Central Florida Health News by Central Florida Media Group

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volume 9 | issue 13 | april 2020

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THE ENDORSED PUBLICATION OF THE POLK COUNTY MEDICAL

CORONAVIRUS PANDEMIC Local Response and Essential Resources

SPECIALIZED CARE Chapters, Bartow Regional Open Palliative Care Clinic

POP QUIZ:

Are You Washing Your Hands Correctly?

STAYING IN THE GAME

Polk Games Keep Seniors Active, Involved

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AS E L P

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C e t Da

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Presents

Polk State College is proud of all of its excellent academic offerings and the increasing wins achieved by its student athletes. The Polk State College Foundation is turning to the community to enhance the College’s decreasing budget in order to enable a group of dedicated and successful students to achieve their dreams and goals. Please help the Eagles continue to soar through your support of the John R. Alexander Memorial Clays Classic. TEAM SPONSOR INVESTMENT $1,000 Includes: Four (4) Shooters Ammunition (12 or 20 gauge) Breakfast Cart Steak Luncheon Recognition at Steak Luncheon Event Signage Corporate Sponsor Gift Individual Gifts INDIVIDUAL SHOOTER INVESTMENT $200 Includes: One (1) Shooter Ammunition (12 or 20 gauge) Breakfast Steak Luncheon Individual Gift

John R. Alexander 1936 – 2018

Please Join us

for this special event to benefit student athletes at Polk State College

May 29, 2020 Polk Sporting Clays 5000 Firetower Road Haines City, FL 33844 9:00 Am • BREAKFAST 10:00 AM • 50 TARGET SPORTING CLAYS SHOOT STEAK LUNCHEON (immediately following the shoot)

Special gifts & prizes!

Includes: One professionally designed sign placed on one of the shooting stations to be displayed during the tournament.

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John was a child fascinated by everything, a trait that characterized his entire life. Throughout his educational journey, John excelled academically, athletically, and artistically. Five days after his college graduation in 1958, John married Sarah Jane Griffin, beginning their shared life of mutual devotion, love for family, and an abiding confidence in Christ. John’s professional career began in the United States Marine Corps. He became an expert marksman and traveled throughout the United States as Captain of the Second Marine Division Rifle and Pistol Team. He was proud of his military service, as well as his more than forty years working at Ben Hill Griffin, Inc. John retired as CEO and Chairman of the Board of Alico, Inc.

SHOOTING STATION SPONSOR INVESTMENT $100

SUPPORTING SPONSORS Can receive recognition with the following investments: Steak Luncheon $1,000 Clays $500 Ammunition $750 Registration $250 Breakfast $500 Course $250 Gifts $500 Refreshments $250 Carts $500

John R. Alexander served on the Polk State College Foundation Board of Directors from 2008-2012. He recommended a sporting clays fundraiser to secure new donors and assist students. Since 2012, Clays for Courts has raised more than $100,000 and introduced hundreds of new supporters to the Foundation. We are thankful to his family for allowing us to pay tribute to him by continuing to help students through the renaming of Clays for Courts to the John R. Alexander Memorial Clays Classic in 2019.

Register at foundation.polk.edu/clays For more information, call 863.297.1071 999 Avenue H, Northeast • Winter Haven, FL 33881

John had a lifelong infatuation with guns and was an avid sportsman who enjoyed hunting with friends and family. He often set out on big game hunts in the western United States and took his dream trip to South Africa with Sarah Jane. He also competed regularly in skeet and sporting clays tournaments and events throughout Central Florida.

He simply loved life! And we loved him!

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Accepting New Primary Care Patients

Niyomi De Silva, MD

Ashley Falk, MD, FAAFP

Welcome to BayCare Medical Group’s Family Health Center, where it’s our mission to deliver high-quality health care. Our board-certified physicians provide all primary care needs for newborn, pediatric and adult patients, including: ■ Back-to-school and sports physicals ■ Lab services ■ Nonoperative orthopedic care including sprains, strains and arthritis

Nathan Falk, MD, FAAFP

■ Osteopathic manipulation treatment (OMT) ■ Pharmacy consultations ■ Skin procedures ■ Sports medicine, including sports injuries and sports-related concussions ■ Women’s health care, including prenatal care Most major insurance plans accepted, included Medicaid HMO. Ashley Wilk, DO

To schedule an appointment: (863) 280-6080 Florida State University College of Medicine Family Medicine Residency at BayCare Health System (Winter Haven) 1201 First St. S., Suite 100A | Winter Haven 20-1065141-0320

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BayCareMedicalGroup.org

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CONTENTS | a p r i l 2 0 2 0 ENROLL PA GE 12

THE ENDO RSED PUBL OF THE POLK ICATI COUNTY MEDI ON CAL

Coronavirus Pandemic

There is a new “C” word CORONAVIRUS PANentia Loc al Re spo nse an d Ess DEMIC scaring people these days, l Re sou rce s and we’re willing to bet you’ve already heard it – coronavirus, or COVID-19. Learn how local healthcare facilities are handling the emerging health crisis, and find out how to get the latest information. Pages 18-21 SPECIALIZ

CARE Chapters, Bart Open Palliativeow Regional Care Clinic

POP QUIZ:

Are You Was hing Your Hands Correctly?

centralflorida

STAYING IN THE GA ME Polk Gam Seniors Activ es Keep e, Involved

BOOS IMMUNE T YOUR WITH THESESYSTEM RECIPES

PAID

Palliative care is specialized medical care focused on relieving the symptoms and stress of a serious illness. In partnership with Chapters Health System, Bartow Regional Medical Center has opened a palliative care clinic in Bartow. Bartow Regional Chief Medical Officer Dr. Mark Vaaler says the palliative care center offers a valuable service to the community.

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SPECIALIZED CARE

On the Cover

Permit No. 335 Lakeland, Fl.

For more photos from this edition, follow us on Facebook. Scan the QR code here with your smart device.

volume 9 | issue 13 | april 2020 FRE

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CentralFlorida

QUIZ 10 POP Proper handwashing procedures are essential to protecting yourself from coronavirus.

They are one of the best defenses against any virus, bacteria, or germ. But are you washing your hands the correct way? Take our quiz and find out!

14 The Polk Senior Games have been held in the county since 1992. They are designed to STAYING IN THE GAME

promote friendly competition, fellowship, health, wellness and volunteerism and are qualifiers for the state and national Senior Games. Learn more about the games and their participants.

VOLUNTEERS NEEDED! New medical research studies have opened at Meridien Research in Lakeland. Enrolling studies include:

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5 PCMA LETTER 6 PUBLISHER'S LETTER 7 BODY, MIND & SPIRIT 10 POP QUIZ 11 HEALTHY COOK 11 HEALTHY AGING

HealthNews.

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16 CALENDAR 18 HEART NEWS 21 MEDICAL ADVICE 21 SPINE HEALTH 22 EDITOR’S DOSE 22 HEALTH COMMUNITY

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PCMA LETTER

FACTS FEAR

POLK COUNTY MEDICAL

in time of

ASSOCIATION 4315 Highland Park Blvd, Suite B Lakeland, Florida 33813 863-644-4051 QQQ 2019 OFFICERS JAMES J. BOOKER, MD President GEORGE LYLE, MD Secretary STUART PATTERSON, MD Treasurer QQQ BOARD OF TRUSTEES RALPH NOBO, JR., MD, Chair GEORGE LYLE, MD STUART PATTERSON, MD GARY SCHEMMER, MD SERGIO SEOANE, MD ARVIND SONI, MD QQQ JACKIE COURTNEY Executive Director 4315 Highland Park Blvd Suite B Lakeland, Florida 33813 centralfloridahealthnews.com

WE ARE LIVING IN UNPRECEDENTED TIMES. At the Polk County Medical association, we know these new experiences raise anxiety and stir even more questions. April is a month for growth and rebirth, though we know that coronavirus health concerns are keeping this month from feeling much like we expected. April is traditionally the edition of Central Florida Health News that focuses on healthy seniors. In this edition, we introduce you to Deena Wilbur, executive director of the Polk Senior Games. She and other contestants in the Games explain the value of staying active and involved in your Golden Years. We feel it’s important to acknowledge the changes that coronavirus is bringing into our lives. So in this edition, we also take a closer look at how local healthcare facilities are responding and how you can get the most up-to-date information to make decisions for you and your loved ones. By now, we all know one of the best tools for protecting yourself is handwashing. Simple, right? But are you doing it right? Test yourself with our quiz and make sure you’re being as effective as possible. Be sure to check out our Body, Mind & Spirit article. Licensed mental health counselor Mary Joye has useful advice on how to calm your mind and get better control of anxiety. We hope this edition gives you a better understanding of coronavirus and arms you with tools to stay safe. Some of the benefits of a PCMA membership include the following: ✱ Physician referrals

