Networking Publisher of: The St. Augustine Woman’s Journal
Publisher/Editor Suzanne Egeln publisher@NEFLWomansJournals.com
Business Manager Anthony Egeln bizmgr@NEFLWomansJournals.com
Graphic Design Samantha Angeli samantha.angeli74@gmail.com
Photography Christine Cousart Christine@Cousartstudios.com
Email / Web info@neflwomansjournals.com www.NEFLWomansJournals.com P.O. Box 3655, Ponte Vedra Beach, FL 32004 Voice & Fax: 904-280-0788
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Suzanne Egeln, Publisher
ake new friends, but keep the old”, was one of my favorite songs from Girl Scouts. As we get older, how do you make new friends? Attending “networking” events has become a great way to meet women with like interests, learn about volunteering opportunities and have good coffee. My favorite group thus far meets “early” at City Bistro (formerly City Coffee) on the last Tuesday of the month. Besides bringing coffee to the table everyone is positive and forthcoming with a “good” story for
the day. I recently met Kelly Youngs, who has organized Women’s Wednesdays for the month of June. Not only will you get a chance to network at her events, but also the speakers she has lined up will send you away with a positive message. Earlier in the spring I had a chance to attend Generation W in Jacksonville. Founder Donna Orender believes that women connecting gives them power to be successful whether it’s running a business or a home. These events enable women to learn, inspire our spirits and take in energy from others. So where to I connect the best? Well, that would be my hair stylist, Lisa Harris (page 39). Not only is she a fantastic stylist and colorist, everyone knows that the hair salon is where it all happens. For those who are fans of “Steel Magnolias” you know that what happens in the beauty parlor stays in the beauty parlor.
U.S. Mail • Direct Drop Distributors • Subscription The St. Augustine Woman’s Journal is published bimonthly by Northeast Florida Woman’s Journals and is available free of charge, by display stands in approved private and public establishments and by authorized distributors only. Subscriptions are available.Trademark laws and U.S. copyright laws protect The St. Augustine Woman’s Journal. No part of this paper may be reproduced without the written permission of the publisher. The St. Augustine Woman’s Journal is not responsible for (1) any editorial comment (other than its own), (2) typographical errors from advertisements submitted as camera ready or (3) any reproductions of advertisements submitted as camera ready. If an advertisement does not meet our standards of acceptance, we may revise or cancel it at any time, whether or not it has been already acknowledged and/or previously published. The advertiser assumes sole responsibility for all statements contained in submitted copy and will protect and indemnify The St. Augustine Woman’s Journal, its owners, publishers, and employees, against any and all liability, loss or expense arising out of claims for libel, unfair trade names, patents, copyrights and proprietary rights, and all violations of the right of privacy or other violations resulting from the publication by this newspaper or its advertising copy. Publisher shall be under no liability for failure, for any reason, to insert an advertisement. Publisher shall not be liable by reason of error, omission and/or failure to insert any part of an advertisement. Publisher will not be liable for delay or failure in performance in publication and/or distribution if all or any portion of an issue is delayed or suspended for any reason. The publisher will exercise reasonable judgment in these instances and will make adjustments for the advertiser where and when appropriate. The St. Augustine Woman’s Journal assumes no responsibility for unsolicited material or reproductions made by advertisers. Representations by The St. Augustine Woman’s Journal™, Copyright 2009.
Find us on the web at: staugustinewomansjournal.com
As we plan to travel this summer, remember to check out the special tours offered by AAA Travel’s Kelly Maguire Monroe (page 26), and to consider a “staycation” in St. Augustine. Our Florida beaches and state parks are the best. As a resident of Florida, I find it my obligation to be a steward of the outdoors, keeping an eye on the sea turtles and enjoying our resources. Have a safe summer and remember to wear sunscreen! As always we invite you to enjoy the articles enclosed in these pages, to support our Contributors, and to suggest new Contributors. We are especially looking to add Contributors from the Home Improvement area: Electrical, Plumbing, Heating & Air, Roofing, Painting and building contractors. Likewise we welcome your suggestions for new ideas for the Woman’s Journal and recommendations for our Women in Profile section.
Slainte! Suzanne Egeln
In This Issue
st. augustine woman’s journal | JUNE/JULY 2016
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33 32 13 25
39 26
Health & Medicine 4 | 5 | 6 | 7 | 8 |
Hammer (Toe) Time Going Beyond The Call of Duty Discover the latest in varicose vein treatment Celiac Disease Flagler Hospital is Among Top 5% of Hospitals in Clinical Outcomes in Nation According to Healthgrades 9 | Innovative Non-Surgical Weight-Loss Procedure Now Offered at Flagler Hospital 10 | Short and Long Term Healthcare: Coverage of Skilled Nursing Facility Services 13 | It’s Your Business: Get Clear and Get Going in Your Career 14 | Why Do We Sleep? 16 | Polycystic Ovarian Syndrome 17 | Are You an Expectant or Nursing Mother? 18 | Is it Time For a Mommy Makeover?
Life Services
20 | Tuck-In Call Program 21 | Simply Susie. Let us clean, cook and run errands for you! It’s just a part of what we do! 22 | Celebration Reception Enhances Memorial Service
Business & Finance
23 | 5 Enduring Myths of Online Marketing
Legal
25 | No Will, Will or Trust? (It’s really a no-brainer!)
Fashion & Beauty
38 | Relationship, Relationship, Relationship! 39 | Why Hair Consultations are Needed Before You Cut or Color!
Food & Entertainment
Travel
41 | Ichiban Buffet 42 | WFOY 43 | Treat Your Taste Buds at PJ’s Asia One Market
Women in Profile
Back Cover
26 | Discover The Caribbean’s Biggest Adventure
27 | Sandy Gorton, Chance Backert, Dilyn Jackson, Mary McKemy, Emily Stimler, Becca Cady, Susan Johnson
44 | Women’s Wednesdays
Community
31 | The 8th Annual Caribbean Calypso Night 32 | Find Your Park Plein Air Awards Announced 33 | Sixty-Six Seconds 34 | Mertz in meinem Herzen - The Guitar Music of Johann Kaspar Mertz (1806-1856) 35 | Adoption: A Beautiful Option Choosing Life and Choosing Parents 36 | Lincolnville Festival 37 | St. Francis House Holds Ribbon Cutting for Rotary Funded Kitchen Renovation
Find us on the web at: staugustinewomansjournal.com
Health & Medicine
Hammer (Toe) Time
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By JosĂŠ Concha, DPM
Coastal Foot & Ankle Wellness Center
he term hammer toe refers to a common deformity of the foot in which the second, third, fourth, or fifth toe is bent at the middle joint of the digit or digits. Typically the tip of the toe is bent downward into the floor while the middle joint is cocked upward resembling a hammer. The hammer toe is the most common deformity of the lesser toes. When a hammer toe first develops it can be flexible, or bent back to its normal position with manipulation. If not treated, a hammertoe can become rigid and require surgical correction in order to repair the deformity. Symptoms and signs associated with hammertoes can include corns or calluses on the affected digit. Deformity
June/July 2016
of nails and fungal changes may also ensue and may require treatment. People suffering from this condition may find it difficult to find comfortable shoes to wear. Improper shoes, such as high heels and pointy toed, can lead to the development of hammertoes due to excessive stress on certain muscles. Aside from shoes, causes for hammertoes may include genetics, trauma, diabetes, arthritis and neurological causes such as a stroke. Diabetics can be especially at risk for infections and ulcers in the areas related to the hammertoe deformities and should seek the services of a podiatrist for evaluation and preventative measures. If you have hammertoes, avoiding tight shoes and limiting high heels may provide initial relief. Shoes should be at least one half inch longer than the longest toe. Conservative (non-surgical) treatment for hammertoes involve wearing shoes with plenty of room in the toe box. Gel pads, cushions, or toe splints may also help in reducing associated friction at the prominent areas. Stretching and strengthening exercises for the toes (such as stretching the toes by hand or picking up items with the toes) are also recommended. In more advanced cases of hammertoe or if the accompanying pain can not be relieved by conservative measures, surgical treatment may be required. Different types of surgical corrections depend on the type, location, and severity of deformity. Surgical treatment is generally effective for both flexible and rigid (fixed) forms of hammertoes. The length of the recovery period will vary depending on the procedure performed. A majority of patients may benefit from newer, less invasive techniques that can have most people back in their normal shoes in one week. Hammertoes are progressive and don’t go away by themselves. They should receive early intervention. A podiatrist can evaluate your hammertoes and develop a treatment plan that is suited to your needs.
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We have been treating your feet in St Augustine and Palatka for over 12 years. Make an appointment today with Richard Johnson, DPM or Jose Concha, DPM at (904)826-1900 in St Augustine or (386)328-1122 in Palatka. At Coastal Foot & Ankle Wellness Center, we are setting the highest standards for your foot and ankle care.
Health & Medicine
Going Beyond The Call of Duty
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Dr. Roy H. Hinman, Island Doctors
r. Roy H. Hinman II is as self-disciplined and self-driven as they come. With twenty-three family practice locations across north Florida, Dr. Hinman sees the potential for health improvement in every patient who walks through his door. “Anybody who walks in this office, their health can be improved in one form or another- usually by patient intervention with us to guide, assist and educate them,” he explains. “Whether that’s helping them quit smoking, starting an exercise regimen, or changing their diet- patients are the ones who activate the key to success.” After eight years in the U.S. Army as a Calvary Officer, where among other things, Dr. Hinman served as a foreign military advisor with the Saudi Arabia National Guard (he speaks both Arabic and Spanish), he decided to make a career change and go into medicine, which he calls “a kinder, gentler profession than teaching anti-tank tactics in the desert.” A Tulsa, Oklahoma-native, Dr. Hinman already earned a bachelor’s degree in psychology from Tulsa University and a master’s degree in human resource management from Pepperdine University. In 1987, Dr. Hinman added a medical degree to his resume when he graduated from Universidad Tecnologica de Santiago in Santo Domingo, Dominican Republic.
