Global Health Tribune - August issue by Global Health Tribune

Global Health TRIBUNE

AUGUST ISSUE - 2012

Serving: Jupiter

Palm Beach Gardens

Royal Palm Beach

Wellington

Belle Glade

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

Lake Worth

Lantana

CDC recommends hepatitis C testing for all baby boomers Hepatitis C is an unrecognized health crisis in the United States. This life-threatening infection affects an estimated 3.2 million Americans, most of whom are “baby boomers” (those born from 1945 through 1965). The Centers for Disease Control and Prevention issued a recommendation this week for all baby boomers in the United States to get tested for hepatitis C.

NANCY PELOSI AND LOIS FRANKEL TAG TEAM BOCA RATON DENTAL HEALTH

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Boynton

Boca Raton

INSIDE

Falling Arches… Not to Be Ignored PAGE 3

South Florida Radiation Oncology is Making Huge Strides in Cancer PAGE 8 Treatment Roger L. Kirk, President and CEO of Bethesda Memorial Hospital PAGE 10

In addition to Pelosi and Frankel, Dr. Shekhar Sharma, a respected board certified Internist and a regular contributor to the Global Health Tribune was a guest speaker on the panel. PAGE 2

COMMUNITY EVENTS

One of the ways Dr. Betancur can treat your sleep apnea is in the form of Oral Device Therapy.

Roger L. Kirk.

Good Samaritan Chief Nursing Officer Awarded The 2012 Palm Healthcare Commitment to Community Award

PAGE 13

Phelps Media hosts another "Girls Night Out" with the Kids Cancer Foundation in PAGE 14 mind.

Angela Prestia, RN MSN NE-BC. PAGE 13 GLOBAL HEALTH TRIBUNE P.O. Box 213424 Royal Palm Beach, FL 33421

New Features on Mobile App from West Boca Medical Center Helps Keep Expectant and New Moms Up-to-date and Organized PAGE 4 WEST PALM BCH, FL PERMIT NO. 1340

PAID PRSRT STD U S POSTAGE

2 AUGUST ISSUE

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Nancy Pelosi and Lois Frankel tag team Boca Raton

inority Leader of the United States House of Representatives, Nancy Pelosi, was at the Veranda Club in Boca Raton on Monday, August 6 to support former member of the Florida House of Representatives and former West Palm Beach Mayor, Lois Frankel, on her quest for Congress serving the 22nd Congressional District. Pelosi and Frankel were in good company as over 100 seniors, local politicians and media were more than eager to listen as they both spoke at the forum for Medicare. Frankel obviously hit home as she spoke of changes to Medicare. “Imagine if I had to decide whether to help my mother with health care or my son with college. That’s why it’s so

important for our families with children to know that their parents and grandparents are taken care of with health care.” In addition to Pelosi and Frankel, Dr. Shekhar Sharma, a very well-known and respected board certified Internist and a regular contributor to the Global Health Tribune was a guest speaker on the panel. He discussed how health care costs can be reduced by using universal electronic health record computer software systems that interconnect physicians and health care providers for better health care for patients that would avoid duplication of services. Pelosi agreed. Days after Nancy Pelosi’s visit, Lois Frankel beat Kristin Jacobs in the Democratic primary for Palm Beach-Broward District 22.

Nancy Pelosi talking at the Veranda Club in Boca Raton.

Global Health TRIBUNE

Deborah Lynn Staff Writer and Sales Executive (312) 351-2383 deborah@globalhealthtribune.com Lois Frankel, Dr. Shekhar Sharma and Nancy Pelosi.

FUTURE OF MEDICINE SUMMIT REGISTRATION OPEN; 16 CMES AND CEUS OFFERED WEST PALM BEACH (August 14, 2012) – Registration is now open for the sixth annual Future of Medicine Summit: Striving for Medicine’s Better Future. Palm Beach County Medical Society Services hosts the Summit, which will focus on diabetes, bipolar disorder, heart disease, health care economics, health policy, health care transformation and other topics. The Future of Medicine Summit will take place from September 27-28, 2012, at the Palm Beach County Convention Center. Up to 16 CMEs and CEUs are available for the following disciplines: physician, nurses, social work, pharmacy, occupational therapy, physical therapy, psychology, and nutrition. Eight hours are available each day. The Summit will feature national thought leaders dis-

Dr. Sharma was a guest speaker on the panel.

Study: Home Healthcare Could Help Reduce Readmissions, Increase Cost-Savings

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

cussing relevant issues with Palm Beach County leaders including physicians, health policy experts, hospital administrators, researchers, business executives, and community representatives.

GRAPHIC DESIGN Sergio Aguilar (561) 797-2325 ads@globalhealthtribune.com

Sponsorships and exhibit space are available.

ome healthcare for chronically ill patients could help cut down on hospital readmission rates and improve healthcare spending, according to research conducted by Avalere Health.

Registration is open at www.pbcms.org. Registration fees vary. To register, learn about sponsor and exhibit opportunities, and view the Summit speakers and schedule, visit www.pbcms.org/FOMSummit or call 561-433-3940.

The study compared hospital readmission rates and Medicare spending for chronically ill patients who received home healthcare to chronically ill patients who received other postacute care services, such as services from long-term acute-care

The general public is invited to attend.

hospitals or inpatient rehabilitation facilities. Home healthcare for patients with diabetes, chronic obstructive pulmonary disease or congestive heart failure resulted in an estimated 20,426 fewer hospital readmissions than patients with the same conditions receiving other post-acute services. The results also showed the fewer readmissions led to an estimated $670 million in Medicare savings from Oct. 2006-Sept. 2009.

ATTENTION Healthcare Professionals… If you are a physician or healthcare professional and would like to contribute an article or two that you feel would be of interest to our readers. Or, perhaps you have a topic of interest that you would like for us to cover. Please e-mail us at articles@globalhealthtribune.com with any suggestions as we would love to incorporate them in future issues.

Please recycle this newspaper.

AUGUST ISSUE • 2012 3

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Falling Arches… Not to Be Ignored difficult to localize or fallen painful arches. Most patients do not recall a specific incident or injury, just a gradual onset of pain and inflammation. Sometimes, the patient will suffer with the deceptive pain and discomfort for years before going to the doctor.

Arthur Hansen DPM, M.S.

osterior Tibial Tendonitis and/or rupture is a common cause for pain on the inside of the foot/ankle and flattening of the foot (sometimes called fallen arches). The posterior tibial tendon connects the leg muscles to the foot. It is responsible for inversion or turning the foot in and up. The posterior tibial tendon starts in the calf of the foot, goes behind the inside ankle bone and finally inserts into the bones of the midfoot. It helps to hold up your arches and support your arches during walking. It is used with every single step we take. That’s why, when it is injured or unhealthy we feel great pain and discomfort. Posterior tibial tendon injuries can range from overuse to full blown rupture of the tendon. Most patients present a generalized complaint of gradual pain on the inside of the foot that is

Signs and symptoms of posterior tibial tendon dysfunction include tenderness over the inside of the midfoot, especially with walking or running, inability to stand on the toes, loss of the arch or development of flatfoot and possible pain and swelling of the ankle. During examination, your doctor should evaluate you standing from behind and facing you. He will be looking for the ‘too many toes sign’ which is a common finding in posterior tibial tendon dysfunction or rupture. He should also ask you to stand on your toes or do a single heel raise. He should also take x-rays or order an MRI. Posterior Tibial tendon disorders are divided into four stages. Stage I injuries, while painful and need treatment, are relatively mild. In stage I, the tendon is inflamed but has no loss of strength. The patient notices little to no change of the arch and is able to stand on his/her toes without a problem. Stage II injuries involve a par-

Conservative & Surgical Treatments Available Whirlpool with every visit!