✱ Access to CME Programs ✱ Workers compensation insurance benefits ✱ Complimentary Socials/dinners ✱ Strong PCMA physician representation in Central Florida Health News and Central Florida Doctor publications ✱ Listing advantages in the annual Central Florida Physicians Directory & Medical Providers Guide ✱ Physician and medicine advocacy at all legislative levels. If you’d like more information about becoming a PCMA member or need to check your membership status for renewal, contact our Executive Director Jackie Courtney at (863) 644-4051 or email director@polkcountydoctors.com. hn

✱ Medical malpractice discounts with The Doctors Company ✱ Ongoing relevant communication Sincerely,

James J. Booker, MD James J. Booker, MD Obstetrician and Gynecologist, Winter Haven President, Polk County Medical Association

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PUBLISHER’S NOTE

www.CentralFloridaHealthNews.com NELSON KIRKLAND, Publisher nelson@centralfloridamediagroup.com

Take Steps to Protect Each Other

s you’ve probably already guessed by a glance at the cover, this edition of Central Florida Health News focuses on coronavirus, or COVID-19. Not only is this a new topic for this magazine, but it’s also a new concern and focus for many throughout the nation. We’ve seen widespread viruses in the past, but none has come close causing the degree of disruption that COVID-19 has. As the virus spread from China through other countries, scientists were able to determine how it was transmitted and what sector of the population was at the greatest risk. It’s been repeated nearly every day that older people and people with compromised immune systems and those with chronic medical conditions are more susceptible to the disease. With all the panic and misinformation out there, I want you to let that resonate. The people who are most likely to have dangerous health

effects from coronavirus are our elderly and sick. Recent data shows that 20 percent of our population here in Florida is people who are 65 and older. That’s a substantial number. That includes the “Greatest Generation,” a title popularized by journalist Tom Brokaw to describe those who grew up during the Great Depression and who fought in World War II or worked to help win it, and the “Silent Generation,” which was raised in a time of war and economic depression. These folks are our living history and witnesses to who were decades ago and what we have become. We have to remember that while an infection in younger people may result in little or no symptoms, we can dampen its potentially fatal effect on our older peers. Good hygiene, responsible social distancing, and other precautions will all help to protect those who are older and less healthy. hn

PUBLISHER

Nelson Kirkland MANAGING EDITOR

Jessica Wilcox ADVERTISING ACCOUNT EXECUTIVE

David Kiessling CONTRIBUTING WRITERS

Erika Aldrich, Joy Jackson, MD, Mary Joye, LMHC, Mary Toothman, Teresa Schiffer, Paul Catala, Carol Corley CONTRIBUTING COLUMNISTS

Chukwuka Okafor, MD, David Loewy, MD, Kollagunta Chandrasekhar, MD CONTRIBUTING ARTISTS

Dawn Lewandowski DELIVERY

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Published by Central Florida Media Group in cooperation with the Polk County Medical Association

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56 Fourth Street Northwest, Suite 100 Winter Haven, Florida PHONE 863.248.7537 Copyright © 2020 Central Florida Media Group. ALL RIGHTS RESERVED. This issue of Central Florida Health News is a trademark of Central Florida Media Group. Reproduction or use in whole or in part of the contents of this magazine without written permission is prohibited. Central Florida Health News makes every effort to ensure the accuracy of content published. In the event of an error found herein however, neither the publishers or advertisers will be held responsible, nor do the publishers accept any liability for the accuracy of statements made by advertisers in advertising and promotional materials. Furthermore, the opinions and claims expressed in advertisements and promotional materials do not necessarily reflect those of the Polk County Medical Association or Central Florida Media Group and do not imply an endorsement.

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BODY MIND SPIRIT Don’t Let COVID-19 Anxiety Overwhelm You by MARY JOYE, LMHC

NEW ILLNESSES AND PANDEMICS have created intense fear and panic throughout human history, but somehow science prevails. Protecting yourself from new contagions is something we should be concerned about, but many are developing vicarious trauma and anxiety symptoms, glued to the news about the novel coronavirus, COVID-19. An ounce of prevention is worth a pound of cure. However, when prevention turns to panic, we have more than a physical health crisis; mental health can also be impaired. Knowledge truly is power. Education and intellectual application can override emotions and dissuade anxiety. That said, if you’re a senior, child, immune compromised, or have lung, heart or diabetes issues, check with your doctor about what you can do to keep yourself safe. If only the anxiety created by COVID-19 is your major concern, below are seven building blocks for stabilization. 1. Precautions vs. panic. Panic and fear stimulate the production of stress hormones, which lessen our immune systems. It’s normal to have some anxiety and to cancel travel plans if you are immune compromised. That’s proactive, not reactive. Panic puts us in fight, flight or frozen mode and produces chaos and fear. Precautions relieve anxiety by reducing risk factors. 2. Don’t lose sleep over it. Really, don’t! Sleep strengthens your immune system. Watching TV news before you go to bed can impair sleep. Watch something calming or comical and it will release feel-good chemicals like dopamine. Laughter really is good medicine. 3. Focus on facts instead of fear. The virus has already slowed down in numbers. Take comfort in knowing there are global experts working 24/7 to outsmart this virus and others. Technological advances make it easier to find cures and vaccines. Watching sensationalized broadcasts increases anxiety. You can stay informed of real facts from The Centers for Disease Control and Prevention website and The World Health Organization (WHO). Their websites respectively are cdc.gov/coronavirus/ and who.int/health-topics/coronavirus. WHO Director-General Tedros Adhanom Ghebreyesus admitted we had a pandemic but stated, “We are not at the mercy of this virus…containment is feasible and should be a top priority for all countries.”

4. Perspective is powerful. Times like this are humbling and sad. We feel for the victims and fear for ourselves. Do keep in mind, over 18,000 United States citizens have died of other influenza viruses this flu season. This didn’t hit the news because they were known viruses. Novelty heightens anxiety with the fear-of-the-unknown factor. Realizing how many diseases scientists have cured in the past can give you a more hopeful perspective. Scientists have conquered smallpox, the plague, polio and more. It takes time and patience to wait for solutions. Panic is counterproductive. 5. Concentrate on the positives. This crisis, like all global crises, brings the world closer together in a way that transcends politics or beliefs. COVID-19 has heightened the awareness of simple hygiene. We are learning how while we are enjoying a luxurious cruise, the staff is suffering from overwork and little to no health care. Nineteen of the 21 passengers with COVID-19 quarantined off the California coast were crew members. We’re shockingly and acutely aware of severe animal cruelty and marketing of “delicacies” like pangolins, bats, and other wild animals that spread diseases to humans with dire health consequences. The Wuhan market is closed and so are many more like it. For research, I watched traumatizing footage of what happened there and knew nothing about this until COVID-19. Much like the origins of HIV and the resulting criminalization of the consumption of monkey meat, when we rally together, we can improve the world for humans and animals, and this is a positive. 6. Flu season is almost over. New COVID-19 cases are expected to fall as temperatures rise, which will expedite management, containment and finding a cure. It’s also a reminder to take vaccines seriously and not be lackadaisical about getting them in years to come. 7. Take positive action. This is a good time to get spring cleaning and disinfecting done in your home environment. You don’t have to become a germaphobe, but a little extra cleaning keeps your corner of the world safer, too. If you need counseling and are afraid to go out, many counselors offer telehealth sessions by phone or video. We’re told to keep social distance, but you can’t catch a disease on the phone or computer. Sociability decreases anxiety, too. Anxiety, much like this or any virus, can be emotionally contagious and dangerous for your overall well-being. However, it is manageable, and fear is conquerable. It’s wise to be prepared and do the best you can to maintain a positive attitude during this crisis. Most of us feel helpless to fix it, and we are. But focus on those who have the skills and are willing to risk their lives to save others. It takes bravery to fight any disease, including anxiety. hn

ABOUT THE AUTHOR: Mary Joye, LMHC, PA, is a licensed mental health counselor with offices in Lakeland and Winter Haven. She holds a Master of Arts in Counseling from Trevecca Nazarene University in Nashville, Tennessee. For more information, visit winterhavencounseling.com.