“The medical training was very advantageous for me, in that for diagnosis, they did not rely on technical equipment, x-rays or laboratories”, Dr. Hinman explains of going to school in the Caribbean. “We relied predominantly on an extremely good patient history and physical examination. That’s really where your diagnosis comes from.” Dr. Hinman says this experience (“different than in the U.S. where patients are often diagnosed by tests and x-rays”) helped lay the groundwork for starting his own family practice, Island Doctors, in October of 1991 on Anastasia Island in St. Augustine. Today, the practice has almost two dozen clinics across north Florida and specializes in health improvement with a focused effort on cholesterol reduction, glucose reduction in diabetic patients and smoking cessation. “When I came here, there were two hospitals competing against one another. And then two months later, Flagler Hospital bought out St. Augustine General Hospital,” Dr. Hinman says of the local medical community back in the early 90s. “It was growing and thriving when I got here. Over the years, I’ve seen an increased focus on health improvement rather than “fix-it” medicine.” During this time, Dr. Hinman has also held a variety of positions in the local medical community including Chairman of Family Practice Department at Flagler Hospital, President of the St. Johns County Medical Society, Medical Director for Total Living Care of St. Augustine and Clinical Affiliate of Physician Assistant Sciences for the University of Florida and Clinical Associate Professor for Nova Southeastern Medical School. He’s also seen the number of healthcare providers grow by leaps and bounds. For many years, Island Doctors was the only medical practice on Anastasia Island. In 1998, the practice began managed care operations with Humana Medicare Advantage Plans and became a Medical
Services Organization (MSO). “It’s hard to imagine,” Dr. Hinman admits. “We went from a regular family practice in acute care/urgent care, to a regional health improvement organization!” “We need to make economical and efficient use of the patient’s time and resources to come to their diagnosis and treatment plan”, he explains. “We, at Island Doctors, really pride ourselves on being a health improvement organization. When a patient walks through the doors of an Island Doctors’ clinic, the first thing my
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staff and I do is evaluate what we can do to help the patient look their best and feel their best, which will place them on the top of their individual health pyramid.” Whether it’s cholesterol reduction, blood glucose reduction in diabetic patients, smoking cessation, or beginning a patient on a weight loss regimen, Dr. Hinman says, “The future of medicine in Northeast Florida needs to focus its emphasis on health improvement. This will create a healthier, happier, and longer living community.”
Health & Medicine Discover the latest in varicose vein treatment -A Solution to Leg Pain
Photo by Christine Cousart www.cousartphotography.com
can become enlarged or varicose. Endovenous ablation is an ultrasound guided procedure that uses heat generated by radiofrequency energy to close off these faulty vessels, diverting blood flow immediately to nearby healthy veins.
ave you taken a look at your legs lately?
What are some common uses of the procedure? Although this procedure may be used for cosmetic purposes, it is more commonly used to help alleviate symptoms associated with venous insufficiency. Leg pain, fatigue, tiredness, heaviness, aching, burning, itching, and restless legs are common symptoms of venous insufficiency. These symptoms often worsen with long periods of standing and can lead to leg swelling, throbbing and leg cramps. Conservative treatments include heavy support stockings, anti-inflammatory medications, and leg elevation. Venous disease is not as yet curable; however with appropriate treatment, the progressive nature of vein disease can be slowed and controlled
What is Radiofrequency Endovenous ablation? There are several options in the treatment of varicose veins. They involve Endovenous ablation, vein stripping and ligation, phlebectomy and sclerotherapy. For the purposes of this article I will focus on endovenous ablation treatment. Varicose vein treatment with endovenous ablation, is the latest minimally invasive treatment that uses radiofrequency energy to cauterize (burn) and close abnormally enlarged veins in the legs, a condition called venous insufficiency. Normally, blood circulates from the heart to the legs via arteries and back to the heart through veins. Veins contain one-way valves, which allow blood to return from the legs against gravity. If the valves leak, blood pools in leg veins, which
How is the procedure performed? Dr. Pereira and Dr. Ross will numb the area where the catheter will enter into the abnormal vein with an anesthetic solution, and use the ultrasound probe to study the vein and track its path. The leg being treated is then cleaned, sterilized and covered with a surgical drape. A very small nick is made in the skin at the site. Using ultrasound guidance, the catheter is inserted through the skin into the vein and positioned within the abnormal vein. The radiofrequency electrode is inserted through the catheter and placed into the ‘safe zone.’ The local anesthetic solution is injected around the abnormal vein with ultrasound guidance. Radiofrequency energy is applied as the catheter is withdrawn 7 cm every 20 seconds. The skin is then covered with a bandage. No sutures are needed. This procedure is usually completed within 45 minutes. Following the procedure, you will need
For more information about vein treatments, please visit: www.anastasiamedicalgroup.com or contact the office at 904-461-0821. The Center for Advance Vein Care (CAV care) treats all of the aspects of venous disease, the most common of which are varicose veins, spider veins, venous ulcers, and refluxing veins. We utilize the VNUS® Closure® procedure and treatments usually last approximately 45 minutes. In order to provide for total comprehensive vein care, vein stripping, ambulatory phlebectomy and sclerotherapy are also performed at the Center for Advance Vein Care. Dr. Ryan J. Pereira (pictured above) has been in
practice since 2002 and has been treating venous disease since 2005. He is a Diplomat of the American Board of Podiatric Surgery and is Board Certified in both Foot Surgery and Reconstructive Rearfoot/ Ankle surgery. He is also a Fellow of the American ColDr. David S. Ross lege of Foot and Ankle Surgeons. He graduated from the Ohio College of Podiatric Medicine with his Doctorate in Podiatric Medicine.
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By: Ryan Pereira, DPM FACFAS
If you don’t like what you see then, at the Centre for Advanced Vein Care, Dr. Ryan Pereira and Dr. David Ross are who can relieve your painful symptoms and improve the appearance of your legs to restore them to a more youthful look!
June/July 2016
to wear a gradient compression stocking to help reduce bruising, tenderness, and minimize the very rare possibility that blood clots may form. You may resume your normal activity immediately, with the exception of air travel or prolonged sitting (such as a long car trip). The physicians will perform a follow up ultrasound examination in order to assess the treated vein. Within Additional procedures (such as sclerotherapy or ambulatory phlebectomy) may be necessary to treat the smaller associated vein and are finishing touches to make your legs beautiful and youthful once again! What are the benefits of this procedure? Benefits are . . . • No surgical incision is needed-only a small nick in the skin that does not have to be stitched closed. • When compared with traditional vein stripping techniques, endovenous ablation is more effective, has fewer complications, and is associated with much less pain during recovery. Dr. David S. Ross has been in practice since 1977 and has been treating venous disease since 2008. He is Board Certified in both Emergency Medicine and Family Practice and is a Fellow of the American College of Emergency Physicians. He graduated with a Doctorate in Medicine from the University of Florida.
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• Endovenous ablation is generally complication-free and safe. • This procedure leaves virtually no scars because catheter placement requires skin openings of only a few millimeters, not large incisions. • Endovenous ablation offers a less invasive alternative to standard surgery. • Most of the veins treated are effectively invisible even to ultrasound 6-12 months after the procedure. • Most patients report symptom relief and are able to return to normal daily activities immediately, with little or no pain. And finally Your legs will look great!
Health & Medicine
Celiac Disease Some patients have no symptoms whatsoever. Some patients have classic symptoms of the disease related to decreased intestinal absorption such as diarrhea, weight loss, abdominal discomfort and bloating. Some adults do not exhibit digestive signs and symptoms and instead have an associated condition such as rash, osteopenia or osteoporosis (weakening of the bones), iron deficiency anemia (low blood count due to lack of iron), etc.
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Camille A. McGaw, M.D. GI Associates of Saint Augustine
hat is Celiac Disease? Celiac Disease is a condition resulting from an intolerance to a protein called gluten that can present at any age. It affects as many as 1 in 133 Americans. This is an autoimmune condition which affects the lining of the upper small intestine after consumption of gluten. The small intestine is responsible for absorbing food and nutrients. When gluten is consumed, the immune system of a person with Celiac Disease responds abnormally causing damage to the intestinal lining leading to faulty digestion and malabsorption of nutrients thereby producing symptoms. Consequently, patients who have the disease get sick when they eat gluten containing foods such as wheat, rye and barley. Signs and Symptoms The symptoms of celiac disease can vary from one patient to the next.
