Central Florida Health News October 2022

tude of excited Jollibee patrons waiting to get their hands on their Jollibee favorites, but also first-timers waiting to have their own Jollibee experience," said Jose Miñana, Jollibee Foods Corporation's Group President for North America. "There's no greater joy for us than serving the needs and tastes of Jollibee fans in the community. At Jollibee, we aim to bring families together for happy moments over great tasting food with superior value, served with warm and friendly service –our own brand of joy." The brand has become a symbol of nostalgia and warm childhood memories for many overseas Filipinos in the U.S. To many, Jollibee is the go-to restaurant of Filipinos for both special

THE ENDORSED PUBLICATION OF THE POLK COUNTY MEDICAL ASSOCIATION volume 12 | issue 7 | october 2022 — TAKE ONE!

See JOLLIBEE

get to try Jollibee's signature menu items such as the world famous Chickenjoy. This dish is delicately breaded to be crispylicious on the outside and juicylicious inside. The well-loved Jolly Spaghetti is a favorite of both kids and kids-at-heart because of its signature sweetstyle sauce, loaded with chunky slices of savory ham, ground meat, and hotdog. Other classic menufavorites include the juicy and cheesy Jolly Hotdog, and the Peach Mango Pie, which is made with real Philippine sweet mangoes and a flaky golden brown crust.

largest Asian restaurant company, is now open in Jacksonville. This is the 36th store in the US, as well as the first in the state and Southeast US. It opened to the public on March 18, 2017. Jacksonville is the most populous city in the Sunshine State, as well as home to the largest FilipinoAmerican community in Florida. The longawaited arrival of Jollibee in the city has

Breast Cancer Awareness

LIGHT FROM DARKNESS

Survivors Share Stories of Hope, Courage, Perseverance

COMMUNITY HEALTH

Early Detection Is Everything

MEN ARE NOT IMMUNE

Learn the Signs of Breast Cancer in Men

SAVING LIVES

New Test Can Quickly Detect Deadly Amoeba Infections

Ritu Aparajita, Vascular Surgeon MD RPVI

Kollagunta Chandrasekhar, MD, FACC Cardiologist

Meet Your Providers…

• Board certified in Cardiovascular Disease and Internal Medicine

• Executive Director the Heart Function Clinic, Low Risk Chest Pain Center and the Cardiac Rehabilitation Program for BayCare Winter Haven Hospital

• President of Medical Staff for BayCare Winter Haven Hospital

• Chairman of Cardiology for Lake Wales Medical Center

• Clinical Associate Professor, FSU College of Medicine

Ritu Aparajita, MD, RPVI

A Vascular and Endovascular Surgeon who earned her MBBS at University of Delhi, India. She then completed a research fellowship at Columbia University Medical Center and a residency in general surgery at Staten Island University Hospital in New York, she completed her fellowship training in Vascular Surgery at Newark Beth Israel Medical Center and St. Barnabas Medical Center in New Jersey. She’s co-authored more than two dozen journal articles. She was recently nominated for the American Medical Association Inspiration Award that recognizes physicians who have contributed to the achievements of women in the medical profession.

Roan Cadavona, ARNP, FNP-C

…brings a high level of education and experience in Cardiac Catheterization, Electrophysiology and working in the Cardiovascular Progressive Care unit. He serves a vital role in providing patients with optimal cardiovascular care through counselling and screening, as well as disease prevention and management strategies.

• Board certified Family Nurse Practitioner

• Member of Staff for BayCare Winter Haven Hospital

On the Cover

See JOLLIBEE and sustainable sourcing, local and seasonal produce, and global flavors and forms, all done within the steakhouse format showcasing cuts of meat as entrées with choice sides. Moreover, new menu categories (such as flatbreads) and service elements freshen the concept. About the Report 2017 Forecast: Culinary Trend Tracking Series offers an outlook on the culinary trends—the foods, dishes, ingredients and flavors—that Packaged Facts expects to grow in popularity in 2017. Rockville, MD When it comes to American cuisine, there are few things more iconic than steakhouses. The slabs marbled meat, the sizzling grills, the oozing butter, and the dripping bravado, maybe even a cowboy hat or two for ambiance—it's enough to make even fictional steakophile Ron Swanson misty-eyed. Yet for all the traditional steak dinners ordered daily, there are restaurants nationwide pushing the concept of the all-American steakhouse new culinary heights, according to market research firm Packaged Facts in the brand new report 2017 Forecast: Culinary Trend Tracking Series. "The steakhouse back and will capture our attention 2017. Not that the classic restaurant style ever disappeared, but renewal of the model is taking place in response to new sources beef and new flavorful expressions the concept that get chefs and diners excited," says David Sprinkle, research director, Packaged Facts. Today's steakhouse menus increasingly feature grass-fed cattle, locally raised animals, heritage varieties, meat butchered and dry aged in-house, and dishes that stem from the whole animal, not just the premium cuts. And that's just the meat. Creative side dishes lieu old standards, global and seasonal flavors, and wider menu selection also distinguish these new school operations. Chefs and consumers both want their meat taste delicious and feel good about its’ consumption, too. This new breed of steakhouse broadcasts its mission to support local ranchers, factor sustainability and animal welfare, and create dining experience that showcases culinary flair, not just a grill master's skill at cooking steak to the requested doneness. These operations are also designed to be more inclusive, more great place for all kinds of people to dine well, not just traditionminded men on expense accounts. As result, the modern steakhouse is increasingly similar to other modern restaurants with focus on distinctive 2017 forecast: Steakhouses

beef up menus with new twists on American classics

CentralFloridaHealthNews.com ENROLL PAGE 12 THE ENDORSED PUBLICATION OF THE POLK COUNTY MEDICAL ASSOCIATION volume 12 issue | october 2022 — TAKE ONE! Ap petizer s: Entrées: Advertisers Directory 2 Appell Pie Calendar Events 10 Classified Ads 14 What’s Going On 3 Analysis:Catering industry revenues on the rise 4 “Big Data” — Doesyourrestaurantneedit? 7 RiseBisquitsDonuts to open in Coral Springs 11 Del Taco spices up expansion in the Southeast 13 PRSRT US POSTAGE PAID WESTPALMBEACH,FL PERMIT WWW.TRNUSA.COM VOLUME 21 NUMBER 3 MARCH 2017 FLORIDA’S FOODSERVICE INDUSTRY NEWSPAPER  ◆ $3 FLORIDA EDITION Jollibee's U.S. expansion continues with first Florida location opening Jacksonville, FL After much anticipation and excitement, Jollibee, the largest Asian restaurant company, is now open in Jacksonville. This is the 36th store in the US, as well as the first in the state and Southeast US. It opened the public on March 18,2017.Jacksonville is the most populous city in the Sunshine State, as well as home to the largest FilipinoAmerican community in Florida. The longawaited arrival of Jollibee in the city has "As Jollibee debuts Florida, we anticipate seeing not only multitude excited Jollibee patrons waiting to get their hands on their Jollibee favorites, but also first-timers waiting to have their own Jollibee experience," said Jose Miñana, Jollibee Foods Corporation's Group President for North America. "There's no greater joy for us than serving the needs and tastes of Jollibee fans the community. At Jollibee, we aim to bring families together for happy moments over great tasting food with superior value, served with warm and friendly service –our own brand of joy." The brand has become a symbol of nostalgia and warm childhood memories for many overseas

On the Cutting Edge

The University of Central Florida’s Burnett School of Biomedical Sciences Cancer Research Division, led by Dr. Annette Khaled, is on the cutting edge of cancer research. Its researchers have identified a way to track metastatic cancer cells in the body, making earlier detection a reality.

Pop Quiz!

Autism, or autism spectrum disorder (ASD), is one of the most talked about conditions, especially when children and young adults are concerned. It is a broad range of conditions that can present in a number of ways. Take our quiz and broaden your knowledge of autism.

Early Detection Goes a Long Way

Since October is Breast Cancer Awareness Month and the weather is starting to cool off a bit in Central Florida, it’s the perfect time for the annual Central Florida Health Care Golf tournament. This special event is a chance to raise much-needed funds to provide mammograms to uninsured and underinsured patients throughout Polk County. We talked with Central Florida Health Care to learn more about the tournament and the care they offer.

