Advances | Tampa General Hospital | West Coast Spring 2024 by Palm Beach Media Group

ADVANCES THE ACADEMIC DIFFERENCE

WORLD-CLASS INNOVATION TGH PERFORMS ITS FIRST LIVING-DONOR LIVER TRANSPLANT

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SPRING 2024

CONTENTS Departments FORWARD 08 GROWING THE FUTURE Q&A with John Couris, president and CEO of Tampa General Hospital 10 DREAMING OF SLEEP? Are you and your partner in a sleep divorce as a result of snoring? TGH is home to the largest multidisciplinary sleep center in Florida 12 ACCLAIM FOR CANCER INNOVATIONS The TGH Cancer Institute is a national leader in oncological treatment, research, clinical investigation, and continuum of care 14 BOOSTING SURVIVAL RATES New frontiers in multiple myeloma treatment offer hope

WELL-BEING 58 NOURISH THE BODY & SOUL Boost your energy and improve digestion with these plant-based recipes that are easy to make 64 GOOD VIBRATIONS Eco-friendly wellness gear

22 MEETING THE MENTAL HEALTH CHALLENGE TGH’s freestanding Behavioral Health Hospital will be the only one of its kind in Florida 28 THE NEXT ERA OF INNOVATION AI-powered programs are saving precious time for physicians and helping lead to quicker diagnoses 32 GROUNDBREAKING PROCEDURES & TREATMENT ADVANCES The TGH Heart & Vascular Institute ranks among the top 10 percent nationwide 36 LIFE & LIMB The new TGH Limb PreservationPeripheral Arterial Disease Program helps to prevent lifealtering amputations 38 FOCUS ON WOMEN’S HEALTH Expanded obstetrics and gynecology services and treatments make the TGH Women’s Institute one of the top facilities in the nation 42 A QUICK TRIP TO EXPERTISE A kidney removal is placed in TGH’s trusted hands

Features

44 SPOTLIGHT ON A MYSTERIOUS MALADY Learn about cardiac sarcoidosis and how it led to a heart transplant and documentary

16 THE WAIT IS OVER TGH Transplant Institute’s livingdonor liver transplantations allow patients to live fuller lives today

50 NOURISHING GIFTS Go inside the new neonatal Milk Lab, made possible by a generous DeBartolo Family Foundation gift

ON THE COVER: Dr. Kiran Dhanireddy, Vice President, Chief of the TGH Transplant Institute and Surgical Director of the Comprehensive Liver Disease & Transplant Center, TGH Transplant Institute

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I N N O VAT I V E S E R V I C E L I N E S

MEET OUR LEADERSHIP Ambulatory Services

Daron Diecidue, MD

Chief of TGH Ambulatory Services

Cancer Institute

Abraham Schwarzberg, MD Chief of Oncology

Eduardo Sotomayor, MD

Executive Director of the TGH Cancer Institute

Richard Tuli, MD

Deputy Director, TGH Cancer Institute

Dermatology Institute

James M. Grichnik, MD, PhD

Chief of the TGH Dermatology Institute

Digestive Diseases Institute

Christopher DuCoin, MD, MPH, FACS

Chief of the TGH Digestive Diseases Institute, Surgery

John Jacobs, MD

Interim Chief of the TGH Digestive Diseases Institute, Medicine

Ear, Nose & Throat Institute

Tapan Padhya, MD

Chief of the TGH Ear, Nose & Throat Institute

Endocrinology Institute

Jeffrey Krischer, PhD

Chief of the TGH Endocrinology Institute

Enterprise Imaging

Krishna Nallamshetty, MD

Chief of TGH Imaging, Diagnostic Radiology

Bruce Zwiebel, MD

Chief of TGH Imaging, Interventional Radiology

TGH-USF Health Office of Clinical Research

Clifton Gooch, MD

Co-VP of Clinical & Translational Research

Abraham Schwarzberg, MD

Heart & Vascular Institute

Benjamin D. Mackie, MD

Interim VP & Chief of the TGH Heart & Vascular Institute, Medicine

Murray Shames, MD

Interim Chief of the TGH Heart & Vascular Institute, Surgery

Hospital at Home

Joanna Barris, DO

Medical Director of TGH Hospital at Home

Neuroscience Institute

Clifton Gooch, MD

Chief of the TGH Neuroscience Institute, Neurology

Harry van Loveren, MD Chief of the TGH Neuroscience Institute, Neurosurgery

Orthopaedic Institute

Roy Sanders, MD

Chief of the TGH Orthopaedic Institute

Transplant Institute

Kiran Dhanireddy, MD, FACS

VP & Chief of the TGH Transplant Institute

Trauma Institute

Jose J. Diaz, MD

Chief of the TGH Trauma Institute

Urology Institute

Raviender Bukkapatnam, MD Co-Chief of the TGH Urology Institute

Rafael Carrion, MD

Co-Chief of the TGH Urology Institute

Women’s Institute

Judette Louis, MD, MPH

Chief of the TGH Women’s Institute

Muma Children’s Hospital

Patricia Emmanuel, MD

Chief of the Muma Children’s Hospital at TGH

Co-VP of Clinical & Translational Research

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1 Tampa General Circle Tampa, FL 33606 813.844.7000 • TGH.org

John Couris, President and CEO, Tampa General Hospital BOARD OF DIRECTORS Drew A. Graham, Chairman of the Board Marylou Y. Bailey Kimberly A. Bruce Raviender Bukkapatnam, MD

Kenneth A. Burdick Blake J. Casper Gregory J. Celestan Phillip S. Dingle, Immediate Past Chairman

Gordon Gillette Oscar J. Horton Patricia Jurinski T. Corey Neil Debbie A. Rinde-Hoffman, MD

Murray L. Shames, MD Chief of Staff Bruce Zwiebel, MD

EXECUTIVE LEADERSHIP TEAM Scott Arnold, Executive Vice President & Chief Digital and Innovation Officer Stacey Brandt, Executive Vice President & Chief Administrative Officer Peter Chang, MD, Senior Vice President & Chief Transformation Officer Kelly Cullen, Executive Vice President & Chief Operating Officer Wendi Goodson-Celerin, DNP, APRN, NE-BC, Senior Vice President & Chief Nursing Executive Jennifer Crabtree, Vice President of Corporate Communications & Chief of Staff, Office of President & CEO Robin DeLaVergne, Senior Vice President, External Affairs Peggy Duggan, MD, Executive Vice President, Chief Physician Executive & Chief Medical Officer Rachel Feinman, Vice President of Innovation & Managing Director, TGH Ventures Qualenta Kivett, Executive Vice President, Chief People & Talent Officer Jim Kennedy, General Counsel Charles J. Lockwood, MD, MHCM, Executive Vice President and Chief Academic Officer, Tampa General Hospital; Executive Vice President, USF Health, Dean, USF Health Morsani College of Medicine Frann M. Leppla, Senior Vice President & Chief Philanthropy Officer, TGH Foundation Mark Moseley, MD, MHA, CPE, Executive Vice President & President, USF Tampa General Physicians Mark Runyon, Executive Vice President & Chief Financial Officer Abraham Schwarzberg, MD, Executive Vice President, Chief of Oncology & President of the Tampa General Provider Network (TGPN); Vice President, Clinical & Translational Research, TGH-USF Health Joint Office of Clinical Research Steve Short, Executive Vice President & Market President, TGH North Adam Smith, Executive Vice President & Chief Ambulatory Care Officer

SHARED PURPOSE We heal. We teach. We innovate. Care for everyone. Every day.

VISION We will become the safest and most innovative academic health system in America.

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MORE BREAKTHROUGHS, BETTER OUTCOMES

FUELED BY ACADEMIC MEDICINE

Tampa General Hospital and the USF Health Morsani College of Medicine drive innovation. Every day.

For more than 50 years, our team of world-renowned researchers, doctors and pioneers in the medical field has partnered to deliver game-changing medicine. Through our focus on research, innovative treatments and clinical trials, we provide patients with lifesaving medical breakthroughs and groundbreaking care. That’s how we define medicine.

TGH.org Florida’s Leading Academic Health System For Over 50 Years

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THE ACADEMIC DIFFERENCE Publisher Terry Duffy Director of Sales Deidre Wade Associate Publisher Dina Turner Editorial Director Daphne Nikolopoulos Editor Cathy Chestnut Creative Director Olga M. Gustine Senior Art Director Ashley Meyer CONTRIBUTING EDITORS Stacey Brandt, Laurie Slater, Jennifer McVan, Tom Zebold, Beth Hardy CONTRIBUTING WRITERS Jules Aron, Eric Barton, Robin DeMattia, Karen Feldman, Sandra Gurvis, Kelley Marcellus, K.S. Meyer, Dave Scheiber, Liza Grant Smith, Seth Soffian CONTRIBUTING PHOTOGRAPHERS Cara DeHart Lewis, Allison Long, Emily Panakos, Gyorgy Papp, Jerry Rabinowitz, Nick Shirghio, Daniel Wallace ADVERTISING Publisher, Naples Meegan Wyatt Account Managers Kathleen Beuttel, Kathy Breen, Tanya Lorigan 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 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 Omar Greene

In Memoriam Ronald J. Woods (1935-2013) HOUR MEDIA, LLC CEO Stefan Wanczyk President John Balardo PUBLISHERS OF

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CONVENIENTLY LOCATED

NEW, 24/7 ER IN SOUTH TAMPA

Emergency Care from Tampa Bay’s #1 Hospital Tampa General Hospital has expanded our trusted emergency care with the opening of a convenient, new location at the corner of Kennedy and Willow. The TGH Kennedy Emergency Center brings together board-certified emergency medicine physicians and world-class, compassionate care for adult and pediatric patients in a new, cutting-edge facility — 24/7, 365 days a year — with easy access. For more information, visit TGH.org/Emergency OUR EMERGENCY LOCATIONS:

NEW: TGH Kennedy Emergency Center (Freestanding on Kennedy Boulevard in South Tampa)

W. Kennedy Blvd.

S. Willow Ave.

TGH Brandon Emergency Center (Freestanding at TGH Outpatient Center)

S. Oregon Ave.

TGH Emergency & Trauma Center (Davis Islands Main TGH Campus)

W. Cleveland St. Selmon Expy.

TGH.org Florida’s Leading Academic Health System For Over 50 Years

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FORWARD

GROWING THE FUTURE

TGH’s president and CEO discusses the system’s $550 million investment in growing the Tampa Medical and Research District

BY CATHY CHESTNUT

In just five years, Tampa General Hospital has expanded its footprint from 17 to 150-plus locations in the Tampa Bay area and across Central Florida to the East Coast. TGH president and CEO John Couris is executing initiatives prioritized in the ambitious TGH Master Facility Plan. Learn about the accomplishments thus far in the Tampa Medical and Research District, ongoing goals, and its impact on the region, the state, and beyond. Tampa General Hospital is making a significant capital investment in the future of Tampa Bay and health care in this state. What does that look like? We are executing a $550 million capital commitment—our master facility plan—to deliver the most advanced technology and innovative care by creating a growing medical and research district in downtown Tampa. Anchored by Tampa General and the USF Health Morsani College of Medicine at the University of South Florida, the Tampa Medical and Research District is modeled after renowned medical districts in cities like Boston and Houston. It houses an ever-growing hub of world-class clinical care facilities and academic, research, and biotech spaces. We are excited to partner with USF on the district and are engaged in a multi-faceted partnership with the Tampa Bay Economic Development Council to maximize the district’s impact. In the past 18 months, the district has grown to include a freestanding emergency department and the TGH|USF Health Precision Medicine Biorepository. We recently broke ground on the TGH Behavioral Health Hospital. In response to the increasing need for mental health and psychiatric services, the

new hospital will offer a full range of inpatient and outpatient services led by psychiatrists from the USF Health Morsani College of Medicine and raise the level of behavioral health care across the Tampa Bay region. With the new freestanding emergency department and the TGH Rehabilitation Hospital, which opened in May 2022, the TGH Behavioral Health Hospital will cement Kennedy Boulevard as a major artery of the district. In alignment with our new board-adopted fiveyear strategic plan, the TGH Master Facility Plan also includes the construction of the 13-floor Surgical, Neuroscience and Transplant Pavilion on the main hospital campus, which will serve as a platform for the growth of the academic health system’s surgical, neuroscience, and transplant services, adding 144 beds and 32 operating room suites. The pavilion is estimated to be completed in March 2027. What is your goal for the Tampa Medical and Research District? Our goal is to make Tampa Bay an anchor on the health care landscape with the creation of a complete health care ecosystem. We want to create a vibrant, attractive, and innovative hub that will motivate people to move here and start a business or bring to our region the brightest research minds and clinical care providers. We are striving to deliver an environment with a robust infrastructure ripe with collaboration. We are actively working with other sectors, such as private equity and biotech, with a focus on intentional collaboration. We aim to build relationships and leverage our assets to create a collaborative environment where all organizations can thrive and cement Tampa’s reputation and identity as a true health care destination.

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THE DISTRICT IS ALREADY ATTRACTING RENOWNED CLINICIANS AND RESEARCHERS, RESULTING IN INCREASED ACCESS TO EXPERTS, CUTTING-EDGE RESEARCH, EDUCATION, AND TECHNOLOGY FOR PATIENTS AND STUDENTS.”

