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contents S P R I N G • 2020

8 Mission Regional Medical Center’s

Dr. Melecia Fuentes Be Well Clinic

Dr. Raquel Silhy General Surgeon

Dr. Susan Redmond Obstetrics & Gynecology

Newest Procedure Offers Hope to Breast Cancer Patients

Dr. Cynthia Salinas Laser Surgical Solutions

Making Their Mark:

How These CNOs are Improving the Future of Valley Healthcare

Mari Garza, NNP-BC NICU Nurse Practitioner

Libby Elrod R.D.,L.D. MRMC Food Services

Dr. Padmini Bhadriraju Hospitalist

Dr. Annabelle Lopez Obstetrics & Gynecology

Chicken Enchilada Casserole

The Difference between a “Leader” and a “Boss”

My Mental Health Plan

UTRGV launches Physician Assistant Career Track

Precision Fitness for a Healthy Active Lifestyle

Stress Management & Support for Caregivers

Upcoming Community Events 2020 Women of Health & Wellness

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Women of Health & Wellness

Dr. Melecia Fuentes Be Well Clinic

Dr. Melecia Fuentes comes from a household where both her mother and father worked in the medical industry for over thirty years, which has influenced Dr. Melecia greatly. She always knew she wanted to be a doctor from a young age. “I had a lot of good people as role models growing up, including my parents and Dr. Robert Keller, who was our family physician and was always really good to me and my family.” Dr. Melecia laughed as she admitted, “I would always sign my name Melecia Fuentes MD in my classmates yearbook.” Dr. Melecia Fuentes is now a 20 year veteran in the field of family medicine. Her parents provided guidance, advice and many valuable lessons which have carried over into Dr. Melecia’s career. The biggest lesson learned from her parents in regards to the healthcare field is to always be good to people. She states, “There’s always something else going on beyond what we can see.” This is a message she keeps in mind daily when treating her patients and a reminder of why she feels the desire to always give back to her community. Dr. Melecia graduated from Ohio State University College Of Medicine and Public Health in 1996 with specialization in

family medicine. Being in Ohio was a different experience as Dr. Melecia was born and raised in Weslaco, Texas. She talks about how she enjoyed the seasonal changes as well as being able to meet people from all over the world. After medical school she went on to the UT Health Sciences Center in San Antonio for her residency program. Being that the school was so close to the Air Force base, recruiters would come to talk to students about joining the Air Force. Dr. Melecia decided it would be a great opportunity for her and enlisted as a Captain. Dr. Melecia was stationed at Barksdale AFB in Shreveport Louisiana, entering as a physician Captain and later leaving the Air Force as a Major. “I really enjoyed the experience. You always see things differently. When I was in the military there wasn’t a lot of bureaucracy. It was easy because I could just practice medicine and not worry about all the insurance red tape.” After her service, she returned home to Weslaco and began working with Dr. Jose Luis Hinojosa in McAllen and later closer to her home with Dr. Julio Lopez in Weslaco. In 2004, she decided to establish her independent practice at the Medical Arts building in Weslaco until she recently opened up her own facility just down the street called the Be Well Clinic. The Be Well Clinic on sixth street in Weslaco is founded on the bases of promoting a positive and healthy lifestyle. The “Be Well” ideology is essentially a focus on prevention, such as eating better, maintaining a lower carb diet, including more fiber, and of course, daily exercise. Dr. Melecia refers to exercise more commonly as simple “movements” like doing heel-toe raises which can easily be done in the waiting room to see a doctor, a checkout line at the grocery store or even while cooking in your own kitchen. Dr. Melecia is a firm believer in patient and physician communication. If you are a patient of Dr. Melecia’s, you have access to a portal created by her team, where patients are able to ask any questions they wish about their follow ups, vital charts, medications, and more. The message is sent directly to Dr. Melecia where she is quickly able to relay in-

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If you have a medical concern that you feel is non-emergent, you are able to call 956-4478377 to reach a provider 24 hours a day. Many medical issues such as vomiting, fever, sore throat and minor injuries like fractures, cuts or fall assessments can be resolved more conveniently in the office at a much lower cost than in an Emergency Room. Dr. Melecia’s team of providers can quickly assess if the medical issue warrants a trip to the ER and help to smooth that path if necessary. The Be Well Clinic is open from 7am-9pm Monday through Friday and Saturday and Sunday noon-five. With extended hours, competent, caring staff, and a positive atmosphere, Dr. Melecia is excited to continue on her journey of medicine by providing excellent medical care to her patients at the Be Well Clinic.

The Difference Between a “Leader” and a “Boss” By: Libby Elrod, RD, LD

Years ago I worked with an individual that truly needed feedback to improve his relationship with the work team. When we were discussing options he could implement quickly and with no additional cost, I mentioned how far a sincere “Thank you” can go to motivate individuals. His response was, “I say 'Thank You' to all my employees every two weeks. It is called a Pay Check.” I quickly made a mental ‘note to self’ to NEVER be that kind of boss. I am sure everyone has a story to tell about a boss just like that. In healthcare, we witness numerous types of behaviors and not just in patients. In my opinion, there are two types of leaders: Formal Leaders – those with a title - like Director or Manager; and Informal Leaders – individuals with no management title but who truly engage, inspire and motivate those around them. Sometimes those informal leaders have more influence on their work environment and co-workers than formal members of management. So the question is... what distinguishes a “leader” from a “boss”? The answer is their behavior – how they treat people. When you take the time to observe and analyze the behaviors, it becomes apparent that a boss expects people to do as expected because ‘I said so’. For example, I am the boss and you have to do what I say because I control your schedule, work environment, promotions, etc. When you observe a leader in the same situation, a leader expects people to do as asked because the ‘why’ is included along with feedback, even if the feedback is for your improvement in that situation. The “why” we do things is built in - because it improves patient out-comes, makes our process more efficient or makes our workflow smoother.

Over my 40 years in healthcare, I have worked with some outstanding leaders; I consider many of them to be my mentors. Some examples of great leadership qualities and behaviors include: active listening, showing empathy, recognizing high performers publicly, encouraging new ideas and remembering to bring a servant’s heart and kindness to work every day whatever your title may be. The opposite is also true. We have all had experiences in ‘difficult’ situations where the boss dismissed a well thought out idea or talked down to someone in front of peers. Those negative behaviors have taught me how not to treat co-workers. We all know who that ‘boss’ is, because they are the one we talk about over dinner. And, don’t kid yourself, our co-workers do go home and talk about their boss with their friends and family. When we invest in our management team to develop leadership skills, I believe it sends a strong message that we care about our work environment. Enhancing those skills enriches the work environment and helps to build effective teams. But, we don’t need to wait for our employer to provide a class. One of my favorite ‘leadership development’ tools is the movie, Remember the Titans. Next time you watch that movie, don’t focus on the story line. Instead focus on the behaviors of the conflicted leaders and the team. It will make you think differently about your leadership style. Making a difference in someone’s life is a privilege and you never know how much you influence those you work with. Take the time to reflect on those who have influenced your behavior in a positive way and ask yourself……Are you a leader or a boss? Women of Health & Wellness

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formation back to her patients. Patients are able to speak to Dr. Melecia directly at any time as needed for family health or acute care situations using the portal. Dr. Melecia and her staff are also available after hours at her facility which can reduce patient trips to the ER.

Mission Regional Medical Center’s

Newest Procedure Offers Hope to Breast Cancer Patients

ccording to the Centers for Disease Control and Prevention (CDC), about 245,000 cases of breast cancer are diagnosed in the United States each year.

Receiving a breast cancer diagnosis can be a traumatic experience. From fear and anxiety to rising healthcare costs, there are many worries a patient will experience during this type of hardship. Mission Regional Medical Center is hoping to alleviate at least one concern with a breakthrough medical procedure, called Hidden Scar surgery. “This is a very hot topic, generally not spoken about except during October,” says Chris Hansen, Surgical Director at Mission Regional Medical Center. “We are hoping to get the word out to the community so we can provide this service to more patients.”

Making an Impact Hidden Scar surgery is Mission Hospital’s newest advancement in breast cancer surgery, and Hansen says it’s been a long time coming in terms of patient care. Throughout his career, Hansen has become all too familiar with the struggles breast cancer patients face after diagnosis and throughout treatment. He’s seen firsthand the devastation some patients encounter when dealing with their post-surgery bodies. In addition to the many physical symptoms, patients must also overcome a variety of psychological issues that arise post-surgery. According to Hansen, one of the leading causes of concern in recovering patients is the sometimes extensive scarring after breast cancer removal surgery. “In the history of hysterectomies and breast reconstruction surgery, some of the scars are noted to be horrific and a daily reminder, psychologically,

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for the patient and their families.” This, he says, has the potential to negatively affect self-esteem, emotional healing, and even intimacy.