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FEATURE | p a t i e n t

Specialized

CARE

Chapters Health System, Bartow Regional Medical Center Open Palliative Care Clinic

by MARY TOOTHMAN

IN PARTNERSHIP with Chapters Health System, Bartow Regional Medical Center has opened a palliative care clinic in Bartow. Palliative care is specialized medical care focused on relieving the symptoms and stress of a serious illness. The provision of palliative care services on an outpatient basis allows patients to stay in the comfort of their own homes. The clinic is now open on Tuesdays, from 8 a.m. to noon. It is located in one of the medical office buildings at Bartow Regional Medical Center. A soft opening was held in November, and the official open house was on Feb. 18. Bartow Regional Chief Medical Officer Dr. Mark Vaaler says the palliative care center offers a valuable service to the community. Vaaler also serves as chief medical officer for South Florida Baptist Hospital and BayCare’s St. Joseph’s

8 | CFHN

North and South hospitals. “Based on our experiences with palliative care at some of our other BayCare facilities, palliative care is a very valuable service for our patients in helping them navigate chronic medical issues,” he says. “These services often happen in the hospital setting, but do not end there.” With palliative care, patients are provided with ongoing attention to their medical needs — and can avoid the feeling that their care is “over” when they are discharged from a hospital. “An outpatient service is extremely valuable,” Vaaler says. “It offers continuation of the inpatient services or standalone outpatient services for those patients not currently hospitalized.” Hospice care is end-of-life care, and one must have a terminal illness with life expectancy of less than six months, as a general rule. “Palliative care often is also end-of-life care,

but can start at any time,” Vaaler says. “It focuses on improving life, and providing comfort to people of all ages who have serious, chronic and life-threatening illnesses.” Palliative care can also be provided while a patient continues to seek an illness cure. Some examples of patients the center can help would be patients with very severe Congestive Heart Failure (CHF) or Chronic Obstructive Pulmonary Disease (COPD) or cancer who make frequent trips to the hospital or have many severe symptoms. “Palliative care is very helpful in formulating a plan to deal with many of the symptoms, and works on trying to reduce suffering while also improving quality of life, and reducing trips to the hospital,” Vaaler says. The palliative care team usually works with the existing team of providers to collaborate on

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Palliative care is very helpful in formulating a plan to deal with many of the symptoms, and works on trying to reduce suffering while also improving quality of life, and reducing trips to the hospital. the most appropriate plan of care for each patient. It is usually affordable for insured patients. “Medicare coverage is excellent — obviously, there are several different types of Medicare coverage these days, so coverage may be slightly different. But all plans cover palliative care as far as I know,” Vaaler says. Dr . Andrea Miller is regional medical director for Chapters Health Palliative Care, She says since the doors opened, it has been clear the center is both needed and wanted in the area. “Community response has been wonderful,” she says. “Our patients have been very receptive to our services. We are starting to get referrals from community doctors, as well as hospitals. We have seen dozens of patients so far. Right now, we have the capacity to see 12 patients per week, but as demand increases, we’ll be able to increase capacity.” The care process begins with referrals. “Patients are referred from several sources, including their primary care physician, their specialist, from prior consultation with palliative care in the hospital and from other patients,” she says. Once a referral is made, our staff collects the necessary information and contacts the patient with information about our clinic, and, if appropriate, sets up an appointment to see a provider.” The clinic is small, but its size provides a benefit of familiarity. “We currently staff the clinic with one physician and at least one, sometimes two nurse practitioners. We try to have the patient meet as many of our providers as possible, so that they know each other. “Since we are a small clinic with three exam rooms, it is easy for us to pull each other in for introductions. We work as a team, including non-clinical staff, nurses, social workers, nurse practitioners and physicians to provide coordinated care. The clinic offers in-patient hospital consultations and out-patient clinic visits, and it hopes to expand to home visits in the future. The enhancement of palliative care medical experts can dramatically ease the way for patients in navigating through their medical care journeys. “We add an extra layer of support for the patient and their healthcare providers to deal specifically with their symptoms, their function and their quality of life concerns,” she says. And on a personal level, she adds that she loves the work. “Palliative care is my passion,” she says. “The ability to really get to know my patients and work with them, their families, their communities, and the healthcare system to maximize their quality of life and function is very rewarding. “As a family physician, I have always valued the relationships I make with my patients, and in palliative care, I am able to give my attention to the people who need it most.” For more information, contact Bartow Palliative Care Center at 813-8718200 or info@chaptershealth.org. You can also find more information on the website at baycare.org. hn

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FEATURE | p r e v e n t i o n

POP QUIZ

Handwashing Is the Best Defense, but Are You Doing It Right?

D. All of the above. It is important to lather and scrub all parts of your hands to properly remove germs. B. Wet, lather, scrub, rinse, dry. To often, people skip over adequately scrubbing and drying their hands, which can leave more germs behind.

5. True. Studies have found that the use of soap with clean, running water significantly reduces the number of germs on the hands. A. 19%. The CDC estimates that approximately 19% of people worldwide wash their hands after using the toilet.

E. All of the above. You should also wash your hands after touching or handling animals, animal food and bowls, and garbage.

B. Prevents about 30% of gastrointestinal illnesses. Handwashing can prevent approximately 30% of gastrointestinal illnesses.

C. Prevents about 20% of respiratory illnesses. Handwashing can prevent approximately 20% of respiratory illnesses.

ANSWERS:

compiled by ERIKA ALDRICH / Information provided by the Centers for Disease Control and Prevention (CDC)

If you have no soap or clean, running water to wash your hands, and you have to use hand sanitizer, what is the lowest amount of alcohol it should contain? A. 40% alcohol C. 60% alcohol B. 50% alcohol D. 70% alcohol

What is the correct order to wash your hands? A. Wet, lather, rinse B. Wet, lather, scrub, rinse, dry C. Wet, dry D. Wet, rinse, dry When lathering and scrubbing your hands with soap, what parts of the hand should you make sure to get, in addition to your palms? A. The backs of your hands B. Between your fingers C. Under your nails D. All of the above How long should you spend lathering and scrubbing your hands with soap? A. 5 seconds C. 15 seconds B. 10 seconds D. 20 seconds True or False? Hand sanitizer is a better option than washing your hands with soap.

D. 20 seconds. A good rule of thumb is to sing the Happy Birthday song twice in a row while washing your hands to ensure you spend at least 20 seconds doing so.

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True or False? Washing your hands with water and soap is much more effective than just washing with water.

9. False. Hand sanitizer has been shown in studies to be less effective at removing germs than handwashing with soap and clean, running water.

Handwashing can prevent approximately what percentage of respiratory illnesses, such as the cold, flu, and COVID-19, by removing the germs from your hands? A. Prevents about 5% of respiratory illnesses. B. Prevents about 10% of respiratory illnesses. C. Prevents about 20% of respiratory illnesses. D. Prevents about 30% of respiratory illnesses. Handwashing can prevent approximately what percentage of gastrointestinal illnesses, such as diarrhea, by removing the germs from your hands? A. Prevents about 20% of gastrointestinal illnesses. B. Prevents about 30% of gastrointestinal illnesses. C. Prevents about 40% of gastrointestinal illnesses. D. Prevents about 50% of gastrointestinal illnesses. When should you wash your hands? A. Before, during, and after preparing food, and before eating. B. Before and after caring for someone at home who is sick with vomiting or diarrhea. C. After blowing your nose, coughing, or sneezing. D. After using the toilet or changing a diaper. E. All of the above. What is the estimated global rate of handwashing after using the toilet? A. 19% C. 42% B. 27% D. 59%

10. C. 60% alcohol. Use hand sanitizer that has a label that says it contains at least 60% alcohol. hn

AMIDST THE INFORMATION being released concerning COVID-19, also known as the coronavirus, is a gem that will serve you well far into the future: proper handwashing procedures. Study after study has shown that properly washing your hands is one of the best defenses against any virus, bacteria, or germ. If you want to prevent being sick with a cold, stomach virus, or COVID-19, then handwashing is one of your best lines of defense. Take our quiz on the correct way to wash your hands and to learn the science behind handwashing.

