Health Matters
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DECEMBER 2018
MODEL PATIENT A new high-tech mannequin patient can mimic everything from a heart attack to child birth. SEE PAGES 8-9.
Providers At Advanced Pediatrics, PA: MONA PATEL, MD FARAH USMANI, MD AISHA ASIF, MD
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Providers At Clermont Pediatrics, PA: MONA PATEL, MD FARAH USMANI, MD VIPIN MENDIRATTA, MD SHAHRZAD TARAFDAR, MD
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Safe and scrumptious
Happy Holidays from the Newly Renovated
With the holidays upon us, here’s how to ensure your culinary celebrations are both delicious and safe to consume. DANIELLE HENDRIX BLACK TIE EDITOR
It’s the holiday season, and you’re already dreaming of the holiday feast you’ll be cooking up with your family — maybe some ham, cranberry sauce, potatoes, rolls and countless other delicacies. As with preparing any meal, though, there are steps one needs to take in order to prevent food contamination and ensure the food is both delicious and safe to eat. According to the Florida Department of Health in Orange County, many of the reported cases of food-borne illness are caused by bacteria or the toxins produced by bacteria. “Bacteria multiply extremely fast when food is kept at an unsafe temperature (above 41 and below 140 degrees Fahrenheit),” the department stated. The department’s website states that “once ingested, the microbe or toxin passes through the stomach into the intestine, attaches to the cell walls and starts to multiply.” For that reason, it might take several hours
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or even days before symptoms appear. The first symptoms often include nausea, vomiting, abdominal cramps and diarrhea. Common food-borne illnesses include campylobacter, cyclospora, E. coli, listeria, norovirus, salmonella, shigella and vibrio vulnificus. To help reduce chances of food contamination as you begin your holiday meal preparations, department staff recommends
TIPS AND TRICKS Each type of food — meat, poultry, seafood and other cooked foods — must reach a safe minimum internal temperature. For a list of proper temperatures and rest time by food, visit foodsafety.gov/ keep/charts/mintemp.html. HHS offers a FoodKeeper app, which helps users maximize the freshness and quality of food items by teaching them about proper storage. The app allows users to look up different foods and learn how long they can be safely kept for consumption. Visit foodsafety.gov/keep/ foodkeeperapp/index.html to find an index and links to download the app to your smartphone or tablet. For more information on food safety, visit foodsafety. gov and follow the Florida Department of Health in Orange County on Twitter at @GOHealthyOrange.
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cleaning, cooking to proper temperature, properly refrigerating food and avoiding cross contamination amongst foods. Before you begin cooking and after you’re finished, be sure to wash hands, utensils and all surfaces — especially if you’ve been preparing meat, poultry, eggs or seafood. All countertops and work areas should be kept clean with hot, soapy water. When cooking, be sure to read package directions before you begin. According to the department, the safest thawing method is in the refrigerator at 40 degrees Fahrenheit. Be sure to check for doneness with a food thermometer, and cook the food at the proper internal temperature. As far as keeping food, perishables, prepared food and leftovers should be refrigerated or frozen within two hours. The refrigerator should be set at no higher than 40 degrees, and the freezer should be set at 0 degrees. “Keep raw meats, poultry, eggs and seafood and their juices away from ready-to-eat food,” the department stated. “It is recommended that leftovers be heated to 165 degrees.” For leftovers, divide into smaller portions and be sure to freeze or refrigerate them in covered, shallow containers for quicker cooling. A large container or whole turkey will take too long to cool to a safe temperature and allow for the possibility of a bacteria breeding ground. And according to the U.S. Department of Health & Human Services, leftovers can be kept in the refrigerator for three to four days. “If you store leftovers in the freezer, they will be of best quality within two to six months,” said Luis Delgadillo, HHS senior public affairs specialist. “Not enough consumers know that food can become unsafe in the refrigerator after four days. In fact, 31% of participants in our recent research indicated they would eat leftovers kept longer than four days in the refrigerator. After four days, spoilage bacteria can cause food to develop a bad smell or taste.” It is safe to reheat frozen leftovers without thawing, Delgadillo said, but they must reach a temperature of 165 degrees and covered when reheating. Sauces, soups and gravies should be brought to a rolling boil. If
According to the HHS, these are some dangerous foodsafety mistakes people often make. For explanations and solutions, visit foodsafety. gov/keep/basics/mistakes/ index.html. n Tasting food to see if it’s good n Putting cooked meat back on a plate that held raw meat n Thawing food on the counter n Washing meat or poultry n Letting food cool before putting it in the refrigerator
n Eating raw dough, cookie dough or foods with uncooked eggs or uncooked flour n Marinating meat or seafood on the counter n Using raw meat marinade on cooked food n Undercooking meat, poultry, seafood or eggs n Not washing your hands
reheating in a microwave, cover and rotate the food for even heating. “Arrange food items evenly in a covered, microwave-safe glass or ceramic dish and add some liquid if needed,” Delgadillo said. “Be sure the covering is microwave safe, and vent the lid or wrap to let the steam escape. The moist heat that is created will help destroy harmful bacteria and will ensure uniform cooking.”
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DECEMBER 2018
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The cells will return home in January. Then, researchers will compare them to control cells.
