Jupiter Medical Center Foundation Pinnacle Spring 2023

Pinnacle

WORLD-CLASS HEALTH CARE IN PALM BEACH COUNTY

NEXT-DAY ONCOLOGY APPOINTMENTS

7 THE

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Contact a Client Advisor at Braman BMW Jupiter to learn more today.

Saturday, September 23, 2023

6:30 p.m.

EAU PALM BEACH RESORT & SPA

Chairs

Jessica & Nicholas Mastroianni III

Honorary Chairs

Aliyah & Justin Howard

CONTENTS

Features

22

NEXT-DAY ONCOLOGY APPOINTMENTS

The Anderson Family Cancer Institute o ers next-day appointments to those newly diagnosed with cancer

By Kelley Marcellus

28

TO HRT OR NOT TO HRT?

THAT IS THE QUESTION. When faced with the side e ects of menopause, women have options beyond hormone replacement therapy

By Sandra Gurvis

34

BEATING THE ODDS

Advances in screening, medications, and noninvasive treatments have revolutionized cardiac care

By K.S. Meyer

38

NOURISH FROM WITHIN

Pinnacle’s guide to eating well during pregnancy and while breastfeeding

By Karen Feldman

44

PUTTING OUT THE FIRE

How PSMA scans have enhanced the identification and treatment of prostate cancer

By K.S. Meyer

48

CARRYING THE TORCH

The legacy of David and Gladys Chleck lives on in their philanthropic gifts

By Heather Graulich

3 IN THE PALM BEACHES

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1210 S. Old Dixie Highway Jupiter, Florida 33458 561.263.2234

jupitermed.com

JUPITER MEDICAL CENTER OFFICERS AND TRUSTEES 2022-2023

Martin A. Dytrych, CPA, Chairman

Robert J. Stilley, Vice Chairman

Jack Waterman, DO, Secretary

Rosanne M. Duane, Esq., Treasurer

Mark L. Corry, MD

Henri J. DesPlaines, CPA

Michele D. Deverich

Lee Fox, MD

Harvey Golub

Philippe Jeck, Esq.

Michael Leighton, MD

Peter A. Lund

Thomas Rowe, MD

John Seifert

Anthony P. Shaya, MD

JUPITER MEDICAL CENTER FOUNDATION, INC. TRUSTEES 2022-2023

Peter A. Lund, Chairman

Donald H. McCree, Jr., Secretary

Salvatore A. Tiano, Treasurer

Leonard Abramson

Edward L. Babington

Douglas S. Brown

George H. Damman

Neil S. Devlin

Martin A. Dytrych

Fred Lissauer

John Healy

Emeritus: Peter O. Crisp

William C. Mattison, Jr.

Jane F. Napier

James E. Perrella

Joseph M. Petri

Katharine F. Plum

M. Jude Reyes

Burton M. Tansky

Dennis K. Williams

Amit Rastogi, MD, MHCM President and Chief Executive Officer, Jupiter Medical Center Traci Simonsen Interim Philanthropy Officer and President, Jupiter Medical Center Foundation

Pinnacle

WORLD-CLASS HEALTH CARE IN PALM BEACH COUNTY

Publisher Terry Duffy

Sales Director Deidre Wade

Associate Publisher Dina Turner

Editorial Director Daphne Nikolopoulos

Editor Mary Murray

Creative Director Olga M. Gustine

Senior Art Director Jenny Fernandez-Prieto

Digital Imaging Specialist Leonor Alvarez Maza

CONTRIBUTING WRITERS

Karen Feldman, Sharon Geltner, Heather Graulich, Sandra Gurvis, Kelley Marcellus, K.S. Meyer, Seth Soffian

CONTRIBUTING PHOTOGRAPHER

Steven Martine

ADVERTISING

Account Manager Melissa Zolin Schwartz

Advertising Services Coordinator Elizabeth Hackney

Marketing Manager Rebecca Desir

PRODUCTION

Production Director Selene M. Ceballo

Production Manager Lourdes Linares

Digital Pre-Press Specialist George Davis

Advertising Design Coordinators Anaely J. Perez Vargas, Jeffrey Rey

Production Coordinator Ileana Caban

Digital Marketing Manager Tyler Sansone

OPERATIONS

Chief Operating Officer Todd Schmidt

Office Manager Tanya Gomez

Accounting Specialist Mary Beth Cook

Accounts Receivable Specialist Ana Coronel

Distribution Manager Judy Heflin

Logistics Manager Omar Morales

Circulation Manager Marjorie Leiva

Circulation Assistant Britney Stinson

Circulation Promotions Manager David Supple

IT Manager Keith Gonzalez

In Memoriam Ronald J. Woods (1935-2013)

HOUR

LLC

CEO Stefan Wanczyk

President John Balardo

IN THIS ISSUE

Staying ahead of the curve with new medical technologies, treatments, and disease prevention is critical for our care teams in their commitment to provide award-winning medical care and comprehensive support to our patients, their families, and our community.

Sometimes, cutting-edge technology arrives in the form of new screening and imaging capabilities that enable cardiologists to identify heart disease earlier than ever before. In this issue, you’ll meet Jupiter Medical Center’s renowned cardiologists and cardiac team members and discover the great strides they are making in diagnosing and successfully treating a range of cardiac disorders. Whether degenerative and disabling heart conditions are caused by lifestyle choices, genetics, aging, metabolic imbalances, or other underlying risk factors, they can now be identified early via new imaging technologies that peer deep inside the heart without damaging surrounding tissues or valves. Likewise, a range of heart ailments can be treated with noninvasive methods, medications, or a combination of both to greatly improve quality of life and life expectancy.

A novel innovation in patient care emerges at the Anderson Family Cancer Institute. Moreover, it’s powerful yet simple: a phone call. Because patients with cancer should not have to wait, the institute supports next-day oncology appointments for any newly diagnosed patient eager for answers regarding their disease, treatment plan, and prognosis.

“We believe it is our responsibility to help patients navigate that process,” says Dr. Rogerio Lilenbaum, a renowned oncologist and director of the Anderson Family Cancer Institute, in an enlightening article about the institute’s patient-centric initiative. Bolstered by the institute’s award-winning accolades and collaboration with the University of Florida Shands Hospital in Gainesville for specialized care, “we are in a position of leadership to raise the bar on cancer care in Palm Beach County,” he points out.

For men with prostate cancer, new screening technologies and treatment regimens are offering hope for earlier detection and more targeted treatment of this leading cause of cancer and second-leading cause of cancer death in men. Dr. Adam Kotkiewicz, a medical oncologist who specializes in genitourinary cancers, describes new tests and technologies that fine-tune the identification of prostate cancer and inform the most effective protocols, enhancing oncologists’ ability to diagnose, stage, and treat cancer with more precision and confidence.

In this issue of Pinnacle, you’ll learn about our clinical teams’ opportunities to experience high-impact, hands-on training using Gaumard robotic human simulators for everything from treating heart attacks or strokes to inserting a catheter. You’ll also read about donor and philanthropist Ross Levine, whose Chleck Family Foundation and passion for excellence in health care supports continuing education and training of our staff.

Every day, I am inspired by the dedication, expertise, and passion for health care that defines Jupiter Medical Center. As you browse this issue, I invite you to be inspired by the caring professionals who make it happen.

To your health,

Amit Rastogi, MD, MHCM President and Chief Executive Officer Jupiter Medical Center

Heart Pulsing to the Beat of a Different Drum?

Atrial Fibrillation (AFib) is an irregular and often rapid heart rhythm that affects millions of people. If left untreated, AFib increases the risk of heart-related complications. At the Robson Heart & Vascular Institute at Jupiter Medical Center, we offer advanced procedures to correct AFib that help ensure future heart and vascular health. From medication management to ablation to minimally invasive procedures including the Maze and WATCHMAN™ procedures, Jupiter Medical Center offers the latest options.

To speak to a patient coordinator call 561-263-3767. jupitermed.com

PULSE

Ask the Expert

An introduction to eye floaters

Insight into water safety for kids

Prevention

How to prevent and treat diverticulitis

Tips for identifying heat exhaustion and when to seek medical care

Preparation

Training the workforce of the future with high-tech simulators and hands-on education

PULSE ASK THE EXPERT

By Seth Soffian

Eye Spy

does, collagen fibers in the vitreous can pull at or pluck away from the retina, causing potential retinal tears and detachments.

Who is at risk?

Along with age, a number of other factors can cause floaters. Trauma can cause them. Kids, for instance, can have floaters if they take a ball to the head or collide with another child. Myopia, or nearsightedness, can also contribute to floaters because the eyeballs can get longer with myopia, stretching the vitreous. Hormonal changes and inflammation, such as from autoimmune issues, also can cause floaters.

What should people experiencing floaters do?

As we age, many of us experience the fairly common and usually harmless vision nuisance known as floaters. It is estimated to occur in at least 30 percent of the general population. In some instances, floaters can be an indication of a more serious visual issue, such as a retinal tear or detachment. Here, Dr. Debra A. Shim, an optometrist and the owner and operator of Visual Eyes of the Palm Beaches, discusses their causes, symptoms, and when to seek care. What are floaters?

Floaters can appear as dark spots, strings, web-like strands, or other shapes in your vision. They’re most commonly caused by age-related changes to the gel-like substance that fills the eye, called the vitreous. As we age, the vitreous starts to shrink and liquify. As it

Always see an eye doctor any time you experience changes in your vision, especially if this includes the appearance of floaters. In most cases, there is no intervention required, nor anything medically proven that can be done. Although a nuisance, most people learn to live with floaters and gravity usually pulls them out of our way so they are less noticeable.

Seeing a doctor is critical because floaters can be an indication of a more serious problem, such as a retinal tear or retinal detachment, which require immediate surgery. Depending on the onset and severity of symptoms, your doctor may want to see you again within six weeks of the onset of floaters. If a floater is going to worsen and lead to a tear, this will usually happen in that time frame. What are the more severe symptoms to watch for?

