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FROM THE PUBLISHER
Iam pleased to bring you another issue of Florida MD. I can only imagine the emotional and physical trauma that a woman goes through when she has a mastectomy. The procedure affects not only her body, but her mind and her self-esteem. Now add in the inability to not be able to reconstruct her breasts and give that part of her life back, because she’s uninsured or under insured, and it becomes an unthinkable crushing blow. Fortunately there is My Hope Chest to help women who are unable to afford reconstructive surgery. I asked them to tell us about their organization and how you, as physicians, can help. Please join me in supporting this truly wonderful organization.
Best regards,
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Donald B. Rauhofer Publisher
MY HOPE CHEST — Making Women Whole Again
In 2010, more than 22,000 uninsured women lost their breasts to cancer and were left disfigured, deformed and feeling “less than whole.” How many years has this figure been growing? Many organizations raise funds for research, education and “awareness” of breast cancer. Most have no idea there lies a huge gap in assistance for delayed reconstruction and co-pays for survivors wanting this surgery. My Hope Chest is the ONLY national 501c3 non-profit organization focused on funding breast reconstruction for the uninsured and under insured survivors. Our services “pick up” where other breast cancer organizations leave off… providing the “final step in breast cancer treatment. ” My Hope Chest is about addressing the needs of survivors now. Through wonderful surgeon partnerships we are able to transform the lives of breast cancer survivors who otherwise have no hope of reconstruction. We hope to hear from you to learn how we can work together to eliminate our wait list and take action to help every woman who desires reconstruction after mastectomy and feel restored in body, mind and spirit. Wish List • Surgeons to create awareness for My Hope Chest and to identify new clients • Doctors of Distinction- Surgeon partners nationwide to join our program. • Corporate partners, interested in Win-Win, Commercial- coventure marketing campaigns promoting their product or service by sharing our vision to make sure there is always coverage for reconstruction surgery.
For additional information on how you can help or refer a patient please go to www.MyHopeChest.org.
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Publisher: Donald Rauhofer Photographer: Donald Rauhofer / Florida MD Contributing Writers: John “Lucky” Meisenheimer, MD, Daniel T. Layish, MD, Ramamoorthy Nagasubramanian, MD, Scott Bradfield, MD, MBA, Andy Kolb, MD, Naina Mehta, MD, Sonda Eunus, MHA, Michael Patterson NHA, OTR/L, CEAS, Juan Lopez, Pharm D, Pragati Gusmano, ND, John Meisenheimer, VII, Art Director/Designer: Ana Espinosa Florida MD is published by Sea Notes Media,LLC, P.O. Box 621856, Oviedo, FL 32762. Call (407) 417-7400 for more information. Advertising rates upon request. Postmaster: Please send notices on Form 3579 to P.O. Box 621856, Oviedo, FL 32762. Although every precaution is taken to ensure accuracy of published materials, Florida MD cannot be held responsible for opinions expressed or facts expressed by its authors. Copyright 2021, Sea Notes Media. All rights reserved. Reproduction in whole or in part without written permission is prohibited. Annual subscription rate $45.
By Michael Patterson, NHA, OTR/L, CEAS
A recent study published in the September 2020 edition of the Drug and Alcohol Review, determined that the use of medical cannabis does not create a cognitive decline in Senior Citizens. The link to the study is below:
https://onlinelibrary.wiley.com/doi/10.1111/dar.13171
The study was performed by Sharon R. Sznitman PhD, Senior Lecturer, Simon Vulfsons MD, Director, David Meiri PhD, Lecturer, Galit Weinstein PhD, Senior Lecturer at Israel’s Haifa University School of Pubic Health. The study included 125 cannabis users who were 50 years and older. Out of the 125 study participants, 63 had Israeli government permission to used cannabis and 62 did not have permission to use cannabis from the Israeli government.
Each participant was put through a multitude of tests consisting of CogState computerized brief battery used to assess cognitive performance of psychomotor reaction, attention, working memory and new learning. Regression models and Bayesian t‐tests examined differences in cognitive performance in the two groups. Furthermore, the associations between Medical Cannabis use patterns (dosage, cannabinoid concentrations, length and frequency of use and hours since last use) with cognition were assessed among Medical Cannabis licensed patients.
Patients were tested before use of Medical Cannabis and after use of Medical Cannabis. The result of the study showed no detectable difference in cognitive ability before or after use of medical cannabis.