“The final cosmetic, anatomic result

is improved with these techniques, especially when patients are receiving radiotherapy after surgery.” A Revolutionary Procedure The advanced technology behind the Hidden Scar surgery is forging an impact upon patients across the nation. This minimally invasive surgical procedure utilizes LED lighting and retractors to remove cancer cells from breast tissue through strategic locations, which make the scar hidden to everyone including the patient. “We essentially have these retractors that have different variations of lengths and a special LED light goes at the tip of the retractor,” Hansen explains. “In former years of surgery, we’d have to make a larger incision to see down deep into a cavity. These lighted retractors allow us to achieve the same beneficial results through much smaller incisions.” “Surgeons can utilize this retractor and perform the entire procedure through, depending on the case, a 1 to 2 inch incision,” he said. “Leading this team is Dr. Guillermo Marquez, a general surgeon who has been certified to perform this

The Hidden Scar surgery can be performed in conjunction with plastic reconstructive surgery. The surgeons at Mission Regional Medical Center work alongside fellow team member, Dr. Rafael Avila, a plastic surgeon, in order to perform both procedures at once, thus eliminating the need for multiple procedures. According to Hansen, less surgeries means less risk.

Why Should I Consider Hidden Scar Breast Cancer Surgery?

Scars matter! Breast surgeons are very skilled at removing the cancer or cancer risk. But finding a surgeon who prioritizes your cosmetic outcome is equally important. Studies show that scars from breast cancer surgery can impact a woman’s self-confidence, intimacy, and body image.1

Hidden Scar Mastectomy A Nipple Sparing Mastectomy can be performed as a Hidden Scar Procedure. This means that the incision is made in a place that is hard to see. There is one location for a Nipple Sparing Mastectomy that makes the scar less visible: Single Hidden Incision

Exploring the Benefits Not only does Hidden Scar surgery offer psychological and sociological benefits, but patients who opt for this advanced type of surgery do not carry any higher risk of cancer recurrence than those who have undergone more traditional surgical techniques. This is what makes the procedure such a promising option for so many patients. “It doesn’t take any longer and usually there is less pain because it’s a smaller incision being made,” said Hansen. “They’re recovering faster. They’re healing faster. It’s generally a better outcome for the patient.” Whether Hidden Scar surgery is a viable option for you will depend on several factors. Patients may qualify for Hidden Scar surgery based on the location and size of their tumor, as well as their breast size and shape. If you have been diagnosed with breast cancer and surgery is recommended as part of your treatment, Hansen recommends thorough research before coming to a final decision. Patients will need to work closely with their doctors to determine whether Hidden Scar surgery is right for them. “Weigh all your options. There’s a ton of information out there on surgical techniques,” he adds. “We encourage everyone to talk to their doctors. Get your regular check-ups. There’s nothing too embarrassing that you can’t ask your doctor.” •

1. Inframammary Fold: The natural crease underneath the breast. 1

In a Hidden Scar Nipple Sparing Mastectomy, all of the breast tissue is removed, but the nipple and skin are not. Since the scar is placed in the Inframammary fold, you will not have a visible scar.

Hidden Scar Lumpectomy A lumpectomy can be performed as a Hidden Scar procedure. This means that the incision is made in a place that is hard to see. There are three different locations for a lumpectomy incision that make the scar less visible: Incision locations 1. Inframammary Fold: The natural crease underneath the breast.

3 2 1

2. Periareolar: Along the edges of the areola 3. Axilla: In the armpit, usually hidden in a natural fold

In a Hidden Scar Lumpectomy, the tumor and a small portion of healthy tissue surrounding the tumor (margin) are removed. The majority of your breast tissue, breast skin, and nipple are preserved. Since the scar is placed in a hidden location, you will not have a visible scar. LIT 12728 Wakefield Research Data Report: Survey of Breast Cancer Surgery Patients 1

breast cancer surgery

*Remember that any surgical procedure, results will vary.

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procedure, and who says he has been seeing great results.” Dr. Marquez states that, “The final cosmetic, anatomic result is improved with these techniques, especially when patients are receiving radiotherapy after surgery.”

Women of Health & Wellness

Dr. Susan Redmond Obstetrics & Gynecology

Dr. Susan Redmond has been in private practice for 32 years as an obstetrician-gynecologist, in the Rio Grande Valley. Originally from Illinois, Dr. Redmond graduated with honors from Monmouth College and then Southern Illinois University School of Medicine. She started her residency on the East Coast in Stamford, Connecticut but shortly thereafter decided the area just did not suit her so she ventured to Michigan where she finished off her residency program.

night while she was watching the NFL Packers vs. Bears playing in Soldier Field in the middle of a blizzard. Feeling the dread of having to drive to work in those conditions, she immediately decided to take the offer down south. She packed up and headed to the Rio Grande Valley and hasn't had a moments regret. Dr. Redmond found the Valley to be a unique and enjoyable area where she felt she could provide good medical care for an underserved population.

While living in Michigan, she recalls an epiphany that changed if not the path of her life, at least her location. “One day I was putting oil in my car and while doing so, I looked up across the street at the thermometer and it said -50° that's when I realized...there are places that are not this cold that need doctors too.”

In joining a private practice with Dr. Mitchell Houghston in Harlingen, Dr. Redmond realized there were some differences in this area she wouldn’t encounter in other parts of the country. Even the diseases found in the Valley are different as opposed to those found in other places. For example, she has seen some various infections in patients that only occur when someone has crossed paths with infectious waters - referring to the Rio Grande River. When asked about her entrance into the medical field and what motivated her to study medicine, Dr. Redmond attributes the path of her success to her father who always pushed her to go to medical school even back in the 60's when it wasn’t a very traditional route for women to pursue. She reminisced all the way back to the fourth grade where one day during a career-day event she said aloud, “I’m going to be a doctor.” The teacher kindly patted her on the head as if to say, “Good luck with that.” Dr. Redmond's competitive spirit took that as a direct challenge and she made it her mission to continue on the path of medical studies from then on. In an age when women were not expected to do anything other than maybe teaching, nursing or being a stay at home mother, Dr. Redmond’s father continued to encourage her to pursue her dreams regardless of her gender. Her mother had passed of ovarian cancer when she was just eleven years old; which she said was a guiding factor that encouraged her to study obstetrics and gynecology. While attending college, Dr. Redmond’s father fell into a very deep depression, during which she took responsibility for his daily care. Though taking care of her father, while also attending school was tough, she accredits this trial to now being able to multitask very well as a doctor.

She knew it was time to move somewhere a lot warmer, and as fate would have it, as these thoughts began floating around in her mind, the recruiters started calling. This usually happens around the second or third year of residency. The very day after her blizzard “epiphany” moment a recruiter called and said they were looking to hire someone in Harlingen, Texas. She remembers the call coming in on a Monday

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Although Dr. Redmond does not have children of her own aside from her fur babies, she believes she has many blessings. “I have thousands of children,” she stated in reference to her profession in obstetrics, “handing someone a healthy baby can bring tears to your eyes.” Dr. Redmond has been able to offer very personalized care by knowing her patients well, their families and has even treated several generations of each family thereafter. She considers it a true privilege to not only bring these babies into this world, but to be able to continue to provide medical care throughout their lives and through their future generations.

Quilting Wall Art by Dr. Susan Redmond

In regards to trending new technologies in medicine, Dr. Redmond is a firm believer that while she wouldn't want to be the first person to try some of these new technologies or medications on her patients, especially without thorough research, you also shouldn’t be the last. She says it is important to stay abreast of current education and policies regarding your field to be able to offer the best care for your patients. One of the procedures Dr. Redmond does offer in office is an option for hormone therapy for certain patients who meet the required criteria. This therapy is available for women in certain stages of life where they may encounter issues such as hot flashes, night sweats, vaginal dryness, loss of energy, fatigue, loss of muscle mass or weight gain or changes in mood and thinking. When asked about her future goals or the idea of transitioning into another kind of profession within the medical industry, Dr. Redmond said she made the decision early on in her career that to provide the best ongoing personalized care for her patients she would devote her time to practicing exclusively, instead of dividing her time between her patients, hospital positions or teaching. Her patients have greatly benefited from her dedication and care. Dr. Redmond smiled at a patient who waved as she was led into an exam room and commented, “Someday I’ll retire, but for now I greatly enjoy what I do. I can’t imagine not doing this.” Dr. Susan Redmond sees patients in Harlingen, Texas. To schedule your personal consultation for obstetrics or gynecologic care with Dr. Redmond, call (956) 425-8545.

Member of Prime Healthcare

Your Hospital, Your Delivery The award-winning Women’s Center at Harlingen Medical Center is committed to providing excellence in healthcare for women beginning with the miraculous childbearing experience. We care for a broad range of women’s health matters, oﬀering a family-centered approach with personalized nursing care.

What type of specialists are available at the Women’s Center? At Harlingen Medical Center, obstetrician / gynecologists, anesthesiologists, neonatal-certified nurses, and other medical professionals work together to provide the highest-quality care.

What should you expect when you arrive at our Women’s Center? • • • • • •

Your own private suite “Homelike,” comfortable labor and delivery suites Dedicated OB/GYN operating suites 21-Bassinet Newborn Nursery Highly-trained, neonatal-certified specialists Individualized, quality nursing attention

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Women of Health & Wellness

Mari Garza NICU Nurse Practitioner

Mission Regional Medical Center

Maria Garza’s journey into the healthcare field started by playing “pretend” as a child. She remembers playing “doctor” with her dolls as a young girl and explains the feeling of being a caretaker as a very natural role. “I never felt like I was confused about what I wanted to be or what I wanted to do. In high school I started working for a dentist initially, but I knew that ultimately my goal was to go into a nursing program,” she states. When asked why she selected the nursing field as the medical area she wanted to study she explained that the nursing industry itself is such a broad field with so many different areas of specialization to choose from. She ultimately chose to specialize in neonatal care. Mari is a licensed Neonatal Nurse Practitioner (NNP-BC,) a Registered Nurse (RN) and is board certified in Neonatal Resuscitation; receiving her RN degree from South Texas College in 2004, her RN to BSN at the University of Texas at Arlington in 2011 and lastly earning her Neonatal Nurse Practitioner degree from the University of Texas Medical Branch at Galveston in 2013.

