Global Health Tribune - April 2012 issue by Global Health Tribune

Global Health APRIL ISSUE - 2012

S er vin g: J upiter

Boca Raton

Hosts Medical Networking Event PAGE 10

Dental X Rays Tied To Brain Tumors

Boynton

Lantana

TRIBUNE

Lake Wor th

Belle G lade

Wellington

w w w. g l o b a l h e a l t h t r i b u n e . c o m

Royal P alm Beach

P alm Beach G ar dens

SPECIAL SECTION

Thoracic month

NIR GOLDSTEIN, M.D. Lung Cancer - To Screen Or Not To Screen ............4

SEETAL MEWAR, M.D. Lung Cancer from the perspective of a medical oncologist ........................6

Kids Cancer Center

"City Lights for Life"

PAGE 13 MARK PERMAN, M.D. Does Low-Dose CT Screening for Lung Cancer Save Lives?.....................8

PAGE 14

The largest study of its kind finds that a history of frequent dental x-rays, particularly at a young age, is tied to an increased risk of developing meningioma, the most common type of primary brain tumor in the United States. PAGE 2

ANTHONY ADDESA, M.D. Cyberknife for the Lung Cancer Patient ...............8

More than one in 10 Americans over the age of 12 takes an antidepressant, a class of drugs that has become wildly popular in the past several decades, U.S. government researchers said. PAGE 2

GLOBAL HEALTH TRIBUNE P.O. Box 213424 Royal Palm Beach, FL 33421

WEST PALM BCH, FL PERMIT NO. 1340

PAID

PRSRT STD U S POSTAGE

2 APRIL ISSUE

â&#x20AC;˘ 2012

WWW.GLOBALHEALTHTRIBUNE.COM

Dental X Rays Tied To Brain Tumors The largest study of its kind finds that a history of frequent dental x-rays, particularly at a young age, is tied to an increased risk of developing meningioma, the most common type of primary brain tumor in the United States.

"This research suggests that although dental x-rays are an important tool in maintaining good oral health, efforts to moderate exposure to this form of imaging may be of benefit to some patients." Meningiomas arise in the "meninges", or the lining of the brain, and account for around 33% of all primary brain tumors in the United States. Primary refers to the part of the body where the cancer starts. The most consistently identified environmental risk factor for this type of cancer is exposure to ionizing radiation; and for Americans, the most common way to encounter this exposure is having dental x-rays.

TRIBUNE

Deborah Lynn Staff Writer and Sales Executive (312) 351-2383 deborah@globalhealthtribune.com

Dr Elizabeth Claus, a neurosurgeon at Brigham and Women's Hospital (BWH), in Boston, and the School of Medicine at Yale University in New Haven, and colleagues, write about their findings in a paper due to be published in the journal Cancer on 10 April. Claus said in a statement:

Global Health

Erica Whyman Staff Writer and Sales Executive (561) 308-1428 erica@globalhealthtribune.com

Claus and colleagues are careful to point out that their conclusions do not refer to x-rays undertaken today:

"It is important to note that the dental x-rays performed today use a much lower dose of radiation than in the past," said Claus.

For their study, Claus and colleagues examined records on 1,433 patients who were aged between 20 and 79 when they received a diagnosis of meningioma during the period May 2006 and April 2011. They compared their data to a group of 1,350 matched controls. The results showed that com-

pared to the controls, participants with meningioma were more likely to have undergone a type of dental x-ray known as a bitewing exam. This type of exam shows the crowns of the lower and upper teeth at the same time.

Those participants who reported having such an exam annually or more frequently, were 1.4 to 1.9 times more likely to develop a meningioma compared to controls.

The risk of developing meningioma was even higher among participants who reported having a panorex dental x-ray: having this exam yearly or more frequently raised the risk by nearly 3 times, and having it while under

the age of 10 by 4.9 times, compared to controls.

A panorex exam is one that shows the upper and lower jaws as well as teeth, in the same film.

In their background information, Claus and colleagues draw attention to an American Dental Association's statement that urges dentists to make sure they weigh up the risks versus the benefits when doing dental x-rays, and how they point out there is scant evidence to support scheduling regular x-rays in healthy patients.

Funds from the National Institutes of Health, the Brain Science Foundation and the Meningioma Mommas helped pay for the study.

GRAPHIC DESIGN / PHOTOGRAPHY Sergio Aguilar (561) 797-2325 ads@globalhealthtribune.com CONTRIBUTING ARTICLES U.S. Department of Health and Human Services, ARA Content, Hispanic PR Wire, Centers for Disease Control and Prevention, METRO Editorial Services, Family Features ÂŠ SEA PUBLICATIONS, INC. ALL RIGHTS RESERVED. Printed in United States.

Global Health Tribune is a newspaper published every month in Palm Beach county and surrounding areas. Copyright 2012, 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 does not accept responsibility for advertisement error beyond the cost of the advertisement itself. All submitted materials are subject to editing.

"What's" the Beef?

By David Fagin

Writer, producer, musician

orget, for a moment, the John Walker Lindh's and Timothy McVeigh's of the world. This article is not about that kind of domestic terrorist. Rather, it's about those individuals whose job it is to knowingly look the other way, and contribute to the poisoning of their fellow citizens on a daily basis. Especially when it involves children.

It's no secret, when it comes to food, we, as a nation, have been slowly killing each other for decades with the products that our supermarkets and fast food chains happily stock en masse, and which may contain any num-

ber of unpronounceable ingredients, usually ending, ironically enough, in "a-t-e." Yet, even though the Internet has leveled the playing field tremendously when it comes to protesting these types of actions before they take effect, or even forcing them, in some cases, to reverse direction, it's still "business-as-usual" for our government.

Yesterday, for instance, the U.S. Dept. of Agriculture announced it is buying seven million pounds of "Pink Slime" -- the ammoniatreated beef byproduct consisting mostly of connective cow tissue (barf), and deemed a "bad idea" by the likes of McDonald's, Burger King, and Taco Bell. How bad does this stuff have to be to be dropped by the food versions of Gordon Gekko? Granted, celeb chef Jamie Oliver played a big part, but the "slime" was exposed for what it is. Literally, garbage. Nonetheless, this junk is now well on its way to becoming a key ingredient in your child's school lunch. If that doesn't make you

'sick to your stomach,' nothing will.

The statements made by the USDA claim "All USDA ground beef purchases for the National School Lunch Program must meet the highest standards for food safety." Highest standards according to who? Just because there's no immediate threat of bacteria making the kids sick tomorrow, or the next day, doesn't mean that the chemicals being consumed now, under guise of making the meat "safe," won't lead to all kinds of wonderful ailments ten or twenty years down the line (God only knows what those of us who went to school in the '70s and '80s were consuming -- probably television parts). The capper is, scientists say, even after this "mystery meat" is treated with this possible carcinogen, the meat's still believed to be susceptible to e. coli and salmonella, anyway. And, lest we forget, this stuff has almost no nutritional value at all! When traces of dozens of phar-

maceuticals and pesticides were found in New York City's drinking water, the city's Department of Environmental Protection maintained there was no danger - as the water met the highest standards allowed by law. The problem was, nowhere in the law did it require limiting levels of pharmaceuticals of any kind. So, technically, they were right.

And, it just gets worse. The FDA, the organization that's supposed to protect us from eating things that will cause our babies to be born with three heads, doesn't even require labeling products treated with ammonia. Nor will they require labels when they allow salmon to be injected with human growth hormones. Add to that, Obama quietly appointing a former Monsanto CEO to head its Food Safety division, and you can see we're being attacked from all sides. (Although, the hormones-in-salmon thing looks like it could be good, as one salmon reportedly hit 61 home runs.) Unfortunately, as a society, we don't have each other's backs.

We're simply not honest with each other when it comes to the risks surrounding the foods we eat and the chemicals we use to make them. Because, when ya get right down to it, we don't know what the risks are. We don't know what type of diseases or complications consuming ammonia, or drinking trace amounts of insecticide, will ultimately cause. So, why must we always say, "It's probably fine," when it comes to the health and well-being of our children, as well as ourselves? Why not err on the other side? Why not take the position, "We're not going to allow this until we know -- for certain -- that it's completely safe?" The answer's obvious: money. It takes money to change policy. It takes money to overhaul an industry. And these industries pay better than the environmental groups fighting them. Perhaps, next time you hear someone ask, "Where's the beef?," you should tell them the correct term is, "What's the beef?"

APRIL ISSUE • 2012 3

WWW.GLOBALHEALTHTRIBUNE.COM

SHIN SPLINTS

can be defined as pain and discomfort in the leg from repetitive running on hard surfaces or overuse use of the muscles that bring up the foot.