Rocket science of microgravity on
Muscle cells from eight Central Florida residents took a trip into space for the sake of science and to obtain a deeper understanding of muscle loss.
these cells are ap-
GABBY BAQUERO
“The negative effect
plicable not only to spaceflight but also in a clinical context, particularly the loss of muscle mass that occurs with aging and the acute loss of mass that comes from an illness, injury or disuse.” — Dr. Paul Coen
NEWS EDITOR
O
n Thursday, Nov. 15, an experiment containing muscle cells from eight Central Florida residents blasted off into space from NASA’s flight facility at Wallops Island in Virginia. The experiment — a collaboration between Micro-gRx, Florida Hospital and SpacePharma — intends to study the negative effects of a low-gravity environment on the muscle cells to gain a better understanding of muscle health, said Dr. Paul Coen, an investigator at Florida Hospital’s Translational Research Institute in Orlando. “This is a really exciting experiment,” Coen said. “It was an opportunity for us to send an experiment into space to the International Space Station. The goal of the experiment is to understand how exposure to microgravity in space can affect muscle cell biology. And this is
important, because spaceflight and exposure to microgravity have very detrimental effects on muscle health. It results in muscle atrophy and loss of muscle mass.” Astronauts who spend extended periods of time in space in microgravity undergo an accelerated loss of muscle mass and tend to experience significant muscle weakness upon their return to Earth. Many are temporarily restricted to a wheelchair, because they are weak and need to recover. But the detrimental effect of microgravity on muscles presents a unique opportunity for research focused on understanding the process behind muscular atrophy and the resulting loss in muscle mass, said Coen, who specializes in research on aging muscles. “The negative effect of microgravity on these cells are applicable not only to spaceflight but also in a clinical context, particularly the loss of muscle mass that occurs with aging and the acute loss of mass that comes from an illness, injury or disuse,” he said.
“For example, someone who’s admitted to a hospital as an inpatient and exposed to bed rest for a few days would lose muscle mass and strength. So the results from this experiment will inform us of some of the basic biology underlying the atrophy and recovery processes not in just the context of space flight but in a clinically relevant context.” A better understanding of those processes can lead to the development of countermeasures that can be used to help both astronauts and patients in the future, he said. The experiment is being led by Dr. Siobhan Malany, president of Micro-gRx and a scientist at the Sanford Burnham Prebys Medical Discovery Institute in Lake Nona. Because Micro-gRx has been awarded funding for two more launches, the team also will be able to study the potential efficacy of the countermeasures aimed at preventing muscle loss, Coen said. “We might incubate the cells with ... compounds that might protect against muscle atrophy,” he said. “We can also contract the
muscles by electrically stimulating them, so we can also look at any positive effects of inducing muscle contractions and see it can help prevent or reduce the negative effects of microgravity on cells.” The cells all are contained on chips the size of a business card, which are encased in a small 10-by-30-centimeter box. They also are submerged in a medium that basically feeds the cells, Coen said. After their weeklong space vacation, the cells will be frozen for preservation and returned to Earth in mid-January on a SpaceX Dragon capsule. Once retrieved, a team will analyze the cells to see how they were affected by their time in space, he said. The cells also will be compared to control cells that remained on Earth to better pinpoint any molecular and biochemical changes that may have occurred during their space vacation. In the next five years, more experiments will be launched into space. The follow-up experiments will allow the research team to study countermeasures to muscle mass loss, Dr. Coen said. “The opportunity to send an experiment up into space doesn’t come up too often in one’s career, so it’s pretty cool to be involved in sending an experiment to the International Space Station,” he said. “But also we’re really bullish in this line of research, because we want to help develop therapeutics to help maintain muscle health.”
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DECEMBER 2018
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DECEMBER 2018
Sam Winter is meant to have the look and feel of a real patient.
A new high-tech mannequin patient at Winter Park Memorial Hospital marks another investment into training medical professionals. TIM FREED ASSOCIATE EDITOR
W
inter Park Memorial Hospital’s new patient breathes, blinks, talks and has a pulse, but it isn’t human. It’s Sam Winter — the new high-tech mannequin at Winter Park Memorial Hospital used to train nurses and doctors. Hospital staff had the chance to meet Sam for the first time at an open house event in early October, catching a glimpse of the high-tech patient that can mimic a broad range of symptoms and situations, from heart attacks to child birth. Sam Winter — a human patient simulator created by Laerdal as the Laerdal SimMan 3G — works through a computer system to mimic human bodily functions. That includes breathing, bleeding, sweating, blinking and talk-
ing — done through a microphone system by a training specialist in a separate room. The mannequin also can be changed from male to female simply by switching some of the parts. Medical staff in training can use the mannequin to check a pulse, give an IV, perform CPR, check for compromised lungs by listening to the breathing and deliver a baby through an automated birthing system — even allowing trainees to go through a variety of birthing scenarios by repositioning the baby inside the mannequin. “It’s basically a high-fidelity, physiological model that controls almost every human function that you would see in a body,” said Patrick Connors, executive director of simulation at Florida Hospital. “It bleeds, it breathes, it can sweat; it can have discharge from the nose, the eyes, the ears, the
Courtesy photo
mouth; it has very realistic teeth and a jaw, where you can do intubations by putting a tube down the throat. It’s got eyes that blink and eyes that dilate when you put light on them — it’s really cool.” Trainees can even push “drugs” into the mannequin, Connors said. “You scan the barcode on the side of the vial — it’s all just distilled water, a clear liquid like all the drugs that you see,” Connors said. “The provider would scan those, and then the computer would know that you’re giving the right medication and the physiological model of the mannequin would react to that. If you push the drugs too fast or too slow or the wrong type, there’s consequences for that.” The mannequin — named “Sam” because it’s a genderneutral name and “Winter” after Winter Park — was purchased for about $100,000 for Winter Park Memorial in response to the investment the hospital made in establishing a simulation lab on site, Connors said. Every bit of square footage in a hospital is valuable, and Winter Park Memo-
“If you’re going to fail, fail early and fail often and do it in a safe place, and then you come out of there with more competence and more confidence in your skills.” — Patrick Connors, executive director of simulation, Florida Hospital
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Observer Publisher / Matt Walsh, mwalsh@YourObserver.com Publisher / Winter Park/Maitland Observer Jackie Fanara, jfanara@OrangeObserver.com Executive Editor / Michael Eng, meng@OrangeObserver.com Design Editor / Jessica Eng, jeng@OrangeObserver.com Community Editor / Amy Quesinberry, amyq@OrangeObserver.com News Editor / Gabby Baquero, gbaquero@OrangeObserver.com Black Tie Editor / Danielle Hendrix, dhendrix@OrangeObserver.com Sports Editor / Troy Herring, therring@OrangeObserver.com
rial Hospital deserves to have the best technology in place, he said. “We’ve been on a journey to improve the learning culture across all the Florida Hospitals in Central Florida, and one of the ways to do that is build simulation labs or simulation centers — they’re all different based on the space that you have at each physical location,” Connors said. “They all contain a space where you can go to a safe learning environment away from the patient setting and get practice skills and learn through repetition, observation and debriefing to really get better, reduce risk and increase patient safety.” “We opened up the sim lab (in Winter Park) probably in 2017,” he said. “I had a lesser-capable mannequin placed there, and then based on the feedback from the staff at Winter Park and the clinical educators, the leaders and what they wanted to do, it became pretty apparent to me that we needed to put a really high-end
model over there — that’s the SimMan 3G.” Connors — who has worked in the simulation field for more than 30 years and served as a U.S. Army colonel training soldiers — knows well the benefits of practicing with a piece of equipment and perfecting techniques. It’s one thing to read about a condition in a book, but it’s another to actually treat it and be in a hospital environment with real doctors, nurses, patients and their families, Connors said. That’s one of the reasons why some training sessions with Sam include role players who might serve as the mannequin’s spouse, daughter or son — it creates a richer learning environment that’s more realistic, Connors said. “If you’re going to fail, fail early and fail often and do it in a safe place, and then you come out of there with more competence and more confidence in your skills,” Connors said. “You’ve got the education, you’re licensed and you’ve got the degree, but now, it’s time to practice. You know the hard skills, but when you add the complexity of the hospital environment and the complexity and emotion that you have with patients’ interaction with family members, it’s imperative that you practice that before you go onto the floor. “The more competent you are, the more confident you become,” he said. “It’s a cycle, and it spirals upward.” Innovation is on the rise in the medical field — and Sam Winter is just a glimpse of how far the technology has come, Connors said.