When Mari started the nursing program her son was one year old and was the motivation she needed to keep going so he was a major factor in her educational success. “I never really had the encouragement of going to school or pursuing a career from my family, so I had to push myself.” Despite being mostly on her own, Garza pushed through going to school while being a mother. Her husband at the time was working in Houston so getting through her daily tasks of school and motherhood were exhausting yet her motivation always remained strong. “I knew that I did not want the same struggles that my parents had in trying to provide for their children. I wanted a better future for my son, my family, and myself.” Her first position in the medical industry was at the Women’s Hospital of Texas in Houston where she was working in the newborn nursery. She rotated through the NICU unit and caught a glimpse of the NICU world where her interest was instantly sparked. From Houston she transferred to McAllen Medical Center and started working in their NICU department doing bedside and post-delivery transitional nursing as well as floating level II NICU and postpartum. After a few years at McAllen Medical, she then put in for a position at the Women’s Hospital at Renaissance and worked there from 2014 to 2019 where she worked with high risk deliveries and performed procedures such as Endotracheal intubations, lumbar punctures and thoracentesis. Mari is currently employed at Mission Regional Medical Center as a level III Nurse Practitioner in the NICU. In order to become a level III trauma center, Mission hospital is required to have a neonatal nurse practitioner in house 24/7 so Mari Garza is scheduled for twelve-hour day shifts. When the offer was presented to Mari, it fit her schedule as she had her own newborn baby at home. Mari Garza is going on a year and a half at Mission Regional Medical Center and is very happy with her position. She loves her team of respiratory therapists and fellow neonatologists. She finds her team extremely friendly and respectful of each other and says this is what helps make her days at work enjoyable.

Mari was born in South Texas to a family of migrant workers who traveled the routes to and from Florida, Michigan and eventually back to Texas when her father retired from migrant working. She was in third grade when they finally settled in the valley. Mari has ten siblings; seven brothers and two sisters in which she is the youngest. Although she comes from a large family, Mari is the only child to have graduated from high school and the only one who pursued a career in healthcare. Her siblings were all born in small towns in Mexico, so she believes this was a large factor which held back her siblings from having the educational opportunities she did.

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Mari Garza is now a mother of two; a seventeen-year-old and a two-year-old. She truly cherishes her children and explains her outlook on life and part of her strong love for her family stems from working in the NICU and seeing the good and bad of life’s natural path of birth. For individuals considering a career in neonatal care, she says, “The world of Neonatologists is always changing. You will never get bored; you will never stop learning. I think that goes in general for nursing… there are new advances, new techniques, new protocols that come up every single day and that’s one of the best things that I like about my job.” The constant learning curve keeps Mari Garza’s mind active and sharp and is what continually fuels her passion towards healthcare.

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Dr. Padmini Bhadriraju Hospitalist Physician

Like many other professionals dedicated to their craft, Dr. Padmini Bhadriraju, often referred to by colleagues as “Dr. B” realized a career in medicine would be in her future at an early age. She counts her father as her biggest role model. “My father was a general practitioner and ophthalmologist and he is my hero,” said Dr. Bhadriraju. “I must have been a tiny little girl when I decided I wanted to become like dad and be a physician.” One in a family of six children living in India, Dr. B began medical school at the age of 16. This is typical of schooling in India, and education was always an important part of her parents’ teachings. Of the children, two of her siblings also chose to pursue careers in healthcare, while the others followed pathways into science and IT. “My father always said education is the best equalizer of all inequalities. It’s because of this education that I have been able to do so many wonderful things and meet so many wonderful people.”

Over the years Dr. B has honed her skills in several areas of medicine including women’s wellness and senior care, though it is internal medicine that she finds the most rewarding. “With internal medicine, you take care of the whole patient,” she said. “Health is not just treating a disease. It is a lot more than that. Many times, there are so many social, economic and family support issues. As an internalist, you are able to grow with your patient and see the big picture of their health.” Dr. B takes pride in making herself available to patients 24/7, even though her days are long. On a typical day, she may work 16-18 hours, and then head home to cook dinner for her husband and two children. She recalls times, earlier in her career, when her children did their homework in the hospital lounge while she worked. “My husband and my kids have been extremely supportive. That has been a very big blessing.” Her daughter is now following in her professional footsteps, training for the MCAT, while her son, who had two books published at the age of 12, is also contemplating a career in the medical field. When it comes to the future of healthcare in the Rio Grande Valley, Dr. B notes a lack of preventative care as an issue that must be addressed. She sees a growing need for

Dr. Padmini Bhadriraju & Family

education about preventable diseases, as well as more doctors to address the needs of the community. As a physician advisor, Dr. B is dedicated to guiding physicians toward more effective methods of healthcare. “I very actively participate in educating physicians. That is something I wholeheartedly get involved in,” she said. She also works closely with case management to ensure that patients receive the best kind of care. “It is almost like playing music. You have to take care of both sides.” In addition to treating illness with medicine, one of her greatest philosophies includes stressing the importance of gratitude, faith, and a positive mindset. And although Dr. B admits she has gone through difficult times on her path, she emphasizes the power of a positive mindset and a healthy work-life balance. This includes, for her, plenty of family time, taking time to meditate, and giving thanks for her many blessings, including her rewarding career. “I just love being a physician. I feel so grateful. The same enthusiasm and gratitude I had when I started medical school, I still have it. It’s a privilege to have the trust of a patient with their care,” she said. “If a student is contemplating a career in medicine, the most important thing is that you have to love what you do. Being a physician is an amazing opportunity and you can make such a difference. It is a long journey but do not give up.” “For me, the glass is always half full,” she said. “If there is any adverse situation, it is just an opportunity for you to learn something and grow from it. You must have an attitude for gratitude. That is what I have been practicing, and it is amazing.” Women of Health & Wellness

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Dr. B chose to move to the Rio Grande Valley in 2009, primarily due to the excellent school systems available for her children, such as the Science Academy of South Texas and IDEA Academy. Previously, Dr. B and her family lived in Michigan, where she had her internal medicine residency and prior to that, she worked for years as a physician in Ghana, West Africa. Here in the Valley, she has held numerous roles, including as a primary care physician, a hospitalist physician and even as Chief Medical Officer at Knapp Medical Center up until 2015. “All the hospital systems here have been very supportive,” she said. “There is a good, healthy competition, which is very necessary for growth. It has been a great journey here in the Valley, and I continue to learn and teach every day.”

Women of Health & Wellness

Dr. Raquel Silhy General Surgeon

Dr. Raquel Silhy grew up in El Salvador but has called the Rio Grande Valley home for the past three years. When asked why she chose the Valley, Dr. Silhy expressed it was her desire to raise her kids in dual languages and cultures that led her here. “My husband is from West Virginia and finding people who speak Spanish in West Virginia is like trying to find a needle in a haystack.” Moving to a predominantly bilingual and bicultural area of the world just made sense for their family. From a career standpoint, being a bilingual physician in the Valley is very important. "I can usually tell that patients become more at ease when I’m able to speak to them in Spanish if they so choose. It helps them relax a little more when they’re already stressed about their health.” Dr. Silhy has a personal passion and dedication to the research and medical care of breast cancer patients as her mother was diagnosed with breast cancer shortly after she completed medical school. Supporting her mother through her treatments gave Dr. Silhy a more understanding perspective from the patient side and contributed to her becoming the compassionate physician she is today. For the upcoming year, Dr. Silhy hopes to be a part of the two new breast cancer centers opening soon here in the Valley. She has confidence that this will keep more of our patients here locally.

interview was conducted, Dr. Silhy was waiting for one of her daughters at dance class - demonstrating a classic example of how women are the true masters of multitasking.

Dr. Silhy also works extensively with pediatric patients, performing surgeries for children from three weeks old to eighteen years of age. “I’ve found that a lot of these young patients are being sent far from home to get their procedures done when we can do their pyloric stenosis and other surgical procedures right here.”

To Dr. Silhy, patient safety is her biggest priority. Some procedures such as colon resections for colon cancer and diverticulitis can be performed with robotic surgery, which is an advanced type of surgical procedure that allows for smaller incisions, faster recovery time and shorter hospital stays, thus allowing patients to get back to their normal routines much faster. While not everyone is a candidate for robotic procedures, it is a beneficial option to discuss with your physician. Some complications that may prevent a patient from being a candidate for robotic surgery include having too many prior surgeries, too much scar tissue in the area of concern, and abnormalities that could potentially block the view of the camera during the procedure.