Arthur Hansen DPM, M.S.

o, you have made the commitment. The commitment to exercise and get yourself in shape. You started running. You bought running shoes and are all set to go. Your first run goes well, you went further than you thought, almost a full mile. You are proud and excited, you can do this. And you do it, every day for a week. But then, it starts, a pain and soreness in your shin. The pain is enough that you can’t keep running. You didn’t bump it against anything, you see no redness, no bruising, no swelling. What is it?

While stress fractures to the tibia (leg bone) do happen after starting running programs and if you run long distances, the most common cause of pain in the front of the leg along and near the ‘shin bone’ is shin splints. Shin splints

Aching, throbbing or tenderness along the inside of the shin or directly on the shin are the most common symptoms associated with shin splints. The pain is felt when the area along the tibia (shin) where muscles attach becomes inflamed. While more appropriately named periostitis, we will continue with the more common term known as shin splints. Another symptom is pain when you press on the inflamed area. Shin splint pain is most severe at the start of a run, and sometimes will go away during a run once the muscles are loosened up. On the contrary, a stress fracture of the tibia, shinbone, will hurt all the time.

The shin splints can result from tired or stiff calf muscles putting too much stress on tendons, which become strained and torn. Overpronation of the foot aggravates this problem, as does running on hard surfaces, and running in stiff shoes.

Beginning runners are the most susceptible to shinsplints for many reasons, but the most common is that they’re using leg muscles that haven’t been stressed in the same way before.

support, in conjunction with the strengthening and stretching exercises.

Finally, think about your running form. Are you leaning forward too much? Are you slouching? If you are doing any of these you may be putting too much strain on your muscles.

If, after following the above recommendations, the pain continues, it is possible that micro-fractures may form in your tibia; these are stress fractures. You won't have a sudden break, just a gradual increase in pain until it becomes quite severe. If you have extreme shin pain, see a doctor for an x-ray.

Another reason beginning runners develop shinsplints is because of poor choices in running shoes or running in something other than running shoes. Those runners who have started running again after long layoffs are also at a higher risk of developing shinsplints because they often run too far initially on return.

Rest is the best treatment, with a slow return to normal activity as

long as the pain is no longer present. Reducing the inflammation is key and can take from 2-3 days up to 2-3 weeks. Ice to the area two to three times per day, a course of anti-inflammatory medications, and stretching and strengthening exercises are useful along with rest. Some athletes who develop shin splints have flat feet (excessive pronation) which exacerbates the strain on the leg muscles. In such cases, the runner should obtain orthotic

Shin splints are extremely common among beginning runners, whose enthusiasm for their new sport has over-stepped the limits of their legs. Take a look at your running program; you may be doing too much too soon. Call to make your appointment

(561) 433-5577 WEST OFFICE:

3347 SR 7, Suite 204 Wellington, FL 33449 EAST OFFICE:

2326 South Congress Ave. 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. Juan Sardina Dr. Daniel Heck Dr. Shelley Plumb

Whirlpool 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

(561) 433-5577

3347 State Rd 7 Suite 204 Wellington, FL 33449

Medicare Medicaid HCD - PPO & Most Insurances Accepted

2326 S. Congress Ave. Suite 1-A West Palm Beach, FL 33406

4 APRIL ISSUE

• 2012

WWW.GLOBALHEALTHTRIBUNE.COM

Lung Cancer - To Screen Or Not To Screen ung Cancer is a growing problem in the U.S. It is the number one cause of cancer related death in both men and women, and accounts for more deaths than the next three most common cancers combined (colon, breast, and prostate).

Nir Goldstein, MD, FCCP

Board Certified by the American Board of Internal Medicine in: Pulmonary disease, Sleep Medicine, and Critical Care Medicine Completed Medicine Residency and Pulmonary Fellowship at Barnes-Jewish Hospital at Washington University in St. Louis in 2001

Practicing in Wellington since 2002 Hospital affiliations: Palms West Hospital Wellington Regional Medical Center JFK Medical Center Published scholarly articles in the areas of Pulmonary Embolism, Lung Transplantation and Emphysema Trained in Electromagnetic Navigational Bronchoscopy - an advanced bronchoscopic technique for the early detection of lung cancer.

87% of lung cancer deaths are related to tobacco - both active and passive, and the relative risk of dying from lung cancer is 1020 times higher in smokers compared with non-smokers.

When lung cancer is detected at an early stage (Stages I and II) survival may approach 88% at 5 years, compared with only a 15% 5 year survival when detected at later stages. Much attention has been focused therefore on early detection techniques for lung cancer. However up until recently, no screening method was shown to reduce lung cancer mortality.

Previous screening studies with Chest X-rays, and/or sputum cytology did not show a reduction in mortality from lung cancer.

Recently a landmark study - the National Lung Screening Trial (NLST) - showed that screening Computed Tomography (CT) scans could lower lung cancer mortality by 20%, and all cause mortality by 6.7%.

surgery, chemotherapy, or radiation - even if it would not have become clinically significant in the patient’s lifetime. Although impossible to document in a living individual, autopsy studies have shown that about 15% of lung cancers detected at autopsy were not known during life i.e., the patient died with a lung cancer rather than from it.

In this study persons aged between 55 and 74 and with a smoking history (current or those who have quit within the last 15 years) of at least 30 pack years (one pack per day for 30 years, or 2 packs per day for 15 years, etc), who received annual screening Low Dose Helical Computed Tomography scans (LDCT) - had a significantly reduced mortality from lung cancer.

In the NLST, approximately fifty thousand persons were enrolled, half were assigned to Chest Xrays and half to LDCT. Over the trial period, 40% of the LDCT group had a positive finding with 96.4% being false positives. A total of 356 deaths occurred from lung cancer in the LDCT group and 443 deaths in the Chest XRay group (a 20% reduction in the LDCT group).

However, screening does have its downsides and did result in many false positive tests (i.e., incidental lung lesions were detected that were not cancer). In the NLST 96% of the positive findings were false positive. Apart from the anxiety and cost that results from false positive findings, some people may require biopsy procedures. Biopsy procedures, which may be done by needle biopsy, traditional or advanced bronchoscopic techniques or surgically, can all be complicated by bleeding, infection, or lung collapse. In the NLST harmful effects from the screening or the diagnostic procedures prompted by a false positive finding was under 2%. A less familiar harm from screening is over-diagnosis - when a cancer is detected and treated, by

Radiation exposure with LDCT is much lower than with regular diagnostic chest CT - however, the impact could not be directly measured as the potential harm from radiation present long term effects.

NSLT data also still needs to be analyzed to address issues of cost effectiveness, quality of life, and benefits in other age groups.

Because of the complexities mentioned above, lung cancer screening is not routinely recommended or covered by medicare or most insurers. Recently however, the National Comprehensive Cancer Network (NCCN) has recommended LDCT screening for lung cancer. It remains to be seen, based on further analysis of the NLST and other ongoing similar studies, whether screening for lung cancer will be recommended by groups such as the American Cancer Society or the US Preventative Services Task Force.

|3HHUUUVVRQ RQQDDDOO 3ULLYYYDDDWWWHH 'XXWW\ +RPPHH &DDUUUHH :KKHHHUUUHHHYYYHHHUU <RX $UUH} H} Care Management · Home Health Aides Cer tified Nursing Assistants · Companions · Homemakers Download our FREE Smartphone application: §&RPSOHWH &RPIRUW ++&¨

www.co www .completecomf comfort orth ort homecare.com

561-433-8999 Lic. # NR 30211507

$50.00 off 1st Week of Service Minimum 10 hours caregiver ser servic vices for week applying to discount.

FR EE FREE

Li censed Nurse Visit for Licensed Evaluation and as ses sment sment sessmen asses

$25 Gift Card** Refer a friend or loved one an and receive a $25 gift card. *Gift card will be issued af after ter one week of service

APRIL ISSUE • 2012 5

WWW.GLOBALHEALTHTRIBUNE.COM

Palm Beach Tenet Hospitals Celebrate National Doctors’ Day Honoring physicians for their service, skill and compassion, Tenet Hospitals in West Palm Beach celebrate with special events and activities

EST PALM BEACH, Fla. -March 30, 2012 – Tenet hospitals in West Palm Beach celebrate National Doctors’ Day in honor of its physicians’ hard work and commitment to delivering quality, compassionate care. The exemplary group of physicians across the Tenet Florida network will be celebrated with various events and activities at Delray Medical Center, Good Samaritan Medical Center, Palm Beach Gardens Medical Center, St. Mary’s Medical Center, and West Boca Medical Center. “We are proud of the dedication our physicians have to serving the health care needs of our patients,” said Mitch Feldman, chief executive officer of West

Boca Medical Center. “National Doctors’ Day allows us the chance to say thank you to these extraordinary people who care for us, our families and our communities,” continued Mike Cowling, chief executive officer of Palm Beach Gardens Medical Center.

Celebrated on March 30 each year, Doctors’ Day was officially established in 1991 when President George Bush issued a proclamation in observance of the day. March 30 marks the anniversary of the first use of

general anesthesia in surgery by Dr. Crawford W. Long in 1842.