Dr. Sharon Sznitman and Dr. Galit Weinstein noted that the results of the study do not show any widespread change on cognition in older chronic pain patients. Considering use of medical cannabis is increasing in older populations, this study could be a first step towards a better risk-benefit assessment of the use of medical cannabis with Seniors. The researchers also noted that “previous studies have shown that medical cannabis can have long-term effects on the brain when consumed at a young age. Those affects are not necessarily the same when consumed in old age.” ANALYSIS
Senior Citizens are the fastest growing demographic of users of Medical Cannabis in the United States. With over 435,000 medical cannabis patients in Florida and the average age of a medical cannabis patient over 50 years old, many Seniors are currently using medical cannabis. However, these numbers could be considered the “tip of the iceberg”. As more senior citizens become comfortable using medical cannabis for their diagnoses with less side effects and more relief than traditional pharmaceutical medications, we will see many more seniors starting to use medical cannabis into 2021 and beyond.
Physicians and health care organizations need to educate seniors on the benefits of medical cannabis and begin to track the data related to outcomes of seniors who take cannabis as a medicine. Not only is medical cannabis safer than traditional pharmaceuticals (for most patients), but it is also more cost effective for health care organizations (ACOs) for cost of care per patient. The evidence is in the data. As more ACOs and health care entities start to track the data around use of medical cannabis and see better outcomes and decreased cost of healthcare within their system, you will see more acceptance of medical cannabis as a medicine within the current healthcare community.
Michael Patterson NHA, OTR/L, CEAS is CEO of US Cannabis Pharmaceutical Research and Development LLC. (uscprd.com). Mr. Patterson is a healthcare executive with over 25 years experience in the following areas: Cannabis-Hemp investment, Law, Regulation, Compliance, Operations, and Management, Skilled Nursing, Pharmacy, Laboratory, Assisted Living, Home Healthcare, and Healthcare Analytics. Michael is a subject matter expert in the Global Cannabis and Hemp Industry with Gerson Lehrman Group (glg.it) and Guidepoint. Mr. Patterson is an editorial board member of the American Journal of Medical Cannabis, licensed Nursing Home Administrator, and licensed Occupational Therapist in 4
states.
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AdventHealth Medical Group:
Providing Top Comprehensive Head and Neck Surgery Care to Central Florida
By: Staff Writer
AdventHealth Medical Group Otolaryngology-Head and Neck Surgery has been specializing in the treatment of benign and malignant tumors of the head and neck area for the past nine years. The program has been so successful in treating patients across central Florida that it has expanded with a second location. J. Scott Magnuson, MD, FACS is the medical director of the program. He explains, “Our first location was opened in 2012 on the campus of AdventHealth Celebration. With the program growth, and many patients seen from Seminole, Flagler, Volusia and Brevard counties, a decision was made to expand the program to the AdventHealth Altamonte Springs campus. This location will better geographically serve the head and neck cancer patients who live in those counties.” COMPREHENSIVE CARE
The AdventHealth Head and Neck Oncology program includes a multidisciplinary approach to the care of the head and neck cancer patient. The team includes doctors from medical and radiation oncology, head and neck surgeons, a speech and swallowing therapist, a cancer dietician, physician assistants, social workers, and specialized head and neck oncology nurses. While treatment for these patients happens daily, the multidisciplinary team meets weekly to discuss patient cases and make recommendations for the most advanced, state-of-the-art, personalized care.
Dr. Magnuson was recruited by AdventHealth from the University of Alabama-Birmingham in 2012. During his 18 years at UAB, Dr. Magnuson led the residency training program in Otolaryngology-Head and Neck Surgery (ENT) as well as formed part of the team that cared for patients with head and neck cancer. He is best known for his work in pioneering minimally invasive surgery for patients with tumors of the pharynx. He was part of the team that developed the roboticassisted surgery procedure to remove tumors from the tonsils and deep portions of the tongue and larynx.
The goal for recruiting Dr. Magnuson was to build a comprehensive head and neck oncology program that was at the level of an academic, tertiary care center. Prior to his arrival, many patients with head and neck cancers were referred to other centers many miles outside of the Orlando area. Quickly the program was established, so that today, all head and neck cancer patients may be treated here, close to home, and not travel long distances.
“The resources that AdventHealth has allowed us to develop and build for our patients has been unbelievable,” says Dr. Magnuson. “The commitment this organization has for the best care for the patients in Central Florida is truly remarkable.”