As a mother of three, Dr. Silhy knows how hectic life can be for a working parent. She also says when it comes to medicine and practicing surgery, “I always think, if I can’t do it for my kid, I can’t do it for somebody else’s kid.” She states that comfort with her own skills is very important and feels a personal responsibility for the care of her patients. Speaking as a mother of three daughters, one of whom needed to have multiple surgeries of her own, “I understand the difficulty when a family has to leave work and other family members, drive long distances and take your child out of town for medical procedures. You do it because it’s your child and you’ll do whatever it is you need to, but I also understand how much more convenient it would have been if I could have had my child’s procedures and care in my own city.” Dr. Silhy contributes her ability to stay on track and focused with her daily life as a busy doctor and mother due to the wonderful support of her husband. “We tag team a lot. No matter what profession you have as a mom, you always have to juggle everything. It’s a different degree of things. It takes a village to raise a kid,” she giggles when asked how she is able to manage so much. She also mentioned that having everything within close proximity (work to school, school to home, etc.) is a major factor in the life balancing act. As this 14

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When Dr. Silhy spoke of her medical education and training, she expressed her gratitude for the opportunities to learn procedures such as colorectal surgery, trauma, pediatric, vascular, and oncology surgery. Dr. Silhy was privileged to rotate through these areas during her residency and she accredits her excellent training and specialization as a general surgeon as the reason she is now able to perform these complex procedures.

Hiatal hernia repair and gallbladder surgery are also procedures that benefits from robotic surgery. Many patients are prescribed pain medications after such procedures, but with robotic surgery’s more rapid healing and smaller incisions, many patients have stated that they have not needed to use any pain medication stronger than Tylenol or Motrin post-surgery. Thus, the robotic technology is promoting a cut back on the usage of narcotics and opioids; a rising epidemic in our country. Benefits also include shorter hospital stays, such as those for a colon resection, which on average used to be a seven to ten day stay at a hospital, whereas now, with robotic technology, many patients are now able to leave the hospital after only three to five days. Dr. Silhy sees patients in Weslaco, Harlingen, and Brownsville and may be reached at 956-622-3281 or 956-621-4981.

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Amy Flores

Chief Nursing Officer Harlingen Medical Center

Kennetha Foster

Chief Nursing Officer Mission Regional Medical Center

Anna Hinojosa

Chief Nursing Officer Knapp Medical Center

Making Their Mark:

How These CNOs are Improving the Future of Valley Healthcare

he importance of a Chief Nursing Officer in the hospital setting is indisputable. As one of the most distinctive roles in hospital leadership, this position is crucial to the ongoing success of a hospital. A CNO is largely responsible for the oversight of patient experiences and typically oversees large teams of nurses and staff.

In the Rio Grande Valley, three female CNOs, occupying positions at Harlingen Medical Center, Knapp Medical Center, and Mission Regional Medical Center are changing lives.

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Amy Flores

Chief Nursing Officer Harlingen Medical Center For Amy Flores, a career in medicine wasn’t just an option. It was her destiny.

States who have received this recognition. This is the second year HMC has received this award. Also, HMC has received numerous Health Grade awards in Orthopedics, Patient Safety Excellence, Gynecologic, and General Surgery. And in 2018, HMC was recognized as one of only four Prime hospitals on the 100 SafeCare hospitals in the US. Harlingen Medical Center recently welcomed two new leaders, Matt Wolthoff, Chief Executive Officer and Michael Bergstrom, Chief Financial Officer. “We’re creating a very cohesive, strong leadership team that I’m excited to be a part of, and I can’t wait to see where we’ll be headed next.” Flores credits determination, hard work, and clear goals for her rise in leadership. For others hoping to break into the healthcare field, she shared a few words of advice. “It is possible to achieve your goals. I’m certainly someone who has set goals and achieved them. I worked hard. It wasn’t easy. You can do it if you persevere.”

“I knew I wanted to be a nurse at the age of three,” said Flores. “I set goals for myself when I was in high school of what I wanted to achieve in life. And one of those goals was to be a Chief Nursing Officer of a hospital.”

“I knew I wanted to be a leader in healthcare so that I could impact nursing as well as all the other clinical departments,” said Flores. “Florence Nightingale is obviously someone that I’ve looked up to throughout my career in nursing. That’s my aspiration; to be sure we give that good, quality, compassionate care to patients because that’s what they deserve.” While Flores has worked in several areas of healthcare, including eight years as a nursing instructor at Valley Baptist Medical Center School of Vocational Nursing, she enthused that her role in administration at Harlingen Medical Center has been the most rewarding. Prior to beginning her role as CNO, Flores was a staff nurse at HMC on the Medical Surgical Unit and eventually the Director of that unit. At the same time, she facilitated the opening of an Orthopedic Unit and a Pediatric Unit and assumed being the Director of these units. Soon after the Orthopedic unit opened, Flores applied to the Joint Commission for the unit to obtain a Disease Specific Certification in the Knee and Hip replacement surgery. This successful survey continues to remain current. She began her work as CNO in 2016, and now oversees a staff of 200 nurses. In addition to her role as CNO, Flores is also Vice President of Clinical Services at HMC and is responsible for departments such as the wound healing center, radiology, laboratory, pharmacy, respiratory, dietary and contracted services. “In this role, I have a better and greater impact and influence on more people.” Harlingen Medical Center has been named “Best of the Best’ Hospital three times out of the last five years in a local newspaper Readers Choice survey. In addition, HMC has been awarded a Grade A in the Leapfrog Patient Safety Survey and most recently, a 5 Star Rating from CMS, which puts HMC among one of only 293 hospitals in the United

Kennetha Foster

Chief Nursing Officer Mission Regional Medical Center Kennetha Foster’s path to healthcare began at an early age. Raised on a dairy farm in Kentucky, Foster took an interest in taking care of animals. She honed this passion for caregiving, eventually leading her to work as a nursing assistant, helping with geriatric patients. The culmination of these experiences led Foster to pursue a career in nursing. “I’ve always worked in healthcare, and it just seemed like a natural thing to do, to go into nursing,” she said. Foster’s formal education in healthcare began when she attended Ivy Tech College in Sellersburg, Indiana, where she earned an associate degree in nursing in 2000. In 2008, she received a Bachelor of Science in Nursing from McKendree University in Louisville, Illinois. Then, in 2016, she earned a master’s degree in Nursing from the University of Phoenix. “My parents were a huge support to me while I was in school.” Today, as Chief Nursing Officer at Mission Regional Medical Center, Foster is responsible for all clinical operations pertaining to nursing, radiology, laboratory, pharmacy, dietary, case management, wound care and cardiopulmonary. “I’ve been in this position for four years now, and I think my favorite part about this job is that I’m able to affect change at many different levels.” During her tenure, MRMC has been awarded a grade of A in LeapFrog safety and has earned the Patient Safety Excellence Award, the Labor and Delivery Excellence Award, and the Obstetrics and Gynecology Excellence Award, as well as the Orthopedic Surgery Excellence Award — all from Healthgrades. In 2018, MRMC also received the Texas Medical Foundation’s Bronze Award. Women of Health & Wellness

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After graduating as a licensed vocational nurse in 1987, Flores went to work at Valley Baptist in the intensive care unit (ICU). She continued in the ICU for about ten years before earning an associate degree in 1995, then later a bachelor’s degree in 2007 from the University of Texas at Brownsville. She then earned a master’s degree in 2010 from The University of Texas at Brownsville.

“When people describe Mission Regional Medical Center, you always hear them say it’s like family,” says Foster. “We work together as a team. We help each other out when there’s a need. It’s a very welcoming, family environment.” In addition to her work with Mission Regional Medical Center, Foster, a married mother of three daughters, is well engaged in her community, serving on the board of several organizations. “We always want to help people to grow and to strive to be better and be happy with what you’re doing. I grew up on a dairy farm. I never would have dreamed I’d be the CNO of a 297-bed hospital,” she said. “So, you can’t give up. You have to keep working for it even when it’s hard, and I share that same philosophy with my employees.”

Anna Hinojosa

Chief Nursing Officer Knapp Medical Center With nearly 30 years of experience in healthcare, Anna Hinojosa, who grew up in Harlingen, knew she was interested in medicine from the start. As a young girl, Hinojosa was inspired by her grandfather’s passion for healthcare. She used to watch with admiration as he, a medic in the army, helped treat patients in his underserved Starr County community. It was her grandfather who instilled in her the motto “passion for compassion”. “You have to have some passion for compassion,” said Hinojosa. “You need to be self-motivated and want to learn, because healthcare changes every day.” Moved by her grandfather’s efforts, Hinojosa began volunteering in hospitals during her teen years, spending time at Dolly Vinsant Memorial Hospital in San Benito and Valley Baptist Medical Center in Harlingen. Her formal education in healthcare began with a Bachelor of Science degree in nursing from the University of Texas Health Science Center in San Antonio. She would later go on to pursue a Master of Science in Nursing from the University of Texas at Brownsville. Hinojosa’s career at Knapp Medical Center began in 2006 when she accepted the role of Emergency Department Director. Then, in 2014, she began her work as Chief Nursing Officer, where she is now responsible for the oversight of 650 nursing and clinical staff. Under her leadership, Knapp Medical Center received the Labor and Delivery Excellence Award and Obstetrics and Gynecology Excellence Award and Gynecologic Surgery Award from Healthgrades, a benchmark for hospital performance. Knapp has been one of only twelve hospitals in the entire state of Texas to receive all three of these “Women’s Care Specialty Excellence Awards” from

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Healthgrades. In addition, Knapp Medical Center was recognized as one of Healthgrades’ “America’s 100 Best Hospitals for General Surgery for 3 Years in a Row” – as well as being named a “5-Star Recipient for Hip Fracture Treatment for 7 Years in a Row”. When it comes to improving healthcare in the Rio Grande Valley, Hinojosa says continuing education is crucial. “The nurse plays a lot of roles, not just as a nurse. She’s a scientist, too,” said Hinojosa. “She has to interpret lab work, x-rays, communicate with different physicians and specialty physicians, as well as collaborate with other healthcare disciplines.” Hinojosa is excited for the future of nursing. From bladder scanners to vein finders, there exists a growing number of technological advances to help nurses provide better care, which promotes Hinojosa’s long-standing goal of patient-centered excellence. “It’s an intense vocation that encompasses your mind, body, and soul, to grant unselfishly to others,” she said. “I love what I do. I love interacting with our staff, physicians and our patients. It’s really a rewarding career.” HealthStream, an educational platform provided by Prime Healthcare, offers more than 2,500 online courses to employees hoping to strengthen their skills and learn new methods for patient care. “We just had our annual skills fair to help keep our nurses up to date,” Hinojosa said. “We encourage them to go back to school, become better nurses, become more marketable nurses.”