How is the diagnosis made? The diagnosis is made with a blood test which looks for antibody production. This is a protein that patients with celiac disease produce after eating gluten. Before testing, patients must be on a diet containing gluten for the screening test to be valid. If you are on a gluten-free diet at the time of testing, other blood tests may be needed to evaluate for genetic predisposition. Confirmation of the diagnosis is made by intestinal biopsy. This is done by way of a short painless procedure called an upper endoscopy. Under sedation, a gastroenterologist will use a thin flexible tube with a tiny camera to examine your small intestine. A small sample of tissue will then be taken at that time to be examined for specific changes consistent with celiac disease. How is it treated? Celiac disease cannot be cured and at present, there are no medications available to stop, prevent or reverse damage done to the intestinal lining. However, the mainstay of treatment is the strict elimination of gluten in the diet which will stop the damage to
the intestinal lining. A gluten-free diet can be difficult to maintain as gluten is present in many common foods and products. Consultation with a dietitian is recommended. Potential sources of hidden gluten in processed foods, cross-contamination at restaurants and within medications or supplements. It is important to read labels carefully paying close attention to additives used. Oats can be introduced with caution and may be tolerated by some patients Monitoring Response to treatment A large percentage of patients have noticeable improvement in symptoms within two weeks of a glutenfree diet. Patient are monitored at regular intervals with blood tests and sometimes require a repeat endoscopy. Close attention must also be paid to vitamin and mineral deficiencies and supplemented as needed. The most common reasons for lack of improvement is poor compliance or unintentional gluten ingestion. A small subset of patients do not respond to a strict gluten-free diet and need to be evaluated and treated further by a gastroenterologist. Who should be tested? Anybody who has signs or symptoms of the disease should be tested. There are currently no guidelines for routine testing for celiac disease in asymptomatic patients but relatives of patients with celiac disease are at increased risk for having celiac disease. First degree relatives should consider being tested, especially if signs or symptoms of the disorder are present. Testing is usually done with a blood test, as described previously.
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What our patients say: Well organized & efficient staff! • I feel the level of care and the gentle and kind manner I was treated in was excellent. I think you should be proud of your staff. • This was my first colonoscopy and the entire staff made the experience less nerve racking, than I thought it was going to be. Everyone made me feel comfortable. • Well done from start to finish. Thank you!! • I had high anxiety over the procedure but staff put me at complete ease! Thank you! • I went in quivering in fear and left with no trauma. Thank you! • Very satisfied, would refer my family to you all.
Consultants in Digestive Disorders Santiago A. Rosado M.D. • Steven Yu Villanueva M.D. Timothy J. Cavacini D.O. • Stuart A. Soroka, M.D. Daniel J. Gassert, M.D. • William J Barlow, M.D. Anis A. Ahmadi, M.D. • Camille A. McGaw M.D St. Augustine 216 Southpark Circle East St. Augustine, FL 32086 Phone: 904.824.6108 Fax: 904.823.9613 Murabella/WGV 52 Tuscan Way, Suite 203 St. Augustine, FL 32092 Phone: 904.824.6108 Palatka 199 S. Highway, Suite C East Palatka, FL 32177 Phone: 386.326.4060 PALM COAST 50 Cypress Point Pkwy, Condo C1 Palm Coast, FL 32164 Phone: 386.986.3400 www.GI-Associates.com info@gi-associates.com
Health & Medicine
Flagler Hospital is Among Top 5% of Hospitals in Clinical Outcomes in Nation According to Healthgrades
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lagler Hospital has received the Healthgrades 2016 Distinguished Hospital Award for Clinical Excellence™. The distinction makes Flagler Hospital one of the top five percent of more than 4,500 hospitals nationwide for its clinical performance as measured by Healthgrades, the leading online resource for comprehensive information about physicians and hospitals. The hospital earned 5 stars in 22 of the 32 common inpatient conditions and procedures, as evaluated by Healthgrades, and was also named in America’s 100 Best for orthopedic surgery and pulmonary care. “Earning a place among the top 5% of hospitals in our country reflects the unwavering commitment of our staff, our community physicians, our leadership team and our board of directors to achieve the very best clinical outcome for every patient, every time,” commented Flagler Hospital CEO, Joe Gordy, during a hospital town hall meeting where a Healthgrades representative was onsite to present the award. “Our community should be proud of this tremendous accomplishment, just as I am proud to work among such passionate people who truly care about our mission and maintain a commitment to caring for our community year after year.” In the Jacksonville, FL area, there were 2 hospitals out of 8 eligible hospitals recognized as recipients of the Distinguished Hospital for Clinical Excellence Award. As evaluated by Healthgrades, Flagler Hospital is among the hospitals in the Jacksonville, FL area with some of the best quality care across a broad spectrum of common inpatient conditions and procedures. From 2012 through 2014, Healthgrades Distinguished Hospitals for Clinical Excellence, as a group, had a 26.5% lower risk adjusted in-hospital mortality rate across 19 procedures and conditions
June/July 2016
where mortality was the clinical outcome, compared to all other hospitals. During this same period, if all other hospitals performed at the level of Distinguished Hospitals for Clinical Excellence across these 19 procedures and conditions, 158,858 lives could potentially have been saved. For example, patients treated at a hospital that achieved the Distinguished Hospital for Clinical Excellence Award had, on average, a 32.0% lower risk of dying from heart failure than if treated at a hospital that did not receive this distinction. “When it comes to hospital selection,
two of the most important questions to consider are where you are most likely to have a complication-free hospital stay and which hospital offers the best chance of survival, both during the hospital stay and in the weeks that follow,” said Evan Marks, Chief Strategy Officer, Healthgrades. “Selecting a hospital that has achieved Healthgrades 2016 Distinguished Hospital for Clinical Excellence award is one way to be confident that you will receive the right care.” The 260 recipients of the Distinguished Hospital Award for Clinical Excellence™ stand out among
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the rest for overall clinical excellence across a broad spectrum of care. During the 2016 study period (2012-2014), these hospitals showed superior performance in clinical outcomes for patients in the Medicare population across at least 21 of 32 of the most common inpatient conditions and procedures — as measured by objective performance data (risk-adjusted mortality and inhospital complications). To learn more about how Healthgrades determines Distinguished Hospital Award for Clinical Excellence™ recipients, please visit www.healthgrades.com/quality.
Health & Medicine
Innovative Non-Surgical Weight-Loss Procedure Now Offered at Flagler Hospital
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or many people who are overweight, the challenge of dropping pounds is often difficult and urgent. But now, a new technology available at Flagler Hospital is offering hope. The ReShape Procedure is a new, FDA approved, non-surgical approach to weight loss that is proven to help people achieve and maintain significant weight loss. The ReShape Procedure was specifically designed
healthy foods you enjoy, but the balloons act as built-in portion control, helping you feel full and less hungry. The balloons are a weight loss jump-start, and are only part of the procedure. You also receive a full year of personalized coaching to support your success and help you make the changes that will encourage a lifetime of healthy living. ReShape combines the portion-controlling benefits of the balloons
ReShape Balloon in Stomach for patients with a lower BMI (between 30– 40). In a recent study, patients lost more than twice as much weight with ReShape than with diet and exercise alone.1 Most ReShape patients keep the weight off or continue to lose, even after the balloons are removed. With ReShape, two connected balloons filled with saline (salt water) are placed temporarily inside your stomach in an outpatient medical setting. The procedure lasts about 20 minutes while you are comfortably sedated under light anesthesia. The balloons remain in the stomach for six months, helping you lose weight and encourage healthy eating habits by taking up room in your stomach. You can still eat the
with comprehensive coaching to change your eating habits, enhance your physical fitness, and help you adopt a healthy lifestyle that supports long-term success.
Virginia lost 72 pounds with the ReShape Procedure
For more information about the ReShape procedure, visit our website at www.FlaglerHospital.org/Reshape or call 904-819-5861.
Before
About Flagler Hospital. Flagler Hospital is a 335 bed, acute care hospital that has consistently ranked among the top hospitals in the nation by leading ratings agencies. The hospital has operated as a not-for-profit healthcare institution in St. Augustine, Florida since its founding in 1889. Flagler Hospital’s focus on quality has resulted in numerous national accreditations including, designation as a Chest Pain Center by the Society of Chest Pain Centers, ANCC Magnet Status for Nursing Excellence, the Gold Seal of Approval™ from The Joint Commission for Primary Stroke Care Centers, National accreditation for its total hip and total knee replacement programs and accreditation of its Cancer Institute by the Commission on Cancer. To learn more about all of the hospital’s services log on to www.FlaglerHospital.org.
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Health & Medicine
Photo by Christine Cousart www.cousartphotography.com
Short and Long Term Healthcare: Coverage of Skilled Nursing Facility Services This forum is a regular contribution from BayView Healthcare to help share the knowledge and expertise of the more than 280 healthcare professional across our continuum of care. In each issue an area of interest is address to help consumers be even more informed about their health and wellness.
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EALTHCARE REFORM, MEDICAID MANAGED CARE, AND MEDICARE ADVANTAGE PLANS… Care in a skilled nursing facility, or nursing home, is currently a hot topic. How that care is paid for is of great interest and debate at both the state and national level. Healthcare reform, Medicaid managed care, and Medicare advantage plans all add to the confusion of how care in a skilled nursing facility is covered, or if it is even covered at all. According to the Florida Health Care Association, “Among people turning 65 today, 69 percent will need some form of longterm care, whether in the community or in a residential care facility.” Not all of those people will need skilled nursing facility care – some may live
June/July 2016
We are living longer, and with the changes in healthcare reform, confusion continues to arise regarding what healthcare services are covered and not covered at all. As we age, most of us contend with multiple healthcare issues, many of which are chronic and cannot be cured – only managed. In
this FORUM, Sue Edwards will explain how healthcare services are provided and paid for in a skilled nursing facility, both short term and long term. Type of coverage varies on the type of care provided and the insurance elected by the patient. Sue Edwards is the Business Office Director for BayView Healthcare. She has been with BayView for 19 Years and is the in house expert on Medicare, Medicaid and all-around resident billing. Sue and the business office team are committed to providing excellent customer service for our residents and patens and are strong advocates for their healthcare management.
in assisted living facilities or receive services within their own home. But for those people who will need more intensive services, how will they cover the costs of the care that they need? Skilled nursing facilities (SNF, for short) provide care at different levels. Not all clients come to a nursing facility with the intention of making it their permanent residence. Clients can be admitted for a short-term stay or for long-term care. The coverage and payment of those stays are very different. WHAT IS SHORT-TERM CARE? WHY DO I NEED SHORT-TERM CARE IN A SNF? A client admitted for short-term care is expected to return to his prior living arrangement (or other alternate
arrangement) at the conclusion of the services for which he was admitted. Short-term care clients usually are admitted for rehabilitation services or skilled nursing services. The rehabilitation services that can be provided in a SNF are of a more intense nature than are provided in a home health or outpatient setting, and may be recommended by a client’s physician in order to facilitate recovery after surgery. For example, a client may need intensive rehabilitation after receiving a knee replacement. Another example of SNF services would be intravenous medications that need to be administered at a frequency greater than that which can be provided at home and need to be administered and monitored by professional staff , but do not require an acute hospital setting.