Associate Editor / Tim Freed, tfreed@OrangeObserver.com Black Tie Reporter / Harry Sayer, hsayer@OrangeObserver.com
Photos by Tim Freed
Florida Hospital currently has access to about 77 mannequins — an entire family of “patients” ranging from adults to children to newborns, and it’s all to prepare medical professionals to do their jobs to the best of their ability. “The technology has gotten better and better, but we’re now moving into not just mannequinbased but augmented reality, where you can look at something through special glasses and then you can see certain wounds or certain things on a mannequin or human,” Connors said. “It’s really changing the learning culture. At Florida Hospital, we’ve come a really long way — we’ve gone from no sim labs to eight different sim labs across the Central Florida footprint. … We’re really moving medical training and medical education to the 21st century like a lot of other industries — like the space industry, nuclear industry, defense industry, etc. I’d say that the health care industry has lagged behind, and now we’re playing rapid catch-up. We realize we have to change the way we embrace technology. “They’re doing things in that sim lab that we didn’t ever imagine,” Connors said.
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CONTACT US The West Orange Times & Observer and Observer are published once weekly, on Thursdays. The Winter Park/Maitland Observer is published once weekly, on Fridays. The Observer papers can also be found free in many commercial locations. If you wish to subscribe to the West Orange Times, Observer or Winter Park/Maitland Observers, call (407) 656-2121 or visit our offices at 661 Garden Commerce Parkway, Suite 180, Winter Garden, FL., or 180 S. Knowles in Winter Park, FL.
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PINPOINT ACCURACY New equipment at the West Orange-area cancer center allows doctors to minimize radiation exposure while treating tumors. AMY QUESINBERRY COMMUNITY EDITOR
A new, dual-use machine at Health Central Hospital’s cancer center is making it easier for doctors to pinpoint tumors during radiation therapy. “The MRIdian is essentially two devices in one,” said Dr. Patrick Kelly, a radiation oncologist with Orlando Health UF Health Cancer Center who has hours at the new Health Central Hospital center. “It’s a traditional radiation
Courtesy photo
The MRIdian Linac is capable of combining radiation therapy and MRIs so doctors can pinpoint tumors more accurately during treatment.
machine,” Kelly said. “It makes high-intensity, high-energy X-ray radiation that is used to treat patient with cancers. That treatment machine is connected to an MRI machine in which the patient will lie, allowing them to undergo an MRI and undergo radiation treatment at the same time.” With the MRIdian Linac from ViewRay Inc., magnetic resonance
imaging and radiation therapy are fully integrated during the course of treatment, allowing for a targeted approach. The technology allows specialists to track and adjust its beam delivery to any subtle changes in the tumor and surrounding tissue during treatment. As a result, cancer patients benefit from this personalized radiation therapy while
minimizing radiation exposure to surrounding healthy tissue. “Fighting cancer requires a constant search for the latest advances in treatment, and the MRIdian system is another example of our commitment to provide our patients with personalized, exceptional cancer treatment,” said Dr. Daniel Buchholz, chairman of radiation oncology at Orlando Health. “Soft-tissue tumors have subtle, natural movement during treatment, but this technology allows us to track and treat the tumor while sparing surrounding healthy tissue from radiation exposure, which may result in better outcomes and less side effects for our patients.” With the MRI machine active, the radiation beam is concentrated on the tumor. If it is located in the chest or abdomen — where there’s movement such as breathing — the doctor can adjust the beam and redirect the radiation to the right place if the tumor shifts. Kelly said the MRIdian doesn’t necessarily lessen the number of treatments but makes them more accurate and therefore, more effective. “We have been limited in terms of how much radiation we can give,
because we haven’t been able to take into account the movement of tumors in certain locations,” Kelly said. “We’ve had to account for a certain amount of error. We can give higher doses of radiation therapy safer than ever before.” The MRIdian is safe for all patients except those who have metal in their body, such as those who have had hip or knee replacements. The facility is one of nine in the country to treat cancer with MRIguided radiotherapy. The MRIdian System is one of the advanced treatment options available at the new Orlando Health UF Health Cancer — Health Central Hospital. The 30,000-square-foot cancer center was funded primarily by a $21 million grant from the West Orange Healthcare District and almost doubles the size of the previous facility, located near Health Central Hospital. In addition to MRIdian MRI-guided radiotherapy, the new cancer center features expanded chemotherapy and radiation treatment areas, medical oncology services, surgical oncology consultations, laboratory facilities and cancersupport community programs.
