurocognitive deficit.”

The intricate network of blood vessels encircling and feeding the heart’s muscle, or myocardium, stems from several large coronary arteries branching off the root of the aorta, the prominent artery emerging from the top of the heart and responsible for carrying oxygen-rich blood to the rest of the body. The closer an occlusion is to the aorta, the greater and more widespread its potential for damage to the myocardium—and the higher the likelihood the patient will not survive or make a full recovery. “Restoration of blood flow to the heart muscle is often necessary and lifesaving,” says Katz.

Over the last half-century, there have been marvelous advances in treating these occlusions and restoring the heart’s blood circulation; some of the most recent and noteworthy are catheter-assisted stent insertion and balloon angioplasty. However, for the severest blockages, the most reliable procedure is one that’s been enhanced and perfected since its first successes in the 1960s.

Katz elaborates: “There are circumstances when percutaneous intervention [e.g. stents, angioplasty] is either not feasible or, per guidelines from the medical literature, not the best treatment option for the patient. This is when surgical intervention becomes appropriate. The surgery performed is coronary artery bypass grafting [CABG].”

As its name implies, the CABG procedure involves taking segments of unobstructed, “clean” blood vessel from elsewhere in the patient’s body and using them to reroute the flow of blood from either the aorta or an artery branching from the aortic arch to the portion of the coronary artery

on the other side of the blockage—effectively forming a detour for the blood. “There are two methods for performing CABG,” continues Katz. “One technique requires putting the heart to sleep utilizing cardiopulmonary bypass.” This allows the surgeon to execute the intricate task of sewing together tiny blood vessels without having to work around a continuously beating heart. “This requires ‘the pump,’ or the heart-lung machine, to temporarily take over the function of the heart and lungs.”

The heart-lung machine is a miraculous invention that has saved countless lives, but its use is not without significant risk. “The pump has been associated with a number of complications resulting from embolization, hypoperfusion, compliment activation, and systemic inflammatory response,” Katz explains. He notes that this can lead to damage to the heart, kidneys, lungs, and brain, including stroke and neurocognitive deficit. “Coagulopathy [severe bleeding] can also occur as a result of blood circulating through the heart-lung machine.”

In order to avoid these potentially devastating side effects, it can be efficacious to avoid the use of the pump altogether. “Off-Pump CABG [OPCAB] was developed to minimize mortality, reduce the complication rate, and improve the outcomes of coronary artery bypass grafting,” says Katz. “A stabilization device is used so that the bypasses can be constructed safely and precisely while the heart is beating. The heart literally never skips a beat.”

While at face value this may seem intrinsically higher risk than stopping the heart to perform the detailed grafting, Katz points out that

Utilizing a stabilization device, Off-Pump Coronary Artery Bypass (above) reduces the complications of treating arterial occlusions (left).

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“A stabilization device is used so that the bypasses can be constructed safely and precisely while the heart is beating. The heart literally never skips a beat.” —Dr. Arthur Katz the chance of death is actually lower than with conventional CABGs. “OPCAB reduces the morbidity and mortality of coronary artery bypass surgery, particularly in high-risk patients. In experienced hands, it has been shown to reduce the risk of death, stroke, kidney failure, and perioperative heart attack, as well as lung and liver injury. The need for blood transfusion is [also] substantially reduced.”

Continues Katz: “High-risk patients include people of advanced age and those with pre-existing conditions such as vascular disease of the brain, peripheral arteries and aorta, kidney disease, lung disease, and liver insufficiency, but also, curiously, women. Women have traditionally been documented to have higher mortality rates than men when undergoing CABG.” There is not yet a consensus among medical academia as to why this is. Regardless of the mechanisms behind it, the data clearly shows that women do not fare as well after traditional CABG operations as men do. However, “OPCAB negates the gender disparity with regard to mortality,” says Katz. “Studies have also shown reduced length of ventilatory support, time in the ICU, and length of hospital stay.”

