07.12.18 Health Matters by Orange Observer

Health Matters

Observer

JULY 2018

MANAGING MIGRAINES Not all migraines are the same, but prevention is key to all of them. SEE PAGES 10-11

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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Observer Publisher / Dawn Willis, dwillis@ OrangeObserver.com

Executive Editor / Michael Eng, meng@OrangeObserver.com Design Editor / Jessica Eng, jeng@OrangeObserver.com Senior Sports Editor / Steven Ryzewski, sryzewski@OrangeObserver.com Community Editor / Amy Quesinberry, amyq@OrangeObserver.com News Editor / Gabby Baquero, gbaquero@OrangeObserver.com Black Tie Editor / Danielle Hendrix, dhendrix@OrangeObserver.com Associate Editors / Tim Freed, tfreed@OrangeObserver.com; Troy Herring, therring@OrangeObserver.com Black Tie Reporter / Harry Sayer, hsayer@OrangeObserver.com Staff Writer / Eric Gutierrez, egutierrez@OrangeObserver.com Advertising Executives / Cyndi Gustafson, advertising@OrangeObserver.com; Laura Rubio, lrubio@OrangeObserver.com

HEALTH BREIFS

CONTACT US The West Orange Times & Observer and Windermere 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, Windermere or Winter Park/Maitland Observers, call (407) 656-2121 or visit our offices at 720 S. Dillard St. in Winter Garden, FL. or 180 S. Knowles in Winter Park, FL.

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COUNTIES INSTALL SUNSCREEN STATIONS AT PARKS Orlando Health UF Health Cancer Center and the parks and recreation departments in Orange and Seminole counties have installed sunscreen stations in 15 Central Florida parks, including multiple in West Orange County. “Since installing the sunscreen dispensers in several parks, we have had positive feedback from visitors,” said Matt Suedmeyer, manager of Orange County Parks and Recreation. “Thanks to Orlando Health, guests can have a little extra sun protection.” Park attendees now have the opportunity to protect themselves from the sun’s harmful ultraviolet (UV) rays as part of an initiative to help prevent skin cancer and other effects of extended sunlight exposure. Nine Orange County parks now hold a total of 18 sunscreen stations: Barnett, Cypress Grove, Downey, Dr. P. Phillips Community, George Bailey, Kelly and Moss parks; as well as Chapin Station on the West Orange Trail and Fort

Gatlin Recreation Complex. Most sunscreen products work by reflecting or scattering sunlight to protect the skin from UV rays. The sun’s UV rays can damage your skin in as little as 15 minutes. Be aware that sunburn and sun damage can occur even on cloudy days. Increased exposure to UV radiation increases during the summer months between 10 a.m. and 4 p.m. According to the Centers for Disease Control and Prevention, sun exposure is the most preventable risk factor for skin cancer. Cumulative overexposure to the sun leads to premature aging of the skin, including wrinkling and age spots and an increased risk for skin cancer, including basal cell carcinoma, squamous cell carcinoma and melanoma. Repeated exposure to sunlight in the eyes can also result in cataracts and macular degeneration.

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Florida Department of Health in Orange County is urging parents to prepare their children now for the upcoming school year. This free immunization event has been planned in the community so parents can vaccinate their children and obtain their DH680 form for school. Those eligible are OCPS students and children ages 2 months to 18 years of age entering, attending or transferring to Florida schools. It takes place from 8 a.m. to 3 p.m. Monday, July 23, through Saturday, July 28, as well as 9 a.m. to 2 p.m. Sunday, July 29, at the OCPS Academic Center for Excellence, 701 W. Livingston St., Orlando. Parents and students must take the most recent im-

munization record, original birth certificate or Social Security card and a valid photo identification. For information, call (407) 858-1444 or visit orange.floridahealth.gov.

REMEMBER ABC’s OF BABY SAFE SLEEP Every baby deserves a first birthday, and that is why Department of Health-Orange is raising awareness about Baby Sleep Safe practices in order to prevent Sudden Infant Death Syndrome These are the recommended Baby Safe Sleep practices: Babies sleep alone, on their back and in a crib. No soft bedding and/or bumper pads in the crib. Don't overheat or overdress your baby. Parents, share your room but never your bed. According to National Healthy Start Association, one of the top five leading causes of infant mortality in the United States is Sudden Infant Death Syndrome. The 2017 Infant Mortality rate in Orange County increased to

7.2 per 1,000 live births from 6.4 in 2015. An increased has also occurred with the Black Infant Mortality rate (BIMR) the last four years. The number jumped from a low in 2014 of 8.4 to 12.3 per 1,000 live births in 2016 and up again in 2017 to 15.5 per 1,000 live births. There are several other risk factors that can contribute to infant mortality including late prenatal care, being overweight, smoking, substance abuse, poor nutrition, domestic violence, preterm labor and SIDS. To learn more about the Healthy Start, Mom Care or the Bellies, Babies and Beyond program, call (407) 858-1472.

CORNERSTONE HONORED WITH AWARD OF EXCELLENCE Cornerstone Hospice and Palliative Care has received an Excellence in Program Innovation Award – Clinical Practice from the Florida Hospice and Palliative Care Association (FHPCA) for its Nurse Onboarding Program.