The holiday season is in full swing! There’s so much to do with all the cooking, shopping, travel, parties, and opportunities to spend time with friends and family. But all this holiday cheer can lead to holiday stress, a few too many cookies, and by New Year’s Day, a less than healthy you. So let Healthy West Orange help. All month long we’ll have ideas and tips to keep your activity up and your eating healthy. It’s not about being perfect or depriving yourself of the holiday cheer, but rather the small choices you can make to enter 2019 a healthier and happier you. Looking for ideas to keep you on track right now? Join our Facebook group, HWO Wellness Squad, a place where you can connect with other folks on the health journey, sharing your successes and challenges. And don’t forget to register for our 2nd Annual Virtual 5K in January. It’s a great time to be in west Orange County, and Healthy West Orange wishes you and yours a happy and healthy holiday season!
Join the movement at HealthyWestOrange.org
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DECEMBER 2018
MARIJUANA CBD VS. HEMP CBD Hemp and marijuana both are varieties of cannabis, but hemp contains less than .3% THC and marijuana contains .3% or more THC. Marijuana must comply with seed-tosale state laws that make products illegal to transport across state lines, but hemp is legal for use throughout the U.S., as long as the hemp is imported from an international source. Hemp grown in the U.S. is subject to the same seed-to-sale state laws that apply to marijuana. CBD is the same plant compound, whether it’s found in a low-THC or highTHC cannabis plant.
DIVINE WELLNESS
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Right: CBD, or cannabidiol, is a cannabis extract and can have antipsychotic or even therapeutic effects on users. Photos by Danielle Hendrix
Understanding CBD oil Despite the stigma surrounding CBD oil, public interest is growing in the cannabinoid and the therapeutic effects it is thought to have. DANIELLE HENDRIX BLACK TIE EDITOR
I
f you’ve seen newscasts, articles, advertisements and social-media posts about CBD oil and have been curious about it, you’re not alone. Stories, testimonials and explanations of the therapeutic effects many claim about CBD — or cannabidiol — are plentiful, especially with ongoing, related news of more states legalizing the use of cannabis. Although cannabidiol is extracted from marijuana or hemp plants, it is not to be confused with the chemical tetrahydrocannabinol — or THC — which is responsible for the high associated with use of marijuana. However, there is still a stigma that surrounds CBD oil thanks to its origin — the flowers and buds of marijuana or hemp plants.
CANNABIS CONTROVERSY
Cannabidiol makes up about 40% of cannabis extracts and is thought to have antipsychotic effects for reasons that are unclear, according to Medline Plus, an online information service from the United States National Library of Medicine. “Cannabidiol seems to prevent the breakdown of a chemical in the brain that affects pain, mood and mental function,” Medline Plus’ website states. “Preventing the breakdown of this chemical and increasing its levels in the blood seems to reduce psychotic symptoms associated with conditions such as schizophrenia. … Also, cannabidiol seems to
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reduce pain and anxiety.” Michele Miller, co-owner of Divine Wellness in downtown Winter Garden, initially began researching CBD oil a while back and now sells varieties of it in her shop. “A lot of people come in here, and they’re confused and have this stigma and make jokes about it,” Miller said. “I want them to understand how their body works, how this works with their bodies and what the possibilities are to be able to consume it.” The history behind marijuana in the United States has been a rocky one. In the 1930s, when Prohibition was repealed, bureaucrats began looking for another target and turned their attention to marijuana. In 1937, the Marijuana Tax Act passed, essentially outlawing the plant in the United States. Even today, only nine states have legalized marijuana, with 29 allowing medical marijuana. But, Miller said, cannabinoids such as CBD have healing properties — and hemp CBD, which is
CAUSE AND EFFECT
Divine Wellness in Winter Garden carries CBD-infused lotions that can help relax users or aid with pain relief.
legal in all 50 states, has low levels of THC. “Hemp has very high levels of CBD and low levels of THC,” Miller said. “In our body, we have this endocannabinoid system. … There’s receptor sites (on our bodies) and when they get filled with a cannabinoid, homeostasis can happen in that part of the body. That’s when the body gets this state of calm or peace. Our
bodies have been programmed to heal pretty much everything, given the right tools. “Life is so stressful, and everything is so chaotic that we can’t get to that state of homeostasis to allow the nutrients we put in our body to actually work,” she said. “That’s the beautiful thing about CBD — it’s like a big chill pill. It just calms you down and relaxes the body.”
CBD is non-psychoactive, although due to its support of homeostasis, many report feeling relaxed after using it. “People have heard about it and are looking for it,” Miller said. “They want to get out of their pain, stop taking drugs and have relief. They want to be them. When you take some CBD and it gets into your system, it lets you be you. That’s the beauty of it.” At Divine Wellness, Miller and her business partner sell hemp CBD in the forms of oil, wax, syrup and lotions. The oil is a whole-plant, full-spectrum oil that is grown, processed and packaged in the United States. The organic CBD isolate syrup is combined with nutrients such as magnesium that promote mind and body relaxation. Lotions at the shop contain CBD combined with a pure essential-oil blend of menthol, camphor, clove, wintergreen, eucalyptus, lavender and Roman chamomile for a relaxing blend. The premium-blend hemp CBD wax includes 99% CBD isolate and blueberry terpenes and is meant to work in a wax vape pen. Other methods of CBD delivery
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“I want them to understand how their body works, how this works with their bodies and what the possibilities are to be able to consume it.” — Michele Miller, Divine Wellness co-owner
on the market elsewhere include tinctures, creams and gels, capsules, sprays, transdermal patches and even lollipops. Also important to keep in mind is finding the correct dosage. “Each bottle has a serving size on it, but a serving size does not mean a dose,” Miller said. “What I like to do is tell people to start with just a few drops at a time, because how are you going to know what your dose is if you’re putting a full dropper in? You need to start slow and work your way up, to count your drops to see what your amount is when you start feeling the benefits of it.”