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Healthy Cook

Food to Bolster Your Immune System

N by CAROL CORLEY

NO MATTER WHERE WE GO, no matter what we do, there is always something out there that could bring us down. An upper respiratory infection if we hug a sick child, a flu if we shake hands or touch a doorknob, other illnesses if we are bitten by a mosquito, or maybe one of the scary diseases that crop up every few years. Caution is always good; be careful around people with fevers, maybe pass on hand shakes for awhile, use a paper towel to open some door knobs, wear protection against mosquitoes, and — the big one — wash your hands often. But rather than live in fear, having a healthy lifestyle with a good diet, exercise, enough sleep, and less stress might assist your body in fighting off infections before they take hold. We have an entire army in our bodies that help keep bacteria and viruses from bringing us down — like natural killer cells, white blood cells fight off viral infections. And while there is no guarantee, it’s up to us to keep SALMON WITH GINGERY VEGETABLES AND TURMERIC (Adapted from Food & Wine) Ingredients 1 lb. mixed broccoli & cauliflower florets 3/4 cup water 3 tablespoons vegetable oil 1 medium onion thinly sliced 1 tablespoon minced fresh ginger 1/2 cup unsweetened coconut milk 4 six-ounce salmon fillets with skin salt and pepper to taste Directions Simmer broccoli and cauliflower for 3 minutes in 1/2 cup water, using a deep skillet. Place in bowl. In the same skillet, heat 3T vegetable oil, add ginger, onion, salt, pepper, cook over medium heat until golden in color. Add turmeric and stir, then add coconut milk, 1/4 cup water, and simmer. Stir in vegetables, cover and remove from heat. In a preheated grill pan, place oiled salmon skin-side down and grill about 4 minutes over moderately high heat until just crisp, turn and grill about 2 minutes longer until cooked through. Serve with the vegetables.

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our immune system as strong as possible to help it do its job. And that might just start in the kitchen. We could make an entire meal of foods that will boost our immune system. Among them would be oily fish, turmeric, broccoli, spinach, sweet potatoes, ginger, garlic, green tea, kefir, and — the good stuff — blueberries, and dark chocolate, according to Medical News Today. And don’t forget oranges — we lived in Florida, after all. Pair orange juice with spinach, and you also get better iron absorption. To have fun and help boost your immune system, we have some recipes for you to try. hn

CITRUS SPINACH SALAD (Adapted from Florida Dept. of Citrus) Ingredients 1 cup Florida orange juice 1-1/2 cups sliced fresh mushrooms 2 slices chopped bacon (or turkey bacon) 1/4 teaspoon finely shredded orange peel 1/4 teaspoon black pepper 1/2 orange or red bell pepper cut into thin strips 8 cups torn fresh spinach 1/2 cup sliced green onions 2 teaspoons cornstarch 3 Florida oranges, segmented 1/8 teaspoon garlic salt Directions Cook bacon in a 12-inch skillet until crispy, remove and drain on paper towels. Wipe skillet with paper towel. Combine cornstarch, orange peel, Florida orange juice, garlic, salt and pepper, then add to the skillet. Cook, stirring until thickened, and cook for 2 more minutes. Remove from heat. Add mixture of spinach, mushrooms and onions, tossing until coated. May return salad to heat for 30-60 seconds, tossing until slightly wilted. Place mixture in

salad bowl. Add bacon, Florida oranges, bell pepper strips and serve immediately. BLUEBERRY CHOCOLATE CLUSTERS (Adapted from U.S. Highbush Blueberry Council) Ingredients 1 cup fresh blueberries 1 cup d ark chocolate chips (or could use milk or white chips) Directions Rinse blueberries and pat dry. Line baking sheet with wax paper or parchment. Place chocolate in top of double boiler over barely simmering heat. Stir until melted. Remove from hot water, fold in blueberries. Make clusters by spooning 4-5 warm chocolate-coated blueberries onto wax paper, placing them 1 inch apart, or use candy molds. Refrigerate 30 minutes or until firm Transfer to an airtight container and refrigerate for up to 3 days.

healthy aging

Refractive Surgery – What Does It Mean? DAVID M. LOEWY, MD.

Eye Specialists of Mid Florida

efractive error is the term used to describe the need for glasses or contact lenses to see clearly. Another alternative exists to these aids, namely Refractive Surgery. Refractive Surgery is an operation designed to correct a refractive error of the eyes. Historically there have been many Refractive Surgery procedures developed. Currently, there are two very popular procedures and a couple of others that are available and as always many undergoing research. The most popular current procedure is LASIK. LASIK is an acronym that stands for Laser in situ Keratomileusis. This means that a flap is created in the cornea and laser treatment is applied to the remaining cornea and then the flap is replaced. Vision frequently is improving the afternoon of the procedure and there is mild short-lived scratchiness. Another fairly popular procedure is Photorefractive Keratectomy or PRK. Results from PRK and LASIK are identical. Six months after either procedure studies have shown no difference in vision outcomes achieved. PRK sometimes does not heal as fast. It may be slightly more uncomfortable for 3-4 days and vision may not stabilize for a month. There are some advantages to PRK. It does not involve making a flap which decreases the risk of the procedure slightly. Also, it can be done in corneas that are thinner or patients with higher degrees of nearsightedness. Another procedure that is available for patients with high degrees of refractive error is Intraocular Contact Lens or ICL. This procedure implants a specially designed soft lens inside the eye. This procedure is much more expensive and slightly riskier due to entering the eye. A new procedure called SMILE which stands for Small Lenticule Laser Extraction is available and still developing. It involves making a small incision in the cornea and creating a lens-shaped disk of cornea all with a specially designed laser and then manually removing this disk. The result is a change in the shape of the cornea, which changes the focus of the eye. There may be some advantages to the smaller incision with less post-operative dryness and discomfort. However, the range of refractive errors amenable to correction is not as broad as LASIK and PRK. At present, there is not an ideal surgical procedure available to correct Presbyopia, the need for reading glasses in people that see well in the distance over age 40. Making one eye nearsighted can help with reading in that eye, while the other eye can still focus on distance. This is called Monovision and works well for many people but not everyone can tolerate the imbalance. There is a lot of research ongoing to find alternative options to treat Presbyopia. We offer Refractive Surgery at Eye Specialists of MidFlorida to appropriate surgical candidates that are motivated to be free from glasses and contact lenses. Please give us a call at 800-282-3937 to schedule a consult to discuss if refractive surgery is correct for you. You can learn more about our services and our company on our website at eyesfl.com. #2020YourVisionOurFocus This column is sponsored by Eye Specialists of Mid-Florida, and the opinions expressed herein may not reflect those of CFHN or of its advertisers. BIO: Ophthalmologist David M. Loewy, MD specializes in laser and cataract surgery and practices at Eye Specialists of Mid-Florida.