Today, the possibilities for the district feel limitless. We are on a continuous journey, one that began five years ago, and now we are starting to reach critical mass. We will be constantly developing, growing, and investing in the district. We are looking to engage with new sectors, including our public-school systems and independent schools, as well as museums, aquariums, and the arts and sciences. The district will be a source of constant and ongoing activity. What impact will the district and the facilities created have on the community and the state? How will folks in other communities benefit? The district is already attracting renowned clinicians and researchers to Florida, resulting in increased access to experts, cutting-edge research, education, and technology for patients and students. Once completed, the total economic impact of the district will be more than $6.4 billion annually, including the creation of 41,500-plus jobs, approximately $4 billion in GDP, and $798 million in federal, state, and local fiscal revenues. Additionally, it is estimated that the new Tampa General facilities, once completed, will make a $1 billion economic impact across the region. Individuals across the state will benefit from the work being generated out of the district, such as access to new therapies and treatments and medical devices, or in terms of the ability to seek treatment in world-class facilities or expertise from clinicians in Tampa Bay, particularly for critical or complex cases. Is there anything else you would like to add? The district and the facilities we invest in, along with other recent expansions, including our pending agreement to acquire the Bravera Health network in West Central Florida, represent

our commitment to providing citizens across Florida with increased access to world-class care. Our strategy to leverage strategic public-private partnerships to drive growth and access has resulted in an organizational footprint that has increased from 17 to 150-plus locations in just five years. ADVANCES

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FORWARD

DREAMING OF SLEEP?

BREATHE EASIER

Dr. Tapan Padhya

Dr. Abhay Sharma

ARE YOU AND YOUR PARTNER IN A SLEEP DIVORCE AS A RESULT OF SNORING? HELP IS AVAILABLE AT THE LARGEST MULTIDISCIPLINARY ACADEMIC SLEEP CENTER IN FLORIDA BY CATHY CHESTNUT

Do you remember the first time you slept on the couch or in the guest room because your partner’s snoring was keeping you awake? Are you still there? You are not alone. The National Sleep Foundation says 1 in 10 couples report sleeping in separate rooms due to differing schedules, preferences in temperature, restlessness, and the most common: snoring. Nighttime separation “becomes a problem when it bothers one or both partners. If someone feels like they’ve been kicked out, it causes distress in one partner because

they might think something is not right in the relationship,” said Dr. Abhay Sharma, assistant professor and director of the Division of Interventional Sleep Surgery and co-director of the USF ENT Sleep and Snoring Center at the USF Health Morsani College of Medicine at the University of South Florida. Snoring can be loud, disruptive, or embarrassing, but it may also be a sign of something more insidious: sleep apnea. Apnea is the offand-on cessation of breathing, which can result in a myriad of side effects, including fatigue, heart problems, high blood pressure, metabolic disorder, and Type 2 diabetes. Sharma said it is estimated that about 10 percent of women and 15 to 20 percent of men have sleep apnea, while 40 to 50 percent of people snore. He and his mentor and colleague, Dr. Tapan Padhya, chief of the Tampa General Hospital Ear, Nose & Throat Institute and professor and chairman of the Department of Otolaryngology-Head and Neck Surgery at the USF Health Morsani College of

Medicine, said it’s important for snorers to be medically checked to determine whether they have apnea. Primary care physicians and other types of doctors can make a referral to a sleep specialist. Today, 80 percent of sleep studies are provided in the comfort of home with user-friendly equipment. From noninvasive nasal strips and dental appliances to nerve-stimulation implants and sinus surgery, an array of treatment options for snoring and apnea are customized for each patient, they noted. TGH was an academic test site 14 years ago for U.S. Food and Drug Administration approval for Inspire Sleep, which remains the only approved neurostimulation technology that keeps airways open for patients with obstructive sleep apnea. TGH has the largest multidisciplinary sleep study center in Florida, Padhya said. If you feel like you just cannot get a good night’s sleep, it’s time to investigate the reason. “The only person who knows your quality of sleep is you,” Padhya said.

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EXPANDING TAMPA’S MEDICAL & RESEARCH DISTRICT

INNOVATION, INSIDE AND OUT Introducing Tampa General Hospital’s Surgical, Neuroscience & Transplant Pavilion.

Patients throughout our region and across the state count on Tampa General Hospital (TGH) for cutting-edge research, the latest technologies and innovative approaches to health care, all of which contribute to more lives saved. The new TGH Surgical, Neuroscience & Transplant Pavilion on Davis Islands will reflect that same modern sophistication and exceptionalism that patients experience at TGH. This building will provide 144 beds, state-of-the-art operating rooms, and space for education and training, increasing access to care at one of the nation’s leading academic health systems. Breaking ground in 2024 and opening in 2027, the TGH Surgical, Neuroscience & Transplant Pavilion will be the newest addition to the burgeoning Tampa Medical & Research District.

TGH MAIN CAMPUS

Downtown Tampa & Ybor City

TAMPA MEDICAL & RESEARCH DISTRICT

TGH.org Florida’s Leading Academic Health System For Over 50 Years

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FORWARD

Acclaim for

CANCER INNOVATIONS

RIGHT: Dr. Eduardo M. Sotomayor, vice president and executive director of the TGH Cancer Institute, confers with Dr. Richard Tuli, TGH medical director of radiation oncology and deputy director of the TGH Cancer Institute.

The Tampa General Hospital Cancer Institute is a national leader in oncological treatment, research, clinical investigation, and continuum of care BY SAN D R A GU R V IS

When Dr. Eduardo M. Sotomayor, vice president and executive director of the Tampa General Hospital (TGH) Cancer Institute, arrived at TGH in 2021, his goal was “to help create an innovative, nimble, and compassionate—emphasis on the compassionate—center of excellence in cancer care and research,” he said. Less than three years later, the TGH Cancer Institute is in the top 3 percent of cancer hospitals in the United States, according to Newsweek’s 2023 list of “America’s Best Cancer Hospitals.” In 2022, it earned a three-year accreditation from the American College of Surgeons’ Commission on Cancer and teamed up with the Cancer Center of South Florida to extend the same level of state-of-the-art and compassionate care to cancer patients on Florida’s East Coast.

How did the cancer institute forge ahead so quickly? “It is because of the passion and commitment of our team members at TGH and its affiliated academic partner, the USF Health Morsani College of Medicine at the University of South Florida, as well as the unwavering support from our leaders in both institutions. This partnership has provided the cancer institute with a broad knowledge base and the complementary expertise to make fundamental discoveries that can be rapidly translated to the clinic,” said Sotomayor, now vice president and executive director of the TGH Cancer Institute and a professor in the USF Health Morsani College of Medicine. “We wanted to offer a continuum of care that would focus on the pillars of prevention, diagnosis, treatment, education and training, and community outreach and engagement.

Dr. Eduardo M. Sotomayor

To achieve this goal, we are making a significant investment in cancer research from basic sciences, translational, and ultimately, clinical research. Needless to say, this investment is already paying off and our institute is now a point of destination to receive cutting-edge treatment in, most importantly, a compassionate and supportive environment.” While addressing all types of cancer, the TGH Cancer Institute has focused on complex and rare forms of cancer and has already built a team of leading medical oncologists/hematologists, surgical and radiation oncologists, and

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basic/translational and clinical investigators who have been recruited from top-tier academic institutions nationwide. All of them share the same passion and commitment to bring the best clinical trials to address unmet needs in cancer treatment in the region, state, and beyond. “Because of the sophistication and expertise available at TGH in medical disciplines beyond oncology, we are able to address challenging cases by not only providing complex surgery expertise but also to address any potential complications after surgery,” Sotomayor added.

AMONG TGH’S INNOVATIONS: Establishing the Bone Marrow Transplant and Cell Therapies Unit. This unit offers stem cell transplants and chimeric antigen receptors (CAR) T-cell infusion therapy for complex cancers. Autologous stem cell transplant is a form of high-dose therapy to deepen the overall response and prolong remission in certain types of hematologic malignancies. CAR T-cell therapy is an innovative gene-modified therapy that may help certain types of lymphomas, acute lymphocytic leukemia, and multiple myeloma when other therapies are

not able to control the disease. (See page 14 for “Boosting Survival Rates.”)

tor delivers quick, calculated radiation beams and advanced imaging capabilities.

Creating the TGH | USF Health Precision Medicine Biorepository. This lab collects, catalogs, and stores samples of biological material and facilitates the development of clinical and translational research. Its focus is advancing research into tumor sequencing and precision (personalized) medicine.

Developing a Proton Therapy Center. The most advanced form of cancer-fighting technology available, proton therapy treats cancerous and benign tumors, especially those close to vital or difficult-to-target organs. The development of Tampa Bay’s first center is a collaboration between TGH and the Florida Cancer Specialists & Research Institute.

Establishing a Phase 1 Clinical Research Unit. This unit supports early phase or investigator-initiated clinical trials with novel targeted and/or immunotherapeutic drugs/agents. Providing Innovative Radiation Oncology Options. High dose-rate brachytherapy— delivered internally through applicators placed near the tumor or on the skin— treats many cancers. TGH also introduced a noninvasive alternative to surgery: the fully automated CyberKnife S7, which uses precisely focused radiation beams to treat tumors in the brain, neck, lungs, liver, spine, and other areas of the body in 15 minutes. Also designed to decrease treatment time, the TrueBeam linear accelera-

Our institute is now a point of destination to receive cuttingedge treatment in, most importantly, a compassionate and supportive environment.” –Dr. Eduardo M. Sotomayor ADVANCES

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FORWARD

BOOSTING

SURVIVAL RATES NEW FRONTIERS IN MULTIPLE MYELOMA TREATMENT OFFER HOPE BY SANDRA GURVIS

Like a many-headed hydra serpent, myeloma, or multiple myeloma (MM), can start with the most insidious of symptoms—none at all. When patients experience symptoms, they are non-specific: bone pain in the back, hips or chest; anemia; fatigue; loss of appetite; brain fog; and others. As with many cancers, treatments can be challenging, and until a few decades ago, the survival rate for MM was less than 25 percent. But there is good news that keeps getting better. MM comprises two percent of all cancer diagnoses annually in the United States. In recent years, the survival rate has more

than doubled to almost 58 percent, thanks to state-of-the-art therapies that are being utilized by oncology specialists at top-tier hospitals, including Tampa General Hospital. Myeloma occurs when abnormal white blood cells build up and form tumors in the bones. Because it can spread throughout the body, “specialized treatment makes a difference in not only survival but remission,” said Dr. Ivan Borrello, medical director of the TGH Cancer Institute’s new Bone Marrow Transplant and Cell Therapies and Myeloma programs. There are many options, so it’s vital to go to an expert who can provide the latest therapies best tailored to the individual’s needs, explained Borrello, a nationally renowned leader in the field of myeloma, immunotherapy of blood cancers, and bone marrow transplants (BMT). Early treatments may include targeted

Myeloma occurs when abnormal white blood cells build up and form tumors in the bones and can spread throughout the body.

therapy that attacks tumor-growing proteins in cancer cells, chemotherapy, and/or immunotherapy. Immunotherapy weaponizes the body’s immune system in finding and destroying cancer cells; chemotherapy kills all fast-growing cells, whether cancerous or not. Depending upon the type and stage of MM, stem cell (bone marrow) transplants are another option. Bloodforming stem cells are collected either from the patient or a healthy donor, then the patient is bombarded with high doses of chemotherapy. The stem cells are then put back into the body, where they can rebuild healthy marrow. Radiation therapy can be another approach used to kill or shrink bone-destroying plasmacytomas (masses of myeloma cells). Among the last lines of defense against MM is chimeric antigen receptor or CAR T-cell infusion therapy, where immune cells (T-cells)

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Dr. Ivan Borrello

A 3D rendering of chimeric antigen receptor (CAR) T-cells attacking cancer cells and releasing cytokines.

Dr. Eduardo M. Sotomayor

The field of myeloma is exploding in terms of novel therapies and is no longer the death sentence it once was. We’ve been able to develop a program from essentially the ground up so patients can get the best possible care” in their own back yard. — DR. IVAN BORRELLO

are extracted from the patient’s blood through leukapheresis—a procedure that separates out the white blood cells. After the T-cells are collected, they are genetically altered to help the immune system seek out and attack cancer cells, a process that takes up to three weeks. The patient receives chemotherapy a few days before the CAR T-cells are to be reinfused into their body. CAR T-cell therapy was first approved by the U.S. Food and Drug Administration in 2021. It is only used in patients when the disease returns, Borrello noted. The procedure comes with potential side effects. Cytokine release syndrome (CRS) “is a non-specific inflammatory response that can manifest as high fever and chills, low blood pressure, and respiratory distress, among other symptoms,” Borrello said. CRS is the result of the release of these chemicals from T-cells that ramp up the immune system. It can occur within a few days to weeks after treatment and can be life-threatening. Another is neurotoxicity, the disruptive effect of chemicals on the nervous system, which “can range from mild difficulty in finding words and writing to unstable gait to, in very rare cases, coma,” Borrello said. Other reactions to CAR T-cell therapy can include a weakened immune system, low blood counts,

and allergic reactions. “Patients are monitored very closely during the two months or so after the final infusion procedure is completed,” Borrello said. The road may seem long, but the destination is worth it. Clinical trials show that CAR T-cell therapy completely shrinks tumors in a large percentage of patients and curtails recurrence. Several drugs have been approved for its use but the endgame is to avoid the point where they are needed at all. “If patients get optimal therapy at diagnosis, we can hopefully stem recurrence for many years or perhaps altogether,” said Borrello, who came to TGH in 2022 from Johns Hopkins University, where he established a translational cell therapy and processing laboratory. Borrello is doing the same and more at TGH. Along with providing the full range of existing and novel therapies, TGH’s Myeloma, BMT, and Cell Therapies programs participate in novel clinical trials. Timely care is key to saving and extending lives. “The field of myeloma is exploding in terms of novel therapies and is no longer the death sentence it once was,” Borrello said. “We’ve been able to develop a program from essentially the ground up so patients can get the best possible care” in their own back yard. ADVANCES

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The procedures were performed by Dr. Ashish Singhal and Dr. Kiran Dhanireddy, who were assisted by other experienced surgeons. RIGHT: Derek Sanz donated a portion of his liver to his his mother, Patty Sanz.