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f you’re a senior enjoying retirement and looking to get in touch with your creative side, Central Florida Community Arts might have something for you through its Arts in Action Program. The Arts in Action Program offers classes in singing, dancing, storytelling, acting and more to healthy seniors. Classes run for 10 weeks each season and are $35 per course. Scholarships are available for those who might need financial assistance. The program is open to beginners looking to try something new or experienced individuals looking to stay active in their artistic endeavors. “The program was designed for people ages 60 and older — who are healthy, aging adults — to experience the arts in an accessible way,” said Matt Heim, senior director of marketing and communications for CFCArts.“They all start at beginner level. … If you’ve never tried one of these things — if you’ve never tried singing or playing an instrument or you’ve never danced in your whole
life or anything like that — you can start even at 60 and older because (classes are) truly beginner level.” The Arts in Action program has been around for about a year, and Heim said the program is made possible through a grant awarded to CFCArts by the Winter Park Health Foundation. “This program came about through the Winter Park Health Foundation,” Heim said. “The idea really came (about) because a lot of our other outreach programs and arts and wellness programs are for people who may have a physical or cognitive disability or ailment or disease. This (Arts in Action Program) is really something to make sure people who are healthy remain active and healthy in the arts.” Heim said Arts in Action offers a wide selection of classes offered in different locations in Maitland and Winter Park. Class locations include the Maitland Senior Center, Maitland Library, Winter Park Center for Wellness and Westminster Winter Park. Each class is taught by a professional or semi-professional artist to ensure program participants learn from the best, said Leah Por-
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Courtesy photos
Above: Jean Witherington, left, and Esther Hand are just two of the many happy participants of the Arts in Action Program. Left: Arts In Action participants such as Netta Darroch are given to an opportunity to perform at the end of each course.
rata, senior director of Education and Outreach for CFCArts. “Each of our 10-week courses (is) taught by a master teaching artist, so we have some really wonderful, fantastic professional and semi-professional artists who are out in the community teaching these courses,” Porrata said. “People love our teachers. That’s the No. 1 thing we always get good feedback about is our educators. We have teachers who are trained specifically in teaching senior populations.” Of all the different classes offered through the Arts in Action Program, dancing has been the most popular. Dancers typically learn contemporary/modern techniques, and each class is tailored to participants, Porrata said. “The dance classes are our most popular classes,” Porrata said. “They’re all formulated around the (class’) population, so there’s always modification so that if you can’t do something, there’s
another alternative move that you can do that doesn’t make you feel like you’re sticking out because it still matches with the choreography. And they’re really fun. “It’s all about the joy of dance and movement, and it’s not scary and intimidating, but it’s also not too easy or simple,” she said. Porrata added that at the end of each 10-week course, participants are given the opportunity to perform; however, performances are not mandatory. “We end (each class) in an optional, but encouraged, final recital,” Porrata said. “We never force anyone to do anything, but we find that most of them do want to participate and perform.” The Arts in Action program is just one of many programs offered at CFCArts. CFCArts offers a number of programs for individuals of all ages and skill level. For more information about the Arts in Action program or others, visit cfcarts.com.
• • • • • • • • • • • • • • •
Anger Management Anxiety Women’s Issues Codependency Coping Skills Divorce Family Conflict Grief Life Transitions Marital and Premarital Parenting Peer Relationships Relationship Issues Self Esteem Stress
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BettyJo Camp, LMHC Completed level 1 training in Gottman Couples Therapy
American Counseling Association (ACA) Florida Mental Health Counselors Association (FMHCA) American Mental Health Counseling Association (AMHCA) Dance is the most popular class offered by the Arts in Action Program.
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DECEMBER 2018
Don’t let sore feet stop you from having fun!
Train ’em right At Total Athlete Training’s new Winter Garden location, Dan Bessetti is looking to help aspiring local athletes. TROY HERRING SPORTS EDITOR
A
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MAKE AN APPOINTMENT TODAY! DR. PHILLIPS
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s Dan Bessetti paces on the turf inside his new facility, there’s a controlled excitement about his demeanor. It’s in this large space filled with weights and training equipment in Winter Garden that he plans on helping mold the area’s young athletic talent. Total Athlete Training, located on Gillard Avenue, is the physical embodiment of Bessetti’s life work preparing middle and highschool athletes to play at the next level by offering programs that are geared specifically for their age group. “Most of the information out there about training is still based upon the college and the elite level — unfortunately, that doesn’t extrapolate naturally down to someone who is 12,” Bessetti said. “I learned that the hard way. Obviously, the parents and the athletes didn’t know any better, but (I) as a practitioner saw (that) these kids are not understanding how they need to move and contort their bodies.” By continually utilizing college workout programs at the middle and high-school level, it actually can prevent a studentathlete from reaching fullest, and healthiest, potential, Bessetti said. Teaching age-appropriate
technique and training can help build a stronger base for an athlete — setting the foundational requirements needed to excel at his or her sport. “You need to train them where they are at with an eye toward where you would like to get them to — where almost everyone aspires to,” Bessetti said. Getting kids started at an early age — their early teens or sooner — helps further establish those required skills thanks to the makeup of the brain. The human brain contains the most neurons between the ages of 9 to 13, Bessetti said, which means the more that young athletes can learn in that time, the better off they will be when it comes to nailing down those needed skills. “At the base of the brain — in the cerebellum — which is the coordinative center of the brain, that’s where the thought of, ‘OK, I need to shuffle over there’ goes to here (legs, feet) to tell what muscles to make to do it,” Bessetti said. “This is like the relay point where everything is connected together. So there are a lot of connections that are possible in there, and the more you make, the more varied your movement skill repertoire is.” Another big aspect of the training programs that Bessetti offers to younger athletes is focused on keeping them physically healthy by showing them proper technique.
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Get Get INVOLVED
“Obviously, the parents and the athletes didn’t know any better, but (I) as a practitioner saw (that) these kids are not understanding how they need to move and contort their bodies.” — Dan Bessetti
LEARNING PROPER TECHNIQUE
The concept of “old habits die hard” is true in many aspects of life, and that includes sports. Think about it this way: If a middle-school football player learns to lift weights by using bad posture, it could cause serious injury without him even knowing it. Along with the chance of unintentional physical harm, there’s the added issue of having to totally relearn the technique at a later point in his career — something that can take up a lot of precious time and set an athlete back. That issue is one of the many that Bessetti has seen throughout his 20-plus years of experience working with athletes — dating back to his time studying sports medicine as a student at Slippery Rock University in Pennsylvania.