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WILL MY INSURANCE COVER SHORT-TERM SNF CARE? The client must first know what type of coverage she has. Many clients over the age of 65 who need skilled care in a nursing facility have traditional Medicare – that is Medicare part A (Medicare part B is usually for outpatient and physician services). However, there is also Medicare part C. If you have a part C plan, it may be referred to as a Medicare Advantage plan, a Medicare HMO or Medicare PPO, depending upon your particular plan. Sometimes a client has enrolled in a Medicare HMO or PPO through his former employer because he believes he is enrolling in a plan that supplements his traditional Medicare coverage. If you are unsure of what type of coverage you have, look at your insurance card. You may still have a red, white and blue Medicare card, but have you received a card from another insurance company? If you are unsure of your coverage, start with the customer service phone number on the back of your card. You should also have a copy of the insurance policy/plan. Many times policies can be accessed via the insurance company’s website. HOW LONG WILL MY INSURANCE COVER SNF CARE? Short-term care is often “skilled” care. And in order for many insurance carriers, including Medicare, to consider coverage of a client’s stay, the care provided and required must be skilled in nature. Just by virtue of the fact that
Health & Medicine the care is rendered in a SNF does not make it “skilled”. Medicare will cover skilled care until skilled services end, or until Medicare days exhaust, whichever happens first. Medicare HMO’s and PPO’s follow Medicare’s guidelines, however, these plans often require case management and authorization for the client’s services. Medicare HMO or PPO will cover skilled care as long as it is authorized by the plan’s case management team or until benefits exhaust. SHORT-TERM SKILLED NURSING FACILITY SERVICES: UTILIZING YOUR MEDICARE PART A BENEFIT From www.cms.gov “Medicare Benefit Policy Manual” Chapter 8 “Coverage of Extended Care (SNF) Services Under Hospital Insurance”
TECHNICAL REQUIREMENTS: • Three night consecutive
inpatient hospitalization,
also called a “qualifying
stay”. This does not include
observation. • Admission to a SNF within
30 days of the qualifying stay.
• “Services must be for the
treatment of a condition for
which the client was
receiving inpatient hospital
services (including services
of an emergency hospital)
or a condition which arose
while in the SNF for
treatment of a condition
for which the beneficiary
was previously hospitalized”.
“SKILLED” SERVICES COMPONENTS: • • • •
The client requires skilled nursing services or skilled rehabilitation services, i.e., services that must be performed by or under the supervision of professional or technical personnel; are ordered by a physician and the services are rendered for a condition for which the patient received inpatient hospital services or for a condition that arose while receiving care in a SNF for a condition for which he received inpatient hospital services. The client requires these skilled services on a daily basis; and As a practical matter, considering economy and efficiency, the daily skilled services can be provided only on an inpatient basis in a SNF. The services must be reasonable and necessary for the treatment of a patient’s illness or injury, i.e., be consistent with the nature and severity of the individual’s illness or injury, the individual’s particular medical needs, and accepted standards of medical practice. The services must also be reasonable in terms of duration and quantity.
WHAT WILL I PAY FOR SHORT-TERM CARE? Medicare part A: There is no copay or coinsurance for days one through twenty. Starting on day 21 of the benefit period, there is a copay of $148.00 per day (for calendar year 2013). That copay is paid privately (out of pocket by the client), or may be paid all or in part by another carrier (private insurance or Medicaid). If you have any questions about what the supplement, secondary or Medicaid plan may (or may not) pay, contact the carrier and the SNF’s business office. While the SNF’s staff likely verified the insurance coverage, it is ultimately your responsibility to understand your coverage. Do not assume that because your supplement or secondary insurance covered copays or coinsurance for other providers that the same will happen for SNF services. Some services and items are excluded from coverage. The facility is required to notify you in advance if a service or item is not covered under Medicare. Medicare HMO or PPO: It is important to know if the SNF is a participating provider with the Medicare HMO or PPO. HMO’s often do not have out of network benefits; this leaves you vulnerable to high out of pocket expense. If the SNF is a participating provider, you may be subject to plan deductible and out of pocket before your plan makes any payment for your services. Your plan may have copays that start on day one of your stay. Or, the copay amounts may vary over the length of your stay. If you do not know the specifics of the copays, deductibles, or out of pocket expense, contact your plan or speak with the SNF business office or admissions staff.
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WHAT IS LONG-TERM CARE? WHY DO I NEED LONG-TERM SNF CARE? Clients admitted for long-term care are not able to live in a home setting or a setting that is less intense than that of a nursing facility. When he is admitted, the expectation is that he will remain in the facility for the duration of his life or for an undetermined period of time. The client may have a physical or cognitive impairment that prevents him from performing some or all of activities of daily living (bathing, grooming, dressing, hygiene) or is otherwise unable to provide his own care. This type of care is also called custodial or intermediate care. This type of care does not typically qualify as previously defined “skilled” care. WILL MY INSURANCE COVER LONG-TERM SNF CARE? Medicare does not cover long-term care. Medicare HMO’s and PPO’s do not cover long-term care. Sometimes a client is admitted with the intention of returning to her prior living situation, but then she remains in the SNF as a long-term care client. The coverage of her skilled services under her insurance will cease when the skilled services end, or when her coverage exhausts, which ever happens first. HOW WILL I PAY FOR LONG-TERM SNF CARE? Long-term care is paid privately or by the State Medicaid program. Some clients may have long-term care insurance which helps cover the cost of such care. According to the 2011 MetLife Market Survey of Nursing Homes, Assisted Living, Adult Day Services and Home Care Costs, the daily national average for SNF costs Continued on next page
Health & Medicine was $214; the average for Florida was
be no greater than $2130 per month
$223. Annually, that is $78,110 and
and total assets can be no greater
$81,395, respectively.
About 40%
than $2000. In some cases if the cli-
of clients paid the expense privately,
ent’s income is greater than $2130 per
WHAT ELSE DO I NEED TO KNOW ABOUT PAYING FOR SHORT OR LONG-TERM SNF CARE?
while the other 60% were eligible for
month, he might still qualify for ICP
Don’t be afraid to ask questions. If
Medicaid coverage.
Medicaid if he establishes a Qualified
you call your insurance company
When evaluating how to pay for
Income Trust (known as a QIT).
and you don’t understand what the
long-term SNF services, the client
For additional information about
must not only take into account the
qualifying for ICP Medicaid, contact
representative tells you, call again.
room and board rate, but ancillary
Department of Children and Families
items and services as well. If the cli-
(DCF)
ent has no prescription drug cover-
florida), which is the State agency that
age, medications will be paid for out
determines Medicaid eligibility, or the
of his pocket. If he has coverage, he
SNF Medicaid specialist.
is still responsible for the medication
The ICP Medicaid-approved cli-
copays. If the client required the use
ent will have out of pocket expense
of specialized medical equipment
for her SNF stay based upon her
at home, this may have been cov-
income. ICP Medicaid pays the facil-
ered under his Medicare. In a SNF,
ity a daily rate minus the amount the
that same medical equipment can-
client is expected to pay the facility.
not be covered by Medicare, as the
This amount is called the “patient
Medicare coverage rules are different
responsibility” or “resident liability”.
for “home” setting versus an “insti-
DCF notifies the facility and client of
tutional” setting.
(www.myflorida.com/access-
This also applies
the liability that is due to the facility
to oxygen tanks. If you are unsure
from the client each month. “Facilities
what is covered as part of the room
must discuss with residents or their
and board rate, ask the admissions or
representatives the cost of any items or
business office staff. They will explain
services not included in the per diem
to you what is included and excluded.
before a nursing facility supplies such
The staff should be able to provide
items or services.” (Nursing Facility
you with a charge list of items
Coverage and Limitations Handbook,
Ask an admission or business office staff member to call your insurance company with you. These staff members have the experience to know what questions need to be asked and answered. If you have a copy of your policy and you don’t understand the phrases or terms used, bring the policy to the SNF and ask the business office to review the policy with you.
Health & Wellness Forum
161 Marine Street, St. Augustine, FL (904) 829-3475 www.bayviewhealthcare.org
which is found on http://mymedicaidDO I QUALIFY FOR MEDICAID?
florida.com)
The client may qualify for one the
many Medicaid programs. First, you
managed care system over the coming
must know if the SNF is a Medicaid
year. It is unclear at this time exactly
provider. If yes, the SNF may have
how the transition will occur and
a designated person on staff to assist
how SNF clients will be affected. Our
with determining if the client is eli-
Northeast Florida region (includes
gible and with the application process.