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FEATURE | s e n i o r

Staying in the Game Polk Games Help Seniors Stay Active and Involved

D by PAUL CATALA

DURING HER YOUNGER YEARS in her Michigan hometown, Dot Van Farowe says she participated in a variety of sports and leisure activities. But at 91 years old, Van Farowe’s days of “pass, punt and kick” football, playing basketball, water and snow skiing and long jumps are over. But that hasn’t stopped the Lakeland resident from continuing to take part in the annual Polk Senior Games. The Senior Games, which this year were held from Feb. 29 to March 12, have been held in the county since 1992. Open to anyone 50 and older, the games are designed to promote friendly competition, fellowship, health, wellness and volunteerism and are qualifiers for the state and national Senior Games. They provide challenges for serious competitors, recreational participants and the physically challenged. Most of the events are grouped by gender in fiveyear age increments. Gold, silver and bronze medals are awarded in each event and age division and Polk County residency isn’t required. During the bowling competition in Lakeland’s Orange Bowl Lanes bowling alley March 11, Van Farowe, who retired as a registered nurse in 1994, bowls her second frame. With a score of 113, Van Farowe, a seasonal Lakeland resident, says she’s having a bit of an “off day” but is still

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having fun. She says the Polk Senior Games amount to more than just ribbons or trophies. “The main thing is I’m happy to get up and do this; I’m very blessed. It’s just a fun thing and a fun way to meet people. The sports are fun, but I like to win, though,” she adds with a smirk, waiting for her next turn at the lane. Executive Director Deena Wilbur says 2,488 seniors registered to participate in the 2020 games, hailing from Florida, 18 other states and as far away as Puerto Rico and Canada. Additionally, about 125 senior communities were represented. Among the approximately 99 events in 36 sports and games for 2020 were: • Archery • Lawn bowling • Cornhole • Racquetball • Basketball shooting • 5K road race and 3-on-3 • Shooting • Billiards • Shuffleboard • Field events • Softball • Fishing • Swimming • Golf • Tennis • Horseshoes • Track

The competitions take place in various venues throughout Polk County, including All Saints’ Academy in Winter Haven, Southwest Complex in Lakeland, Ariana Beach Clubhouse in Auburndale, Kirkland Gym in Lake Wales, and the Haines City Community Center. For each event – overseen by individual event managers — gold, silver and bronze medals are awarded in each age group and event. Special awards for “Best of Age Groups,” “Outstanding Competitor,” “Outstanding Volunteers,” “Outstanding Event Managers” and “Most Represented Senior Community” are usually given out at the Closing Ceremony. Unfortunately, this year’s Closing Ceremony was canceled because of coronavirus health concerns. To enter, athletes pay $10 for the first event and $3 for each additional event up to a maximum of $28. Additional fees were set for bowling, golf, archery, shooting and team sports. All entrants got a Senior Games T-shirt designed by artist Alison Lamons. Wilbur is serving her 27th year as executive director – the only paid staff position. She is assisted by about 750 volunteers who keep the games on track. “But the best thing about (the Senior Games) are the friendships that are developed,” says Wilbur, who lives in Lakeland. “They might not get medals, but they still have a lot of fun and fellowship.” Staying active and involved is a key way to maintain a healthy lifestyle in the “golden years,” according to The National Senior Games Association. According to

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the Association, aging is linked to a decrease in aerobic fitness, strength, and lean body mass resulting from conditions such as osteoporosis, sarcopenia and injuries from falls. Leading active lifestyles helps seniors preserve fitness and maintain independence. In addition, leisure activities, participation in sports, and moderate physical exercise have three significant benefits in older people: They create psychological

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benefits, provide social support, and can enhance overall physical health of seniors while providing comradery. Friendship is definitely one of the main reasons 86-year-old Bobby Lucas of Lakeland has returned to take part in the Polk Senior Games for the past 12 years. The retired U.S. Navy master chief who lives in Lakeland with his wife, Evelyn, won a Bronze medal in bowling for 2020. In the past, he says he used to take part in basketball, softball and horseshoes, for which he won a Gold Medal in 2010. “It’s really about meeting different people – the veterans and others. It’s very fun. For the senior citizens, it’s the greatest thing ever,” says Lucas, originally from Charleston, West Virginia. “Healthwise, it keeps people from just sitting at home and instead coming out and exercising and having some fun fellowship.” The Polk County Senior Games were founded in 1992 by Nancye Thornberry of Lakeland, inspired by her 70-year-old brother who competed at the National Senior Games in Syracuse, New York. Each year, the Polk Senior Games continue to grow and evolve. In 1992, 777 people competed, according to Senior Game statistics. By 2002, there were 2,280, and 10 years later, there were 2,540. The continued growth and popularity of the Polk Senior Games are inspiring, says Wilbur. She says she plans to lead the games once again in 2021. “They (Senior Games) encourage active lifestyles and friendly competitions and volunteerism,” she says. “They incorporate it all.” hn

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Due to coronavirus concerns, some events in this calendar may be canceled or postponed. Please call the facility for the status of the event before attending.

SUPPORT GROUPS

CLASSES

calendar DIABETES PREVENTION PROGRAM – Held every Thursday from 1 -2 p.m. at Plant City Community Resource Center, 307 N Michigan Ave in Plant City, you can learn to reduce your risk of diabetes by controlling your diet, losing weight, managing stress, and getting enough exercise. DIABETES SELF-MANAGEMENT CLASS – AdventHealth Lake Wales holds this class on the fourth Wednesday of each month from 1-3 p.m. There is no charge for this course. For more information, please call (863) 676-1433.

ACCESS ART: SPECIAL NEEDS – Individuals with special needs and various exceptionalities are invited to this class held monthly at Polk Museum of Art to view and discuss exhibited artwork. Group meets on the first Saturday of each month (unless it is a holiday weekend) at 11 a.m. ALZHEIMER’S SUPPORT GROUP – Held the first Thursday of each month at AdventHealth Heart of Florida Regional Medical Center: 40100 U.S. 27 in Davenport. For more information or to register, call (863) 292-9210.

BETTER BREATHERS PROGRAM – This course provides information and support for individuals with Chronic Obstructive Pulmonary Disease. Held the third Tuesday of each month from 1-3 p.m. at AdventHealth Heart of Florida Regional Medical Center, 40100 US Highway 27 in Davenport. The program is endorsed by the American Lung Association. Preregistration is required by calling (863) 419-2247. BRAIN INJURY SUPPORT GROUP – This is an open forum for brain injury survivors and their caregivers on how to live life to the fullest after a traumatic injury. Group meets on fourth Tuesday from 7-8:30 p.m. at the Winter Haven Hospital Wellness Center conference room. For more information, call (863) 292-4060. BREASTFEEDING CLASS – Offered by the Winter Haven Women’s Hospital, this Breastfeeding Class will be held on Monday, April 13, 6 – 8:30 p.m. in classroom A, 101 Avenue O SE in Winter Haven. Registration is required and the cost is $15. For more information and to register, call (855) 314-8352. CAREGIVER SUPPORT GROUP – Meetings are held the second Friday of each month at the Winter Haven Hospital Wellness Center conference room, 200 Ave F, Northeast, Winter Haven, from 1:30-2:30 p.m. For more information, please call (863) 291-6095.

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GRIEF SUPPORT GROUP – Cornerstone Hospice offers a weekly support group each Thursday to help you on your journey of grief recovery and rebuilding your life. This is a free support group that is facilitated by a trained counselor who understands the grieving process, and is held 9:30-11 a.m. at Highland Park Church, corner of Hallam Drive and 540A, at the Main Campus, 4777 Lakeland Highlands Rd, Room 101, Lakeland, FL 33813. Registration is required. For more information, call Cornerstone Hospice at (863) 291-5560. HEARING LOSS ASSOCIATION OF AMERICA, LAKELAND CHAPTER MEETING – The Hearing Loss Association - Lakeland Chapter extends an invitation to join them every second Thursday of the month at 6 p.m. at First Presbyterian Church, 175 Lake Hollingsworth Drive in Lakeland. The meeting will be held in Multipurpose Room A. To learn more about the Lakeland HLAA Chapter meetings, visit hla-lakeland.org.

HEARTSMARTS CARDIAC CLASS – Lakeland Regional Health offers this free program on the second Tuesday of every month from 2-3 p.m. in the B-Wing Classroom B201. Registration is not required. For more information about HeartSmarts, please contact Kara Bailey, MSN, RN, CMSRN, CCCC at (863) 687-1100 ext. 7618 or kara.bailey@myLRH.org. LUPUS SUPPORT GROUP – Held on the third Monday of each month, 6:15-8:15 p.m. at AdventHealth Heart of Florida Regional Medical Center, 40100 US Hwy 27 in Davenport. For more information, call (800) 339-0586.

MENTAL HEALTH PEER RECOVERY PROGRAM – This program is offered by Winter Haven Hospital Center for Behavioral Health on two different days per week. The first meets weekly on Mondays from 11 a.m. to 3 p.m. at the Lions Park Clubhouse, 820 Avenue L SW in Winter Haven. The second meets at the center, 1201 First Street North in Winter Haven on Wednesdays from 12:30-4:30 p.m. This program is free and registration is not required. OSTOMY SUPPORT GROUP – Meets in the Winter Haven Hospital Wellness Center conference room on the third Wednesday of each month from 10-11 a.m. For more information, please call (863) 293-1121 ext. 1511. PARKINSON’S DISEASE SUPPORT GROUP – Held the second Wednesday of each month at 1 p.m., this support group is located at Rath Senior ConNEXTions and Education Center. The address is in the Lakeland Volunteers in Medicine building, 1021 Lakeland Hills Boulevard in Lakeland. Interested attendees can get more information at therathcenter.org or by calling (863) 937-8023.