It is one of six hospice agencies across Florida to receive Awards of Excellence at a recent forum. The program was developed in April 2017 to help educate and acclimate new nurses to the hospice environment while familiarizing the new employees to Cornerstone Hospice’s internal processes and culture. The new nurses shadow an experienced Cornerstone Hospice nurse as he or she interacts with patients, family and other members of the Cornerstone interdisciplinary team, which may include home health aides, social workers, chaplains, bereavement counselors and physicians. “We had key objectives in developing the Cornerstone Hospice Nurse Onboarding Program,” said Nadia Soulouque, director of training and professional development. “We want to ensure new hires are comfortable working in a hospice setting and that they become proficient with the necessary documentation required by Cornerstone Hospice and the Centers for Medicare & Medicaid Services. We also wanted to facilitate an early sense of camaraderie for

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the new hires and enhance job satisfaction.” “Since implementation of the Cornerstone Hospice Nurse Onboarding Program, turnover of nurses has declined 18 percent,” said Chuck Lee, president and CEO of Cornerstone Hospice. “Ultimately, these positive results mean our patients and family receive a higher level of care in all of our coverage areas.” The FHPCA Excellence in Program Innovation Award recognizes services and programs provided by a hospice organization that demonstrate the power of creativity and ingenuity to impact the practice and the community. Cornerstone Hospice and Palliative Care Inc. is a not-for-profit community organization that provides comfort and care to Central Florida families experiencing life-limiting illnesses.

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JULY 2018

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When it comes to dental care, resources are limited for individuals who are uninsured or underinsured. The West Orange Dental Alliance aims to address that issue at no cost to its patients. Established by the West Orange Health Alliance in April 2017, the dental alliance was created to assist individuals who might not have insurance or the financial means to pay for dental care, said Tiffany Williams, WODA executive director. “(The West Orange Health Alliance) has been wanting to get a dental program going,” she said. “I know this is something that’s really needed. We’ve got lots of food pantries (and) lots of places to go for medical (needs), but dental is hard. Even people (who) are above … poverty level — even if they have dental insurance, dental is the last thing on their list.” Williams said a goal for WODA is to get patients out of pain. She added that many of the individuals WODA aims to assist typically go to hospitals for dental needs. “A lot of patients go to hospitals right now (for dental needs) because they ... don’t have dental insurance,” Williams said. “Patients are frequent fliers of the hospitals when they don’t have medical or dental insurance. … We’re trying to help those frequent fliers stay out of the hospital.” WODA offers services for extractions, fillings, crowns, cleanings and root canals. It even offers a program for patients to get their smiles restored. “A big thing that we’ve been doing is called our Jump Start program,” Williams said, “(For) somebody homeless or at poverty level … their teeth (might) have not been taken care of and they have a broken smile. We’d have them apply (to Jump Start).” Williams said the Jump Start program is aimed toward patients who are seeking employment or a better job. Patients who are interested are required to sign up with Career Source. “One of the very first (Jump Start) patients we did, he was working at a Circle K in Apopka — (he had) really broken teeth,”

Courtesy WODA

Tiffany Williams is the executive director of the West Orange Dental Alliance.

ARE YOU ELIGIBLE?

Services offered by WODA are only available to individuals who reside in the West Orange Healthcare District. Individuals who live in these ZIP codes are eligible: 32703, 32818, 32819, 32821, 32830, 32836, 34734, 34761, 34786 and 34787. Note: 32835 and 32809 are only partially located in the district.

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Williams said. “Once we were done with him, he’s now at an office job making the most he’s ever made in his life.” Services provided by WODA are only available to individuals who live in the West Orange Healthcare District. Individuals also are required to submit proof of residency. Since WODA is a mobile program with no physical facility, applications are available online and in hospitals and other locations throughout West Orange, Williams said.

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Colon correctness HARRY SAYER BLACK TIE REPORTER

The Center for Advanced GI, a group gastroenterology practice specializing in colonoscopies, endoscopies and more, is moving to a new location in Maitland. The two-story building, located at 740 S. Concourse Parkway, has an operational clinic that has handled initial visits for a few months. But after more than a year of work, the business is almost ready to move its surgical center into the new facility. “Downstairs is going to be the gem, it’s the jewel,” Dr. Raouf Hilal said. “It’s going to have four endoscopy rooms, one fully operational operating room; it’s going to be incredible.” He’s particularly excited about the new technology he and his partners will be using in the colonoscopies themselves. While Hilal used to have to pump light from a processor to light up his scope during procedures, Advanced GI will now use panoramic cameras with a built-in light to detect polyps and cancerous masses. It will provide what Hilal says is 330 degrees of vision rather than the old 170 degrees. “The colon is like a winding road,” he said. “If you take your car at night and are driving, you’re not going to see your left, right or behind you. … We can now, with this technology.” The providers handle thousands of patients each year, but Hilal said not nearly enough people are getting their screenings. Colon and rectal cancer are some of the most common cancers found in Americans and the third-leading cause of cancer death. They typically are found in adults over the age of 60. While the common wisdom has been to recommend people to receive checkups around 50 — about 10 years before the disease begins to exhibit itself — the American Cancer Society recently recommended having screenings at age 45 due to a sharp rise in rectal cancer

HEALTH OBSERVED

WHAT TO DO (AND NOT DO) BEFORE A COLONOSCOPY

Know Before You Go Know Before You Go -

Urgent Urgent Care Care vs. vs. Emergency Emergency Room Room

The Advanced Center for GI, like many colonoscopy centers, gives its patients tried-and-true instruction to prepare for a procedure. But that doesn’t mean those patients always listen. “You’re not supposed to eat or drink anything within a certain amount of hours before the procedure,” Dr. Joseph Quagliata said. “That’s to decrease the risk of a complication while (the patient) is under anesthesia. … I think many patients think ‘I can get away with it; so what if the doctor has to get past some fried chicken on his way to my colonoscopy.’ It doesn’t make my life any more difficult, but it does put them at risk.” Patients are heavily advised to stick to clear liquids the day before the procedure.

