No. 7 • November • 2009
THE BEST INFORMATION IN YOUR HANDS
Also in this issue
Health care Reform ...................2 Spotlight on nuclear medicine ...3 8 foods that fight fat ..................4 Medical Community Business
Networking ................................5
SERVING PALM BEACH COUNTY AND SURROUNDING AREAS
www.floridahealthnews-online.com
Governor Charlie Crist Supported by Area Physicians for U.S. Senate
Pot Legalization gains momentum in California ...............................6 Listen to your feet......................7 5 breakfasts that burn fat ..........8
How Xbox can help fight heart
disease ....................................10 Near half of swine flu patients
otherwise healthy ....................12 How healthcare reform could get
you hired..................................13
Swine flu vaccine arriving, but
don’t line up yet .......................14
Palms West Hospital and
Wellington Regional Medical
Center kick off a fundraiser for Elizabeth Benaquisto for the
Florida Senate at the home or Dr. & Mrs. Sharma ........................15
The event attended by prominent area physicians and business owners was applauded by Governor Crist as he began his bid for the U.S. Senate. From left to right: Seema Dass, Dr. Kishore Dass, Sarojini Tripuraneni, Nirmala Tripuraneni, Carole Crist, Governor Charlie Crist and PAGE 11 Dr. Krishna Tripuraneni.
Independent Imaging/Advanced Diagnostic Solutions are proud to announce the Grand Opening of our State of the Art Diagnostic Center at 3347 State Road 7 in Wellington, Florida. • • • • • • •
High Field MRI 64 Slice CT Scans Digital XRay Nuclear Medicine Cardiac Stress Tests MRA Ultrasound
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561.795.5558 to schedule an appointment or speak to one of our associates FLORIDA HEALTH NEWS P.O. Box 542527 Lake Worth, FL 33454-2527
Please call WEST PALM BCH, FL PERMIT NO. 1340
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PRSRT STD U S POSTAGE
Health Care Reform
2 NOVEMBER • 2009
I
s there anyone out there who would oppose the present health care reform being debated in and outside Washington, D.C.? I for one as an independent minded person would give my opinion, which definitely does not follow any party line. My belief is that there is no Left or Right as some news channels would profess. What I support is affordable health care for everyone, be it for the poor or not so poor. I have heard enough debates about how health care reform should focus on the poor, and not the well to do that can afford their own premiums. Health care is not about poor or rich, since there are the so called well to do who really cannot afford the high monthly premiums that takes away a sufficient portion of their monthly pay checks. They too are suffering the burden of these large insurance premiums and this should not be ignored. Sooner or later, without health care reform the private insurance companies would enjoy a free for all as they are doing right now, and this would make matters worse to those who feel stretched paying high premiums. The media has often ignored the above facts. A segment of the so called insured which could run in the tens of millions would possibly not be able to afford their own health insurance, thereby adding to the present 46 million uninsured. Without Public Option as an option, matters would definitely get worse for the insured. Healthy competition with Public Option in play would definitely drive down costs for Americans. On the other side of the coin, who is going to pay for all this…??The Tax Payer!!! In the coming years I foresee the middle class sector being taxed to pay the health care bill despite Obama’s campaign promise “No Taxes for the Middle Class”. Taxing the upper 1% or 2% rich Americans for the health care plan is not going to fly financially.
FLORIDAHEALTHNEWS-ONLINE.COM
By Larry Ford
What about tort reform? Tort reform means capping malpractice awards to a certain dollar amount. If tort reform is not put into place, there would be several frivolous malpractice suits against physicians, and the cost is carried down to the taxpayer. Tort reform is a must with Public Option.
Obama’s health care plan would force physicians to order less tests that may sometimes be needed by the patient. It would put the fear in physicians, that if you order ‘too many tests’ as defined by the bureaucrats then physicians could face being profiled and be part of the statistics in Washington. Those physicians that do not fall within the curve would be potentially penalized (being terminated from the plan).
I would leave it up to you to make a decision for the type of health reform this country needs based upon the points I have put forward. If there is no TORT REFORM there will definitely be a shortage of doctors operating under Obama’s Health Care Plan, which would make it similar to some insurance companies that went bankrupt because many doctors opted out of there panel. This will cause patient dissatisfaction when there are not enough doctors on the plan, and the result is that insurance companies collapse. Without doctors no Insurance Plan can survive. A hospital having no doctors on staff would leave behind just a concrete structure. In the same manner if there are no doctors affiliated with an Insurance Plan, that plan whether it be a government one or a private one will fail. No Doctors…No Insurance. No Doctors…No Hospitals….
CONTACT US P.O. Box 542527 Lake Worth, FL 33454-2527 Phone: 561-716-5054 info@floridahealthnews-online.com SALES & ADVERTISING Grace Edwards Phone: (561) 319-6919 sales@floridahealthnews-online.com PUBLIC RELATIONS Phone: (561) 267-5232 WEB SITE www.floridahealthnews-online.com CONTRIBUTING ARTICLES U.S. Department of Health and Human Services, Contexto Latino, ARA Content, Hispanic PR Wire, Centers for Disease Control and Prevention, METRO Editorial Services, Family Features,
Florida Health News is a newspaper published every month in Broward, Palm Beach, and surrounding areas. Copyright 2009, all rights reserved by SEA Publications, Inc. Contents may not be reproduced in any form without the written consent of the publisher. The publisher reserves the right to refuse advertising. The publisher accepts not responsibility for advertisement error beyond the cost of the portion of the advertisement occupied by the error within the advertisement itself. The publisher accepts no resposibility for submitted materials. All submitted materials are subject to editing.
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BOYS & GIRLS CLUBS OF PALM BEACH COUNTY The Boys & Girls Club of Wellington is delighted to welcome Drs. Arthur Hansen and Lori Lane Hansen as the Chairpersons of the 22nd Annual Boys & Girls Club Wellington Dinner Dance. The Dinner Dance, themed “Mardi Gras Masquerade”, will take place the evening of Saturday, December 5th at Wycliffe Golf & Country Club. The black-tie optional event is known for kicking off the busy social season in Wellington. It will begin with a cocktail reception and silent auction followed by dinner, dancing and a spectacular live auction. Drs. Arthur and Lori Hansen started LA Podiatry Group, LLC with offices in Wellington and West Palm Beach. Dr. Arthur Hansen was raised in West Palm Beach and attended Palm Beach County public schools, including the University of Florida. He received his Doctor of Podiatric Medicine from Barry University of Podiatric Medicine in Miami.