It would seem, therefore, that OPCABs would be ideal as first-line

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surgical interventions for patients historically suited for CABGs. Yet owing, perhaps, to the level of skill demanded of the surgeon and advanced technology required to stabilize the heart, OPCABs have not seen widespread use in the United States since the technique was introduced 30 years ago. However, Katz has championed the procedure at Jupiter Medical Center. “Nationwide, only 18 percent of CABGs use the off-pump technique,” he notes. “At Jupiter Medical Center, OPCAB is the procedure of choice, with about 60 percent being performed off-pump.

We are already the highest volume OPCAB center in Palm Beach County and one of the highest volume OPCAB centers in Southeast Florida.”

For most patients with coronary artery disease, hopefully, nonsurgical therapies or minimally invasive operations will be sufficient to treat the condition and prolong life. For those with severe cases requiring a bypass procedure, on the other hand, an OPCAB can mean the difference between life and death, or full recovery and disability. Cardiac patients in northern Palm Beach County can rest assured that, if things go from bad to worse and surgery is necessary, the specialists at JMC are ahead of the game. «

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Exercise

After Quarantine How maintaining four key pillars of fitness will help you transition back into your favorite physical activities

By Judy Martel

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arred from their usual pastimes during the months-long quarantine caused by the COVID-19 pandemic, athletes and recreational-sports enthusiasts have had to employ some creativity within their exercise routines. Those who remained sidelined on the couch quickly learned the truth of the “use it or lose it” philosophy. While working out solo at home is no substitute for organized sports, maintaining at least a baseline for fitness makes it easier to get back into the game eventually, says Ben Klein, a physical therapist and the outpatient rehabilitation operations manager at Jupiter Medical Center. After

all, the best medicine is prevention.

“When you take prolonged time off from exercise, the body becomes deconditioned, meaning it’s not at its peak level of performance,” Klein says. And although muscle memory will kick in after resuming an activity, even after a long hiatus, it doesn’t mean you’ll be at the top of your game. “The analogy is kind of like how you don’t forget how to ride a bike. You don’t forget how to play golf or tennis, but you lose flexibility and strength. If you’re a golfer, for example, your golf swing won’t be as good.”

Most athletes and dedicated exercise war-

riors can handle two to three weeks of doing nothing and still safely step back into an activity, Klein says. But after four weeks or more, muscles will be sore and endurance will suffer. In order to ensure an easier re-entry postquarantine, he recommends focusing on four core areas of fitness: flexibility, strength, endurance, and positive mental attitude. Even though gyms are open, many will still want to stay away, but Klein says fancy, high-tech equipment isn’t required to remain fit. A pair of sneakers and a small space in which to work out is all that’s needed.

Water bottles or laundry detergent jugs make great substitutes for hand weights, Klein says. He also notes that body weight alone provides its own stress on the muscles, so squats, push-ups, sit-ups, pull-ups, and leg raises will all increase and maintain muscle mass. But exercising at home without a trainer or coach does come with risk, namely injury from incorrect form or overdoing it. With any strength training, it’s normal to feel muscle soreness, like a dull ache, but never a sharp, stabbing pain, which indicates potential joint injury. A pain that persists for more than 48 hours is cause for concern.

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The most common injury-producing mistake Klein sees is incorrect squats. He explains that the knees should never shift forward over the toes and suggests standing in front of a chair and lowering down, as if to sit in it, to help with proper alignment. Daily stretching, whether it’s a class online, yoga, or tai chi, will help you maintain the necessary flexibility to prevent injury from strength training or cardiovascular activity.

Getting the heart pumping increases stamina in nearly every sport and improves the mood by raising serotonin levels in the brain, says Klein. Cardio exercise is a cinch for nearly everyone: Simply lace on a pair of walking or running shoes and go outside, or pedal a bicycle indoors or out. A regular routine will result in a strong heart and lungs that provide staying power when it’s time to resume a favorite sport.

The final pillar of the foundation for good health—a positive attitude—is not often topof-mind for dedicated fitness buffs, but the mental aspect of missing out on a favorite activity can be the most difficult to manage.

“Aside from the physical benefits, there is an emotional and social element to an activity that is very important,” says Klein. “For people used to a certain activity six days a week, it is easy to get depressed.” Though online workout buddies, coaches, and classes can’t take the place of face-to-face interaction, it helps on some level to stay connected and motivated.