Flashes of light accompanying floaters may be an indication of a retinal tear. Multiple floaters or an increase in the number of floaters also can be an indication of a more serious problem. In all cases, see an eye care professional. «

For more information, please call 561.625.4380

What to do when floaters appear in your vision and why you should consult a doctor

PULSE ASK THE EXPERT

By Sharon Geltner

Safety First

The state of Florida leads the country in drowning deaths in children 5 years of age and under. In fact, it is the state’s top cause of death for children between the ages of 1 and 4, according to the Centers for Disease Control and Prevention. Following a tragic loss of her own, Palm Beach Gardens mom Keri Morrison founded the Live Like Jake Foundation, a drowning prevention nonprofit focused on babies, toddlers, and children. Pinnacle recently caught up with Morrison to discuss the foundation and precautions parents can take to protect their children.

What motivated you to start the foundation?

My almost 3-year-old son, Jake, drowned in 2013, when we vacationed at my in-law’s home on the Intracoastal. He slipped out one night to push his baby doll stroller

and fell in. At first, I felt I could not go on, but I had to be there for my baby daughter and my daughter to come. I went on a mission to honor Jake.

What have you accomplished since?

We’ve raised $2 million. Around $750,000 of that has paid for swim scholarships for over 3,200 children in 41 states. Children ages 6 months and older are taught self-rescue swim lessons. We’ve also covered funeral and medical expenses for 200-plus families. And two years ago, we built an indoor aboveground pool in Palm Beach Gardens, where over 600 children have learned to self-rescue using the ISR (Infant Swimming Resource) method. [Should kids fall into the water, they stay calm and rotate on their backs.] My 6-and-a-halfmonth-old Josie’s demonstration video in 2016 now has well over 500 million views.

A record 99 children died due to drowning in Florida in 2021. Why? COVID, in part. People were cooped up and siblings could leave a fence open or a door unlocked. When families traveled, drownings rose in central Orlando at hotels and rentals with pools. Many people are moving to Florida from out of state and just don’t understand the danger that water imposes. They

don’t know that if a child is mobile, he can and mostly likely will find water.

Why is drowning the leading cause of death for children ages 1 to 4?

If all the layers of protection are in place, especially a fence around the pool, drowning would be 100 percent preventable. I am often asked by parents, “Can you help me convince my husband/wife to fence our pool?” I tell them, “Why do I have to convince them? You have young children and a pool. There should be no other choice, regardless of whether your child knows how to swim.”

Also, pool owners could install a pool alarm and alarms for windows and doors. Florida law states all outdoor swimming pools must have a 4-foot fence or other barrier around the outer perimeter of the pool, with no gaps in coverage. There are problems with people putting these safety features into place. When building a new pool in Florida, pool owners must have one of the three: a pool fence, a pool alarm, or alarms for windows and doors. However, older pools are grandfathered in, but there still must be a perimeter fence in place. «

Support Live Like Jake The foundation will host its annual 5K race in Abacoa April 29. (livelikejake.org)

The mother behind the Live Like Jake foundation shares insight into drowning prevention

PULSE PREVENTION

By Karen Feldman

You Are What You Eat

Severe cases may require hospitalization. In more extreme cases, patients may need surgery to remove the infected section of the colon. Once the condition has been controlled, Soyka says a colonoscopy should be done six to eight weeks later (if the patient hasn’t had one within the past year) as a precaution to rule out colon cancer.

To keep diverticulitis from occurring, Soyka prescribes a high-fiber diet. “There’s no evidence that avoiding meat, corn, nuts, and seeds makes a difference,” she says. “Many of these foods are high in fiber, and we do recommend eating them. We recommend adding in a fiber supplement as well, something like Benefiber or Metamucil.”

Soyka also advises eating more lean proteins and high-fiber vegetables such as broccoli, brussels sprouts, and artichokes, as well as consuming fruits, including pears and apples, with the skin on. “Berries are high in fiber too,” she adds. “Oatmeal, grain bread, and bran add fiber to the diet as well.”

A diagnosis of diverticulitis isn’t good news, but it need not be as dire as it once was. In most cases, maintaining a healthy diet and a moderate fitness regimen can keep this painful condition under control.

Diverticula are “fat-like protrusions that form along the colonic wall” and tend to develop as people age, explains Dr. Caroline Soyka, a gastroenterologist at Jupiter Medical Center. “By age 60, 60 percent of people will have diverticulosis.”

However, it’s when those pouches become inflamed or infected—a condition known as diverticulitis—that there’s cause for concern. The number of people who have diverticulitis seems to be increasing, Soyka notes, most likely due to diets that are heavy on red meat and fast food, paired with a lack of exercise. Smoking can exacerbate the condition as well.

Most diverticula form in the sigmoid colon, Soyka says, which is on the lower left side of the abdomen, so pain in that area can signal the onset of diverticulitis. Pain over several days anywhere across the lower abdomen, fever,

diarrhea or constipation, and an elevated white blood cell count are all symptoms. Patients may be diagnosed based on their history. If necessary, a CT scan can help detect the condition.

There are two types of diverticulitis: uncomplicated, meaning a mild case without abscesses or perforation of the colon, and complicated, which can range from infected diverticula to blockages in the bowel or, in very severe cases, peritonitis, which requires immediate treatment.

Most treatment plans begin with pain control, Soyka explains. “Tylenol or Advil and a liquid diet are first,” she says.

“Not everybody needs antibiotics, although those more at risk [for serious outbreaks] can take them.”

Fiber, she stresses, “only works if you get enough water, so try for 8 cups a day.” Finally, aim for 15 to 20 minutes of daily moderate exercise, which can be something as easy as walking, as long as you increase your heart rate. «

For more information, please call 561.744.2200

A high-fiber diet and light exercise can lower your risk of developing diverticulitis

PULSE PREVENTION

By Sharon Geltner

Hot and Bothered

humidity. I had to cool off. I left the bleachers and found some shade and drank water.”

Romero cautions that heat exhaustion is a real threat—and people don’t often realize they are experiencing it until they reach a dangerous point and need to be hospitalized. “If you feel those symptoms, don’t push through. If you can’t go inside, find shade and drink water.”

can progress to feeling weak, with cold, clammy skin, a racing pulse, weakness, confusion, headache, even fainting. None of those are lifethreatening. But things can progress very quickly into heat stroke. A person can lose consciousness, have a heart attack, or [experience] serious damage to their heart and kidneys.”

This is an increasingly urgent concern. According to the Centers for Disease Control and Prevention, between 2004 and 2018, there was an average of 702 heat-related deaths in the United States each year. In 2020, there were 1,156 deaths. In 2021, there were 1,601. Climate change is exacerbating the problem. “We have more hot days than we used to, and those days are hotter than before,” Romero says.

While Romero often treats athletes and construction workers—typically with rest and an IV to rehydrate them—tourists, snowbirds, and weekend warriors are also vulnerable. “People moving from northern states need time to adjust to the heat here,” he explains. “Human beings are very adaptable, but it can take months or years for metabolism to change.”

Heat exhaustion can sneak up on anyone. Just ask emergency medicine expert Dr. Harry Romero. It happened to him.

“I was in Houston for the Junior Olympics where my teen daughter was competing in the heptathlon,” Romero recalls. “I was in the concrete stands with no cover. I was dizzy, sweating, feeling nauseous. I thought I was about to pass out. It was the heat and high

A graduate of Harvard College and Harvard Medical School, Romero is now the medical director of the Jupiter Medical Center Urgent Care locations in Palm Beach Gardens, West Palm Beach, Jupiter, and Stuart. He notes that heat exhaustion, if untreated, can lead to the much more serious heat stroke.

“There is a continuum of heat-related illnesses,” he explains. “The least serious are heat rash, sunburn, muscle cramps, and sweating. But that

The very young, elderly, obese, and pregnant women are also at risk. So are those with pre-existing medical conditions. “Patients are not aware that a lot of medications [such as beta blockers, diuretics, antihistamines, and antipsychotic drugs] lead to a decreased ability to regulate temperature,” Romero continues. Furthermore, “low-income people may turn off the air-conditioning in order to afford groceries and medications.”

In addition to avoiding extreme heat situations and paying attention to symptoms, Romero advises to think before you drink. “Avoid caffeine, alcohol, and sugary carbonated beverages, which make you lose more water,” he says. “Drink water, Gatorade, and electrolytes.” If after hydrating, finding shade, or escaping into A/C, you feel worse, then seek treatment. «

For more information, please call 561.263.7010

Dr. Harry Romero

PULSE PREPARATION

By Sandra Gurvis

Stimulating Simulation

The scene could be straight out of 2001: A Space Odyssey, except it’s more than 20 years later and the astronauts have been replaced with physicians and nurses. Yet they too, along

with other Jupiter Medical Center staff, are mesmerized by Hal, an eerily lifelike simulator equipped with conversational abilities, motor movement, physiology, and more. Only at JMC, the team is using Hal to create learning opportunities rather than to commandeer a spaceship.

Hal and his entire “family”—which includes females, a child known as Pediatric Hal, an in-

fant named Tory, and a premature infant simulator—are products of Gaumard, a robotics company that specializes in building simulators for health care education.

“It’s as close to working on an actual human as you can get,” says Carol Milliken, who serves as JMC’s clinical education director and oversees the Excellence in Nursing Professional Practice, Clinical Education, and NICHE (Nurses Improving the Care of Health System Elders) programs. Along with understanding speech patterns and responding appropriately, Hal and his pals “actually get better at communicating the more you use them,” she adds.

At around 200 pounds, Hal is the same weight as the average adult male. He can also exhibit physiological responses, such as those that might occur during a stroke or cardiac event, including swelling and dilated pupils.

“You can put in an IV, shock him, or insert a breathing tube or catheter,” Milliken explains. The female simulators can mimic childbirth—complete with a newborn and a neonatal resuscitation option—and pediatric and senior simulators “help us address educational needs affecting those populations.”