Posterior Tibial Tendonitis

Navicular bone

Area of pain Posterior tibial tendon

tially torn tendon or inflammation and experience a loss in the strength of the muscle. Falling of the arch is evident and the patient usually cannot do a single-limb heel raise. There is associated pain of the ankle. In stage III injuries, the tendon is completely torn and not functioning. A full collapse of the midfoot is seen on examination and arthritic changes are noted on the x-ray because of the lack of support of the arch and subsequent overuse of the midfoot joints. Stage IV injuries are identical to stage III, except arthritis is also noted in the ankle joint as well. All stages are painful and require treatment. Untreated flatfoot from a posterior tibial tendon disorder will eventually lead to arthritis and rigidity in the midfoot and hindfoot. Pain will

worsen and shoe gear may become uncomfortable. Treatment ranges from rest, NSAIDS, and immobilization for 6-8 weeks to bracing and/or surgical reconstruction. Treatment almost always begins with reconstituting support of the foot. Stage I and II injuries are usually successfully treated with rest, ice, anti-inflammatories and immobilization. Following a dedicated period of immobilization, physical therapy may or may not be indicated and custom molded orthotic devices are a necessity. Custom molded Ankle-Foot-Orthoses, or AFO, are sometimes necessary.

ment plan. Surgical reconstruction procedures are invasive and come with risk. Your physician should appropriately consider your lifestyle, activity level, and overall general health and discuss all the risks and benefits of the procedures with you before recommending surgical correction. However, if conservative therapy fails to provide adequate relief and control of symptoms then surgery can be indicated. Surgical procedures range from procedures limited to work on the tendon itself to fusion of arthritic joints or a combination of procedures. Almost always and no matter the Stage, posterior tibial tendon disorders/injuries require supportive custom bracing or orthotic devices long-term. It’s important to remember that each stage can progress to the next if left untreated. So, don’t ignore that seemingly harmless ‘falling of your arches’, it can be quite deceptive.

Stage III and IV injuries, while much more severe and progressive, require a complex thought process when developing a treat-

Get back on your Feet!

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

Podiatric Physicians & Surgeons

Personal & Gentle Care For:

• Diabetic Foot Care • Hammer Toe • Fracture Care • Ingrown Nails, Bunions • Ankle/Heel/Foot Pain • Poor Circulation • Neuropathy • WOUND Care • Custom Molded Orthotics • Diabetic Shoes Medicare Medicaid HCD - PPO & Most Insurances Accepted

Dr. Juan Sardina

Dr. Lori Lane

Dr. Arthur Hansen

Dr. Shelley Plumb

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(561) 433-5577 w w w. l a p o d i a t r y g r o u p . c o m 3347 State Rd 7 Suite 204 Wellington, FL 33449

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

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New Features on Mobile App from West Boca Medical Center Helps Keep Expectant and New Moms Up-to-date and Organized allows you to rate the severity of contractions, and the labor section that shows the stages of labor, Relaxation and breathing techniques, delivery methods, and guidance about when to seek immediate attention.

physician finder. The hospital’s app is powered by WorldLink, and available as a free download for iPhone™, iPad™, iTouch™, Android™ and BlackBerry™ products.

oca Raton, FL July 2012 – The new Maternity TrackerTM and Baby’s First Year features on West Boca Medical Center’s mobile app may not be able to get rid of your food cravings during pregnancy or keep you awake for a three a.m. feeding, but they can help moms-to-be and new mothers juggle all the responsibilities that come with expecting and taking care of a baby. The new features are being added to the hospital’s existing app that currently includes a mobile web browser to view the hospital’s emergency room wait time, map and directions, list of frequently called numbers, health data page, first aid guide, health library, and

“In this advanced technological world we live in, this is just another way for new families to get information at their fingertips that can help them care for their baby, said chief executive officer of West Boca Medical Center Mitch Feldman. “We are always looking for new and innovative ways to connect with our patients to make sure they know we are here to help them every step of the way.” Expectant moms don’t need to tote a heavy pregnancy book around or write things down on a calendar. The Maternity Tracker feature that can help you get through your pregnancy with flying colors includes:

• A countdown timer based on your due date. • An easy-to-use appointment tracker. • A section for journal entries. • Helpful tips for both mom and dad throughout pregnancy. • Baby name ideas. • Information about body changes. Closer to your due date, you also can use the contraction timer that

New moms will be able to get all the information they need with the Baby’s First Year feature. Since being a parent is a fulltime job, this feature allows you to record baby information and schedules, as well as track your baby’s weight and height. It also includes: • A section for journal entries • Lullaby music • An appointment tracker and notes • Immunization reminders • A baby feeding timer

New mothers also have a variety of helpful information at their fingertips, such as a breastfeeding guide, tips for childproofing your home, and facts about solid foods for baby. To download the hospital app for your iPhone, iPad or iTouch, visit the iTunes Store from your mobile device; for your Android mobile device, visit the Android Market; and for your BlackBerry device, visit the BlackBerry App World. West Boca Medical Center offers maternity care that includes a level III neonatal intensive care unit, and spacious private labor, delivery, and recovery suites that are designed to look and feel like the comforts of home. For more information about services provided for expectant and new mothers at the Women’s Health Center, visit www.westbocamedctr.com.

Managing Your Child’s Asthma During the School Year one that can be accessed at www.lung.org. The action plan provides a written reference as to what to do on a daily basis as well as how to recognize worsening asthma symptoms and how to treat them. It lists specific medications to take and when to take them. Even emergency phone numbers can be recorded on the plan. Before school begins or at least within the first few days, a meeting with the school nurse is in order and a copy of the Asthma Action plan should be left with her. A copy of the plan should also be kept in your child’s back pack. Now the question is “What medication should be sent to school and where should it be kept”?

Sheryl Gilman B.S., RRT-NPS, CPFT, CTTS

American Lung Association statistics show that 7.1 million children are diagnosed with asthma in the United States and 4.1 million of them suffered from an asthma attack or episode in 2009. Asthma is the leading cause of school absenteeism accounting for 14.4 million lost school days in 2008 (Centers for Disease Control and Prevention). In that same year, the Centers for Disease Control and Prevention noted 679,000 emergency room visits for asthma symptoms in children. Thus, you might ask “How can I provide my child with a successful school year through management of his/her asthma”? Peak Flow Meter

The peak flow meter (sample pictured) is your child’s best friend. By measuring the amount of air the child can blow out and how fast it is blown, the peak flow meter can measure the extent of asthma symptoms dayto-day. First, it is important to determine your child’s personal best number. For two weeks, morning and late afternoon, while asthma symptoms are at their minimum, the child places the meter in his mouth, fills his lungs with his biggest breath, and then blows out with a short, hard blast. This is done three times and the highest number is recorded. After two weeks, the highest number recorded is considered the child’s personal best.

The peak flow meter has colored indicators that are then set for future reference. The green indicator which indicates asthma stability is set at the personal best number. The yellow indicator, urging caution, is set at 80% of the personal best. Finally, the red indicator, indicating the need for medical attention, is set at 50% of the personal best. When the indicator stops anywhere from 80-100%, the asthma is under control and you can send your child off to school confidently. When it stops in the 50-79% range, caution is needed and it may be wise to keep the child home or increase asthma medication, depending on how low the peak flow is. If the indicator stops in the red zone, immediate medical attention is necessary, perhaps even a visit to the emergency room. Your child should

have two such meters, one for school and one for home use. How do you really determine what the best course of action is? This is where the Asthma Action Plan is useful.

Rescue Medications Specific medications are prescribed by your doctor and should be utilized accordingly. Every child with asthma should have a rescue inhaler with a spacer on them at all times. Using a spacer (see photo), will significantly improve the amount of medication reaching the lung and dramatically decrease the amount of medication deposited on the tongue and other tissues of the mouth.

Asthma Action Plan

The Asthma Action Plan is a joint development between family and the doctor. Note, everyone in the family should understand the action plan and what to do just in case of an emergency. There are several good websites featuring a color-coded Asthma Action Plan that can be downloaded and utilized throughout the year. One such plan can be found at http://www.ihacares.com/index.c fm/HealthAdvisors/PediatricAdv isor/crs-paart.asthma.action.plan/ or the American Lung Association has

Florida Law 1002.20 K-12 allows an asthmatic child to have his rescue medication (inhalers containing Albuterol, Proventil, or Ventolin) on him AT ALL TIMES. Some schools may not be aware of this and it is up to the parent to make clear that this is a medical necessity backed by state law. Both the parent and the physician must provide written approval to the school principal.

Sheryl Gilman has been practicing respiratory care for 14 years in Palm Beach County. For the last 5 years she has been the Clinical Supervisor of the Cardiopulmonary Department at Lakeside Medical Center, the hospital in Belle Glade serving the residents of the Western Communities. She has specialty certifications in Neonatal and Pediatric care, Pulmonary Function Testing, and is a Certified Tobacco Cessation Specialist as well as having a Bachelor degree in Health Care Services Management.

Parental involvement is an absolute necessity and communication is the key to successfully managing your child’s asthma at school. Communication with the child’s physician, the school nurse, the teacher, and even the principal can greatly reduce the chances of your child having an unmanaged asthma attack at school. Regular doctor visits should be scheduled every 3-6 months, per physician recommendation. Also, talk to the physician about the necessity and safety of the flu shot in your child’s health management. You can visit the American Lung Association’s website at www.lung.org for much information on asthma, how to manage it, and tools to help your asthmatic child have a healthy and safe school year.