With those resources, Dr. Magnuson has been successful in recruiting head and neck surgeons to AdventHealth. One of the recruited surgeons is Bruce Haughey, MBChB, MS, FRACS, FACS, a renowned surgeon and researcher who is a leading expert on cancers related to human papilloma virus (HPV) infections. Both Drs. Magnuson and Haughey publish on this area of head and neck cancer and present the data at local, national and international conferences. Dr. Haughey was a member of the American Joint Committee on Cancer (AJCC) where a new staging system was made specifically
Dr. J. Scott Magnuson demonstrates robotic surgery at the Nicholson Center, AdventHeath’s state-of-the-art surgical training facility.
for HPV-mediated cancers of the tonsils and base of tongue.
Another area of need in the surgical treatment of head and neck cancer patients was with reconstructive plastic surgery. Many times, large tumors involve important structures of the mouth and throat area. Reconstruction of these areas is necessary to allow the patients to continue to eat and speak after surgery. “Unfortunately, we see many patients that require removal of the mandible, or even the entire tongue,” says Dr. Magnuson. “Thankfully we can offer the complex reconstruction of those body parts by using bone from the leg, or tissue from the arm or thigh, and rebuild their mouths so they may still speak and eat.”
The surgeries that the team performs do not stop at large invasive tumors or tumors of the pharynx. Dr. Magnuson and his colleagues also perform thyroid and parathyroid surgeries, skin cancer surgery, surgery of the salivary glands, and removal of tumors from the skull base. “We are able to perform surgery of the entire head and neck area with the exception of the brain and spine” explains Dr. Magnuson. QUALITY AT THE CORE
“We believe patients are best taken care of in a high-volume facility where they can stay within the organization and not have to go to other places to search for care,” Dr. Magnuson
Dr. Magnuson and his PA review a patient’s scans post-surgery.
Dr. James Bekeny, Head and Neck Surgeon, examines a patient during a consultation.
said. “This comprehensive approach streamlines the care for the patient, allows for timely treatment, and gives the patient a sense of safety because there is an entire connected team looking after their needs.”
Always on the cutting edge, the AdventHealth team leads clinical trials aimed at offering the latest treatment plans for head and neck cancer patients. These trials include the newest immunotherapy treatments as well as novel surgical procedures intended to reduce the side effects of treatment. An example is a surgical clinical trial for patients with HPV-mediated cancer of the tonsils. “We believe the treatment for these patients may include less radiation and chemotherapy and still provide the excellent cure rates” states Dr. Magnuson. “AdventHealth is the only center in the state of Florida that can offer this surgical clinical trial to those patients.” A STREAMLINED REFERRAL PROCESS
From the outset, Dr. Magnuson wanted to assure that referrals to the head and neck oncology program were easy. He recognized that it may be difficult for referring providers to get a timely appointment for a patient. “For best patient care, we must see the patient as soon as possible in the office and then begin the care journey for the patient right away” Dr. Magnuson says. To accomplish this priority, a single phone number has been made available for patient referrals. Provider offices and patients may call 407-303-4120. This number serves the offices at both Celebration and Altamonte Springs. Staff are trained to get the patient in quickly to the best location for the patient. The
The Head and Neck Surgery team collaborates to perform a procedure on an oncology patient.
doctors in the head and neck surgery group are committed to seeing a new patient within a week, if needed. BETTER ACCESS
With the addition of its Altamonte Springs location, the AdventHealth Medical Group Otolaryngology-Head and Neck Surgery team can provide even better service to cancer patients in Central Florida. And, with the ability to provide care that matches that of a tertiary academic medical center, AdventHealth is the premiere comprehensive head and neck surgery program in Central Florida. For more information, call 407-303-4120.
J. Scott Magnuson, MD, is a board-certified otolaryngologist - head and neck surgeon at Otolaryngology and Head and Neck Surgery in Celebration. He possesses advanced training in robotic-assisted surgery, is a leading authority on transoral robotic surgery (TORS), and specializes in helping patients with cancers of the head and neck. His areas of expertise include advanced head and neck surgery, tumor removal, skin cancer surgery, airway surgery, thyroid and parathyroid surgery, reconstructive surgery and voice and swallowing disorders. Dr. Magnuson is an award-winning surgeon whose credentials include his medical degree earned at the University of Texas Medical School in Houston as well as his internship in general surgery and otolaryngology residency at the University of Alabama at Birmingham.
During a procedure, the surgeon uses a microscope to hyper-focus on the surgical site, sparing surrounding healthy tissue.
SERVICES PROVIDED
• Surgical treatment of head and neck tumors • Endocrine surgery (thyroid and parathyroid) • Endoscopic/open repair of esophageal diverticula • Surgical management of sleep apnea • Advanced reconstruction including flaps and free flaps • Clinical trials • Minimally invasive surgery including transoral robotic surgery (TORS) and transoral laser microsurgery (TLM) • Skull-base surgery including temporal bone