In addition to providing beginners with a platform for practice, simulators enable Milliken and her team to train staff on a new procedure or diagnosis before they work with patients. “It builds confidence and creates an opportunity for our clinical staff to ask questions, troubleshoot issues, debrief, and give feedback,” she says.

Yet learning involves more than hightech mock patients, and JMC is investing in programs that center around experience and mentorship too. For example, a shortage of phlebotomists (professionals who perform blood draws) led the hospital to create its own phlebotomy training program. “After

How Jupiter Medical Center is training its staff for the future

COURTESY OF GAUMARD

eight weeks of in-unit orientation, classroom instruction, and hands-on clinical experience under the mentorship of an experienced instructor, attendees become nationally certified phlebotomists,” explains Milliken.

Nurses also receive leveled-up guidance. “Nurses, especially those just starting out, are faced with a dizzying array of choices and

specialties,” Milliken points out. Along with continuing education classes and training, JMC’s RN residency program o ers mentoring through extended clinical orientation and preceptorship with seasoned nurses. “This helps new nurses transition into the fast-paced hospital environment with confidence, comprehensive knowledge, and enhanced skills.”

Other continuing education programs focus on everything from reading arterial blood gases, to interpreting ventilation carbon dioxide levels, to the relaunch of an institute designed to grow leadership within the organization. “We also have guest speakers; for example, we’ve scheduled someone from a cadaver lab, which will be an amazing experience for our teams,” Milliken adds. This is in addition to providing tuition assistance/reimbursement and/or scholarships so sta can receive outside training as well. Plus, “we provide educational support to the community through outreach classes, such as Friends and Family CPR.”

And unlike the confusing ending of 2001 JMC’s motive is clear: “We want our people to keep learning and growing and to stay happy here for the rest of their careers,” concludes Milliken. «

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Carol Milliken

NEXT-DAY

APPOINTMENTS ONCOLOGY

When faced with a cancer diagnosis,

By Kelley Marcellus

Ask nearly anyone what are the most dreaded words a doctor could utter, and the answer is nearly universal. Whether you’ve visited your provider for a routine screening, an acute symptom, or a nagging health complaint, when a doctor says, “It’s cancer,” time stands still and life begins to feel divided into “before” and “after.”

What lies in between is a purgatory of seemingly endless decisions. What specialist will you see? Where will you go for diagnostics? Will treatment be tolerable? How far has the disease spread? Are genetics to

blame? Can this be beat? What if rehabilitation or nutrition services are needed? What about support for caretakers? So many questions, and when not feeling well is added into the mix, knowing what to do next can feel overwhelming.

That’s why the Anderson Family Cancer Institute at Jupiter Medical Center, a world-class comprehensive cancer treatment center, launched an initiative in 2022 to provide next-day appointments for the newly diagnosed. “The period between diagnosis and treatment can be agonizing for patients and their loved ones,” says Dr. Rogerio Lilenbaum, director

next-day appointments and world-class care are just what the doctor ordered

of the Anderson Family Cancer Institute and a senior vice president and chief physician executive at JMC. “If you are newly diagnosed with cancer, you can call and request a next-day appointment.”

The center operates under the motto that patients should not have to wait for cancer care. Timely appointments can provide patients and their families an opportunity to ask questions and learn what the next steps will be and who will be on the care team. “Typically, a cancer diagnosis is a life-changing event,” Lilenbaum says. “It’s difficult for patients and families to navigate the process and go from clinic to clinic

for testing or intervention. We believe it is our responsibility to help patients navigate that process.”

Utilizing a multidisciplinary, team-based approach, the Anderson Family Cancer Institute offers care on par with any nationally recognized cancer center, with the advantage of being close to the comforts of home and local support systems. “Each component of cancer treatment is important,” Lilenbaum adds. “We believe cancer patients should be treated by experts, and they should have access to comprehensive treatment that goes beyond the typical chemotherapy, radiation, and surgery.”

Patients at the Anderson Family Cancer Institute are rarely seen by just one physician like they would be if they sought treatment with an individual, freestanding physician’s office, left to figure out complementary steps on their own. At JMC, multiple physicians and experts discuss each case in order to craft a start-to-finish action plan. Furthermore, in addition to oncologists, radiologists, and surgeons, the institute’s cadre of health care professionals includes nurses, patient navigators, genetic counselors, social workers, psycho-oncologists, support groups, nutritionists, integrative and creative therapists, and more. Lilenbaum says the team will help

patients navigate each step and take their circumstances and worries into consideration.

“We select our cancer physicians and nurses very carefully,” he notes. “We believe in compassionate care. It is our responsibility to empathize with the patient and family, put ourselves in their shoes, and understand their needs.”

Even so, sometimes patients desire a second opinion. For those in South Florida, that can lead many to travel out of state, Lilenbaum says. While he encourages patients to gain the information they need, he believes that JMC can offer the same services found at out-of-state facilities, coupled with many advantages of being close to home. Furthermore, many of the institute’s physicians have worked, studied, or conducted research at the country’s leading research centers. As a multidisciplinary, comprehensive cancer center, the

Dr. Rogerio Lilenbaum (left) is director of Jupiter Medical Center’s Anderson Family Cancer Institute (above).

“We believe in compassionate care. It is our responsibility to empathize with the patient and family, put ourselves in their shoes, and understand their needs.”

Anderson Family Cancer Institute can deliver the same modalities available at distant centers—even clinical trials—without the hassle of travel.

“Having your own home to recuperate in, the support of family, and the access to a support system around you are immeasurable,” Lilenbaum says. “A differentiator here is that we see it as part of our mission to serve this community. We are here to make sure a patient doesn’t go through unnecessary hardship when they face cancer. Everything in our system is set up to make that experience less painful and less traumatizing.”

The Anderson Family Cancer Institute is at the forefront of the most innovative advancements in cancer treatment that have occurred over the last two decades. Surgery traditionally has played an important role, but today’s procedures are often robotic—and the Anderson Family Cancer Institute employs three da Vinci surgical systems. These minimally invasive procedures achieve highly effective results without lengthy hospital stays or scarring. “Surgery was a big ordeal for a lot of patients in the past,” Lilenbaum says. “Our goal is to return them to normal life in a much shorter period of time.”

Lilenbaum also describes the advances in radiation modalities. As one of only two radiation oncology departments in Palm Beach County to be accredited by the American College of Radiology, the Anderson Family Cancer Institute offers radiosurgery utilizing the CyberKnife, among other interventions. “We use several radiation modalities that are meant to improve the efficacy of treatment and

The Anderson Family Cancer Institute uses the CyberKnife (right), which is a noninvasive method of radiation therapy.

minimize the damage to surrounding tissue,” he adds.

Medical treatment, Lilenbaum says, has undergone a revolution. While chemotherapy is an effective first-line option, some cancers respond just as well—or better—to targeted therapies or immunotherapy options, neither of which have the difficult side effects associated with chemotherapy.

With targeted therapy, an analysis of cancer cells or the patient’s blood is conducted. When certain genetic mutations are present, “they are actionable,” Lilenbaum says. “There are drugs that stop the cancer and, in some cases, cure the cancer. They have changed the landscape.”

Immunotherapy is another paradigm shift. After decades of research, scientists discovered a way to activate the body’s immune system to fight cancer, with minimal side effects for many patients. The method was first employed to treat advanced melanoma, which was previously considered almost a death sentence. “Now, we are seeing patients alive six or seven years past diagnosis,” Lilenbaum explains. “We are even talking about a cure for patients with advanced cancers.”

For situations that require particularly specialized care that is best handled in an academic center, JMC is collaborating with the University

of Florida’s Shands Hospital in Gainesville. “That is a way for us to allow our patients access to services and clinical trials that are not available in Palm Beach County,” Lilenbaum says. “We can also provide tertiary and quaternary care when necessary.”

The goal, however, is to provide world-class care close to home, where you’re comfortable and your support is nearby, long-term follow-up services are convenient, and the treatment discussion can begin the day after your diagnosis.

“Cancer leaves an indelible mark on you and your family, even when it seems to be over and done with,” Lilenbaum concludes. “We are not just another oncology group. We are in a position of leadership to raise the bar on cancer care in Palm Beach County.” «

For more information, please call 561.263.4400

“We are seeing patients alive six or seven years past diagnosis. We are even talking about a cure for patients with advanced cancers.”

To HRT or

Not to HRT?

THAT IS THE QUESTION.

When reaching menopause, women face what could be a life-changing decision

By Sandra Gurvis

Menopause dumps a load of baggage onto the body’s carousel. Because it marks the end of your menstrual cycle—12 months from the last period being the official start date— you are free from the associated discomfort and concerns about birth control. However, menopause comes with its own host of negative symptoms, both physical and mental: hot flashes, night sweats, insomnia, weight gain, vaginal dryness, loss of libido, and depression and mood swings, among others, as well as a possible increased risk of heart disease and osteoporosis.

Depending upon the severity of symptoms, you may need to decide whether to take hormone replacement therapy (HRT), which in itself can be impactful and contingent upon your predisposition toward breast and endometrial cancer, heart disease, blood clots, stroke, liver disease, gallstones, and, in certain situations, Alzheimer’s. “Each or a combination of these conditions may inform the decision to go with other

Dr. Nichole Corry (above) and Dr. Jessica Schwartz (left) of Jupiter Medical Center note that women today have options beyond HRT.

types of therapy,” says Dr. Nichole Corry, an internist at Jupiter Medical Center.

Nevertheless, HRT can be a good solution for many people, adds Dr. Jessica Schwartz, also an internist at JMC. “It gives the body

back the estrogen that it needs,” she explains.