NEWS RELEASE
He trained for residency in Miami and New York City. Dr. Hansen’s wife, Dr. Lori Lane, was raised in Texas and graduated from Texas State University. She also received her Doctor of Podiatric Medicine from Barry University but had residency training at Wellington Regional Medical Center. The doctors have three sons, Anthony, Colby, and Alex who attend Equestrian Trails
Elementary and Emerald Cove Middle School in Wellington. They became involved with the Boys & Girls Club of Wellington to help motivate and inspire children to follow their dreams and realize their inner strength no matter what the circumstance. “We hope all children will realize there is not limit to what they can accomplish”, says Dr. Lane Hansen. Ticket prices to the event
are $200 per person and sponsorship opportunities are still available. Proceeds from the Dinner Dance will directly benefit the members of the Boys & Girls Club of Wellington. The Club provides services during nonschool hours, as well as summer camp opportunities, to more than 750 boys and girls from ages 6 to 18. The Boys & Girls Clubs emphasize educational, vocational, social, recreational, health, leadership and characterbuilding skills in a positive and safe atmosphere. Through quality programs, the Club experience provides children with the guidance they need to make a healthy transition from childhood to young adulthood. For more information on sponsorship opportunities for this year’s Wellington Dinner Dance, or to find out more about The Boys & Girls Clubs of Palm Beach County, please call Sara Mariani, Special Events Coordinator, at 561683-3287 or visit www.bgcpbc.org.
NOVEMBER • 2009
FLORIDAHEALTHNEWS-ONLINE.COM
Spotlight on Nuclear Medicine
When you hear the words Nuclear Medicine, what immediately comes to mind? Depending on your knowledge and point of reference, your perceptions may include tests in cold and impersonal environments, extremely painful exams or simplistic images.
A
t Independent Imaging we provide patient-focused care each day, which involves taking the time to explain to patients what their diagnostic test entails and why such a test is being performed. Our Nuclear Medicine department is no exception to this process, and is an area that tends to have the most questions due to the unfamiliarity of the exams themselves.
Like other common exams such as x-ray or MRI, Nuclear Medicine is an incredibly safe and relatively painless way of capturing detailed images necessary for diagnostic purposes. Unlike other imaging services, however, these diagnostic exams require introducing a very small amount of radioactive material, called a radiopharmaceutical, into a patient’s body either orally or intravenously.
The radiopharmaceutical is then easily detected with the use of specialized imaging equipment, which in turn provides detailed images not only showing the structure but also the function of the organs within the patient’s body.
Once the images have been properly captured, one of the on-site Board Certified Radiologists at Independent Imaging will examine the data before providing a complete and detailed report to the patient’s referring physician. With over 45 years of combined experience, our Radiologists are among the most experienced in the community.
With the use of Nuclear Medicine, physicians are able to obtain information regarding their patient’s health that once was only possible through invasive and often painful methods such as exploratory surgery.
The next time you hear the words Nuclear Medicine, may you visualize a spa-like experience at a state of the art facility providing painless and patient-focused care found only at Independent Imaging.
ALL F OR O NE Home Health Care, Inc.
“Helping Hands for Your Wellness” We are a team of healthcare professionals who make your own home an alternative to hospital or nursing home stays. But, moreover, All For One focuses on your health and your ability to live at home safe, happy and independent. Our team of highly qualified healthcare professionals we can send to your home includes: • Skilled Nursing • Occupational Therapy
• Physical Therapy • Speech Therapy
• Home Health Aides • Medical Social Work
CORPORATE OFFICE
2326 S. Congress Ave. Suite 2-E West Palm Beach, FL 33406 Phone: (561) 433-5677 • Fax: (561) 433-8191 PALM BEACH COUNTY
ST. LUCIE COUNTY
OKEECHOBEE COUNTY
Phone: (561) 433-5677 Fax: (561) 433-8191
Phone: (772) 403-2563 Fax: (772) 403-2564
Phone: (863) 393-0004 Fax: (863) 393-0600
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8ThatFoods Fight Fat 4 NOVEMBER • 2009
FLORIDAHEALTHNEWS-ONLINE.COM
Almonds These
Want to lose weight as you chow down? Your wish is granted! (I promise, this is no fairy tale.) Your supermarket is filled with foods that studies show have lipid-melting powers to help melt fat and keep you slim. Stock up on these fat-fighting super bites, and you'll be trimmer even as you indulge. Read on to discover the eight foods that deserve a permanent spot in your fridge—and in your diet! By Lucy Danziger
yummy nuts are high in alpha-linolenic acid, which can accelerate your metabolism of fats. In fact, dieters who ate 3 ounces of almonds daily slashed their weight and bodymass index by 18 percent, while those who skipped the nuts reduced both numbers less— just 11 percent—a study in the International Journal of Obesity revealed. Chomp almonds à la carte (limit yourself to 12 per serving to keep calories in check). I get a pack at Starbucks and nibble throughout my day. Or sprinkle them into a recipe such as Black Bean–Almond Pesto Chicken. Go nuts!
Cinnamon Adding 1/4
Berries
I tell my daughter, "These are nature's candy!" Turns out they're also your body's best friends. Strawberries, raspberries and other vitamin C–spiked fruit can supercharge your workout, helping you burn up to 30 percent more fat, research from Arizona State University at Mesa has found. If they're not in season, buy the little gems frozen in a bulk-sized bag so you'll always have them on hand to whip up a Berry Bliss Smoothie or Strawberry-Sunflower Pops, regardless of whether berries are in season.
teaspoon to your plate may prevent an insulin spike—an uptick that tells your body to store fat. Sprinkle it on your morning cereal or coffee or on your yogurt in the A.M., or savor it in Apple-Cinnamon-Raisin Oatmeal.
Mustard
It's heaven on a soft pretzel, but mustard may also be a weight loss wonder. Turmeric, the spice that gives mustard its color, may slow the growth of fat tissues, a study in the journal Endocrinology finds. Use it on sandwiches instead of mayo, or sprinkle turmeric on cauliflower pre-roasting to give it a kick. Try it on tuna salad—I promise it adds zest.
Oranges This citrus fruit, which contains
fat-blasting compounds known as flavones, deserves to be your main squeeze. Women who ate the most flavones had a much lower increase in body fat over a 14-year period, a study in The American Journal of Clinical Nutrition notes. Eat oranges sliced or swig fresh OJ (including pulp!) to get the best benefit from the fruit.
Swiss cheese Calcium-rich foods reduce fat-producing enzymes and increase fat breakdown, and Swiss has more calcium than many of its cheesy peers. Choose the reduced-fat variety, such as Sargento. Slip it into your sandwich, put it on top of high-fiber crackers or use it for a healthier grilled cheese. Yum!