Prime Healthcare Setting the standards

With the explosive growth seen in South Texas, healthcare options and opportunities are now more readily available. Steadily increasing rates of employment in the industry and innovative technologies in patient care, are being made in countless areas throughout healthcare in the Rio Grande Valley. But, despite global studies of the benefits of female leadership, women remain disproportionately represented in these roles. In the United States alone, these statistics show that only sixteen percent of healthcare leadership positions in administration or at department levels are occupied by women. Prime Healthcare is an award-winning health system operating 45 hospitals in 14 states. Their mission is to deliver compassionate, quality care to patients and better healthcare to communities. Our own Rio Grande Valley Prime Healthcare facilities have repeatedly demonstrated why having qualified women in leadership roles adds value to their health care organizations. While these facilities are all unique in their own way, the one common denominator they exhibited was the sense of family and unity. The women portrayed in this article are not only educated, driven, and experts at multi-tasking, but they have the added benefit of years of experience in patient care at a variety of levels; not just administrative. These experiences have added up in each of their lives to where they are now highly competent individuals with their own innate abilities for empathy, emotional intelligence and intuition. These CNOs are true leaders in healthcare.

Jose A. Cobos, M.D., F.A.A.O.S.

HMC RGV Physician Group

STOP START

As an experienced surgeon with more than 20 years in orthopedics, Dr. Cobos takes a personal approach to caring for his patients. He firmly believes the most important aspects of providing quality care are listening to the needs of his patients, comprehensive testing, along with providing patient education on prevention of musculoskeletal injuries. This in turn, helps in presenting treatment options to the patient involving them in their treatment plan.

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APRIL 24-25, 2020

28th Annual Rio Grande Valley Medical Education Conference & Exposition Isla Grande Conference Room 500 Padre Blvd South Padre Island, TX For more information call: (956) 969-5455 or (956) 969-5468 or, visit: www.KnappMed.org

Harlingen Medical Center

PRESENTED BY

Knapp Medical Center

Mission Regional Medical Center Women of Health & Wellness

Women of Health & Wellness

Dr. Cynthia Salinas Wound Care and Hyperbaric Medicine Trama Surgeon Raised in Mercedes, Texas, Dr. Cynthia Salinas knew she was interested in medicine at an early age. “I had a grandfather who had diabetes when I was a young girl. I’m guessing we didn’t have many oral medications at the time, so he was injecting insulin, and he allowed me to help him. At that point I got interested in being a doctor, and I remember being very specific, too. My mom bought me a nursing kit, but I remember telling her, ‘No mom, I need a doctor’s kit’.” Even though Dr. Salinas had long dreamed of a career in medicine, she, like many of us, experienced doubts of her own about being able to fulfill her dream. After much deliberation, she decided that she wanted another option, and instead chose to attend pharmacy school at the University of Texas at Austin. After graduation, she worked for several years as a pharmacist, and while she enjoyed what she was doing, her dream of becoming a doctor never quite left her alone. With the encouragement of her parents, she ultimately decided to pursue an additional professional degree, this time, to become a doctor like she’d always wanted.

rewarding, a joyous occasion had Dr. Salinas pursuing a different career move. With the birth of her son, Dr. Salinas sought a position that would allow her to spend more time with family. “My career path may have morphed, but it’s been a good metamorphosis,” she said. Now, alongside Dr. John Hovorka, whom she met while working as a trauma surgeon, Dr. Salinas is now part of an amazing team of physicians that educates and treats patients suffering from venous conditions or who require wound care. She divides her time between their clinic in McAllen, Laser Surgical Solutions, and her responsibilities as Medical Director of the Wound Care Center at Mission Regional Medical Center and wound care physician for Harlingen Medical Center. Dr. Salinas is a passionate advocate for providing Valley residents with the education and care necessary to take charge of their health. Two of the most frequent conditions she sees in the Valley is Chronic Venous Insufficiency and Peripheral Arterial Disease. “Chronic Venous Insufficiency means the valves in the veins don’t work well anymore, and we don’t really have a reason behind that,” she said. “For women, it’s usually due to pregnancy or obesity. For men, we don’t really know. A lot of it is genetic.” Peripheral Arterial Disease is a circulatory condition that may be preventable. “High cholesterol, smoking, leading an unhealthy life, and inactivity, in general, are all risk factors for PAD.” Dr. Salinas recognizes her talented teams as the reason for the wound care departments’ success. “We have excellent nurses; our ultrasound technicians are fantastic. We have a whole ultrasound lab here.” While Dr. Salinas specializes in surgery, she says the goal for patients is early diagnosis. “If we can catch these conditions earlier, we can instigate treatments that are non-operative. A lot of times we’ll send them on a walking program with a physical therapist. They’ll walk with them three times a week for three months. That’s in the hope that the body will be able to create its own new arteries. Experience has proven that when we send a patient to a walking program, they come back feeling so much better.”

She chose to attend the medical school at the University of Texas Health Science Center at San Antonio. While medical school was grueling, Dr. Salinas said that having already gone through pharmacy school was a huge help in allowing her to complete her medical degree. “At first, I thought I was going to go into internal medicine and specialize in endocrinology. But then I attended a surgery clerkship and really excelled at it, so I chose surgery instead,” she said. Dr. Salinas completed her general surgery residency and critical care fellowship in New York. Eight years later she was finally able to return to her home and family in the Valley. “My whole idea in going into medicine was to come back and help serve my community.” Once back in South Texas, Dr. Salinas began working as a trauma surgeon at McAllen Medical Center. “I loved it,” she said. "I was a trauma surgeon for two years and every day was a new challenge." While her position as a trauma surgeon was highly 20

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Although the path to her current role has been a long and winding one, Dr. Salinas says she is right where she wants to be. “My current positions allow me to establish rapport with my patients, get to know them, and really invest in their well-being and healing rates," she said. “I see my patients once a week, so I get to hear about their lives, their families, I know their kids. I think it’s awesome.” Dr. Cynthia Salinas specializes in Wound Care and Hyperbaric Medicine at Prime Healthcare's Wound Care Centers at Harlingen Medical Center and Mission Regional Medical Center. The professionals at Laser Surgical Solutions in McAllen offer in office treatments for varicose veins, vascular medicine, diabetes management for wound care, lymphatic services, Tibiopedal Access Minimally Invasive (TAMI), IV-Infusion, and compression sock measurements. For an appointment at Laser Surgical Solutions please call 956.992.9161.

Women of Health & Wellness

Libby Elrod R.D., L.D. Registered Dietician & Director of Food & Nutrition Services at Mission Regional Medical Center

Elrod’s interest in nutrition began when her youngest brother was diagnosed with a severe food allergy during childhood. She, along with her mother, a registered nurse, began experimenting with different food recipes to help her brother navigate his food allergy. When she became aware of a career path called Food Science and Technology at Texas A&M, her goals became clear. After graduating with a specialization in nutrition, Elrod accepted an internship at Texas Woman’s University in Houston at the Texas Medical Center. While Elrod’s initial career plans would take her outside of the Valley, it was a reunion with her high school boyfriend while she was visiting home that would bring her back to the Rio Grande Valley. The couple is now married with two daughters. “It was a blessing coming back to the Valley.” At MRMC, Elrod is responsible for a wide scope of tasks aimed at elevating patient care and comfort. She oversees the vast majority of food services for the hospital, including customized patient meals and the hospital cafeteria, which provides meals for employees and guests of the hospital. From ordering food supplies to employee management, organizing food production, planning menus and budgeting, there’s no shortage of work involved in running a hospital’s food system. “The production side of food, especially in a hospital, is different than when you go to a retail type of restaurant,” she said. The well-being of the patients at Mission hospital keeps Elrod motivated each day. “Many times, people are here during the most difficult time of their lives,” she said. “They’ve got an illness, and we’re the caregivers. In the hospital, we

have people that have many different types of illnesses that have separate dietary requirements. It’s really important to provide each patient with food that will help nourish them and help them get well while maintaining the restrictions the doctors have placed on what they can and cannot eat. We’re constantly adjusting what we’re producing to meet those patients’ needs and make mealtime an enjoyable experience while they’re with us. They trust us to give them that support and help them get better. I think that’s part of being a leader in healthcare." On any given day, Mission Regional provides meals for 120–160 patients, three times per day, as well as scheduled between-meal snacks for patients that require them. The department currently has 28 full-time employees and five part-time employees. “It takes a lot of coordination and a lot of dedicated people to make it happen,” says Elrod. “Our staff is amazing. We have people that truly care about what they do every day,” she said. "We open opportunities for people to bring new ideas, and welcome those ideas, and work in an environment with collaborative people that know they do something important every day, which is to provide nourishing meals for our patients, the public and our employees.” Having worked at several hospitals throughout South Texas, Elrod says her current role at MRMC feels like the right fit. "Mission Hospital is a great place to work. The culture here is fabulous,” says Elrod. "When I started, I was amazed at the support from my peers. It’s like a family environment where everyone is covering you, making sure if you have questions you get help. It was a wonderful, refreshing change for me. Throughout the time I’ve been here, we’ve worked really hard at building a team and making sure we all take care of each other.” Libby Elrod and the staff at MRMC Cafeteria welcome the public to join them for meals, especially when the costumed staff goes all out with themed menus for a variety of holidays!