THE WAIT IS OVER THE TAMPA GENERAL HOSPITAL TRANSPLANT INSTITUTE IS PERFORMING LIVING-DONOR LIVER TRANSPLANTATIONS THAT ALLOW PATIENTS TO BEGIN LIVING FULLER LIVES TODAY BY KAREN FELDMAN 16

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My mother is going to live a longer, healthier life.” –Derek Sanz

erek Sanz gave his mother, Patty, the gift of life last spring. In early May, he donated part of his healthy liver, which surgeons at the Tampa General Hospital Transplant Institute implanted in Patty because her own organ was failing. The procedure marked the first living-donor liver transplant performed on Florida’s West Coast. “I’ve told him ‘You never need to give me another Mother’s Day gift in your life,’” Patty Sanz said four months after the procedure

changed her life. The 64-year-old paralegal became ill with liver disease in early 2022. Fluid repeatedly built up in her chest cavity, making it difficult for her to breathe. Her condition grew steadily worse, her stays in the hospital more frequent. As the condition worsened, “I had to have my chest drained every two days,” she recalled. Her kidney doctor realized that she needed a liver transplant and referred her to the TGH Transplant Institute. “That was the best thing that ever happened to me,” she said.

The TGH transplant team agreed with her Carrollwood doctor that she needed a transplant, but they encountered a roadblock. The Model for End-Stage Liver Disease (MELD) score determines the severity of a patient’s liver disease based on their three-month survival outlook. The higher the score, the more urgent the need, and the patient moves up in placement on the waiting list for a deceased-donor liver. “My MELD score was just high enough to get on the (donor) list, but not high enough to get to the top with the sickest ADVANCES

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Derek and Patty display their customized T-shirts. Patty wants others to know that this life-changing procedure is available at the TGH Transplant Institute.

people,” Patty explained. The waiting period can range from 30 days to 5 years, depending on the demand and availability of organs, according to the National Institutes of Health. Livers are the second-most in-demand organs (behind kidneys). They represent about 10 percent of those on the waiting list, which was 11,000 people in 2022. Patty’s prospects of getting a liver from a deceased donor looked dim. Then she learned of an exciting new option. Dr. Rashid Syed, a TGH transplant hepatologist, told her the TGH Transplant Institute was starting a living-donor liver program. In this type of donor transplantation, a healthy person volunteers a portion of their liver to someone whose liver is fail-

ing from end-stage disease or cancer. After the donated portion is removed, the donor’s remaining liver regrows close to its full size and capacity within a couple of months. The transplanted liver also grows, restoring normal liver function to the recipient. Receiving a donation from a living donor means patients won’t languish on a waiting list as their condition worsens. “Living-donor liver transplant is another avenue to save more lives of patients with liver disease in our community,” said Dr. Kiran Dhanireddy, vice president and chief of the TGH Transplant Institute and surgical director of the Comprehensive Liver Disease and Transplant Center. “The profound generosity of living donors circumvents the need

Dr. Kiran Dhanireddy

Dr. Vijay Subramanian

Dr. Diego Reino

Dr. Ashish Singhal

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This can drastically reduce the time and costs of waiting for a donor organ.” —Dr. Kiran Dhanireddy Live-donor transplants negate the long wait for a deceased donor’s organ.

for extended periods of time to gain access to lifesaving transplantation.” TGH is one of the nation’s top 10 transplant centers and ranked by U.S. News & World Report as one of the “2023-2024 Best Hospitals.” This new transplant program “is a prime example of Tampa General continuing to drive innovation to deliver world-class health care,” John Couris, president and CEO of TGH, said. “This program opens up additional access to patients in need of a liver transplant and has the potential to transform the lives of patients and their families in the Tampa Bay region, Florida, and across the United States.” Live-donor transplantation offers a wealth of benefits, and many more could ultimately be performed if people knew about them and were willing to participate. The advantages include:

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* A transplant can take place more quickly when a living donor is available, rather than waiting for organs from deceased donors. * The transplant can be scheduled at the convenience of the recipient and donor. * Research shows recipients of organs from living donors have better outcomes than those who receive organs from deceased donors. Once the transplant team explained the procedure to the Sanzes, it made sense. “I was a little scared, but Derek stepped right up and said, ‘I’m going to do it,’” Patty recounted. “I said, ‘No, you won’t.’ What parent wants a child to do that?” He responded that he wanted his mother to remain a vital part of his 2-year-old son’s life. And that was that. Over the course of two months, Derek underwent the tests and screenings required to assess

his health and liver function status and ensure that he was a good match for his mother. When it was time, surgeons removed a portion of his liver, then transplanted it into his mother during a day-long procedure. “It’s a win-win for everyone,” said Dr. Ashish Singhal, director of Living Donor Liver Transplant, who performed the procedure on Derek while Dr. Kiran Dhanireddy operated on Patty. “This can drastically reduce the time and costs of waiting for a donor organ,” he added. “Donor safety is always a priority. At the same time, it most definitely can give very sick people an opportunity to experience improved health.” An entire team of experienced TGH liver transplant surgeons participated in the transplant operation, including Dr. Diego Reino, who assisted Dhanireddy, and Dr. Vijay Subramanian,

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I feel so much better than I have in a couple of years. We want to get the word out there so that many more people can be saved.” –Patty Sanz

who assisted Singhal. The operation is complex. During the operation for an adult recipient, the right lobe of the liver is removed. The technique can preserve the blood supply from the hepatic artery, portal vein, bile duct, and right hepatic vein. As part of the procedure, the recipient’s diseased liver is removed, and the donor’s right lobe is put in its place. Blood vessels and bile ducts are then connected to their appropriate counterparts. Four months after the transplant, both mother and son reported they were feeling well. Patty was experiencing slight numbness in her hands and had not returned to her para-

legal job. However, she was back to walking and swimming in the pool. “I feel so much better than I have in a couple of years,” she said. “My energy is good.” An ultrasound the previous day had shown that her liver had grown back. “I was so happy to hear it,” she said. “I’m going to protect this liver and live my life to the fullest, which I haven’t been able to do.” Although she decided to forgo a cruise in the summer, Patty was looking forward to a short Bahamian cruise with family in 2024. She has nothing but praise for the medical team. “They are my heroes,” she said of the physicians who conducted the transplant. “I’m

so blessed to have surgeons that truly cared— both the doctors and the whole team.” Derek said he had mild numbness in his hands but returned to work as a pharmacist 10 weeks after the procedure. Although he wasn’t permitted to lift weights for three months, he started running again six weeks after the transplant and finally resumed weight lifting. “The hardest part was that I wasn’t supposed to lift my 2-year-old up for the first two months, but we adapted,” he said. “I’m feeling good, doing just about everything I did before, and my mother is going to live a longer, healthier life.” Both Patty and Derek Sanz have shared

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The TGH Transplant Institute’s skilled surgery teams are meeting increased demands for organ transplants. They performed a total of 750 procedures in 2023—a nearly 10 percent increase over the previous year.

their experiences to encourage others to consider living-donor liver transplant if they have a family member in the same condition. “How wonderful it is that they have that choice, too,” she said. “It’s certainly worked for us and that’s why we want to get the word out there so that so many more people can be saved.” The hospital’s nearly 50-year-old transplant program continues to strive to meet the increasing demand, performing 750 procedures in 2023—a nearly 10 percent increase over the previous year. “Tampa General had another record year for transplant volume due to the commitment of our team to help the sickest patients in our community,” Dhanireddy said. ADVANCES

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TGH: MEETING THE

MENTAL HEALTH CHALLENGE TA M PA G E N E R A L H O S P I TA L’ S B E H AV I O R A L H E A LT H H O S P I TA L W I L L B E F L O R I DA’ S O N LY F R E E S TA N D I N G AC A D E M I C M E D I C A L B E H AV I O R A L H E A LT H H O S P I TA L

s a leading academic health system, Tampa General Hospital is stepping up to enhance resources to meet the serious need for behavioral and mental health care in the Tampa Bay region and across Florida. Last year, ground was broken on the state-of-the-art TGH Behavioral Health Hospital. “As the community continues its trajectory of unprecedented growth, the demand for mental and behavioral health services is higher than ever before,” said John Couris, president and CEO of Tampa General Hospital. Florida is not only the nation’s third most populous state, it’s also the fastest-growing. This rapid expansion, combined with growing

recognition of the importance of accessible mental health care in communities, underscored the need for scientific understanding and treatments, as well as enhanced state funding for this critical area of health care. In 2023, state lawmakers approved $2.5 billion in funding for mental health and substance use programs along with $126 million in recurring mental health funding. The TGH Behavioral Health Hospital is expected to open in early 2025—becoming the first and only freestanding academic medical behavioral health hospital in Florida—with a focus on highly specialized and personalized care for many behavioral and mental health conditions. “We are proud to have the support of our state lawmakers, local leaders, and

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A A A community in this endeavor,” Couris said at the hospital’s groundbreaking. “The TGH Behavioral Health Hospital will significantly expand Floridians’ access to mental health services, and our patients can expect the world-class care we consistently deliver at Tampa General.” The academic health system has entered into a joint venture partnership with Lifepoint Behavioral Health, a business unit of Lifepoint Health, which operates more than 20 behavioral health hospitals nationwide. Tampa General and Lifepoint have a history of working together to bring exceptional patient care to the Tampa Bay area. “We know that Tampa General Hospital shares our commitment to expanding access to high-quality, evidence-driven specialty care, and we are honored to once

ABOVE: Hospital officials, board members, and state dignitaries broke ground in August 2023 for the construction of the state-of-the-art TGH Behavioral Health Hospital. LEFT: A rendering of the hospital located near the new TGH Kennedy Emergency Center and TGH Rehabilittion Hospital in the heart of the Tampa Medical and Research District.

again work alongside their team as we bring new and vitally needed services to Tampa and the surrounding region,” said Russ Bailey, president of Lifepoint Behavioral Health and Lifepoint Rehabilitation. Through its first joint venture, Tampa General and Lifepoint Rehabilitation opened the TGH Rehabilitation Hospital in 2022 to provide comprehensive care for patients recovering from debilitating injuries, illness, surgery, and chronic medical conditions. According to TGH’s 2019 Community Health Needs Assessment, respondents identified mental health as the second most important need in the community. In addition, 21 percent rated their mental health as “fair” or “poor,” and 14 percent stated that they needed mental health ADVANCES

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THIS FACILITY WILL BE AN ESSENTIAL RESOURCE FOR PATIENTS WITH BEHAVIORAL HEALTH CONDITIONS, ESPECIALLY THOSE EXPERIENCING COMPLEX CHALLENGES —DR. CHARLES J. LOCKWOOD

services but did not seek or receive them. A recent analysis of the Tampa Bay area determined that there is a demand for behavioral health care equaling 606 beds in Tampa General’s primary service area. Assuming an 80 percent occupancy rate, the area has an unmet need of 318 beds. At the TGH Behavioral Health Hospital, psychiatrists on the faculty in the USF Health Morsani College of Medicine at the University of South Florida will also offer learning opportunities for USF medical students and resident physicians. The hospital will be directly linked to TGH’s nationally recognized Neuroscience Institute, through which best-in-class physicians provide a full spectrum of care to patients of all ages with neurological disorders. “Despite an increased emphasis on preventative care, hospitals and emergency rooms are often the first point of contact for someone experiencing a mental health crisis,” said Dr. Glenn W. Currier, a professor in the Department of Psychiatry and Behavioral Neurosciences in the USF Health Morsani College of Medicine, which is chaired by Dr. Ryan C. Wagoner. “TGH Behavioral Health Hospital will provide patients with the specialized, evidence-based care they need in an environment better suited for their needs.” Currier noted that 40,000 people a year seek psychiatric help at USF Health. In fact, the respected nonprofit Mental Health America, which issues its annual “State of Mental Health in America,” identified about 1.7 million individuals in Florida who were experiencing a behavioral health condition that went untreated last year.

“This facility will be an essential resource for patients with behavioral health conditions, especially those experiencing complex challenges,” said Dr. Charles J. Lockwood, executive vice president of USF Health, dean of the USF Health Morsani College of Medicine, and executive vice president and chief academic officer of TGH. “With the new behavioral health hospital, we are increasing much-needed access to highly specialized and personalized care for many behavioral health conditions to make a positive impact on the mental health and well-being of the communities we serve.” Providing access to mental health treatment for a large community— regionally and throughout Florida—is logistically a complex undertaking. As a leading academic health system, Tampa General is ready for the challenge along with its partner Lifepoint. One thing that sets Lifepoint Behavioral Health apart from other partners is its focus on consistency and innovation. “We have resources and best practices that we can bring to bear on any of our facilities,” said Dr. Jeremy Musher, chief medical officer for Lifepoint Behavioral Health. “When we find that one of our hospitals is successfully utilizing a novel approach to a problem, we’ll replicate the practice across our system. Overall, we’re committed to providing patients with excellent care.” The four-story facility is designed with space on the first floor for a partial hospitalization program. Here, patients will receive high-intensity services four to five days per week, but rather than staying in a residential facility overnight, they will return home, and continue to receive

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WHAT TO EXPECT TAMPA GENERAL HOSPITAL WILL PROVIDE FACILITY AND MEDICAL SUPPORT SERVICES, WHILE LIFEPOINT BEHAVIORAL HEALTH WILL MANAGE THE DAY-TO-DAY John Couris

Dr. Charles J. Lockwood

Dr. Ryan C. Wagoner

OPERATIONS. PHYSICIANS WITH THE DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL NEUROSCIENCES IN THE USF HEALTH MORSANI COLLEGE OF MEDICINE WILL PROVIDE A FULL RANGE OF INPATIENT AND OUTPATIENT CARE IN SPECIALIZED UNITS FOR PEDIATRICS, ADOLESCENTS, ADULTS, AND GERIATRICS.