Baker, Clay, Duval, Flagler, Nassau, St
The current eligibility guidelines for
Johns and Volusia counties) is slated
Institutional Care Medicaid (known
to implement the Medicaid man-
as ICP or nursing home Medicaid)
aged care program for ICP clients
are that the client’s gross income can
March 1, 2014.
June/July 2016
Sue Edwards, Business Office Director, BayView Healthcare.
The State is moving to a Medicaid
BayView Healthcare is a private, not-for-profit comprehensive continuum of healthcare provider founded in 1920. Our superior level of services includes short-term inpatient and outpatient rehabilitation, skilled nursing at BayView Rehab at the Samantha R. Wilson Care Center, BayView Home Health and BayView Assisted Living at The Pavilion and Buckingham Smith, an Emergency Charitable Assistance Program and BayView Wellness. Caring Hands-Caring Community is a separate 501(c)3 charitable organization founded in 2004 by our parent organization. It was formed to support the exceptional services and continuum of care provided to people in need of healthcare services and financial assistance. For further information about any of the programs offered through the BayView Healthcare continuum please call (904) 829-3475.
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Health & Medicine
It’s Your Business: Get Clear and Get Going in Your Career
hen coaching executives and professionals my first question is often: Where would you like to be in your business or career a year from now? The purpose of this question is meant to evoke excitement, unleash motivation, and open clients up to their true potential. Becoming crystal clear about your aspirations and dreams can be very powerful. Getting clarity on your goals can open your mind up to what is possible and when done wisely it can also provide a manageable action plan. This is one of the first steps executives should take when looking to improve their income, performance, job satisfaction, or work-life balance. Whether you are a seasoned seniorlevel executive or aspiring professional, it’s imperative to know your desired destination. Otherwise, life can resemble the proverbial hamster wheel. When you know where you want to go, your career and life has greater meaning and vitality. It’s as the saying goes, when you change the way you look at things, the things you look at change. Well, when you change the way you look at where you want to go, your career and life can completely change. While change can be scary, it doesn’t have to be. Change can actually be quite invigorating. It starts with viewing change as positive growth and viewing challenges as part of the growing process. After all, getting the career and life you want takes
Kathleen Abbott,
diligence and perseverance. That is part of how the game of life is designed, but it is also what makes the victories of life so sweet. Understanding that getting to your long term goals will take thoughtful effort helps mentally prepare you to effectively navigate your journey. It also gets you over the initial fear of “what if it doesn’t work” that executives and professionals tell themselves prior to setting their dream destination. Another common concern executives will often tell themselves is, “I’m not exactly sure where I want to go.” The truth is your goals and dreams can and should evolve, that’s also part of the process. However, you need to start somewhere and the only place you can start is where you are presently. So, I greatly encourage you after reading this to sit down and write out your dream destination in as positive, clear, and specific language as possible.
Dr. Dan Vosgerichian Director of Executive Coaching and Life Coach “Dr. Dan” has a doctorate in Educational Psychology with a concentration in Sport Psychology from Florida State University, and a Masters Degree in Counseling and Psychology from Springfield College in Massachusetts. He specializes in helping businesses, executives, organizations, athletes, and performers reach their full potential. He brings a very empowering perspective to coaching and consulting by emphasizing a dynamic balance of achievement and appreciation. Dr. Dan is certified in Hypnosis through The International Association of Counselors and Therapists and is a Master Practitioner of NLP. He has been helping individuals and groups increase their quality of life for over a decade. Dan actively volunteers for multiple organizations in St. Augustine and is a member of St. Johns Chamber of Commerce.
ST. AUGUSTINE’S BEST COUNSELORS 2011-2014
Licensed Mental Health Counselor & Clinical Director
Once you’ve done this you can begin to set small daily goals to get to your destination. Getting clear on your dream destination will get you clear on the first step you need to take. Once you complete that step, you’ll start to build confidence and momentum. Then you’ll take the next step, where you can build more confidence and more momentum. It’s as Mark Twain says, “The secret of getting ahead is getting
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John R. “Jack” Jones, Jr,
Licensed Mental Health Counselor & Executive Director
started. The secret to getting started is breaking your complex overwhelming tasks into small manageable tasks, and starting on the first one.” If something doesn’t work out as you planned; it’s an opportunity to learn, reevaluate, grow, and continue building momentum. The trick is getting clear on where you want to go and getting started with your first step. Let’s get started.
Lasting Results Through Science & Spirituality
an We are now ic Amen Clin Affiliate
Kathleen Abbott, LMHC John “Jack” Jones, LMHC Lisa Brice, LCSW Liggett M. Cato, CECP Barbara Jenkin, M.A., CAP Sarah Kamienski, LMHC Allison Masters, LMHC Melissa Muller, LMHC Melody Ott, LCSW Thomas Swisshelm, MEd, EdS Liz Villanueva, RMCHI
Dan Vosgerichian, PhD
Free Counseling Through Our Graduate Intern Program Free Substance Abuse Groups Featuring Smart Recovery
(904) 797-5680
Displaying the Spiritual Paintings of Mary Lou Gibson Fax: (904) 797-5681 • www.TheLifeSourceGroup.com
248 Southpark Circle East • Saint Augustine, FL 32086
Health & Medicine
Why Do We Sleep?
A
By Mara Cvejic, DO
s a sleep physician, I have been asked many philosophical questions about what I do. Considering that we spend one third of our day occupying this activity, it certainly is a valid question. In regards to sleep, I’ve often heard the phrase from friends and patients alike that “I’ll sleep when I’m dead”. The pressure to succeed in life has sent so many mixed messages to people that over time it has degraded the fabric of this very basic physiologic function. Why do we sleep in the first place? The ramifications of the complete lack of sleep are incontrovertible – you will die. For example, the disease Fatal Familial Insomnia is a neurologic disorder in which over the course of a few short months to a year, individuals with this extremely rare condition are unable to sleep and eventually pass away.
The body requires sleep. It isn’t just about health; it also serves the important role of helping us form new memories. To fully answer the question of why, one must first ask what is sleep. Sleep is a neurologic state – controlled by the most important organ in our body, our brain. It would be an oversimplification to say that there are only two states of being – awake and asleep. Have you ever heard the phone ring in your dream, only to awaken and realize that it was really ringing? Or been noticed to talk, mumble, or even laugh in your sleep? Sleep is more aptly described as a symphony – a conductor, a captive audience, and a curtain that likes to go up at the same time each night. Think of the audience as your lungs, your heart, and your muscles – all closely listening to cues from the brain. As the symphony begins, slowly conversation stops, phones are turned off and the outside world drifts away. Healthy sleep is a gradual and rhythmic process. Watch a person fall asleep on a train or bus, constantly nodding their head and then jerking awake multiple times. Marvel at the number of babies that you see completely passed out in their strollers despite the chaos of blaring noises around them. Our brain gradually filters noise and sound from the outside world and successively falls deeper into a state where it no longer receives signals that are not emergent, including from the body itself – like your full bladder or your stubbed toe. Evidence from brain waves shows proof that during tran-
sitional states of sleep we can elicit certain brain activity, despite the lack of a conscious response. Deep sleep typically follows this transitional period, and during this stage the neighbor’s loud party or your partner’s snoring is of no concern to you. Next comes dream sleep. Rapid Eye Movement (REM) sleep is a neurologic state where our muscles, with the exception of a few including our diaphragm are completely paralyzed and our eyes dart in quick movements from side to side. This process repeats itself – transitional sleep, deep sleep, REM sleep over and over again through the night. REM, as well as deep sleep (slow wave sleep), are two vital states of our brain that have proven to be essential to the process of neurologic repair and memory formation. Daytime energy usage of your brain is no different than using your muscles during exercise and your gut for digestion. When you exercise thought, you use energy and this energy comes at a cost, which is that byproducts of usage are built up over time and need to be removed. Similar to recycling, your brain uses glucose while active, but recycles the waste products at night and files away important information in the brain. Learning is an exercise that shows true potential once permanently stored away in long-term memory. Evidence for this comes from many scientific studies – children in particular have demonstrated this. When taught a procedure such as a piano piece, full recognition
of that learned ability does not occur until after a night of sleep. Take into consideration athletes who have been tested and shown to improve their performance with an extra hour of sleep at night. Even more disturbing, is that some studies have shown that just 1 hour less than the average time of sleep in a child reduces their school performance by two grade levels. Ouch. Numerous scientific studies have linked sleep deprivation to ADHD, behavioral problems, and mood disorders. And the quantity of sleep is not the only thing important to your body, so is the quality of sleep. A growing problem in this country is sleep apnea, a disorder of breathing while you lay unconscious. For sleep apnea patients, it doesn’t matter how long you sleep, you will never be able to “catch up”. The quality of your sleep is poor and constantly disruptive to your brain, your heart, your lungs and your metabolic system. The ramifications of this disease on your body and mind have become so widespread that non-sleep physicians struggle to keep up with the overwhelming amount of data showing its perpetration of obesity, cardiovascular disease, dementia, stroke, diabetes, depression and even cancer. And therein lies the answer that most people are seeking. We sleep so that we can live, and live well. My best advice as a sleep physician is cautionary: don’t adopt the attitude of sleeping when dead, because otherwise that day might come a lot sooner than expected!