Along with progesterone, estrogen drops as menopause progresses, causing many of its symptoms. HRT, which can consist of estrogen and/or progesterone, has been proven effective in relieving hot flashes, night sweats, dryness in the vagina and skin, and insomnia, and even in improving bone density, which can stave off osteoporosis and support dental health. It’s also convenient to administer and offered in a wide array of pills, gels, creams, patches, rings, and implants. That being said, even when conditions are ideal for its use, HRT is not a magic bullet. Schwartz notes that

for those dealing with certain types of depression, HRT may not be as effective. It also does not address the issue of weight gain.

Additionally, “women are turning to a more targeted approach,” says Corry. “As physicians, we look at individual treatment for each symptom and patient.” Non-HRT solutions can range from meditation to antidepressants to, in some cases, herbal and alternative medicine. Here, we look at some therapeutic alternatives for common menopause symptoms.

Hot Flashes, Night Sweats

Vasomotor symptoms (VMS), also known as hot flashes and/or night sweats, “can be very disruptive for many women,” says Corry. Although used to treat depression and anxiety, selective serotonin reuptake inhibitors (SSRIs) such as Zoloft (Sertraline) and Lexapro (Escitalopram) “increase the amount of serotonin in the body [and] greatly reduce the discomfort” from VMS with minimal side effects, Corry explains.

“Low doses of Gabapentin (Neurontin) may also provide relief,” adds Schwartz. Normally used for seizures and nerve pain, Gabapentin can be addictive, “so it needs to be carefully monitored.”

Fezolinetant, a new nonhormonal medication specifically designed to reduce VMS, was pending FDA approval as of February 2023. Along with being studied for safety, it has proven successful in clinical trials.

Hot flashes can be managed in nonmedical ways too. Sleep systems such as Ooler use a water-based technology designed to keep you cool at night. Lifestyle modifications— wearing lighter, looser clothes and/or dressing in layers, reducing or eliminating alcohol and smoking, and avoiding spicy foods—may also help.

Mood Swings, Depression

SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs), and other types of antidepressants can help stabilize moods. “Emotional reactions manifest in different ways,” notes Schwartz. “We need to match the symptom with the appropriate medication.” For example, Bupropion (Wellbutrin) works by restoring the balance of natural chemical neurotransmitters in the brain “and is used to treat depression, rather than anxiety.”

Some women prefer meditation over medication. With its focus on breathing exercises, inner peace, and silent awareness, “meditation can go a long way toward managing anxiety and depression,” observes Corry. Along with increasing mindfulness, it can instill a sense of calm and perspective, reduce discomfort, and ramp up energy. In fact, researchers at the Mayo Clinic found that menopausal women with higher mindfulness scores had fewer depressive symptoms.

Schwartz and Corry also suggest cognitive behavioral therapy (CBT). By reframing

“As physicians, we look at individual treatment for each symptom and patient.”

—Dr. Nichole Corry

negative thoughts into positive mental patterns, CBT “can help you manage the stress caused by menopause as well as other situations,” says Schwartz.

Insomnia

“Sleep is a habit, which menopause can also disrupt,” remarks Corry. Nonhormonal solutions include avoiding the computer, televi-

sion, and phone screens late at night, going to bed and waking up at the same time, and staying away from caffeine and alcohol, as well as getting daily exercise.

Ideally “the bedroom should be used only for sleeping and sex,” adds Schwartz. “It’s not a place for work or any other activities that can cause nighttime stress.”

Should these methods prove ineffective, “PM” formulations of over-the-counter medications such as Tylenol (Acetaminophen), Advil (Ibuprofen), and others as well as melatonin and CBD “can offer first-line solutions,” continues Schwartz. A hormone produced by the brain at nighttime, melatonin can be derived from plants or synthetically produced. Although CBD (cannabidiol) comes from the cannabis plant, unlike THC (tetrahydrocannabinol), it doesn’t get you high, but instead has a wide range of stress and pain management uses.

As a last resort, some physicians may prescribe serotonin antagonist and reuptake inhibitors (SARIs) such as Trazodone or sedativehypnotics like Ambien (Zolpidem) or Lunesta (Eszopiclone). Because these drugs can have side effects and potentially be addicting, “they should be considered as short-term solutions,” says Schwartz.

Lack of Libido, Vaginal Dryness/Atrophy

Corry estimates that about 25 percent of menopausal women experience a loss of libido. “It’s not clear whether it’s hormonally driven. Other contributing factors could be adolescent children moving on, career and financial pressures, age-related health concerns, or having to care for aging parents.”

While there is no clear-cut solution—Corry points out that studies have shown that even HRT may not definitively improve this—a related and possibly mitigating factor is what’s known as GSM (genitourinary syndrome of menopause). “This is the new term for vaginal atrophy that occurs after estrogen depletion

“A holistic approach can make [menopause] manageable.”

—Dr. Jessica Schwartz

and the resultant thinning of the vaginal tissue,” explains Corry. “The symptoms can include pain with intercourse as well as recurrent urinary tract infections and chronic irritation with urination.”

One solution is vaginal estrogen (Vagifem/ Estradiol cream/Yuvafem). “Absorption is so minimal that the risks normally associated with HRT are not a factor,” Corry adds. Moisturizers, lubricants, and even inserts are other options.

Weight Gain/Bloating

While hormonal changes, stress, and other age-related factors can cause weight gain and bloating around the abdomen, “this can be managed by eating a clean, low-carb diet,” says Corry. The concept behind clean eating is fairly simple: Prioritize foods as close to their natural state as possible and avoid heavily processed

items made from synthetic ingredients that may include sodium, fat, sugar, chemicals, preservatives, and other artificial additives.

“While there are a lot of so-called weight loss ‘solutions’ such as infusions and supplements, few if any work long-term,” notes Corry. “Plus, they may have unintended side effects” and potentially result in individuals regaining the weight and then some.

Schwartz recommends prioritizing protein to help replace the muscle mass lost during menopause. “The more muscle you have, the more calories you burn.”

Associated with this is exercise. Supplement cardio with weight-bearing activities such as dance or tennis classes, practices that improve flexibility including Pilates or yoga, and resistance and strength training. Regular exercise can also help to boost your mood and—along

with cutting down on processed foods, spicy foods, and alcohol—can reduce bloating.

What About Herbal Supplements?

Herbs such as soy, black cohosh, St. John’s Wort, red clover, flaxseed, dong quai, ginseng, and others are popular for their purported ability to alleviate everything from hot flashes to depression, insomnia, and possibly even vaginal dryness. But both Corry and Schwartz caution against their use without first consulting a physician. “Well-designed, large studies are needed before we can recommend them in place of standard treatment,” adds Corry.

While menopause is rarely an easy passage, “a holistic approach can make it manageable,” notes Schwartz. An eye toward prevention and “working closely with your physician can help get you back up to speed.” «

BEATING THE ODDS

Cardiologists at Jupiter Medical Center are embracing new solutions to the age-old problem of heart disease

By K.S. Meyer

While lifestyle choices such as exercise support cardiac health, they do not fully prevent heart disease. However, there are now many medications and treatments that can correct contributing factors.

With so much focus in medical literature and media on various cancers, it is easy to forget that the leading cause of death worldwide is still cardiovascular disease. Though the incidence of catastrophic, lifeending, acute cardiovascular events has diminished from what it was 50 years ago, chronic heart disease remains a severe and insidious affliction. And, as the average lifespan rises, so too does one’s potential to face such a sobering diagnosis.

“As life expectancy continues to increase, some things such as hypertension, diabetes, and hyperlipidemia seem to play a larger role,” says Dr. James Gardner, a cardiologist with Jupiter Medical Center.

“As patients are living longer, degenerative conditions such as aortic stenosis are being seen and treated more frequently,” adds Dr. Craig Vogel, also a cardiologist at JMC.

“Another is diastolic heart failure,” says Dr. Rahul Aggarwal, another member of JMC’s board-certified cardiology team. “This is a newly recognized condition of old age.”

While some of these conditions are the result of factors beyond anyone’s control—genetics, environmental variables, and pure chance— many others are not. “These are preventable and controllable medical problems,” says Gardner. Preventative measures go beyond the obvious lifestyle protocols of a healthy diet, adequate exercise, stress management, and avoidance of tobacco and alcohol; there are now numerous medications and treatments that can proactively correct for factors that might otherwise lead to problems later in life. Early detection, however, is arguably the most important piece of the puzzle.

“Early detection is paramount in any disease, but especially cardiology,” notes Gardner. “Many things can be prevented or treated before they

become major problems that would need major invasive treatment.”

The technical advances made in screening and imaging theory and practice in the last half-century have profoundly enhanced physicians’ capabilities in this respect. “We are able to recognize things much sooner and treat people with noninvasive methods such as stenting,” Gardner continues. “Even ventricular tachycardia or occluded vessels, which previously would have resulted in a decrease of life expectancy, can be treated with ablation or other [medical or minimally invasive] treatments.”

Vogel concurs: “Early detection of cardiac disease can provide significant benefit to the patient as preventative and treatment strategies can be employed in an effort to limit the progression of disease, hopefully avoiding the need for invasive treatment. For example, aggressive medical therapy with a statin [cholesterol-lowering medication] and

aspirin can reduce the likelihood of heart attacks when detected at an early stage. This diagnosis is often easily accomplished with noninvasive testing.”

Aggarwal explains that coronary calcium scoring/testing, which is a tool frequently employed for detection and diagnostic purposes, is done through a CAT scan and can assess calcium levels, with elevated calcium indicating more active sclerosis and narrowing arteries. “Another way to assess heart issues is the advanced lipid panel analysis,” he adds.

When cardiac illnesses are detected in their early stages via such methods, far more options are available that may not involve the patient ever seeing the inside of an operating room. Indeed, for many, medication alone will be sufficient to keep their conditions at bay.

“As cardiologists, we are able to take advantage of many exciting new pharmaceuticals that have become available based on testing in large clinical trials,” says Vogel. “While some pharmaceuticals are utilized for diagnostic purposes, many new drugs have become available to treat risk factors that lead to coronary artery disease and also to directly treat heart disease itself. There are now a multitude of antihypertensive drugs, multiple classes of cholesterol-lowering drugs, many antiplatelet drugs and thrombolytics. Use of these drugs can often help prevent heart disease and improve or treat the symptoms of heart disease as well as [improve] outcomes of patients with heart disease.”