URGENT CARE URGENT CARE CENTER CENTER

Cold, flu, or fever Cold, flu, or fever Strains, sprains, or breaks Strains, sprains, or breaks Infections Infections Mild burns Mild burns Allergies Allergies

71 % 71%

THE FOUR PROVIDERS n Dr. Raouf Hilal n Dr. Andria Mushahwar n Dr. Joseph Quagliata n Dr. Panzarella

EMERGENCY EMERGENCY ROOM ROOM

Chest pain Chest pain Abdominal pain Abdominal pain Stroke Stroke Severe head injury Severe head injury Major trauma Major trauma

of emergency department visits are of emergencyordepartment unnecessary could have visits beenare avoided.1 unnecessary or could have been avoided.1

1 2013 study completed by Truven Health Analytics https://truvenhealth.com/news-and-events/ press-releases/detail/prid/113/ study-finds-most-emergency-room-visits-made-by-privately-insuredpatients-avoidable 2 Savings may vary depending on plan2benefits and treatment you receive. 2 copay applies copay appliesand 2 3 American Collegecopay of Emergency Physicians, Emergency Department Wait Times, Crowding applies copay applies2 Access Fact Sheet, http://newsroom.acep.org/fact_sheets?item=29937

LOWER LOWER

IF YOU GO

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Average length of You will usually Average length time spent in theofER Youseen will ARNP, usually be in under by Carol Lemerond, Florida Blue Nurse Practitioner time spent 3in the ER nationwide be seen in under nationwide3 minutes hours minutes hours You never expect a sore throat, Urgent care facilities are a less minutes 15 15 minutes expensive and quicker alternative fever or a broken bone. Life’s

WHERE: Center For Advanced GI, 740 S. Concourse Parkway #200, Maitland PHONE: (407) 644-4222 WEBSITE: http://centerforadvancedgi.net/

deaths in men and women under 50. Black people, males in particular, already have been encouraged to receive screenings at 45. But Hilal doesn’t think the new warnings go far enough. “If you have a family history … you’re recommended to start at age 40, or 10 years younger than the affected member,” he said. “If you’re seeing a spike in colorectal deaths and diagnostics in age 35 to 45, putting the screening at the latter end isn’t going to make a huge difference.” Raouf’s older brother Talal traveled to the United States from Palestine and founded the center in 1983. Raoul, the youngest of seven siblings, grew up watching Talal pursue a career in medicine and eventually joined his oldest brother at the center in 2002.

JULY 2018

20 20

EXTENDED HOURS health emergencies happen EXTENDED HOURS without a moment’s notice, and usually at the W most E E Kinopportune ENDS WEEKENDS times.

OPEN OPEN

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to emergency rooms that can Open handle a variety of medical Open problems. Trips24/7 to the emergency 24/7 room should be reserved for severe medical issues.

you have a life-threatening illness or injury, While it’s idealIf see your If to you have a life-threatening illnessaway. or injury, go to the ER or call 911 right primary care doctor gowhen to theyou ER or call 911 right away. have health concerns, sometimes 1 2013 study completed by Truven Health Analytics https://truvenhealth.com/news-and-events/press-releases/detail/prid/113/ Carol Lemerond is a nurse practitioner at the that’s possible. 1 study-finds-most-emergency-room-visits-made-by-privately-insured-patients-avoidable 2013 study not completed by Truven Health Analytics https://truvenhealth.com/news-and-events/press-releases/detail/prid/113/ Florida Blue Centers in Winter Park Village and

2 32 3

study-finds-most-emergency-room-visits-made-by-privately-insured-patients-avoidable Savings may vary depending on plan benefits and treatment you receive. the Clermont Wal-Mart, where she teaches Savings may vary depending on Physicians, plan benefits and treatment you inside receive. American College of Emergency Emergency Department Wait Times, Crowding and Access Fact Sheet, freeWait health and wellness thatSheet, are open to Many head to the local American College of Emergency Physicians, Emergency Department Times, Crowding andclasses Access Fact http://newsroom.acep.org/fact_sheets?item=29937 public in addition to providing health coaching. http://newsroom.acep.org/fact_sheets?item=29937 emergency room when ancoverage is offeredthe Health insurance is offered by Florida Blue. HMO by Florida Blue HMO, an HMO affiliate of Florida Blue. These companies are Independent of theHMO Bluecoverage Cross andis Blue Shield Association. We comply with applicable Federal civilThese rights Health insurance is offeredmedical byLicensees Florida Blue. offered by Florida Blue HMO, an HMO affiliate of Florida Blue. unexpected issue laws and doare notIndependent discriminate on the basis of race, disabilityWe or sex. companies Licensees of the Bluecolor, Crossnational and Blueorigin, Shieldage, Association. comply with applicable Federal civil rights lawsarises, and doSinot discriminate oncan thea basis of race, color, national origin,deage, disability or sex. Llame al 1-800-352-2583 (TTY: ATENCIÓN: habla español, sube disposición servicios gratuitos asistencia lingüística. but thattiene 1-877-955-8773). ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-352-2583 (TTY: costly, time consuming and 1-877-955-8773). ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-800-352-2583 (TTY: 1-800-955-8770). ATANSYON: Si w pale KreyòlNearly Ayisyen, gen sèvis èd out pou lang ki disponib gratis pou ou. Rele 1-800-352-2583 (TTY: 1-800-955-8770). 88660-0217 unnecessary. three (352) 242-6800 Clermont 88660-0217

of four emergency room visits are avoidable and unneeded.

(321) 441-2020 Winter Park www.FloridaBlue.com

Health Observed allows brands and businesses to connect directly with the Observer’s readership — and participate in the conversation — by creating engaging content on the Observer’s digital publishing platform. For more on Health Observed, email us at kohara@yourobserver.com.

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The Center for Advanced GI is opening a new surgery center in Maitland.

HEALTH MATTERS

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JULY 2018

1 in 5 Americans will develop skin cancer. Capacity Command Center

Florida Hospital soon will have a new state-of-the-art command center, similar to the Capacity Command Center at The John Hopkins Hospital in Baltimore.

Florida Hospital command center coming soon

Voted PHYSICIANS 2017

The high-tech facility will help Florida Hospital make quicker decisions and expedite care.