Dr. Mara Cvejic Paryani completed her residency in pediatric neurology at Mayo Clinic Jacksonville through a joint program with Nemours Children’s Clinic. With a special interest in sleep medicine, she traveled to Palo Alto, CA and completed a Sleep Medicine fellowship at Stanford University, the original birthplace of sleep medicine. She is an active advocate in the Florida Medical Association (FMA) and the Duval County Medical Society (DCMS) and currently is a delegate to the FMA from the DCMS. She graduated from the Florida Medical Association Leadership Academy and continues to advocate for pediatric and adult care in Jacksonville. She has travelled to Haiti to the Hospital of Sacree Coeur as part of a volunteer pediatric medical relief team. With a special interest in sleep medicine and seizures, she evaluates and treats both adult and pediatric patients, performing and interpreting EEGs and sleep studies in all age groups over the age of 4y/o. To make an appointment with Dr. Cvejic regarding pediatric neurology or sleep disorders, please call our main office at 904-222-6656.
Central Scheduling 904.222.6656 • DrAshchiHeart.com
June/July 2016
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Keep the Blood Flowing with an Active & Healthy Life
Health & Medicine Test your sleep IQ with the following questions: 1. 2. 3. 4. 5. 6. 7. 8.
Children need 8 hours of sleep, like adults. a. True b. False Some people only need 4 hours of sleep, that’s just the way they are. a. True b. False Napping is ok because I’m older and it is normal aging to feel sleepy in the day. a. True b. False If I cannot sleep, it is best that I stay in bed until I force myself to sleep a. True b. False Watching TV in bed is always bad. a. True b. False I’m not working so it doesn’t matter what time from night to night that I go to bed. a. True b. False Restless Legs Syndrome (RLS) is a disease that occurs while awake and asleep. a. True b. False People who have PTSD move in their dreams sometimes, acting out their nightmares or memories. a. True b. False
Answers:
1. False. A child’s sleep needs varies on their developmental and chronologic age. This can vary from 18 hours a day to 10 hours in a school aged child and teenager. 2. False. This myth has been debunked. While there are extremely rare cases of this, sleep less than 6 hours a night is associated with maladaptive behavior and increased risk of heart attack, obesity,and mortality. 3. False. Sleepiness during the day leading to daytime sleep periods is suggestive of a problem with your sleep. 4. False. Evidence shows that insomniacs benefit from removing themselves from the bed when awake longer than 20 minutes. 5. False. Some people who do not suffer from insomnia can watch TV in bed with no alteration of their sleep pattern. This is not recommended, however, in people who have disrupted sleep such as insomnia. 6. False. Your body runs on a clock, and varying your bedtime by more than an hour from day to day puts a physiologic stress on your body. 7. True. RLS is treated when you have daytime symptoms, but there are manifestations of this disease during sleep called Periodic Leg Movements. 8. False. Movement during REM sleep is called REM Behavior Disorder and is a distinct neurologic disease that is treated with education and medication, and is not associated with psychiatric disease.
Questions to ask yourself that may indicate you need a sleep study and referral to a sleep doctor: 1. 2. 3. 4. 5. 6. 7. 8.
Am I obese with a BMI of greater than 35? Do I snore loudly? Am I over the age of 50? Do I have high blood pressure? Do I have diabetes? Has my bed partner said that I pause in my breathing? Am I tired, fatigued or sleepy during the day? Is my neck size greater than 16 inches? (15 if you are female)
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If you answered yes to more than 2 of these questions, you should ask to be referred to a sleep professional.
Health & Medicine
Polycystic Ovarian Syndrome This helps with managing irregular menstrual cycles, decreasing the androgen hormones causing acne and unwanted hair growth, and reducing the risk of endometrial cancer. For a woman who desires pregnancy, initial lifestyle modifications can be beneficial. In some situations, a weight loss of 5-10% body weight can reinitiate ovulation. If this is unsuccessful, a medication called Metformin, approved to treat Type 2 Diabetes, may be started to assist in ovulation. It affects the way insulin controls blood sugar and lowers testosterone levels, which
on a search for warmer weather and moved to Raleigh, NC where she worked as an ICU and Labor and Delivery nurse at Duke University Medical Center. Elizabeth knew her passion was always caring for women during pregnancy. She then went back to school to at Frontier Nursing University where she graduated with her MSN degree and became a Certified Nurse-Midwife. Elizabeth moved to St. Augustine before she Elizabeth Arnett, ARNP, CNM started her clinical training with OBGYN AssociElizabeth grew up in Saginaw, Michigan until ates. After graduation, she was hired to join the she graduated from Saginaw Valley State Uni- practice as a Nurse-Midwife and is very excited to versity with her BSN degree. She then went continue caring for the women in our community. can lead to ovulation. There are also two oral medications used to induce ovulation called Clomid and Letrozole. If none of these treatments result in pregnancy, the patient may need further fertility treatments such as gonadotropin injections or surgery. At any point, the woman may be referred to a fertility specialist for management.
P
Elizabeth Arnett, ARNP, CNM
olycystic Ovarian Syndrome or PCOS is the most common diagnosis related to female infertility. Women usually present with irregular menstrual cycles that are absent, occur infrequently, too frequently, or are unpredictable. Other signs and symptoms of PCOS are obesity; excessive hair growth on the face, chest, abdomen, or upper thighs; severe acne; patches of thickened, velvety, darkened skin; multiple cysts on the ovaries visualized on ultrasound; and infertility. Not all patients experience the same symptoms with PCOS. Some women experience irregular periods or have no symptoms at all. The cause of PCOS is unknown; however, it is related to factors including insulin resistance and increased levels of androgen hormones. Unlike other disorders, PCOS cannot be diagnosed with just one test. It is the combination of multiple signs and symptoms experienced by the individual patient, along with an exam, laboratory tests, and sometimes a pelvic ultrasound that lead to a diagnosis. The treatment for PCOS is dependent on the woman’s desire for conception at the time of diagnosis. For a woman who does not want to get pregnant, a hormonal birth control is usually the standard management method.
June/July 2016
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Health & Medicine
Are You an Expectant or Nursing Mother?
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By: Susan Detar, CFm Owner, The Pink Door
s you may already know, one of the earliest physical signs of pregnancy can be breast tenderness. At some point in your pregnancy (often but not always around the second month), breasts will start becoming larger as they prepare to nurse the new arrival. Some women experience this as a feeling of fullness rather than actual increase in size, and others are very aware of needing a larger cup size. Some women will continue to increase in cup size over the course of their pregnancy, and others find they have an increase during their first trimester, and not again until close to the end of their pregnancy. As your belly increases in size, your rib cage (band) measurement will also likely increase. Women who are petite or carrying high will often experience more increase in rib band than women who are taller or carrying low. Generally, most women increase one or two cup sizes and one or two rib band sizes over the course of their pregnancy.
Then, for the first few days after giving birth, when you breastfeed, your baby receives colostrum. At around the third day, your milk will ‘come in’. At that point, you can experience an increase of one or two more cup sizes from your third trimester. Typically after about 6 weeks to a few months of nursing, these fluctuations settle down. You will have established your breastfeeding relationship and routine, and will usually decrease a few cup sizes. As well, around this point, your rib band size will begin to go back to your pre-pregnancy size. This is the size you will likely stay until you finish breastfeeding. That is, at about your pre-pregnancy rib band size, and up one cup size. The ideal time to size for a nursing bra is during the last few weeks of your pregnancy which will ensure a good prediction of your size once your milk comes in. It’s a great idea for a pregnant mom to go with a nursing bra when she begins to feel her prepregnancy bras are no longer working for her rather than a traditional bra, so she can get double duty out of it by also using it to nurse when she has her baby. Both during pregnancy and breastfeeding, a woman’s skin and nipples in particular can become extremely sensitive, even to the point of being sore. Moisture is a serious consideration: when breasts leak, it is important that the wetness does not stay next to the skin because this can result in irritation or infection. Using breast pads will absorb moisture and wick moisture away from the body so the nipple area remains dry. Both disposable and reusable pads are available. While disposable may be cheaper, reusable pads are much softer and “green”.
During your pregnancy you may also be experiencing abdominal straining, backache, hip separation, pubic symphysis and ankle and leg swelling. You might even feel that you have the sensation of “everything is going to fall out the bottom”. There are a number of supportive garments to alleviate any pain or discomfort you feel. By cradling the torso, these garments support strained muscles, encourage better posture and provide relief. Some women develop vulvar varicosities which are swollen veins in the pelvic area caused by the increased weight of the uterus. A supportive device with compressive properties will help keep the veins from swelling.
Susan Detar is a Certified Mastectomy Fitter. The Pink Door is an accredited post-mastectomy care center. Our mission statement: “The Pink Door will be recognized as the preferred provider of foundations to women affected by breast cancer. We will offer a wide selection of products in a knowledgeable and caring environment. Our goal is to fulfill 80% of our customers’ needs on the first visit.” This mission extends to all women who walk through the door. You will be served in a warm, inviting boutique occupying a home in the south historic district of Palatka. Our job is to provide products that will make you look and feel better.
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This condition typically resolves after the birth of the baby. If you are interested in learning more about the benefits of nursing your baby, your local health department has a Lactation Peer Counselor on staff. Contact information: St. Johns County, (904) 825-5055 ext. 1110. Putnam County, (386) 326-3251.
Health & Medicine
Is it Time For a Mommy Makeover?