The Mission Regional Medical Center Cafeteria is located on the First Floor. Cafeteria Hours: Breakfast 7:30 am – 9:30 pm Lunch 11:00 am – 2:00 pm Dinner 4:30 pm – 6:00 pm

Women of Health & Wellness

SPRING 2020 | www.adelantergv.com

As a registered dietician and Director of Food and Nutrition Services at Mission Regional Medical Center, Libby Elrod knows a thing or two about healthy eating. The Edinburg native has worked for decades in the food industry, helping patients treat a variety of illnesses through the power of a healthy diet.

Women of Health & Wellness

Dr. Annabelle Lopez Obstetrics & Gynecology

Dr. Annabelle Lopez comes from a small family that she describes as a “typical Latino family” who spend much of their time together. Her husband is an ICU nurse at Knapp Medical Center and their daughter, who shares her parents drive for helping people, also wants to be in the medical field one day. Dr. Annabelle shared her memories of growing up in a volatile Cuba. When she was 15, her family took actions to seek a better life and moved to Venezuela. While living there, she graduated from high school, where in that country the collegiate system runs a little differently. In Venezuela you are asked to write down three professions you may wish to pursue after high school. From those options you take an assessment exam to determine what you would be most suited for and then you are encouraged to pursue that path. When Dr. Annabelle was asked this question, she wrote down “doctor, engineer, architect.” Of the three areas, she scored highest in the medical portion and followed that path into medical studies where she completed a year and a half of schooling in Venezuela. However, about 5 years after moving to Venezuela, the growing unrest and political climate saw her family uprooted once again. Her family decided to move to Brownsville, Texas where other family members were living. By that point Annabelle recognized her passion and curiosity for medicine was strong and decided to enter the healthcare studies program at the University of Texas in Brownsville. Dr. Annabelle recalls that her first encounter at the University was a bit negative when one of her counselors tried to discourage her from pursuing the medical program due to her language barrier. She was told she did not know enough English to do well in her classes, but Dr. Lopez did not let this discourage her. What she did instead was take that criticism as a challenge, enrolled in several classes for English as a second language and

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obtained her bachelor's degree with further studies at the University of Southwestern Medical School in Dallas. When deciding upon her specific field, Dr. Annabelle says, “OB is the best of both worlds. You provide immediate care and you also get the follow up with your patients.” Dr. Annabelle believes this is the most valuable aspect of her chosen field. She has now been practicing for nine years and has developed a very close relationship between her patients and staff. Dr. Annabelle attends five to six conferences and trainings per year to stay current with the newest treatment options and procedures available for her patients. Her three nurse practitioners and the midwife from her team accompany Dr. Annabelle to the medical conferences so that they all gain the knowledge necessary to care for their patients. Dr. Annabelle and her staff routinely provide care for pregnancies and postpartum follow-up visits, pediatrics, teenagers experiencing their first periods, difficult menstrual cycles, preventative annual exams, and surgeries such as hysterectomies and the removal of ovarian cysts. Hormone replacement is also offered in office for patients who have voiced their concerns about feeling tired, have trouble losing weight, losing hair, having a lack of sexual desire or even emotional instability that tends to happen after age 35. Dr. Annabelle also offers cosmetic treatments including, but not limited to liposuction, fillers and Botox treatments. “Many of our patients were asking for it,” she commented when referring to the cosmetic services. “After getting so many requests, I deliberated and researched the safest and most current techniques and procedures. I went to New Jersey and took many classes and seminars and practiced with a wellknown physician. Upon completion I finally was able to bring the techniques down here for my own patients.”

Healthy Body

Precision Fitness for a Healthy Active Lifestyle

“When you go on one of these missions you think that you’re going to help, but as a matter of fact you come back feeling that they helped you far more than you did them,” she stated emotionally. She explains the feeling of returning home and feeling immensely grateful for the kind of life we have here in our country. “When you see their living conditions you come back feeling like your problems are not problems. Their problems have no solutions such as women dying just because they have no way to stop a hemorrhage that could have been stopped by a simple 45-minute medical procedure.” Dr. Annabelle is also an associate professor at UTRGV’s Medical School in the departments for Family Medicine and in the nurse practitioner program. Her dynamic personality, entrepreneurial spirit and humanitarian heart will continue to drive her to new places in the field of medicine. To schedule an appointment with Dr. Annabelle in Weslaco or Mercedes please call: 956.647.5529. Contact Nobu Medical Spa in McAllen for laser body contouring, medically supervised weight loss, cosmetic and anti-aging procedures at 956.618.9915.

By: Charlie Cardenas

We only have one life to live and keeping healthy and fit increases our chances of living a long one. In fact, staying healthy and fit is one of the most important things we can do for ourselves. People who live a sedentary lifestyle and who don't take care of their health have a higher mortality rate than those who exercise and eat right. Exercising, staying active, and eating a healthy diet reduces the chances of being overweight and of having heart disease, high blood pressure, Type 2 diabetes, a stroke, osteoporosis, and many other illnesses. Living a healthy lifestyle includes making healthy choices, staying away from unhealthy habits, being physically active, eating whole grains, fruit, vegetables, and lean protein, and maintaining a healthy weight. The definition of fitness, according to the United States Department of Health and Human Services, is "a set of attributes that people have or achieve that relates to the ability of perform physical activity." Being physically fit includes several components, and how fit a person is depends on how well he/she can perform each component. These components include cardiorespiratory fitness, muscular strength and endurance, flexibility, and body composition. Being fit and able to perform physical activities requires exercising to elevate our heart rate and improve cardiorespiratory endurance by doing things like swimming, jogging, or cycling. It also includes strengthening and increasing muscular endurance by working our muscles with resistance training and by exerting our muscles without tiring. One more element of fitness is flexibility, which can be achieved through a regular stretching regimen. One very important element of being fit that is not mentioned by the U.S. Department of Health and Human Services and is often forgotten or ignored by many people who exercise (and even trainers) is the importance of having a strong core. Some of the main muscles of the core are the pelvic floor muscles, transverse and rectus abdominis, internal and external obliques, the erector spinae, and the diaphragm. Our core muscles are our stabilizers and our movers. A strong core helps everybody, from the young to the elderly, with balance and stability. It also helps to prevent us from getting injured, helps improve posture, and makes it easier for us to perform physical activities. Doing exercises to strengthen our core will help us reach our fitness goals safer and faster. At Precision Fitness, you will begin an exercise regime that will help you get fit, stay in shape, and reach your goals. Along with personal weight training, core training is a big part of our program. You will train in the comfort of a private studio with a trainer who will show you the correct form for all exercises so you will train safely. A nutritionist is also available to show you the best, safest, and most beneficial foods and eating plan. At Precision Fitness, all the attention is on you.

Women of Health & Wellness

SPRING 2020 | www.adelantergv.com

This October, Dr. Annabelle will be departing to Guatemala for her fifth Healing International Medicine expedition with Dr. Juan Padilla, where indigenous tribes are offered care in a medical camp in what she describes as “the middle of nowhere.” She explains it is not an easy task as the people speak a different language so their group has translators to assist as they perform about 70-90 surgeries, including the removal of large tumors, ovarian cysts and other major complications. Dr. Annabelle’s mother has volunteered with her on previous expeditions. This year, for the first time, she will be taking her daughter as well. Dr. Annabelle encourages her daughter to learn about parts of the world where children are less privileged and encourages her to help and assist whenever possible.