Depression can also lead to weight gain because it’s easy to overeat or indulge in unhealthy snacking as time away from a physical routine drags on, Klein says. A dependable

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support system, even if it’s virtual, will help stave off temptation and preserve focus on the end goal. “I recommend reaching out to people, whether it’s your doctor, a family member, or a friend, to alleviate the emotions that come from being isolated,” he says. “You’ll find that a lot of people are feeling the same thing.”

A positive mindset, coupled with a base level of physical fitness, will lead to the fastest rebound, according to Klein. During the first three months of quarantine, approximately half of the individuals he had been in contact with reported staying active with daily walks, bike rides, and chores around the house. “But a good number of people were feeling a little depressed or emotionally down. They missed the camaraderie and social activity.” In Florida, he notes, the weather is conducive year-round to getting outside and finding something active to do, even if it’s not a favorite sport. “I run 4 to 5 miles a day,” he says. “I taught my daughter to ride a bike during quarantine. It’s great to see people outside.”

The best way to resume sports and other activities is to take it slow, Klein advises, even for those who have worked at maintaining a base level of fitness. Muscles need time to adapt again to something different. “If you haven’t been running 10 miles, you can’t just go out

and do it the first day,” he explains. “It’s the same with tennis or golf. Don’t go out and play 18 holes. If you were playing every day before the pandemic, we always recommend taking a day off in between, so you ease in with three times a week rather than six or seven.” «

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Leveraging

TECHNOLOGY in Oncology

Cutting-edge tech and tools are at the center of Jupiter Medical Center’s approach to cancer care, from catching it early to treating it quickly

By Judy Martel

W

hen it comes to fighting cancer, the use of innovative technology can make all the difference in early detection and treatment.

Jupiter Medical Center has acquired some of the latest tools to diagnose and treat a variety of cancers without disrupting healthy organs and cells, resulting in faster, less painful recovery. “I believe technology creates efficiency in treatment plans, and that leads to better [patient] outcomes,” says Dr. K. Adam Lee, medical director of the Thoracic Surgery and Lung Center and chief of surgical oncology at Jupiter Medical Center.

The good news is that, as a whole, the rate of new cancer cases is declining, according to the National Cancer Institute. However, the bad news is that more than 600,000 people are estimated to die from the disease in 2020. And while overall rates are trending downward, some types of cancers are on the rise, with smokers, older people, and the obese generally at higher risk.

Catching cancer before it progresses and spreads to other parts of the body is crucial, and technology can tell physicians a lot about what’s going on inside us.

PET/CT scan imaging, the

most common tool for diagnosis, has been around for more than two decades but has consistently improved, says Lee. It employs both positron emission tomography (PET) and computed tomography (CT) to provide doctors with a picture of what’s happening within the body and determine where cancer cells are and if they are active.

A more recent technological advancement, robotic bronchoscopy, assists physicians with the use of an ultra-thin endoscope (a tube fitted with a camera) and computer-aided navigation with 3D images to explore the inside of the lungs and identify certain nodules that were previously difficult to detect, says Lee. Because the endoscope is so thin, it can get to all areas of the lung, and its improved stability and peripheral vision allow surgeons to go inside and potentially take samples of nodules for biopsy.

Jupiter Medical Center was the first in the area to use this minimally invasive technology, which allows for a more accurate diagnosis.

When cancer treatment is required, there are options at the Jupiter Medical Center Anderson Family Cancer Institute that make it easier on the patient and ensure a speedier recovery. TrueBeam® radiotherapy is new to the institute and is commonly used for cancer of the neck, lung, head, breast, abdomen, and prostate. “It uses computerized, robotic movements to concentrate a more targeted beam of radiation to tumors, delivering doses quickly and with less risk to surrounding organs,” says Lee. The machine itself, which is operated by a therapist or radiation oncologist actually rotates around the patient to deliver

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the radiation. Similarly, the CyberKnife targets tumors with high doses of radiation that ensure minimal damage to surrounding tissue via a flexible robotic “arm” that moves around the body. The type of cancer and its location are two of the determining factors in choosing one therapy over the other. With both options, patients lie on a couch and can listen to music during the procedure, which is fast; for example, some treatments that used to take anywhere from 10 to 30 minutes can now be accomplished in 2 minutes with TrueBeam®. That’s not only better for the patient experience, but it also means tumors have less of an opportunity to move within the body during treatment and radiation has less time to affect healthy tissue.