Soybeans Reason to toss a half
cup on your salad? Soybeans are rich in choline, a compound that blocks the absorption of fat and breaks down fatty deposits. Oh, and they're addictively delish! But if breast cancer runs in your family, experts suggest you should talk to your doc before adding soy to your diet.
Sweet potatoes The colorful
spuds' high-fiber content means they keep your insulin steadier than their white sisters, which means less fat packed on your hips, research finds. Top a small baked tater with lowfat cottage cheese for a tempting side dish, or whip up Miso Soup With Sweet Potato Dumplings.
NOVEMBER • 2009
FLORIDAHEALTHNEWS-ONLINE.COM
Medical Community Business Networking
The Board of Managers of the Palm West Chamber of Commerce Medical committee. From left to right: Dr. Michael Mikolajczyk, Bruce White, Bland Eng CEO Palms West Hospital, Dr. Maureen Whelihan, Dr. Shekhar Sharma, Dr. David Soria, Dr. Kishore Dass, Dr. Edward Becker, Kevin DiLallo CEO Wellington Regional Hospital and Dr. Jeffrey Bishop.
The Board of Managers of the Palms West Chamber of Commerce Medical committee celebrated the event of Medical Community Business Networking at HSBC Bank located at State Road 7 in Wellington. The event was attended by more than 100 area physicians and business owners.
Dr. Jeffrey Bishop talking to the audience.
Dr. Shekhar Sharma, Jaene Miranda and Bland Eng.
William Duesler of HSBC.
Dr. Gina Harris and Dr. Brad Glick.
Dr. Tom Kichner, Dr. Daniel Ghiragossian and Dr. Shanmugam.
Craig Cuden and Dr. Adolfo Millan.
These are 7 of the 13 residents at Wellington Regional Medical Center, starting from left to right: 2nd year Internal Medicine Resident Hadi Siddiqui DO, 1st year IM Resident Fahran Israr DO 3rd year IM Chief Resident Adriene Miller DO 1st year IM Resident Alissa Tomiaolo DO 2nd year IM Resident Kimberly Sussman DO 1st year IM Resident Adam McDaniel DO 1st year Family Practice Resident Elena Feliciano DO
Dr. Mohammed Yaqub, Dr. Steven Wyome, Dr George Patsias and Dr. Adolfo Colman.
Bruce White and Michael Graves with a guest from Palms West Chamber of Commerce.
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Dr. Kimberly Sussman and Dr. Alisa Tomiaolo.
Mary Martinez, Dr. Arthur Hansen, Dr. Kishore Dass and Ravi Patel.
6 NOVEMBER • 2009
FLORIDAHEALTHNEWS-ONLINE.COM
Pot legalization gains momentum in California By MARCUS WOHLSEN, Associated Press Writer
SAN FRANCISCO – Marijuana advocates are gathering signatures to get as many as three pot-legalization measures on the ballot in 2010 in California, setting up what could be a groundbreaking clash with the federal government over U.S. drug policy. At least one poll shows voters would support lifting the pot prohibition, which would make the state of more than 38 million the first in the nation to legalize marijuana.
Such action would also send the state into a headlong conflict with the U.S. government while raising questions about how federal law enforcement could enforce its drug laws in the face of a massive government-sanctioned pot industry.
The state already has a thriving marijuana trade, thanks to a first-of-its-kind 1996 ballot measure that allowed people to smoke pot for medical purposes. But full legalization could turn medical marijuana dispensaries into all-purpose pot stores, and the open sale of joints could become commonplace on mom-and-pop liquor store counters in liberal locales like Oakland and Santa Cruz.
Under federal law, marijuana is illegal, period. After overseeing a series of raids that destroyed more than 300,000 marijuana plants in California's Sierra Nevada foothills this summer, federal drug czar Gil Kerlikowske proclaimed, "Legalization is not in the president's vocabulary, and it's not in mine."
The U.S. Supreme Court also has ruled that federal law enforcement agents have the right to crack down even on marijuana users and distributors who are in compliance with California's medical marijuana law. But some legal scholars and policy analysts say the government will not be able to require California to help in enforcing the federal marijuana ban if the state legalizes the drug.
Without assistance from the state's legions of narcotics officers, they say, federal agents could do little to curb marijuana in California."Even though that federal ban is still in place and the federal government can enforce it, it doesn't mean the states have to follow suit," said Robert Mikos, a Vanderbilt University law professor who recently published a paper about the issue.
Nothing can stop federal anti-drug agents from making marijuana arrests, even if Californians legalize pot, he said. However, the U.S. government cannot pass a law requiring local and state police, sheriff's departments or state narcotics enforcers to help. That is significant, because nearly all arrests for marijuana crimes are made at the state level. Of more than 847,000 marijuana-related arrests in 2008, for example, just over 6,300 suspects were booked by federal law enforcement, or fewer than 1 percent.
State marijuana bans have allowed the U.S. Drug Enforcement Administration to focus on big cases, said Rosalie Pacula, director of drug policy research at the Rand Corp. "It's only something the feds are going to be concerned about if you're growing tons of pot," Pacula said. For anything less, she said, "they don't have the resources to waste on it." In a typical recent prosecution, 29-year-old Luke Scarmazzo was sentenced to nearly 22
Indiana doctor among 1st to get swine flu vaccination years and co-defendant Ricardo Ruiz Montes to 20 years in federal prison for drug trafficking through a medical marijuana dispensary in Modesto.
At his bond hearing, prosecutors showed a rap video in which Scarmazzo boasts about his successful marijuana business, taunts federal authorities and carries cardboard boxes filled with cash. The DEA said the pair made more than $4.5 million in marijuana sales in less than two years.
The DEA would not speculate on the effects of any decision by California to legalize pot. "Marijuana is illegal under federal law and DEA will continue to attack large-scale drug trafficking organizations at every level," spokeswoman Dawn Dearden said. The most conservative of the three ballot measures would only legalize possession of up to one ounce of pot for personal use by adults 21 and older — an amount that already under state law can only result at most in a $100 fine. The proposal would also allow anyone to grow a plot of marijuana up to 5 feet-by-5 feet on their private property. The size, Pacula said, seems specifically designed to keep the total number of plants grown below 100, the threshold for DEA attention. The greatest potential for conflict with the U.S. government would likely come from the provision that would give local governments the power to decide city-by-city whether to allow pot sales.