Gardner agrees: “Even in the past 10 years … new medications have improved life expectancy greatly in people who previously would have had only a couple years to live.”

“There are better side effect protocols and a better handle [overall],” adds Aggarwal, specifically citing PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors, “which have taken on the role to reduce low-density lipoproteins (LDL) with fewer side effects.”

JMC cardiologists (from top left) Dr. James Gardner, Dr. Rahul Aggarwal, and Dr. Craig Vogel utilize diagnostic tools such as CAT scans (left) to conduct coronary calcium scoring/testing.

Although such medications alone have yielded promising results, there are some patients who will require more aggressive and interventional treatment, either in addition to or in lieu of medication. “There are many cardiac conditions that can benefit from a combination of minimally invasive treatment along with medication,” explains Vogel. “Cardiac arrhythmias such as atrial fibrillation are often treated with both [catheter] ablation and antiarrhythmic therapy. Coronary artery disease is also often treated with combined therapy—that is, stent and medication.”

Vogel also points to transcatheter aortic valve replacement (TAVR), a procedure at the forefront of modern surgical techniques in which the damaged valve of the body’s largest artery, positioned deep within the center of the heart, is replaced, in full, through a catheter, without a single chest incision. “The TAVR procedure allows for a minimally invasive replacement of significantly stenotic [narrowed] aortic valves even in patients well into their 90s,” he says. Patients, in other words, whose physical conditions would have precluded their undergoing open-heart surgery.

“Open-heart surgery for aortic valve replacement has been replaced by a procedure that is similar to a stent, with people leaving within a day or two after the procedure,” confirms Gardner. Furthermore, Gardner continues, regarding the ubiquitous coronary artery bypass graft (CABG), “nowadays with the advent of stents, [where] CABG was the

standard, people are sometimes leaving the next day who’d normally be in the hospital a minimum of three to five days.”

Surgery in general, and heart surgery in particular, is trending away from the invasive, life-threatening procedures they have been throughout much of history and toward gentler, intricate, relatively unobtrusive operations that enable patients to go home the very next day instead of weeks post-op. It is tempting to imagine that one day, all surgery will be manageable by such means, but alas, there remain conditions so grave and complicated that open-heart surgery will still be necessary.

“Patients want minimally invasive,” says Aggarwal. “It’s less pain, fewer complications, lower infection rates, and these operations continue to get better, but it will never be just minimally invasive. There will still be a need for open-heart.”

Ultimately, it requires vigilance on the part of both patient and doctor to detect and treat any malady, but especially one involving the organ responsible for powering every other in the body. Even the mildest irregularities within it could eventually cascade into full-blown disease with dire consequences, but with the three-tiered strategy of prevention, early detection, and minimally invasive intervention, it is encouraging to note that many previously lethal cases are becoming far less so.

“Survival rates, in general, are better,” says Aggarwal. “The death rate for heart attacks used to be 50 percent, and now it’s 5 percent.”

“Heart disease is not a death sentence,” explains Gardner. “We have improved longevity and quality of life for patients by leaps and bounds through medications and noninvasive treatments, and things have improved greatly to the point where people are living long and productive lives despite having a diagnosis that would previously have been considered a terminal illness.”

“We’ve come so far,” agrees Aggarwal. “Treatments have evolved so much in the last 50, 60 years. [Cardiac patients] live with chronic conditions, [and we are] attacking it on all fronts: preventative, managing acute and emergent cases, and getting to the point where we are managing it all rather than reacting—or telling people there is nothing that can be done.”

Indeed, something can always be done, and these days the outcome is generally better than one might expect. «

For more information, please call 561.627.3130

“Heart disease is not a death sentence. We have improved longevity and quality of life for patients by leaps and bounds.” —Dr. James Gardner

Nourish FROM WITHIN

Proper nutrition

By Karen Feldman

Though the wisdom to “let food be thy medicine and medicine be thy food” dates to the ancient Greek physician Hippocrates, it remains sage advice for pregnant women of the twenty-first century.

Eating nutritious meals, taking vitamins, and maintaining a healthy weight should start well before pregnancy, says Lisandra Cruz Diaz, a registered dietitian with Jupiter Medical Center.

“Women planning to get pregnant should be within the ideal BMI [body mass index] between 18.5 and 24.9, because when a woman goes into pregnancy at a higher BMI, there’s a higher risk of developing gestational hypertension and gestational diabetes.”

But what constitutes a healthy diet?

“In general, your diet should consist

becomes even more important when pregnant. Here, we outline the information you’ll need to make the healthiest choices to support you and your baby.

of complex carbohydrates, protein, and healthy fats,” Cruz Diaz explains. “That includes whole-wheat bread and pasta; brown rice; starchy vegetables like potatoes, yams, peas, and lentils; lean proteins; vegetables; fruits; low-fat milk; olive oil; and avocado. Rule of thumb is to do three meals a day, even if you do not have gestational diabetes.”

For those who are pregnant or thinking of becoming pregnant, Pinnacle has compiled an easy-to-follow introduction

to how to eat before, during, and after your pregnancy.

Choosing a Vitamin

The American College of Obstetricians and Gynecologists recommends taking a daily prenatal vitamin while trying to conceive and continuing to take it throughout your pregnancy. Pregnant women need 400 mg of folate to help prevent neural tube defects, Cruz Diaz says. Some vitamin brands are better than others in

the way they are available to the body, therefore consult your physician to determine the best one that meets your needs.

The vitamin should also contain choline, DHA, and iron. Iron prevents anemia, but should it cause constipation, find a vitamin with less iron and supplement in another way, such as with meat, seafood, beans, or dark leafy vegetables. The vitamin should also have vitamin D3, which helps the body absorb calcium and promotes bone development, muscle

PREGNANCY NUTRITION 101

A quick rundown of what to know, what to eat, and what to avoid

Weight gain recommendations:

• For a normal BMI of 18.5 to 24.9 pounds: 25 to 35 pounds

• For an underweight BMI of less than 18.5: 28 to 40 pounds

• For an overweight BMI of more than 25: 15 to 25 pounds

Daily nutritional guidelines while pregnant:

• 2 cups fruit

• 3 cups vegetables

• 3 cups milk or dairy products

• 5 to 7 oz. grains, such as whole-wheat bread and pasta

• 5 to 6 oz. protein, with an emphasis on lean meats, low-mercury fish, poultry, eggs, and plant-based protein such as beans, lentils, and nuts

Limit:

• Weekly consumption to 12 oz. or less of shrimp, canned light tuna, salmon, pollock, and catfish

• Weekly consumption of albacore tuna to 6 oz.

Avoid:

• Alcohol

• Excessive caffeine, no more than 200 mg per day

• Raw meat, fish, poultry, or eggs

• Raw, unpasteurized milk or dairy products and soft cheeses

• Raw sprouts

• Unpasteurized fruit juice

• Fish high in mercury, including shark, swordfish, king mackerel, and tilefish

• Uncooked lunch meat

• Herbal teas as some contain herbs that can be harmful, such as black cohosh and licorice root, which can cause premature labor

health, and nerve function for the fetus. Other important nutrients include vitamin A, which supports healthy vision; iodine, which promotes baby’s brain and cognitive development; zinc, which bolsters baby’s immune system, nervous system, and overall development; and omega 3, which supports the development of baby’s retinas and brain.

How Many Calories?

Calorie intake can be broken down by trimester, Cruz Diaz says, but pregnant women should remember that “you don’t have to eat for two.”

In the first trimester, you do not need to add calories. If you are within the 18.5 to 24.9 BMI range, aim for around 1,800 calories per day. In the second trimester, Cruz Diaz advises increasing your intake by 340 calories a day, which can be accomplished by adding a snack that consists of a serving of a protein and a complex carbohydrate. During the third trimester, add another 110 calories (over the 340 added in the second trimester for a total of 450 calories). This can be achieved with a second snack. Whatever your weight, do not aim to lose weight; the time to do that is before getting pregnant.

“It’s important for the mother not to focus on staying skinny throughout the pregnancy; it’s natural for the body to gain weight,” Cruz Diaz notes. “Breastfeeding helps with weight loss due to the energy requirement that utilizes calories to produce breast milk.”

Therefore, after giving birth, should you choose to breastfeed, the Centers for Disease Control and Prevention recommends adding 330 to 400 calories to what you were consuming before pregnancy. “Breastfeeding contracts the uterus after delivery, which helps it get back to its normal size,” Cruz Diaz says. “It will help

burn calories for energy, however, it’s very individual how your body reacts to it,” so the calories burned will vary.

Battling Nausea

Cruz Diaz says nausea generally occurs during the first trimester because of hormonal shifts and should resolve by the start of the second trimester. If it lasts beyond that first trimester, consult your physician, as you may need an antinausea drug to combat it.

One of the best ways to minimize firsttrimester nausea is to eat often: Aim for small meals every two to three hours,

Nutritious Snacks

By combining complex carbs with protein, the body can use the nutrients most efficiently and create a feeling of fullness that will ward off cravings, Cruz Diaz explains. Try these options the next time hunger hits.

• 5 whole-wheat crackers with 1.5 oz. cheese

• 1 tbsp. peanut butter with half a sliced apple

• ½ cup plain yogurt with 1 small piece of fruit

composed of calorie-dense, nutritious foods. High-fiber foods are great options—wholewheat bread or pasta, apples, bananas, oranges, carrots, broccoli, potatoes—as well as protein-rich foods such as eggs, lean meats, yogurt, and peanut butter. In addition, instead of regular sugar, opt for natural sweeteners like stevia.