“Our physicians’ commitment to quality care is vital to the success of our hospital and the well-being of our patients,” said Mark Bryan, chief executive officer of Delray Medical Center. Mark Nosacka, chief executive officer of Good Samaritan Medical Center continued, “It is imperative that we take the time to acknowledge our physicians for their efforts on Doctors’ Day with various recognition events, but also throughout the entire year.”

Davide Carbone, chief executive officer of St. Mary’s Medical Center concludes, “Our physicians are the reason we can provide health care to protect the health and safety of our community, and we encourage our community members to remember and thank their physicians for the very important service they provide.”

ABOUT TENET FLORIDA Tenet South Florida, a region of Tenet Healthcare Corporation, comprises nine acute care hospitals with ten sites of service. The

ANNOUNCING

network of hospital includes 3,483 beds and numerous related health care services. Tenet’s hospitals aim to provide the best possible care to every patient who comes through their doors, with a clear focus on quality and service. Hospitals in the Florida region include Coral Gables Hospital, Delray Medical Center, North Shore Medical Center, North Shore Medical Center FMC Campus, Good Samaritan Medical Center, Hialeah Hospital, Palm Beach Gardens Medical Center, Palmetto General Hospital, St. Mary’s Medical Center and West Boca Medical Center.

Tenet distinguishes itself as a leader in redefining health care delivery and has been recognized for the passion of its people and partners in providing quality, innovative care to the patients it serves in each community. What’s more, Tenet Florida region hospitals have been recognized consistently by organizations such as CIGNA, HealthGrades and the American Heart Association/American Stroke Association for their commitment to providing quality care.

ACCOUNTABLE CARE HOSPITALIST GROUP

(ACHG)

Now available to admit and manage all patient care at Providing:

Palms West Hospital

n Comprehensive Quality In-Patient Care

n Full Communication with Primary Care Physician n Complete 24 hour in-house coverage

n Clinical Care Coordinator to manage all patient hospital stays and discharge orders

561.247.1190

n Emergency Room Service

6 APRIL ISSUE

• 2012

WWW.GLOBALHEALTHTRIBUNE.COM

Lung Cancer from the perspective of a medical oncologist

Seetal Mewar, M.D.

Primary Specialty: Hematology/Oncology

Dr. Seetal Mewar joins MSPB as a Hematologist-Oncologist. She completed medical school at Jefferson Medical College and went on to complete her Internal Medicine training as well as her subspecialty training at Beth Israel Medical Center, an affiliate of Albert Einstein College of Medicine, in Manhattan prior to joining our practice. She prides herself on compassionate care and commitment to staying aware of current breakthroughs in her field in order to provide personalized care to each of her patients. Her areas of expertise include breast cancer, lung cancer, head and neck cancer, gastrointestinal malignancies, and blood disorders (benign disorders, leukemia and lymphomas).

nfortunately Lung Cancer is the most common cancer worldwide. In the United States we have finally started to see a decline in lung cancer related deaths likely related to a decrease in smoking over recent years. The primary risk factor for the development of lung cancer is cigarette smoking, which is estimated to account for approximately 90 percent of all lung cancers. The risk of developing lung cancer for a current smoker of one pack per day for 40 years is approximately 20 times that of someone who has never smoked. Factors that increase the risk of developing lung cancer in smokers include the extent of smoking and exposure to other carcinogenic

factors, such as asbestos. There have been several trials attempting to screen smokers to attempt to catch lung cancer in its early stages as unfortunately 75% percent of Lung cancers are not caught until they cause symptoms at a later and less curable stage. Screening has not become a standard of care because the trials while showing that they can catch a small proportion of lung cancers at earlier stages, screening ends up being very costly to patients and insurers both in actual money spent on CT scanning and other tests as well as exposing patients to possibly unnecessary radiation exposure. The goal is preventing people from ever smoking and encouraging those who do to quit. There are many medications and nicotine supplementation methods available to help a patient quit, as well as support from associations like tobacco free Florida (www.tocaccofreeflorida.com.)

The symptoms that may lead a patient’s primary care provider to start looking for cancer include cough, pain in the chest, shortness of breath, phlegm that may be streaked with blood. Any such symptoms in a smoker or patient with a previous history of smoking should be taken seriously and evaluated with x-rays or CT scans.

When a patient comes in with a diagnosis of lung cancer, what I like to look at first is their pathology. There are a lot more treatments available now and new targeted treatments that are specific to the kind of pathology. Until about five years ago, lung cancers were treated in two different ways. One was if you had a small cell lung cancer (SCLC). A small cell is an aggressive cancer that usually starts with a nerve type cell, what we call a neuroendocrine cell. It’s a very aggressive type of cancer, but the good thing about that is that it usually responds very well to chemotherapy. Chemotherapy works well on rapidly dividing cells and this is very the nature of small cell cancer. If it’s limited to the area of the lung in small cells, it is potentially curable. However, the

Lung Cancer

cure is tough because it involves the combination of chemotherapy and radiation for six weeks and it’s difficult for patients, but they are often able to manage the side effects and the fatigue associated with it because of the potential to be cured.

All the other cancers are nonsmall cell lung cancers (NSCLC). Those used to be treated in a dealers choice manner by the oncologist with a combination of chemotherapy. Over the past few years, we have become more specific with treatments and have even the National committee. An adenocarcinoma is a kind of a glandular cancer. It comes from the glands in the lung and that has a few targeted treatments that can be pill based. One of them is called Tarceva. The other is a new medication that came out a year ago, Xalkori. Those two are pill based and if you have these certain mutations that we can see in a patient with advanced lung cancer. Since patients seem to respond well by taking these pills first, and they more directly target the cancer without causing as much compromise to the system as a whole patients can often expect a better outcome than with standard chemotherapy. However, that is for only about 410% of adenocarcinomas, and unfortunately the EGFR or EMLALK mutations are more often seen in non- smokers. The percentage of lung cancer that is in non-smokers is only about 10% of the lung cancers diagnosed. The prototype patient for the EGFR mutation is a young Asian female that is a non-smoker, sadly not the population I typically see in south Florida. For about

95%, they up end receiving a standard chemotherapy regimen. That will be different if you have the adenoid glandular type or squamous cell lung carcinoma, which is from the surface cells of the lung. There are different infusional therapies, which can have different expected benefits, and side effects and it is the obligation of an oncologist to try to personalize the treatment to the patient in front of them to see what would work the best and cause the least side effects. The way that I explain this to patients is that if this is Stage Four and has spread outside the lung, and then the treatment and goal is not to cure it, but to keep the disease stable and contained. I would love to see the cancer shrink, but stable is good in lung cancer because it means we have achieved control.

The earlier stage cancers, if you are lucky enough to catch them, are Stage One and Stage Two. That being a local mass or it has spread to just a few lymph nodes. Typically, surgery will be performed which requires removing a portion of the lung. The issues with that are the patient has to be fit for surgery and not have a lot of underlying lung issues such as Emphysema that can rule out surgery if there isn’t enough good working lung left. Again the optimistic side is with the new research and advances in the field even patient with very poor lung function can be treated with new therapies such as Cyberknife, which is a non-surgical approach to removing small single lung masses.

The complicated one is the Stage Three lung cancer. That is when it has spread to several of the lymph nodes. Due to the recurrence rate being very high, instead of performing surgery, we use a combination of chemo and radiation therapies. I do have a lot of Stage Three cancer patients in my practice and it is very tough on them. They need a lot of support both emotionally and with nutrition and a holistic approach to their care.

However, we always look for the light and the end of the tunnel and I will always work for a cure and do whatever I can, but there is still a chance of relapse afterwards.

People always ask about nutrition and what should I eat. There have not been any proven studies for lung cancer that show certain foods are better for you. For colon cancer and breast cancer and those studies have shown that a low-fat diet has decreased your risk of relapse. But with lung cancer, nothing dietary has ever been show to help. However, maintaining good nutrition habits are very important regardless. If you’re not hungry, there are supplements such as ensure and others to maintain your calories.

I also advocate for exercise and maintaining your normal routine including work if you have a flexible job as much as possible. I find that patients that stay in their routines often do better emotionally and physically.

While cancer itself is a depressing thought, and Lung cancer still has a long way to go before we can really achieve good control I am truly optimistic about the future. First there has been a significant decline in smoking and I think it’s the obligation of anyone involved in the health of a smoker to encourage and support quitting immediately. The other silver lining is that science is working very hard to find new treatments that can directly target cancer cells and hopefully allow us to offer a cure to even patients with advanced disease.