South Texas GRASS & LANDSCAPE SPECIALISTS (956) 755-H4O6R7T8 • www.STXHort.com

PERSONAL TRAINING • GROUP TRAINING & BOOT CAMPS • WEIGHT LOSS CORE, STABILITY & STRENGTH TRAINING • NUTRITION NASM CERTIFIED PERSONAL TRAINER

CHARLIE CARDENAS 4800 North 10th Street • McAllen, TX

956-250-5842

By appointment only. First session FREE

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Healthy Mind

Mental Health plan By: Dr. Cynthia Salinas

I continued to run through pharmacy school and then through medical school. I think I chose running because it was the most inexpensive form of exercise I could do. By the time I got to medical school, I was running about 5 miles a day. It kept me the skinniest that I would ever be, which I’m sure is not equivalent to society’s definition of skinny, but that was enough for me. Then came surgery residency in New York. Probably the most difficult of my endeavors. Time became the most valuable of commodities. Working 90-100 hours a week, any time I could steal was for sleeping. I was anxious most of the time (though admittedly, my anxiety had started in medical school, post 9/11). I was constantly stressed with the responsibility of caring for people while trying to figure out how to manage all the feelings of inadequacy and self-doubt you develop while a resident; my anxiety and stress both complicated by a situational depression I experienced after being stuck with a needle that had entered the body of a woman that I was trying to save and who, unbeknownst to everyone at the time, was in full-blown AIDS. I became more and more depressed as I waited the months it takes to determine if I had contracted HIV (it was negative). I suppose I should be thankful that I didn’t eat much as I had little money and was sitting on roughly $200K worth of school loans; there was not much weight gain, but more importantly, there was also not much exercise. That all changed one night in my third year of residency: I broke down. I'd had enough of the shear chaos of life as a surgical resident and I completely lost it. I called my parents in Texas and sobbed and then begged my father to drive to New York and take me home. I was done with this self-imposed challenge of trying to become a doctor. My dad, in his infinite wisdom asked me a question that changed my life forever. He asked, “Have you been running?” And it suddenly became so clear. I didn’t run JUST to be skinny. I ran to help myself “get through this thing called life,” in the words of the late cultural

icon, Prince. It struck me like a ton of bricks. Yes, running had helped me stay my version of skinny in my 20’s, but more importantly, it had helped me through the anxiety and stress of life. It occurred to me that though I had been taught for many years that exercise releases endorphins and that it is an excellent form of therapy for depression and anxiety, I hadn’t actually applied that to my own life. From that day forward, I ran every chance I got, even if only a mile or two, and even if it made me sacrifice an extra half hour of sleep. I did finish my training and I also finally moved back to Texas, as my mother became quite ill, having had a fatty liver that progressed to cirrhosis, requiring a liver and kidney transplant. I was 38 years old when I had my son. I weighed in at 210 pounds right before his birth. I had gestational diabetes, which places me at a 70% chance of being diagnosed with Type 2 diabetes by the time my son is 7 (he just turned 4). I am a single mom with a full-time job. I am a doctor, though I am not practicing surgery. I have had to make some career compromises in order to raise my son, which I clearly do not regret, as my son is my greatest joy and accomplishment. I still run almost every day, though most days it’s a walk/jog combination (I blame my aging body). Still, this is enough to maintain my sanity and keep away any negative energy that surrounds me or comes from within me. I have been able to get my 4-year old son excited about exercise and he has joined me in a few 5K’s. Don’t get me wrong--there are periods of my life when my cardio routine falters because I get overwhelmingly busy. It usually takes a few weeks, but I eventually start to feel the negligence, both physically and mentally, and so I know I need to restart my routine. It never ceases to amaze me how quickly my mind reaps the benefits of exercise once I resume. I am still trying to lose the weight I gained while pregnant, which has proved difficult. I have come to realize that to lose weight in my 40’s requires more discipline in the kitchen as opposed to discipline at the gym. I’m still trying different diets (I’m currently on Jenny Craig). I try to make better food choices and practice portion control. I do this mostly to prevent diabetes and fatty liver, but also because I ask my patients to do the same each day and I simply cannot sit in an exam room day in and day out and ask my patients to do something that I am not willing to do. They say weight loss is 80% what you eat. At 42 years of age, I completely agree with that statement. Diet has become my physical health solution. Exercise is now my mental health solution. Women of Health & Wellness

SPRING 2020 | www.adelantergv.com

I started running in college. I ran because I wanted to be skinny. And let’s face it … I’m a short Mexican American girl from the Rio Grande Valley, with the tendency to eat an abundance of homemade Mexican food and sustain a baseline truncal obesity. There is nothing skinny about me. But, still, I ran. Unbelievably, I still managed to gain the notorious “freshman 15” during my first semester at UT Austin, crying over Christmas break because my clothes no longer fit. Thankfully, with the help of my mother, I was able to lose the weight by starting on what would become my very first diet in a very long list of fad diets I would try throughout my adult life. I chose Weight Watchers. It was 1994. I was 17 years old.

Support

Stress Management & Support for Caregivers By: AHM Staff Writer When it comes to caring for people with serious or long-term illnesses, the most important—but too often ignored—aspects for caregivers is to make sure they care for themselves. If the caregiver's emotional, physical, and mental health are adversely affected it is bound to have a detrimental effect on the well-being of the person. Being a good caregiver starts with being good to yourself. Let’s face it, as a caregiver you are highly likely to experience anxiety, stress, depression, and a lot of frustration. If you ever feel overwhelmed, don’t be hesitant about finding support. It is fairly common for a caregiver to feel angry, alone, afraid, guilty, and sad. Talking to others who are also caring for family members or friends is a great help when you need to cope or destress. Do not be afraid to ask a social worker about local resources, like support groups. You can also seek advice from the support network program provided by the patient’s own medical center. To recognize whether you are becoming stressed, watch out for the tell-tale signs, which include: • Feeling constantly exhausted • Falling ill more often than usual • Not getting enough sleep • Becoming impatient, irritable, or forgetful • Not being able to enjoy things you used to like • Withdrawing from family and friends In order to get help, you need to ask people to help you care for the patient. They can assist with chores, errands, or even childcare that may be associated. There are often members of your family, your friends, or members of community and religious groups who would be willing to assist you. It is important that you don’t ignore these offers of help and provide people with tasks that would relieve your burden and this will perhaps give others a sense of purpose and accomplishment as well. When you are able, it is advisable to give yourself time for your other relationships, because time spent doing something you enjoy with your own loved ones will allow you to relieve stress. Taking these breaks will help you be an effective caregiver. Spending time with people who are able to support you is key to your own well-being. It may also be a good idea to seek financial assistance, because expenses for things like parking, transport, medications and food can easily add up and become another source of pressure for a caregiver. Explore whether there are any programs within the hospital or social services that can help. There are also many foundations that can also provide financial assistance. It is not uncommon for caregivers to experience bouts of frustration and even anger, and feel guilty about it. These

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are natural emotions so look for positive ways to be kind to yourself; it will help you cope with difficult feelings. Talk to supportive friends, take up an exercise routine, or keep a journal. Taking care of your own body is also crucial. Taking time out for exercise, eating healthy foods, staying hydrated, and getting enough sleep are all important for managing your health and well-being as a caregiver. The stress of being a caregiver can easily lead some to develop unhealthy habits, like drinking too much alcohol, smoking, or abusing prescription drugs. Many studies have found that caregivers suffer increased risks of depression and anxiety. If this applies to you arrange an appointment with your doctor or talk to a therapist. If you are finding it difficult to maintain a healthy lifestyle it may be time to seek out professional help. Depression has many symptoms that can include feelings of despair and sadness. Other signs can include: • Overeating or loss of appetite • Sleeping too much or too little • Tired and lacking energy • Losing interest in your normally enjoyable activities • Difficulties concentrating, remembering, or making decisions • Irritability and restlessness • Suffering headaches Anxiety is also a common response to stressful situations, but it’s important to keep it in check, because it can lead to health problems of your own. The signs to watch for include: • Difficulties with making decisions and focusing on tasks • Restlessness • Feelings of tension • Headaches • Unexplained anger and irritability • Difficulties sleeping • Worrying excessively To manage depression and anxiety, seek professional help and take steps to: • Drink less alcohol • Make plans for spending time with family and friends • Join caregiver support groups • Arrange enjoyable and relaxing activities • Exercise, even if it’s for a small period of time each day • Practice meditation, yoga or other relaxation techniques Making sure you look after your emotional and physical well-being will make you a better and more effective caregiver, which in turn will help the person you are caring for. Visit www.AdelanteRGV.com for Support Groups Calendar of Events.

Education

UTRGV Launches Physician Assistant Career Track Program for High School Students By Victoria Brito

UTRGV Informational Writer

BROWNSVILLE, TEXAS – Starting in Spring 2020, The University of Texas Rio Grande Valley will launch its new Physician Assistant Career Track (PACT) program, designed for South Texas high school students moving toward a Master of Physician Assistant Studies. The objective of the early assurance program – which was announced at a press conference Wednesday, Nov. 20, 2019 on the UTRGV Brownsville Campus – will help increase the number of students who enroll and complete their undergraduate studies at UTRGV while securing a seat in the UTRGV College of Health Professions’ Physician Assistant Studies Program. “Our Physician Assistant Career Track is our ‘pact’ with South Texas high school students who wish to pursue a master’s degree in Physician Assistant Studies,” said Dr. John Krouse, dean of the UTRGV School of Medicine and executive vice president for the Division of Health Affairs. “We want to attract and retain high-achieving students from South Texas that have an interest in pursuing an exciting career in health care, and that have a desire to train locally and help care for this community.” In partnership with the UTRGV Honors College, up to 10 applicants will be selected for the program, which is geared toward high-achieving South Texas high school students who will begin their undergraduate education at UTRGV in Fall 2020.