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TIM FREED

SKIN CANCER SCREENING

ASSOCIATE EDITOR

A new chapter is on the horizon for Florida Hospital and its locations around Central Florida — one that could result in more efficiency and more lives saved. Florida Hospital will team up with GE Healthcare Partners to design and build a new command center, which will guide the clinical operations of all the campuses in the local area. The first high-tech facility of its kind in the Central Florida region, the new command center will use predictive analytics to guide decisions on patient care, according to the Florida Hospital website. It will do that by using what’s called a Wall of Analytics, which takes data from various systems and combines it with Artificial Intelligence algorithms. The result is efficient, data-based

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“We are keeping the patient at the center of our thinking, and this technology will help us meet our goal of achieving high-quality clinical outcomes.”

JULY 2018

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— Eric Stevens, CEO, acute care services, at Florida Hospital

a surgery or a baby delivery. “Command Center staff using advanced analytics in a purposebuilt space will help caregivers help patients, all the time,” Jeff Terry, CEO of Command Centers for GE Healthcare, said in a statement. “The combination of human and Artificial Intelligence is what’s so powerful. Florida Hospital is so advanced in many ways. We’re honored for them to join GE’s command center community.” Florida Hospital will be joining the ranks of other hospitals with similar command centers, such as The Johns Hopkins Hospital in Baltimore and Humber River Hospital in Toronto. And early data shows that the centers are working. The Capacity Command Center launched by The Johns Hopkins Hospital in 2016 saw some promising statistics — a critical-care team is now dispatched 63 minutes sooner to pick up patients from outside hospitals; a patient is assigned a bed 30% faster after a decision is made to admit him or her from the Emergency Department; and patients are transferred 26% faster after they are assigned a bed. The finished Florida Hospital Command Center is expected to be the largest health-care command center supporting the largest number of beds and campuses. The command center will be built in a centralized location and is expected to open next year, according to the Florida Hospital website.

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decisions on everything from staffing to discharges, helping to reduce wait times and getting doctors quickly to the next patient. Just think of NASA’s mission control, but instead of orchestrating space missions, the center will watch over nine Florida Hospital campuses in Orange, Seminole and Osceola counties and the two million patients they see every year. “The command center is about managing capacity and patient transitions across multiple hospitals,” Eric Stevens, CEO of acute care services at Florida Hospital, said in a statement. “We are keeping the patient at the center of our thinking, and this technology will help us meet our goal of achieving high-quality clinical outcomes.” “Florida Hospital prides itself on utilizing innovative technology to provide the best possible care for our patients,” said Daryl Tol, president and CEO of Florida Hospital and Adventist Health System’s Central Florida Division, in a statement. “Our goal is to improve the patient experience, enabling caregivers to spend more time with their patients while making care decisions more easily and quickly. We are excited to partner with GE Healthcare Partners to bring this innovative concept to our care network.” Another aspect of the technology that helps the hospitals even more is the fact that everything is in real time — allowing the command center to weigh in during critical moments, such as during

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OrangeObserver.com

JULY 2018

Pain in the brain? What causes migraines remains a mystery to scientists, but doctors have managed to pinpoint effective treatments for migraine sufferers. GABBY BAQUERO NEWS EDITOR

Imagine having a massive headache that feels like there’s suddenly no space inside your skull for your brain – a pain that makes you shun the sun and cringe at fluorescent lights like a vampire while making you lightheaded, nauseated and dizzy. Now, imagine trying to function at work or in daily life with that same sensation. This is the monumental task that one in every 10 people who suffer from migraines has to manage on a monthly, weekly or, in some cases, daily basis. Migraines are characterized by recurring severe headaches, which are often accompanied by other symptoms that differ from person to person. The neurological illness is estimated to affect about 39 million people in the U.S. alone, and more than one billion worldwide, according to the Migraine Research Foundation.

“(Scientists) don't know for sure what causes it, but it’s thought to be related to pain substances in the brain called neuropeptides, and those neuropeptides are released in certain people at certain times.” — Dr. James Schaus

For many migraine sufferers, the thought of inadvertently triggering another attack is a constant fear. Although no cure exists yet, luckily there are ways to effectively manage the excruciating pain in your brain and research that pinpoints the most common triggers. “(Scientists) don't know for sure what causes it, but it’s thought to be related to pain substances in the brain called neuropeptides, and those neuropeptides are released in certain people at certain times,” said 35-year physician Dr. James Schaus, who also works as the medical director at the University of Central Florida’s Student

Health Services. “But there can be triggers, such as food or stress. Everybody has their own specific trigger, but a lot of people describe stress. Those people often get a tension headache that evolves into a migraine headache.” Although still painful, common tension-type headaches, otherwise known as stress headaches, feel like a dull ache or tight band wrapped around your head. They are often confused with migraines, and while people who experience tension headaches have episodic headaches as well, tension headaches are usually not associated with the symptoms linked to migraines.

BY THE NUMBERS Migraine is the third most prevalent illness in the world: One in every 10 people suffers from migraines. Migraines are most common between the ages of 25 and 55. About 12% of the population suffers from migraine. Three times as many women as men suffer from migraine in adulthood. Migraine attacks usually last between four and 72 hours. 90% of migraine sufferers have a family history of migraine. 25% of migraine sufferers also have a visual disturbance called an aura, which usually lasts less than an hour. More than 90% of sufferers are unable to work or function normally during their migraine. More than four million adults experience chronic daily migraine – with at least 15 migraine days per month. More than half of all migraine sufferers are never diagnosed, and the majority of migraine sufferers do not seek medical care. American employers lose more than $13 billion each year as a result of 113 million lost workdays due to migraine. Source: Migraine Research Foundation