Pets at Work Keep Workers Happy Research shows employees more productive, less stressed if their dogs accompany them to the job.

llowing employees to bring their dogs to work appears to reduce stress and boost job satisfaction levels,

according to a new study. The research was conducted at a service-manufacturing-retail company in Greensboro, N.C., which has about 550 employees and allows up to 30 pet dogs on company premises each day. Over the course of a week, Virginia Commonwealth University researchers compared stress levels and job satisfaction among those employees who brought their dogs to work, those who didn't bring their dogs to work,

and employees without pets. The study found that dogs in the workplace seemed to help reduce job-related stress for their owners and make work more satisfying for other employees who came into contact with the dogs. "Although preliminary, this study provides the first quantitative study of the effects of employees' pet dogs in the workplace setting on employee stress, job satisfaction, support and commitment," principal investigator Randolph

Barker, a professor of management in the VCU School of Business, said in a university news release. "Dogs in the workplace can make a positive difference," he added. "The differences

in perceived stress between days the dog was present and absent were significant. The employees as a whole had higher job satisfaction than industry norms." The findings were published in the issue of the International Journal of Workplace Health Management. Stress is a major cause of absenteeism, poor morale and burnout and can lead to significant declines in productivity and resources, the researchers noted.

APRIL ISSUE • 2012 7

WWW.GLOBALHEALTHTRIBUNE.COM

Wellington Regional Offers FREE Prenatal Education Classes Wellington Regional Medical Center is pleased to offer FREE prenatal education classes to all parents-to-be when they register to have their babies at the Centre for Family Beginnings maternity unit. To schedule your tour of the maternity unit, call 561-753-2626

Free classes include:

Lamaze Childbirth Education - Provides the knowledge, skills and support to help you give birth with confidence and joy. All instructors are ASPO Lamaze Certified Childbirth Educators

The ABC’s of Breastfeeding - Taught by a certified lactation consultant, this class prepares parents with breastfeeding and basics

Baby Care - Designed to give expectant parents the skills and confidence needed to care for their new arrival. Topics include umbilical cord and circumcision care, bathing, feeding, burping, putting baby to sleep, etc.

Sibling Preparation - Taught by an obstetrics nurse, this class is designed to help big brother or big sister adapt to his/her new role.

Infant/Child CPR - For expectant parents, Friends and Families CPR and first aid are taught by an American Heart Association-certified instructor.

Additional classes offered at Wellington Regional Medical Center include:

Boot Camp for Dads - Teaches expectant dads how to care for, and enjoy, their new babies. $20 payable at the time of class. To register, call 561-798-9880.

Infant Massage - Whether your little one is newborn or several months old, massage can bring immediate and lasting positive results. Classes are offered weekly at $20/session, including massage oil. To register, call 561385-1301. Monthly Support Groups:

La Leche League - First Monday/month, 7PM. For information, call 561-963-9020

Lactation Tea & Support - Third Thursday/month, 9AM. For more information, call 561-586-BABY (2229)

ACCESS MEDICAL LABORATORIES: “It’s All About Access…” “Patients spend a lot of time choosing their doctor, they should choose their lab the same way,” says Mr. El-Hossieny, “we are [a] local, trusted laboratory that is an extension of your medical practice.”

By Erica Whyman

Jupiter, FL --- With their corporate office located in the heart of what is becoming known as Palm Beach County’s Biotech Community, Access Medical Laboratories in Jupiter is a local business that is providing one of a kind, distinct laboratory services.

I had the opportunity to sit down with Mr. Ryan El-Hossieny, the executive vice president of Access, to discuss their continued growth in our community, as well as abroad. The company recently moved into a state of the art 25,000 square foot location in Jupiter, Florida, in direct response to their volume and growth. The state of the art facility allows for all testing of labs to be done onsite, allowing for quicker turn around time and increased accuracy and precision for patients and physicians.

It was obvious upon stepping inside that this was no ordinary laboratory, with a beautifully appointed office and warm staff, I almost forgot this was somewhere you got your blood drawn, and not a spa or high-end health club. Mr. El-Hossieny explained that is exactly their goal, superior customer service from the moment you come inside until

Ryan El-Hossieny.

the moment you leave. Small touches, like their waiting area, the staff’s attentiveness, the fact that only butterfly needles are used for patient comfort, and all employees regardless of certification, attend intense Access training, contribute to this first class facility.

Access Medical Laboratories is a family run business, but with services abroad from China to Dubai, this is no “mom and pop” operation. Their goal is cutting edge innovation and technology while providing a full line of diagnostic testing from basic chemistry to high end hormone testing.

With five locations in West Palm Beach, Palm Beach Gardens, and Jupiter, Access Medical Laboratories, is one of those perks of living in paradise. Access Medical is doing business all over the US and internationally and we are fortunate enough to have them in our backyard.

Laboratory testing is an important part of diagnostics and has an important impact on our health. Results at Access Laboratories are usually turned around in 24hours with accurate and precise results.

Access Medical Laboratories is licensed in the state of Florida, accredited by COLA with a seal of excellence, and a participant in the College of American Pathology Proficiency Testing.

Access Medical Laboratories sets high standards for themselves throughout the process and is committed to providing the most thorough services for their patients.

Dea r Debora h I have been on Match.com for a year now. In that year, I have met a lot of really nice guys. The problem is that every man I go out with has been out with the same women. If I go out with John, he’s been out with Sarah, Joan, and Michelle. If I go out with Joe, he’s been out with Sarah, Joan, Michelle and the list goes on. It’s kind of sick in a way that we are all “sharing” the same people. It seems that all these guys are serial daters. When I find out they’ve all been out with the same women, I have no interest in seeing them again. Do you have any suggestions on where I can meet someone that everyone else hasn’t dated? - Want a man to myself

Dear Want a man to myself: There are so many other options for you to meet some incredible men. First, there are other dating websites and services, such as singles dinners and speed dating. You can look in your local newspaper for upcoming functions and charity events. Your local Chamber of Commerce has networking events and mixers, just look on their website. You can also volunteer at a local hospital, political office or a charity, not only will you meet incredible people, but you will be helping a wonderful cause. Another option is to do a search online for singles meet-up groups and sign up for their emails. I can go on and on with ideas, but that should give you a good foundation to build from. DEAR DEBORAH: I am a divorced woman in my 30’s who has dated quite a bit since my split. I am fortunate to say that although the men I met and dated have been really good for me, none of them turned out to be “the one.” I am, however, still in a casual relationship with some of them. As great as they are, I want a long-term committed relationship. Should I end all of these casual relationships so I can focus on finding that one special partner? Or, should I keep all of them while I search? - Looking for a long-term partner

Dear Looking for a long-term partner: I see nothing wrong with having male friends. However, that may take away from giving another man a real chance. You are using your casual relationships as a security blanket, perhaps out of fear of being alone. When you feel as though you have a “back-up” your tolerance level for other men will be less since you already have a man or two in your life. Therefore, by maintaining those relationships, you are not being fair and true to yourself. You never know what you will find until you completely open your heart and mind to finding love. By the way, you didn’t mention if you were having sex within your casual relationships. If you are and you are serious about finding a long-term relationship, I highly recommend that you stop seeing them immediately.

DEAR DEBORAH: I have been living with a woman that I am madly in love with for a year now. When she came home from a business trip last week, she started crying and told me that she cheated on me with a random guy she met at the bar. It’s been a week now and I keep picturing her getting it on with another man. I don’t even want to look at her and I’m not sure if I ever want to again. I’m thinking of moving out and ending the relationship, but I still love her. - She Cheated!!! Dear She Cheated: I know that you are in pain right now, but it’s still fresh. She was wrong, regardless of what was going on in your relationship. However, you need to give yourself time before making any rash decisions. Until you get past the shock, disgust and “why me” mentality, you need to give yourself some space. Believe me, those thoughts will fade in time and you will eventually be able to forgive her, the problem will be forgetting. You can work through infidelity, but only with forgiveness and an open mind and heart.

Dear Deborah is a monthly advice column written by Deborah Lynn with a common sense approach to dating. If you have any questions or comments, please forward them to: questions@globalhealthtribune.com as we would love to help.

8 APRIL ISSUE

• 2012

WWW.GLOBALHEALTHTRIBUNE.COM

Does Low-Dose CT Screening for Lung Cancer Save Lives?

Mark Perman, MD

Mark Perman, MD Board-Certified Radiation Oncologist Graduate of Medical University of South Carolina. Dr Perman has been practicing for more than 20 years.

4,000,000 current or former smokers in the US are at risk to die from the number one cause of cancer-related mortality. Since early detection of cancer is our mantra,

it seems that mass screening for those at a high risk would make sense. Unfortunately, randomized trials using chest x-rays either with or without cytologic examination of sputum, have done nothing to reduce the risk of dying. Molecular markers in blood, bronchial brushings and sputum have been studied in the lab, but are not yet ready for primetime in the clinic. What about helical CT screening? Nonrandomized trials have shown that low-dose single breath-hold CT shows more lung nodules and early lung cancers than chest radiography; but does it warrant the expense of CT screening and radiation exposure?