“I was always more interested in the preparation side of it rather than the reaction side of it,” Bessetti said. “When you’re in sports medicine, you’re kind of waiting for bad stuff to happen, and that’s when you’re really needed. “I knew I was different, because I was like, ‘Ugh, I don’t want them to get hurt,’ whereas everyone else was like, really pumped up when people got hurt,” he said. Bessetti moved in 2001 to Central Florida to take on the role of college strength coach at the University of Central Florida, where, during a seven-year tenure, he helped train seven future MLB athletes, one NBA draft pick and numerous future NFL players. Then, in 2008, Bessetti decided to do something a little bit different and created Total Athlete Training — leading him to where he is today, doing a job he loves. “My overall, biggest goal for Total Athlete Training is to be a resource and an asset to anybody involved in sports in West Orange County,” Bessetti said. “If a highschool coach has some kind of strength-and-conditioning program that they’re using, I’d be happy to consult, look over it with them and say, ‘You might be able to do this better.’ I don’t see any reason why our high schools around here can’t be consistently, across all sports, tops in the state.”
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DECEMBER 2018
Goodwill to all men The Limitless Options Men’s Clinic conducts hormone therapy treatment for men. HARRY SAYER BLACK TIE REPORTER
Sometimes, it can be hard to feel right. There can be many symptoms when things feel off — lack of sleep, low libido, fatigue, depression and more. But it still can be hard to understand precisely why those things are happening. Limitless Options, a recently opened men’s clinic in Winter Park, tackles these issues that are harder to detect — testosterone imbalance, hormone deficiencies and erectile dysfunction. The clinic specializes in both human-grown hormone treatments and testosterone injections. “Testosterone is the hormone that makes the male body work,” owner Gabe Sullivan said. “It
consists of anything that burns fat, gains muscle mass, causes us to have energy. It’s what makes a guy a guy.” PROGRESS
The major symptom of testosterone balance, according to Sullivan, is simply fatigue. “It’s being 40 years old and feeling like you’re 60 years old,” he said. “You go to bed and get eight hours of sleep but wake up and you’re tired throughout the day. I call it ‘watching the grass grow’ — you sit on your couch and know you need to go mow the lawn, but you just watch the grass grow taller and taller.” Other symptoms include loss of muscle mass, bad moods and low sexual drive. He claims people often can be prescribed medicine for depression when, in
Harry Sayer
Limitless Options Men’s Clinic Director Ryan Nelson and owner Gabe Sullivan work with 25 patients suffering from testosterone and hormone imbalance and erectile dysfunction.
reality, the problem is in a hormone imbalance. To combat this, patients take an initial series of tests during which the on-staff physician checks for as many maladies as possible. Sullivan said the clinic runs tests for thyroid problems, kidney and liver functions and
anything else that could be the true reason for symptoms rather than a hormone imbalance. When it has confirmed the issue stems from a testosterone deficiency, the clinic prescribes a treatment plan and the exact costs. Hormone and testosterone
treatment has come a long way in the past five years, as well. Physicians once tested simple testosterone numbers, without seeing if there were other health factors keeping the levels stifled, and then prescribed a series of injections that would lead to patients feeling sporadic results.
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and (he or she) tells you to do this, this and this to feel better. But you get a bill in the mail, and now you’re sick again with a bill of $2,500. “You leave our office knowing exactly what the out-of-pocket costs are going to be,” he said.
IF YOU GO LIMITLESS OPTIONS MEN’S CLINIC 201 N. Lakemont Ave., Suite 2100, Winter Park WHEN: 8 a.m. to 5 p.m. Mondays through Fridays PHONE: (407) 790-4205 CONTACT: menslimitlessoptions.com
COMFORT ZONE
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It’s no secret men sometimes can have trouble discussing erectile dysfunction or testosterone with other people. Sullivan believes it takes a lot for men to admit they need assistance. That’s where clinic director Ryan Nelson comes in. He makes it a priority to know every client’s name. “I see patients the moment they come in, I stay throughout the therapy, I guide them along with the doctor,” Nelson said. “If they ever have questions after hours, I’m the person they call. … I try to keep a good report with these guys, build a good friendly basis.” The clinic has an all-male staff to make the patients experience more comfortable. A grand ribbon-cutting ceremony is planned for Dec. 7.
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Now, the shots are timed with different days of the week — Sullivan said testosterone works on a seven-day cycle — to produce more consistent effects. It’s important to note the treatments don’t turn patients in superhumans such as Captain America — the point is to get a middle-aged man feeling like his age, not something much older. Sullivan, a former paramedic who has owned multiple men’s clinics, attributes his success in the hormone-replacement industry to his client’s ability to use insurance to help pay for the expensive treatments. “One of the big things I (take) pride in is that we don’t have any surprises,” Sullivan said. “You can go to a doctor’s office,
• New & Conservative Approach
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DECEMBER 2018
G
HEALTH CALENDAR
Get more out of life!
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e a part of a community where you can feel at home.
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Ask us today how you can qualify for our New Resident Incentives. Call (407) 933-1999 to schedule a personalized tour.
At Good Samaritan Society – Kissimmee Village, we believe that you deserve choices. • 55+ gated golf community • 425 acres nestled along the southern banks of Shingle Creek • Perfect setting to enjoy Florida’s natural beauty and wildlife • Full calendar of activities • Three wellness centers • Boat slips with access to Lake Toho • Kayaking on Shingle Creek • On-site RV/boat storage • Beautiful indoor and outdoor pools • Dog park and community gardens • Wide range of housing options, amenities and services • Unique financial option to minimize expenses and preserve your assets
4250 Village Drive Kissimmee, FL 34746 Phone: (407) 933-1999 good-sam.com/kiss All faiths or beliefs are welcome. © 2018 The Evangelical Lutheran Good Samaritan Society. All rights reserved. 183158
TUESDAY, DEC. 11
HANDLING THE HOLIDAYS IN GOOD HEALTH WORKSHOP Noon to 1 p.m. Tuesday, Dec. 11, at Florida Blue Orlando Center, 434 N. Orlando Ave., Winter Park. Take the stress out of the holidays with a new, fresh perspective to focus on what means the most to you at the holidays. Get tips to handle the holidays in good physical, emotional and mental health.