Foods and Labor

There are lots of myths about what foods induce and facilitate labor. As Cruz Diaz notes, while many of those foods may have health benefits, their purported labor effects are not backed by research. “The only food I’ve found with scientific evidence that [they] helped kick-start labor are dates,” she says. Some studies support the notion that eating dates daily toward the end of one’s pregnancy can reduce the amount of time a woman spends in labor and her need for medical intervention. To try it for yourself, aim to eat either three Medjool dates or six smaller Deglet Noor dates every day during the final weeks of your pregnancy.

Gestational Diabetes

Gestational diabetes occurs when the body cannot produce enough insulin (the hormone that helps cells convert blood sugar into energy) during pregnancy. Not only can it impact the mother, causing symptoms such as fatigue, nausea, excessive thirst, and blurred vision, but babies can be born with breathing problems, at larger weights, and with a higher risk of obesity later in life.

Cravings

It’s no secret that pregnant women can experience cravings for specific foods. Frequently, these cravings occur when a mom-to-be is feeling nauseated yet has a big appetite, so she hungers for what she can tolerate. When this occurs, Cruz Diaz advises not to tell your body no. “It will crave more. So, if you’re craving a Big Mac, go ahead and have it. Just don’t have one every day for nine months. Have it once and feel satisfied.”

In general, when faced with nausea, it’s best to eat solid foods first and then liquids. Also, use trial and error to find out what you can stomach; what might trigger one pregnant woman could be a safety food for another. Try foods individually or blend them into a smoothie. Finally, if nothing else works, eat “whatever you can tolerate,” Cruz Diaz says. “Something is better than nothing. If it’s cake, a piece of bread, or a cracker and cheese, that’s okay.”

There are two methods of testing for this condition, Cruz Diaz explains. The first is a two-step process, in which the mother drinks a liquid containing glucose, then her blood is drawn an hour later. If the results show a blood sugar level of more than 140 milligrams per deciliter, she will be asked to fast for 8 to 14 hours. She will then drink more glucose and undergo blood tests an hour apart for three hours to assess how she processes it. A one-step test requires the mother to fast before having her blood drawn and tested. Then she will drink a liquid containing glucose and her blood will be drawn again an hour later.

Typically, these tests are conducted when the mother is around 28 weeks pregnant. However, those with an increased risk of gestational diabetes or who had the condition in a previous pregnancy will likely be tested earlier.

If you are diagnosed with gestational

diabetes, you will have to carefully manage your blood sugar levels for the remainder of your pregnancy. In most instances, women can keep the condition under control through their diet, though insulin may be necessary in some extreme cases. Regardless of the severity, gestational diabetes goes away after the pregnancy is over.

When tackling how to eat with gestational diabetes, Cruz Diaz recommends consulting a dietitian to determine calorie needs and how to divide up carbohydrates. “Don’t save all your carbs for one meal,” she says. “Distribute them evenly throughout the day.”

She stresses the importance of staying hydrated too. To help you drink more water, consider adding noncaloric flavor enhancers such as fruit and citrus. Limit 100 percent fruit juice to 4 ounces per day and avoid sugar-heavy beverages. Also, always carry a lunch bag with snacks, even if you don’t have diabetes. Include an apple, nuts, cheese sticks, dried fruit

(no sugar added), and popcorn. And remember: Be sure to eat a carb and protein together.

Promoting Lactation

Once the baby arrives, it’s time to think about breastfeeding. At Jupiter Medical Center, new mothers whose babies have a NICU stay are served a “Milkin’ Cookie” that contains flaxseed, chia seeds, and oatmeal, all of which help increase the hormones needed to produce breast milk.

After returning home, don’t worry about adding certain foods to your diet, says Cruz Diaz, but instead focus on continuing to eat a well-balanced diet and drinking plenty of water, around 128 ounces per day.

Most importantly, check in with yourself regularly and monitor your own well-being. “Every woman is built to breastfeed,” Cruz Diaz notes. “Mom has to eat well, sleep, and keep stress under control. It’s not just what she eats, but how she is feeling.” «

“Mom has to eat well, sleep, and keep stress under control. It’s not just what she eats, but how she is feeling.“

PUTTING OUT THE FIRE

How PSMA is transforming the treatment of prostate cancer

By K.S. Meyer

The majority of prostate cancers will express the prostate-specific membrane antigen (PSMA), a biomarker that is helping oncologists better understand and treat the disease.

he biggest question with prostate cancer is, ‘Are you going to die with prostate cancer or from prostate cancer?’”

Such a comment might take someone aback, but when an expert medical oncologist makes it, it can be especially unsettling—at least at first. Upon further discussion, however, it reveals itself as not so much a lamentation as an exhortation for early and decisive action.

“The most common [cancers] that we come across are breast, prostate, lung, and colon, and certainly as men live longer and stay healthier longer with good health care, we’re more at risk for developing [prostate cancer] later in life,” says Dr. Adam Kotkiewicz, program leader of genitourinary and hematologic cancers at Jupiter Medical Center and the aforementioned expert medical oncologist. Even as lifespans

elongate, the seeming inevitability of prostate cancer is no cause for despair, so long as men pay adequate attention to signs of trouble.

As with all cancers, those of the prostate fall somewhere on a spectrum from “indolent” to “aggressive.” Some appear quietly, over considerable time, and present relatively little risk to the patient even if untreated, while others arrive rather dramatically, seemingly out of nowhere, and quickly progress to metastatic, life-threatening disease. Even more confounding is the sad truth that the former can happen to a man in his 90s and the latter to a man in his 50s.

With so many variables at play, the task of diagnosing and treating prostate cancer is daunting at best. In years past, it has been particularly cumbersome. “Typically, if someone had an intermediate or high-risk prostate cancer, we’d want to know if it progressed outside

the prostate or if it was still localized to the prostate,” says Kotkiewicz. “We would do a CAT scan and a bone scan, which would pick up a lot of larger, obvious sites of disease outside of the prostate gland, but it wasn’t as accurate as we would like it to be.”

Part of this systemic shortfall was due to the limited nature of one of the most well-known biomarker tests for prostate cancer: the PSA, or prostate-specific antigen. “The PSA is a marker that you can find in the blood,” Kotkiewicz explains. “It’s basically a protein that most prostate cancers secrete.” Essentially, it identifies the presence of cancer in the body, but doesn’t specify where the cancer is. Recent studies and use of the prostate-specific membrane antigen (PSMA) based PET scans have shown great potential for closing this gap.

As Kotkiewicz describes, roughly 80 to 90 percent of prostate cancers will express the PSMA, and radiologists are able to administer dyes during PET scans that can attach to this “door” on the cancer cell and it will illuminate on imaging. “It’s a much more sensitive test because you not only see the anatomy in the images, but you see color that lights up when it attaches to the membrane protein, the antigen.”

In other words, whereas general CT scans and bone scans previously could only determine the presence of smoke, PSMA scans can better pinpoint the exact location of the fire.

The importance of this in putting together a course of treatment cannot be understated. With this advancement, oncologists can better determine who is better suited for locally directed prostate treatment and those who should go on systemic treatment.

To return to the fire analogy, locating and putting out the embers that have floated off and landed elsewhere is every bit as important as putting out the original fire. Indeed, as with all metastatic cancers, the secondary sites usually are more noteworthy than the original neoplasm in that they are diffuse, quite small, and can be even more difficult to locate.

Often the first indication of metastasis in prostate cancer is a PSA that begins to rise again after an

initial, localized treatment. “You shouldn’t see a rising PSA after you’ve had your prostate cancer out, and you shouldn’t see it rise after you’ve had radiation,” observes Kotkiewicz. “Before, we would do CAT scans and bone scans and not see anything, but we’d know the PSA is rising. … The PSMA can help pick up areas of disease that you may be able to treat locally, where before you might not have been able to find them.”

Once the sites of metastasis are located, the care team can make important decisions regarding how to proceed. Combined androgen blockade therapy is now the mainstay.

“What we’re starting to do now, for those with high-risk disease and treated with localized radiation and for those with metastatic disease, we not only use the hormone suppression shot, but also a secondary pill that blocks the little bit of additional hormone that’s produced by the adrenal gland or other areas of the body,” explains Kotkiewicz. “We’re using what’s called a combined androgen blockade, so you’re doing the shots to block the major part of testosterone production, but then these pills that you take once or twice a day block the remaining bit of it.” Short courses of chemotherapy prior to or at the same time as enhanced hormone suppression may still be necessary, he acknowledges, but currently that step is reserved for the most advanced cases of metastatic prostate cancer.

Another treatment option being explored for metastatic prostate cancer involves utilizing the very biochemical properties of PSMA that make sites of metastasis visible to radiologists. In this scenario, the same mechanism that causes a cancerous nodule to show up in a PSMA PET scan becomes a target and binding site for medicines designed to destroy it. To accomplish this, oncologists are utilizing a drug called Pluvicto, which Kotkiewicz describes as essentially a liquid radiation.

“If you have metastatic disease, your PSMA lights up in all the different areas,” he continues. “This drug, which is given once every six weeks, is infused, and it binds to everywhere that scan lit up and delivers a payload of radiation to each one of those spots.” The remnants of the radioactive medication that do not bind to any cancerous spots are then passed in the urine, minimizing detrimental side effects to the rest of the body.

However, as Kotkiewicz notes, there are two caveats: Pluvicto is currently only approved for use after a patient has had chemotherapy and it failed, and the patient’s PSMA scan must have a lot of activity. For

PSMA scans (left) can more acurately identify where prostate cancer has metasthesized, thereby informing the best course of treatment.

Dr. Adam Kotkiewicz

the time being, this treatment is reserved for only the most extreme, advanced cases.

As with most cancers, the paradigms for diagnosis, assessment, and treatment have gone from broad to more focused over recent years and decades as theory and technology have progressed, yielding far better results for patients. Instead of only having a biological clue that there is something wrong somewhere (PSA), we now have a method of determining this and finding out exactly where the problem is at the same time (PSMA scan). Instead of flooding the body with chemotherapy or radiation or surgically castrating the patient, we now have far gentler hormone suppression therapies—which can be enhanced to provide additional protection against current and future metastases—as well as methods of introducing agents harmful to cancers but harmless to the

rest of the body’s cells.