In 2002 the National Cancer Institute funded the National Lung Screening Trial (NLST). This randomized trial was designed to answer the question of whether low-dose CT as compared to chest x-ray would

radiography arm. No surprise that more early stage cancers were seen on CT. At the time of the final followup report in 2010, there were 354 deaths on the CT arm compared to 442 on the chest x-ray arm. This 20.3% reduction in the death rate was statistically significant.

reduce the death rate in high risk individuals. Eligible participants were asymptomatic men and women with no prior history of lung cancer between 55 and 74, smoked at least 30 pack-years, or had quit within 15 years of the study. 53,000+ were randomized and underwent three annual screening examinations at enrollment, one year and two

Cyberknife for the Lung Cancer Patient yberKnife is a very precise way of delivering radiation to a specific area that can minimize treatment or injury to normal tissue while getting rid of a tumor or cancerous cells.

Anthony Addesa, M.D. Board-Certified Radiation Oncologist

Dr. Addesa is a graduate of the Drexel University School of Medicine. After completing a medical internship at Jackson Memorial Hospital, he completed his radiation oncology residency at the Sylvester Comprehensive Cancer Center at the University of Miami School of Medicine. He was awarded an ASTRO Fellowship at Harvard Medical School, Brigham & Women's Hospital in Boston, Mass., for stereotactic radiation training. Dr. Addesa has subspecialty interests in tumors of the central nervous system, lung and prostate. He has been invited to speak at courses in both the U.S. and Europe, and has co-authored several book chapters on prostate cancer and articles in peerreviewed journals on various cancer-related topics. He is fluent in Italian, Spanish and French.

CyberKnife for lung is used in a few different ways. We often see patients who have early stage lung cancer that for whatever reason, whether it be other health comorbidities or age cannot have surgery.

What we do at CyberKnife is it’s a non-surgical way of treating early stage lung cancer and the results are as good as surgical receptions. So, we can ablate or kill the tissue with very precise targeting and minimizing normal lung injury. It’s also very convenient for the patient because they will not be going through a major surgical procedure which would crack the chest.

The most invasive portion of this procedure is putting a marker into the lesion. The best way to describe it is it’s almost like a GPS marker for the machine. We put this in through a needle or bronchoscopy into or around the tumor site. Then the machine is able to track that as the patient is breathing. Each treatment takes about 30-60 minutes and the way the machine moves is that it can track the movement of the lesion by following the marker. The treatment itself can take one to three treatments and as many as five. All this can be done in one week, typically Monday, Wednesday and Friday; so every

other day. This treatment can also avoid the normal lung, heart, esophagus and the trachea, all of the major organs that you want to protect in surgery.

The machine treatment device is like a mini-radiation delivery on the end of a robot. CyberKnife was developed at Stanford in 1994 and approved by the FDA in 2001.

The other way that CyberKnife is used in relation to lung cancer is after traditional fractional radiation which happens over a period of five to six weeks. There are patients that come along that are not Cyberknife candidates because of the size of the lesion or location next to a major vessel, such as the heart or in the center of the chest. So, those patients may require a more traditional treatment which are daily treatments given Monday through Friday over a period of about 3035 treatments for six to seven weeks. Unfortunately, that has a lot of side effects because you have to treat the esophagus, so they may get heartburn and since they can’t eat as well, they tend to lose a lot of weight. So, what the CyberKnife can do after that traditional six or seven week course is to take care of anything left after the traditional therapy in the form of a boost dose. It’s a knock out punch for a tumor.

The gold standard for early stage lung cancer has been to surgically remove it. Cyberknife is an alternative non-surgical method and the data among various institutions is that it’s equivalent in terms of local control.

years with 5 years of followup. A positive result considered “suspicious for cancer” included noncalcified masses at least 4 mm in diameter in the CT group, or any noncalcified nodule on xray. 96.4% of the CT arm and 94.5% of the chest x-ray arm were false positives. 1060 lung cancers were diagnosed on the CT arm and 941 on the chest

So, should we be scanning 7,000,000 high risk folks? What about the risk of malignancy from radiation from the CT itself? Is CT screening cost effective particularly when factoring in the cost of the CT, diagnostic followup and treatment? How do these results affect the other 87,000,000 less heavy smokers? Until the day comes when we can figure out who is really not at risk, most physicians will opt to order the CT, a test that is associated with a relatively low cost and has a possible benefit for a lot of people.

You Survived Cancer: Now Pay Attention to Your Overall Health

Half of cancer survivors die of other conditions, such as heart disease and diabetes.

ancer survivors need to pay close attention to other aspects of their health as they age, researchers urge. A new study finds that nearly half of cancer survivors die of something other than cancer, such as heart disease or diabetes. And the further from the initial cancer diagnosis they get, the more likely it is that their cause of death will be something other than cancer. The study was to be presented at the American Association for Cancer Research's annual meeting in Chicago. "After the detection of cancer, clinicians and cancer survivors pay less attention to the prevention and treatment of other diseases and complications," lead researcher Dr. Yi Ning, assistant professor in the department of epidemiology and community health at Virginia Commonwealth University in Richmond, said in an association news release. "We shouldn't neglect other aspects of health because we are focused on cancer and overlook other chronic conditions." In following 1,800 cancer survivors over the course of more than 18 years, researchers found that 776 of the patients died: 51 percent eventually died from cancer and 49 percent died from other conditions.

"We realized that the mortality rates for some types of cancer, such as breast cancer, had declined," said Ning, also an associate research member at VCU Massey Cancer Center. "Cancer survivors live much longer than they did several decades ago. So with this large group of cancer survivors, we need to pay more attention to cancer survivors' overall health." The patients followed in the study survived some of the most common forms of cancer, including breast, prostate, cervical, lung and colorectal. A large percentage were also diagnosed with conditions other than cancer, including high blood pressure and diabetes. The more time that passed after the initial cancer diagnosis, the more likely cancer survivors were to die from another illness. Among those who died from a condition other than cancer during the study period, 33 percent had been diagnosed with cancer within the previous five years and 63 percent had been diagnosed 20 years earlier. Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Your lungs deserve better. SFRO is changing the way lung cancer is treated. When you’re facing cancer, it’s personal—you want the latest treatment techniques and the best physicians so you can get back to living your life.

TToday, oday, lung lung cancer is the secon second-most-common d-most-common cancer in both men (aft (after er pr prostate) ostate) and and women (aft (after er breast). br east). It accounts ffor or 15 per percent cent of all new cancers. cancers. Att South Florida RRadiation A adiation O Oncology ncology (SFR (SFRO), O), w wee hav havee the expert expertise ise an and d a complet completee rrange ange of tr treatment eatment opt options ions ttoo help yyou ou mak makee the right choice in yyour our fight against llung ung cancer. cancer. TrueBeam™ rredefines TrueBeam™ edefines llung ung cancer treatment. treatment. It’s It’s powerful. po werful. It’ It’ss pr precise. ecise. A And nd it’ it’ss mor moree comf comfortable ortable ffor or you, you, with ffewer ewer side ef effects. fects. SFRO iiss tthe SFRO he oonly nly ccancer ancer treatment treatment ccenter enter iinn SSouth outh FFlorida lorida with TTrueBeam™ rueBeam™. It’ It’ss just one of the man manyy weapons weapons in our po werful ar senal, which also incl udes CyberKnife®, CyberKnife®, powerful arsenal, includes RRapidArc™ apidArc™ an and d Br Brachytherapy, achytherapy, so we’ll we’ll find find the treatment treatment that’ss right ffor that’ or yyou. ou. Isn ime yyou ou got back ttoo living yyour our lif e? Call us today today Isn’t’t it ttime life? ttoo explor dvanced cancer tr eatments av ailable at exploree the a advanced treatments available an SFR SFRO O locat location ion near yyou. ou.

877-930-SFRO 8 77-930-SFRO (7 (7376) 376) www.SFROLLC.com www.SFROLLC.com CyberKnife® C yberKnife®

RRapidArc™ apidArc™

Brachytherapy Br achytherapy

Port Port St. Lucie Lucie

| Stuart | Wellington Wellington Wellingt

TTrueBeam™ rueBeam™

10 APRIL ISSUE

• 2012

WWW.GLOBALHEALTHTRIBUNE.COM

Central Palm Beach County Chamber of Commerce Medical Committee

Hosts Medical Networking Event By Erica Whyman

Wellington, FL --- On the evening of March 28th, prominent members of the local Healthcare community gathered for a networking event hosted by the Central Palm Beach County Chamber of Commerce’s Medical Committee at the beautiful offices of Palm Beach Urology Associates, P.A.

Guests were welcomed by sponsors PNC Bank and the staff of Palm Beach Urology Associates. The event provided a warm environment for busy professionals to enjoy cocktails, hors d’oeuvres and an opportunity to connect with peers. The other sponsors, Palms West Hospital, PrintIt Plus, Anderson Moore Construction, and Wellington

Regional Medical Center contributed to the success of the evening.