Saving Lives

6 8 9 14 17 Departments 16 CALENDAR 18 HEALTHY COOK 19 HEART NEWS 20 HEALTHY SKIN

AdventHealth shared some news that’s pretty exciting for anyone who likes to enjoy freshwater lakes in warmer climates. Scientists have recently developed an effective test to determine whether an individual has been infected with any of three of the most common deadly amoebas lurking in lakes.

Men Aren’t Immune to Breast Cancer

21 MEDICAL ADVICE

23 BODY, MIND & SPIRIT 23 EDITOR’S DOSE

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

Access the 2022 Central Florida Physicians Directory online!

Roan Cadavona, ARNP FNP-C Nurse Practitioner

K.S. Chandrasekhar, MD, FCC

…established his clinic over 20 years ago. He is well known in the community and trusted for his accurate diagnosis and compassionate care.

A Message From Mom

NELSON KIRKLAND, PUBLISHER nelson@centralfloridamediagroup.com

In our annual Breast Cancer Awareness edition, we let the heroes do the talking. We pass the bullhorn to the women who, despite facing the scariest of encounters in their lives, press on and spread an important message. Loud and clear, their message rings out, lighting the darkness and spreading awareness. There are many in our community who fit this bill.

One breast cancer survivor, in particular, enjoyed a long and celebrated career in our area’s County Health Department and Public School system. She was widely known — and just as widely loved — by those blessed enough to share their world with her. She was a survivor through and through, and the message she preached is the same echoed by the many survivors featured in this edition of Central Florida Health News: Early detection and regular screening are key.

She was a rock for the community and a rock star for my family. Many knew her only as Nurse Kirkland. I knew her as Mom.

There are many organizations set up to help make mammograms possible for the uninsured and underinsured. I encourage you to reach out if you need assistance for screening. Remember, you’re not doing it just for yourself, you’re also doing it for your loved ones.

• Florida Breast Cancer Foundation: floridabreastcancer.org/ support-resources/Polk

• Central Florida Health Care: cfhc.org

• We Care Central Florida: wecarecentralflorida.org/project-thinkpink-2

• Polk County Department of Health: polk.floridahealth.gov

• Breast Cancer Foundation of Central Florida: www.bcfcf.org. HN

Retirement Planning College Savings Plans Financial Planning

John Scheck

Portfolio

Management Director

Senior Vice President

Branch

Manager

1101 1st St S, Ste 201

Winter Haven, FL 33880

+1 863 291-8306

john.scheck@morganstanley.com

PUBLISHER

Nelson Kirkland

MANAGING EDITOR

Jessica McDonald

PROJECT MANAGER

David Kiessling

ACCOUNT EXECUTIVES

Juanita Halter, Cinda Shelby

CONTRIBUTING WRITERS

Erika Aldrich, Mary Joye, LMHC , Teresa Schiffer, Carol Corley, Dr. Joy Jackson, Paul Catala, Kristen Guevera, Gerard Johnson

CONTRIBUTING COLUMNISTS

Ritu Aparajita, MD; Alex Kennon, MD; Selina Lin, MD

CONTRIBUTING ARTIST

Dawn Lewandowski

1596726

MS. KAIA

© 2016 Morgan Stanley Smith Barney LLC. Member SIPC. CRC

POLK COUNTY MEDICAL ASSOCIATION

4315 Highland Park Blvd, Suite B

Lakeland, Florida 33813

863-644-4051

2022 OFFICERS

JAMES J. BOOKER, MD President

GEORGE LYLE, MD Secretary

STUART PATTERSON, MD Treasurer

BOARD OF TRUSTEES

RALPH NOBO, JR., MD, Chair

GEORGE LYLE, MD

STUART PATTERSON, MD

GARY SCHEMMER, MD

SERGIO SEOANE, MD

ARVIND SONI, MD

BREAST CANCER AND YOU

You’ve probably noticed the familiar, annual inundation of pink just about everywhere lately as we start Breast Cancer Awareness Month. From pink T-shirts and hats to pink pizza boxes and law enforcement badges, everything is awash in the color of awareness! As healthcare providers, we’re always thrilled to see so much awareness and support.

Aside from skin cancer, breast cancer is the most common type of cancer for women in the United States. Fortunately, it can be treated when it is detected early. That’s why doctors and survivors around the world emphasize the importance of annual screenings, mammograms, and selfexams. Simply put: They save lives.

Inside this edition of Central Florida Health News, we share with you the journey of four women who battled breast cancer and emerged victorious. Their insights, courage,

JACKIE COURTNEY

Executive Director

4315 Highland Park Blvd Suite B

Lakeland, Florida 33813

Sincerely,

James J. Booker, MD

James J. Booker, MD

Obstetrician and Gynecologist, Winter Haven President, Polk County Medical Association

and messages offer hope and encouragement. We hope their stories inspire you to take control of your health and get screened.

While it is very uncommon for men to develop breast cancer, they account for an estimated 1 in every 100 cases in the U.S. We spoke with Winter Haven Hospital oncologist Hassan Ebrahim about the occurrence in men and the signs and symptoms. Learn more in our Q&A with him.

Inside, you’ll also find information on innovations in cancer detection, a quiz on Autism Spectrum Disorder, and a peek at a test AdventHealth developed to earlier detect braineating amoeba.

On behalf of the Polk County Medical Association, have a great month and remember to make it your mission to get screened or remind a loved one to do so! HN

Some of the benefits of a PCMA membership include the following:

✱ Physician referrals

✱ Medical malpractice discounts with The Doctors Company

✱ Ongoing relevant communication

✱ 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.

ON THE CUTTING EDGE

UCF Researchers Use Liquid Biopsies to Detect Cancer Earlier

by GERARD JOHNSON

The University of Central Florida’s Burnett School of Biomedical Sciences Cancer Research Division, led by Dr. Annette Khaled, is on the cutting edge of cancer research. Its most recent publication in the peer journal Plos One delved into the cancer detection technology of liquid biopsy. Liquid biopsies have revolutionized the field of clinical oncology. The new diagnostic methods are a non-invasive option that could potentially provide a better picture of the whole tumor. This can help the oncologist improve the treatment, management, and monitoring of a host of different cancers.

Liquid biopsies isolate tumor-derived entities — like circulating tumor cells, circulating tumor DNA, and tumor extracellular vesicles— present in the body fluids of patients with cancer. Then the genomic and proteomic data within them are analyzed. Isolation and analysis of methodologies for liquid biopsies are rapidly evolving, providing researchers with greater details regarding the tumor progression while opening up newer avenues for the detection, continuous monitoring, precision treatment, and screening of markers for therapeutic resistance. Despite the development of new methods for liquid biopsy, few have gained approval from the U.S. Food and Drug Administration (FDA) for clinical use. The lack of FDA approval methodologies is due to the lack of robust

research in the field.

Fighting cancer is personal for Khaled after she watched her grandmother fight cancer. Although her grandmother beat the cancer, the treatments weakened her and ultimately led to her passing later in life. Khaled has been focused on noninvasive diagnostic tools like liquid biopsy as a way to reduce the impact of cancer treatments on the bodies of cancer patients. Current liquid biopsy technologies focus on enumeration, or simply counting the number of CTCs present in the blood. The current gold standard for clinical circulating tumor cell (CTC) enumeration is the FDA-approved CellSearch® System (CSS). CSS is the first and only actionable test for detecting CTCs in metastatic breast, prostate, and colorectal cancer patients. CCS and other liquid biopsy analyses are used as companions of other diagnostic tools to gain new insights into metastasis biology, improve the stratification of therapies, and obtain insights into therapy‐induced selection of cancer cells. Yet, liquid biopsy methods for the detection of CTCs are used in clinical settings as an additional diagnostic tool with mainstream tissue biopsy methods. The use of CTCs counts is still not a part of routine cancer screens due to the lack of standardization and validation needed to implement liquid biopsies as well as tumor heterogeneity, even within the same patient,

THE GALA

Presented by: Anonymous

Save the Dates:

Online Silent Auction:

OCTOBER 28 - NOVEMBER 3, 2022

The Gala:

THURSDAY, NOVEMBER 3, 2022

All proceeds will be utilized locally to establish an American Psychological Association accredited training program for Doctoral level clinical Psychologists in Winter Haven.