Dr. Glenn W. Currier

Dr. Jeremy Musher

Russ Bailey

THE 83,000-SQUARE-FOOT HOSPITAL WITH 96 TO 120 INPATIENT BEDS WILL FEATURE

services as outpatients. “Patients will experience a holistic treatment program,” Musher said. “First, we address the crisis that led them to their admission to the hospital. Then second, we engage them in ongoing treatment to prevent the next admission and, most importantly, further their journey to recovery.” Musher noted that in addition to medications and group therapy, patients will participate in therapeutic activities like yoga, exercise, art, and music therapies. “We view these activities as essential to the recovery process,” he said. “They build coping skills and add meaning and enjoyment to their lives.” Currier said TGH Behavioral Health Hospital will offer innovative, comprehensive services and programs that will draw patients from around the state and the Southeast. “We’ll have the full spectrum of mental health care services,” Currier said. “If people need unique treatments that are only available here—of which there are several—then absolutely, they can come from outside of the Tampa Bay region. And that’s what the Southeast has been missing: a premier program for complex cases.” Patient care constitutes just one facet of the overarching mission of any academic health system. Additional vital aspects involve conducting clinical research trials—collaborative efforts that contribute to the extensive reservoir of medical knowledge shared within the health care community. This not only benefits the medical community but also proves highly advantageous for patients. The TGH Behavioral Health Hospital will house a USF residency program.

DEDICATED UNITS FOR “We’ll be doing reTREATING PATIENTS WITH search there—clinical trials of new treatments BEHAVIORAL HEALTH ISSUES and National Institutes COMPOUNDED BY OTHER of Health-funded studMEDICAL CONDITIONS. ies of non-drug interventions,” Currier said. The ultimate goal is for these trials, novel treatments, and studies to provide help for those in immediate need of acute mental health care. “Tampa General Hospital is taking the lead to expand access to highquality care and fulfill our greatest needs,” said Florida Sen. Jarrid “Jay” Collins, who collaborated with Florida Rep. Lawrence McClure to secure $10 million in the state budget to support the construction of the new hospital. “Right here in the heart of the Tampa Medical and Research District, the patients of the new TGH Behavioral Health Hospital will benefit from the world-class care that Tampa General provides, the latest innovations and research findings, and the newest technologies,” Collins said. McClure added: “This was an important investment for the state to expand access to high-quality care, fulfill the growing demand for behavioral health services, and create jobs and foster growth right here in Tampa Bay. With the construction of the state’s only freestanding academic medical behavioral health hospital, it’s clear Tampa Bay is the leader in accessible, high-quality care.” ADVANCES

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BRAVERA HE ALT H IS NOW

We are pleased to announce that TGH is growing by bringing the Bravera Health network into our health system to increase local access to world-class care. By coming together as one organization, we are stronger in our united mission to transform health care for all Floridians.

BROOKSVILLE • SPRING HILL • CRYSTAL RIVER

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THE NEXT ERA OF

INNOVATION COMPUTER PROGRAMS POWERED BY AI ARE SAVING PRECIOUS TIME FOR PHYSICIANS AND HELPING LEAD TO QUICKER DIAGNOSES By Eric Barton

The days of doctors and nurses flipping through a chart hung from the end of the hospital bed have made way for computerized records that streamline the patient’s medical history. But not so fast. On average, according to a 2020 study from the journal Annals of Internal Medicine, doctors spend more than 16 minutes analyzing and studying electronic health records and taking notes before even seeing a patient. In the future, those precious minutes can be summed up by artificial intelligence (AI) in milliseconds. Soon patients lying in a hospital bed or sitting in an exam room at Tampa General Hospital will be served by clinicians who already have a succinct medical history summary. It will be prepared in advance using AI, speeding up the process and giving doctors and nurses more accurate information about their patients. Patient records is one of several key systems at TGH that will be revolutionized in the coming months and years with the help from AI, said Dr. Karna Patel, vice president of Tampa General Medical Group. “We’re looking to take away the burden of the clerical work from physicians to get back to spending time with the patient and the families,” Patel said. In 2023, TGH signed a contract with Navina to

develop AI-powered software called Patient Portrait that analyzes documents and produces a summary for clinicians. Without it, doctors and nurses typically must spend valuable time before appointments creating a summary of a patient’s history, called a chart prep. Typically, clinicians will click through multiple scanned pages of notes, searching for key details, such as past surgeries and prescriptions. The goal of Navina’s program is to empower doctors by freeing up time they used to spend digesting data to allow them instead to spend more time interacting with patients, said Navina CEO Ronen Lavi. Lavi spent 24 years in the Israel Intelligence Corps and led the Israeli Military Intelligence’s AI Lab. He cofounded Navina in 2018 with Shay Perera with the idea of bringing what they had learned about AI to the health care industry. In 2020, the company raised startup funding after pitching investors on a simple promise: using AI to streamline medical care. By 2020, the New York-based company had joined several other companies in The TGH CareComm command developing AI tech for health care, center utilizes 20 artificial intelligence applications to such as Bot MD, a clinical chatbot optimize minute-to-minute for doctors, and Suki, a doctor’s patient care operations voice assistant note-taker. Navina’s throughout the hospital.

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Dr. Thomas Bernasek is seen here performing a total knee replacement using the VELYS Robotic-Assisted Solution. The VELYS system is much smaller than previous designs, it contains everything a surgeon needs to complete the procedure, and it can provide real-time feedback on the implant.

Dr. Karna Patel

Rachel Feinman

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WE’RE LOOKING TO TAKE AWAY THE BURDEN OF CLERICAL WORK FROM PHYSICIANS TO GET BACK TO SPENDING TIME WITH THE PATIENT AND THE FAMILIES.” —DR. KARNA PATEL

software promises fewer missed diagnoses and a reduced burden on clinical teams. “We are enthusiastic about improving the lives of physicians and patients, and to accomplish that we need extraordinarily committed partners like Tampa General,” Lavi said. “Tampa General is at the forefront of innovation. They actively seek new solutions because they recognize that data overload is a real burden plaguing our health care system, and they require technology like our AI platform to end the scourge of burnout,” which can lead to doctor shortages and worsened health outcomes. It’s not just about giving doctors more time with patients. Navina’s program is designed to help doctors identify disease and

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risk factors more quickly and make speedier diagnoses. More time and better tools to help diagnose a patient could lead to a quicker turnaround from illnesses—and may even save lives. The program from Navina has already had early successes. Central Virginia Family Physicians, a medical group of 52 physicians, has been using the program to better identify diseases that could be life-threatening, including chronic kidney disease, diabetes, and morbid obesity. Dr. Jarrett Dodd, medical director of the physicians’ group, said in a television interview: “Navina basically sits on top of our electronic health record and dives into the individual patient’s data. It takes all the vital information

and creates a “patient portrait,” where all that information is much more easily accessible to the clinician at the point of care.” The Navina program has become so effective that the American Academy of Family Physicians Innovation Lab identified it as essential to help keep family doctors from burnout and IT-related stress. That’s more needed than ever, with some studies estimating as much as half of all doctors are suffering from fatigue, often driven by the demands of paperwork and IT overload that Navina hopes to reduce. Because other hospitals and medical groups have implemented the Navina program, it will be easier for TGH to do so as well, Patel said. However, the program is now being tailored

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A to the needs of patients TGH serves across the state. In addition to the summaries, the program helps in tedious recordkeeping by allowing clinicians to find the correct Hierarchical Conditional Coding—sets of medical codes for specific clinical diagnoses regulated by the federal government for health insurance reimbursement. The final details of TGH’s version of the Navina program were being worked out last summer, with implementation expected by early this year, Patel said. “Eventually, this reduces the paperwork burdens on physicians and providers,” Patel said. Oftentimes, physicians spend hours after clinical visits handling paperwork, steps that will soon be managed largely by AI. The Navina program is one of several ways TGH is considering how to use AI to improve health care, said Rachel Feinman, vice president of innovation at TGH. Feinman also serves as managing director of TGH Ventures, the hospital’s venture capital

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investment fund that works with external partners to leverage the hospital’s resources and staff to solve problems. In addition, through TGH Ventures’ Co-Lab Program, the hospital partners with private companies, including startups like Navina, to codevelop and refine solutions that improve health care. “It has been clear for some time that AI could help in health care,” Feinman said. “It was always just a matter of how.” Now, TGH is looking at areas where it makes sense to benefit from AI’s vast computing ability— places where analyzing substantial amounts of data can be beneficial. For instance, AI may soon be used to analyze large amounts of patient datasets to look for trends. That analysis could help clinicians discover cures or new ways to treat diseases by discovering a solution that is not immediately obvious to the people dealing with that disease every day. “The cure for a disease may be waiting in our ER, and AI might be able to find it,”

Feinman said. While developing The CareComm center the new Navina prohelps the hospital optimize the gram, TGH is also surgical block schedule, working with Microoperate at maximum occupancy, decrease soft on the impleaverage length of stay, mentation of AI softand manage emergency room bed capacity. ware that will allow doctors to dictate patient notes, removing the time-consuming process of physicians typing up their notes after a visit—a step patients do not often see. Also coming to TGH in the future, Patel said, will be Symptom Checker, an AI-assisted decision-making program that can help patients navigate the health care system and receive the right care at the right time. “Of course, AI can never replace doctors and nurses, but it can reduce the low-value work burden and empower them to perform high-value work, acting as a thought partner,” Patel said. ADVANCES

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Groundbreaking Procedures &

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A H THE TAMPA GENERAL HOSPITAL HEART & VASCULAR INSTITUTE RANKS AMONG THE TOP 10 PERCENT NATIONWIDE FOR ITS HIGH-PERFORMING, FULL-SPECTRUM CARDIOVASCULAR CARE BY KAREN FELDMAN

eart failure occurs when the heart is unable to pump blood as well as it should. The symptoms can creep up gradually. You may find yourself short of breath while taking a short walk, loading the dishwasher, or playing with your grandchildren—the types of activities you previously did without difficulty. “If those things are hard to do, we usually consider heart failure as a possible cause,” said Dr. Benjamin D. Mackie, interim co-director of Tampa General Hospital’s Heart & Vascular Institute (HVI), medical director of the TGH HVI Heart Failure Center of Excellence, and TGH Transplant Institute medical director of heart transplantation. Certain heart conditions render the heart too weak or stiff to function properly. When this occurs, heart failure ensues, resulting in fatigue, shortness of breath, coughing, and fluid retention. According to the Centers for Disease Control and Prevention, some 6.2 million adults in the United States have some degree of heart failure. The severity is generally classified in four stages: • At-risk patients may not have symptoms but have risk factors such as high blood pressure, coronary vascular disease, obesity, or diabetes. • Pre-heart failure is when the patient is

diagnosed with a heart disease. • Symptomatic heart failure occurs when someone is diagnosed with heart disease and has symptoms. • Advanced heart failure is diagnosed when the illness interferes with daily life or requires frequent hospitalizations. TGH has long led the way in treating this potentially debilitating condition. U.S. News & World Report ranks TGH in 2023-2024 among the top 10 percent of hospitals in the nation for cardiology and heart surgery and among the best for treating heart failure and heart attack. “We do a really good job of holding ourselves to a true standard of clinical excellence—to make sure we have the right process to set patients up for success,” said Mackie, a cardiologist who specializes in non-surgical cardiac transplantation. To that end, the hospital’s 200-bed HVI has 86 specialists offering a full range of cardiovascular treatments. There are seven centers of excellence: • Cardiothoracic surgery • Electrophysiology • Heart failure and mechanical circulatory support • Interventional cardiology • Vascular surgery • General and preventative cardiology ADVANCES

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• Advanced cardiac imaging Community hospitals and physicians do a good job The 200-bed of managing the early stages of the disease, Mackie Heart & Vascular Institute has 86 said, but TGH’s substantial medical arsenal comes into specialists and play when their disease advances. Those who already seven centers of excellence offerhave a pacemaker, whose heart activity is being moniing a full range tored, are sick often, see doctors frequently, or are hosof cardiovascular treatments. pitalized more than once a year for heart failure need advanced care. “That’s usually when we get involved,” Mackie said. “We have a more advanced toolbox, more expertise for pharmacological interventions, and the luxury of having a multidisciplinary team. It allows us to tackle what most community hospitals and physicians are not equipped to do.” The institute is equipped with the latest technology to assist the surgical team in the operating room. That includes 3D printing for planning aortic valve replacements, trauma and cancer surgery, and other reconstructions. Surgeons also use robotics to perform operations, such as mitral valve repair, when it’s suitable. “It’s traumatic to have your chest cut open,” Mackie explained. “If we can accomplish the same surgery with tiny holes made by a robot, that’s a much less traumatic procedure.”