Skilled surgeons and technicians are able to be even more precise with robotic-assisted surgery because they can see more on several screens in the operating room. This level of micro-precision results in a decreased chance of bleeding, which leads to less post-op pain and quicker recovery. “This type of surgery is remarkable,” Lee says. “With less blood loss and pain, patients are back to their usual

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routine in life, which is what we and the patients want.” If chemotherapy is needed, technology allows it to be delivered in targeted, higher doses, rather than the old “scattered” approach, he adds. “It’s like delivering a smart bomb.”

Jupiter Medical Center strives to provide a continuum of care for patients and for that, Lee says, physicians need the technology necessary to compete with big hospital complexes such as the MD Anderson Cancer network in major cities and Memorial Sloan Kettering in New York City. He believes Jupiter Medical Center compares favorably. “What we looked at when we designed the cancer center is an integrated, team approach,” he says. “The goal is to keep patients in one place from initial diagnosis through treatment and manage all facets of cancer care. With technology, our strategy of screening, diagnosis, and treatment has improved a patient’s quality of life and survival. We have all the technology, often far superior to what one might see at major academic medical centers, to meet most needs, and we’re always looking for the latest thing and the next evolution.” «

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DONOR PROFILE:

Joe & Barbara

CHARLES After selling their namesake company, this philanthropic couple paid their good fortune forward by gifting a revolutionary piece of diagnostic technology

By Michele Meyer | Photography by Jerry Rabinowitz

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ifelong entrepreneurs Joe and Barbara Charles have long been dedicated to dreaming big and giving generously. In fact, this dual philosophy is so ingrained in their outlook on life that it guided them in making one of the most significant donations in their careers.

After founding the company business in their family basement in 1968, and putting 50 years of sweat equity into growing the company and creating thousands of jobs, they sold their Illinois-based telecommunications manufacturing company, Charles Industries, to Amphenol Corporation in April of 2019.

Upon reflecting on all that they had achieved in life and business, and all that they were blessed with, they celebrated their tradition of giving with a single big-ticket item focused on community health and welfare: a $2 million PET/CT machine, which they donated to Jupiter Medical Center.

The GE Healthcare digital PET/CT (positron emission tomography/computed tomography) advances the medical center’s patient care and prevention as it is the first state-ofthe-art nuclear imaging device in the greater Treasure Coast region. Named Discovery IQ,

the diagnostic tool provides a superior resolution that enables oncologists, cardiologists, and other physicians to detect disease faster and with increased accuracy. It is ideal for scanning patients with metal implants because it all but eliminates visual interferences caused by such artifacts.

Joe explains his success in business, among other things, has always been to have the latest, most advanced capital equipment and technology one could afford. The donation to Jupiter Medical Center’s Anderson Family Cancer Institute reflects his longstanding philosophy. The gift is also very personal, as the couple lost not only Joe’s parents, but also several very dear friends to cancer. “Perhaps a bit self-serving, but should Barb or I get cancer, I want to ensure our doctors are using the latest technology, available locally, to treat us,” says Joe. High school sweethearts, they would both go on to Culver-Stockton College in Canton, Missouri, marry in 1960, and honeymoon in Florida. What was their initial attraction?

“We’ve laughed about this for years,” reflects Joe. “She always says, ‘I saw potential.’” While Joe admits he was first drawn to Barb’s 1956 coral-and-white Ford convertible.

Joe began his career selling custom-molded plastic and rubber products and recalls selling rubber to Sam Davison, who started Dacor Dive Equipment. But Joe had an entrepreneurial spirit and was inspired to strike out on his own. He turned his attention to developing and patenting a modular load coil, a device capable of reducing online noise and improving voice quality in a telephone company’s embedded copper plant.