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OrangeObserver.com

JULY 2018

FOOD TRIGGERS Migraine symptoms differ widely from patient to patient, but prevention methods and treatments tend to be the same for migraines, with the exception of cluster migraines. Cluster migraines, which are mostly seen in men, are associated with tearing, eye irritation and multiple attacks that will cluster in a single day or over many days in a week “Migraines are basically broken down into two main categories: Migraine With Aura and Migraine Without Aura,” Schaus said. “And the aura is usually a feeling people get immediately before a headache begins, and it's commonly a visual disturbance, such as flashing lights or wavy lights or even areas of visual blindness in your visual field. The other things you get with auras are abnormal sensations: pins and needles, numbness or weakness of extremities and other visual symptoms. And there are other subcategories, such as a hemiplegic migraine or an ophthalmic migraine.” Via surveys and observation, doctors have identified eight types of migraines, each of which has its own symptom complex and some of which have subtypes. The eight types identified, so far, are hemiplegic, ophthalmic/retinal, ophthalmoplegic, menstrual, basilar, vestibular, abdominal and chronic. The go-to treatment options are generally prescription or over-the-counter medicines, but Schaus encouraged migraine sufferers to be conscientious of their lifestyle, diet, exercise and stress

Some people report consistently developing migraines after meals, which are believed to be triggered by food. Certain foods, such as alcoholic drinks, chocolate and caffeine, have been identified as common migraine triggers. Other triggers include apples; bananas; chocolate; corn; citrus fruits; cultured dairy products; nuts and nut butters; onions; tomatoes; aged cheese; and foods with certain additives, such as MSG, Aspartame and nitrates and nitrites. Source: WebMD

MENSTRUAL MIGRAINES As if periods weren’t already a painful affair for most women, about 7% to 19% of women also have the added misfortune of suffering from menstrual migraines. Menstrual migraines are attacks that occur up to two days before and up to three days after a woman’s period begins. These migraines are triggered by hormonal fluctuations involving estrogen. Menstrual migraines are generally treated with the same medications used for treating other migraine variants, but women who don’t respond to regular medication might be treated with hormonal contraception. Some women experience fewer headaches with hormonal contraception, while others experience even more pain or are simply unaffected. The prevalence of migraine tends to decrease when a woman reaches menopause. Source: Migraine Research Foundation

levels to avoid potential triggers. Some individuals also report promising results with massage therapy and cognitive behavioral therapy that emphasizes positive thinking, he added. “Treatment falls under two main categories: Prevention is one of them,” he said. “If you're having more than a few every month, then it might be worth taking a prevention medicine. For prevention, there are a number of medicines we use. But the oldest one, which is still in use and proven to work, is an antidepressant called Amitriptyline. Another one is a beta blocker – they're actually blood pressure or heart medicines. Some others are used to treat seizures, such as Depakote and Topamax. “But if you get them pretty infrequently, then just treat them as they occur. Usually, the most effective class of medicine are Triptans. There are five different varieties of Triptans available, and they are medicines that affect the chain of events that lead to migraines. The most common one is Sumatriptan – it was recognized as a very effective medicine to treat acute attacks. It's best to take it at the early onset of a headache, so you don't wait until it's been established for hours.” Understanding the type of migraine you get, tracking how frequently you develop migraines and identifying your triggers are all a step in the right direction to combating migraine attacks. Usually, physicians and neurologists use a trial-and-error method to figure out which medication works best for you.

MIGRAINES IN KIDS It is suspected that migraine is often undiagnosed in children and believed that about 10% of school-age children suffer from them. Because they are hereditary, a child with a parent who suffers from migraines has a 50% chance of inheriting them. If both parents are migraine sufferers, the chances rise to 75%. Research suggests about half of all migraine sufferers have their first attack before the age of 12. During childhood, boys are more prone to developing migraines than girls, but in adolescence, migraines are more prevalent in girls than in boys. Children who suffer from migraines are absent from school twice as often as children without migraine.

PREVENTION TIPS n Stay hydrated n Do not skip meals n Get good-quality sleep n Exercise regularly n Learn relaxation skills n Eat a balanced diet n Manage stress levels n Avoid smoking n Identify your triggers n Keep a ‘headache’ diary

COMMON TRIGGERS n Bright lights n Loud noises n Strong smells n Preservatives and sweeteners n Sleep cycle changes n Skipping meals n Hormonal changes n Physical exertion n Mental stress n Prolonged sun exposure n Highly processed foods n Alcohol and caffeine n Weather changes n Medications

MIGRAINE SYMPTOMS n Sensitivity to light n Sensitivity to sound n Sensitivity to smells n Changes in vision n Throbbing pain n Stiff neck n Pain one side of your head n Lightheadedness n Blurred vision n Nausea n Dizziness n Vomiting

HEALTH MATTERS

OrangeObserver.com

JULY 2018

Taking precautions in the senior years TROY HERRING ASSOCIATE EDITOR

There are a lot of things that come with age, and that includes taking precautions about your health in and around the house. It’s a subject that folks like Dr. Ariel Cole — who, among her many jobs, serves as the medical director at Mayflower Retirement Community in Winter Park — know all too well. Throughout her years of medicine, where she has specialized in fields such as nursing home care and geriatric syndromes, Cole has seen a lot, but some healthrelated topics pop up more than others.

AVOID FALLS

The No. 1 biggest health concern for the elderly — by far, Cole said — is falls. “Falls can happen out and about as well, but we spend most of our times at home, so most falls happen at home,” Cole said. “It’s important to stay active and maintain your strength and balance, but recognize that those things do decline with normal aging. Our ability to compensate for an irregular surface and rate yourself does decline, even in a healthy older adult.” And there are a lot of things that can cause a fall — from those irregular surfaces, to wet spots on the floor, to simply getting your feet tangled up with one another. Cole said the most common place for a person to fall is in the bathroom, where oftentimes water and soap can end up on the floor. The simple nature of falling itself is why it’s the leading cause of injury and death for the elderly, according to the Centers for Dis-

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For many seniors, the dangers in and around the home can often have serious consequences, which is why those in the elderly community should take precautions.