Please join us at Polk County’s premier fundraising event, the Winter Haven Hospital Foundation Gala. This year’s Gala event will feature live music by Atlanta-based “Rhythm Nation”, four-course gourmet dinner, exquisite wines and open bar, and exciting live auction filled with incredible trips and experiences.

For more information: (863) 292-4138 or whhfoundation@baycare.org

POP QUIZ!

Autism Doesn’t Always Look the Same

Autism, or autism spectrum disorder (ASD), is one of the most talked about conditions, especially when children and young adults are concerned. It is a broad range of conditions that can present in a number of ways. Take our quiz and broaden your knowledge of autism.

1. What percentage of children are affected by autism, according to the Centers for Disease Control?

A. One in 19 children C. One in 32 children

B. One in 26 children D. One in 44 children

2. True or false? Autism is a spectrum disorder, with many different subtypes, and each person with autism has a distinct set of strengths and challenges.

3. Which of the following areas could be affected in someone with autism?

A. Social skills D. Nonverbal

B. Repetitive behaviors communication

C. Speech

E. All of the above

4. Though the primary causes of autism are not known, research suggests a person’s genes, together with aspects of their environment, can affect development in ways that can lead to autism. Which of the following are factors associated with an increased likelihood of developing autism?

A. Having a sibling with ASD

B. Having older parents

C. Having certain genetic conditions (such as Down syndrome or Fragile X syndrome)

D. Having a very low birth weight

E. All of the above

5. Though it can be diagnosed at any age, by what age do signs of autism usually appear in children?

A. 2 to 3 B. 4 to 5 C. 6 to 7 D. 8 to 9

6. True or false? In some cases, autism can be diagnosed as early as 18 months.

7. Several factors may influence the development of autism, and it is often accompanied by sensory sensitivities and which of the following medical issues?

A. Gastrointestinal (GI) disorders

B. Seizures or sleep disorders

C. Mental health challenges such as anxiety, depression, and attention issues

D. All of the above

8. True or false? People of all genders, races, ethnicities, and economic backgrounds can be diagnosed with autism.

9. Which of the following characteristics is NOT common in those with autism, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a guide created by the American Psychiatric Association that

healthcare providers use to diagnose mental disorders?

A. Difficulty with communication and interaction with other people

B. Difficulty waking up from Rapid Eye Movement (REM) sleep

C. Restricted interests and repetitive behaviors

D. Having symptoms that affect one’s ability to function in school, work, and other areas of life

10. Which of the following are examples of social communication/interaction behaviors those with autism may display?

A. Making little or inconsistent eye contact, appearing not to look at or listen to people who are talking

B. Infrequently sharing interest, emotion, or enjoyment of objects or activities

C. Often talking at length about a favorite subject without noticing that others are not interested or without giving others a chance to respond

D. Displaying facial expressions, movements, and gestures that do not match what is being said

E. All of the above

11. Which of the following are examples of restrictive/repetitive behaviors people with autism may display?

A. Repeating words or phrases (a behavior called echolalia)

B. Having a lasting intense interest in specific topics, such as numbers, details, or facts

C. Becoming upset by slight changes in a routine and having difficulty with transitions

D. Being more sensitive or less sensitive than other people to sensory input, such as light, sound, clothing, or temperature

E. All of the above

12. Those with autism can also display many strengths. Which of the following are areas that those with autism may excel in?

A. Being able to learn things in detail and remember information for long periods of time

B. Being strong visual and auditory learners

C. Excelling in math, science, music, or art

D. All of the above

13. True or false? Research shows that early intervention leads to positive outcomes later in life for people with autism.

Difficulty waking up from Rapid Eye Movement (REM) sleep

compiled by ERIKA ALDRICH / Information provided by the National Institutes of Mental Health and AutismSpeaks.org.

Early Detection Goes a Long Way in the Breast Cancer Fight

by TERESA SCHIFFER sponsored by Central Florida Health Care

Since October is Breast Cancer Awareness

Month and the weather is starting to cool off a bit in Central Florida, it’s the perfect time for the annual Central Florida Health Care Golf tournament. This special event is a chance to raise much-needed funds to provide mammograms to uninsured and underinsured patients throughout Polk County.

“They raised enough money last year to provide 608 women with mammograms,” says Central Florida Health Care’s Natalie Wipert, APRN, CNM.

“That’s a big opportunity for us to help make sure the uninsured and underinsured get their mammograms done on schedule.”

Wipert goes on to explain that women should begin getting mammograms annually at age 40, preferably. If patients choose not to have the screenings done at that age, then they should definitely have one performed at age 50.

“Sometimes cost is the reason that stands in the way of that, so I’m excited that I’m involved with an organization that is working to provide that,” Wipert says.

Central Florida Health Care is dedicated to providing a full range of healthcare services to those in need and to overcoming the

barriers to access experienced by many. This includes making sure that patients who wish to begin screenings for breast cancer are able to do so. This aspect of the care is of special significance to Central Florida Health Care CEO and breast cancer survivor Ann Claussen.

“Every year, we put out information about breast cancer awareness and mammograms, and when we know we are able to provide for those women who are uninsured or underinsured, we will put out information for that,” Wipert says.

About one in eight women will develop breast cancer in their lifetime, and more than 40,000 women die of the disease in the U.S. each year. Early intervention is the key to a positive outcome, and mammograms play an important role in getting care when it’s needed. Being familiar enough with one’s body to be able to recognize unusual changes is another way women can protect themselves so that they are able to get medical attention in time should a problem arise.

“Breast cancer is extremely survivable today, but early detection is the key,” Wipert says. There is less emphasis on self-detection than there was a few decades ago. The

reason for this is that in many cases, women would report finding a lump in the breast to their physician, and a biopsy would be performed only to discover that the mass was benign and posed no threat to the patient. Healthcare professionals wanted to decrease the number of invasive procedures being performed on patients unnecessarily, so the message was adjusted.

Of course, any time a painful lump is detected it should still be examined by a healthcare provider. A tiny, virtually unnoticeable lump can be a true harbinger of danger. These types of tumors generally will not be something a patient is able to discern on their own and can be detected only through a mammogram. This is what makes the recommended screenings so vital to saving lives.

Some warning signs that women should watch for include new lumps in the breast tissue or underarm area, thickening or swelling of the breasts, irritation or dimpling of the skin of the breast, or changes to a nipple. The presence of any of these symptoms warrants a visit to a healthcare provider, and Central Florida Health Care is equipped and ready to address your concerns.

LIGHT FROM DARKNESS

Breast Cancer Survivors Share Stories of Perseverance

B

reast cancer doesn’t discriminate. It doesn’t care if you’re a mother, daughter, sister, aunt, or sole provider. It doesn’t care if you’re embarking on the best adventure of your live or going through your most trying time. Despite the awareness campaigns and vast education on the topic, the disease rocks the lives of those who are afflicted. Radiating out of the darkness of fear and uncertainty, the voices of patients share tales of courage, faith, life lessons, and perspective. Central Florida Health News spoke with four survivors who were gracious enough to share their journeys with us.

Vickie Ballin: A New Lease on Life

by PAUL CATALA

Vickie Ballin’s strongest and most direct advice to other women: “Get your yearly mammogram; it can definitely save your life.”

It was Ballin’s annual visit with her obstetriciangynecologist in September 2020 when what looked like “pepper dropped on a paper” showed up on a follow-up mammogram at Winter Haven Women’s Hospital. That discovery led to a biopsy by Dr. Robert Gabordi at St. Joseph’s Women’s Hospital in Tampa a month later and the confirmation of two areas of breast cancer on her left breast.