In 1968, Joe launched his own telecommunications equipment manufacturing company in the family basement in Mount Prospect, Illinois. Fourteen patents and millions of dollars in worldwide sales later, Barb was proven right: Joe indeed had potential. Barb was also involved with the company, serving as head of human resources. However, she jokingly sums up her life mission: “I have one job, and that’s to make him look good, period.”

Outside of their primary business, the pair raised two children and also took up boating on Lake Michigan in 1980 after Joe competed in the Chicago Mackinac sailboat race. Owning several power boats over the years on Lake Michigan, their largest an 80-foot Burger, they navigated all five of the Great Lakes as well as cruised up and down the East Coast and Mississippi River from Chicago to Mobile, Alabama. “We’re boat nuts,” Joe says. “You meet a lot of interesting people while boating—and Barb has never met a stranger.”

Their passion for boating contributed greatly to their returning to Florida and later becoming full-time residents. Boating also led to founding Charles Marine Products in 1980,

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which manufactures battery chargers, power cords and adapters, and isolation transformers. Today, their Neptunus Express yacht carries the same name as all their prior Florida boats, C–Charger®, after the first Marine U.L. battery charger the company developed.

Joe’s inability to find a quality boatyard to store their boat during Florida’s hurricane season led to his next business. In 2004, he launched River Forest Yachting Center (RFYC), the state’s first climate-controlled boat storage facility, built to withstand hurricane force winds. After the success of the Stuart location, a second, larger facility was built in LaBelle in 2007.

A lift operator at RFYC’s Stuart facility was the impetus for Joe’s involvement with the Okeechobee Marshals and SASS (Single Action Shooting Society). The international organization was created to preserve and promote the sport of Cowboy Action Shooting.

Two years after he joined the Marshals, the local club was unable to maintain a permanent location and in need of a new home to hold their matches.

Citing “problems are only opportunities looking for a solution,” in 2010 Joe and Barb bought 40 acres in Okeechobee and built the OK Corral Gun Club, an Old West–inspired shooting and recreational facility, dedicated to offering the Florida sportsman the ultimate shooting venues. Ten years later, the gun club and event destination now covers 350 acres and includes a SASS venue, numerous ranges, trap and skeet, two sporting clay fields, a tactical park, mercantile pro shop, event ballroom and restaurant, and overnight cabins.

Whether relaxing on their yacht or enjoying one of their treasured pastimes, Joe and Barb truly find comfort and happiness in their companionship with one another. Having just celebrated their sixtieth wedding anniversary, the duo shares a dry sense of humor, a mutual gift of gab, and the recognition that their hard work over the years has enabled them to enjoy their passions. And as demonstrated by this generous donation to Jupiter Medical Center, both are passionate about giving back and supporting the communities in which they reside. «

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Fit from Home

Insight into making the most of your at-home workouts

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By Jana Soeldner Danger

hen the coronavirus pandemic took hold in the spring, it altered some of the day-to-day practices many of us took for granted—including going to the gym. As fitness facilities were forced to temporarily close, we had to find creative ways to stay fit at home. While developing new workout routines can be difficult, being in shape is now more important than ever. “It helps you build your immune system and your vitality,” says Mike Lenox, a certified personal trainer and owner of Xhilarate Fitness and co-owner of Vitality Online Training, both based in Jupiter.

Working out at home can be convenient, but it also comes with its fair share of distractions and excuses for forgoing fitness. Even if you don’t have an extra room in which to create a home gym, Lenox suggests defining a specific area for working out. The corner of a bedroom, family room, or air-conditioned garage can suffice. This way, when you enter that space, you’ll be mentally prepared to sweat. “It’ll be like turning on a switch,” he says. Dedicating a section of your home office to exercise can also make it easy to squeeze in a few reps

when you need a break from work.

Outfitting these personal workout areas doesn’t have to be expensive. In fact, there are numerous exercises you can do with just your body weight. Others only require basic equipment, such as light hand weights, yoga mats, and resistance bands. It’s also helpful to make the space inviting so that you’ll be more motivated to use it. Think of the little things you love about the gym experience and re-create them at home. Installing a mini fridge to keep chilled water and icy towels within reach, for example, is a small addition that can go a long way to making your workout more enjoyable.