These advancements are no reason for complacence: Prostate cancer can still kill, and a great deal of whether or not it will depends upon when it is spotted, how accurately it is located and assessed for aggressiveness, and how thoroughly it is treated.

“If you have a high-risk cancer and it’s already spread to the other organs, it could be a five-year survival of 30 percent or so,” says Kotkiewicz. “Whereas if you have a low-grade cancer and it’s spread, your five-year survival could be 70 or 80 percent. It really depends on how it presents, the nature of the cancer, and the individual.”

While some of that may fall to chance, early detection through appropriate screening remains the most important measure men can and should take to increase the likelihood of a beneficent prognosis. “There’s not a reason not to get screened,” Kotkiewicz concludes. “Colon cancer [when] caught early can be removed before it becomes an issue. Same thing with prostate cancer, but the only caveat with prostate cancer is, even though you find it, you might not do something about it right away. It all depends on that risk. Knowing it’s there and treating it before it becomes a problem is important.” «

For more information, please call 561.263.4400

“The PSMA can help pick up areas of disease that you may be able to treat locally, where before you might not have been able to find them.”

Carrying the Torch

Ross Levine keeps his grandparents’ legacy alive through their family foundation

By Heather Graulich

Sometimes, it’s the unexpected path that fills a life with purpose and provides new opportunities to use one’s unique talents in meaningful ways.

That’s exactly what happened to Ross Levine. He had been studying in Tel Aviv, Israel, having earned a master’s degree in Middle Eastern history and working on another in Arabic, when family circumstances presented an intriguing choice: continue his studies or pivot to lead the Chleck Family Foundation, a philanthropy started by his grandparents, David and Gladys Chleck.

The Boston native chose the latter. Through his work alongside his mother, Mara Levine, aunt Risa Chleck, and other relatives, he now oversees the grant-making entity as its president and executive director at the foundation’s Massachusetts headquarters.

“Having been a graduate student and working at a research center, I felt comfortable speaking to faculty and professors in different fields and learning how the funding structures for their projects work,” Levine says. “It’s exciting in that we can take the foundation in different directions. I can read about something and use the critical thinking and research components of my background to analyze new grants and projects.”

Among the Chleck Family Foundation’s gifts to medical and educational causes since its founding in 2014 have been grants totaling $600,000 toward continuing education and training for Jupiter Medical Center’s physical therapy, rehabilitation, and nursing personnel. The foundation also gave a one-time gift in March 2020 to support the hospital’s COVID Relief Fund, providing for enhanced personal pro-

tection equipment and other critical needs.

The Chleck family’s ties to the hospital go back many years. David and Gladys Chleck split their time between Boston and Jupiter for nearly four decades, spending the last 10 years of their lives enjoying the warm Florida climate full-time.

“They were very much a unit, very close,” Levine says of his grandparents. “They passed in 2017 within three months of each other after being married for more than 60 years. They were of their generation, more formal and conservative, dressing for cocktail hour and dinner and that sort of thing. My grandmother was social and glamorous. Grandfather was work-centric and serious. But he had sales offices in Asia and Europe, and they loved to travel and share stories of their adventures.”

As health issues arose late in life, the couple received superlative care from the team at Jupiter Medical Center, Levine notes. “My grandmother spent a significant amount of time there, in the advanced nursing wing and also for physical therapy,” he adds. “The quality of care and the commitment of the therapists and nursing team really helped extend her life. They both lived to be 90 and they received excellent care.”

Levine’s grandfather achieved his business success as the co-founder of Panametrics, a company that produced process control instrumentation, such as flow and humidity meters, for commercial and industrial applications

that was later acquired by General Electric. This achievement had its roots in David Chleck’s early life growing up in New York City.

“The challenge for the foundation is narrowing the focus and mission,” Levine explains. “We looked at my grandfather’s life experiences and used those as the guiding principles. He was born in the Bronx, the child of Eastern European immigrants, and studied for free at City College of New York in the 1940s. For those who could pass the entrance exams, it was an engine for upward mobility.”

Chleck’s higher education changed the course of his life, so Levine and Chleck’s other surviving relatives strive to preserve that legacy through the foundation’s gifts toward education. The philanthropy offers scholarships to undergraduates as well as graduate fellowships at Boston-area universities.

“Another important principle of my grandfather’s was research and development,” Levine says. “We’ve interpreted that with gifts toward R&D in the medical and health care fields. We have a cancer research fellowship and other medical research projects at Bostonarea hospitals, along with the educational support for Jupiter Medical Center.

“Ultimately, these projects become an investment in human capital and helping people gain additional education and training that they’ll bring back to the community. We felt there was this great infrastructure at Jupiter Medical Center, and this investment strengthens that.”

Levine and his wife, Dana, an architect, often travel to Jupiter with their 3-year-old son to visit extended family, and Levine reflects on how his grandparents’ medical needs as they aged expanded his empathy and support for quality senior health care. “Jupiter has changed and has more families and young people, but seniors still represent a large segment of the population of the community,” he notes. “We really wanted to give back and strengthen nursing and therapy so seniors can age gracefully and extend their lives.” «

Showing Gratitude

Through the Jupiter Medical Center Foundation’s “Honor a Caregiver” program, grateful patients and their loved ones can make donations in recognition of caregivers who have gone above and beyond. This support aids the hospital in its mission to provide world-class care to the community and expand its footprint, facilities, and technology.

This year’s “Honor a Caregiver” recipients include:

Dr. Robert Biscup

Dr. Christopher Boyes

Dr. Debra Brandt

Pamela Canter, RN, BSN Cardiac Rehab Team

Dr. Christopher Boyes Alysha Tennant, RN

PHOTOGRAPHY BY STEVEN MARTINE

Patricia Coates

Widline Colas

Krista Coquillette

Dr. Mark L. Corry

Jennifer D’Agostino

Donor Relations Team

Emergency Department

Elizabeth Enriquez

Dr. Jeffrey S. Fenster

Fourth Floor Telemetry Nurses

Dr. Lee A. Fox

Alicia Frith, RN

Dr. Kenneth Fuquay

Cynthia Garcia, RN

Kathy Gavin, APRN

Dr. William Gustave

Osiris Hernandez

Ketlie Jerome, RN

Dr. Arthur Katz

Dr. K. Adam Lee

Margaret W. Niedland Breast Center

Dr. Elisabeth McKeen

Dr. Michael D. Milstein

Dr. James P. Mullen

Annett Oliver

Dr. Daniel E. Peters

Dr. Donna M. Pinelli

Dr. Morgan R. Poncy

Dr. John A.P. Rimmer

Austyn Scotten

Second Floor Orthopedics Nurses

Dr. Henry Shapiro

Ann Sias, RN

Dr. Ryan Simovitch

Linda Sousa, RN

Terry Staggs, RN

Christine Targett, RN

Alysha Tennant, RN

Dr. Nathan Tennyson

Third Floor PCU Nurses

Dr. Edit Tolnai

Dr. Al Ventzek

Dr. Craig D. Vogel

Dr. Jack Waterman

Marie Weaver, RN

Dr. Morgan R. Poncy

Krista Coquillette

Fourth Floor Telemetry Nurses

Marie Weaver, RN

Dr. Debra Brandt

Dr. Robert Biscup

Austyn Scotten

Dr. Craig D. Vogel

Margaret W. Niedland Breast Center Team

Third Floor PCU Nurses

Osiris Hernandez

Pamela Canter, RN, BSN

Dr. Donna M. Pinelli

Patricia Coates

Dr. William Gustave

Elizabeth Enriquez

Dr. Jack Waterman

Second Floor Orthopedics Nurses

Donor Relations Team

Jennifer D’Agostino

Dr. Jeffrey S. Fenster

Kathy Gavin, APRN

Widline Colas

Dr. Henry Shapiro

Dr. Mark L. Corry

Emergency Department Team

Annett Oliver

Dr. Michael D. Milstein

Dr. John A.P. Rimmer

Dr. Arthur Katz

Dr. Nathan Tennyson

Cardiac Rehab Team

Dr. Al Ventzek

Terry Staggs, RN

Dr. Lee A. Fox

Dr. K. Adam Lee

Linda Sousa, RN

Dr. James P. Mullen

Dr. Daniel E. Peters

EVENT PHOTOS

ELEVENTH ANNUAL HIGHBALLS & HIBISCUS

September 24, 2022

Eau Palm Beach Resort & Spa, Manalapan

Chris and Anne Battifarano, Laura and Paul Blatz

Brian and Courtney Hickey, Justin and Aliyah Howard

Brad and Kerry Stangis, Mark and Katie Anderson

Bill and Melissa Lazarchick, Jessica and Nicholas Mastroianni III

Steve Mierley, Jody Oliver, Alyssa and Matthew Oliver

Christy Holmes and Gerhard Jakits

Linda Walker, Steve and Katherine Pinard

Nicholas Mastroianni III, Dr. Amit Rastogi, Rich Nestro

Emily Cortez, Al-Alim White, Brian and Katie Trappy, Leigha Taber, Kimi and Jason Mercer

Patty and John McDonald

FORTY-THIRD ANNUAL CHARITY GOLF CLASSIC November 14, 2022

Emerald Dunes and Lost Tree Golf Clubs, North Palm Beach

Tommy Hutton, Ed Frankel, Keith Frankel, Elliott Schnier, Russell Bourne, Joel Girsky

Jeff Knight, Jaye Marie Greene, Brad Ball, Andrew Knight

Russell and Lauren Fuchs, David Sherman

Harvey Golub, Jeff Fisher, John Seifert, Leta Lindley, Peter Miller

Fred Harkness, Traci Simonsen, Brad Faxon

Johnathan Peavy, Ken Kunde, Richard Johnson, Heith Comer, Jason Mercer Drew Stoddard, John Merola, Michelle McGann, Rick Stoddard, Rick Rizzuto