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ease Control and Prevention. And the statistics alone are jarring. In a study of people 65 and older, the CDC found that each year three million elderly people are treated in emergency departments throughout the country while more than 800,000 are hospitalized due to an injury sustained from the fall. Most injures are often head injuries and fractured hips. While fall rates have increased 30%, Cole said that there were some clear — and obvious — options to best avoid falls or protect yourself if you do fall. Some of the basic steps you can do to make your home safer is to simply get rid of possible trip hazards in the home, such as an old rug that curls up on the edges, and put grab bars inside and outside your shower and by your toilet. “Anybody who has that possibility (to fall) really ought to have a call button available and wear it and use it,” Cole said. “It won’t do you any good if it’s over there on the counter and it’s not with you in the garage when you fall. There’s a variety of them on the market, and many of them are quite affordable.”

JULY 2018

“Anybody who has that possibility (to fall) really ought to have a call button available and wear it and use it. It won’t do you any good if it’s over there on the counter and it’s not with you in the garage when you fall. There’s a variety of them on the market, and many of them are quite affordable.”

MANAGE MEDICATIONS

Another big issue that Cole has seen regarding senior health in the home is the accidental mismanagement of medication. Cole said many elderly people have to take a number of different medications to treat health issues that come with aging, which can sometimes see individuals juggling 15 to 25 prescriptions. The idea of balancing so many medications can be incredibly difficult and confusing, and that confusion can lead to serious health risks. The best way to deal with it, Cole said, is to use pill boxes and set yourself up with a daily routine. “We advocate for using pill boxes — so once a week or every two weeks you put a blood pressure pill that you take every morning and every evening and place them into (the box’s) date,” Cole said. “That way you know when to take which, and you don’t have to go through it every day — it’s all there.”

— Dr. Ariel Cole

Florida summers are hot and oppressive, and for many — especially seniors — that can be a huge issue. Older adults tend to be much more prone to heat-related health issues for a variety of reasons — from the simple fact that they cannot handle such sudden changes in temperature to the specific medications they take — and it’s why the elderly must be mindful of their time outside, Cole said. The most common issue is heat stroke, which has a number of symptoms, including: heart palpitations, headache, nausea and vomiting. “You’ve got to get fluids, and if you’re sweating a lot, replacing it with just water isn't enough — you’ve got to get sodium, so replace it with a sport drink or

LIMIT HEAT EXPOSURE

While there are precautions to take inside the home, there are also some to take while outside as well — especially during this time of the year.

eat some pretzels, because you’re sweating out that salt,” Cole said. “It can drop their sodium, and that can get very dangerous pretty quickly.” Finally, Cole offers up the simplest solution — be aware of the time of day, as well as how much time you spend outside. “Go out first thing in the morning or late in the evening, not during the heat of the day — 10 to 2 is forbidden, and for me it’s 10 to 4,” Cole said. “And take breaks every 10 to 15 minutes — sit down, evaluate how you feel and go back inside. I never want someone to not participate in their favorite activity, but also maybe do what you love to do best and pay somebody else to mow the yard.”

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Senior experts collaborate in new venture Jennifer Talbot and Rebecca Lanterman have combined their experiences to serve the elderly population. AMY QUESINBERRY

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Two Winter Garden women with decades of combined experience in the field of senior-citizen care have partnered to open Winter Garden Senior Home Care. Jennifer Talbot and Rebecca Lanterman are the owners of the private-duty, in-home health care agency in West Orange County. The business was formerly Age Advantage, but when Talbot’s franchise contract ended, she rebranded it and brought in Lanterman as co-owner. Talbot owned and operated Age Advantage for 11 years. Lanterman has 15 years of long-term care and hospice experience. At Winter Garden Senior Home Care, the team creates a care plan personalized to each individual so he or she can remain at home. Clients are matched with their ideal caregiver, which allows them to live the rest of their lives at home — what Talbot and Lanterman call “aging in place.” “We’ve read so many articles about people who just want to stay home, but so many people don’t know it’s an option to keep their loved ones at home,” Lanterman said. Too many people wait until they are in the hospital emergency room or another dire situation and then are forced to make an immediate decision regarding health care, she said. “You see the toll it takes on families,” Lanterman said. “It hurts the harmony of the family when no one knows what to do with Mom. It causes unnecessary conflict. And people aren’t talking about it. People aren’t having the conversation.” The business partners are available to speak to families who are searching for answers to their questions about in-home care. It can be overwhelming, especially for families who don’t know all of the options. As Lanterman slips into the operations aspect of the business, Talbot will focus on addressing some of the needs of seniors in

Amy Quesinberry

Jennifer Talbot, left, and Rebecca Lanterman have 21 years of experience working with senior citizens and their care.

WINTER GARDEN SENIOR HOME CARE ADDRESS: 112 S. Main St., Winter Garden PHONE: (407) 347-2050 EMAIL: jennifer@wghomecare.com WEBSITE: WinterGardenHomeCare.com

West Orange County. She wants to start a Brain Fitness Club.. She hopes to bring more Seniors First Meals on Wheels delivery routes to this area. She would like to start a program similar to Seniors Helping Seniors — which pairs volunteer drivers with senior citizens needing transportation to medical appointments. Talbot said the office manager became certified in CPR so they can offer classes to the public. WGSHC participates in community programs six times a year, serving on a panel to provide guest speakers who discuss topics of interest to the elderly. “We’re excited about that, any time we can hold classes or open discussions,” Talbot said. Both women stress their compassion for the older generation and a commitment to their wellbeing. “We’ve aligned such very similar passions, (and) we both are incredibly committed to this community,” Lanterman said. “We have many seniors who are in assisted-living and are happy, but we … want people to know that there is an option to stay at home,” she said.