WEDNESDAY, DEC. 12
AARP DRIVER SAFETY PROGRAM 9 a.m. to 3 p.m. Wednesday, Dec. 12, at Health Central Park, 411 N. Dillard St., Winter Garden. Take a driver’s license and AARP membership card, if you are a member. AARP, (888) 227-7669. NATURE WALK AND BOOK TALK: A WALKING BOOK CLUB 10:15 a.m. Wednesday, Dec. 12, beginning at the Dr. P. Phillips Community Park office building, 8249 Buenavista Woods Blvd., Orlando. Experience the benefits of exercising your body and mind by joining the Southwest Library for a casual walk followed by a lively book discussion with Mike Gunter Jr., author of “Tales of an Ecotourist.” (407) 835-7323.
THURSDAY, DEC. 20
AROMATHERAPY: MUSCULOSKELETAL 11 a.m. Thursday, Dec. 20, at the Winter Park Public Library, 460 E. New England Ave., Winter Park. Enhance your body and mind with aromatherapy by learning the basics of this natural healing art. This class is free, but enrollment is required. Sign up by calling (407) 623-3300, Ext. 3.
SATURDAY, DEC. 22
STRESS BUSTER ART: HOLIDAY CALM WITH YARN PAINTING 10:15 a.m. to noon Saturday, Dec. 22, at the Southwest Branch Library, 7255 Della Drive, Orlando.
Color, create, paint and meditate. Join the library for a de-stressing holiday art adventure creating a yarn painting. No art experience required. All supplies are provided. For women and men ages 18 and up. Registration required. Limited seating. (407) 835-7323.
TUESDAY, JAN. 1
WESTLY’S SECOND ANNUAL VIRTUAL 5K Healthy West Orange invites residents to join the organization for its second virtual 5K event, which runs from Jan. 1 to 31. Participants can complete 3.1 miles at their own pace, wherever they like, whenever they like. If runners prefer to participate with a group, the organization will host Westly’s West Orange Walk at 7:30 a.m. Jan. 26, at a Horizon West location to be determined. For more, visit healthywestorange.org.
WEDNESDAY, JAN. 9
HEALTHY LIVING FOR SENIORS 10:30 a.m. Wednesday, Jan. 9, at the Southwest Branch Library, 7255 Della Drive, Orlando. Senior experts will provide information and education on how to take steps toward creating and maintaining a healthy lifestyle. Registration recommended. (407) 835-7323. MEDITATION AND MINDFULNESS 10 a.m. Wednesday, Jan. 9, at the Winter Park Public Library, 460 E. New England Ave., Winter Park. Want to reduce stress, restore focus and balance, and improve health and well-being? Discover what meditation is and isn’t. Learn its many benefits, how a regular practice tones the nervous system, enhances the structure and composition of the brain and more. This class is free, and enrollment is required. Sign up by calling (407) 623-3300, Ext. 3.
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We are your hometown solution for one-on-one assistance. With some of the best rates in Central Florida, we make staying independent affordable.
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• Meal preparation • Light housekeeping & laundry • Medication reminders • Personal hygiene • Dressing & grooming • Walking & exercise • Going shopping or to appointments
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DECEMBER 2018
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Breaking the habit
Open Enr
If you are resolved to quit, look at the strategies that work and see what fits for you. You can get help, for free, from TobaccoFreeFlorida.com, 877-UCANNOW. It can help you find quit classes, send you patches
Now Through December 15th for coverage starting January 1, 2019
We are proud to accept the
Disney Cigna HMO Plan
We accept BOTH Florida Hospital and Orlando Health plans
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Benefits of Choosing Windermere Medical Center • • • •
Comprehensive medical services for the entire family Cost-effective care Complete access to ancillary services Open 6 days a week with extended hours in evening until 9 p.m. and Saturdays 9 a.m. - 5 p.m. • Our top priority is ensuring your optimal health by focusing on preventative care
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I-4
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e e y o l p m E y e n s i D ollment
QUIT STRATEGIES AND RESOURCES
Turkey Lake Rd
Then, there are the financial considerations. Smoking and other tobacco use can cost you about $9,000 each year. That could buy a lot of other enjoyments. Smoking one pack per
To quit, you have to want to. You have to look at the pros and cons and balance your reasons for using tobacco against the reasons to quit. Look at the reasons, places and times you use tobacco and consider what you can and want to change. Ask yourself, on a scale of one to 10, how motivated are you? On a scale of zero to 10, how confident are you that you will succeed? Each quit attempt gets you a bit closer to a long-term break up with tobacco.
y
Pretty much everyone knows tobacco can cause cancer. Smoked tobacco destroys lung tissue, increasing the risk of lung cancer and chronic obstructive lung disease. It
YOU CAN DO IT
if appropriate and coach you along the way. The American Lung Association (lung.org) has an interactive online program to help you quit tobacco. Florida Area Health Education Centers have a free tobacco program also, with phone, web and live classes in most areas (ahectobacco.com). The American Cancer Society has great resources to help you (cancer.org, under the “Stay Healthy” tab). That website also has tips for friends and families of smokers. Plan your quit strategy, set a date, implement your strategy and build some accountability and support. Celebrate each tobacco-free day.
w
TOBACCO COSTS
Y
(and most tobacco users think of quitting) you need your own reasons and a winning strategy.