H
Dr. Michael Duffy, Jacksonville Cosmetic & Reconstructive Surgery Center
as having children and breastfeeding changed the appearance of your breasts and abdomen? This is not due to decreased physical activity (you are likely running now more than ever), slow metabolism, or poor eating habits. These changes are due to structural alterations in your body’s tissues that can be explained and rejuvenated to restore your pre-pregnancy appearance. The Abdomen The abdominal wall is composed of skin, then fat, then the rectus abdominus muscles (the “six-pack”) encased in a non-elastic substance called fascia. To accommodate the enlarged uterus (or womb) during pregnancy, all three abdominal wall layers—skin, fat, and muscle encased in fascia—from just above the navel (belly-
button) to the pubic bone stretch at a rate that often outstrips a woman’s ability to make new tissues. How well these tissues bounce back after delivery is dependent on many factors including the mother’s age, health, skin elasticity, and weight gain during pregnancy. The abdominal wall tissues of mothers bearing multiple children (twin, triplets, etc.) are stretched to a more extreme degree. “Stretch marks”, or striate, are caused by a rate of skin stretch that overwhelms the skin’s elasticity or ability to create new skin. Even though women spend millions of dollars every year purchasing products to improve stretch marks, there are no FDA approved therapies to remove stretch marks. Stretch marks are irreversible. Although the abdominal wall muscles will snap back after pregnancy, the tissues that encases these muscles (the fascia) does not have the same elasticity and is weakened. The weakening of the fascia causes a paunch, or protruding belly. This can never be improved with exercise of diet—it is a mechanical change in the tissue. Often I’ll hear, “I work out regularly and still can’t improve my belly.” Fat stores on the back and flanks are increased during pregnancy. These new stores are often also resistant to exercise. This change is natural, but it masculizes the feminine hourglass appearance. The Breasts During pregnancy, the breasts enlarge due to hormonal factors in preparation for milk production. If the mother does breast-feed (a healthy option for mother and child), the internal breast tissue loses much of its structural integrity. This change causes a flatten-
ing of the natural teardrop appearance of the breast. The flattening and dropping of the nipples position is called ptosis, often referred to as “drooping breasts.” The Solution: A Mommy Makeover is a combination of: 1. Abdominoplasty 2. Breast augmentation and/or lift, and 3. Suction lipectomy of the back flanks and hips. • Abdominoplasty: removes the excess skin and stretch marks from the abdomen, and tightens and restores the “abdominal wall corset.” • Breast Augmentation/Lift:
•
Depending on the size of the breasts, the amount of drooping (ptosis) and the patient’s desires, a breast lift (mastopexy), breast augmentation (with silicone “gummy bear” or saline implants), or a combination of the two can be performed to restore and enhance the breast shape. Liposculpture: of the back and flanks is performed to permanently remove the excess fat
The results are striking and long-lasting. Patients, and their partners, are equally ecstatic post-operatively.
“Dr. Michael Duffy is a Plastic and Reconstructive Surgeon providing comprehensive aesthetic and reconstructive surgery services in Jacksonville, Florida and the surrounding areas of Ponte Vedra, North Florida and South Georgia. Dr. Duffy received his Plastics Reconstructive training at Mayo Clinic, Rochester, MN and is certified by the American Board of Surgery and American Board of Plastic Surgery. His plastic surgery treatments include breast augmentation, breast lift, breast reduction, liposuction, tummy tuck, facial rejuvenation, rhinoplasty, mommy makeovers and total body rejuvenations and more. Dr. Duffy also leads a team of experienced medical aesthetician specialists that offers a full range of services from medical spa treatments, advanced skin care and laser services at his Cosmetic & Reconstructive Surgery skin care center. Popular services includes Medical Spa Treatments, BOTOX®, Dysport®, Juvéderm®, Obagi and CLENZIderm M.D.™
June/July 2016
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Health & Medicine
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Life Services
Photo by Christine Cousart www.cousartphotography.com
Tuck-In Call Program
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Cathy Johnston Haven Hospice Administrator
hen someone is receiving hospice care, a unique set of challenges often arise for not only the patient but also for the caregivers. As an administrator, I am so proud of the work we do here at Haven. We provide quality care for our patients and families, and we are
June/July 2016
constantly looking for ways to offer more assistance and comfort. Haven Hospice has several programs which are supported by staff and volunteers to assist with this transition including Tuck-In Calls and Rounding on Caregivers. Weekly Tuck-in Calls are one of the many ways we stay in close contact with our patients and their families to ensure that their needs are being met. These calls bridge the gap between visits and help the patient and family feel more connected to the Haven team. Family members often tell us how much they appreciate the extra effort we put into making sure they have what they need. One of the goals of the Tuck-In Call program is to address possible shortages of supplies and medication. “We want to help out the weekend team and make sure that patients and their caregivers have enough supplies to last them until Monday,” said Haven Hospice Volunteer Diane Mahoney. “I think the Tuck-In Call program is a great way to keep in touch with the families which is important. I use the calls to ask the caregiver how
things are going. As soon as you ask about their week, they will open up and be honest with you.” This program is offered to all in-home patients in St. Augustine and occurs on Thursday each week. Haven Hospice volunteers call patients and caregivers to check their supplies and medication levels to make sure they have everything they need for the weekend. This vital outreach would not be possible without the dedicated support of our terrific volunteers like Diane, a retired nurse, who truly enjoys making the calls and helping the people she speaks with. Diane’s 42 years of experience as a psychiatric nurse as well as her personal experiences with loved ones in hospice care help her truly understand the importance of the Tuck-In Call program. “Calling every Thursday without fail creates stability with the patients and caregivers. They don’t want to talk to a stranger and share personal things,” said Diane. “I am very comfortable doing this, and I think it is an important service to offer.”
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Haven Hospice has also introduced another new program in the St. Augustine area called Rounding on Caregivers. This program provides monthly calls to family members of patients being cared for in facilities. The calls provide information on frequency of Haven care team visits but do not convey any medical information. Volunteers are a vital member of the Haven Care Team. They provide companionship, support and assistance to patients residing at home, in assisted living facilities, nursing homes and hospitals. They also reach out to grieving families, assist with administrative tasks, help staff the Attic Resale Store and serve on special event committees. Haven is proud to have more than 700 community members dedicating their time and talents to patients and families in 18-counties across North Florida. If you would like more information about the Tuck-In Call program, Rounding on Caregivers program, or other volunteer opportunities in St. Augustine, please contact Haven Hospice Volunteer Coordinator Michelle Colee at 904.810.2377.
Life Services Simply Susie: Let us clean, cook and run errands for you! Photo by Christine Cousart www.cousartphotography.com
It’s just a part of what we do!
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Testimonials:
Susie cleans my house and is always happy to do any special chore I happen to need. She is very reliable and my house looks and feels great. - Brenda L. St Augustine
By Susie Sullivan
Simply Susie brings me delicious home cooked meals each week. I have the monthly menu, call her on Friday to order for the following week, and get great tasting and healthy meals. Beats the hassle of having to eat out every night. - J. Sandifer St Augustine
Susie has been helping me declutter ear Friends: my home. We are taking our time While many more mature adults are and she understands sometimes it’s enjoying staying in their homes longer, difficult to let go of things. Already it some find they still need some extra looks so much better. She also takes “care”. That’s where I come in. I am me to my Dr. appointments and is very prompt and knows the area so well. offering a wide variety of “in home non - Pete O. St Augustine medical” services. They include but are not limited to: • Grocery Shopping (send me with a list or come with) • Companionship • Meal Planning (special diets invited) • Homemade meal delivery (up to 4 meals a week) • Budget and/or bill paying (snail mail or online thru your bank) • Decluttering • House Cleaning (special rates apply) Please call me to get my competitive rates! Minimum of 1 hour!
In other words… Make me your personal valet. Use me occasionally or put me on your regular schedule! I hope you will find some value in this opportunity and give me a call and let’s see how Simply Susie can help.