“It was complete terror once I was told. As soon as they said I need to go for a biopsy, your heart stops,” says Ballin, 55, a 30-year registered nurse and quality coordinator at Winter Haven Hospital. “I just sat there and just cried in the parking lot. My family, friends — everyone was in complete shock”

The Bartow resident, who is married and has one grown son, says there was no history of cancer in her family, she’s never smoked, and she maintains a healthy

lifestyle, so her diagnosis caught her by surprise. Nonetheless, Ballin says once she was diagnosed, she wanted to face it head-on and fight to defeat her cancer. With both lesions in her left breast, she decided to have a bilateral mastectomy with reconstruction in November 2020.

“I wanted zero percent chance of ever getting breast cancer again, so that’s why I chose bilateral mastectomy,” she says.

A second surgery was performed the following July. The surgeries showed no cancer had gone into her lymph nodes, but there was some concern as Ballin’s cancer was the fast-growing human epidermal growth factor receptor 2 (HER2). That led to 12 weeks of chemotherapy and 13 more doses of targeted therapy for cancer, which lasted from December 2020 to December 2021.

“The day after my surgery, they said ‘Congratulations, you are cancer free.’ It’s an amazing thing to hear. What I was blessed with was no cancer was found in my lymph nodes,” she says. “The way they presented with the chemo and the targeted therapy, well, is like you’re cancer free and this like your insurance policy.”

If not insurance, but reassurance, part of Ballin’s recovery she says was based on support from family and co-workers, despite going through her surgery at the height of the covid pandemic.

“The nurses (at Winter Haven Hospital infusion center) were amazing; I’d never go anywhere else for something like this,” she adds.

Ballin, who says her life continues to become “more normal,” recommends any women reading her story to get yearly mammograms, even if they have no

Vickie Ballin

symptoms.

“I was very lucky that it was found so early. The odds of it coming back are very slim,” she says. “It’s pretty amazing. I’m so blessed. It was a tough time, but I feel it’s over and I’m recovering well and getting more energy every day and can do a little bit more and more each day. It’s like having a new lease on life; I’m very, very blessed.”

Lesa Brown: ‘I Wanted to Live’

by PAUL CATALA

As a probation officer with the Florida Department of Corrections, Alethea “Lesa” Brown has to sometimes contend with contentious moments.

But one of Brown’s most confrontational life situations didn’t evolve from her career, but rather from a second lumpectomy done in January 2020. Although she had no diagnosis prior to her lumpectomies, that second procedure to remove abnormal tissue from her breast led to a diagnosis of breast cancer.

By March 2, 2020, Brown had her right breast removed. Fifteen days later, discharge prompted the removal of her left breast. She spent three months in recovery, and now, the 60-year-old Seffner resident says she was able to “easily adjust” to life post-mastectomy.

“To be honest, when I got the words ‘You have cancer,’ I thought, ‘Okay, let’s do this.’ There was no hesitation; I wanted to live,” says Brown.

The four-hour operation at Lakeland Regional Health Medical Center was for lobular carcinoma in situ — the presence of abnormal cells inside a milk duct in the breast — considered the earliest form of breast cancer. She was also diagnosed

with follicular cancer in the left breast.

Brown, who gets cancer-screening followups every six months, says throughout her procedures she always “went with the flow.”

“Whatever I was asked to do, I did – some hurt, some didn’t,” she says.

In addition to support from her nurses and physicians, Brown says it has been her strong faith in God that has helped her through trials and tribulations along the way.

“There’s God that brought me to this and he brought me through this,” she adds.

Brown, who now wears prosthetic breasts, joins other survivors in the push for monthly selfexaminations and yearly mammograms.

“Don’t be afraid to seek out confirmation for cancer. If you see something, say something.”

Ashley Page: Perspective & Priorities

by KRISTEN GUEVARA

It was Thanksgiving of 2020 in the midst of the pandemic that Ashley Page’s life was turned upside down. While on vacation with her family in Arizona, the Lakeland resident received a phone call from her doctor with news that she had stage 2 invasive ductal carcinoma, or breast cancer. In total disbelief, Page decided to go on with her week as if it never happened. Denial is often the first stage in processing grief.

Three months prior, Page discovered a lump in her right breast. Believing it was just tissue, she didn’t think much of it. Her boyfriend and her best friend encouraged her to get examined. Stubborn at first, Page finally gave in and had a mammogram and a biopsy. The suspicious lump in her breast turned out to be a cancerous tumor.

Even though the doctor believed the cancer was going to grow slowly, the tumor doubled in size increasing to stage 3 cancer from Thanksgiving to January 5. Page, a natural “fixit” type personality, struggled with this diagnosis because it was something she couldn’t fix. As much as she wanted to, she couldn’t plan what would happen next. Cancer is something no one controls, and nobody knows what tomorrow will bring.

For Page, “tomorrow” brought a lumpectomy, 36 rounds of radiation, and eight Accupoints. During surgery, the doctors discovered the tumor was deeper than expected. With only six treatments of radiation left, the radiation began to burn Page’s skin, posing the risk of infection and pausing the treatments. As much as Page wanted to be done with the treatments, there was no rushing the process.

The radiation treatments drained her of her energy and appetite. With the help of friends and the Breast Cancer Foundation of Central Florida, Page was able to stay home and heal after her surgery. A month and a half later, she was back at work after her morning radiation treatments.

Page has now been in remission for two years. She takes medication and gets a shot to stop the production of estrogen and will continue to do so for the next five to eight years to protect from recurrence. As a result, she is now experiencing menopause at age 37, and she’s unable to have children. This makes her even more thankful that she will soon be a stepmom of three with her now fiance.

Page uses her experience with breast cancer to give back to others facing the same battle. She is a strong supporter of the Breast Cancer Foundation of Central Florida and spends most of her time with family and helping others through their journey. She credits the support of her family, friends, the foundation, co-workers, and church for getting her through those hard days of battling breast cancer.

“Breast cancer was truly the scariest thing that ever happened to me,” she says, “but I learned a life lesson: I can’t plan my life in a daily planner. I now focus on what is important — my kids, my family, saying no when I need to, saying yes when I want to, helping people more, and being kinder.”

Lesa Brown (left) and friend

Ashley Page (left) and friend

Your Eyes Are the Windows to Your Health

Did you know that countless medical conditions can be detected during an eye exam?

The most common medical diagnoses detectable are diabetes and hypertension. These medical diagnoses can cause hemorrhages and swelling in the retina that may need treatment. Worsening eye findings could indicate deteriorating disease processes in the body and vice versa.

Your eye doctor can see signs of medical conditions such as Lupus, sarcoidosis, cancer, anemia, cardiovascular disease, and high cholesterol, to name a few more. In addition, infections from viruses, fungi, parasites, and bacteria can also manifest in the eye.

Sometimes a medical diagnosis is first found by a thorough eye exam. Your eyes can also reveal how the body is healing or responding to medical treatment. A healthy eye can reflect a healthy body.

Your eye doctor can tell a lot from looking into your eyes. So don’t forget to keep your eye doctor’s appointment. There’s a lot more than meets the eye!

Our doctors at Eye Specialists of Mid-Florida offer personalized eye care of the highest quality. To schedule an appointment or learn more about our services, please visit our website, EYESFL.com, or call us at 800-282-3937.

SAVING LIVES

AdventHealth Creates Test to Quickly Detect Deadly Amoeba Infections

by TERESA SCHIFFER

AdventHealth shared some news that’s pretty exciting for anyone who likes to enjoy freshwater lakes in warmer climates. Scientists have recently developed an effective test to determine whether an individual has been infected with any of three of the most common deadly amoebas lurking in our local lakes.

It’s an announcement that has been highly anticipated by the parents of the late Jordan Smelski, an 11-year-old boy who died in 2014 after contracting the Naegleria fowleri amoeba while playing in hot springs during a vacation to Costa Rica. Jordan was an energetic youngster who loved baseball and soccer, horseback riding, and swimming. He was a bright student with a cheery demeanor, and he loved his family and friends dearly. Memories of Jordan are cherished by those who knew him.

To honor their son, parents Steve and Shelly Smelski established the Jordan Smelski Foundation for Amoeba Awareness to increase awareness of the dangers of Primary Amebic Meningoencephalitis (PAM).