Hundreds of medical marijuana dispensaries across the state already operate openly with only modest federal interference. If recreational marijuana became legal, these businesses could operate without requiring their customers to qualify as patients. Any business that grew bigger than the already typical storefront shops, however, would probably be too tempting a target for federal prosecution, experts said. Even if Washington could no longer count on California to keep pot off its own streets, Congress or the Obama administration could try to coerce cooperation by withholding federal funds.
But with U.S. Attorney General Eric Holder's announcement earlier this year that the Justice Department would defer to state laws on marijuana, the federal response to possible legalization remains unclear.Doug Richardson, a spokesman for the White House's Office of National Drug Control Policy, said the office is in the process of reevaluating its policies on marijuana and other drugs. Richardson said the office under Obama was pursuing a "more comprehensive" approach than the previous administration, with emphasis on prevention and treatment as well as law enforcement."We're trying to base stuff on the facts, the evidence and the science," he said, "not some particular prejudice somebody brings to the table."
INDIANAPOLIS – A group of Indiana health care workers is among the first in the nation to be vaccinated against the swine flu. Officials in Indiana and Tennessee set events for Monday to administer nasal mist doses of the swine flu vaccine to doctors, nurses, emergency medical workers and other health care professionals who work directly with patients.
Indiana's first dose was administered to Dr. Charles Miramonti, an emergency room physician at Wishard Memorial Hospital in Indianapolis. He was given the FluMist vaccine in front of a bank of television cameras at an event attended by Gov. Mitch Daniels. Initial shipments of the nasal mist vaccine are so small that in most cases they're being reserved for health workers.
Poor Education May Lead to Poor Health
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By Kathleen Doheny
Navigating a complex health system takes a more literate consumer, experts say. dults with a poor education are also likely to have poor health, a growing body of evidence suggests.
Study after study has confirmed the link, and now experts are zeroing in on the reasons for it and what can be done.
"Persons with a higher education tend to have better jobs, and better income, better benefits," said David R. Williams, a professor of public health at the Harvard School of Public Health and staff director for the Robert Wood Johnson Foundation's Commission to Build a Healthier America.
Those benefits, he said, go beyond health benefits to include such other factors as having the leeway to take a day off or part of a day to see a doctor. People with higher levels of education "tend to have more resources to cope with stress and life, to live in better neighborhoods," Williams said. They have stress, of course, but also more resources to cope with it -such as access to a health club to exercise away the stress -- than do people with less education, he said. Being better educated also means that a person is more likely to understand the world of modern medicine, said Erik Angner, an assistant professor of philosophy and economics at the University of Alabama at Birmingham, who has researched the link between literacy and happiness.
"Modern medicine is incredibly complex," Angner said, "and if you lack the constellation of skills -- including basic reading and numerical tasks -- required to function adequately in the health-care environment, you might find it harder to effectively request, receive and understand your [medical] care." A report issued by Williams's commission found that, compared with college graduates, adults who did not graduate from high school were 2.5 times as likely to be in less than very good health. High school
graduates, it found, were nearly twice as likely as college graduates to be in less than very good health.
The report suggested that factors outside of the medical system play an important role in determining people's health, including how long they will live. Access to medical care is crucial, the report authors said, but it isn't enough to improve health. What's needed, they suggested, is increased focus on schools and education - encouraging people to obtain more education -- as well as more promotion of healthy living in the home, community and workplace. From a "big picture" perspective, Williams said, health promotion should be emphasized and taught more -- and earlier -- in schools. Health habits in adulthood, he said, are built during childhood. It's also crucial, he said, to have a healthy neighborhood and workplace.
Angner said that he's found in his recent research that the older adults he has studied who could read and answer questions on medical forms without assistance were likely to be happier than those who could not. Improving literacy -- and thus improving the ability to read and understand medical forms -- could boost health among adults, he said.
For adults whose education was stopped early, returning to school might help their health as well as their job prospects, the experts say. And if that's not an option, Angner said, simply trying to improve reading skills should make a difference.
Listen to your feet
NOVEMBER • 2009
FLORIDAHEALTHNEWS-ONLINE.COM
susceptible to any changes in their enviroment. Without appropiate nutrients being delivered via bloodflow, hair follicles fail to thrive and the result is a loss of visible hair growth. Hair growth on the toes is usually the first area affected followed by the feet and then the legs below the knees. Many of my patients complain of cold feet and their inability to sleep or go without socks. Cold feet can be the result of many different physiological processes but a lack of circulation will definitely lower the temperature gradient of your legs and feet as you move towards your toes.
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By Dr. Arthur Hansen, D.P.M., M.S.
o you realize that your feet and legs may be trying to communicate with you?
They just may be trying to inform you that the circulation to your feet and legs is not as good as it could or should be. Poor circulation could be the result of faulty arteries (vessels that deliver blood to the feet) or faulty veins (vessels that return blood from the feet to the heart). The voice of your feet and legs can be as quiet as the subtle loss of hair on your toes, or swelling of the feet and ankles, to as loud as painful leg cramping. In this article I'll discuss some of the signs of poor circulation to the legs and feet from the most subtle to the most noticeable.
Hair follicles are some of the most sensitive types of cells in the body and therefore very
those that suffer from them usually find the most comfort with their legs dangling. They may even sleep in a chair all night because this position allows for optimum blood flow to the extremities.
Cramping in the calves and even the feet with walking and/or exertion, is a more noticeable sign of poor circulation. If you repeatedly notice cramping after walking a certain distance, that is relieved if you stop and rest for a few minutes, it is likely that the blood flow to your muscles is inadequate. When you exert the muscles in your legs and feet with walking, they require more oxygen and nutrientes than if they are resting. If the blood vessels are occluded or are not functioning properly then the muscles are not receiving adequate blood flow. Leg cramping can also ocurr when the muscles are resting. This "rest pain" is usually worse at night and relieved if the legs are dangling over the bed. The pain is usually unsymmetrical and the legs show marked pallor on elevation and marked redness with dependency.
Symmetrical swelling of feet, ankles and legs can be a sign of poor venous circulation. That is, the veins are having trouble returning the blood from the feet and legs to the heart. Therefore, the blood pools in the feet and ankles, and swelling is obvious. The swelling is usually less in the morning as you have not been on your feet while sleeping. Varicose veins, painful or not, is a common finding especially among women. These represent faulty valves in the veins and could lead to bulging, painful varicosities and ulcerations.
done to determine the existence and extent of circulatory problems. A doppler, or noninvasive vascular study, can be performed which can verify and sometimes quantify circulatory disorders. Once poor circulation is diagnosed treatment can begin. Treatment options can range from the most conservative such as exercise and diet changes to prescription medications to possible surgical intervention. When someone is trying to communicate with you, you listen. Do the same and listen to your feet and legs.