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Expanded Hepatitis C Testing Recommendations

o identify more hidden infections, provide prompt and appropriate care and treatment, and avoid tens of thousands of hepatitis C-related illnesses and deaths, CDC now recommends that all U.S. baby boomers get a one-time test for the hepatitis C virus.

in 30 baby boomers has been infected with hepatitis C, and most don’t know it. Hepatitis C causes serious liver diseases, including liver cancer (the fastest-rising cause of cancerrelated deaths) and is the leading cause of liver transplants in the United States.

Hepatitis C is an unrecognized health crisis in the United States. This life-threatening infection affects an estimated 3.2 million Americans, most of whom are “baby boomers” (those born from 1945 through 1965). One

More than 15,000 Americans, most of them baby boomers, die each year from hepatitis C-related illness, such as cirrhosis and liver cancer, and deaths have been increasing steadily for more than a decade and are pro-

jected to grow significantly in coming years. CDC estimates one-time hepatitis C testing of baby boomers could identify more than 800,000 additional people with the virus. And with newly available therapies that can cure up to 75 percent of infections, expanded testing – along with linkage to appropriate care and treatment – would prevent the costly consequences of liver cancer and other chronic liver diseases and could save more than 120,000 lives.

Medical Society Publishing History of Medicine in Palm Beach County Book

EST PALM BEACH (July 30, 2012) – Palm Beach County Medical Society (PBCMS) is sponsoring the first comprehensive book on the history of medicine in Palm Beach County. Tentatively titled A Tradition of Caring, the book will recognize medical pioneers and chronicle the major medical milestones of the past 150 years, from the arrival of the first doctor in the area, Dr. Richard Potter, in 1882, to the passage of President Obama’s Affordable Care Act of 2010.

Since its founding in 1919, PBCMS has been at the forefront of many of the major health care developments in Palm Beach County. In the early years, the agency’s members initiated public health policies that protected the public from dreaded disease, and they held leadership positions in the area’s first hospitals, including Good Samaritan Hospital in West Palm Beach. In the modern era, the group’s physicians have worked on reforming medical malpractice insurance and proving health care coverage to the indigent. Author Leon Fooksman is an

award winning journalist and writer. A professional reporter for more than 15 years, he has most recently written for the Sun Sentinel in Fort Lauderdale where he wrote many articles on social development challenges and the workings of local governments. Legacy Publishing Co.,

Birmingham, Alabama has previously published medical histories of Wake County (Raleigh), NC; Nashville, TN; Austin, TX; Memphis, TN; and Charleston, SC. The history of Duval County (Jacksonville), FL is being published this summer. A Tradition of Caring is expected to be published in the spring of 2013. For further information please contact John Compton, owner and publisher of Legacy Publishing Co. He can be reached at Palm Beach County Medical Society at 561-4333940 Ext: 18.

About Palm Beach County Medical Society: Palm Beach County Medical Society is a not for profit organization dedicated to uniting physicians to serve the common interest of the profession, developing and maintaining the highest professional and ethical standards of the medical profession, advocating the interests of physicians and their patients, and collaborating with others to improve the community's health. For more information, call 561433-3940 or visit www.pbcms.org.

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Palm Beach Gardens Medical Center Welcomes 30 Waste Not, Summer Teenage Volunteers known as “Volunteens” Want Not

ALM BEACH GARDENS, Fla.-July 20, 2012- Palm Beach Gardens Medical Center proudly welcomes this summer’s teenage volunteers, or “Volunteens”. The Volunteen program allows teenagers to have the opportunity to volunteer in a variety of areas of the hospital during their summer break. The program gives many of these teenagers their first work experience, and the opportunity to consider a career in healthcare. Staff

members at Palm Beach Gardens say that they enjoy the opportunity to mentor these students and teach them about all of the different career paths they could select in the healthcare field. Currently, Volunteens are working within the nursing department, business office, information technology as well as cooking up some new experiences with the hospital’s dietary department. Volunteens go through a standard hospital orientation and training program.

“The Volunteen program at Palm Beach Gardens Medical Center has always been very popular,” says Colleen Schmidt, the

Volunteen program coordinator. “We recognize a lot of high schools in the area require students to acquire community service hours, so we provide an environment where students can get their hours accomplished, while also gaining first hand experience in various fields,” Schmidt added. Helping future doctors, nurses and even administrators answer the call to care for others is a paramount cornerstone of the program, and the results have been very positive. Volunteen Sean Perez, 17, just began volunteering in the radiology department and says that he has already developed an interest in

this field. “I’m seriously considering going into radiology because of the experience I get from being a volunteer,” Perez said. A student at William T. Dwyer High School, Perez needed community service hours for his student internship program. Perez’s father, an employee at Palm Beach Gardens Medical Center, informed him of this volunteer opportunity. Perez decided it was the best place for him to learn more about patient care, as well as gain his required hours. The Volunteen program at Palm Beach Gardens Medical Center continues to spark the interests of young people considering a career in the healthcare industry.

Is Exercising while Pregnant Safe for Mommy and Baby?

By Erica Whyman

f you have ever participated in an exercise program or taken an aerobics class, you know that they usually start with the advice to consult your physician before beginning any new routine. So, not surprising, the same advice applies once you learn you are expecting and considering whether it is safe to continue with your current exercise regimen or begin a new one. The good news is that for most women, exercising while pregnant is perfectly safe, and in most cases recommended for mom and baby. The American College of Obstetrics and Gynecology recommends thirty minutes or more of moderate exercise per day. The goal is not to overdo it, and trade high impact exercises for low impact ones such as, aerobics, swimming, brisk walking, indoor stationary cycling, or step/elliptical machines. Low impact is important because when a woman is pregnant, there are certain hormones that cause

DEAR DEBORAH: What do you think about couples in which the girl is taller than the guy? Do you think this could work? - Too Tall? Dear Too Tall: You are asking someone that was married to a man shorter than I. Personally, I am not bothered by a man’s physical stature. However, there are a number of women that will only date men of a certain height. So, it boils down to personal choice and confidence. Some men may be self-conscious with a taller woman equally as much as a woman that may be self-conscious of dating a man that is shorter.

the ligaments around her joints to loosen (getting your body ready for labor and delivery) and performing high impact exercises could increase your chance of injury. Some known benefits of maintaining an exercise routine while pregnant: • Reduced pregnancy fatigueeven going for a short brisk walk will give you a pop of energy. • Improved sleep patternsAvoid exercising right before bedtime, but otherwise, it can help moms-to-be with their quality of sleep. • Healthy baby- Moms that exercise during pregnancy are said to deliver babies at healthier weights. • Reduced pregnancy aches and pains- this is also true for those women who exercised prior to becoming pregnant. • Easier Delivery- this can make any pregnant woman eager to sign up for that yoga class. Exercise can result in the

DEAR DEBORAH: How can you tell if a date is going well and if the other person likes you? - Tell Tale? Dear Tell Tale: There are many ways someone will give you an indication if they are interested in you. Body language is one way. Are they leaning into you? Is he/she nervous? Is she playing with her hair? Are they lightly touching you? Laughing? Focusing on your every word? Are you maintaining their attention? Those are some of the ways to tell if someone is interested. However, if they are looking around, not focused on you, checking their watch or the time, not listening to what you are

strengthening of the muscles needed during labor. Every pregnancy is different, and for some women, exercising may not be advisable due to certain medical conditions or being considered high-risk. (Ask your doctors ladies; we are certainly in their offices enough!). Also, consider the fact that as your tummy grows, your center of balance shifts, so be mindful of falling, which can be dangerous for both you and baby. I spoke to my physician early on and throughout my pregnancy about exercising. He saw no reason for me to discontinue my routine. I have been a runner for many years, and continued jog-

saying or constantly interrupting – I would suggest you move on. DEAR DEBORAH: What is your recommended age difference between genders? - Twelve Years Dear Twelve Years: This will probably vary with everyone you ask. I will say, having been in Florida for a year now, it still amazes me when much older men are with very young women. It looks completely inappropriate when a young woman could be their granddaughter. Although we are all young in spirit, there is a difference in life experience. At 40, you have experienced so much more than someone of 25. This question is really difficult

ging my first and some of my second trimester. As I grew and the temperature climbed, I decided to move indoors and have been walking on the treadmill and using the elliptical machine. I always feel better after thirty minutes on the treadmill, and find that I have fewer of those restless nights. My husband and I even tried stand-up paddle boarding. We rented paddle boards from Blueline Paddle Surf and Clothing in Jupiter, Florida. The staff was great in assisting me and pointing out all the low wake areas, and it was a perfect relaxing afternoon of peace and relaxation, which is always good for mom and baby.