These amoebas thrive in warm freshwater environments that contain plenty of nutrients, such as Florida’s lakes. They are able to enter the human body through a swimmer’s nose, where they then travel to the brain via the olfactory nerve. Once the organism reaches a person’s brain, it releases toxins and metabolic waste, and that, in conjunction with the body’s natural immune reaction, causes the symptoms of PAM.

PAM is characterized by symptoms such as headache, fever, nausea, and vomiting, which can appear within one to seven days after infection. As the disease progresses, more symptoms can manifest, including confusion, stiff neck, seizures, and hallucinations. Once the first symptoms appear, PAM usually causes death within five days.

Scientists have been working on this important test for several years but experienced a delay when research was halted to direct research

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: Selina Lin, M.D., is a board-certified ophthalmologist and Retina Specialist. She sees patients at the Haines City, Sebring, and Winter Haven locations for Eye Specialists of Mid-Florida.

DR. SELINA LIN

management company for homeowners associations & condominiums

CarePlus

$145 back every month on your Medicare Part B premium –that’s $1,740 a year back in your pocket!

$0 copay for primary care physician office visits and $20 copay for specialist office visits

$0 copay for prescription drugs (Tier 1 and 2)1 – even during the gap

$125 daily copay for hospital stay days 1 to 4

$0 copay for for routine dental coverage, including dentures2 PLUS

1From a preferred cost-share retail or mail-order pharmacy. 2One set of complete or partial dentures every five years. Hillsborough, Pasco, and Pinellas counties. CarePlus is an HMO plan with a Medicare contract. Enrollment in CarePlus depends on contract renewal. Referrals and/or authorization may be required for certain specialists. Every year, Medicare evaluates plans based on a 5-star rating system. CarePlus Health Plans, Inc. complies with applicable Federal Civil Rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender, gender identity, ancestry, marital status, or religion in their programs and activities, including in admission or access to, or treatment or employment in, their programs and activities. Any inquiries regarding CarePlus’ non-discrimination policies and/or to file a complaint, also known as a grievance, please contact Member Services at 1-800-794-5907 (TTY: 711). From October 1 – March 31, we are open 7 days a week, 8 a.m. to 8 p.m. From April 1 – September 30, we are open Monday - Friday, 8 a.m. to 8 p.m. You may always leave a voicemail after hours, Saturdays, Sundays, and holidays and we will return your call within one business day. Espanol (Spanish): Esta información está disponible de forma gratuita en otros idiomas. Favor de llamar a Servicios para Afiliados al número que aparece anteriormente. Kreyol Ayisyen (French Creole): Enfomasyon sa a disponib gratis nan lot lang. Tanpri rele nimewo Sevis pou Manm nou yo ki nan lis anwo an. H1019_MKBNDMFNPRtampa1040022022_M

October 2022 | CALENDAR

EVENTS AND FUNDRAISERS

October 17 – Stroke Support Group

This group is open to stroke survivors and caregivers. Participants will have to go through a security screening before entry to the building and wear a face mask over their nose and mouth during their visit. Topics for discussion will be determined by the needs of the group. Registration is not required to attend this meeting, which will be held from 4 – 5 p.m. at St. Anthony’s Hospital, Auditorium, 1200 7th Ave N in Saint Petersburg. For more information, please visit www.baycare.org/events or call 855-269-4777.

October 4 – Breastfeeding Support Group

From 10 – 11 a.m. breastfeeding mothers can get together online to support each other and talk with certified breastfeeding consultants for free. Sponsored by St. Joseph’s Women’s Hospital. For more information, please call 855-269-4777 or visit www.baycare.org/events.

October 4 – Life After Childbirth

If you are currently pregnant, or have delivered a child within the last year, this in-person support group can help you learn how to handle the challenges and adjustments that come along with having a new baby. Please bring your own diapering supplies, and be prepared to wear a face mask that covers your nose and face throughout your visit. This group will meet from 10 a.m. – 12 p.m. at Mease Countryside Hospital, Entel Education Center Room 1 & 2, 3231 McMullen Booth Rd in Safety Harbor. You can register online by visiting www.baycare.org/events, or call 855-269-4777 for more information.

October 11 – How to Be a Long-Distance Caregiver

This is a Dementia Caregiver Connection Education Program to help empower caregivers of individuals who are affected by dementia or Alzheimer’s disease with the knowledge and skills needed to care for both themselves and their loved ones or patients. This session will take place from 10 –11:30 a.m. at Center for Health & Wellbeing, located at 2005 Mizell Ave in Winter Park, FL. Please contact Shannon to RSVP at (407) 236-9997 or Shannon.Manning@VisitingAngels.com.

October 20 – Ribbon Cutting for the Center for Independent Living in Central Florida

This nonprofit will provide programs and services to individuals with disabilities in Central Florida. The ribbon cutting will take place from 4 – 4:30 p.m. at 2025 Crystal Wood Dr, 2nd floor, in Lakeland. If you have any questions, you can reach out to Brittany Pilcher at bpilcher@cilorlando.org.

October 23 – Let’s Talk Puberty for Boys

St. Joseph’s Children’s Hospital is sponsoring this informative session for boys ages 10 to 13 to help them understand the physical and emotional changes of puberty, the male reproductive system, and ways to maintain a healthy body during the first half of the class. The second half will give an overview of the female changes of puberty, female reproductive system, and a discussion of conception and abstinence. This course is $35 and will be held from 1 – 4 p.m. at St. Joseph’s Children’s Hospital. For more information, please call 855-269-4777 or visit www. baycare.org/events.

compiled by TERESA SCHIFFER

October 28 – Breast Cancer Foundation of Central Florida Annual Pink Ribbon Gala 2022

The Breast Cancer Foundation of Central Florida Pink Ribbon Gala presented by the Watson Clinic Foundation is a chance to help support breast cancer patients and their families who are facing situational poverty due to a breast cancer diagnosis while enjoying an evening of cocktails, dinner, dancing, silent and live auctions, and more. Individual tickets are available for $100 each. This event will start at 6 p.m. and be held at Haus 820, located at 820 N Massachusetts Ave in Lakeland. For more information or to purchase tickets, please visit www.bcfcf.org/pink-ribbon-gala.

Men Aren’t Immune to Breast Cancer

While men may not be the first ones to come to mind when you think of breast cancer awareness, they can still develop it. Central Florida Health News spoke with Winter Haven Hospital oncologist Dr. Hassan Ebrahim to learn more about breast cancer in men.

Health News: What percent of breast cancer occurs in men?

Ebrahim: Breast cancer is rare in men. It represents between 0.5% and 1% of all breast cancer diagnosed each year.

Health News: Why is it less common for men to develop breast cancer?

Ebrahim: There are cancers that are predominant in men and others in women. Breast cancer is predominantly a female cancer. Many reasons may lead to that; some known and some unknown. Men have a small amount of breast tissue, women have more estrogen and genetic differences.

Health News: What symptoms do men experience?

Ebrahim: Men with breast cancer generally present with a painless, firm mass usually behind the nipple. The left breast is slightly involved more than the right. This could be associated with skin changes including nipple retraction, ulceration, or fixation of the mass to the skin. The axillary lymph node might also be enlarged.

Health News: Is the severity of the disease the same as it is for women?

October 29 – Red Ribbon Run and Challenge

InnerAct Alliance and sponsor Publix Supermarkets present this annual Red Ribbon Run around Lake Mirror in Lakeland on Saturday. Students in grades K – 8 are invited to run in timed, grade level heats for the 1K Kids Fun Run, or run/walk with their families in an untimed Family Fun Run. Registration begins at 7 a.m. at Lake Mirror Auditorium, 121 S Lake Ave, Lakeland. The Family Fun Run will start at 8:30 a.m. and the timed heats will begin shortly after. Students can register for free at www.RedRibbonRun.com. Adults pay $5 for the Family Fun Run.

October 29 – Mr. Central Florida

Mr. Central Florida – the 10th Mission is Central Florida Speech and Hearing Center’s premier fundraiser to benefit individuals who need their services but are unable to pay for them. Gentlemen from the community compete for the title by raising funds – every dollar raised equals one vote. Seating for the in-person event is sold out, but sponsors can still attend the event via Livestream. To meet the contestants and vote for your favorite, please go to www.MrCentralFlorida.org.