HERE ARE SOME OF THE CUTTING-EDGE TREATMENTS AVAILABLE AT THE TGH HEART & VASCULAR INSTITUTE: ELECTROPHYSIOLOGY: Electrical activity within the heart causes it to beat and, in some cases, beat irregularly. These arrythmias are the focus of electrophysiologists and a multidisciplinary team of cardiac specialists who employ advanced 3D mapping and imaging to diagnose and treat heart rhythm and heart rate disorders. The team at TGH is doing cutting-edge work, including complex ablations to cure dangerous atrial fibrillation, ventricular tachycardia, and advanced cardiac resynchronization therapy through conduction system pacing. PUMP IT UP: The HeartMate 3 left ventricular assist device (LVAD) serves as a pump for the left side of the heart. The pump is placed inside the chest—either with a minimally invasive technique or by traditional surgery. The patient then wears a vest to hold a battery that connects to the LVAD. “Most are happy they had it placed,” Mackie said. “They are more functional, and they live longer.” AN ALTERNATIVE: TGH has the ability to place temporary

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We have a more advanced toolbox, more expertise for pharmacological interventions, and the luxury of having a multidisciplinary team. It allows us to tackle what most community hospitals and physicians are not equipped to do.” —DR. BENJAMIN D. MACKIE mechanical support devices to support both the right and left sides of the failing heart while patients are awaiting heart transplantation. One of TGH’s newest devices is used to support the right side of a patient’s heart when help is needed immediately. The new Impella RP Flex with SmartAssist right ventricular assist device (VAD) is a good stopgap, Mackie said, though he favors a transplant when the right side of the heart is affected. VADs are usually a temporary step to stabilize patients so they can live normally—and survive—while awaiting a donor organ for transplant. GROUNDBREAKING PROCEDURE: A first-ever cardiac procedure took place in December 2022, when Dr. Lucian Lozonschi, a cardiothoracic and transplant surgeon and professor and director of the Division of Cardiothoracic Surgery in the USF Health Morsani College of Medicine at the University of South Florida, implanted a VAD for each side of the heart. “Combining both devices is a real game changer,” Lozonschi said. “Using both devices serves as a complete heart replacement, and it’ll change cardiothoracic care. We hope these two advanced technologies will create treatment opportunities for patients whose options had previously been limited.” TREATING CARDIOGENIC SHOCK: When the heart can’t pump enough blood to meet the body’s demands, people develop a condition known as cardiogenic shock. “A lot of patients present in cardiogenic shock,” Mackie said. “In that case, time is of the essence to prevent organ damage.”

He is proud of the streamlined program the team has implemented to treat cardiogenic shock. When any team member recognizes a patient in shock, they sound an alert. “It generates an alert to key team members. We hold an emergent virtual meeting within five minutes and delineate an immediate disposition to get them some type of support, if appropriate,” Mackie said. The institute also has extracorporeal membrane oxygenation (ECMO) devices that pump and oxygenate the blood outside the body, allowing the heart and lungs to rest. Patients are stabilized on ECMO while awaiting a transplant or in recovery, which “has improved our survival rates,” Mackie said. “We are saving lives.” TRANSPLANT ADVANCES: In 1985, TGH surgeons were the first to perform a heart transplant in Florida. The TGH Transplant Institute is working to increase the amount of time an organ is viable between removal from a donor and placement in a recipient. Traditional methods keep a heart viable for about four hours. Using a new TransMedics Organ Care System, which keeps organs in a natural state that mimics the body, can potentially extend the organ’s viability to six or eight hours. “That gives us access to organs that we wouldn’t have had access to before,” Mackie noted. “You can’t pull a heart off of a shelf. There is waiting time and a shortage of donors. Many people die waiting for an organ in the United States. Our team goes to great lengths to see if there is anything we can do to buy patients more time.”

A TGH HEART & VASCULAR INSTITUTE LEADERS

Dr. Benjamin D. Mackie

Dr. Fadi Matar

Dr. Murray Shames

Tara Collet

Dr. Benjamin D. Mackie: Cardiologist; interim vice president and co-director of the TGH Heart & Vascular Institute (HVI); medical director of the HVI Heart Failure Center of Excellence; and medical director of TGH Transplant Institute heart transplantation Dr. Fadi Matar: Associate professor, Division of Cardiology and interim chief of Cardiovascular Sciences, USF Health Morsani College of Medicine; cardiology section chief and medical director of the TGH Cardiac Cath Lab, with specialties in interventional cardiology and cardiovascular disease Dr. Murray Shames: Richard G. Connar Endowed Professor and Chair, Department of Surgery, USF Health Morsani College of Medicine; TGH Chief of Staff; interim co-director of the HVI; and a vascular surgeon for Tampa General Hospital Tara Collet: Senior administrator of the HVI

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Blood clots forced the amputation of youth soccer coach Carlos Marin’s left leg below the knee. Marin, a former professional soccer player, now zips around the field with a prosthetic leg. He explains to his players, “My leg got sick.”

LIFE & LIMB TAMPA GENERAL HOSPITAL’S NEW LIMB PRESERVATION-PERIPHERAL ARTERIAL DISEASE PROGRAM HELPS TO PREVENT LIFE-ALTERING AMPUTATIONS BY KAREN FELDMAN Peripheral arterial disease (PAD) is rarely a hot topic of conversation, yet more than 10 million Americans have this serious vascular condition that can lead to lower extremity amputation. Modifiable patient risk factors such as tobacco use, diabetes, high blood pressure, high cholesterol, and heart disease can lead to atherosclerosis, which is the development of plaques or hardened arteries throughout the body. “When affecting the lower extremities, we refer to this as PAD, and in its most severe forms it can lead

to critical and limb-threatening ischemia (restricted blood flow) with a much-heightened risk of amputation,” according to Dr. Charles J. Bailey, director of the Limb Preservation-PAD Program and assistant professor in the Department of Surgery in the USF Health Morsani College of Medicine. Last spring, the TGH Heart & Vascular Institute (HVI) advanced its care of PAD patients with the launch of the Limb Preservation-Peripheral Arterial Disease Program and off-campus multidisciplinary clinic—the first of its kind in the Tampa

Bay region. The TGH HVI South Tampa clinic offers a collaborative, multispecialty, integrated, and evidence-based approach to the management and caring for patients with complex PAD, said Bailey. The Limb Preservation-PAD Program was designed to prevent limb amputations through the early identification and treatment of patients with critically low blood flow to a limb. The TGH HVI clinic offers patients easy access to advanced care by the multidisciplinary medical team, innovative treatments, and state-of-the-art technology and equipment.

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IF PATIENTS ARE HAVING PREDICTABLE MUSCLE PAIN WITH ACTIVITY, A POORLY HEALING WOUND, OR HAVE HAD A PRIOR VASCULAR INTERVENTION THAT DID NOT DELIVER THE RESULT THEY WERE HOPING FOR, IT’S TIME TO VISIT OUR CLINIC. MANY NON-TRAUMATIC AMPUTATIONS ARE PREVENTABLE, AND PROGRAMS LIKE OURS HAVE PROVED TO REDUCE AMPUTATION RATES AND IMPROVE THE QUALITY OF LIFE FOR PAD PATIENTS.” —DR. CHARLES J. BAILEY The medical team includes vascular surgeons, podiatrists, and wound care specialists, as well as an advanced practitioner and nurse navigator to streamline the patient’s journey through appointments and referrals. The new clinic “enhances our community’s access to that level of expertise, especially for the underserved population, who we know are at increased risk of amputations,” said Tara Collet, senior administrator of the TGH Heart & Vascular Institute. “We are now able to treat more patients, save more limbs, and improve more lives. The medical innovations at the clinic are truly life-altering for patients.” Having multiple top specialists in the same location provides efficient care because it allows patients immediate access to any or all of the specialties needed. “The patient outcomes are better. Did we save the leg? Did we improve amputation-free survival? Without a doubt, these metrics improve when we take this collaborative, though individualized, approach to each patient’s unique problem,” Bailey said. His advice to those with or at risk for PAD: “If patients are having predictable muscle pain with activity, a poorly healing wound, or have had a prior vascular intervention that did not deliver the result they were hoping for, it’s time to visit our clinic. Many non-traumatic amputations are preventable, and programs like ours have proved to reduce amputation rates and improve the quality of life for PAD patients.” Bailey describes the care provided as “truly holistic—the best available medical care, complex wound care, vascular disease management, and ongoing care for those who wind up

Dr. Charles J. Bailey

with an amputation. Vascular surgery is a cornerstone of the program, which is key, as we are the only specialty in medicine comprehensively educated and trained to provide the full spectrum of evidence-based care and options to our patients, whether solely goal-directed medical management, minimally invasive endovascular (balloon or stent) therapies, or traditional open surgical bypass. Great outcomes come from being able to truly discuss and provide all options in care.” TGH Heart & Vascular Institute surgeons are recognized leaders in PAD management, presenting clinical research outcomes at local, regional, national, and international forums. There also is a bimonthly amputation support program that brings together those who have lost a limb, providing ongoing care and support as they recover. Carlos Marin, a youth soccer coach and former professional soccer player, has been an inspirational participant of the support group. He lost his left leg from below the knee about two years ago due to blood clots after the problem progressed from numbness to severe pain. He recalled it was “very shocking, very

traumatic” when TGH doctors told him amputation was necessary. Today, Marin zips around a soccer field, keeping up with his young players, offering advice and encouragement. Unless he’s wearing shorts, exposing his prosthetic left leg, it’s hard to tell he has one. When his players ask about it, he responds, “My leg got sick.” Awed, they respond, “Like RoboCop.” He also attends the hospital’s amputation support group, sharing his experience: “Cry if you cry; smile if you smile. Live like there’s no tomorrow. That’s my attitude.” He is passionate about what he’s doing and plans to keep striving. Marin is also quick to express his gratitude for the care and support he received at TGH. “Thanks to the 9th Floor ICU West Pavilion staff—from Dr. Bailey and his residents to the nurses and techs—who I am now is the result of their hard work.” Bailey said Marin’s story “is what we strive for in all our patients, especially those who do require an amputation—a return to normalcy and a functional lifestyle. He has been a real inspiration to many of our amputees. He’s given them hope that they can get to the place he is in life. He’s incredibly positive.”

ABOUT THE PROGRAM The Limb Preservation-Peripheral Arterial

offers patients at risk for limb loss convenient

Disease Program is part of the TGH Heart &

access to comprehensive wound care, podiatry

Vascular Institute’s Vascular Center of Excel-

services, and vascular care.

lence. The clinic at the TGH Heart & Vascular

Join the Amputation Support Group online

Institute South Tampa at 1202 S. Church Ave.

at facebook.com/groups/tghlppsupportgroup.

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TGH ranks No. 9 in the nation for excellence in obstetrics and gynecology.

Focus on

WOMEN’S HEALTH

Expanded obstetrics and gynecology services, including cuttingedge treatments, make the Tampa General Hospital Women’s Institute one of the top facilities in the nation BY ROBIN F. DEMATTIA 38

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A Dr. Judette Louis

Dr. Emad Mikhail

Dr. Katie Propst

Melissa Golombek

We see the most complex patients in the region and provide the safest care by focusing on quality, outcomes, physician retention, and team member engagement.” —Melissa Golombek

lorida is now the nation’s fastest-growing state and the influx of new residents in the past few years—365,205 arrivals in 2023 alone, the U.S. Census Bureau reports—has increased the demand for health care services. And it is a misconception that retirees make up most of these new residents; young families and professionals edge out residents 65 and up, Statista reports. Tampa is one of the top 10 destinations for new Florida residents and Tampa General Hospital has responded by increasing gynecology services, especially for adolescents and young adults. In collaboration with physician leadership, the team built a strategic plan that included developing further expertise in minimally invasive gynecological surgeries, recruiting physicians who specialize in complex surgeries, and investing $3 million in robotic technology. Adding a focus on adolescent gynecology and reproductive health, the TGH Women’s Institute hired nurse navigators who provide customized service to individual patients to help with scheduling appointments and pre-surgery procedures, getting insurance approvals, and monitoring post-surgery care. Within the first 18 months, TGH cared for double the amount of gynecology patients, confirming that they had identified unmet community health care needs. This increase in patient volume and improved outcomes has attracted national attention. In January 2023, TGH received accreditation as a

Center of Excellence in Robotic-Assisted Surgery from the Surgical Review Corporation (SRC). Later that year, TGH received an additional accreditation from the SRC as a Center of Excellence in Minimally Invasive Gynecology. TGH is ranked as the No. 1 hospital in Florida and No. 9 hospital in the nation for Obstetrics and Gynecology by U.S. News & World Report for 2023-2024. “Our Women’s Institute is a pillar in the community for obstetric and gynecology care. Over the past few years, we have put a strong strategy in place to create a comprehensive women’s program. This accolade demonstrates the steadfast focus of each member of our team,” said Melissa Golombek, vice president of the Muma Children’s Hospital of TGH and the TGH Women’s Institute. ”We see the most complex patients in the region and provide the safest care by focusing on quality, outcomes, physician retention, and team member engagement,” said Golombek of the rankings. Part of the hospital’s success stems from establishing the TGH Women’s Institute in 2021 to provide a continuum of comprehensive care. It houses the Gynecology Center, Obstetrics Center, Breast Cancer Center, Fetal Care Center, and Maternal Fetal Medicine Program. Dr. Katie Propst, assistant professor and director of the Division of Urogynecology in the USF Health Morsani College of Medicine at the University of South Florida, joined TGH in January 2022 to help launch the institute. She is also the director and founder of the Pregnancy and Postpartum Pelvic Health Clinic in the USF Health Morsani College of Medicine—the only specialized postpartum clinic of its kind in the state. “The clinic is really important because we know that women who have advanced lacerations at the time of delivery have much more risk of wound infection, pain and fecal incontinence,” Propst said. “Seeing those women early can improve care and ADVANCES

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Academic medicine incorporates the latest in research, making sure that the treatments we use are backed by science and are the most effective for our patients, so we can quickly improve their overall health.” —Dr. Judette Louis help with long-term prevention of pelvic floor disorders later in life.” Since the launch of the TGH Women’s Institute, Propst said patients have experienced shorter stays, quicker recoveries, and less pain, because of efficiency in pre-operative testing, patient positioning during surgery, assessment of antibiotic treatment, and patient education. “It’s a continuous improvement endeavor,” she said. “As an institute, we’re really focused on outcomes.” Because TGH is the teaching hospital for USF, patients benefit from the academic medicine provided and come for treatment from around the state. “Academic medicine incorporates the latest in research, making sure that the treatments we use are backed by science and are the most effective for our patients, so we can quickly improve their overall health,” said Dr. Judette Louis, chief of the TGH Women’s Institute and the James M. Ingram Professor and Chair of Obstetrics and Gynecology at the USF Health

Morsani College of Medicine. Golombek noted that academic medicine “gives patients the opportunity to try things in modern and advanced medicine that they would not in other places. And it brings new learners and new thinkers to medicine.” Dr. Emad Mikhail, director of inpatient gynecologic services and associate professor and director of the Division of Gynecologic Subspecialties at the USF Health Morsani College of Medicine, is one of those innovators. Like many who work in academic medicine, he joined TGH to take care of patients with complicated cases and to be involved in research and medical advances. Since joining the USF faculty in 2012, he has helped develop the world’s first intraoperative ultrasound-integrated robotic identification of deep-infiltrating endometriosis. With minimally invasive surgery, he said, patients have fewer and shorter hospital

ABOVE: The TGH Women’s Institute staff celebrates national recognition for providing a world-class continuum of care. RIGHT: TGH uses the latest advanced technologies to treat more patients and become experts in complex cases.