Policy Brief Explores Fraud and Abuse in Medicare and Medicaid

edicare and Medicaid fraud and abuse prevention efforts have helped reduce unnecessary spending, but implementation of these efforts remains a challenge, according to a new brief from Health Affairs and the Robert Wood Johnson Foundation. In 2010, Medicare and Medicaid made more than $65 billion in “improper federal payments”—payments that should not have been made or were made in an incorrect amount, according to the brief. An April 2012 study estimated that fraud and abuse added as much as $98 billion to Medicare and Medicaid spending in 2011. To combat the problem, the Affordable Care Act gives the Centers for Medicare and Medicaid Services (CMS) greater authority to tackle fraud and abuse, including the ability to screen out questionable providers and suppliers before they begin work and suspend payments to those who come under investigation. In 2011 alone, $4.1 billion was recovered, the highest recovery amount in a single year. The authors explain, however, that several challenges remain: (a) overzealous investigators who focus on technical mistakes rather than outright wrongdoing, (b) Medicare contractor conflicts of interest, and (c) overlap among antifraud programs, among others. While CMS and others are optimistic about the agency’s new advanced data analytics program to help detect fraud, the authors say that some observers are concerned about the early results.

Dear Deborah because it depends on the stage in your life. I cannot give you a number as it would change with every age. For example, if you are 21, I believe 21-25 is an appropriate range. At 32, I think a great range would be from 2737. At 40, I feel that 35 and above is appropriate. However, beyond 45, I feel that 40 and above is appropriate to date. Again, this is just a brief example and my personal opinion. DEAR DEBORAH: How long should a girl wait before having sex with somebody who she just started dating? - How Long? Dear How Long: You need a foundation to build

on in order to maintain a relationship. Once you spend quality time together, you will get to know their personality, see what you have in common, how you relate to one another, and how well you communicate. Therefore, I would recommend that you wait until you and your partner get to know each other well. You truly need a mental and emotional connection before you can move on to the physical connection. However, I am a firm believer in mental stimulation and once you have established that, the physical stimulation will be that much better.

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.

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Bethesda Memorial Hospital Congratulates 2012 Blum Family Scholarship Recipients (Boynton Beach, FL) – 13 students were selected as the recipients of the 2012 Blum Family Scholarship at Bethesda Memorial Hospital on Friday, August 10. Each of the students, all children of Bethesda Healthcare System employees, will receive $5,000 toward a four-year college degree. Peter Blum is a longtime civic leader and founder of Blum’s Furniture. Mr. Blum serves as Vice Chairman of the Bethesda Hospital Foundation Board of Directors. He established the Blum Scholarship for Bethesda Healthcare System in 2000 with two $5,000 scholarships. In its 13th year, the program has grown with 13 scholarships awarded this year thanks to generous donors including Mr. Blum and the Hospital. Mr. Blum awarded the remaining 18 candidates with a $200 Visa gift card for their academic and community achievements. “Our scholarship program is a wonderful way for us to say thank you to the many dedicated employees of this great hospital who provide exceptional care to our community,” said Mr. Blum. “We are honored to help these outstanding students reach their potential,” he added. Scholarship applicants are required to meet established academic and community service criteria. All of the scholarship candidates and their parents were invited to a luncheon with guest of honor Mr. Blum. Congratulations to the 2012 Blum Family Scholarship Recipients:

Top Row (l to r): Holly Wagner, Javoncia Betty, Kara Seymour, Mia Hardack, Renz Gaviola and Helena Hoayun. Bottom Row (l to r): Meagen Kovacs, Dana Tam, Jillian Burdick, Mr. Peter Blum, Ashley Mucinski, Janel Scholine, Chelsea Kickingstallion and Mrs. Spirazza standing in for her daughter Cara Spirazza.

· Chelsea Kickingstallion, of Boynton Beach, is a sophomore at Palm Beach State College. She is part of the dual degree program at Florida International University where she will pursue a law degree.

· Jillian Burdick, of Palm Coast, earned her Bachelor’s degree in Biology from the University of Florida. She is currently attending Daytona State College to pursue a career in Nursing. · Renz Gaviola, of Lake Worth, is a 2012 graduate of Park Vista Community High School. He plans to attend the University of Central Florida to study Nursing. · Mia Hardack, of Boca Raton, is a 2012 graduate of West Boca Raton Community High School. This fall, she will attend Florida State University to major in Biology. · Helena Hoayun, of Lake Worth, is a 2012 graduate of Atlantic Community High School. She plans to attend Florida State University this fall to major in Music Therapy.

· Kara Seymour, of Boynton Beach, is a 2012 graduate of Park Vista Community High School. She will attend Polk State College to major in Business.

· Meagan Kovacs, of Wellington, is entering her senior year at the University of Florida where she is studying Cognitive Neuroscience and Music Performance.

· Cara Spirazza, of Boynton Beach, is a 2012 graduate of Park Vista Community High School. This fall, she plans to attend the University of Central Florida to major in Biology and Pre-Veterinary Medicine.

· Ashley Mucinski, of Loxahatchee, is a 2012 graduate of Seminole Ridge High School. She will attend Florida Atlantic University to major in Ocean Engineering.

· Dana Tam, of Boynton Beach, is a 2012 graduate of Atlantic Community High School. This fall, she will attend the University of Florida to major in Marketing and Biology.

· Janel Scholine, of Lantana, is a 2012 graduate of Santaluces High School. This fall, she will attend the University of Florida to major in Electrical Engineering.

· Holly Wagner, of Lake Worth, is a 2012 graduate of Park Vista Community High School. This fall, she will attend Palm Beach State College to major in Nursing.

· Javoncia Betty, of Delray Beach, is a 2012 graduate of Boca Raton Community High School. She currently attends Palm Beach State College and will transfer to Florida State University in the spring to major in Biology.

Ask yourself… are you ready to buy? Do you have the means to invest? Do you want to buy as an individual, a small partnership or in a REIT, a real estate investment trust? Can you buy properties in your 401K or your IRA? I’m presenting those questions that you should consider and determine if you want to buy and are qualified to jump into the real estate melee.

Bob Wolff

here are hedge funds rapidly snapping up properties; condos, town homes, and single family properties. Some of these that require minimal improvements are being flipped, quickly resold after repairs are completed, while other investors are buying units for rent. The big boys are buying. Are you?

Once that decision is made, we will guide you carefully and skillfully, directing you toward the property that meets your needs. Keyes is the largest independent real estate company in South Florida. We partner with a title company, a mortgage company, a credit correction company, an insurance company and we are connected with the international community including major relocation companies.

Our children have returned to the classroom. After school, many will happily go home to their new rooms in their new homes.

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Bill Tavernise 561-209-8304 BillTavernise@keyes.com

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Bob Wolff 561-352-0620 BobWolff@keyes.com

8 AUGUST ISSUE

• 2012

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South Florida Radiation Oncology is Making Huge Strides in Cancer Treatment

Kishore K. Dass, MD

Eugene Shieh, MD

Board-Certified Radiation Oncologist

Radiation Oncologist – South Florida Radiation Oncology, LLC

he linear accelerator is the workhorse of any radiation oncology facility, generating the beam used by radiation oncologists to treat most types of cancer and some non-cancerous conditions. In recent years, linear accelerator technology has greatly improved and the Varian TrueBeam incorporates a multitude of technological innovations into one package. This gives the radiation oncologists the tools to deliver the fastest and most accurate treatments for their patients. The capabilities of the Varian TrueBeam are highlighted in the treatment of lung cancer. Each

year, over 200,000 individuals are diagnosed with lung cancer in the United States. For otherwise healthy individuals whose cancer is caught early, surgery is generally performed with high rates of cure. However, the majority of individuals are diagnosed with more advanced disease which requires a combination of surgery, chemotherapy, and radiation therapy to achieve cure. Radiation treatment with the Varian TrueBeam dynamically synchronizes imaging, patient positioning, motion management, and rapid treatment delivery. This offers a significant improvement in tumor targeting, normal tissue protection, and the

speed of treatment for these individuals. Accurate tumor targeting is critical for optimal radiation treatment delivery. The Varian TrueBeam offers multiple targeting modalities to ensure that the patient is properly aligned for treatment. KV-KV and conebeam CT imaging allows the radiation therapist to accurately position the patient immediately before each treatment. Intrabeam imaging allows for an image to be acquired during treatment to ensure that the patient has remained in the prop-

er position throughout treatment. Radiation dose delivery for lung cancer is greatly improved on the Varian TrueBeam. Older, 3D conformal techniques have been replaced with Intensity Modulated Radiation Therapy and RapidArc, which allows the dose to be selectively shaped, focusing the high dose areas onto the tumor and greatly decreasing the dose that the surrounding normal tissue receives. This helps to decrease the side effects of treatment and allow the patients to receive higher

overall radiation doses than that achievable on older linear accelerators. Additionally, the TrueBeam’s higher dose-rate allows for much faster treatment times, making the experience much more comfortable for the patient. The physicians and staff of South Florida Radiation Oncology are committed to providing the best care possible for their patients. This commitment is achievable with the availability of the state of the art technology highlighted in the Varian TrueBeam linear accelerator.