HEALTH MATTERS

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STEVEN RYZEWSKI SENIOR SPORTS EDITOR

Lisa Tepe was looking for something. A longtime runner, the Horizon West resident had an idea — a dream, really — of sharing all that running had done for her with other mothers and women of all varieties. She found what she was looking for in an unlikely place. Tepe was on the receiving end of a rave review from her sister, who lives in Minnesota, about a group she’d joined called Moms on the Run. The catch? Tepe says her sister hated running. “I was like ‘you don’t run’ — we’re kind of polar opposites on that,” Tepe said. “But (Moms on the Run), for some reason, really resonated with her.” That tip led to an eventual meeting with Karissa Johnson — the founder and CEO of Moms on the Run. Johnson started the organization a decade ago after she had three children in four years and saw the fitness regimen she had been on fall to pieces. Motivated to get back into shape, and help other moms do the same, Johnson’s program grew to the point where she began franchising the brand in 2012. Moms on the Run expanded throughout Minnesota and into other states, such as Wisconsin and Illinois. And, thanks to Tepe’s roots in Minnesota, the group is now in Florida. “It sounds silly, but it was this cosmic connection,” Tepe said. “Coming to find out about this Minnesota (-based) company, and its values and giving back to women — it was a perfect match.” Horizon West Moms on the Run was born out of that meeting, and the local organization enjoyed its first two seasons within the past year — with the first program taking place from September through December and the next running from January through May. After two successful programs, Tepe said the Horizon West branch is currently on a break as she sorts out finding the optimal time for a program that pairs with

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the Florida calendar. Moms on the Run is different from a running club, explains Tepe, because it is instructorled. Tepe is the owner and head coach for the Horizon West franchise and says she hopes to add coaches as the branch grows to offer increasingly well-rounded instruction and guidance. According to Tepe, the instructor-led nature of Moms on the Run sets up an added level of accountability and also accommodation, as there is an emphasis on helping women who either are not runners or have not run for some time. “(Getting started) can be very intimidating,” Tepe said. “I think the environment that we’ve set up is very non-intimidating and very inviting.” Joan McMullen, a mom of three living in Horizon West, agrees. McMullen discovered the group through Facebook and decided to give it a shot. “It was a combination of the idea of getting back into running, which I hadn’t been doing, and getting the opportunity to spend time with some other women at the same time,” McMullen said. “I felt very welcomed by all the other women.” McMullen started with Moms on the Run in September, and her growth through the program led her and two other moms to run a half-marathon together. For Tepe, seeing members come together in that way has been a rewarding experience. “What I get back is so much more than what I give,” she said. “Just having the ability to see the confidence in the women and the changes they’ve gone through.” Despite its namesake, the club is open to women who are not mothers. When Horizon West Moms on the Run resumes its program, it will continue to meet at Independence Community Park, adjacent to Independence Elementary. Sessions begin with a dynamic warmup and include cardiovascular interval training, some strength training, stretching and a cool down. There is a fee associated with participating, with classes averaging out to $10 to $12 a session, and there are a variety of plans available. McMullen, who plans to continue to participate, offers a ringing endorsement. “t’s definitely worth coming out and giving us a try — you may be very pleasantly surprised,” McMullen said. “It’s a group for anyone.”

HEALTH MATTERS

OrangeObserver.com

JULY 2018

Danielle Hendrix

Stormy Lake, pictured with two of her three gongs, loves helping her clients through sound therapy and gong-bath healing sessions.

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The first time Stormy Lake played a gong, the connection was instant. “Two years ago I went to a gem show and saw the gongs and knew of them but had never played them,” Lake said. “When I did, it lit me up. … The sound of the gong was such a spiritual uplifting movement, I almost cried. I bought my first gong then right on the spot.” Lake, a sound therapist, is Creek Indian and Italian. As a native Floridian and Creek Indian, she was raised immersed in domesticated Native American culture — one with an emphasis on the earth, as well as holistic medicine and healing. “I was raised Native American, so everything about my life has been of the earth, one with the earth, innocence in the earth, giving back and restoring,” Lake said. “I never saw a doctor, my mom was the doctor. Everything about the holistic world is how I was raised.” Having been raised with the emphasis on holistic, it was natural that she would one day practicing holistic healing herself. “I just knew I wanted to not be the mundane nine-to-five,” she said. “My passion is to help peo-

ple find joy and wake up. Everything we do inspires personal growth.” As a traveling holistic-healing and Eden Energy Medicine practitioner, she has experience with multiple realms of healing, including crystal bowls, native drumming and crystal and gemstone therapy. “I love sound because sound is an art form not controlled by the mind,” she said. “Sound carries us into our natural place of being, and that’s why I love it. We can go back to the innocence we were born and created to be in.” Lake uses gongs in her soundtherapy sessions, which are called gong baths. This is because the gong’s vibrations cause an emotional release — a cleanse of sorts, bathing in vibration. “Vibration transforms our physical DNA to release what is unconscious and held within our body as humans,” she said. “This could be any trauma or emotion not dominated by the mind. Vibration moves to emotions through the water into the (body’s) meridians, which stimulate the organs. We emotionally release. A gong bath, Lake said, helps purge the body to release what no longer serves it. Humans tend to hold on to everything, whereas the gong bath is a holistic healing method that encourages the body to let them go. Lake offers the hourlong gong-bath sessions in both private and group settings. “Healing hurts like hell, but it’s a beautiful journey,” Lake said.

HEALTH MATTERS

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first to go bad without power and can harbor harmful bacteria. Stock up on non-perishable food. Stock up on unsalted nuts, raisins and canned fruits, bread and peanut butter. Be sure to have a manual can opener. Limit junk food; it just will make you feel worse. Sheltering in place can also mean feeling shut inside. Plan some games, reading time and other non-electric activities to keep you and others in your family engaged. It might be the longest you and your family go without a computers or phone screens. It could open up new ways of being together. After the storm, risks to your health include flooding, downed power lines and fallen trees. Never walk in flood waters if at all possible; dangers lurk. Try to remove water-soaked debris from your home. Keep your home and yourself as clean as possible. After the storm, watch for mold and related coughs, sneezes and other respiratory symptoms. Appreciate the public works employees, first responders and others who work long days and nights to get water, power and roads back on line, even if it seems to take a long time. Embrace the challenge. Dr. Nancy Rudner, local workplace nurse coach with HealthAction.biz, helps individuals and employees understand their health, make healthy choices and achieve their health goals. Send your questions to Nancy@HealthAction.biz.