Ebrahim: Breast cancer in men shares the same characteristic as in women. However, there is a slight difference in some of the biology of the cancer. Also, male breast cancer seems to be diagnosed at a slightly later stage because of a lack of awareness. This makes the prognosis of breast cancer in men slightly worse than in women.

Health News: Men typically aren’t the focus of campaigns promoting self-exams. Do you think this contributes to later detection?

Ebrahim: It could be. There is a lack of awareness of male breast cancer. A man may note something growing in his breast, but he ignores it because he is not aware of the possibility of the development of breast cancer. However, it might be challenging to campaign for breast cancer awareness in men because of its rarity and cost-effectiveness.

Health News: Are there any differences in the way it is treated in men and women?

Ebrahim: Not much. Curative surgery is the mainstay of treatment for early stages of breast cancer in both genders. We offer hormone therapy for men as postmenopausal women. More men than women may require chemotherapy because they present at later stages.

Health News: What factors put a man at a higher risk?

Ebrahim: Genetic and family history such as BRCA1/2 mutations in addition to other genetic mutations, hereditary disorders such as Klinefelter syndrome, increased estrogen as in individuals with testicular disorders such as undescended testes and liver disease.

Health News: Is there anything you’d like to add?

Ebrahim: We should be aware that breast cancer exists in men. A man should seek medical advice if he notes a breast mass. However, gynecomastia, which is an enlargement of male breast tissue, may mimic a breast mass. Gynecomastia may be caused by medications, increased estrogen, decreased testosterone, liver disease, and others. HN

From Savory to Sweet, These Superfoods Will Make You Swoon

by CAROL CORLEY

Early in the 20th century, the term “superfoods” was coined by United Fruit Company to market bananas — a fruit loaded with vitamins and minerals and considered a super healthy snack.

Bananas are still considered a superfood, but they have been joined by berries, green tea, nuts and seeds, kale, collard greens, yogurt, ginger, turmeric, avocado, beets, pumpkin, seaweed, and some fish.

Foods gain reputations as “superfoods” because they boast plenty of nutrients — such as antioxidants, vitamins, minerals, and fiber. In other words, they pack a healthy punch for each calorie. However, Cleveland Clinic said this is not a recognized category by dietitians, and there are no specific criteria to warrant being on the list other than that they are thought to boost the immune system, reduce the risk of cancer, reduce inflammation, and help the heart.

One thing to notice about superfoods is that they are colorful — dark leafy green vegetables, brilliant berries, colorful beets, pumpkin, turmeric, and even salmon.

Different sources included different foods on their lists. However, nearly all included salmon. Let’s start with a couple of ways to enjoy these special foods.

Grilled Salmon with Kale Sauté

(Adapted from eatingwell.com)

Ingredients:

Salmon filets thawed, 2 about 1-inch thick Kale, 6 oz stemless, torn Garlic clove, 1 finely minced Thyme, 1/3 teaspoon fresh crushed

Directions:

Fish should be rinsed and dried with paper towels then set aside. Stir together flavorings and sprinkle on top of filets. Cook on the greased rack of a charcoal grill over medium coals. Grill for about 8-10 minutes, turning once, until fish begins to flake. Meanwhile, in a Dutch oven, cook shallot and garlic in hot oil over medium heat until tender, about 2-4 minutes. Add lemon peel and kale and cook covered for 2 minutes, then uncovered for 6-7 minutes until kale begins to wilt. Turn with long-handled tongs. Serve salmon with kale and lemon wedges.

Alternative: Marinade for Salmon

(Adapted from The Spruce Eats)

Ingredients:

Salmon filets thawed, 2 about 1-inch thick Garlic, 1 clove minced

Extra Virgin Olive Oil, 3 tablespoons Honey, 2 teaspoons

Turmeric, 1-1/2 teaspoons ground Black pepper, 1/8 teaspoon (a necessary addition when using turmeric) Salt to taste.

Directions:

Mix together and rub over salmon prior to cooking by your method of choice. I like to bake salmon in an oven preheated to 450F for about 12 minutes or a bit more. It’s best slightly undercooked.

Garlic powder, 1/4 teaspoon

Shallot, 1 tablespoon finely chopped

Extra Virgin Olive Oil, 1/2 teaspoon

Salt and pepper to taste

Lemon peel, 1/2 teaspoon shredded, plus several lemon wedges

Honey-Ginger Kale Salad

(Adapted from allrecipes.com)

Ingredients:

Kale leaves, 10 oz, stems removed, thinly sliced

Extra virgin olive oil, 2 tablespoons

Apple cider vinegar, 2 tablespoons

Orange juice, 2 tablespoons

Soy sauce, 1 teaspoon (can use low-sodium)

Honey, 1-1/2 teaspoons, local preferred

Ginger, 1-1/2 teaspoons, grated, fresh

Directions:

Whisk together all liquid ingredients except oil, then whisk in oil slowly. Put kale in a bowl, drizzle with dressing and mix well. Kale should be mixed until softened, wilted, and reduced in volume by half.

Mixed Berry Smoothie

(Personal recipe)

Ingredients:

With this smoothie, your imagination is your limit. This is what I use — some or all, depending on what is on hand. Quantity will depend on the number of servings and preference, but I am giving quantities for a single serving. The more frozen fruits you have, the thicker the smoothie will be. Add milk or a tablespoon of hot water to thin it.

Mixed berries — frozen or fresh — strawberries, blackberries, raspberries, 1-1/2 cups

Water, 1/4 cup

Greek yogurt, 1/4 cup

Honey, 1 tablespoon

Banana, can be frozen, 1/2, peeled

Chia and flax seeds, 1 tsp each

Turmeric, 1/4 teaspoon or more to taste

Black pepper, a small pinch

Spinach, small handful of fresh baby, chopped

Protein powder, 1 scoop

Directions:

In a strong blender, slowly add in all ingredients except yogurt and blend as you add. Turn up the power to liquefy. Once you have achieved the consistency you like, slowly blend in yogurt and pour the smoothie into a large glass.

Meet Our Doctor

Dr. Aparajita is a fellowship-trained vascular surgeon and has been serving the Polk County community for the past 1 year. She earned her Bachelor of Medicine and Bachelor of Surgery (MBBS) degree at University of Delhi, India. She then completed a research fellowship in vascular surgery at Columbia University Medical Center in New York and a residency in General Surgery at Staten Island University Hospital in New York, she completed her fellowship training in Vascular Surgery at Newark Beth Israel Medical Center and St. Barnabas Medical Center in New Jersey.

Lymphedema Is a Common Cause of Swelling

Dr. Aparajita is also a Member of the Royal College of Surgeons of Edinburgh, UK (MRCS Ed) and completed her Basic Surgical Training in England soon after her medical school.

LDr. Aparajita is the co-author of more than two dozen journal articles, publications and oral presentations, including topics such as endovascular treatment for thrombosis, aortic aneurysm repair, stroke, peripheral artery disease and other vascular conditions.

Additional posts and volunteer work include a teaching position at Hofstra Northwell School of Medicine and as a Member of the Public and Professional Outreach Committee as well as the International Relations Committee at the Society for Vascular Surgery (SVS).

Dr. Aparajita was recently nominated for the American Medical Association (AMA) Inspiration Award that recognizes physicians who have contributed to the achievements of women in the medical profession.

RITU APARAJITA, MD, MRCS (Ed), MBBS

Specialty: Vascular & Endovascular Surgery

ymphedema, which is swelling caused by obstruction or reflux in the lymphatic vessels, is one of the most common conditions affecting humans. The lymph vessels are long, thin-walled tubes that form a very intricate network in the arms and the legs. In some cases, these lymph vessels are absent or are damaged or destroyed, and lymph fluid accumulates in the tissues of the arm or leg. The accumulation causes severe swelling. There are millions of cases in the United States, many of which have occurred following cancer, radiation therapy, trauma, infection, or other causes like obesity. It is estimated that there are more than 100 million people worldwide with lymphedema. In the developing world, infection (filariasis) is the most common cause of this condition.