It is important to realize that the signs and symptoms mentioned above may or may not be caused by poor circulation. For example, not everyone who lacks hair on their feet and toes or who has cold feet suffers from poor circulation. There are many clinical tests that can be
Another obvious sign of poor circulation can be an ulcerated site on the legs, feet and/or toes that is not healing despite treatment. These lesions are painful and
Call to make your appointment
(561) 433-5577 EAST OFFICE
3347 SR 7, Suite 204 Wellington, FL 33449 WEST OFFICE
2326 South Congress Avenue Suite 1-A West Palm Beach, FL 33406
GET BACK ON YOUR FEET! LA PODIATRY GROUP, LLC Podiatric Physicians & Surgeons
Dr. Arthur Hansen Dr. Lori Lane Dr. Daniel Heck
Whirpool with every visit!
Personal & Gentle Care For:
• Diabetic Foot Care • Fracture Care • Ankle/Heel/Foot Pain • Neuropathy • Custom Molded Orthotics
• Hammer Toe, • Ingrown Nails, Bunions • Poor Circulation, • WOUND Care • Diabetic Shoes
Conservative & Surgical Treatments Available
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2326 S. Congress Ave. Suite 1-A West Palm Beach, FL 33406
8 NOVEMBER • 2009
The Silent Killer
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A 60 year old female patient calls and complains of heartburns and wants to be prescribed Zantac. I tell her over the phone that she needs to see me ASAP since there culd be an underlying heart condition. She is skeptical of this situation and states that her neighbor has the same condition that goes away with Zantac, and therefore why couldn't she get the same. I tell her that each person's case history differs. She anyway refuses to seek medical attention. The next day I receive a call from the hospital ER physician who tells me that my patent has had a heart attack. The outcome of this scenario speaks for itself.
Ask Dr. Sharma:
Q
: I have Diabetes Mellitus and kidney problems.I was told not to take any test with Iodine Contrast.Why? Can you please explain this doctor. Marjorie,West Palm Beach
A
: You have 2 conditions above,that together pose a danger for acute kidney failure if you take intra venous Iodine Contrast. I do not know how bad your kidney functions are. Also,you should exercise immense caution in taking what we know as Non Steroidal AntiInflammatory Drugs or NSAIDS because these drugs could cause worsening of kidney problems. Examples of these drugs are Advil,Motrin,Aleve,Ibuprofin etc which are used for arthiritis. Consult your primary care doctor for further understanding of the above.
Shekhar V. Sharma M.D. Board Certified in Internal Medicine
here are several medical conditions in some people that may not manifest itself. In other words, certain people may have hidden medical conditions that are not diagnosed because they are asymptomatic which means that they do not have any symptoms of their hidden medical condition. In my practice I have encountered patients who may have diabetes mellitus, hypertension and hypercholesterolemia without even knowing it. The following are two scenarios from my practice.
FLORIDAHEALTHNEWS-ONLINE.COM
The next scenario is about a gentleman who has uncontrolled hypertension. On examination he is found to have high blood pressure. This patient has no symptoms whatsoever. I advise him to increase his anti-hypertensive medication dosage. He believes that since he feels fine he does not need to increase his dosage for fear of side effects. I tell him that the very reason that these medications are manufactured is to prevent complications of hypertension. I feel that the benefits of an increase in dosage in some cases far outweighs the risks of some side effects. He tells me that he just needs to stay on a low salt diet and this will correct the problem. He is informed that a low salt diet is surely the way to go, but that would not bring the blood pressure down immediately and that there is a possibility of a stroke. A few weeks later he has a stroke with paralysis of one side of the body.
One can definitely learn from the above scenarios and heed the advice of one's physician. To stay healthy is the ultimate goal that we all need to strive for.
Q
: I get frequent headaches what should I do about it? Samuel, Wellington
A
: First of all you should check your Blood Pressure. It could be high. Secondly,you could be having simple tension headaches,muscular pains of the back of the neck,migraines or in the worst case scenario it could also be a brain tumor. Sleep Apnea can also cause headaches in the daytime. You therefore need to consult your primary care physician to guide you in this matter. Questions to Dr. Sharma can be mailed to P.O. Box 542527 Lake Worth, FL 33454-2527
Health Care Plan Hits Rich With Big Tax Increases
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tax in the Senate, and some tax experts think it is a mistake to tap only rich people to pay for services used by all. "If health care is a benefit that is worth having, then it's worth paying for," said William Gale, who was an adviser to President George H. W. Bush's Council of Economic Advisers and is now co-director of the Tax Policy Center. "This gives the impression that it's only worth having if someone else pays for it."
Washington - The typical family would be spared higher taxes from the House Democratic plan to overhaul health care, and their low-income neighbors could come out ahead.
heir wealthy counterparts, however, face big tax increases that could eventually hit future generations of taxpayers who are less wealthy.
The bill is funded largely from a 5.4 percent tax on individuals making more than $500,000 a year and couples making more than $1 million, starting in 2011. The tax increase would hit only 0.3 percent of tax filers, raising $460.5 billion over the next 10 years, according to congressional estimates.
But unlike other income tax rates, the new tax would not be indexed for inflation. As incomes rise over time because of inflation, more families -- and more small business owners -- would be hit by the tax."Twenty years from now, we're going to see more and more small businesses ensnared into paying higher taxes," said Rep. Dave Camp of Michigan, the top Republican on the tax-writing House Ways and Means Committee. The tax would hit only 1.2 percent of taxpayers who claim business income on their returns, according to the estimates by the nonpartisan Joint Committee on Taxation. But that percentage would grow as business owners' nominal incomes rise with inflation.
In 2011, a family of four with an income of $800,000 a year would get a $24,000 tax increase, when the new tax is combined with an increase in the top two tax brackets pro-
or by email: info@floridahealthnews-online.com
posed by President Barack Obama and other scheduled tax changes, according to an analysis by Deloitte Tax. That's a 12.5 percent increase in federal income taxes.
A family of four making $5 million a year would see a $434,500 tax increase, about a 32 percent increase, according to the analysis. "These are very big numbers and very high effective tax rates," said Clint Stretch, a tax policy expert at Deloitte Tax. The new health care tax would come on top of other tax increases for the wealthy proposed by Obama. The top marginal income tax rate now is 35 percent, on income above $372,950. Obama wants to boost the top rate to 39.6 percent in 2011 by allowing some of the tax cuts enacted under former President George W. Bush to expire.