A Special Symbiotic Relationship: Microbes and You that they are on your side. The main purpose of the microbe is to make it easier to digest food, synthesize vitamins and defend us against potentially harmful or “bad” bacteria. Our ecological structure is full of these symbiotic relationships which allow us to thrive.

Cindy Collins, Ph.D., R.D. Experimental Health Psychology / Nutrition

ur bodies carry around “good bacteria” or microbes which serve to protect us, and give us a healthy balance. In turn, we provide them with nourishment, and facilitate colonization inside us, as well as on our body surface. When you think of microbes, you should remember

Raquel Rivera

A perfect example in nature of this kind of bond is the clown fish and the anemone. They coexist in harmony constantly protecting the welfare of the other. Think of someone in your life who adds to its quality. How does that person enhance your daily activities? Most people can think of that particular person as indispensable; almost like they restore the calm in your life, especially in moments of despair. Well, ultimately this is how you should feel about your microbes. It is a natural synchronicity, and it should bring tremendous comfort in knowing it is a favorable partnership. Raquel Rivera is a pre-medical student, also minoring in psychology in the Charles E. Schmitt College of Biological and Behavioral Sciences at Florida Atlantic University. Raquel works in the field of Oncology as a student assistant since December 2011, where she has direct interaction with patients. She is involved with current clinical research projects/studies, as well as specialty programs tailored to patient’s nutritional and emotional needs. Raquel often writes under

Remember to always look for the low-fat, low-sugar version of the products

In general, there should be a natural balance of microbes within each of us which primarily came from your mother. As you experience life, more microbes are introduced to your body system. Sometimes, there is a lack of good bacteria in your gut which can cause adverse effects. The good news is that by taking a probiotic you can restore your microbial ecosystem. It is beneficial to have a good assortment of microbes for health, vitality and overall energy.

Consuming yogurt is a good way to increase the microbial life in your gut. It contains millions of live culture which is what you need to get that balance back. Another way to get them is by taking a supplement containing several varieties of good bacteria. It is up to you how you prefer your microbes; both ways reestablish the symbiotic relationship.

the supervision of Cindy Collins, Ph.D., RD, making cutting edge research available to the lay public in the form of handouts, blogs, and publications. Raquel also has experience mentoring direct independent study interns in health science and nutrition; making them more confident and prepared for the future.

anti-cancer foods into the patient’s diet to enhance their quality of life through nutrition and new recipe ideas. Raquel engages in tai chi, chi kung, stress workshops, mindful meditation and yoga with the patients regularly. She loves to share on different levels with the patients; she finds innovative ways to give them a sense of serenity.

In her time at work, Raquel is passionate about finding creative ways to incorporate well researched

Raquel actively contributes to the community by tutoring and note taking for the department of

Here is a list of good food source options:

1. Fage Greek (good source of protein) 2. Oikos Organic Greek (good source of protein) 3. Dannon Light & Fit 4. Dannon Activia Light 5. Stonyfield Farms Organic 6. Lifeway Non-fat Keifer 7. Lifeway Lassi 8. Horizon Organic Here is a list of supplement source options: 1. Align 2. Culturelle 3. Nutralle 4. Philip’s 5. Florastor 6. Ultimate Flora 7. Jarrodophilus For more information on microbes, refer to Nutrition Action Health Letter July/August 2012. students with disabilities at Florida Atlantic University. She gives students the tools to be successful and supplemental education to aid them with their courses. In her spare time, Raquel enjoys cooking, kickboxing, and cycling. Raquel thinks it is vital to balance her busy schedule with fitness, good nutrition and a few laughs along the way. She has a calm, positive outlook and welcomes any challenge!

Let CyberKnife® revolutionize your cancer ﬁght. Treat your cancer with pinpoint precision. In the shortest treatment time.

C CyberKnife® yberKnife® at South Florida RRadiation adiation O Oncology ncology is lik likee having ssurgery urgery tto o rremove emove yyour our tumor tumorss without cutt cutting, ing, st stitching itching or pain. Ev Even en man manyy inoper inoperable able tumor tumorss ar aree no now w oper operable able with C CyberKnife, yberKnife, an anywhere ywhere in the body, incl uding the pr ostate, llung, ung, br ain, spine, liv er, pancr eas including prostate, brain, liver, pancreas an d kidne y. and kidney. Con ventional rradiation adiation ther apy can rrequire equire 3 5–40 Conventional therapy 35–40 0 trips tto o the doct treatments. That’ss up tto 40 doctor. tr eatments. That’ o4 or. But South Oncology’s Florida RRadiation adiation O ncology’s CyberKnife CyberKnife Radiosurgery Radiosurgery System treats manyy tumor tumorss in one tto Syst em tr eats man o five five treatments. treatments. CyberKnife manyy weapons arsenal C yberKnife is just one of man weapons in an ar senal powerful treatment options of po werful tr eatment opt ions the expert physicians physicians SFRO o ttarget arget an and d destr destroy oy your your cancer cancer.. at SFR O use tto Combining lea leading-edge ding-edge ttechnology echnology with inspir inspired, ed, compassionat compassionatee car care, e, SFR SFRO O also of offers fers TrueBeam™, TrueBeam™, RRapidArc™ apidArc™ an d Br achytherapy—so we’ll we’ll find find the and Brachytherapy—so tr treatment eatment that’ that’ss right ffor or yyou. ou. Isn Isn’t’t it ttime ime yyou ou got back tto o living your your life? life? Don Don’t’t wait oday to to see if CyberKnife CyberKnife is right ffor or yyou. ou. w ait a —call us ttoday

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10 AUGUST ISSUE

• 2012

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Roger L. Kirk, President and CEO of Bethesda Memorial Hospital R

By Deborah Lynn

ecently, I had the good fortune to spend some time with the President and Chief Executive Officer of Bethesda Memorial Hospital, Roger L. Kirk. Bethesda Memorial Hospital is a not-for-profit, 401-bed community hospital that is located in Boynton Beach. With more than 600 physicians on its Medical Staff, Bethesda currently cares for more than 60,000 patients in its Emergency Department annually; delivers nearly 3,000 babies annually and admits more than 20,000 patients each year. Upon my arrival, Mr. Kirk greeted me in the front lobby without hesitation. At 8:45 a.m., while many people are just arriving for work, he had clearly been there for quite some time. Originally from Preston, West Virginia, he received his undergraduate degree there before moving on to Washington D.C., where he received a Master of Arts in Health Care Administration from George Washington University. He came to Bethesda Memorial Hospital in 1988 as the VicePresident of Operations. In 1994, he was promoted to Executive Vice-President and Chief Operating Officer. In February, he was named Bethesda’s President and CEO, when Robert B. Hill retired. He has accomplished quite a bit over his tenure. The most recent, being able to secure the financing for the new Bethesda Hospital West, which is a new state-of-the-art hospital that is currently under construction in Boynton Beach. Once we started talking, I found him to be extremely personable, cheery, funny and just completely delightful to be around. It’s through our conversation that I realized how passionate he is about his job, staff, and everything and everyone around him. So, when I asked him if he had time to answer a few questions

dollars on the table. I think Florida is the third highest state in uncompensated care in the country, so there are a lot of people that need help. We provide over $50 million in uncompensated care, and this number continues to grow every year.

and give his opinion, he readily agreed. Have you heard of Palm Beach Accountable Care Organization (ACO)? I know about two of them. They are physician driven, meaning they are only physician groups. We’re waiting to see how they transform as we certainly want to be a player with them. My understanding is they have no hospital contracts or affiliations currently. So, ultimately as they get contracts or patient bases, we would like to work with them. It’s interesting; there are different versions of the ACO’s and ultimately the risk takers that take some risk have the potential to really improve financially as well as financially improving their positions. We are not in a position to do that, but we are looking to direct contract with those that are. I feel we are well positioned as a hospital in comparison to our competitors - we’re low cost, high quality and I think that’s what they want. What do you think is one feature of your hospital that exceeds other hospitals in the area? We try to differentiate ourselves on our mission, which is to provide quality health services in a caring manner. We have a lot of long-term employees and we focus almost extensively on the caring part. We created our Driskill Center for Caring Excellence to make sure that all of our employees have a compassionate, caring attitude. I don’t think patients today can really differentiate between the true medical care being delivered, but they know whether the people are caring and nice and that makes a big difference. We focus on that and work hard to have an organization that understands that type of culture and realize that we’re here to help the patients get better and improve their lives. Will you be using the same physicians at Bethesda Hospital West?