Joining KSC Cardiology November 9, 2020

Lymphedema is suggested by limb swelling that occurs spontaneously in infancy or during puberty; it can also develop after trauma, surgery, or infection. It is characterized by limb, ankle, and foot swelling associated with induration and sclerotic (scale-like) appearing skin. The skin typically develops “orange peel” rigidity and the foot and toes are often square or shaped like sausages. There may be an associated venous disease, including chronic venous obstruction, venous incompetence, varicose veins, and other forms.

In its most severe form and when untreated, the foot and leg can swell to double or triple the normal size and patients may find it difficult to find shoes that will fit them. To treat this condition, it is important to rule out underlying chronic venous disease.

In the initial stages of this disease, the swelling in the lower extremity is soft. However, as time progresses, the swelling becomes permanent and the limb becomes hard with a scale-like appearance on the skin.

Next month, I will talk about the diagnosis and management of lymphedema.

This column is sponsored by KSC Cardiology, and the opinions expressed herein may not reflect those of CFHN or of its advertisers.

BIO: Dr. Aparajita is a fellowship-trained vascular and endovascular surgeon. She is a co-author of 20+ journal articles and publications and was recently nominated for an Inspiration Award by the American Medical Association (AMA).

RITU APARAJITA, MD, RPVI KSC Cardiology

On the Cutting Edge

Photodynamic Therapy Effective in Fight Against Skin Cancer

ALEX W. KENNON, MD, FAAD

Photodynamic therapy (PDT) is a medical treatment used to treat precancerous cells, as well as other conditions. It can be used on the skin, eyes, mouth and lungs. The treatment involves using a medicine, such as Levulan Kerastick®, either topically or inside the body, followed by a blue light source to activate the drug.

One common use of the photodynamic therapy system is to treat the precancerous cells found in actinic keratosis. This is a skin condition caused by years of sun exposure that results in rough, dry, scaly patches of skin. It’s often found on the face, scalp or arms. When left untreated, actinic keratosis has about a 5 to 10 percent chance of turning into squamous cell carcinoma, a type of skin cancer.

Along with treatment for precancerous cells in actinic keratosis, photodynamic therapy can be used to treat other conditions as well. It can be used for Bowen’s disease and basal cell carcinoma, two other types of skin cancer, as well as some eye conditions. It can also be used in the treatment plan of very early stages of cancer in the esophagus, mouth or lungs.

The actual treatment is fairly simple and is a great option to avoid surgery later on. First, you’ll be given the light-sensitive medicine. This could be a topical cream, an injection, or a special drink, depending on the treatment area. You may be asked to return in a few days, giving the medicine time to build up in the abnormal cells that will be targeted during treatment.

During the procedure, a lamp or laser will be shone onto the treatment area for 10 to 45 minutes, which may result in a temporary burning sensation. If the area being treated is inside the body, rather than on the skin or eyes, an endoscope may be used to target the correct area.

Most patients will recover quickly, with dressing typically being removed after one day. Your skin might be temporarily red or swollen. A full recovery takes about two to six weeks. Your doctor will reassess whether the procedure should be repeated to get the desired effect.

and the lack of biomarkers for CTC detection to overcome this hurdle. The CTC markers provide little information on the potential of these shed tumor cells, which are normally short-lived, to seed metastatic sites.

Khaled and a team of researchers at UCF published a paper on Chaperonin containing TCP1 as a marker for the identification of circulating tumor cells in the blood. They looked at the possibility that using the chaperonin-containing TCP1 or TRiC could be a more accurate alternative to simple CCTs. TRiCs are markers to detect the CCT2 that have been shown to inversely correlate to cancer patient survival. They demonstrated the CCTS staining could be incorporated into existing CTC protocols and provide biologically relevant information. This research brings us a step closer to less invasive diagnostic techniques allowing doctors to track the progression of cancer in their patients without the use of traditional tissue biopsy.

Khaled sees the use of exosomes as markers as being the next big technique for cancer dictation and treatment. Funding for cancer research has slowed as resources were reallocated for Covid-19. Although the funds raised have been reduced, the momentum of the research that is ongoing remains strong. The important work of Khaled and the team will continue to advance the search for less invasive cancer treatments and diagnostics tools for patients HN

This column is sponsored by Lakeside Dermatology, and the opinions expressed herein may not reflect those of CFHN or of its advertisers.

Dr. Alex W. Kennon, MD, FAAD, is a board-certified dermatologist who is fellowship-trained in Mohs micrographic surgery. He received his undergraduate and medical degrees from Florida State University and completed his dermatology residency at Medical College of Georgia at Augusta University. Lakeside Dermatology has offices in Sebring and Winter Haven.

MEDICAL ADVICE

Aisha Wright: Unwavering Faith

by TERESA SCHIFFER

Aisha Wright’s journey began with an unusual pang while she prepared for bed one night in 2018.

“I was getting ready to lay down and I felt a pain, a sharp pain, just one, and that made me just kind of feel,” Wright recalls of her detection of an unusual mass. “Mine was a little bit different; it wasn’t down in my breast area, it was up in my chest wall, so it was a little higher than right at my breast, more at the top of my breast. Initially that night I did not know what was going on, so I went to the emergency room and I was actually misdiagnosed. They didn’t find it that night. The physician checked and did not feel the lump then. That just did not sit well with me. I really wanted someone to do a scan or give me a mammogram or something.”

The Winter Haven resident had no family history of breast cancer, but she scheduled an appointment with her doctor right away. After feeling the lump, he sent Wright to get the mammogram.”

Learning she had cancer at age 40 was a shock, she says. She was fearful but soon found the strength to persevere.

“I knew that I was a fighter, and I just believed what God said,” Wright explains. “I prayed, and He told me it didn’t come to kill me, and so I stood on that. I stood on the word of God, on what God had told me during my prayer time.”

Her faith and her family were pillars of support that bolstered her through the ensuing battle.

“It’s like your world just stops,” Wright recounts. “I pretty much did everything for my family, not only for my husband but also my sisters and my brothers. So for me, my first thought was, ‘Oh my gosh, I’m not going to be able to help them.’ ”

Wright’s mother had passed from ovarian cancer in 2012, so Wright had assumed the matriarchal duties of helping her siblings. The last thing she wanted was to cause them concern.

Her family was deeply concerned nonetheless but supportive as Wright began treatment. While her husband worked, her siblings accompanied her to 12 rounds of chemotherapy over six months, followed by 16 rounds of radiation treatments over seven weeks.

The treatments were exhausting. She lost weight, she lost her hair, but Wright never lost faith. The experience was physically draining, but not so spiritually. She leaned on her faith and sought counseling with her pastor.

Wright committed to minimizing how her struggle affected others. She arranged her schedule so treatments would not interfere with her work as director of a nonprofit organization providing assistance to the needy. Upon completing chemotherapy, she released a video revealing what she had been enduring.

“For me, that was freeing,” Wright says. “At that point, I was really able to embrace it. I no longer wore wigs, I walked around with my bald head. And because of what I did, people realized that I was still being of service to other people, even in the midst of my own trials.”

Wright also wrote a book about her journey, titled “My PINK Is Powerful,” and published it on Amazon. HN

Take a Stand Against Breast Cancer

by DR. JOY JACKSON

Getting diagnosed with breast cancer at any stage is a frightening prospect, but getting diagnosed early can make a difference. During National Breast Cancer Awareness Month this October, we want to remind you of the importance of first, carefully evaluating your risk, and second, early detection through screening.

The first step in evaluating your risk for breast cancer is being aware of your family history and discussing it with your doctor. A woman’s risk for breast cancer is higher if she has either a mother, sister, or daughter who has had breast cancer or multiple family members on either her mother’s or father’s side of the family who have had breast cancer.