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stays, returning to normal activities more quickly. “We are at the forefront of technology and robotic surgery,” Mikhail said of the advancements taking place at TGH. At his suggestion, TGH recently became one of a few hospitals in Florida to offer the Acessa procedure, a new, minimally invasive outpatient therapy for uterine fibroids that uses radiofrequency ablation (RFA). Fibroids are muscular tumors that grow in the wall of the uterus. They vary in size and number and are usually benign. The most common treatment for uterine fibroids has been a hysterectomy—the removal of the uterus—and sometimes the ovaries. “It’s a very debilitating disease that causes a lot of problems and is usually major surgery,” Mikhail explained. “RFA treats fibroids without taking them out. There are a couple of tiny incisions and women resume normal activity in a week or 10 days.” For women with bladder control problems and pelvic organ prolapse, Propst emphasizes that designing surgery that fits the patient’s goals at different stages of life is innovative. Historically, women have been

limited in the timing and types of procedures performed to treat these conditions. Many incorrect assumptions exist, including that urinary leakage is normal, especially after having children. “We want women to know that urinary leakage is not normal and that surgery for prolapse does not have to include a hysterectomy. Women don’t have to live with these conditions,” Propst said. Robot-assisted transabdominal cerclage placement—another fairly new, minimally invasive surgical technique—helps women who have a weakened cervix to prevent preterm birth. It’s offered at few Florida locations beyond TGH. “Our results are great,” Mikhail said. “Women who were miscarrying at 20 weeks now can carry to full term.” Because TGH uses the latest advanced technologies, the doctors are able to see more patients and become experts in complex cases, which has led to a world-class patient experience. “Part of the reason we are successful is because we have a high volume of surgeries and provide high-quality care,” Mikhail said. “Most patients are excited about technology. They want to have surgery in a more modernized fashion.” ADVANCES ADVANCES 41

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A Quick Trip to

EXPERTISE BY KELLEY MARCELLUS | PHOTOGRAPHY BY JERRY RABINOWITZ

A UROLOGIC ONCOLOGIST’S PERSONAL ATTENTION RELIEVED THE FEARS OF A YOUNG PATIENT WHO KNEW THAT A MAJOR SURGERY WAS IN THE BEST HANDS AT TAMPA GENERAL HOSPITAL Just after her 20th birthday, Micaella Guzman had a scare. The Wellington resident awoke for a typically busy day in April 2023. While getting ready, the college student was stopped in her tracks. “The toilet was filled with blood,” she recalled. “My mom said we needed to go to urgent care or the ER, but I just wanted to

get to school.” She’s studying to become a diagnostic medical sonographer—and went to class. As soon as it ended, her mother insisted she go to the local emergency room, where she was diagnosed with a urinary tract infection and sent home with antibiotics. “Once I got home, I couldn’t move,” Guzman recalled. “I was

throwing up and screaming in pain.” She went back to the hospital and was admitted. Around midnight, scans revealed a mass on her right kidney. Fluid that had collected in her abdomen made further diagnosis tricky. Repeated imaging indicated the kidney should be removed. Guzman and her family had questions: Who would do the surgery?

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Wellington resident Micaella Guzman trusted specialists at the TGH Urology Institute to perform her emergency kidney removal after area doctors couldn’t provide answers about her condition.

Dr. Trushar Patel

Would she lose her entire kidney? What were the consequences of living with one kidney? What was the mass? Few answers were offered, and no doctor was available to walk her through what the proposed procedure entailed. The Guzmans were frustrated and scared. A friend suggested she seek a second opinion at Tampa General Hospital. Soon they were on the phone with TGH East Coast Network Development Manager Lynn Stockford, RN, who quickly

coordinated a referral to a urologist and a direct admission to TGH. “I was able to quickly assess Micaella’s needs, coordinate the care she needed, and answer any additional questions,” Stockford said. “I reassured her that she was in good hands.” On the way to TGH, an on-site ambassador stayed in touch with Guzman. TGH’s Health Ambassador Program includes onsite ambassadors and a transfer center. Both are there to take care of logistics and details, so a patient’s experience is as smooth as possible. “A live person is always available 24/7,” Stockford said. Dr. Trushar Patel, a urologic oncologist and vice chairman of the TGH Urology Institute and associate professor and residency director in the Department of Urology in the USF Health Morsani College of Medicine at the University of South Florida, evaluated Guzman upon her arrival. “I immediately got to meet my doctors, which was such a difference from where I was first treated,” Guzman said. Patel ordered multiple imaging studies. “Our first goal was to figure out the best way to treat Micaella,” he said. The diagnosis wasn’t initially clear due to the level of fluid that had collected in her abdomen. Patel described the mass as large— about the same size as her kidney—and it was unknown whether it was cancerous or benign. “We needed to consider how long to watch her and whether to do surgery at all,” he explained. “I presented all the options and pathways.” Guzman spent about a week at TGH before going home to wait for the fluid to subside. Soon, Patel determined that the kidney needed to be removed. “Because she had a significant bleeding event, odds were that she’d have another at some point,” Patel said. “It was a difficult decision to take her to the operating room at such a young age but ultimately it was the right decision for her.” The team discussed the advantages of an open surgery versus a robotic one and what the consequences would be for Guzman going forward. “Dr. Patel was very open,” Guzman

recalled. “He had a game plan. He talked me through it.” Guzman underwent a radical nephrectomy— the complete removal of her kidney—through open surgery, which left her with a single abdominal scar. The alternative was a robotic surgery which can have a quicker recovery but involves multiple smaller incisions in the abdomen through which surgical tools and scopes are inserted. In some instances, a robotic nephrectomy can become more complicated than anticipated and needs to be abandoned, so the kidney is removed through a larger incision. “Scarring was something Micaella was worried about,” Patel said. “I didn’t want to do a robotic surgery that would need to be converted to an open one, leaving her with multiple scars. I made the smallest incision possible” so Guzman would “be more comfortable with the outcome.” Patel consistently communicated with his young patient’s mother, who was protective and concerned every step of the way. “I’m the father of two daughters, so I understood,” Patel said. Guzman was up and walking the day after her surgery with the support of a physical therapist. “I knew if I was walking, I’d recover faster,” Guzman said. She added that her recovery wasn’t difficult, though it took a few months for her pre-surgical stamina to return. The mass turned out to be benign—a cystic anomaly that she didn’t need to worry about going forward. Guzman returned to TGH for a follow-up with a nurse practitioner who assured her that healing was progressing and the pathology left nothing to worry about. Patel followed up with her by telephone to answer lingering questions. “She’s going to be fine,” he said. “Having one kidney is not going to significantly change her life, aside from being cognizant of her overall health and embracing a healthy lifestyle.” Looking back, Guzman knows the drive to Tampa was the right decision. “I 100 percent recommend Tampa General,” she said. “It was the best experience I’ve ever had in a hospital. I didn’t want to be there, but they went out of their way to make me feel welcome.” ADVANCES

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Spotlight on a

MYSTERIOUS MALADY Steve Hilfiker is on a journey to raise awareness about cardiac sarcoidosis since getting a new lease on life at the TGH Transplant Institute BY SETH SOFFIAN 44

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LEFT: Dr. Gundars Katlaps performing the heart transplant on Steve Hilfiker in 2020 after a pacemaker was ineffective.

Dr. Jason Feliberti

Dr. Gundars Katlaps

Dr. Kiran Dhanireddy

It was only a few years ago that Steve Hilfiker couldn’t climb a flight of stairs without feeling faint or nauseous. Severe dizziness, fatigue, shortness of breath, and swollen ankles were more signs his heart was failing—without explanation. Today, the 57-year-old Floridian is leading a full life again thanks to a transplant in August 2020 by Tampa General Hospital and the USF Health Morsani College of Medicine at the University of South Florida, and he is using every beat of his new ticker to make sure his message is heard. With help from his family and a fledgling charity organization, Hilfiker works tirelessly to raise awareness of the need for increased organ donations due to the little-known, often fatal condition—cardiac sarcoidosis—which nearly killed him. Part of his story has been told in a short documentary that screened at the Cannes Film Festival in France in May 2022, directed by his nephew Nicholas Markart. Hilfiker and Markart traveled around the United States and Europe to conduct interviews with doctors, researchers, caregivers, and patients for a planned documentary series about the condition that is frequently discovered in autopsies.

Virtual interviews were also conducted in Africa and Australia for global perspective. “Steve’s story is somewhat miraculous. I’m happy he’s doing all that he is doing. I think his efforts are instrumental,” said Dr. Jason Feliberti, Hilfiker’s cardiologist and a specialist in cardiology transplantation and cardiovascular disease at the TGH Heart & Vascular Institute (HVI). “I feel that congestive heart failure (including cardiac sarcoidosis) is not fully appreciated in the general public until it’s too late.” Sarcoidosis is an inflammatory condition in which an immune response causes clusters of cells—called granulomas or sarcoids—to form in the lungs, eyes,

Dr. Benjamin Mackie

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CLOCKWISE FROM LEFT: Hilfiker with Vannessa Blais, the sister of his heart donor; Hilfiker and his nephew, Nicholas Markart, at the 2022 Cannes Film Festival screening of a short documentary Markart directed about cardiac sarcoidosis; Blais listens to Hilfiker’s heart.

skin, heart, or other organs. For more than five years, Hilfiker was not given a diagnosis for what eventually was determined to be cardiac sarcoidosis, which causes severe debilitation and has a high mortality rate. “Historically it’s been poorly understood and therefore underrecognized clinically,” said Dr. Benjamin Mackie, interim co-director of the TGH HVI, medical director of the TGH HVI Heart Failure Center of Excellence, and medical director of heart transplantation at the TGH Transplant Institute. “It’s a sneaky disease. It’s variable in how it affects each patient. Because of that, it’s not always top of

mind for physicians.” Its causes are unknown, although some research points to environmental triggers as a potential factor. Hilfiker believes his condition can be traced to a severe sinus infection, triggered by seasonal allergies, which his body couldn’t fight off amid a period of heavy work and fatigue. “I had a 104-degree fever, and the next day I was absolutely fine, except for a dry, lingering, wispy cough,” said Hilfiker, founder of an environmental engineering firm in Fort Myers. “Of the 50 participants we’ve interviewed on four continents, almost every one of the sarcoidosis patients has an environ-

mental trigger story,” he said. Patients typically struggle as their quality of life and overall health decline. “Congestive heart failure is very deadly, but also very cumbersome,” Feliberti said. “One patient once described it to me as walking around with a ton of bricks on your shoulder. You kind of live your life like that. You wake up like that. You live fatigued and short of breath. You know nothing else, and it only gets worse.” Three years into his symptoms, Hilfiker had a pacemaker inserted, only to see his symptoms continue to worsen, he said. A year later, when a nuclear stress test to measure blood