House Democrats said they are proud that they found a way to finance the health care package largely from a tax on the wealthy. There is, however, little appetite for a millionaire's
Obama promised during the presidential campaign that he would not increase taxes on couples making less than $250,000. However, the health care bill would impose new taxes on people who don't buy qualified health insurance, including those making less than $250,000 a year. Under the bill, individuals are required to obtain health insurance coverage or pay penalties, which are described as taxes in the legislation. The penalty would be equal to the cost of an average insurance plan or a 2.5 percent tax on incomes above the standard threshold for filing a tax return, whichever is less. There would be waivers for financial hardships.
To help afford insurance, families with incomes up to four times the federal poverty level would qualify for subsidies. The poverty level for a family of four is $22,050 this year. Republicans argue that the penalties violate Obama's tax pledge, and they liken the millionaire's tax to the Alternative Minimum Tax, which Congress enacted in 1969 to ensure that wealthy Americans cannot use loopholes to avoid paying any income taxes.
The AMT was never indexed for inflation, so Congress must enact a fix each year to spare about 25 million middle-income families from being hit with big tax increases. "They're going down the same road by not indexing this tax," said the Republican lawmaker Camp.
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10 NOVEMBER • 2009
FLORIDAHEALTHNEWS-ONLINE.COM
Cardiology Partners, PL BOARD CERTIFIED CARDIOLOGISTS LISTEN TO CONCERNS OF YOUR HEART
• Dr. Chandra Venugopal • Dr. Amarnath Vedere • Dr. Mauricio Melhado
Swine flu vaccine arriving, but don't line up yet
• Dr. Jean Foucauld • Dr. Neerav Shah • Dr. Elizier Hernandez
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(561) 793-6100 • Fax (561) 793-1974 941 S.E. First Street Belle Glade, FL 33430
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LAURAN NEERGAARD, AP Medical Writer
WASHINGTON (AP) - And we're off: Swine flu vaccinations begin Monday with squirts in the noses scheduled for some doctors, nurses and other health workers in Indiana and Tennessee, a first step in a hugely ambitious campaign to try to inoculate over half the population in a few months. But don't start bugging your doctor about an appointment just yet. This week's initial shipments to states are so small that, with a few exceptions for children, most states are reserving them for health workers so they'll stay healthy enough to care for the flu-stricken and vaccinate others. Inoculations won't gear up in earnest until mid-October, when at least 40 million doses against what scientists call the 2009 H1N1 flu will have rolled out, with more arriving each week after that. This is uncharted territory — you really can't plan too far ahead to say, "I'll schedule my shot on Oct. 16 at Clinic X." Only as shipments start arriving will local doctors, clinics, school vaccination programs and drugstores get word that their doses are coming and how much. Each state health department decides that. People will have to stay tuned. "Take a deep breath, be patient, wait a couple of days, make another phone call and cut everyone a little slack, because it's a little hectic out there, folks," says Dr. William Schaffner, a flu vaccine specialist at Vanderbilt University.
Here's what you need to know: Q: Why not wait to start until there's enough for everybody instead of the confusing here-and-there vaccinations? A: Even though Sunday was the official start of flu season, this H1N1 wasn't heeding the calendar — it's already causing illness in nearly every state. That means getting vaccine to the people at highest risk is a race. So each week, states will distribute however much they have on hand.
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Q: If factories are still racing vaccine out the door, how can I be sure it's safe? A: The Food and Drug Administration clears batches of vaccine before they're released. The H1N1 vaccine is made in the same way as the regular winter flu vaccine that is used with very few, minor side effects by nearly 100 million Americans a year. There's no biological reason the H1N1 vaccine should react any differently, and no red flags have appeared in studies of several thousand people. "What I want people to know is that no corners have been cut at all," said Dr. Anne Schuchat of the Centers for Disease Control and Prevention. Q: Why is the nasal-spray vaccine arriving before the shots, and can I use either one? A: They're considered equally effective, but
the maker of the squirt-in-the-nose FluMist was able to finish brewing sooner. There is an important difference, though. Flu shots, made of killed flu virus, are for anyone without an egg allergy. FluMist, besides the egg issue, is only for use in healthy people ages 2 to 49 — no pregnancy or underlying conditions. It's made of live but weakened flu virus. So some people on the first-in-line list for the new H1N1 vaccine aren't eligible for FluMist. Q: Who's first in line once enough vaccine arrives? A: Pregnant women; the young, ages 6 months through 24 years; people younger than 64 who have conditions such as asthma or diabetes that increase the risk of complications from flu; health workers and caregivers of newborns. Q: I thought flu was most dangerous to people 65 and older. A: Regular winter flu is most dangerous to older adults, but the new H1N1 is predominantly striking the young.
Q: How many shots, or squirts, will I need? A: Most people will need one dose each of the H1N1 vaccine and the regular winter flu vaccine. But health authorities believe children under 10 will need two doses of the H1N1 vaccine, about three weeks apart. And some very young children getting their first regular flu vaccination will need two doses of it, too, for a total a four inoculations.
Q: Can I get both types of vaccine at the same visit? A: If you're lucky enough to find a provider who has both at the same time, a jab in each arm is OK, or a jab of one and a squirt of the other. If you opt for the FluMist version of each vaccine, however, you're supposed to wait three to four weeks between squirts. Q: What if I'm not on the high-risk list and want H1N1 vaccine anyway? A: Only some will be physically reserved, doses sent to schools or obstetricians, for example. But eventually enough is expected for everyone who wants it within just a few weeks. The government doesn't expect people to be turned away unless that day's supplies run out.
Q: What will it cost? A: The H1N1 vaccine itself is free because the government bought it with your tax dollars. But providers can charge a small fee for administering it, usually about $20. Regular flu shots tend to cost up to $35. Q: If H1N1 is the only kind of flu making people sick now, why do I need the regular shot? A: Health authorities expect regular flu strains to start circulating, too, as it gets colder; seasonal flu typically peaks in January.
NOVEMBER • 2009
FLORIDAHEALTHNEWS-ONLINE.COM
Governor Charlie Crist Supported by Area Physicians for U.S. Senate
Dr. Krishna and Nirmala Tripuraneni and Dr. Kishore and Seema Dass Honor Governor Charlie Crist and his wife Carole Crist at Dr. and Mrs. Tripuraneni’s home (Nirvana) in Manalapan. The event attended by prominent area physicians and business owners was applauded by Governor Crist as he began his bid for the U.S. Senate.
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Seema Dass, Dr. Kishore Dass, Mrs. Sarojini Tripuraneni, Nirmala Tripuraneni, Carole Crist, Charlie Crist, Dr. Krishna Tripuraneni and Mary Martinez.