George and Sally Strudley, Joe Grohman, Rhonda and Mark Sandridge

Matt Weis, Dr. K. Adam Lee, Tom Fazio, Gavin Fazio

Donna Perkins, Jayne Donahue, Dr. Amit Rastogi, Linda Edelman, Peggy Briggs

Justin Howard, Ryan Smith, Brad Faxon, Dustin Ballard

Steve and Carolyn Haggerty

David and Colleen Waters

EVENT PHOTOS

LIGHTHOUSE LEGACY LUNCHEON

December 15, 2022

Old Marsh Country Club, Palm Beach Gardens

Traci Simonsen, Peggy Katz, Mary Roff

Rose Marie Morton

Jennifer Amarnick, Scott Pittenger, Traci Simonsen, Pam Canter, Bruce and Lori Abel

Dennis Puskaric, Michelle Linen, Dr. Barbara Millen

Jim Felcyn and Louise Brien Felcyn

Terri and Curtis Francisco

Carole and Robert Hartless II

Betty Jakubowicz and Richard Esack

James and Marie Ross

George and Kathleen Damman

OLD MARSH COMMUNITY RECEPTION

January 10, 2023

Old Marsh Country Club, Palm Beach Gardens

David Dunfee, Tom Arenz

Stephen and Gabrielle Demeritt

Peter and Elaine McCombs

Kerry and Denise Haigh

Bruce and Corrine Qvale, Richard Taylor

Linda and Edward Edelman

Karen Fisher, Nancy Kyle

Michelle Russell Johnson and Neil Johnson

Suzy and Robert Butterworth

Dr. Amit Rastogi, Jayne and Tim Donahue TRACEY BENSON PHOTOGRAPHY

EVENT PHOTOS

CLUB COLETTE LUNCHEON

January 18, 2023

Club Colette, Palm Beach

Jim and Gaye Engel

Tom and Carol Kirchhoff

Steven and Katherine Pinard

Virginia and Richard DeAgazio

Dr. Jessica Schwartz, Dr. Amit Rastogi, Traci Simonsen, Dr. Rogerio Lilenbaum

Penny and Alan Murphy

Daniel Drennen, Suzanne Cameron, David Sarama

Henry and Barb Miller, Dr. Amit Rastogi, Lee and Jeff Alderton

Emily Koufis, Herbert Roemmele

Marlene and Ron Jaffe

LOXAHATCHEE CLUB COMMUNITY RECEPTION

January 19, 2023

The Loxahatchee Club, Jupiter

Susie and Barney LaPorte

John and Maria Giamartino

Frank LaRose, Dorothy Marziotto

Debbie and Joe Norberg

George and Kathe Damman

Barbara and Tom Cole Lynn and George Bovenizer

Dominic Pileggi, Dr. Amit Rastogi

Judy and Al Pasquale

Gil Walsh and John Johnston

EVENT PHOTOS

JONATHAN’S LANDING COMMUNITY RECEPTION

January 26, 2023

William O’Donnell, Mary Morrissey, Jim Messersmith, Bill Morrissey

Shirley Babington, Dr. Amit Rastogi, David and Charlotte Nicholson

Barbara and Lawrence Green

Phil Clark, William Tommasino

Andrew and Paula Dulski, Siegfried Buschman, Clay Haferkamp

Traci Simonsen, David Nicholson

Dr. Amit Rastogi, Dr. Jessica Schwartz, Dr. John Rimmer, Dr. Rahul Aggarwal

Jo Ellen and Michael Lampos

Ed Babington, Dr. Lee Fox, Brian Poissant

John and Marlene Canzio

Jonathan’s Landing Golf Club, Jupiter

February 1, 2023

Michael Ruane, Dr. Amit Rastogi

Johnny and Terry Gray

Terry Gray

Katherine and Steven Pinard

Nicholas Mastroianni III, Dr. Amit Rastogi, Nicholas Mastroianni II

Diane Perrella, Lyn Ianuzzi, Peggy Katz

TRACEY BENSON PHOTOGRAPHY

JOHNNY AND TERRY GRAY SURGICAL INSTITUTE TOPPING-OFF CEREMONY

Jupiter Medical Center

EVENT PHOTOS

LEADERS IN PHILANTHROPY

February 8, 2023

Pelican Club, Jupiter

Lynn and George Bovenizer

Mike Smith, Peter Lund, Hank DesPlaines

Marty and Tesa Dytrych, Mona Morello and Dr. Dan Morello

Terry Gray, Dr. Amit Rastogi, Johnny Gray, Lynda and Rick Stoddard

Suzanne Niedland, Dr. Amit Rastogi, Mimi and Frank Walsh

James Korman, Sally Korman, Cynthia and Vincent Pellerito

Dr. George Stechel and Michael Stechel

Peter Crisp and Suzanne Niedland

Peggy Katz, Doug and Ann Brown

Roseanne and Dennis Williams

LOBLOLLY COMMUNITY RECEPTION

February 9, 2023

Loblolly, Hobe Sound

Carolyn Jacobus, Carolyn Keller

Lori Katz and Dr. Arthur Katz

Sally and Kelly Simpson

Mabel Bogel, Dr. Jessica Schwartz

Larry and Jody Carlson

Susan and Ken Neilson

Diane Muccia, Louise Sanborn, Elizabeth Pile

Dr. John Rimmer, Don McCree, Dr. Amit Rastogi

Lucy and Walter Stackler, Adrienne Peacock, Don McCree

Traci Simonsen and Doug Means, Sally and William Sheldon

EVENT PHOTOS

ADMIRAL’S COVE COMMUNITY RECEPTION

February 16, 2023

Admiral’s Cove, Jupiter

Alan and Debbie Titelbaum

Alene Alper, Ann Wimpfheimer, Jacquie Snlifka, Linda Frankel

Priya Rastogi and Dr. Amit Rastogi, Dr. Amratlal Patel and Purnima Patel

Lori Katz, Leonard Abramson

Loretta and Joe Lopez, Rebecca Divine

Kathy and David Rohrer

Mary Beall and William Applestein

Marlene Hewitt, Bill and Ellie Cohen

Larry and Becky Stern

Jodi Butler, Ed and Cindy Giambastiani

FRENCHMAN’S CREEK MEN’S HEALTH DAY CHECK PRESENTATION BENEFITING THE JOHNNY AND TERRY GRAY SURGICAL INSTITUTE

December 14, 2022

Frenchman’s Creek Beach & Country Club, Palm Beach Gardens

Mile Tucker, Bernard Herman, Stephen Weinberg, Avroy Fanaroff, Rocco Panzitta, Dr. Amit Rastogi, Michael Morgan, Gilbert Hollander

THE LOXAHATCHEE CLUB FRIENDS OF JUPITER MEDICAL CENTER GOLF TOURNAMENT CHECK PRESENTATION BENEFITING THE JOHNNY AND TERRY GRAY SURGICAL INSTITUTE

January 12, 2023

Jupiter Medical Center

PETROCELLI EMERGENCY CENTER RIBBON CUTTING

January 26, 2023

Jupiter Medical Center

Dr. Amit Rastogi, Matt Lucchesi, Dan Myers, Dr. John Kowalczyk, Traci Simonsen

Marty Dytrych, Peter Lund, Michael and Jill Lamoretti, Dr. Amit Rastogi, Beverly and Attilio Petrocelli, Traci Simonsen, Melissa and Michael Weinbaum, Daniel Register, Dr. Vishal Gulati, Jennifer Amarnick

KAIT WATSON

Ready for Battle

IN HER WORDS

It’s like a gunshot going off in your mind when you first hear the words, “You have cancer.”

In my case, it was more than two frustrating months after first finding a lump that I got the official diagnosis: triple-negative invasive ductal carcinoma, a generally aggressive form of breast cancer. But I’ve refused to let it define or derail me.

With the examples set by my amazing mother and father—both of whom have already beaten cancer once—and the excellent care provided by Jupiter Medical Center, I’m already on my way to beating cancer, too, and hopefully setting an example for others facing a similar fight. As devastating as the news can be, you can beat it, especially if you catch things early and act promptly.

In December I underwent a double mastectomy with Dr. John Rimmer, the same surgeon at Jupiter Medical Center who performed the same procedure on my mother about 10 years ago. That followed five-and-a-half months of chemotherapy under the care of Dr. Debra Brandt, whose passion for patient care makes me feel like I’m not just another number or case study but a real person.

Sometime around my thirty-fourth birthday in September I’ll have reconstructive surgery with Dr. David Lickstein. The results I’ve seen for other women are nothing short of inspiring.

I also am indebted to Dr. June Lee of Breast Specialists of South Florida. After I spent more than two months running in circles medically, Dr. Lee was the first to cut through the speculation about what I might be facing, perform a biopsy, and give me a diagnosis. Rather than refer me out, she took action. From there, I chose Jupiter Medical Center based in part on how pleased my mother was with the results of her surgery a decade ago with Dr. Rimmer.

Amid my medical journey last year, my mother unfortunately was diagnosed again with breast cancer. After having noninvasive cancer limited only to the milk ducts and not within the surrounding tissue the first time, my mother now has the same type of triple-negative, generally aggressive breast cancer that I have. But she is already tackling it with the same positive outlook she had last time.

Genetic testing, by the way, came back negative for my mother and myself 10 years ago and did so again last year in two different panels of tests. We just don’t have answers there.

What we do have is our refusal to be derailed by cancer. With the right help, you can beat it too.

As told to Seth Soffian

Excellence in Pediatric Specialty Care is Always Close By

As part of our commitment to bring world-class, compassionate care to where the children are, Nicklaus Children’s has further expanded in Martin and Palm Beach counties. We provide specialty appointments, diagnostics and imaging services, rehabilitation and walk-in urgent care (services vary by location).

For locations near you please visit nicklauschildrens.org/locations