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Patients have to understand the symptoms and they need to ask tough questions,” Hilfiker said. “If what their doctor is telling them just doesn’t feel right, they have to get a second opinion.” — STEVE HILFIKER

flow showed that Hilfiker had irreversible heart damage, he still was not provided with an explanation. Nor was he referred to an advanced heart failure facility with the expertise and equipment to treat rare conditions. Another test, an angiogram, showed only that the once-active, otherwise fit, healthy man with low cholesterol had clear arteries. Hilfiker was told by local doctors that the nuclear stress test “must be a false positive, and it’s all in your head,” Hilfiker said. “They called me a hypochondriac and told me to see a psychiatrist.” Finally, Hilfiker was diagnosed in 2019 at the University of Rochester Medical Center in

his native New York. His condition was identified through a positron emission tomography (PET) scan and confirmed through a heart biopsy. Even before the tests, though, Hilfiker said his doctor knew what was wrong. “He diagnosed my enlarged heart with his hands when other doctors were missing it for five years,” Hilfiker said, “because he knew what it was.” When caught early, several interventions can treat cardiac sarcoidosis, beginning with something as routine as steroids. But in Hilfiker’s case, the only option that remained was a transplant. It is because of all the time lost in his and other cases that Hilfiker has become

a crusader for greater awareness of the lifechanging condition and on the importance of patient self-advocacy. “Patients have to understand the symptoms and they need to ask tough questions,” Hilfiker said. “If what their doctor is telling them just doesn’t feel right, they have to get a second opinion.” “Often the best patient advocate is going to be the patient themselves. We encourage that strongly,” said Mackie, pointing to the willingness of doctors at TGH to seek peer input. “We ask each other for help all the time. If we can’t figure it out, then we call colleagues at other [medical] centers. It’s always a very colADVANCES

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Failing hearts in general tend to be significantly bigger, significantly heavier,” Katlaps said in an interview for Hilfiker’s documentary. “Most of them are barely moving. Sometimes you wonder, ‘How is this patient still alive?’ Steve’s heart was not moving well, enlarged, heavy. It was not going to last long.” —DR. GUNDARS KATLAPS

laborative approach that has to be patient-centric. To ask for a second opinion is something I think is a good paradigm within which to practice medicine.” Already in advanced heart failure by the time he chose to be near family in Florida to await a heart donation and transplant, Hilfiker received that gift on Aug. 3, 2020, from a North Carolina man who was 31 when he died. The transplantation was performed by Dr. Gundars Katlaps, a transplant and cardiothoracic surgeon, and assistant professor in the USF Division of Cardiothoracic and Transplantation Surgery and surgical director of the TGH Advanced Lung Disease & Transplant Center. Katlaps said Hilfiker’s heart showed the classic signs of congestive failure. “Failing hearts in general tend to be significantly bigger, significantly heavier,” Katlaps said in an interview for Hilfiker’s documentary. “Most of them are barely moving. Sometimes you wonder, ‘How is that patient still alive?’ Steve’s heart was not moving well, en-

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WARNING

SIGNS lesss

The symptoms of cardiac sarcoidosis can be missed by patients and doctors because they are the same for other serious but common cardiac conditions. These symptoms include:

Hilfiker interviewed 50 people on four continents for his documentary exploring the little-known disease that plagued him for years.

Chest pain larged, heavy. It was not going to last long.” More than 100,000 adults and children are on the national transplant waiting list for kidney, heart, liver, and lung donations, according to the Organ Procurement and Transplantation Network of the U.S. Department of Health and Human Services. Seventeen people die every day waiting for an organ for transplantation. “There’s absolutely no reason not to be an organ donor,” said Hilfiker, who created the nonprofit Foundation for Organ Donation and Sarcoidosis Awareness (FODASA), in part to support organ procurement organizations. “It’s the obvious decision,” he said. Hilfiker was far from out of the woods following his transplant. In an extremely weakened state at the time of the surgery, he contracted pneumonia and sepsis, and was put in an induced coma. He reported a sensation that felt like his brain was spinning backwards, gaining momentum. Feeling like he was nearing death, he steeled his will to live. “I said, ‘I’m a single father of four kids. I’m not ready to go yet,’” Hilfiker said. Under TGH’s care, Hilfiker recovered. Just three months after his hospital release, on Thanksgiving Day 2020, he hiked up a 1,100-foot trail to the summit of Sharptop Mountain in Georgia—a steep ascent he’d completed several times. “I had to do it. I proved to myself I was healed,” Hilfiker said.

Fainting

Shortness of breath

Fatigue

Cough

Ankle and feet swelling

Irregular, rapid, or fluttering heartbeat

IF DIAGNOSED EARLY, treatments can be as simple as steroids or other immunosuppressant medications. Other interventions include the insertion of a pacemaker, implantable cardioverter defibrillator, or catheter ablation. A heart transplant is the treatment of last resort. Because the causes of cardiac sarcoidosis are unknown, the best preventative measures align with healthy lifestyle choices and listening to your body. “Routine visits with your primary care physician and a heart-healthy lifestyle really take people a very long way,” said Dr. Benjamin Mackie, medical director of the TGH Heart Transplant Center. ADVANCES

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NOURISHING

GIFTS FOR THE MOST

PRECIOUS PATIENTS A GENEROUS DEBARTOLO FAMILY FOUNDATION DONATION TO CREATE THE NEONATAL MILK LAB HELPED TO KICK OFF ELEVATING EXCELLENCE: INNOVATING TOMORROW’S TGH CAMPAIGN By Dave Scheiber

It began with a casual lunch—no expectations other than a chance to connect. For the record, no one ordered milk. Yet from this friendly little get-together, a transformative family gift guided by Nikki DeBartolo and her husband, Chad Chronister, will keep that liquid forever flowing in Tampa General Hospital’s soon-to-open Milk Lab. For newborns in critical need of life-sustaining nutrition, it means there will be plentiful supplies of breast milk and fortified formula customized to each baby’s needs in the TGH Jennifer Leigh Muma Neonatal Intensive Care Unit (NICU). Mothers who can’t produce enough breast milk can rest assured this modern lab will keep their newborns well-fed in the crucial days, weeks, or months after birth. That’s what quietly struck DeBartolo and Chronister, Hillsborough County’s sheriff, as they listened intently at a Palma Ceia Golf & Country Club restaurant table in early 2023. Across from them sat Taylor Baker, senior director of development for the Tampa General Hospital Foundation and TGH Foundation consultant Chris Roederer, a friend of the couple.

Roederer was making the introduction because Baker wanted to get to know them and convey the great work being done at the Muma Children’s Hospital at TGH and the bold pediatric services renovations taking place. Baker “told them a little bit of everything—not only about pediatric programs. But I could tell they were interested in that area, so I shared updates with them about our Jennifer Leigh Muma NICU, and they kept coming back to that,” Baker recalled. “When I described plans for the Milk Lab, they were very intrigued and asked a lot of questions.” DeBartolo and Chronister have long supported children’s causes, particularly helping the Hillsborough County Sheriff’s Office raise funds for the Boys & Girls Clubs of Tampa Bay. They also have a strong connection to another generous TGH donor: her dad, famed real estate developer and pro sports figure Eddie DeBartolo. The former owner of the San Francisco 49ers during their glory years of the 1980s and 1990s had become a relatively recent TGH supporter. His gratitude for the

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Nikki DeBartolo and Chad Chronister

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TOP: The new Milk Lab, completed last summer, will provide up to 1,500 newborns annually in the TGH Jennifer Leigh Muma Neonatal Intensive Care Unit with life-sustaining breast milk and fortified formula customized to each baby’s needs. BELOW: Candy and Eddie DeBartolo

orthopedics care he received opened the door to philanthropy totaling some $17 million since 2019. It also heightened his family’s awareness of TGH and the world-class care it provides. That led to the fateful lunch—the key step in teamwork at multiple levels, leading to an outcome that will change lives for years to come. “We didn’t go to that lunch intending to discuss a gift—it was really for the purpose of meeting them and expanding the relationship with their family,” Baker explained. But a few days later, Chronister made it known that he and his wife planned to steer a $2 million DeBartolo Family Foundation gift to the TGH Foundation—half of it to cover the construction costs of the Milk Lab, the other half to help offset construction expenses for TGH’s Neuroscience and Transplant Surgical Tower. The size and timing of the gift was especially exciting for the TGH Foundation, Senior Vice President and Chief Philanthropy Officer Frann M. Leppla said. “We are so grateful to Nikki and Chad for this meaningful gift in support of our littlest and often most vulnerable patient population. And the fact they’re able to carry on the tradition of supporting Tampa General established by Eddie DeBartolo and his wife, Candy, is certainly a full-circle moment,” Leppla said. “The DeBartolos have an unwavering appreciation for the world-class care provided by our academic health system. Now, more than ever before, the family is seeing the impact of that care and they’re really getting excited about it.”

FROM PLANNING TO FRUITION Melissa Golombek, vice president of the Muma Children’s Hospital at TGH and the TGH Women’s Institute, has good reason to share Leppla’s sentiment. The gift has made the NICU team’s dream a reality, paving the way for a Milk Lab that will potentially

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YOU CAN IMAGINE HOW REWARDING IT IS TO KNOW THAT YOUR FAMILY’S DOLLARS ARE GOING TO ENRICHING THE LIFE OF AN INFANT.”

—Eddie DeBartolo

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help 1,500 babies a year. After coming to TGH four years ago, Golombek learned early on of the standout work of the NICU, a vast space that can accommodate nearly 100 babies in need of specialized, life-saving care. But there was one thing missing: a Milk Lab. Donated breast milk was being handled by a skilled team yet without a modernized, dedicated space. “We’re going to fix that,” she said at the time. The team, led by Nikki Hurley, senior director of the Muma Children’s Hospital at TGH and the TGH Women’s Institute, and Beverly Hernandez, director of Clinical Nutrition Services, developed the business plan based on input from nurses, nutritionists, and clinical leaders. “That was a powerful example of teamwork in action,” Golombek said. “Everyone was dedicated to creating our own state-of-the-art lab.” Golombek presented the findings to TGH leadership in 2022. “It was incredible—nobody batted an eye,” she recalled. “In fact, they said, ‘Absolutely, we need to do this for our babies.’” Golombek and Baker began strategizing raising funds for the project. They could talk generally about the major renovations taking place in pediatrics, given its integral role in serving the community. But Golombek wanted to make the Milk Lab a reality as soon as possible. When Baker called to relay the good funding news, “we had team members getting tearful, because they wanted to do this for the babies so badly,” Golombek said.

When DeBartolo and Chronister got their first look at the facility shortly after it was completed last summer, they were thrilled. “It’s easy for some people to just write a check and not see where that’s going,” DeBartolo remarked. “But to actually see all the great things—and how many babies this is going to help—is amazing.” They reflected on the lunch meeting and how the subject instantly resonated with them. Chronister noted that the DeBartolo Family Foundation often focuses on children. “You can imagine how rewarding it is to know that your family’s dollars are going to enriching the life of an infant,” he said. The milk containers are marked with a scannable barcode label that identifies moms, babies, and milk recipes that are customized for each infant based on their specific physiological and nutritional needs. “There are safety checks at every point,” Golombek said.

ELEVATING EXCELLENCE CAMPAIGN The Milk Lab is half of the family’s contribution. The other $1 million slated for the new surgical pavilion is part of the TGH Master Facility Plan. It is the top philanthropic priority in the TGH Foundation’s first comprehensive campaign—Elevating Excellence: Innovating Tomorrow’s TGH—a five-year, $100 million campaign. Launched two years ago in a silent phase, it was officially kicked off for the public during a fall gala and is expected to run over the course of the next three years. “Though the main focus of the campaign is around the TGH Master Facility Plan, every gift counts toward our $100 million goal,” said Michael Masem, vice president of development and campaign manager. “Donors can participate by supporting any growth points of the institution— anywhere from renovating key care units, standing up our new behavioral health hospital, funding our service line strategies and much more—with the crown jewel being the new surgical tower. That will be a real game-changer.” DeBartolo and Chronister were excited to invest in that change now to help TGH grow and babies, too. Leppla couldn’t wait to tell two people about the Milk Lab gift: donors Pam and Les Muma. They named the NICU to honor the memory of their daughter, Jennifer Leigh Muma, who died just days after being born in 1973. “The Mumas are very invested in their NICU flourishing and continuing to receive community support,” she said, so learning about the couple’s $1 million gift “was indeed a very special moment.” And it all flowed from an equally special lunch.

MAKE AN IMPACT To find out how you can support the Elevating Excellence: Innovating Tomorrow’s TGH campaign, contact Mike Masem at the TGH Foundation at 813-844-7574 or mmasem@tgh.org or go to tgh.org/elevating-excellence.

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The five-year Elevating Excellence: Innovating Tomorrow’s TGH capital campaign was formally launched last fall with TGH President and CEO John Couris and Senior Vice President and Chief Philanthropy Officer Frann M. Leppla.

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RANKED REALTRENDS 2023

AMERICA'S BEST

REAL ESTATE PROFESSIONALS

Geraldine Stanko (561) 603-6730 geraldine.stanko@compass.com

Dory Faxon (401) 965-7530 dory.faxon@compass.com

Compass is a licensed real estate broker and abides by Equal Housing Opportunity laws. All material presented herein is intended for informational purposes only. Information is compiled from sources deemed reliable but is subject to errors, omissions, changes in price, condition, sale, or withdrawal without notice. Photos may be virtually staged or digitally enhanced and may not reflect actual property conditions.

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UNCONDITIONAL GIVING. UNLIMITED IMPACT. Together we’re innovating tomorrow’s TGH and redefining what it means to be world-class. Thanks to the philanthropic investments of our generous donors, we can continue to create an ecosystem of expertise, drive discovery and elevate the level of care for all. For more information on our Elevating Excellence campaign, please visit TGH.org/Elevating-Excellence

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1/2/24 10:55 AM

WELL-BEING

NOURISH THE

BODY AND SOUL

SPRING IS A MAGICAL TIME OF YEAR when the world seems to come alive again. With a plethora of colorful fruits and veggies in season, now is the perfect time to experiment with new, healthy recipes. Whether you’re looking to boost your energy, improve digestion, or create healthy habits that will serve you throughout the year, these revitalizing, easy-to-make, plant-based meals will inspire you to nourish both body and soul. From refreshing smoothie bowls and bright salads to hearty soups and wholesome entrees, get inspired this spring with the following vibrant and healthful dishes from my book, Nourish & Glow: Naturally Beautifying Foods & Elixirs. BY JULES ARON PHOTOGRAPHY BY GYORGY PAPP

ABOUT THE AUTHOR

Jules Aron is a five-time author, holistic nutritionist, and wellness ambassador.