In 2009, Palms West Chamber, now known as Central Palm Beach Chamber, launched the Medical Committee to provide programming related to education, networking, marketing and advocacy to the medical community. With a goal of supporting economic development and growth, the Chamber recognized the importance of the medical community as one of the top three industries in economic impact and employment to the community. Events such as this provide important resources and connections to the medical community that contribute to the continued growth of this business sector

Dana Ray, Alan Fripo, and Dr. Jeff Wisnicki.

Chamber of Commerce Medical Committee staff.

Lisa Wilder and Heather Fandrey.

Leah Saporito, Dr. Michael Mikolajczak, Dr. Edward Becker, Dr. Brad Glick, Charlene & Dr. Jeffrey Bishop.

Nabiha Bartlett, Patricia McDermott, and Dr. Georgis Patsias.

Stuart Klein and Ryan Lewis.

Dr. Maureen Whelihan, Dr. Eric Baumel, Dr. Shekhar Sharma, Dr. Michael Mikolajczak, Dr. Dexa Patel.

Hillary Budford and Judith Schumacher.

Dr. Kishore Dass, Mary Martinez, and Dr. Shekhar Sharma.

Woody White, Meroe Rabieifar, Johnny Meier.

Dr. Edward Becker, Dr. Damian Portela, Dr. Ishan Gunawardene, Dr. Georgis Patsias.

Palm Beach Gastroenterology Consultants, LLC

Krishna Tripuraneni M.D., M.B.A.

Vikram Tarugu M.D

Call Us Today If You Suffer From Any Of The Following: Abdominal Pain Bleeding Chest Pain Cirrhosis of the Liver Colitis Constipation Diarrhea

Pancreatis Stomach and Duodenal Ulcer Ulcerative Colitis Reflux Disease Hemochromatosis Hemorrhoids Hepatitis

Digestive Diseases Stats Dysphagia Gallstones Gastroesophageal Jaundice Lactose Intolerance Liver Disease Nervous Stomach

Venra Clinical Studies, LLC Also offering

IRRITABLE BOWEL SYNDROME?

We are conducting a clinical research study of an investigational medicine. If you meet the following criteria, you may be interested in participating in this clinical trial.

• Age 18 – 79 inclusive • At least 28 stools over a 7-day period • Moderate to severe Pain in your abdomen associated with: • relief by defecation, • change in frequency of bowel movements, or • change in appearance of stool.

Participants receive study related care, diagnostic tests, and study medication at no cost. Payment for time and travel to the study center may be provided

For more information about the research study, please contact:

Two Convenient Locations: WELLINGTON

1157 South State Road 7 Wellington, Florida 33414

561.795.3330 Venra Clinical Studies, LLC 561-795-3330 ex. 249 info@venraclinicalstudies.com

BELLE GLADE

1200 South Main Street #102 Belle Glade, Florida 33430

561.996.5600

At Palm Beach Surgery Center we provide a safe and friendly enviroment, with a highly qualified and dedicated staff. A variety of procedures such as colonoscopy, endoscopy, gastroplications, ERCP, Liver Biopsy, 24 PH Monitoring/BRAVO can be done at our facility thus avoiding the need for hospitalization.

www.wellingtongastroenterology.com

12 APRIL ISSUE

• 2012

WWW.GLOBALHEALTHTRIBUNE.COM

Test Your Knowledge

PBCGME receives consortium designation

for a few days. He could not sleep at night without raising his head on three pillows. What do you think he has? (Look for the answer on page 15).

Case #4: A young man thirty-five years of age walks into my office complaining of increased thirst, drinking a lot of water, urinating more frequently than before and has lost some weight over the past one month. What is your answer to this complaint? (Find the answer on page 15).

Shekhar V. Sharma, M.D.

Board Certified in Internal Medicine

am sure most of you out there have walked into a doctor’s office as patients, curious to know what is wrong with you. Below are a few unusual true case history scenarios which I would like for you to diagnose the illness. Case #1: A fifty-year-old woman with Diabetes Mellitus walks into my office with complaints of frequent belching which was new to her. What is your diagnosis? (Look for answers on page 15).

Case #2: A forty-five-year-old woman walks into the emergency room with the worse headache that she has ever had along with nausea and vomiting. A CT scan of the brain was done and this was what she was found to have. (Answer to be found on page 15).

Case #3: A sixty-five-year-old patient with shortness of breath and swelling of his feet

Case #5: A thirty-year-old over weight man started getting headaches almost every morning when he woke up. He is also a cigarette smoker and has never had any medical problems in his life and did not complain of anything else. What do you think he could be having? Dr. Sharma is a Board certified Internist that has been in practice for the past 19 years. His office is accepting new patients: Palomino Park, 3347 State Road 7 Suite 200 Wellington, FL 33449 and for an appointment please call

(561) 795-9087

Dr. Sharma's office in Belle Glade is at 1200 South Main Street, Suite 100 (opposite the Old Glades General Hospital). He will be seeing patients at this location along with his nurse practitioner Grace VanDyk.

He is currently accepting New Patients and the office accepts most insurances.

Call

561-996-7742 for an appointment.

he Palm Beach Centre for Graduate Medical Education (PBCGME) has received designation by the American Osteopathic Association (AOA) as a graduate medical education consortium.

PBCGME is accredited for 120 postgraduate training positions in nine different programs, utilizing the resources of four HCA hospitals. With programs including a traditional rotating internship, dermatology, emergency medicine, family medicine, hospice and palliative care, internal medicine, pediatrics and psychiatry PBCGME residents rotate through Columbia Hospital, Palms West Hospital, St. Lucie Medical Center and University Hospital Medical Center. In addition, the West Palm Beach VA Medical Center serves as a major training affiliate.

PBCGME also serves a core training site for third year medical students from Nova Southeastern University, the Philadelphia College of Osteopathic Medicine and the Kansas City University of Medicine and Biosciences.

According to physician/attorney Bradley Feuer, who serves as the consortium's regional director, there are several features that set PBCGME apart from other programs. "In addition to academics, we place a strong emphasis upon research and professionalism. We require each resident to present one poster each year of training, as well as one publishable paper before they graduate. Residents are also required to conduct annual community service projects.". PBCGME fosters a true team approach with resident activities which include annual ropes course, canoe trips and a "residents day out" in which they are excused from clinical activities to participate in a "day off" with their program leadership. Also unique to PBCGME is the medical education experience of their leadership, many of which are graduates of PBCGME programs, themselves. PBCGME programs have been training physicians for 30 years.

For more information see: www.pbcgme. com, visit their Facebook page or call Rachel Finn, MHA, Regional Medical Education Coordinator at 561-863-2315.

PALM BEACH PRIMARY CARE ASSOCIATES, INC. State of the Art Office Building with Imaging Center,

Shekhar Sharma M.D. Grace VanDyk A.R.N.P.

Medicare patients accepted

Southern Blvd.

MEDICARE, BLUE CROSS BLUE SHIELD, HEALTH CARE DISTRICT AND MOST MAJOR INSURANCES ACCEPTED On Staff: At Palms West Hospital, Wellington Regional Medical Center

Palomino Park

PALM BEACH PRIMARY CARE ASSOCIATES

Lake Worth Rd.

Florida’s Turnpke

The Mall at Wellington Green

State Road 7 (441)

Forest Hill Blvd.

9 AM - 5 PM MONDAY - FRIDAY SAME DAY APPOINTMENTS AVAILABLE 24 HOUR SERVICE AVAILABLE

3347 State Road 7 Suite 200 Wellington, FL 33449

Tel: (561) 795-9087 • Fax: (561) 753-8730

SPECIALIZING IN: • Diagnosis of Complex Illnesses • Cholesterol Management • Diabetes • Cardiac Care • EKG/24 Hour Heart Monitoring/Spirometry • Hypertension • Geriatric Concerns • Osteoporosis ACCEPTING NEW PATIENTS

1200 South Main Street Suite 101 Belle Glade FL 33430

Tel: (561) 996-7742 • Fax: (561) 753-8730

APRIL ISSUE • 2012 13

WWW.GLOBALHEALTHTRIBUNE.COM

By Deborah Lynn

s an adult, there is nothing more painful than to see a child battle cancer, especially if that child is your own. Thanks to the Kids Cancer Foundation and Michelle O’Boyle, they now have a new safe haven away from the fear and pain associated with their treatment. The new Kids Cancer Center is located on the grounds of Palms West Hospital in Loxahatchee. At the center, children can play on the computer, take classes on nutrition, get tutoring, watch TV, work with therapists in the health and wellness center, play games in the teen room or even relax in the music room. There are also many other programs that are currently in the planning process. These wonderful programs and the facility run on donations, both monetary and in the form of time spent by volunteers teaching the classes that are so vitally important to these deserving children.