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ramatic destruction and rescues after a hurricane catch our attention, but the real work for your best health before, during and after a hurricane is preparation. Think of what you need for your health if you are left without electricity and clean running water. Assume stores will not be open and many roads will be blocked. It will most likely be hot, with no air-conditioning and no fans. Oxygen systems, apnea C-Pap machines, asthma medication nebulizers and refrigeration for insulin won’t work without electricity. Think of how you might address a total disruption in your life patterns. Many people in Puerto Rico found ways to survive, months on end, with true grit, determination and neighborly help. What can you do to make it easier on you if hit by torrential winds and rains and long waits for power and water? Make a plan. If you need to leave your home, where will you go to wait out the storm? How will your family communicate with one another if you are not in the same place? Prepare a bag of essentials — clothes, medicine, food, flashlights, batteries and entertainment (non-electric) — for the storm and days following. Get some “hurricane money” – post hurricane is a cash-economy only. Have a paper copy of your medical information on one page, with diagnoses, medications (name, dose, frequency and purpose) along with copies of your insurance cards and key contacts. If you need to go to a shelter, take that information with you. During hurricane season, try to maintain a month’s supply of your medicines. You can ask your pharmacy or your health plan for early refills when a hurricane is heading your way. Store enough bottled water and washing water for at least a week. Fill the bathtub with water so you can use it to wash up and to flush toilets (they might not be working either). Think of what you can eat without refrigeration or electric stove. Meat and dairy are the

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HEALTH MATTERS

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JULY 2018

THURSDAY, JULY 12

ART FOR THE HEART 1 to 3 p.m. Thursday, July 12, at the Winter Park Community Center, 721 W. New England Ave., Winter Park. Are you a caregiver searching for a memorable experience and creative outlet for you and your loved one living with Alzheimer’s or Parkinson’s Disease? Join Bioclinica Research at this free event for an afternoon of painting. Call (814) 461-5614 to RSVP. For questions, contact Diane at Diane.Bucher@bioclinica.com or (407) 591-3449.

SATURDAY, JULY 14

CONVERSATIONS WITH CARE: SUMMER SAFETY Noon Saturday, July 14, at Florida Blue Winter Park, 434 N. Orlando Ave., Winter Park. Learn how to avoid and care for bites, stings, enjoy water and recreational sports without injury and more. (321) 441-2020. EARLY CHILDHOOD RESOURCE FAIR 9 a.m. to noon Saturday, July 14, at the Orlando Public Library, 101 E. Central Blvd., Orlando. Parents and caregivers of children up to age 5 are invited to learn about the community resources available that promote kindergarten readiness and help with early childhood development. Various organizations will offer activities for children and information for caregivers about child health, child care, parenting, community programs and more. Orlando Shakespeare Theater will present a special story time. Featured groups include Amerigroup, KinderCare, Girl Scouts of Citrus, WUCF, Publix and Orange County History Center. (407) 835-7323.

THURSDAY, JULY 19

C-SECTION CLASS 6:30 to 8:30 p.m. Thursday, July 19, at the Winter Park Memorial Hospital Dining Room A, 200 N. Lakemont Ave., Winter Park. This class will be taught by an experienced labor and delivery nurse. She will describe the C-section process and surgery, as well as what to expect after surgery and recovery. Cost is $35. Visit eventbrite.com/e/c-section-classtickets-46774159771?aff=ebdssb destsearch.

SUNDAY, JULY 22

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BABY CARE BASICS 9 to 11 a.m. Sunday, July 22, on the second floor of the medical library at Winter Park Memorial Hospital, 200 N. Lakemont Ave.,

Winter Park. This one-time evening class prepares new parents for the care of their newborn. Topics include newborn characteristics, newborn procedures, diapering, bathing, choosing a pediatrician, car seats and swaddling. Cost is $35. Visit eventbrite.com/e/baby-care-basicstickets-45385002765?aff=ebdss bdestsearch.

WEDNESDAY, JULY 25

FREE BACK-TO-SCHOOL PHYSICAL 1 to 4 p.m. Wednesday, July 25, at Vista Clinical Diagnostics, 10101 W. Colonial Drive, Ocoee. The Ocoee Shepherd’s Hope Health Center is partnering with Nemours Children’s Health System to provide the physicals and other medical services for local uninsured and underinsured families. Children must be younger than 18 and uninsured. Appointment must be scheduled in advance by calling (407) 8766699, Ext. 243.

THURSDAY, JULY 26

FREE BACK-TO-SCHOOL PHYSICAL 9 a.m. to noon Thursday, July 26, and Wednesday, Aug. 1, at The Sharing Center Plaza, 600 N. U.S. Highway 17-92, Suite 124, Longwood. The Longwood Shepherd’s Hope Health Center is partnering with Nemours Children’s Health System to provide the physicals and other medical services for local uninsured and underinsured families. Children must be younger than 18 and uninsured. For appointments, call (407) 876-6699, Ext. 243.

FRIDAY, JULY 27

BOOT CAMP FOR NEW DADS 6:30 p.m. Friday, July 27, on the first floor of the medical library at Winter Park Memorial Hospital, 200 N. Lakemont Ave., Winter Park. This is a “men-only” class. The one-time, three-hour class provides hands-on realistic experience, and participants learn how to calm a crying baby, how to change a diaper and more. The relaxed “locker room meets nursery” setting allows dads the chance to get answers to of their questions from “veteran” fathers who are navigating their way through fatherhood. Along with knowledge, confidence and fun, participants will also receive a copy of “Crashcourse for New Dads.” Cost is $25. Visit eventbrite.com/e/boot-camp-for-newdads-winter-park-memorial-hospital-2018-tickets-47313937260.

HEALTH MATTERS

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JULY 2018

NEW OWNERSHIP is coming to

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SINCE 1980

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