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RAW MATCHA KEY LIME CUPCAKES With a smooth, dense, and creamy texture and bright citrus notes, these deliciously sweet and zesty rounds of bliss are the utter definition of skin food. Loaded with healthy fats from avocado, nuts, and coconut—and the added antioxidants from the matcha tea—these will keep your sweet tooth satisfied and your skin glowing. Makes 12 cupcakes.

INGREDIENTS COCONUT MACADAMIA CRUST 2 cups raw macadamia nuts 1 cup unsweetened, dried shredded coconut 1 tablespoon lime zest 2 tablespoons fresh lime juice 2 teaspoons pure vanilla extract ¼ cup pure maple syrup 1 teaspoon sea salt KEY LIME FILLING 1½ cups raw cashews, soaked in water for 2 hours, then drained 1 avocado, halved and pitted 2/3 cup Key lime or regular lime juice 2 tablespoons pure maple syrup 1 tablespoon matcha powder (optional) 2 tablespoons lime zest, for garnish

HEALTH BENEFITS

Matcha contains various antioxidants and polyphenols that help boost the immune system and protect against antigens. Chlorophyll-rich matcha is also an excellent detoxifier that cleanses the blood, maintaining its alkalinity and flushing toxins out of the body.

TO MAKE THE COCONUT MACADAMIA CRUST: Place all the crust ingredients in a food processor and pulse until well combined. The mixture should appear crumbly but stick together easily when pressed. Line a 12-cup muffin pan with paper liners. Place 2 tablespoons of the dough inside each cup and flatten against the bottom of the cup to form a crust. Repeat with the remaining mixture. Place the tray in the freezer to set. TO MAKE THE KEY LIME FILLING: Place all the filling ingredients in a food processor and process into a smooth, creamy mixture. Remove the muffin pan from the freezer and transfer the cupcake crusts to a large plate. Scoop the filling into each cup. Garnish with lime zest. Chill before serving.

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JACKFRUIT CARNITAS TACOS Carnitas taco lovers, rejoice! This jackfruit re-creation of the pulled pork taco is remarkable. The jackfruit shreds and falls apart just like its meaty counterpart, while its neutral taste makes it the perfect ingredient to marinate. Serves 4 to 6.

INGREDIENTS

HEALTH BENEFITS

With its high water content and potassium levels, the combination of the honeydew melon and cucumber in this soup helps to maintain healthy blood pressure levels. The aloe helps promote collagen production and tissue repair, resulting in ageless skin.

CHILLED HONEYDEW AND FENNEL SOUP Sweet, bright, and refreshing with just a hint of spice, this lovely, chilled soup comes together in a flash, perfect for long, lazy summer days. And your skin will thank you for its natural beautypromoting vitamins and minerals. Serves 4 to 6. 60

INGREDIENTS 4 cups seeded and roughly chopped honeydew melon 1 cup roughly chopped fennel 4 cups roughly chopped cucumber ¼ cup aloe water ½ cup fresh lemon juice ½ green chile pepper, finely chopped Sea salt and freshly ground black pepper Fennel fronds, for garnish 3 tablespoons extra-virgin olive oil or avocado oil, for garnish

Place the melon, fennel, cucumber, aloe water, lemon juice, chile pepper, salt and pepper to taste in a high-speed blender and blend until you have a smooth, vibrant green soup. Adjust seasoning to taste. Chill for 30 minutes before serving. Pour into bowls and top with a fennel frond and a drizzle of oil. Store in an airtight glass container in the refrigerator for up to 2 days.

JACKFRUIT CARNITAS 2 tablespoons olive oil 1 teaspoon paprika 1 teaspoon chili powder 1 tablespoon tamari (or coconut aminos, for a soy-free option) 1 tablespoon pure maple syrup 1 medium onion, minced 4 garlic cloves, minced 1 (20-ounce) can jackfruit in water, drained and rinsed well 1 cup vegetable broth 1 chipotle pepper in adobo sauce, finely chopped SPINACH TORTILLAS 4 cups spinach, rinsed ½ cup water, plus more if needed 2 tablespoons olive oil 1 cup tapioca flour Sea salt Lime juice Salsa, vegan sour cream, avocado slices (for garnish) TO MAKE THE JACKFRUIT CARNITAS: Place the olive oil, paprika, chili powder, tamari, maple syrup, onion and garlic in a large bowl and mix well. Add the jackfruit and allow to marinate for 2 hours. Heat a large skillet over medium

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heat. Add the jackfruit and its marinade, vegetable broth and chipotle pepper. Mix well and bring to a boil. Lower the heat to low and simmer, covered, stirring occasionally. After 20 minutes, uncover the pan and use a fork to break up the jackfruit. Continue to simmer for another 15 minutes, or until the sauce is absorbed, stirring often to break up the larger pieces of jackfruit. TO MAKE THE SPINACH TORTILLAS: Place the spinach and the ½ cup of water in a large pan and simmer over low heat for 3 minutes, or until the spinach wilts. Transfer the spinach and its cooking water to a food processor or blender and add the oil, processing until smooth. Let cool. Whisk together the tapioca flour and salt in a large bowl. Stir in the spinach mixture and knead by hand into a dough until smooth and soft. If the dough appears too dry or is sticky, sprinkle with a tablespoon of water. Divide the dough into six equal-size balls, cover, and place in the refrigerator for 20 minutes. Place a ball of dough between two pieces of parchment paper and roll out to make a 6- to-8-inch tortilla. Heat a dry, nonstick pan over low heat and place the tortilla in the hot pan for 4 minutes. Flip and cook the tortilla for another 4 minutes. Remove and repeat to make the remaining tortillas. To serve, divide the chipotle jackfruit among the tortilla shells, squeeze lime juice on top and garnish with salsa, vegan sour cream or avocado slices.

HEALTH BENEFITS

Jackfruit is a delicious fruit packed with powerful antiulcerative, antiseptic, and antiinﬂammatory properties. The largest tree-borne fruit, jackfruit fulﬁlls the iron needs in the body, promoting proper blood circulation and preventing anemia. It is also known to inhibit the degeneration of cells, helping to maintain suppler and more glowing skin.

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SAFFRON CAULI-RICE WITH CURRANTS AND PINE NUTS IN BAKED TOMATOES Stuffed with saffron-infused cauliflower rice, plump currants, sweet apricots, and savory pine nuts, these baked tomatoes help keep your electrolytes in balance and your skin radiantly hydrated. Serves 6.

HEALTH BENEFITS

The exotic spice saffron is highly prized for its color, flavor, and medicinal properties. The dried stigma of the crocus flower, it contains high concentrations of nutrients that may help stimulate the immune system’s production of white blood cells, the body’s first line of defense against illness.

INGREDIENTS 6 large tomatoes 1 tablespoon pine nuts 1 medium (2-pound) cauliflower 2 tablespoons olive oil, plus more for brushing ½ cup chopped onion ¼ cup finely chopped dried apricots 1 tablespoon dried currants 1 teaspoon ground cumin 1 teaspoon ground cinnamon ½ teaspoon saffron threads Sea salt and freshly ground black pepper 1 tablespoon finely chopped fresh mint, for garnish Preheat oven to 375 degrees. Slice the top from each tomato to make small lids. Scoop out the insides and save 1 cup. Chop the flesh and set aside. Toast the pine nuts in a pan over medium heat for 2 to 3 minutes, until golden. Trim the cauliflower, cutting away the stems. Break up the florets into a food processor and pulse until the mixture resembles rice. Use 2 cups of the rice for this recipe. Heat the oil in a large skillet over medium-high heat. Add the onion and sauté for 2 to 3 minutes. Add the reserved tomato flesh and cauliflower rice; stir to combine. Add the apricots, currants, pine nuts, cumin, cinnamon, saffron and salt and pepper to taste, and continue to cook, stirring frequently until the cauliflower has softened, 3 to 5 minutes. Remove from the heat. Allow filling to cool for about 10 minutes. Fill tomatoes to the top with the cauli-rice and cover with their respective lids. Place the stuffed tomatoes in a baking pan. Brush the tops and sides of the tomatoes with olive oil. Add ½ cup of warm water to the bottom of the pan in between the stuffed tomatoes and bake for 30 minutes. Remove from the oven and let cool for 5 minutes. Serve warm with a generous sprinkle of fresh mint.

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KALE THAI SALAD WITH SPICY CASHEWS This fun twist on the Thai salad adds kale to the mix. If you haven’t made friends with kale yet, this recipe just might change your mind. Serves 4 to 6.

INGREDIENTS SPICED NUTS 1½ cups raw cashews, coarsely chopped and soaked in water ¼ cup pure maple syrup 2 teaspoons chili powder ½ teaspoon sea salt SALAD 4 cups julienned kale, thick stems removed 1 cup shredded red cabbage 1 cup julienned carrot 1 red bell pepper, seeded and julienned 1 yellow bell pepper, seeded and julienned 1 orange bell pepper, seeded and julienned 4 small sheets nori, cut into thin strips ½ cup chopped fresh cilantro Olive oil vinaigrette

TO MAKE THE SPICED NUTS: Preheat the oven to 350 degrees. Line a baking sheet with parchment paper. Drain and dry the cashews and toss them in a medium bowl with the maple syrup, chili powder and salt until well coated. Spread them on the prepared baking sheet and toast for 10 to 15 minutes. Remove from the oven and let cool. TO MAKE THE SALAD: Combine all the salad ingredients in a large bowl and toss with the dressing until evenly coated. To serve, transfer to individual plates and sprinkle generously with the spiced nuts.

HEALTH BENEFITS

We all know kale is good for our health. But did you know that this leafy green contains 130 percent of your daily vitamin C—an essential collagen builder for firm skin. Kale also supports detoxification of your liver and kidneys, essential for clear skin.

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WELL-BEING

Good Vibrations

Have fun in the sun with ECO-FRIENDLY personal wellness gear BY LIZA GRANT SMITH

On Purpose In addition to crafting go-anywhere, chic towels ($40) made with certified post-consumer recycled materials, Nomadix is a Climate Neutral Certified company, which means it’s removing greenhouse gases from the atmosphere at the same rate that it is emitting them. Nomadix ((nomadix.co)

Goody Two Shoes Inspired by the ocean, the creators of Waves didn’t want their flip-flops ($16) to leave a negative impact on the environment. Instead of plastic or other toxic materials, each pair is made from premium-grade, natural rubber tapped from rubber trees in Sri Lanka. In addition to being eco-friendly, the natural rubber provides elasticity that conforms to the curves of your feet and features a silky smooth feel. Waves Flip Flops (wavesflipflopsusa.com)

Quite the Spectacle The startling statistics that an estimated one billion people don’t have access to eye care and nearly 80 percent of the world’s blindness is preventable served as a call to action for two San Diego State University students to found Solo Eyewear. The fashionable sunglasses ($99) are eco-friendly (made with repurposed wood, bamboo, cellulose acetate, and recycled plastic). With each purchase, Solo restores vision for a person in need—nearly 15,000 people across 32 countries to date. Solo Eyewear (soloeyewear.com)

Sun-kissed Designed for avid outdoor lovers who need lasting protection from the elements, Manda Naturals Organic Sun Paste ($28) is the first of its kind to use thanaka powder derived from a type of sandalwood tree native to Myanmar. Thanaka paste is a centuries-old natural sun protectant and skin beautifier as well as a sustainable and regenerative ingredient. Without the addition of the chemicals oxybenzone and octinoxate, the product is also reef-safe—helping coral remain healthy for generations of fish and snorkelers. Manda Naturals (mandanaturals.com)

Game Changer Have some serious beach or backyard fun with Waboba’s entertaining Rewild Paddle set ($20) that is made from pinewood and basswood trees and features a cork ball naturally made from oak tree bark. Waboba (waboba.com)

Sitting Pretty Kick back and enjoy the stylish and socially responsible Low Tides beach chair ($170). Relax with its thoughtful features—easy-fold technology, five reclining positions, smartphone slot, and bottle opener to name a few—and in the comfort of knowing that each chair is made with upcycled ocean plastic. Low Tides Ocean Products (lowtidesop.com)

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PROTON THERAPY

LIVE IN DEVELOPMENT

INNOVATING THE INDUSTRY

ELEVATING THE REGION Tampa General Hospital and the USF Health Morsani College of Medicine propel a hub of world-class care in Tampa’s Medical & Research District.

In partnership with the Tampa Bay Economic Development Council, we are spearheading a hub of world-class clinical care, academics, research and biotechnology. Inspired by renowned medical districts across the country, the district generates an influx of innovation, job creation and top talent for a more prosperous economy and a healthier population. NEW AND EMERGING TGH BROKE GROUND ON DEDICATED TRANSPORTATION TO DISTRICT LOCATIONS

Florida’s Leading Academic Health System For Over 50 Years

TGH.org

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12/27/23 9:40 AM

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Welcome, TGH Employees! USF Federal Credit Union is a TGH Employee Benefit. We are excited to assist with all your banking needs! • Ask about our special offers on credit cards, share certificates, money markets & checking accounts!

USF

FE DER AL CREDI T U N IO N ®

Join online today: usffcu.com/tgh

813.569.2000 • Federally insured by NCUA

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