TOTAL JOINT REPLACEMENT CLASS – For any individual considering or scheduled for total joint replacement, this class teaches expectations preand post-surgery (i.e. pain, exercise, length of stay, equipment, and follow up care). The class is taught by orthopedic nurses and occupational and physical therapists, from 12:30-2 p.m. on the first and third Tuesday. Meets at Winter Haven Hospital’s Orthopedic Department Waiting Room, 200 Ave F NE, Winter Haven. Registration is required. For more information, please call (863) 293-1121 ext. 1806. WOMAN-TO-WOMAN CANCER SUPPORT GROUP – Meets on the second and fourth Monday of each month at the Winter Haven Hospital Wellness Center, 200 Ave F NE in Winter Haven at 6-7 p.m. For more information, call (863) 291-6095.

EVENTS

FUNDRAISERS

APRIL 2 – POLK COUNTY HEART BALL The American Heart Association presents an evening of festivities including dinner, live auction, and an opportunity to Open Your Heart to support the organization’s mission of being a relentless force for a world of longer, healthier lives. Doors open at 6 p.m. at Lone Palm Golf Club, 800 Lone Palm Dr, Lakeland. For information on tickets: megan.rivera@heart.org or (727) 563-8043.

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april 2020

This is just a sampling of some of the many health events going on in your community. For more great events in your area, visit our comprehensive online calendar at CentralFloridaHealthNews.com.

APRIL 2, 9, & 16 – YOGA FOR EVERY BODY This Hatha yoga class is held from 8:30 – 9:30 a.m. at Bok Tower Gardens, 1151 Tower Blvd, Lake Wales. You will learn a core sequence of held postures combined with breath work. Participants of all adult ages, shapes, and abilities welcome. Free with admission, but you must register beforehand at boktowergardens.org/calendar/ yoga-for-everyone.

APRIL 3 – LUNCH & LEARN: THE TRUTH SERIES: THE TRUTH ABOUT STAYING INDEPENDENT AS YOU AGE Georgiana Goodson with Senior Helpers will present this free informative session at Grace Manor Suite Assisted Living, 4620 N Socrum Lp in Lakeland at 11 a.m. For more information or to RSVP, please call Paulina Reyes at (863) 232-9572.

APRIL 18 – SUNSHINE FOUNDATION POKER RUN All motorcycles, cars, and trucks welcome to take part in this day of fun. Register at Gary’s Grove Lounge, 2995 Cypress Gardens Rd, Winter Haven, at 9 a.m. (breakfast provided), then ride at 10:30 a.m. Stops include TL’s Old Place, Krazy Kooters, All Star Bar and Grill, and Shady Cove Bar and Grill. Ride from Sunshine Dream Village to American Legion Post 8 of Winter Haven at 3 p.m. for dinner, 50/50 raffle, music, prizes, and Chinese auction. $15 per hand (rider/driver or passenger), includes dinner, $10 per extra hand, $7 per extra meal plate. Proceeds go to answering the dreams of children ages 3 – 18 who are chronically or seriously ill, physically challenged, or abused. For more info, contact Shelby at info@sunshinepokerrun.com, cell (863) 662-8529, or sunshinepokerrun.com.

APRIL 25 – MARCH OF DIMES: MARCH FOR BABIES The Watson Clinic Foundation proudly sponsors this annual event. Gather your team and get your corporate sponsors to raise funds to support the research and programs that give sick babies a fighting chance. Registration is at 8 a.m., event starts at 9 a.m. at First Presbyterian Church at 175 Lake Hollingsworth Dr, Lakeland. You can learn more at marchforbabies.org.

APRIL 18 – OPEN HOUSE HILLSBOROUGH COUNTY HEALTHY LIVING CENTER Free health screenings, food from Feeding Tampa Bay Mobile Pantry, giveaways, kids’ activities, and more at this free event at the Plant City Community Resource Center, 307 N Michigan Ave, Plant City, from 10 a.m. – 1 p.m. More info at HCFLGov.net/HealthCare.. APRIL 30 – AGE FRIENDLY WINTER HAVEN – FORUM INFORMATION AND EDUCATION

APRIL 16 – CENTRAL FLORIDA SPEECH & HEARING CENTER’S 60TH BIRTHDAY BASH Celebrate 60 years of speech and hearing services at this groovy get-together. There will be an open bar, hors d’oeuvres from Carrabba’s Italian Grill, live music by B.Haven, dancing, and prizes. Get out your bell bottoms and peace signs to dress for the 1960s themed event. Tickets are $75. Taking place at Lake Mirror Auditorium, 121 S Lake Ave, Lakeland, from 5:30 – 9 p.m. Get your tickets at cfshc.org/Birthday.

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APRIL 24 – 2020 SWAN DERBY This exhilarating “derby style” event is staged in downtown Lakeland. The proceeds benefit the Lakeland Volunteers in Medicine (LVIM). Ten hand-crafted swan paddle boats will race from 5:30 – 9:30 p.m. on Lake Mirror at the Frances Langford Promenade. For more information on this free community event, please visit lvim.net/swan-derby/.

This is a community group that encourages active aging, health and well-being, and livable features for individuals of all ages, abilities, and economic circumstances throughout their lives. AARP endorsed the 2019 Age Friendly Winter Haven Action Plan. The Forum will be held in the Florida Room at the Florida Citrus Building, 500 Third St NW, Winter Haven. You may contact Andy Palmer at apalmer@mywinterhaven. com or Jennifer Burke at jburke@mywinterhaven.com for more information. hn

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heart news

Atrial Fibrillation: What You Need to Know

FEATURE | e d u c a t i o n

KOLLAGUNTA SEKHAR, M.D.

Coronavirus Pandemic

KSC Cardiology

trial fibrillation is an irregular rhythm from the upper part of the heart. It is the most common cardiac arrhythmia. Incidence increases with advancing age, with 1 out of 5 over the age 85 having it. It appears this originates due to spontaneous discharges from pacemaker cells in the pulmonary veins at the point where they join the left atrium.

What causes this? Many causes. The most common used to be valvular heart disease years ago (rheumatic valvular disease). Now many causes including age, cardiomyopathy, inflammation of the pericardium, alcohol, drugs etc. What are the common symptoms? Some patients are asymptomatic. Some feel the effects of rapid heart beat (palpitations, dizziness, chest discomfort), some feel effects because of irregular rhythm and variable cardiac output (shortness of breath). Are these the main concerns? No. The biggest issue is that this predisposes to clot formation in the left atrial appendage and risk of stroke. Because of this concern, most patients need to be on anticoagulants (blood thinners). Is that coumadin? This used to be the only agent available. This works indirectly through the liver on production of clotting factors, and has to be monitored, diet controlled and interacts with other medications. Now there are four agents that work directly blocking clotting factors and are easier to take and manage. These are Pradaxa, Xarelto, Eliquis and Sayvesa. What about the risk of bleeding? That’s a big concern. Doctors have to weigh that risk, too. In patients with a high risk of bleeding, doctors can go in from the groin and close the left atrial appendage. (WATCHMAN device) What about ablation? This is a procedure where an electrophysiologist goes in and ablates (superficial burn) the area near the pulmonary vein. This is especially indicated in patients who can’t tolerate medications to slow the heart rate or control the atrial fibrillation because of side effects, or in patients with congestive heart failure. Can medications keep one in regular rhythm? Yes, some medications can be tried and often work. But, doctors have to balance the risk of side effects with the benefit of restoring sinus rhythm. This column is sponsored by KSC Cardiology, and the opinions expressed herein may not reflect those of CFHN or of its advertisers. BIO: Dr. Kollagunta Chandrasekhar, better known as Dr. Sekhar (pronounced Shaker) has been practicing cardiology in Winter Haven for 25 years. Dr. Sekhar is the Chief of Staff at Bay Care Winter Haven Hospital as well as the Director of the Heart Function Clinic and the Cardiac Rehabilitation program at Bay Care Winter Haven Hospital and the Chairman of Cardiology at Advent Hospital in Lake Wales. He is a member of the Heart Failure Society of America, the American Heart Association, the American College of Physicians, and the American Society of Nuclear Cardiology. To schedule an appointment, please call (863) 508-1101.