The center was founded and is headed by Michelle O’Boyle, who herself has been an oncology nurse for over 25 years. Therefore, she not only understands the medical needs of these children and families, but also understands the physical, emotional and financial needs as well. Knowing what these children

KIDS CANCER CENTER (2)

(1)

(3)

(4)

(1) Jennifer gives Jacob a massage in the center "Health and Wellness Center". (2) Leilani enjoys the "Childrens Playroom" (3) Michelle O'Boyle, RN, BSN, CPON. (4) Byron showing off his airplane puzzle.

experience, Michelle founded the Kids Cancer Foundation over ten years ago to meet their needs and to provide hope and support to these children and their families throughout their journey.

In addition to Michelle, the foundation also has a dedicated volunteer and parent of a childhood cancer survivor, Sandy Erb. Both these amazing women are only interested in making these beautiful children feel safe and at home. In essence, these children are

their children, as they are there to love and protect them as a parent does.

For anyone that has battled cancer, you know that there is so much more involved than just the medical aspect. The medical staff does an amazing job; however, there are numerous other things that affect a child. The fact that they are missing school and subsequently fall behind, not socializing with their friends, and the long term effects from not only

Tenet Florida Hospitals Recognize Brain Injury Awareness Month

EST PALM BEACH, Fla.March 27, 2012- In honor of Brain Injury Awareness Month, Tenet hospitals in West Palm Beach are placing attention on raising awareness about brain injuries and preventative measures. This year, the hospitals’ support the Brain Injury Association of America’s focus on the nondiscriminatory aspect of brain injuries with their multiyear campaign theme: “Brain Injury: Anytime, Anywhere, Anyone.”

“Brain Injury Awareness Month honors the millions of people with brain injury, who with proper acute care, therapeutic rehabilitation and adequate long-term supports, are living with the successes and challenges that each day brings,” said Susan H. Connors, president/CEO of the Brain Injury Association of America. “Our goals this year are to sustain and bolster brain injury programs, increase access to care and preserve vital brain injury research.”

Among the five Palm Beach County hospitals in the Tenet Florida network (West Boca Medical Center, Delray Medical Center, St. Mary’s Medical Center, Good Samaritan Medical Center, and Palm Beach Gardens Medical Center), both St. Mary’s Medical Center and Delray Medical Center are equipped with trauma centers and a fully trained staff. Due to the nature of trauma care, both hospitals treat a number of brain injuries, almost daily. “For the month of March, the Palm Beach Hospitals of Tenet place special emphasis on brain injuries awareness and education,” said Marsha Powers, Senior VP of Operations,

the physical aspect, but mentally as well. The delayed effects can also take a toll on the parents. They try to be strong for their child and therefore have no means to relieve the stress that they keep bottled up inside. Some of which will experience post-traumatic stress disorder down the road. Michelle has also found a way to help children eliminate the worry and stress associated with going to the hospital for therapy in the

form of a chemotherapy duck. The duck is even equipped with a central line for those children that have had an issue with getting their port accessed. According to Michelle, some of the children start to worry on Monday about their treatment on Friday. Taking the duck through the same process that they will be experiencing has helped to relieve some of their anxiety. For older children, an iPad is used for distraction and for guided imagery. Unfortunately, cancer not only takes a toll on the child, but the family as well. Therefore, Michelle and Sandy have organized four family social programs throughout the year. When the children and their families get together, they can just let go and forget about all the pain – if only for a few hours.

Since this is a non-profit organization and the space is leased through the hospital, they need monetary donations and support from wonderful people and businesses like you. The center also provides gift cards, clothing, toys, stuffed animals, and other items to help the needs of the children. For information on giving to such a wonderful foundation and cause, please contact Michelle O’Boyle at 561-3338116, or visit their website at www.kidscancersf.org.

Simply 66 Snap Cubicle Curtain System

Tenet Florida. “Our trauma centers in Palm Beach, located at Delray Medical Center and St. Mary’s Medical Center, are especially aware of the fact that you can't plan for a brain injury, but once it happens, you need to know where to go for help.”

Statistics show that 1.7 million people sustain a traumatic brain injury (TBI) each year. According to the Centers for Disease Control and Injury Prevention, the top two leading causes of TBI are falls (35.2%) and motor vehicle-traffic crashes (17.3%). About 75% of TBIs that occur each year are concussions or other forms of mild traumatic brain injury (MTBI). If a brain injury is suspected, no matter how minor an accident may seem, it is critical to receive immediate evaluation and treatment from a qualified emergency healthcare provider.

“Since anyone can sustain a brain injury at any time, it is important for everyone to have access to comprehensive rehabilitation and ongoing disease management,” said Dr. Brent Masel, national medical director for the Brain Injury Association of America. Doing so eases medical complications, permanent disability, family dysfunction, job loss, homelessness, impoverishment, medical indigence, suicide and involvement with the criminal or juvenile justice system. Access to early, comprehensive treatment for brain injury also alleviates the burden of long term care that is transferred to tax payers at the federal, state and local levels.” For more information on brain injuries visit http://www.biausa.org/

The Only Snap Privacy Curtain that Truly Standardizes your Facility

• No Ladders! Eliminate the Risk of a Fall During Curtain Installation • Easy Installation! No More Time Spent Searching for the Right Sized Curtain- Fabric Panels Fit Every Room • No Expensive RetroFit! Simply 66 Can be Installed on Existing Cubicle Track Simply 66 Snap System is Available Through the Following Distributors:

Cubicle Curtain Factory, Inc. 1.800.588.9296 www.CubicleCurtainFactory.com

14 APRIL ISSUE

â&#x20AC;˘ 2012

By Deborah Lynn

n February 27, the Cancer Alliance of Help and Hope (CAHH) held their 5th annual City Lights for Life event at Palm Beach Motor Cars Limited in West Palm Beach. It was a wonderful mix of sponsors, attendees, and local businesses that all came together for such a worthwhile cause. CAHH is a volunteer-governed

WWW.GLOBALHEALTHTRIBUNE.COM

"City Lights for Life" charitable organization, dedicated to improving the quality of life for local individuals and their families who have been touched by cancer. Thus providing need-based financial assistance, information resources, access to services and support groups in our community.

If you would like additional information about CAHH, please visit their website at www.CAHH.org.

5th Annual City Lights for Life.

Angels Envy.

John Biondo and Judy Armstrong.

Susan Nefzger and Jean Fischer.

Mary Martinez at the SFRO booth.

Leila's Restaurant.

Executives from FirstCity Bank, Palm Beach Gardens.

Brown & Brown Insurance.

Mary Martinez, Judy Armstrong, Trish Tucker, Danielle Mirakian, and Dr. Alex Mirakian.

APRIL ISSUE • 2012

WWW.GLOBALHEALTHTRIBUNE.COM

Cancer Alliance

By Jean Fischer

for Help and Hope

hree of the most devastating words a doctor can say to a patient is, “You have cancer”. Following the decisions that have to be made for treatment options, transportation, insurance issues – if you are lucky enough to have insurance – is the realization that if you are unable to work during treatment, or are the parent of a child diagnosed with cancer and have to quit work to take care of the child, “how am I going to pay my bills?” That’s where the Cancer Alliance of Help and Hope, Inc. steps in.

CAHH is a 501(c)3 non-profit organization, located in Tequesta, was founded in 2003 by Charlie and Jean Fischer. The Board of Directors is comprised of local residents who have been touched by cancer. CAHH is dedicated to helping cancer patients who live in or are treated in Palm Beach County. CAHH assists with the most basic and needed items such as rent, mortgage, utilities, car payments, car and medical insurance when a patient is having financial dif-

ficulty while undergoing radiation and/or infusion chemotherapy treatments. The funds go directly to the vendor to assure the bills are paid. This assistance allows the patients to have less stress while they are concentrating on healing. As one patient, Wayne, commented, “If CAHH had not helped me, I could not have received my chemotherapy treatments because I would have had to use that money to keep a roof over my family’s head”. CAHH works with referral sources in Palm Beach County including hospitals, cancer centers, the American Cancer Society, Leukemia and Lymphoma Society, Hospice and self- referrals. To date, CAHH has assisted over 800 patients and has paid out over $1 million in support for the patients. Funding for CAHH comes from grants received from local foundations, donations from individuals and fundraisers. For more information about CAHH call 561-748-7227, email to canceralliance @gmail.com or visit the web site at www.cahh.org

Upcoming Medical Fundraising Events for April 10 – May 10, 2012

April 13

Kids Cancer Foundation. 6th Annual Jenna McCann Memorial Golf Tournament. A shot gun golf tournament at the Madison Green Golf Club, Royal Palm Beach. Cost is $175 and that includes golfing, box lunch and dinner. A foursome with box lunches and dinner is $600. For more information, contact Tom Leinwol at 561-632-0341, or by email t.leinwol@yahoo.com. Or, you can visit the website at www.puttawaykidscancer.com.