She said that, as a PA, you can talk in depth with patients.

Frank Ambriz, PA department chair, graduate program director and clinical associate professor, said this program helps with expansion of an already growing program.

To be eligible for the PACT program, interested students must graduate from a South Texas high school – Cameron, Willacy, Hidalgo, Starr, Zapata, Webb, Kennedy, Brooks Jim Hogg, Kleberg, San Patricio, Aransas or Nueces counties – and enroll at UTRGV as an incoming freshman for fall 2020, among other qualifications.

“Life is not a problem to be solved, but a reality to be experienced.” -Soren Kierkegaard.

“This PA program encompasses everything that I believe that I am,” Del Monte said. “It teaches us to be empathetic and to care for others and work as a team. “You are not only a provider, but you become someone they can turn to,” she said.

Students selected for this program also will receive a guaranteed seat in UTRGV’s Master of Physician Assistant Studies program in 2024, if they meet the necessary requirements.

Stephanie Hernandez

Photo credit: David Pike

Ximena Del Monte, a second-year graduate PA student from Brownsville, said she has known since she was very young that she wanted to be in the medical field. She just didn’t know in what capacity until she encountered the PA program.

“We are now up to 100 students,” Ambriz said. “The competition to get in is very tough, very competitive, and this new program will give an opportunity to local applicants to have a pathway into the PA field.” The competitive online application process will run from Feb. 1 to March 20, 2020. For more information, visit UTRGV.edu/PACT.

Specializing in: • Conﬁdence, Self Esteem • Healthy Loving Rela�onships • Balance your Life • Living Your Purpose • Managing Anger, Frustra�on and Stress • Managing Grief, Loss, Sadness and Change

• Connec�on Paren�ng • Self & Iden�ty • Decreasing the Drama in your life • Forgiveness of others and yourself • Spiritual Growth and Development • among others

INDIVIDUAL | COUPLES | GROUPS (956) 667-6254 • Anveli.Coaching@gmail.com 1811 N. 23rd, St. Suite 125, McAllen, TX Women of Health & Wellness

Healthy Food

Chicken Enchilada Casserole Tasty, skinny and takes less than 30 minutes from start to finish! Great served with hot corn tortillas or tostadas and a fresh green salad.

Ingredients 1 cup cooked brown rice or quinoa 2 cups cooked chicken, cubed or shredded (rotisserie chicken works great) 2 cups salsa 2 chopped green chiles or 1 (4oz) can of green chiles 1 cup corn kernels, frozen or canned 3/4 cup canned pinto beans or black beans, drained and rinsed 2 tablespoons fresh cilantro, chopped 1/4 cup chopped sweet onion (optional) 1/2 tsp cumin 1 teaspoon chili powder 1/2 teaspoon garlic salt or fresh minced garlic Salt & pepper to taste 1 1/3 cup shredded cheese (Mexican blend shredded cheese recommended)

Garnish: diced avocado, tomato and fresh cilantro

Instructions:

Servings = 6

1. Preheat oven to 375 F. and prepare an 2 Â˝ quart baking dish with nonstick cooking spray 2. In a large bowl, combine brown rice or quinoa, chicken, salsa, green chiles, corn, black beans, cilantro, cumin, chili powder, garlic salt and Â˝ cup of shredded cheese. 3. Spread mixture in the prepared baking dish. Top with remaining shredded cheese. Bake uncovered until bubbly and cheese is melted, about 15 minutes. 4. Serve immediately. Garnish with avocado, tomato and cilantro. (For an extra kick use Pico de Gallo.)

SUBMIT YOUR RECIPE

Do you have a great recipe to share? Submit it to us! Adelante Health Magazine works with some of the valley's top nutritionists and dietitians, but some of our very best recipes come from readers just like you. For a chance to see your name and your dish in print, send us your favorite healthy recipe for our quarterly publication. To submit a dish, e-mail your recipe to our editors at office@adelantergv.com, along with your name, address, daytime telephone number, and a brief note about why you love it or how you came up with it.

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Community Calendar

Community Calendar 2020 04 Mission Community Health & Wellness Fair JAN

Mission Event Center from 7 - 11 AM

11 South Texas Health System — Childbirth JAN

Education Classes at McAllen Medical Center 9AM - 2 PM

14 Winter Texan Expo & Health Fair McAllen Convention Center January 14 - 15

18 14th Annual DHR Health Community Health JAN

Fair at Edinburg Conference Center 8AM - 12PM

25 Inaugural Clinical Bioethics Symposium JAN

UTRGV School of Medicine Auditorium

07 4th Annual Senior/Winter Texan “Celebración” FEB

& Community Health & Wellness Expo 2020 Brownsville Event Center

08 Healthy Hearts 5K Run/Walk FEB

McAllen Heart Hospital at 8:30AM

22 Harlingen Health Day FEB

Harlingen Sports Complex from 10AM - 1 PM

Wednesday, January 29, 2020 8:00 AM – 3:30 PM Edinburg Conference Center At Renaissance 118 Paseo del Prado Ave, Edinburg, Texas 78539 Description The Texas Tribune is pleased to present its "Future of" series, exploring the challenges and opportunities that lie ahead for Texas' government, business and civic communities. Join us as we travel to Edinburg for a day-long series of conversations on health care issues affecting a state with the most uninsured citizens of any in the country, a rural health crisis and rising costs that threaten to overtake those associated with education as the top line item in our biennial budget — among other persistent challenges. We'll sit down with lawmakers, thought leaders and medical professionals from all corners of the state to talk about how we can better educate the next generation of health care providers and provide better and more affordable health care access for Texas' fast-growing and dynamically diversifying population, and what the state Legislature — as well as disruptors in the field of health care technology and innovation — are doing to address these questions. The full schedule and panelists for this event will be announced in the coming weeks.

Strategic Thinking.

Event Details This event will be held in Conference Halls A & B, located on the first floor of the Edinburg Conference Center at Renaissance. The event is free, open to the public and will include a light breakfast and lunch. Complimentary visitor parking is available in the parking lot surrounding the facility.

Healthcare Focused. Adelante Strategies 1811 N. 23rd Suite 124 McAllen, TX 78504 956-752-7283 office@adelantergv.com

To Register for the event visit: http://bit.ly/2LKwdKp Women of Health & Wellness

SPRING 2020 | www.adelantergv.com

JAN

Community Events Highlight

Prime Healthcare

W men’s 1st Annual

Health & Fitness Summit of South Texas

Thursday, October 3, 2019 Thank you to everyone that made our 1st Annual Women’s Health & Fitness Summit of South Texas a success! We loved seeing so many of our community members who attended to meet and learn from our amazing medical staff. We appreciate the great participation of each vendor who made this event informative and fun! We’ll see you at the next one!

10th Annual

Mission PINK

BREAST CANCER AWARENESS 5K WALK / RUN

Mission Regional Medical Center

Saturday, October 12, 2019 Thousands of people gathered at Mission Regional Medical Center on Saturday, October 12th with one mission in mind, to spread awareness and support the fight against breast cancer. Not even the weather could dampen the spirits of survivors, volunteers, staff, spectators and race participants. This fundraising event could not have been possible without the support from our sponsors: H.E.B., the City of Mission, Walmart, Walmart Neighborhood Market, Mission CISD, Lacks Furniture, Superior HealthPlan and many more. All proceeds go to the American Cancer Society to benefit the Making Strides Against Breast Cancer program. SEE YOU NEXT YEAR!!!

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SOCRATES GARRIGOS, M.D.

Adult Internal Medicine Specialists

Mary M. Gali,

MSN, APRN FNP-BC

Nadya P. Mendez, MSN, APRN FNP-BC

Socrates Garrigos, M.D. INTERNAL MEDICINE

Wellness and Prevention Annual / Routine Physicals Flu Shots Illness Care Cold, Flu Bronchitis / Respiratory Infections Minor Injuries Muscle Strains Headaches / Migraine Disease Management Hypertension / High Blood Pressure High Cholesterol X-ray / Ultrasound EKG MRI

MSN, APRN FNP-BC

Call to Schedule your appointment.

Our Services & Treatments • • • • • • • • • • • • • • • •

Alyssa A. Sanchez,

We accept most major health plans.

New Patients & Walk-ins Welcome What We Treat

Aracely Uribe,

MSN, APRN FNP-BC

• • • • • • • • • • • • • • •

Diabetes Arthritis Thyroid Disorders Routine Blood Work Depression / Anxiety Allergies Asthma Irritable Bowel Syndrome Heartburn / Gastroesophageal Reﬂux Eczema / Skin Sleep / Insomnia Disorders Gastroenteritis Screening and Testing Thyroid Testings Cancer Screenings

801 E. Nolana Ave. #15 McAllen, TX 78504 www.SocratesGarrigosMD.com

Complete Care You Can Trust We trace our success to a simple and enduring philosophy that aging is a gift. The wealth of knowledge and experience that comes with age is a gift to the individual & the family. We work to provide an environment that supports the whole person. Our advanced practice providers are dedicated to understanding and managing all aspects of adult patients’ general health care. From preventive care to disease prevention strategies, we’re here to help you maintain a healthy and active lifestyle. Please contact our office to schedule an appointment or for more information on how our team can best provide for the healthcare needs of you and your loved ones.

(956) 683-0404