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Healthcare Facilities Focus on Facts, Precautions

T by TERESA SCHIFFER

THERE IS A NEW “C” WORD scaring people these days, and we’re willing to bet you’ve already heard it – coronavirus. Everywhere you look, coronavirus, or COVID-19, is on people’s lips. While the CDC is recommending we all take precautions, such as handwashing, good household hygiene, respiratory etiquette, and staying home when sick, what are local health care professionals doing to control the spread of this contagious virus? Area hospitals like those operated by BayCare Health System and AdventHealth are announcing what steps they are implementing in order to adequately treat patients while preventing further contamination within their facilities.

First, what exactly are we dealing with? The full name of this viral infection is Coronavirus Disease 2019, or COVID-19. It is a new type of infection that causes mild to severe respiratory illness. As of March 19, there was no widely accepted and approved vaccine to prevent the disease. According to Watson Clinic, the symptoms of COVID-19 are similar to that of the common cold or flu – fever, cough, and shortness of breath. Symptoms can begin to manifest anywhere from two to 14 days after exposure to an infected individual. COVID-19 is primarily spread by coughing and sneezing. Tiny droplets expelled in this way can be inhaled by people nearby. Being within six feet of an affected person for a prolonged period of time will increase your risk of catching the disease.

As the presence of novel coronavirus continues to increase in Florida and across the United States, it is imperative that hospitals and clinics remain operational in order to treat and contain the virus. It is important that appropriate measures are employed to protect staff, vulnerable patients, and the public at large. To that end, many health care providers are opting to apply restrictions on visitors to their facilities. BayCare Health System is keeping a close eye on the spread of COVID-19 and screening all visitors to facilities throughout Hillsborough, Pasco, Pinellas, and Polk counties. Anyone who is deemed a risk will be restricted from entering the facility and may be referred to an Emergency Department for further assessment. Children under the age of 18 will not be permitted to enter any facility as visitors, but they will still

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be admitted if they are in need of medical attention. Because the support of friends and family is a vital part of a patient’s recovery, BayCare is encouraging loved ones to reach out via phone or video calling to keep in touch with patients. BayCare asks all individuals with questions about the virus or BayCare’s procedures to go to baycare.org/newsroom. This site is updated regularly with the latest information. AdventHealth, which operates 10 hospitals throughout Central Florida plus dozens of urgent care centers, rehab facilities, emergency rooms, and other specialty services, has begun screening all visitors to any of their facilities each time they enter. This includes vendors. If the screening process identifies a symptom of concern, that person will not be able to enter the building until they are tested for COVID-19 and it is confirmed that they are not infected. No children under the age of 12 will be permitted as visitors. Anyone who is sick in any way or who has had contact with someone diagnosed with COVID-19 will not be allowed to enter the facility as a visitor. All visitors are required to wash their hands or use an alcohol-based hand sanitizer before entering and after leaving patient rooms and the facility. The pediatric departments of AdventHealth will be functioning as normal, so children in need of medical attention will still be admitted. Visiting hours for patients may change, so be sure to call the AdventHealth facility you intend to visit beforehand to get the most up-to-date information in order to avoid any inconvenience. Anyone who suspects that they may have the virus is encouraged to seek treatment with their local healthcare provider. Floridians can have all of their questions about COVID-19 answered for free by trained personnel on the “AdventHealth Coronavirus Information Line.” If necessary, callers can also speak directly with a nurse by contacting the free phone service. The phone number is 877-VIRUSHQ and it is available 24 hours a day, seven days a week. The hotline will also connect Florida residents with health resources such as the Centers for Disease Control and Prevention and the Florida Department of Health. While the initial launch of the AdventHealth Coronavirus Information Line is limited to Florida, the organization will soon be expanding the service to all communities for which AdventHealth provides services. They have also set up a website with important information on the virus, which you can access at CoronavirusSignsAndSymptoms. com. There are other resources available for information on COVID-19 as well. The Department of Health in Polk County is available Monday through Friday, 8 a.m. to 5 p.m. and can be reached at (863) 519-7911. Their website contains the latest information on the disease at FloridaHealth.gov/diseases-and-conditions/COVID-19/. The State of Florida has also opened a dedicated COVID-19 Call Center that operates 24 hours a day, 7 days a week. The number for that service is 1-866-779-6121. Bond Clinic offers these useful tips to help minimize your risk of exposure to COVID-19: • Keep your hands away from your face. • Stay home if you are not feeling well. • Avoid being in close contact with people who are ill. • When you cough or sneeze, cover your mouth with a tissue, then discard the tissue in the trash immediately. • Wash your hands frequently with soap and water for at least 20 seconds, particularly before eating, after using the bathroom, and after coughing, sneezing, or blowing your nose. • When you cannot wash your hands, use a hand sanitizer that contains at least 60% alcohol. • Clean and disinfect objects and surfaces in your home that are touched regularly. • Only use a face mask if you yourself are showing symptoms of COVID-19 in order to prevent transmission of the disease to others. If we work together, we can limit the damage caused by this current pandemic. A little prevention and common sense will work far better than panic and fear when it comes to managing COVID-19. hn

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CFHN | 19

Share Facts About COVID-19 Know the facts about coronavirus disease 2019 (COVID-19) and help stop the spread of rumors. FACT

Diseases can make anyone sick regardless of their race or ethnicity.

People of Asian descent, including Chinese Americans, are not more likely to get COVID-19 than any other American. Help stop fear by letting people know that being of Asian descent does not increase the chance of getting or spreading COVID-19.

FACT

Some people are at increased risk of getting COVID-19.

People who have been in close contact with a person known to have COVID-19 or people who live in or have recently been in an area with ongoing spread are at an increased risk of exposure.

FACT

Someone who has completed quarantine or has been released from isolation does not pose a risk of infection to other people.

For up-to-date information, visit CDC’s coronavirus disease 2019 web page.

FACT

You can help stop COVID-19 by knowing the signs and symptoms:

• Fever • Cough • Shortness of breath

Seek medical advice if you • Develop symptoms AND Have been in close contact with a person known to have COVID-19 or if you live in or have recently been in an area with ongoing spread of COVID-19.

FACT

There are simple things you can do to help keep yourself and others healthy.

• Wash your hands often with soap

and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.

• Avoid touching your eyes, nose, and

mouth with unwashed hands.

• Stay home when you are sick.

For more information: www.cdc.gov/COVID19

• Cover your cough or sneeze with a

tissue, then throw the tissue in the trash.

CS 315446-A 03/11/2020

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MEDICAL

Advice

Preventive Measures Are Your Best Defense by JOY JACKSON, MD, Director of DOH-Polk

THE GLOBAL OUTBREAK of a respiratory illness caused by a novel (new) coronavirus has reached pandemic proportions, according to the World Health Organization. The novel coronavirus 2019 (COVID-19) was first detected in China and is now detected in more than 100 locations internationally, including the United States. Public health efforts at the time of publication were focused on containing the spread and mitigating the impact of this virus. The Florida Department of Health is working closely with the Centers for Disease Control and Prevention (CDC) to monitor the outbreak of COVID-19 and is actively working to ensure that the most up-to-date CDC guidance is quickly and accurately disseminated to communities. The Florida Department of Health is urging residents to stay informed on how to protect themselves and their communities from COVID-19. According to the CDC, reported illnesses for confirmed COVID-19 have ranged from mild symptoms to severe illness and death. The following symptoms may appear 2-14 days after exposure: • Fever • Cough • Shortness of breath There is currently no vaccine to protect against COVID-19 and no medications approved to treat it. The best way to prevent illness is to avoid being exposed to this virus. The Florida Department of Health encourages everyone to seek medical attention and diagnosis if they suspect they have contracted COVID-19 or come into contact with someone who has COVID-19. Everyone plays a part in lowering the impact within our communities and workplaces. Taking every day preventative actions helps to impede the spread of respiratory diseases such as COVID-19. The CDC recommends individuals and families follow everyday preventive measures: • If you are sick, stay home. • Practice social distancing and limit unnecessary travel.