Artist rendering of Bethesda Hospital West.

Roger L. Kirk.

All of our physicians will have staff privileges at both hospitals. However, we do expect an influx of physicians from the surrounding area. To date, we have 50 or so who have applied. We were then joined by Cynthia Williams, Editor of Bethesda Health News, their in-house publication. As we continued to discuss Bethesda Hospital West, you can just feel the excitement in both Roger and Cynthia’s voice. So, how is the new hospital coming along? We’re on track and under budget. We plan to open on Tuesday, January 8. We’re starting to hire the employees and the contractor will turn the building over to us some time in October. That will give us a couple of months to get it fully equipped, tested and staffed; then we’re ready to go. It’s been more than 20 years since Palm Beach County saw the construction of a new hospital. There is a growing population in the western communities, and they are just primed for a new hospital.

What do you think of Obamacare? You know, it’s not to know. I think there are some good parts of it and some parts for concern. I am very concerned with his position in not participating in the Medicaid expansion program. Over the last couple of years, the State of Florida has had a $200,000,000 cut in Medicaid funding. For Bethesda, that meant a cut of $5.6 million in Medicaid funding last year. The good parts are obviously the expansion of coverage and if you look at Massachusetts, they demonstrated that it improved access. There are people that normally show up in the emergency room with coverage to go to physicians so that’s a negative. The unknown is how you are going to pay for all of that; that’s been a concern and we just don’t know enough about the Affordable Care Act in order to really prepare. I am concerned with the state not participating and that we’re going to leave a lot of federal

What we’ve seen over the last three years, since 2008, is a growth in medically indigent not totally indigent, but medically indigent meaning that they are employed, but their employer has dropped health insurance and they’ve had to go out and get really high deductible insurance coverage and all that means that when they come to the hospital, they really can’t afford it. So, we’ve seen a large increase in uncompensated care here. So, that does concern us. There are a lot of parts that we just don’t know enough about. We’re afraid with Obamacare they’re obviously going to take it from somewhere else; cutting the Medicare program would truly negatively affect the state of Florida and all of us. It’s a mixed bag and it’s a little bit unknown. They are gearing up and the health exchanges are a real question and issue and they are looking for the states to either get on-board or get out of it. It’s going to be interesting and everyone I talk with has the same feeling – we just don’t know. Do you feel Governor Scott is working for you or against you? I don’t think he’s working for us or against us, I think he’s looking at it on a very global basis for the state of Florida and saying hey, we can’t afford it. I think he is looking at it very diplomatically. Ultimately, I think he’s looking long term in the state of Florida. Cynthia – we continue to work on our mission is to provide quality service and working with our physicians. There is a good article in FHA, I believe it’s called –Hospitals will lose out if Florida stands firm on Medicaid.

Aerial view of Bethesda Hospital West - currently under construction.

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AUGUST ISSUE • 2012 11

We have seen several million state cuts and one of the things that goes away under Affordable Care is the disproportionate share. Right now, we get an additional bump in payment for taking care of a large number of indigents. In Palm Beach County, among St. Mary’s, JFK and us, we probably provide 99% of the indigent care.

I recently signed a check for a refund of $125.00 for a Lamaze class and the reason on it was she thought she was online signing up in Bethesda, Maryland and she signed up here. So, we had to refund her by check.

Under the Affordable Care plan, that goes away. That is absolutely critical to us and I’m sure the other hospitals. The theory is that patients will have some coverage, so they won’t be indigent. Traditionally, Medicaid is just not a good payer – they don’t cover our costs. We’re concerned, obviously, that we’re going to lose disproportionate of Medicaid since they won’t pick it up and once again, the hospitals lose.

It’s a first-class community hospital with its technology, great physicians and a lot of long-term employees. It’s a family environment here within a very caring hospital, with many longterm employees and a commitment to providing high quality care that is second to none. Since Bethesda Hospital West is in a more visible area, do you feel that will put Bethesda more in the forefront? Yes, and we are working to redefine Bethesda’s brand as a major medical center. With the opening of Bethesda Hospital West, we’re going to become a 500+ hospital system, and with this growth comes our desire to provide an even higher level of service that our community deserves.

July 27 - Bethesda Hospital West lobby under construction.

What is your typical day like? What do you think about having your own Hospitalist program? Well, I think it’s a true benefit to not only the community, but also the medical staff. Many hospitals and physicians have seen a decrease in their revenues because of declining reimbursements. So, physicians don’t make a lot of money rounding on in-hospital patients. They make their money being in their office taking care of patients and generating new ones. What we’ve seen on the internal medicine side is that many of the internal medicine and managed care companies will contract with the hospitalists to take care of the patients in the hospital. I think they do a good job; they’re in-house 24 hours a day, so they’re more readily accessible which affects care. Because they are inhouse, the hospitalists can get lab results quicker and therefore provide more timely care to their patients. As for patients, some are okay with it and some don’t like it because they want their primary physician to take care of them in the hospital. However, the hospitalists provide good quality care and that’s been demonstrated because they are readily available and can react to x-rays, lab tests, diagnostics services and so forth. Their length of stay is a little shorter and the costs are a little better.

I generally start by 7:30 a.m. in the doctor’s dining room. All the physicians know that I’m there and willing to talk about anything on their minds. We usually start in the office at 8:30 a.m. with meetings and it’s one meeting right after another. Whether it’s operationally oriented, such as meeting with the vice-president of patient services, the vice-president of nursing, operations or the CFO. Right now, we’re in the middle of budgets, so we have a lot of budget meetings. I’ll usually meet with a doctor or two during the day and discuss any topic that they or we might have. I serve on several community boards, including the Greater Delray Beach Chamber of Commerce, and spend time in the community as well. At around 5:00 p.m. – 5:30 p.m., we have other meetings, so we usually meet until 6:30 p.m. or 7:30 p.m. and go home. I have a lot of meetings, both physician and staff, leadership, executive leadership and being out in the community.

Exterior view of Bethesda Hospital West on July 27, 2012.

Our cancer program is affiliated with H. Lee Moffitt Cancer Center, the only NCI designated institution in the state and we work with them. We do clinical trials, research, cancer, so we have a lot of good things. While Bethesda Memorial Hospital was built in 1959, all of the facilities and rooms have either been updated or are in the process of being updated. We have brand new operating room suites that are phenomenal and state-of-the-art. Our Cornell Institute for Rehabilitation Medicine is a 28-bed state-ofthe-art facility that exceeds national standards for its success in helping patients make full recoveries from neurologic and orthopaedic conditions.

Artist rendering of the lobby of Bethesda Hospital West.

What is one thing that you want the community to know about you or the hospital?

obstetrics, a Level 3 NICU, pediatrics, cancer center, women’s health and general/vascular surgery. We provide an outstanding level of care for our patients.

I think the community should know that Bethesda is the most comprehensive hospital you’ll find in Palm Beach County, with a full range of services that include cardiovascular services,

Our board has been so concerned with making sure that we have high patient to nurse ratios, high quality of care and the latest technology. A lot of people don’t know that our open heart

program is world-class. Our cardiovascular surgery group headed by Dr. Michael Carmichael, who is world-renowned, and our survival rates and complication rates are top in the country. We have a very strong orthopaedic program and general vascular program. And yet, outside of our market, if you say Bethesda, they say ‘where’s that, Maryland?’

One of our greatest strengths that I would want people to know is that Bethesda has tremendous community support. In fact, through the support of our Foundation, we raised $100,000,000 for the heart hospital. And they continue to do an outstanding job in supporting our new western hospital. That’s just incredible. There are so many wonderful things….

Sister Mary Murphy Celebrates 50 years as Franciscan Sister Jubilee celebration event scheduled for August 24th.