Dr. Krishna Tripuraneni, Dr. Shekhar Sharma, Charlie Crist and Ranjita Sharma.
Laeticia Han and Dr. Ben Han.
Guest, Ravi Patel, Mary Martinez, Craig Cuden, Mohan Pillai and Dr. Mendelson.
Meghan Malynn and Tony Pollak.
Carole Crist, Dr. Lori Lane, Dr. Arthur Hansen and Charlie Crist.
Dr. Chandra Venugopal and Dr. Ram Shetty.
Mrs. Meredith Adams and Mrs. Christina Smith.
Mr. Amin Sanaia and Edwin Reyes of Woodlake Nursing Charlie and Carole Crist talking with guests. and Rehabilitation.
Gopi Barot, Shariffa Gunawardene and Dr. Ishan Gunawardene.
12 NOVEMBER • 2009
FLORIDAHEALTHNEWS-ONLINE.COM
Near half of swine flu patients otherwise healthy The CDC looked at 1,400 adults and more than 500 children with swine flu who were hospitalized in 10 states at medical centers participating in a special disease surveillance network. The hospitalizations occurred from April through the end of August.
H
ATLANTA - The largest U.S. analysis of hospitalized adult swine flu patients has found almost half were healthy people who did not have asthma or any other chronic illnesses before they got sick.
Looking at a larger number of hospitalizations was important because "we wanted to make sure that we weren't missing some important underlying conditions that we hadn't talked about earlier," said Dr. Anne Schuchat, who heads the CDC's National Center for Immunization and Respiratory Diseases.
ealth officials released the surprising results at a news conference on Tuesday, noting that 46 percent of 1,400 hospitalized adults did not have a chronic underlying condition.
They have said before that the majority of swine flu patients who develop severe illness have some sort of pre-existing condition, but the new data suggest the majority may be slimmer than was previously thought.
A study of 272 hospitalized swine flu patients, released by the New England Journal of Medicine earlier this month, concluded that 83 percent of adults and 60 percent of children had underlying conditions.
However, health officials cautioned that the new analysis is preliminary and did not count obesity as an underlying condition. Earlier research has suggested obesity could be a separate risk factor for severe swine flu illness. Further analysis that counts obesity could change the results, said a spokesman for the Centers for Disease Control and Prevention.
Of the adult cases, about 26 percent had asthma, 8 percent had some other chronic lung disease, 10 percent had diabetes, nearly 8 percent had weakened immune systems, and 6 percent were pregnant.
Not as much analysis has been completed on the children's cases, but health officials noted that 6 percent were kids with sicklecell disease or another condition from the same family of blood diseases.
By MIKE STOBBE, AP Medical Writer
The new virus, first identified in April, is a global epidemic. The CDC doesn't have an exact count of all swine flu deaths and hospitalizations, but existing reports suggest more than 600 have died and more than 9,000 have been hospitalized. Health officials believe millions of Americans have caught the virus. The virus is hitting young people harder. Experts believe older people are suffering from it less, perhaps because they have a bit of immunity from exposure over the years to somewhat similar viruses.
On Tuesday, Schuchat said that five additional pediatric swine-flu deaths have been reported since late last week, bringing to 81 the total count of U.S. children who have died with the infection.
States have ordered almost 6 million doses of swine flu vaccine in the vaccination campaign that started last week. About half the available doses are shots and half are the nasal spray version of the vaccine, Schuchat said.
Stop-Smoking Vaccine in the Works
T
he National Institute on Drug Abuse has given a $10 million grant to a Maryland company to help it in the final phases of research regarding a possible anti-nicotine vaccine. Nabi Biopharmaceuticals of Rockville will launch a phase III study of a potential vaccine called NicVAX. The study, which could be the last step of research if the vaccine works, represents the most advanced investigation of a smoking-cessation vaccine. The vaccine is designed to help people quit smoking and not relapse. According to a statement by institute director Dr. Nora D. Volkow, the vaccine has received "fast track" designation from the U.S. Food and Drug Administration and has survived a successful "proof-of-concept" study. There's no guarantee that the study will prove that the vaccine works, nor is it clear whether it will get federal approval if it does. But researchers are hopeful. The vaccine works by making the immune system kick into action when it detects nicotine. The idea is that antibodies will bond to nicotine molecules and prevent them from entering the brain, where they give smokers the high that they crave. Study results are preliminary so far, but they suggest that smokers who develop high levels of the antibodies in their bodies are most likely to quit for good. Researchers reported few side effects. They expect that the vaccine will be effective for six to 12 months after it is given. In the United States, tobacco use is linked to 400,000 deaths a year, according to background information.
NOVEMBER • 2009
FLORIDAHEALTHNEWS-ONLINE.COM
How Healthcare Reform Could Get You Hired
T
In the debate over healthcare reform, references to outcomes mostly have to do with patients. But the impending overhaul of the health insurance system may lead to very different outcomes in employment.
hat's because health insurance coverage seems to guide the career choices of many older workers-and healthcare costs can guide the decisions of many employers.
If healthcare reform makes insurance much more affordable to individuals and businesses, it could result in a greater variety of career options for workers. For one thing, it would reduce barriers to entrepreneurship. Reform also could make it easier for workers to leave employers to whom they are "job-locked," or committed to solely for health benefits--a situation more common to older workers and those with pre-existing conditions.
It also could ease one of the greatest obstacles to older workers' job searches--even more pressing after nearly two years of recession and rocketing unemployment rates. "One of the long-standing barriers to hiring elderly workers is healthcare costs," says David Autor, an economist at the Massachusetts Institute of Technology. Because rates are higher for smaller employers, "if that concern were taken off the table," it would be easier for more businesses to hire older workers, Autor says.
Some employers worry about the potential for higher healthcare costs when hiring an older worker--although in most cases, a worker who's 50 or older will be more productive than someone younger who has less on-the-job experience, according to a 2005 report by the human resources and financial consulting firm Towers Perrin, prepared for AARP.
Although it's unclear what precise shape healthcare reform will take, President Obama has insisted it will reduce the expense of benefits for small businesses. Last year, fewer than half of businesses with between three and nine employees offered health benefits, compared with 99 percent of businesses with 200 or more employees, according to the Kaiser Family Foundation. A disadvantage. Small businesses pay as
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much as 18 percent more than large firms for the same health insurance policy, according to the president's Council of Economic Advisers. Employees at small businesses also tend to get leaner benefits packages and pay higher deductibles.
"Small firms are likely to be at a competitive disadvantage in the market for hiring workers," according to the council's report. While Obama's goal may be competitive parity, opponents to existing healthcare reform legislation have argued that payroll taxes to pay for more affordable healthcare or mandates for levels of coverage could be prohibitive for small businesses.