• P ractice good hand hygiene (regularly and thoroughly wash hands with soap and water for at least 20 seconds or if not readily available, use a hand sanitizer with at least 60% alcohol). • Avoid touching eyes, nose and mouth with unwashed hands. • Sneeze or cough into the elbow or tissue. • Clean and disinfect frequently touched surfaces such as door handles, bathroom fixtures, phones. Public health authorities suggest the cancellation of gatherings greater than 10 people and smaller gatherings that may bring people from multiple areas in the U.S. Put distance between yourself and other people if COVID-19 is spreading in your community. This is especially important for people who are at higher risk of getting very sick. The Department of Health has a dedicated COVID-19 webpage for all of the most recent updates on the virus. Here is that link: FloridaHealth.gov/COVID-19. This remains the best and most up-to-date resource for information and guidance regarding COVID-19 in Florida. For any other questions related to COVID-19 in Polk County, residents can contact the Department of Health in Polk County by calling 863-519-7911 Monday through Friday from 8 a.m. to 5 p.m. The state has also established a dedicated COVID-19 call center. More information can be found by calling 1-866-779-6121 or emailing COVID-19@flhealth.gov. The state’s call center is available Monday through Friday, from 8 a.m. to 5 p.m.

ABOUT THE AUTHOR: Dr. Joy Jackson, an internal medicine physician, serves the community as director of the Florida Department of Health in Polk County (DOH-Polk). For more information about DOH-Polk, visit mypolkhealth.org. Follow DOH-Polk on Twitter at twitter.com/FLHealthPolk.

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spine health

The Opioid Journey to Addiction

Chukwuka Okafor, MD, MBA, CIME, FAAOS Spine Institute of Central Florida

here are 16 ounces in 1 pound; but it is true today, as it was when Benjamin Franklin stated that “an ounce of prevention is worth a pound of cure.” A little precaution to avoid/prevent an undesirable condition is preferable to developing a long-term negative situation and dealing with its potential consequences. If you consume an opioid tablet, you have little control of what chain of actions it triggers in your body. Hence the only way one can prevent any potential negative consequences/sequelae of initial opioid use is either avoiding opioids until when absolutely necessary, and when needed, taking the least amount possible, for a very short duration. As mentioned in my prior articles, opioid dependence can occur very quickly. Today let’s discuss the science! Someone can go from not having taken any prior opioid to developing long-term opioid dependence, within just a few days of taking opioids. There are no warning signs before dependence sets in. How does this happen? Well, there is a small part of our midbrain called the Ventral Tegmental Area (VTA). The VTA produces dopamine (a neurotransmitter), which is transmitted to another part of the brain called the Nucleus Accumbens (NA). Dopamine is then transmitted from the NA to the Prefrontal cortex (PfC). This dopamine related circuitry “VTANAPfC pathway” is the “Reward Pathway” responsible for making us associate specific activities with pleasure. This pathway exists as feeling pleasure motivates us to repeat behaviors that are critical to our existence. This pathway reinforces life sustaining activities like eating or having sex. Opioids and addicting substances trigger the very same pathway, but while doing so, produce pleasure 10X greater than experienced with eating or having sex; this is due to initial overproduction of dopamine. The dopamine induced pleasure experienced reinforces the opioid use behavior, as opioid use is met with the “pleasure” reward. There is then resulting continued desire to use opioids, and longer-lasting adaptations subsequently occur in our brain. The pleasure reward provokes desire for ongoing use and dependence sets in. The “pleasure” reward also described as “euphoria” or “high” fuels the ongoing craving of the opioids initially. However, with ongoing use there are profound changes in neurons and brain circuits; the initial “high” experienced due to overproduction of dopamine, is drastically blunted as our brain tries to adjust for the overproduction of dopamine. Continued opioid use triggers a negative feedback loop which drastically turns down dopamine production. Presence of dopamine suppresses the Locus Coeruleus (LC) part of our brain. Hence with suppression of dopamine production, there is activation of the LC part of our brain. The LC part of our brain when activated produces another neurotransmitter norepinephrine (NE). When NE is released, it creates unpleasant symptoms including insomnia, anxiety, mood changes, sweating, cramping, nausea, aches and pain, diarrhea, fever, severe flu-like symptoms, and continued opioid craving. Another way to explain this: initially, the desire and craving for opioids is due to the experienced pleasure/high with each dose. But with additional opioid doses, the effects become less pleasurable (as dopamine overproduction is significantly blunted). Subsequently, NO further pleasure/high is experienced with each dose; instead, the desire for more opioids use is solely to allow the user to just feel “normal,” and to eliminate the unpleasant symptoms precipitated by the norepinephrine release described in the paragraph above. FOR ILLUSTRATION AND SIMPLICITY (Numbers here are just for ease of understanding): • Imagine normal dopamine level to be 5. (On a 0-10 scale) • With opioids dopamine level shoots up. • Dopamine level ≥ 9 results in “high” and “pleasure/euphoria.” • Dopamine level ≤ 3 results in Norepinephrine production and very unpleasant symptoms. • Prior to 1st opioid use: Dopamine level is = 5 (one feels like their normal self) • Initial few days of Opioid use: Dopamine level at 10 (overproduction). “Increased pleasure feeling” • With continued Opioid use: Dopamine production is progressively blunted as the brain senses the overproduction and must counteract it. Level drops to between 1 and 2; unpleasant symptoms kick in. More opioids are then needed to allow for more dopamine release, which can now only get dopamine level to 5, as overproduction is never again experienced after the initial few days of opioid use. Imagine craving to take a medication to remove negative symptoms including insomnia, anxiety, mood changes, aches and pain, diarrhea, fever, and flu-like symptoms? In a lot of cases, when opioid dependence sets in, a great deal of opioid intake is unrelated to the exact cause of initial pain, but more related to changes in your brain chemistry, and quest to feel normal and avoid withdrawal symptoms. Avoid taking opioids if there are alternatives that can help reduce your pain, remember opioids don’t eliminate pain. If you ever have to take opioids, take them sparingly, and only for a short duration of time. This column is sponsored by Spine Institute of Central Florida, and the opinions expressed herein may not reflect those of CFHN or of its advertisers. BIO: Dr. Okafor is an Orthopaedic Spine Surgeon at the Spine Institute of Central Florida.

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Zooming in on health in your community. JESSICA WILCOX, Editor

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Coronavirus: Keeping Kids in the Loop

A Milestone for Bostick Heart Center BayCare and Winter Haven Hospital recently congratulated the Bostick Heart Center team for completing its first transcatheter aortic valve replacement, or TAVR, procedure. They’ve been working toward this moment for more than a year and are excited to provide this option for heart valve replacement to the community. photo provided to Central Florida Health News

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s people around the world process, cope, and adjust to life in the time of coronavirus, the dynamics of everyday life continue to change. Virus updates dominate the news. Social media posts are filled with memes and horror stories. Conversations are laced with words like quarantine and infection rate. An environment of uncertainty has set in. As adults, we have the tools to evaluate the situation and moderate our level of concern. Children, on the other hand, don’t yet have these tools. That’s why it’s important to talk to children and help them understand what is, and isn’t, going on. Here are some things to keep in mind when broaching the topic with children. • Don’t avoid the topic. Children are extremely observant. They’ve seen the face masks, they’ve heard about the shortage of hand sanitizers, and they know something is going on because school is canceled. Avoiding conversations about coronavirus will only increase their anxiety.

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• Monitor your own feelings. It’s natural to feel overwhelmed, but it’s important not to let that anxiety set the tone for your children, too. • Set the tone. You can filter the gloom and doom from the news and make sure kids get the important, yet age appropriate, information. • Keep conversations flexible. Answer your child’s questions honestly and clearly. Even if you can’t answer a question or concern of theirs, it’s important that your child knows they can talk to you. • Give them concrete actions they can take to stay safe. People feel better when they can take effective action in a situation, and children are no different. Talk about the importance of handwashing and covering your mouth when you sneeze or cough. • Maintain perspective. Keep the tough conversations to a minimum while still answering questions. Make sure to continue to talk about other topics. hn

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