EST PALM BEACH, Fla.-August 2012-It’s a golden anniversary for Sister Mary who is celebrating 50 years of dedication and service to the Franciscan Sisters of Allegany. As one of the chaplains at St. Mary’s Medical Center, Sister Mary is relied upon by employees, patients and visitors of the hospital. They know that they can count on her for spiri-

can talk to, when they are struggling,” Sister Mary said. Sister Mary’s illustrious career began in teaching, which has spanned over 30 years. Through the years, Sister Mary’s transitioned from teacher to principal at the Immaculate Conception Preparatory School in Kingston, Jamaica. In addition to her responsibilities as principal, she also worked in the Kingston community with the Missionary of the Poor organization. After Sister Mary Murphy. 25 years in Jamaica, she moved tual counsel and advice. “My to Miami where she continued day-to-day duties are constantly her work for the less fortunate at changing, but what doesn’t the Camillus House. change is my dedication tor those St. Mary’s Medical Center is the who rely on me as someone they first hospital Sister Murphy has

provided spiritual guidance at, but her background in education has allowed her to transition seamlessly into her healing role in healthcare. “It is Sister Mary’s compassion that stood out to me the most when I first met her,” Father Aidan Lacy said. “Her 50 years in the Franciscan Sisters of Allegany is a testament to how dedicated she is to the health and wellness of others,” Lacy continued. Chief Executive Officer of St. Mary’s Medical Center, Davide Carbone, echoed Lacy’s sentiments, “Sister Murphy is someone who has helped bridged the gap between faith and community. Our hospital is committed to

maintaining the strong connection to our Catholic roots, and her perspective and dedication and has been invaluable to all who know her and who have been touched by her over the years.” Sister Murphy’s jubilee celebration will take place on August 24th with a Noon Mass at which she will renew her vows as a religious. Those vows are of poverty, chastity and obedience. Present will be many special people she has touched along the way. “Several families from Jamaica that I have kept in touch with over the years will be flying up to attend, so I am very pleased that they will be joining me in my celebration,” she added.

12 AUGUST ISSUE

• 2012

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Have a (Good) Heart! plain of pressure in the chest, others will say they had a feeling of heaviness on the chest, as though someone was sitting on their chest. There are times when diabetics may not feel any chest pains - even though they have underlying heart disease. This could be quite dangerous, because the symptom of chest pain alerts a patient to seek medical attention. I have seen patients with diabetes mellitus that have no symptoms at all, but have severe underlying coronary artery disease, which can only be diagnosed by doing a stress test. Some patients present with shortness of breath and palpitations, which means a racing heart beat or skipped heart beats, fluttering in the chest, and sometimes near fainting or fainting episodes. All the above symptoms could be interconnected and suggest an underlying cardiac arrhythmia.

Shekhar V. Sharma, M.D. Board Certified in Internal Medicine

eart disease is a very common problem with Americans. Sometimes we address this disease as cardiovascular disease, which actually involves blockage of arteries that supply blood to the heart muscle. However, there are various other diseases that fall under the cardiovascular definition. Those include; abnormal heart rhythms (also called arrhythmias) infection of the heart, congenital heart defects, and of course, diseases of the heart blood vessels.

If one has swelling of ankles or legs with shortness of breath on exertion - like walking up the stairs, that could suggest a failing heart also called congestive heart failure. Fatigue, weakness, waking up at night to sit up to breathe better can also suggest congestive heart failure. Fatigue can also come from a slowing heart rate, which sometimes can be due to a severe heart blockage. Such a condition would require a pacemaker.

How do you know if you have heart disease or not? Heart disease can be manifested by chest pains and if someone has any sort of discomfort in the chest, of which is described differently by different patients who have heart disease. Some will com-

the risk of heart disease?

Coronary artery disease is the cause of roughly 1.2 million heart attacks each year. Sadly, more than 40% of those that suffer a heart attack will die. A sizeable number of patients will die even before they reach the hospital. According to the American Heart Association, over seven million Americans have suffered a heart attack in their lifetime. So, what are the risk factors for heart disease? • A strong family history of heart disease, which I feel is one of the strongest risk factors. • Cigarette smoking • A high LDL or bad cholesterol • A low good cholesterol or HDL levels.

• Uncontrolled hypertension. • Diabetes mellitus Other risk factors include intense stress, anger, and obstructive sleep apnea. So, what does one do to lower

• Lower your total cholesterol levels to be below 200 milligrams. • Increase your HDL level to above 45 milligrams (the higher the better). • Lower the LDL levels below 100 milligrams • Control of blood pressure below 140/85 • Control your diabetes mellitus by following a healthy diet suggested by the American Diabetic Association. • Manage stress by doing yoga, medicatation and get good sleep. If you suffer from sleep apnea, it can be treated with a sleep mask (CPAP), oral appliance therapy and in some cases, surgery. Daily exercise is also very important as long as your heart is strong enough to take it.

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

Call

561-996-7742 for an appointment.

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Accepting New Patients

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

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

AUGUST ISSUE • 2012 13

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Sleep Apnea and the Use of an Oral Device

Good Samaritan Chief Nursing Officer Awarded The 2012 Palm Healthcare Commitment to Community Award

Angela Prestia honored for her dedication in promoting the nursing profession.

Alvaro Betancur, DDS, has practiced dentistry in Florida since 1990. After receiving his dental degree, Dr. Betancur completed a residency in craniofacial pain and pathofunction at the University of Florida and a fellowship at the University of Florida Pain Center rand the American Academy of Craniofacial Pain. Dr. Betancur is a member of the American Academy of Dental Sleep Medicine.

By Deborah Lynn

o, you’ve finally had it! You are too tired to get up in the morning, too tired to bring the kids to school and simply too tired to go to work. Now it’s time to give Dr. Alvaro Betancur a call. His practice not only encompasses general and cosmetic dentistry, oral surgery, and dental implants, but it also includes sleep medicine. When Dr. Betancur realized that sleep apnea was significantly underdiagnosed, he decided to obtain advanced training in sleep medicine. It was there, during his day-today practice, that he learned the

number one reason people grind their teeth was due to sleep apnea. It had often been thought that it was due to the stress in one’s life. However, that opinion has since changed as it appears that it’s the body simply trying to move the jaw forward to open the airway. One of the ways Dr. Betancur can treat your sleep apnea is in the form of Oral Device Therapy. During your exam, Dr. Betancur will evaluate which oral device will work best for you. He can then create your custom fit appliance which will help you to maintain an unobstructed airway while you sleep. When you treat the sleep apnea using oral appliances, the grinding seems to stop. After you receive your device, you will need to continue your therapy in the form of short or long-term maintance. As this is an essential part of your treatment with your new oral device. This will allow for Dr. Betancur to assess the treatment of your sleep disorder, see how you respond to your new device, its effectiveness and to be sure that it is a comfortable fit.

W Dental Appliance

There are numerous advantages of using Oral Appliance Therapy. Not only are they comfortable, but it generally only takes a few weeks to get used to wearing one. In addition, because of the small size, you can take it with you anywhere. From a financial standpoint, this form of sleep apnea treatment is considered economical by patients and insurance companies alike. You can also discontinue the therapy at any time. Dr. Betancur would love to help you attain that long overdue restful night of sleep. To make an appointment – please call 561-750-6970 for his Boca Raton location, or 954-392-1851 for Pembroke Pines. Or, if you would like additional information, you can visit www.dentistrx.com or www.sleepsnoredentist.com.

EST PALM BEACH, Fla-August 2012Good Samaritan Medical Center’s Chief Nursing Officer, Angela Prestia RN MSN NEBC, recently received the accolade of the Commitment to Community award at the Palm Health Care 2012 Commitment to Community and Volunteer Recognition luncheon. Prestia was honored as a community partner for her continuous dedication to promoting the profession of nursing in Palm Beach County. In her tenure as CNO at Good Samaritan, Prestia has been known as a leader in the nursing community. Prestia championed the novice nurse leadership institute, a program for newly licensed nurses (12-18 months) that helped integrate them into the profession, and engaged them with colleagues and the community they serve. Prestia had six nurses from Good Samaritan as participants in the program. Prestia has also focused on the education of young people pursuing a career in nursing. She is an active member of the Florida Atlantic University curriculum advisory panel for the emerging nurse leader master’s degree. “I

Angela Prestia, RN MSN NE-BC.

am thrilled to be recognized for my passion for nursing because it is such a huge part of my life.” Prestia said. This award is such an honor to receive, and I am so touched that Palm Health Care believes I have made a difference in this community.” “Angela has always been committed to the advancement of the nursing staff at Good Samaritan and to our patients, and I am pleased to see her efforts are being acknowledged through the Commitment to Community award,” Chief Executive Officer, Mark Nosacka said. “This recognition is a true testament to the leadership and dedication Angela and her team have devoted to our goal of delivering the highest quality patient care.”

FDA approves vaccines for the 2012-2013 influenza season

he U.S. Food and Drug Administration announced today that it has approved the 2012-2013 influenza (flu) vaccine formulation for all six manufacturers licensed to produce and distribute the vaccines in the United States. Each year experts from the FDA, the World Health Organization, the Centers for Disease Control and Prevention (CDC), and other

public health experts study influenza virus samples and global disease patterns to identify virus strains likely to cause the most illness during the upcoming flu season.

flu vaccines are: A/California/7/2009 (H1N1) like virus A/Victoria/361/2011 (H3N2) like virus B/Wisconsin/1/2010-like virus.