To increase accountability, consider joining an online class or establishing a virtual workout buddy. “Some people like the class environment, with someone telling them what to do,” Lenox says. “It’s harder to skip a workout if someone else is waiting for you and holding you accountable.” Whether you opt for a Pilates class over Zoom or a Facebook Live yoga session, it’s important to choose activities that you enjoy so that you’ll be more likely to stick with them. “What’s good for one person isn’t necessarily good for someone else,” adds Lenox.

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READY TO GET STARTED?

Lenox suggests beginning with these body-weight exercises.

Modified push-up

PUSH-UP: Begin in a high plank

MOUNTAIN CLIMBER: In a standing position, run in

position on the floor, with your hands under your shoulders and your feet shoulder-width apart. Keep your spine straight, bend your elbows, engage your core, and lower your body to the floor. Push away from the floor and raise your body back up.

place, raising your knees while reaching upward with elbows bent and alternating your arms. Or, start in a high plank position, bringing one foot forward and off the floor and swiftly alternating with the other foot.

EXERCISE ESSENTIALS Take your workout to the next level with a few inexpensive pieces of equipment.

1. Suspension trainer: This device consists of two ropes that can be attached to a door or other stable anchor. Some common exercises include a recline pull (hold the ropes, lean backward, then pull your body forward) and a bicep curl (relax your shoulders, bend your elbows at a 90-degree angle, bring palms toward your forehead, then return).

2. All-purpose bands: These long, elasticized ropes

LOW PLANK HOLD: With your forearms on

can also be fastened to a door and provide resistance for a range of moves. To perform archers, stand with your feet shoulder-width apart and hold the bands with your arms extended. Stand back with your left foot as you pull with your left arm, opening up the shoulders and hips. Return to a starting position and repeat on the right side.

3. Super band: A super band is basically a giant rubber band that can help you achieve a full-body workout. To use it with a squat, for example, loop the band around your waist, then cross it in front of you to form an X. Step on the loop with your feet shoulder-width apart to create resistance.

4. Small dumbbells: Opt for two sets of dumbbells: hand weights of 1 to 3 pounds, as well as another heavier set of 5 to 10 pounds for women and 10 to 20 pounds for men. The smaller weights are ideal for enhancing cardio workouts, such as boxing, while the heavier ones are good for strength-training moves like bicep curls and arm presses.

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the floor and arms at 90 degrees, hold your body straight on your forearms with a long, neutral spine looking down at the floor and up on the balls of your feet. Start by holding for 30 seconds and increase the intervals by 30 seconds as you progress.

SKATER: Stand with your feet shoulder-width apart.

Place your right foot behind and across your body at an angle and load the hip as you bend the left leg.

Keep the majority of your weight on your left leg and then leap laterally, landing on the right leg and crossing your left foot behind your body. Decelerate the momentum before you load the right hip and leap back to the left.

SQUAT: Stand with your feet shoulderwidth apart. Bend your knees and sit back, lowering your hips toward the floor while keeping your gaze slightly down and your spine elongated. Your knees can extend about one fist width over your toes. As you rise back up, squeeze your glutes at the top of the movement.

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9/18/20 2:01 PM

In Loving Memory

A Heart for Our Community.

A Heart for Animals.

Herb Baum led with his heart at home, in business, and in the community.

Jupiter Medical Center Foundation honors his legacy of love.

“Herb wanted to make the world a better place, and he did – through his leadership and by giving generously of his time and resources.”

– Liv Vesely, President, Jupiter Medical Center Foundation “We are still grieving from the loss of Herb who was taken from us too soon. Under his leadership, we instituted his strong business acumen at Furry Friends, and his amazing spirit of giving will allow us to continue to save abandoned and abused animals for years to come. He was a true champion for animals and his legacy will always be an integral part of our organization.”

– Pat Deshong, President, Furry Friends

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UNDERNEATH

IT ALL Photography by Tracey Benson

Jupiter Medical Center health care providers step out from behind the front lines Throughout the coronavirus pandemic, health care providers have been caring for patients with an insidious sickness unlike anything they’ve ever experienced in their careers. Health care workers have had to adjust to a new normal of working under multiple layers of personal protective equipment: disposable gowns, multiple face masks, face shields, goggles, surgical caps, and, in some cases, respirators.