Pk
TOBACCO HARMS
DR. NANCY RUDNER
day costs more than $2,000 a year. If you smoke in your car, you drop its value by at least $1,000. If you smoke at home, you cut the resale value by about $2,000 per year. Smokers pay more for health, homeowners and life insurance and more out-of-pocket costs for health care. Employers find that smokers cost more, with more tobacco breaks from work and more sick days, as well as more medical costs. That is why tobacco users are banned from many workplaces, limiting employment and income options. For more on the costs, check out costofsmoking.com. The social costs are significant, too. Popular dating sites find that most people are looking for a non-smoker. In fact, smoking is such a dating issue that smokers, shunned on main dating services, have their own dating sites. These are just some of the reasons to not use tobacco. If you are thinking of quitting
Pa lm
ou know tobacco is not good for you, but can you count the ways? First, let’s get clear what we mean by tobacco. Cigarettes, cigars and chewing tobacco all deliver the addictive nicotine, along with other unhealthy chemicals. Vapes are not much better, so don’t delude yourself that it is a safer alternative. It is still nicotine and still damaging.
damages your heart, arteries and veins and increases the risk of blood clots. Tobacco users are more likely to have high blood pressure, strokes and heart attacks. Tobacco use also damages bones, increasing the risk of osteoporosis. Tobacco users have a higher risk of eye problems, such as glaucoma, macular degeneration and cataracts. It also harms teeth, causing inflammation and tooth loss. Chewing tobacco causes mouth ulcers and cancers. It isn’t pretty. The tobacco smell permeates your clothes, hair and skin. Tobacco use causes skin to age quicker and have more wrinkles. Smokers often develop a harsh, raspy voice.
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HEALTH MATTERS
For EXCELLENCE in VEIN CARE and treatments for (PAD) PERIPHERAL ARTERIAL DISEASE
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www.orlandoveins.com
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Seniors deserve special care. That’s why FPG opened its first medical center more than 30 years ago dedicated to senior-centered health
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DECEMBER 2018
23
HOSPITAL CARE COORDINATION Coordinating your care to put you on the road to recovery.
and wellness care. Today, our network of 22 clinics are still devoted to caring for people as they age. Our comprehensive approach brings your primary care physician
TESTING & DIAGNOSTICS Blood work, X-rays, EKGs, ultrasounds and more.
and other healthcare providers together to address your specific medical needs. It’s proactive, preventive, and personalized just for you and your changing priorities. And that’s just the start of how we’re different.
PERSONALIZED CASE MANAGEMENT Assessing, monitoring and educating.
We accept most Medicare Advantage Plans, including Aetna, CarePlus, Freedom, Humana, Optimum, Simply and WellCare. We also accept traditional Medicare.
Call us for a one-on-one appointment to talk about your healthcare needs. Family Physicians Group does not discriminate on the basis of race, color, national origin, age, disability or sex. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-320-2188 (TTY: 711). 注意：如果您使用繁體中文, 您可以免費獲得語言援助服務. 請致電 1-877-320-2188 (TTY: 711). The provider may also contract with other Plans/Part D sponsors.
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(407) 537-0395 | getFPG.com
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Freestanding ERs Provide More Options – Close to Home on a 74-acre campus at 17000 Porter Rd., at the corner of Porter Road and Avalon Road. The emergency room opened in late September and features 24 ER patient rooms with inpatient imaging and laboratory services. If a patient needs more acute care or a complex procedure, Orlando Health’s Air Care team can lift off from the onsite helipad and transport the patient straight to one of Orlando Health’s main hospitals.
As Central Florida continues to grow at unprecedented rates, Orlando Health is looking for ways to increase access to its high-performing healthcare. A key component in that initiative is opening freestanding emergency rooms across the region. Freestanding ERs, such as the newly opened Orlando Health Emergency Room and Medical Pavilion – Horizon West, keep pace with the healthcare needs of growing communities, says Orlando Health – Health Central Hospital President Mark Marsh. “We’re excited to open this new facility and offer its enhanced services to the rapidly-growing Horizon West community.”
What is a Freestanding ER? A freestanding ER is simply an emergency facility that’s not attached to a hospital building. Freestanding ERs eliminate the need to travel long distances on congested roadways by placing services within the community. Just like the Orlando Health – Health Central Hospital emergency room at 10000 W. Colonial Dr. in Ocoee, a freestanding ER provides 24/7/365 access to: • Board-certified emergency doctors and nurses • Diagnostic services (lab tests, radiology and advanced imaging) • Treatment for illnesses and injuries, including heart attack, stroke and trauma Located in southwest Orange County, the new two-story, 78,000-square-foot freestanding ER in Horizon West sits
Opening in early 2019, the second-floor medical pavilion will offer the following services:
currently under construction on the Health Central Hospital campus ($24.5 million), and the newly opened Orlando Health UF Health Cancer Center – Health Central Hospital ($21 million).
Other Planned Freestanding Emergency Room and Medical Pavilions Six freestanding Orlando Health ERs are open or coming soon across the region:
• Primary care including family medicine, pediatrics and OB-GYN • Specialty care including orthopedics, cardiology, gastroenterology, urology, neurology • General surgery • Outpatient diagnostic imaging • Orlando Health LabWorks • Outpatient Rehabilitation Center • Center for Health Improvement Phase 2 will include a six-level, 214,000-square foot hospital with 103 inpatient beds and additional primary care and specialty physician offices. The facility is part of a $100-million expansion currently underway to bring much-needed healthcare services to West Orange County. It includes $75 million in funding from the West Orange Healthcare District for the freestanding emergency department and medical pavilion ($29.7 million), a 100-bed skilled nursing facility
• Orlando Health South Lake Hospital Emergency Room and Medical Pavilion – Blue Cedar, 22316 US Hwy 27, Leesburg, FL 34748 (open) • Orlando Health South Lake Hospital Joe H. & Loretta Scott Emergency Room and Medical Pavilion in the Four Corners area, 16966 Cagan Ridge Blvd., Clermont, FL 34714 (open) • Orlando Health Emergency Room and Medical Pavilion – Horizon West, 17000 Porter Rd., Winter Garden, FL 34787 (open) • Orlando Health Emergency Room and Medical Pavilion – Osceola, 1001 E. Osceola Pkwy., Kissimmee, FL 34744 (opening January 2019) • Orlando Health Emergency Room and Medical Pavilion – Lake Mary, 412 Rinehart Rd., Lake Mary, FL 32746 (opening summer of 2019) • Orlando Health Emergency Room and Medical Pavilion – Randal Park in southeast Orange County (opening early 2020)
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