Based on that information and the recommendations of the FDA’s Vaccines and Related Biological Products Advisory Committee, the strains selected for inclusion in the 2012-2013

While the H1N1 virus is the same as what was included in the 2011-2012 influenza vaccines, this year’s influenza H3N2 and B viruses differ from those in the 2011-2012 influenza vaccines.

Save your life… Peaceful Sleep without CPAP

PEACEFUL SLEEP WITHOUT CPAP SNORING AND DAYTIME SLEEPINESS may signal a potentially life threatening disorder:

OBSTRUCTIVE SLEEP APNEA OR OSA OSA can lead to heart attack and reduced libido Covered by most Medical Insurance and Medicare

Obstructive Sleep Apnea (OSA) affects more than 18 million Americans and can lead to hypertension, heart attack, stroke, diabetes, reduced libido, TMJ Dysfunction, morning headaches and excessive daytime Sleepiness which can lead to work and car accidents.

Vaccination remains the cornerstone of preventing influenza, a contagious respiratory disease caused by different influenza viruses infecting the nose, throat and lungs. This year’s seasonal vaccines will provide protection against the three influenza virus strains that global surveillance indicates are likely to be the most common strains circulating during the upcoming season.

The CDC’s Advisory Committee on Immunization Practices, recommends that everyone six months of age and older receive an annual influenza vaccine.

Comprehensive

Family Dental Care Our Services Include: Dental Implants Wisdom Teeth Removal * Oral Rehabilitation Gums Treatment: surgical and non-surgical Root canals * Fillings * Crowns * TMJ

Orthodontics & Dentofacial Orthopedics Snoring ruins your sex life

Treatment with Oral Appliance Therapy (OAT): for mild and moderate sleep apnea and snoring. Plus severe OSA when the patient is intolerant to CPAP or needs to be used in conjuntion with CPAP.

Compare Treatment Options

Starting as young as 2 years old, you may help your children to solve ear inflammation symptoms, develop a beautiful face and smile with a more attractive profile as well as prevent sleep apnea and avoid orthognathic surgery; all with Funtional Appliances and Facial focused Orthodontics.

SuperFastOrtho.com Full Lip Seal

Custom Fit

Permits Movement

Eliminate the CPAP mask and continue using CPAP equipment with the new oral appliance to obtain the benefits of both. Member Alvaro Betancur, D.D.S.

According to the CDC, between 5 percent and 20 percent of the U.S. population develops influenza each year. This leads to more than 200,000 hospitalizations from related complications.

OAT is covered by most Medical Insurance and Medicare

We can straighten your teeth at any age, fast and comfortably using invisible technology with or without braces. Improve your facial appearance with a beautiful and healthy smile. 3401 N.Federal Hwy. Suite 101 18503 Pines Blvd. Suite 305 Boca Raton, FL 33431 Pembroke Pines, FL 33029

Dentist-rx.com

Phone: 561-750-6790

Phone: 954-392-1851

14 AUGUST ISSUE

• 2012

WWW.GLOBALHEALTHTRIBUNE.COM

Upcoming Medical Fundraising Events For August 20 – September 30, 2012 August 21 Adopt-A-Family of the Palm Beaches. Physicians Talent

Showcase presented by Kretzer Piano. Featured headliners and PBCMS Board members Dr. Hatem Abou-Sayed and Dr. Jack Zeltzer along with emcees and Board member Dr. Maureen Whelihan and Dr. Gordon Johnson. Harriet Himmel Theatre at City Place, West Palm Beach. Tickets are $50.00. Call CTS at 866-449-2489. For additional information, contact Kathi Kretzer, Kretzer Piano at 561-748-0036 or by e-mail kkretzer@kretzerpiano.com.

August 23

Girls Night Out benefits the Kids Cancer Foundation

By Deborah Lynn

The Pap Corps and Royal Palm Place. Eat to Beat Cancer - Diamond Jubilee. The Boca Raton Chamber of Commerce's Boca Festival Days. Royal Palm Place, Boca Raton. Participating restaurants include Caruso Ristorante, Casimir Bistro, Cypress Mediterranean Grill, Jake's Stone Crab, Raffaele Ristorante, Ristorante Sapori, Saquella Cafe, Yakitori Sake House. Please visit www.royalpalmplace.com for menus, a map of locations and free parking areas. To help or find out additional information, visit www.papcorps.org. Muscular Dystrophy Association. MDA's Northern Palm

Beach Executive Lock-Up. III Forks Palm Beach Gardens, Palm Beach Gardens. Over 100 Northern PBC business owners, executives and community leaders are participating. The LockUp is a jail-themed event where jailbirds go behind bars to raise bail for local children and adults with neuromuscular diseases. All "jailbirds" who raise their $4,000 bail are able pre-tape their check presentation which will be aired on 9/2 during the MDA Show of Strength (FKA MDA Labor Day Telethon). For additional information or to participate in this event, contact 561-742-3748.

August 25

The Leukemia & Lymphoma Society (LLS). Macy’s Shopping for a Cause. Purchase a $5.00 shopping pass and you’ll receive 25% off all day at any Macy's (also good for 10% off electronics, watches, furniture and mattresses). For additional information, visit www.lls.org.

hat do you get when you put jewelry, make-up, body lotions, sweets, food, fashion accessories and a DJ in one room? Women and plenty of them! On July 12, Phelps Media and Maureen Gross organized a “Girls Night Out” event at The Players Club in Wellington. There were over 20 vendors that offered so many beautiful items for purchase. In addition, each vendor gave an item to raffle off of which benefitted the Kids Cancer Foundation. This was such a wonderful event on many levels, but mainly because it benefitted a great cause with such a dedicated founder in Michelle O’Boyle. If you would like additional information on how you can help the Kids Cancer Foundation, please visit their website at www.kidscancersf.org. As these events happen monthly, please visit Phelps Media website at www.phelpsmediagroup.com to find out where the next event will take place and which local charity will benefit.

Michelle O'Boyle from Kids Cancer Foundation.

Mindy Sepinuck sizing up a customer.

Jusuru Life Blend

SEPTEMBER September 13 Arthritis Foundation. 2012 Team Kick-Off Wine Social. Arthritis Foundation, 400 N. Hibiscus, West Palm Beach. RSVP by September 10 to srhodes@arthritis.org or 561-833-1133.

September 29 Bethesda Next. 2nd Annual White Party. Eleven Spa, Delray Beach. $50.00 per person in advance and $60.00 at the door. Proceeds benefit the Bethesda Memorial Hospital Pediatric Playroom renovation. Must be 21 or older to attend. For additional information, contact 561-278-1100.

Cindy Soto showing off her custom creations from Sweet Servings.

Facelift Bungee giving a client an instant lift.

American Heart Association. Heart Walk of the Palm Beaches. Meyer Amphitheatre, West Palm Beach. For additional information, contact Brittney Farwell at 561-697-6617 or pbcheartwalk@heart.org. MISCELLANEOUS

Arthritis Foundation. Order your 2012 discount golf book today. Books are $15.00, or buy three books and get one free. Great Florida golf courses with discounted green fees from May through October and some select courses year round. To order your book(s), contact Terri Johnson at 800-672-0882 or 941747-8303 or by e-mail to tjohnson@arthritis.org. Shaun Santoro and Gail Boss from Scentsy.

Passion Parties by Yani was a complete hit!

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

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

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

Also offering

Venra Clinical Studies, LLC

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 BELLE GLADE

Venra Clinical Studies, LLC

1200 South Main Street #102 Belle Glade, Florida 33430

561-795-3330 ex. 249 info@venraclinicalstudies.com

561.996.5600

At Palm Beach Surgery Center we provide a safe and friendly environment, 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

Tha Thanks Th T hhan ank nks k tot You, ks Youu, You Yo -Y 7OUND IS (EALED AT THE CENTER FOR WOUND CARE AND HYPERBARIC MEDICINE AT WELLINGTON

SERVICES INCLUDE :

Most insurances accepted. 4 O SCHEDULE YOUR 4O SCHEDULE YOUR CCONSULTATION PLEASE CALL ONSULTATION PLEASE CALL

-EDICAL 0ARK "OULEVARD s 7ELLINGTON -EDICAL 0ARK "OULEVARD s 7ELLINGTON On the Campus us of W ellingto e Wellington ellington Regional Medical Center 7 7ELLINGTON2EGIONAL COM ELLINGTON2EGIONAL COM Physicians are independent practitioners who are not employees or agents of Wellingto e ton Regional Medical Centerr. The hospital sh shall not be liable for actions or treatments provided by physicians.