Patients never see the faces of those who are putting their own lives on the line to care for them through coughs, fever, shortness of breath,

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and a plethora of symptoms unique to each COVID-19 patient. In an effort to limit potential exposure, hospitals nationwide have closed their doors to visitors, creating a void that is filled by hospital workers.

Patients learn the voices of their care team and get a limited glimpse of character, such as colorful shoes or a floral fabric mask.

These images show Jupiter Medical Center’s frontline workers as they are seen by their patients, and also reveal each person’s personality and passions.

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9/22/20 9:44 AM

Kingkes Hoke Concierge Suites Nurse For the past few months, Kingkes has been working on the front lines of the pandemic in her role as a concierge suites nurse at Jupiter Medical Center.

For Kingkes, providing her patients with hope is just as important as providing medical care. “I always tell my patients, ‘You’re going to walk out of here.’”

Kingkes also finds time to help patients FaceTime with their families and says those two to three minutes can make such a difference. Outside of work, Kingkes is a photographer and says, “Every picture has a story behind it. It’s how I express myself.”

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9/17/20 2:24 PM

Megan McGuinniss-Hamric Clinical Manager of the ICU Megan has been a nurse for 15 years and is currently a clinical manager in Jupiter Medical Center’s Intensive Care Unit (ICU).

She has been on the front lines of COVID-19 since March. As a former Florida State University cross-country athlete, Megan continues to run as a release from her work caring for some of the hospital’s sickest patients. Megan is married with two daughters and says her family is helping her mentally manage caring for coronavirus patients.

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Nicole “Nikki” Schinske Clinical Manager Nikki’s first day at Jupiter Medical Center coincided with the hospital’s launch of its COVID-19 care, and she has been on the front lines of the pandemic ever since. Nikki has been a nurse for 20 years and typically works with oncology patients, but says, “It’s all about bending and flexing right now. We are all in this together.” She is also a seven-year breast cancer survivor and believes in treating the whole person, not just the illness or injury. Outside of caring for patients, Nikki is passionate about spending time with her three children, gardening, and tae kwon do.

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9/17/20 2:24 PM

Kristoffer “Kris” Pernsteiner Critical Care Nurse in the ICU Kris, a Jupiter Farms native, is a critical care nurse in Jupiter Medical Center’s ICU. Having been on the front lines of COVID-19 since March, Kris describes a coronavirus patient’s recovery as miraculous “because it’s insidious.” He believes that “we can’t let this pandemic cause us to lose our sense of decency.” Besides providing critical care to patients most in need, Kris enjoys fishing and spending time with his wife.

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9/17/20 2:24 PM

Veronica “Ronnie�

Ruff-Miller Assistant Clinical Manager of the COVID-19 Unit In 2005, one of the deadliest hurricanes ever to hit the United States devastated the city of New Orleans and surrounding areas. Inspired by the humanitarian response, Ronnie joined the United States Navy. She has served as a Navy lieutenant for nearly a decade and has been a nurse for 13 years. Ronnie has been on the front lines of the fight against COVID-19 at Jupiter Medical Center and says her favorite part of the job is seeing patients recover. When she is not caring for her patients, Ronnie loves shopping, running, and spending time with her husband and son.

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9/22/20 9:44 AM

Lizvet Torres Environmental Services Aide Lizvet works tirelessly at Jupiter Medical Center to help maintain a sterile environment for patients and staff, and to help prevent the spread of disease and infection. She says the most rewarding part of her job is seeing patients happy and smiling. Lizvet is a Lake Worth native and a mom to three boys under the age of 5. For Lizvet, her family is of utmost importance, which is revealed through her tattoos honoring loved ones. Lizvet also enjoys music, candy, and shoes.

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9/17/20 2:24 PM

Porch Sessions

Project Socially distanced family photo shoots remind us that, despite this new normal, our need to connect will never change Photography by Christy Burke

A

Photographer Christy Burke and family

s people retreated to the safety of home during the unprecedented times of social distancing and isolation, photographers around the world stepped up to capture family portraits during lockdown.