After evaluating your family history, you should discuss the best schedule for screenings with your doctor. A woman’s best defense against breast cancer is early detection screening. Breast cancer screening does not prevent breast cancer but can detect it early on, making it easier to treat. A mammogram is usually the best way to detect breast cancer early. There are several guidelines that differ about when or how often someone should be screened for breast cancer, you should discuss with your doctor which set of guidelines is best for you. American Cancer Society guidelines state that women aged 40 to 44 years should have the choice to start mammography screening once a year and women aged 45 to 49 years should be screened with mammography annually. Although it is rare, men can also get breast cancer. About 1 out of every 100 breast cancers diagnosed in the United States is found in a man. Both men and women should be aware of common symptoms of breast cancer:

• A lump or swelling in the breast or underarm.

• Redness or flaky skin in the breast.

• Irritation or dimpling of breast skin.

• Nipple discharge.

• Pulling in of the nipple or pain in the nipple area. Many factors can influence your risk of breast cancer, some of these factors, such as family history, cannot be changed, but you can influence other factors. To reduce your risk of breast cancer you can maintain a healthy weight, exercise regularly, limit alcoholic drinks, and breastfeed your children, if possible. You can stay two steps ahead by evaluating your risk and staying on top of your health screenings. Learn more about breast cancer by visiting cdc. gov/cancer/breast. HN

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.

Aisha Wright

Saving Lives

resources to the pandemic.

Dr. Jose Alexander, the Medical Director of the Microbiology, Virology and Immunology Department for AdventHealth Central Florida, led the team devoted to creating the new diagnostic tool. The test is similar to the tests now used for COVID detection, except that instead of a nasal swab, the amoeba test requires a sample of cerebrospinal fluid from the patient. Test results can be determined within five hours.

In a recent press conference, Alexander explained how the innovative test detects microorganisms.

“This test is looking for the presence of DNA from the three most common, free-living amoebas that we find in freshwater bodies,” Alexander explains. “If a specific sequence of the DNA from these amoebas is present in the specimen, the test is going to amplify, or replicate, this sequence, to make it available for the instrument to identify.”

Dr. Vincent Valente, Emergency Medicine Physician with AdventHealth, worked on Jordan Smelski’s case, and as a father of three who enjoys swimming and being outdoors with his family, he was affected profoundly by Jordan’s passing. From that experience, Valente realized the importance of clinicians asking the right questions during their time with patients and the families of patients. Patients who present with symptoms consistent with these types of infections should be screened for the possibility of recent freshwater exposure.

Valente spoke briefly on behalf of emergency room doctors at the online press conference, saying, “This revolutionary test will help us confirm the diagnosis expeditiously, enabling us to initiate the proper treatment sooner, thus allowing the patients to hopefully survive this possibly lethal illness.”

The Smelskis were also on hand at the conference.

“For me, this is just game-changing as a life-saving opportunity for other families, and that’s really what we want, is children’s lives to be saved,” Shelly Smelski says.

Prior to the development of the test, the only option available for accurately diagnosing this type of infection was a PCR test that was exclusively accessible through the CDC. For that test to be done, a clinician needed to communicate with the CDC regarding the details of the patient’s case, and then, with the CDC’s approval, a specimen had to be preserved and transported to the nearest Health Department.

This new test has been released for use by physicians throughout Florida and the rest of the nation. HN

Fall 2022 Health Expo

October 14

International Market World 1052 US 92, Auburndale, FL 33823

Affinity Dental

Central Florida Media Group offers professional content marketing, niche advertising, website development, SEO, social media management, publicity, blogs, videography and more.

Topping the List

JESSICA McDONALD, EDITOR jessica@centralfloridamediagroup.com

Lakeland recently found itself at the top of a list, but there aren’t too many people who are excited about it. According to the Asthma and Allergy Foundation of America, the city ranks as the worst place in the south to live if you have asthma, and fourth of the top 100 metropolitan areas in the country, following Detroit, Cleveland, and Allentown, PA.

Now, we’ll be the first to tout the countless benefits of living in Central Florida. It’s the perfect mix of urban, suburban, and rural areas, meaning we have something for everybody. Just as there are upsides and downsides in most scenarios, that mix can spell trouble for the 25 million Americans who suffer from asthma.

Our blooming flowers and lush trees mean pollen is out in force. On top of that, ragweed and mold peak in September and October, and the start of cold and flu season further compounds symptoms for those who struggle with asthma.

So what can you do?

The AAFA offers the following tips for staying healthy and mitigating asthma complications:

• Get the flu shot

• Know your triggers

• Use an air filter in your home

• Remove your shoes before entering your home

• Keep the doors and windows closed

• Get plenty of sleep and eat a healthy diet

• Stay on top of your symptoms so you can intervene before they get worse

The good news is that Central Florida is lucky enough to have many talented healthcare providers who are qualified to treat asthma. Take advantage of the resources in our area to stay healthy and manage your asthma. HN

Mental Health Is an Important Part of Surgery Recovery

by MARY JOYE, LMHC

Modern medical surgical techniques have come a long way. Less invasive procedures call for less hospital time. However, our primitive healing responses set a pace that may be less than what we expect in this age of instant gratification. Much like the emotional grieving response, any serious life event takes time to process and to find balance, which is referred to as homeostasis. Homeostasis is achieved through incremental adjustments and time. Perhaps this is why we call those undergoing medical treatment, “patients.” You must be patient to heal properly.

It is difficult to be patient with our bodies when we want to get back into living our fullest life as quickly as possible. However, it is important to rest after any major surgery or traumatic life event and not to push yourself too far too fast. Your medical team will tell you what is the best course of action for physical recovery, and it is crucial for you to tell them how you feel, too.

But what about mental health issues surrounding surgery? A 1989 article titled “Psychological Consequences of Surgery” by O’Hara et al, published through PubMed.gov shares statistics about mental health aspects of surgery. In a study, 10.9% of people felt anticipatory anxiety before surgery, which is understandable. Depression, trauma symptoms, or anxiety were reported in 13.9% of patients in the three months following surgery.

When we heal physically, we can visually note progress and understand the expected guidelines of the process. However, with mental issues, there are far more complex and individual differences that make recovery less predictable. Factors such as age, pain management, social support, financial means for proper care, and memory or cognitive impairment from anesthesia are components that may contribute to individual rates of recovery. Healing is not a one-size-fits-all process.

It is important to discuss with your doctor what recovery may look like for you, not just

physically but mentally. Pain can exacerbate anxiety and depression symptoms. If the surgery was invasive, sudden, serious, or with complications, post-traumatic stress disorder symptoms may develop. It is not necessarily true that time heals all wounds. Time can make the invisible wounds of mental health issues more serious and a quick recovery may be impaired. This month’s subject of breast cancer awareness is but one major surgery where mental health recovery may be more complicated and subjective.

If you or someone you know is having difficulty with surgical recovery and mental health issues, there are ways you can help.

1. Be compassionate and empathetic.

2. Do not judge where a person is mentally. Be patient with a patient, or yourself if you are the patient.

3. Honor requests such as visitation desires or a wish for solitude.

4. Do not compare one person’s surgery to another. Healing or trauma is not a competition.

5. Listen but do not offer unsolicited advice.

6. Be cognizant of any negative effects of anesthesia and pain management.

7. Allow yourself or others time to heal at a relaxed pace.

8. Medical advice should come only from physicians or a trusted team of providers. Resist interjecting medical or mental health opinions.

9. Respect the right to privacy. No one has to discuss or defend medical or mental health issues or their healing progress.

10. Discuss what the future will look like after recovery without putting pressure on the time or date.

Healing is a deeply personal journey. Honor the sacred process and a person’s requests. This will be supportive and will increase mental wellness, which is always a necessary component of recovery. 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.

“I put my heart into saving yours.”

It’s not just an ID badge. It’s a badge of honor.

At Winter Haven Hospital, we give you compassionate, highquality care in a comfortable atmosphere. Our Bostick Heart Center focuses on providing a full continuum of cardiac care to the communities of central Florida. You’ll get cutting-edge heart care at our center, which can now meet the growing demand for minimally invasive procedures that include transcatheter aortic valve replacement (TAVR) and WATCHMAN™. And our state-of-the-art catheterization labs and intensive care units use the latest technologies. At Winter Haven Hospital, we make sure you’ll receive the extraordinary heart care you deserve. Learn more: WinterHavenHeart.org