April 14

JDRF Walk to Cure Diabetes – Treasure Coast/Stuart. 10th

Annual Walk to Cure Diabetes at Flagler Park, Stuart. The cost is a donation. Register online at www.walk.jdrf.org, call JDRF at 561-686-7701, or e-mail greaterpalmbeach@jdrf.org.

April 18

The Children’s Healing Institute. 3rd Annual Turn on the

Light Child Abuse Prevention Luncheon. Michael Dolce, will be the keynote speaker. Benvenuto Caterestaurant, Boynton Beach. For more information, visit www.childrenshealinginstitute.org.

April 19

Diabetes Research. American Fine Wine Competition Gala. Boca Raton Resort, Boca Raton. Cost is $310 per person. For ticket information, call 954964-4040 or visit their website, www.diabetesresearch.org/AFWCG2012.

April 22

Diabetes Research Institute at the University of Miami Miller School. 2nd Annual Randi Fibus-Caster

Pro Am Diabetes Golf Classic. Polo Club of Boca Raton, Boca Raton. Cost for 9 or 18 holes is $275. Dinner only is $200. For additional information, e-mail info@drif.org, or visit the website www.diabetesresearch.org.

April 27

Central Palm Beach County Chamber of Commerce Installation Gala. International Polo

Club Palm Beach, Wellington. Tickets are $125/member and $175/non-member. For additional information, e-mail Jaene Miranda at jaene@palmswest.com, or call 561-791-6200.

Gilda’s Club of South Florida. Friend’s of Gilda’s Palm Beach Red Door Luncheon. Woodfield Country Club, Boca Raton. For more information, contact Gail Weinbrum at gsw45@bellsouth.net, or visit the website at www.gildasclubsouthflorida.org.

April 28

Give A Smile To A Child Foundation. 5th Annual “Give A

Smile To A Child” Golf Classic at Palm Beach Gardens Municipal Course. Entry fee is $150/player or $500/foursome (early registration ends April 15). After that date, the entry fee is $600 per foursome. Space is limited. To register, call 561-707-7813, or go to www.softballangel.com, or www.giveasmiletoachild.com.

May 10

Juvenile Diabetes Research Foundation. 5th Annual Young

Professionals Bachelor & Bachelorette Auction. Rome Nightclub at Roxy’s, Downtown West Palm Beach. Tickets are $30/advance, or $40/at the door. Go to www.facebook.com/theauction for more details, or www.jdrf.org.

Announces Fifteenth Annual Physician Recognition Award Honorees

BOCA RATON, Fla. – March 30, 2012West Boca Medical Center announced its fifteenth annual physician award honorees as a traditional part of its hospitalwide Doctor’s Day recognition. This year, Ivonne Reynolds, DO, OB/GYN; David Kay, MD, Pediatric Otolaryngology; and George Varsegi, MD, Pathology were presented with the hospital’s prestigious Physician Recognition Award. Accompanying the award, each doctor will receive $500 to donate to a charity of his or her choice.

“Doctor’s Day and our annual physician recognition event is a time where the entire hospital makes it a priority to stop and thank our doctors and recognize them for the selfless job they do each day to take care of our communities,” said CEO Mitch Feldman. “We give special honor to those physicians voted by their coworkers as going above and beyond to exemplify West Boca Medical Center’s mission to provide quality care with outstanding service, and look forward to helping them benefit the charitable organizations about which they are passionate with their award-winning donations.”

Award winners were selected based on an employee nomination and voting system, which encourages West Boca Medical Center employees to nominate physicians that exemplify the hospital’s values of practicing compassionate care, being engaged as team members in delivering quality patient care, and standing out as a true professional and asset to West Boca Medical Center.

Feldman concludes, “The administrative team congratulates all 2012 physician recognition award winners; they are now among a respected 15- year list of past recipients, of which we are proud.”

About West Boca Medical Center West Boca Medical Center, part of Tenet South Florida, is a 195-bed acute care hospital located at 21644 State Road 7 in Boca Raton, Florida. West Boca Medical

Center has been serving the medical and healthcare needs of its community and surrounding areas for over 20 years.

West Boca Medical Center offers a broad array of services, including general medical and surgical care; orthopedics and sports medicine; a robotic surgery program offering minimally invasive surgery for gynecological, urological and general surgical procedures; a state-ofthe-art diagnostic imaging center featuring open MRI and digital mammography; cardiac and surgical intensive care; outpatient surgery services; 24-hour emergency services for adults and children; diabetes education; outpatient rehabilitation services; and a specialized sleep diagnostic center with a dedicated lab for infants, pediatrics and adults. West Boca Medical Center is a State Certified Primary Stroke Center, and received the 2012 American Stroke Association/American Heart Association Get With The Guidelines-Stroke Silver Plus Performance Achievement Award and Heart Failure Gold Plus Performance Achievement Award.

The hospital also offers several specialties, including women’s and children’s services. With its BirthCare Pavillion and Level III Neonatal Intensive Care Unit, the hospital is equipped to treat expectant mothers and their babies from the routine to very high-risk. West Boca Medical Center earned the HealthGrades Maternity Care Excellence Award each year from 2006-2012. In addition, HealthGrades ranked West Boca’s maternity program among the top 5% five percent in the nation for six years in a row (2007-2012).

The hospital is fully accredited by the Joint Commission on the accreditation of Healthcare Organizations, the nation’s oldest and largest hospital accreditation agency. For more information about West Boca Medical Center or for physician referral, call 866-904-WBMC (9262) or visit the website at www.westbocamedctr.com.

Answers to Dr. Sharma’s Questions

Answer to Case #1: This was a tough case!! I did an EKG on her with a suspicion that she could be having a heart attack. I did a STAT EKG and found her to be having an acute myocardial infarction (In other terms a heart attack). If you notice there is a blatant absence of chest pain as a complaint. Why is that? This is because a certain percentage of diabetics have silent heart disease where they may have other symptoms to suggest heart disease without having chest pains. So diabetics have to be made aware and educated about this potential problem by their physicians Answer to Case #2: This lady had sub arachnoid hemorrhage due to a ruptured vessel in the brain. The bleed was found by the brain CT scan. The condition as far as I recollect was dangerous but not fatal in this case and the patient lived to walk back home later after being admitted in the hospital.

Answer to Case #3: He has congestive heart failure (CHF) which means having a weak heart that does not pump blood as normally as it should. Fluid starts building up in the lungs causing shortness of breath. He has a condition called orthopnea which is shortness of breath on laying down flat. He also has fluid in his feet which is a sign of CHF in this case. Answer to Case #4: Patient has new onset of Diabetes Mellitus which is a disorder of sugar metabolism. This disease can be potentially dangerous if left untreated. There are various oral medicines and injectables that are available now to control this very common disease. There is no known cure for this disease yet.

Answers to Case #5: This person in fact has severe hypertension causing morning headaches and could potentially have a condition called sleep apnea that is associated with cardiovascular problems of which hypertension is one of them.

Trust the Areaâ&#x20AC;&#x2122;s

TOP TEAM in Emergency Medicine

In an emer emergency gency â&#x20AC;¦ expertise, experience and minutes count. Thatâ&#x20AC;&#x2122; Thatâ&#x20AC;&#x2122;ss why the areaâ&#x20AC;&#x2122;s Center.. ar eaâ&#x20AC;&#x2122;s top team in emergency emergency medicine is at Wellington Wellington Regional Medical Center s %XPERTISE n !LL SEVEN %2 RESIDENCY TRAINED PHYSICIANS XPERTISE n !LL SEVEN %2 RESIDENCY TRAINED PHYSICIANS ARE CERTIlED BY THE !MERICAN "OARD OF %MERGENCY -EDICINE A RE CERTIlED BY THE !MERICAN "OARD OF %MERGENCY -EDICINE s %XPERIENCE n -ORE THAN YEARS OF COLLECTIVE %2 EXPERIENCE XPERIENCE n -ORE THAN YEARS OF COLLECTIVE %2 EXPERIENCE s s -INUTES #OUNT n !LL SEVEN DOCTORS HAVE BEEN A TEAM FOR MORE THAN A INUTES #OUNT n !LL SEVEN DOCTORS HAVE BEEN A TEAM FOR MORE THAN A s DECADE AT 7ELLINGTON 2EGIONAL WHERE ADVANCED TECHNOLOGY AND DECADE AT 7ELLINGTON 2EGIONAL WHERE ADVANCED TECHNOLOGY AND CARING FOR YOU WITH LITTLE OR NO WAIT TIME IS A TOP PRIORITY CARING FOR YOU WITH LITTLE OR NO WAIT TIME IS A TOP PRIORITY

For more information and to meet the docs, visit WellingtonRegional.com.

10101 Forest Forest Hill Blvd, W Wellington ellington Physicians are are independent practitioners who ar are e not employees or agents of W Wellington ellington Regional Medical Center. Center. The hospital shall not be liable for actions or tr treatments eatments pr provided ovided by physicians.