Jupiter-based natural light photographer Christy Burke invited local families to step outside to document life during the pandemic as a snapshot in time. Burke’s “Porch Sessions Project” allowed her to connect with people in the community, yet stay far enough away to respect social distancing guidelines.

“I believe that the one thing we all need is human connection,” Burke says. “As a photographer, I was trying to think of a way to help people feel connected. I hope these photos bring a smile to your face.”

Burke’s porch photo sessions were inspired by the Front Steps Project social media movement created

by Boston-based photography and public relations duo Cara Soulia and Kristen Collins.

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9/17/20 2:20 PM

The Roy Family, Palm Beach Gardens

The Vestry Family, Jupiter

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The Lang Family, Jupiter

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The Ashcraft Family, Jupiter

The Hollinger Family, Jupiter

“I believe that the one thing we all need is human connection.” —Christy Burke

The Vanderwalker Family, Jupiter

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9/17/20 2:20 PM

The Silver Family, Jupiter

The Sig Family, Riviera Beach

The Herbold Family, North Palm Beach

The Barnes Family, Jupiter

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The Cecchini Family, Jupiter

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9/17/20 2:20 PM

IN HER WORDS As told to Michele Meyer

MARJORIE ODEEN:

JERRY RABINOWITZ

Safe and Sound at Jupiter Medical Center After several years of having my right knee clicking with each step, and no longer able to easily go downstairs, not to mention playing golf or tennis, I knew I had to face up to a knee replacement.

Having been active all my life, I had no choice but surgery. I chose Dr. Andrew Noble of Palm Beach Orthopedic Institute because he was up-to-the minute on the latest joint-replacement surgery and pain management techniques.

While we scheduled for November, I had the chance to visit vineyards in Argentina—an opportunity I couldn’t pass up. We rescheduled for early spring, but this time, COVID-19 led to a shutdown for all elective surgeries in Florida.

I could have gone elsewhere on the East Coast, but I knew if anyone was going to keep me safe from COVID-19, it was Jupiter Medical Center.

This wasn’t my first rodeo: I already had my other knee and a hip replaced elsewhere. This time, I was only willing to have the surgery at Jupiter’s Anderson Family Orthopedic and Spine Center of Excellence, which has an excellent track record.

Even so, it was a bit unnerving to walk into the hospital alone at 5 a.m. on June 9. Despite the early hour, the center was bustling with an energetic and very kind staff.

From that point on, their attitude and willingness to anticipate my needs were really amazing. Every interaction was positive, and I credit the staff’s esprit de corps.

I only needed a spinal-block injection for the surgery, so I woke up clearheaded and ready to go to my room in time for lunch. Chef Wally provides great menu choices and his plates are beautifully presented. Each mealtime was a real treat!

I couldn’t leave the hospital without saying goodbye to all the nurses, including my shift nurse, Tiffany Kletzky. They were always smiling and laughing, which meant all the more after being isolated at home due to the pandemic.

Fortunately, their outstanding physical therapist had prepared me well, helping me practice stairs and other motions I’d need to get around. That made the transition from hospital to home so much easier.

I have now completed outpatient physical therapy and the knee is as strong as ever. I am thrilled. I never thought I’d say this about surgery, but if I had a third knee, I’d go back. Absolutely.

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9/18/20 2:17 PM

Detect. Treat. Prevent.

The scientists at Scripps Research work day and night to fight COVID-19.

Your philanthropic support helps propel their efforts to detect, treat and prevent its spread.

There has never been a more urgent time for the scientific community and the general public to join forces. Help accelerate this vital work by donating now.

Visit scripps.edu/covid19 to learn about our work and how you can help.

Or call (561) 228-2013 to make your donation.

The Scripps Research Institute is a 501(c)(3) nonprofit charity. For tax purposes, our EIN# is 33-0435954.

A COPY OF THE OFFICIAL REGISTRATION (#CH17266) AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (1-800-435-7352) WITHIN THE STATE OF FLORIDA. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATIONS BY THE STATE.

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#1 AGENT Illustrated Properties

A Top Seller of $3 Million+ Homes

in the Northern Palm Beaches

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9/10/20 8:41 AM