Joanna Lahey, an economics professor at Texas A&M University, says there is little empirical evidence that proves insurers charge employers more in premiums for older workers--insurers don't exactly publicize their actuarial algorithms--but older individuals are charged more on individual plans. It would appear that older workers tend to accept lower wages in return for greater health insurance compensation. In New York, for example, after a law was passed prohibiting insurers from charging rates based on age, older workers' wages shot up.
Lahey's research finds that older workers often make new choices in employment when they are covered by insurance that is not provided by an employer. Her study looks at employment changes that occurred after the Department of Veterans Affairs decided to cover all veterans. Less-educated veterans were more likely to drop out of the workforce or work part time, while more-educated veterans were more likely to strike out on their own. Lahey suspects that if a public option in health insurance is good--in quality and price--there might be a similar effect. This would, in general, be a good thing for the economy. Workers who choose to stay with employers merely to receive health insurance are not ideal for employers, who benefit more from motivated and productive workers. At the same time, workers are not helped by staying in jobs so they can maintain their coverage. There is what Lahey describes as a "loss of well-being" when, say, an older worker is ailing but continues to work until he or she reaches 65 and can be covered by Medicare. Yet many workers, particularly low-income ones, feel that's what they have to do.
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14 NOVEMBER • 2009
FLORIDAHEALTHNEWS-ONLINE.COM
How Xbox Can Help Fight Heart Disease
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Countless medical studies have concluded that playing too many video games can be harmful to one's health.
save lives.
ow, however, it turns out that one of the more popular videogame consoles on the market, the Xbox 360, could be used to
A computer scientist at the University of Warwick in England has devised a way to use an Xbox 360 to detect heart defects and help prevent heart attacks. The new tool has the potential to revolutionize the medical industry because it is both faster and cheaper than the computer systems that are currently used by scientists to perform complex heart research. The system, detailed in a study in the August edition of the Journal of Computational Biology and Chemistry, is based on a videogame demo created by Simon Scarle two years ago when he was a software engineer at Microsoft's Rare studio, the division of the U.S.-based company that designs games for the Xbox 360. Scarle modified a chip in the console so that instead of producing graphics for the game, it now delivers data tracking how electrical signals in the heart move around damaged cardiac cells. This creates a model of the heart that allows doctors to identify heart defects or conditions such as arrhythmia, a disturbance in the normal rhythm of the heart that causes it to pump less effectively. "This is a clever use of a processing chip ... to speed up calculations of heart rhythm.
What used to take hours can be calculated in seconds, without having to employ an extremely expensive, high-performance computer," Denis Noble, director of Computational Physiology at Oxford University, tells TIME. To create a heart model now, researchers must use supercomputers or a network of PCs to crunch millions of mathematical equations relating to the proteins, cells and tissues of the heart, a time-consuming and costly process. Scarle's Xbox system can deliver the same results at a rate five times faster and 10 times more cheap, according to the study. The Xbox 360 isn't the only video-game console that is being used for scientific research. At the University of Massachusetts campus in Dartmouth, scientists are using Sony PlayStations to simulate black-hole collisions to try to solve the mystery of what happens when a supermassive black hole swallows a star. So perhaps parents shouldn't be too worried if their children are spending an inordinate amount of time playing video games. Who knows, today's Grand Theft Auto or Halo addict may end up discovering a new moon around Saturn or finding a cure for cancer.
Veggies in Pregnancy Lowers Child's Diabetes Risk
Children born to mothers who ate plenty of vegetables during pregnancy are less likely to have type 1 diabetes, Swedish researchers say. "This is the first study to show a link between vegetable intake during pregnancy and the risk of the child subsequently developing type 1 diabetes, but more studies of various kinds will be needed before we can say anything definitive," study author Hilde Brekke, a clinical nutritionist at the Sahlgrenska Academy at the University of Gothenburg, said in a news release from the university. Brekke and colleagues studied 6,000 5-year-olds and found that 3 percent either had fully developed type 1 diabetes or had elevated levels of antibodies that indicate a risk of developing the disease. The risk was twice as high in children whose mothers rarely ate vegetables during pregnancy, and lowest among children whose mothers ate vegetables every day of their pregnancy. The study was recently published online in the journal Pediatric Diabetes. "We cannot say with certainty on the basis of this study that it's the vegetables themselves that have this protective effect, but other factors related to vegetable intake, such as the mother's standard of education, do not seem to explain the link," Brekke said. "Nor can this protection be explained by other measured dietary factors or other known risk factors." While it's not known what actually causes type 1 diabetes, factors believed to play a role include immunological mechanisms, environmental toxins and genetic variations. Type 1 diabetes occurs throughout the world but is most common in Finland and Sweden.
NOVEMBER • 2009
FLORIDAHEALTHNEWS-ONLINE.COM
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Palms West Hospital and Wellington Regional Medical Center kick off a fundraiser for Elizabeth Benaquisto for the Florida Senate at the home of Dr. & Mrs. Sharma
Louis Morgenier and Dr. Chandra Venugopal.
Dr. Mike Mikolajczyk and Michael Graves.
Tricia and Michael Hughes, AIA.
Dr. & Mrs. Bishop and Mr. & Mrs. Kevin DiLallo.
Annette Ortega and Dr. Raul Ortega.
Mr. & Mrs. Bland Eng, Mrs. Susan Allongo and Dr. Jose Allongo.
Elizabeth Benaquisto thanked area physicians, CEO’s of hospitals and business owners for their support as she launched her campaign for the Florida Senate. The event held at Dr. Shekhar & Ranjita Sharma’s home was attended by about 80 people.
Dr. Krishna Tripuraneni, Dr. Ed Becker, Dr. Kishore Dass, Elizabeth Benaquisto, Mr. Mohan Pillai, Dr. Shekhar Sharma, Attorney Craig Cuden and Mary Martinez.
Dr. & Mrs. Sharma, Elizabeth Buenaquisto, Dr. Ishan Gunawardene and Dr. Lori Lane.
Maria Mikolajczyk, Seema Dass and Dr. Maureen Whelihan.
Young fans of Elizabeth Benaquisto: Betsy Lampert, Samantha Epling, Elizabeth Benaquisto, Mira Sharma, Isabella Wright and Araliya Gunawardene.
Dr. Harvey Montijo, Dr. Shekhar Sharma, Amin Sanaia, Edwin Reyes and Dr. Arthur Hansen.
Dr. Han and Family.
Stelli Ott and Gene Bliman.
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