Hi friends, My husband Michael and I have been in St Augustine since 1980. We enjoy being active in our community and were lucky to raise 2 great daughters here. We are now proud grandparents of 9 awesome grandchildren! I am finally at the right place to where I can combine 2 of my long time passions: Cooking and providing services to others. The idea of “in home non medical” services is extremely appealing to me in that there is nothing in those words we can’t do for you. This allows you to get personal, reliable and quality care and attention without having to rely on several “agencies” to provide them for you. I have spent many years private catering and also residential cleaning as a 2nd income. Now it’s time to make Simply Susie and you, my client, my main focus. So, give me a call at 904-392-0423 and let’s get together and come up with a plan for you. Best regards, Susie Sullivan Simply Susie
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June Weekly Menu
Jun 6 Stuffed Peppers/Garden Salad/Roll Honey BBQ Wings/Potato Salad/Baked Beans Healthy Choice Chicken Tacos/Chips and Salsa Salmon in Dill Sauce/Herbed Red Potatoes/St Asparagus Jun 13 Beef and Bean Ragout over Rice/St Broccoli/Roll Chicken and Dumplings/Green Peas/Cornbread Healthy Choice Pork and Kale Zuppa (soup)/Chopped Salad Pan Seared Swai in Herb Butter Sauce over Seasoned Rice/St Spinach Jun 20 Cheesy Veggie Alfredo/Spring Mix Salad/Garlic Bread Pork Tenderloin w/ Caramelized Onions/Edemame Salad Healthy Choice Italian Style Chicken and Mushrooms over Whole Grain Pasta/Green Beans Lemon Caper Tilapia/Sweet Potatoes/Brussels Sprouts Jun 27 Chicken Osso Buco over Orzo/Carrot Raisin Salad Beef Stroganoff over Egg Noodles/Baked Curry Cauliflower Healthy Choice Grilled Butterflied Chicken/Teriyaki Rice/Sauteed Zucchini Mediterranean Swai/Summer Swuash and Pepper Gratin/ Whole Grain Muffin ll
Life Services Photo by Christine Cousart www.cousartphotography.com
Celebration Reception Enhances Memorial Service
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Presented by: Howard R. Beckham, Jr., CFSP
t is difficult to say when food first became associated with funerals. Is many ancient cultures from all over the world, gifts of food have been associated with the funeral or memorial of someone’s passing. Gifts of food have been discovered in ancient tombs perhaps as an offering, or to provide symbolic nourishment to the deceased in the afterlife. Whatever the reason food has been associated with funerals for thousands of years. It has been common in most American cultures for friends, family, and religious communities to bring food over to a family’s home after they have experienced a tragic loss to help ease some of their day to day burden during the first few days of mourning. The social meals with family and friends bring comfort to both the mourners and those seeking to comfort them. The social interaction of sharing a meal is a
valuable part of the recovery process. As funeral practices have evolved, more and more families have come to want something different than what has been call the “traditional funeral or memorial service.” Today’s families are often scattered across the country and may not have a church affiliation. The social interaction and exchanges between the mourners and those seeking to comfort them can be lost. This became very evident one day almost seven years ago during a funeral arrangement. The son, who had come from California, knew no one in the area. His mother was in her ninety’s and many of her friends have already passed. As we discussed the service arrangements, he asked if there was a place where he could invite a small group to thank his mother’s local friends for being there for her. I asked the question “Would you like to have refreshments?” His eyes lit up and he asked “you can do that?” A few days later, Craig Funeral Home held our first “reception gathering.” The family was very appreciative. The informal gathering gave them time to share wonderful stories about their mother. It was a hit. Right away, we knew we needed to develop a reception program. Since then, we have been able to assist client families with flexible offerings from a small reception following a service to a “Celebration Reception” where the reception with its food and drink become an integral part of the funeral or memorial service. Craig Funeral Home has been improving our reception offerings over the years, working on developing a memorable experience for our families. We also looked at our other successful special events to see how we might apply our receptions to them. Seven years ago we began to hold a special catered “Holiday Remembrance” program for all
Food turns a funeral into a “Celebration of Life.” Many attendees have made the remark that “ I want something just like this when I go.” June/July 2016
families in the community who had lost a loved one during the year. These programs have proven to be a great success. Then, with a remodeling project four years ago, we added a family lounge and a refreshment area with fresh baked cookies, coffee, soft drinks, teas, and bottled water for our families and guests. Today, Craig Funeral Home offers receptions as a part of our regular offerings so that our client families and their friends can gather together to comfort and uplift one another without the hassles that surround serving food in the home. We have developed and tested a flexible menu in order to satisfy the varying needs of our client families and their guests. Today, we offer a variety of sandwiches, cheeses, fruits, meats, and several
specialty items and sweets along with coffee, tea, bottled water, and soft drinks to serve fifty or two hundred and fifty. We can tell from the comments from the families and their guests that our receptions add to the experience that surrounds a death. Food turns a funeral into a “Celebration of Life.” Many attendees have made the remark that “ I want something just like this when I go.” Experts who have researched funerals for years have said that funerals are not for the deceased but to help the living. Craig Funeral Home has been helping families for almost one hundred years. By adding the ability to offer reception services to the families we serve, we help families celebrate life and find hope in tomorrow.
Howard Beckham is a Licensed Funeral Director and Embalmer with Craig Funeral Home Crematory Memorial Park. He is a Northeast Florida Native. He has been married to Marie for 31 years and they have three great children and three wonderful grandchildren. He is currently the PresidentElect of the Independent Funeral Directors of Florida, an Adjunct Professor at Florida State College in Jacksonville, active with the Kiwanis Club of St. Augustine, The Boy Scouts of America, and The Church of Jesus Christ of Latter-Day Saints. He has also achieved the Certified Funeral Service Practitioner (CFSP) professional and educational recognition. Something only 44 out of over 2,500 funeral directors in Florida currently have achieved.
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Business & Finance
5 Enduring Myths of Online Marketing into a small business website template isn’t usually the great idea it seems, though. That’s because the point isn’t to just have a site for your company, but to have one that attracts new business. Over time, a customized layout can make an enormous difference in the percentage of visitors you’re able to turn into buyers.
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By Jay Owen Owner, Design Extensions
o much has been written and said about finding customers over the Internet in the last few years that I sometimes wonder if it has become our national sport. No matter where you go, or what industry you look at, you’ll find men and women combing the web, looking through statistics, and otherwise trying to gain a leg up on the competition. There’s good reason for this: the right Internet marketing mix can bring you a steady flow of new buyers day and night – a bottom line benefit that’s hard to match in any other part of your business. That doesn’t mean it’s as easy as some people would have you think, however; there is a lot of bad advice that continues to hang around and forces otherwise smart business owners to make bad decisions. Here are five enduring myths in online marketing: 1. That you need a website, not a brand. It seems sometimes like there is a software package for everything these days. Not only can business owners keep their own books, do their own taxes, and draft simple legal documents using a simple PC, but there are titles that can teach you to play the guitar, design a house, and even edit movies. Is it any wonder, then, that the do-it-yourself trend has started to include websites? Plugging some simple text and images
2. It’s all about spending money. This is probably the biggest myth, and one I hear repeated in various forms all the time. If you want to make profits online, some suggest, or reach the top spot on a major search engine, then be ready to write a big check. Fortunately, nothing could be further from the truth. The web is full of examples of companies that found profits by being smart and efficient, not pouring cash into their programs. Don’t be pressured into making a huge investment that you can afford – spending big is not the only blueprint for success. 3. You should be making sales in minutes. Online marketing can work quickly, especially with tools like pay per click advertising. More often than not, though, it takes time to develop a customer base, online brand recognition, and even a search engine profile to bring you new customers. None of these is easy, and none of them is going to happen overnight. Have a little patience and plan on building your company’s Internet presence one step at a time. It requires a little more perseverance, but it’s also the best way to position yourself for long-term success. 4. It’s all about low prices. A lot of business owners, when they think of companies that have done well over the Internet, imagine warehouses full of merchandise at rock-bottom prices. In other words, they assume that online customers will always go for the lowest cost option, and that there’s no room for quality in their industry. But just as some customers will always look for the smallest price tag, online or off,
others are seeking a certain kind of product, satisfaction guarantees, better shipping times, or just higher quality. Don’t be dissuaded if you cost more than your competitors – just be sure buyers can see why and let them make the smart choice. 5. It’s only for big companies and “Internet” businesses. This myth is ironic, since it’s usually small, specialized companies that have the most to gain from online marketing. That’s because they tend to be unique; if buyers can’t find what they offer on the Internet, they aren’t likely to find anywhere else, either. The distinctions between an “online” business and one that has a brick-and-mortar storefront are blurring every day. If part of your business plan is finding new customers, then having some sort of Internet marketing plan is a good idea. The web is constantly changing, and so there are probably always going to be myths and misunderstandings about how to find customers online. Pay attention and stay informed, however, and you won’t have to fall for any of them.
▶ Metal Treating Institute – Jacksonville Beach, FL ▶ Worked with CEO since
1998
▶ Custom Design, Content Management System, Video Storage, Database “Having worked with Jay at Design Extensions for over 11 years now, I would say they are one of the best in providing creative design, quality work with on-time delivery for their web design services. I would highly recommend them to any business of any size for simple to complex web projects.” – Tom Morrison, CEO http://callmti.com
Design Extensions was founded by Jay Owen in St. Johns County in 1999. He and his team at Design Extensions design and develop websites for clients all over the country. His passion is for developing high quality web sites and graphic design work that help his clients businesses grow. When not working on websites, he is usually spending time with his wife, Claire, and four children.
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Why
should your business or practice become a contributor to the Woman’s Journal?
Kelly M. Monroe, The Auto Club Group
“The Woman’s Journal has really helped me build business for the AAA Travel department in St. Augustine. I ‘ve been contributing articles for just about a year now and hardly a day goes by that someone doesn’t mention the fact that they have seen us in the SAWJ. I have made some VERY profitable sales because of this exposure and feel so lucky to be partnering with Suzanne and Anthony . Thanks for all your support.”
“I cannot tell you the number of patients that have found their way to our office in response to their having seen our articles in the Woman’s Journal. From former patients who lost touch years ago who were delighted to see a familiar face again, to brand new patients who have never seen a podiatrist before, but who felt so encouraged by what they read that they placed that important phone call. The Woman’s Journal is a publication that is informative, inviting and compassionate to it’s readers. We are proud to be associated with the Woman’s Journal and so pleased with the increased business we’ve experienced as a result!” Amy Smith– Practice Manager, Coastal Foot & Ankle Wellness Center “The Woman’s Journal has been a great asset to our community. I love sitting in doctor’s offices and watching people pick up the Journal and enjoy the articles. It has certainly spread the word about our mission at St. Gerard Campus. We have had the opportunity to touch people’s minds and hearts with the plight of pregnant teens and teen mothers who otherwise might not have had the opportunity to finish high school and make a better life for themselves and their children. Through the Woman’s Journals we have been able to share the success stories of our graduates. We thank the Woman’s Journal for bringing attention and awareness of issues facing women today.” Maria Gleason - St. Gerard Campus, Inc. “I am always so pleased to have customers tell me how they came to our restaurant while browsing through the Woman’s Journal. The articles are informative and the distribution is widespread. We are very grateful to the staff of Woman’s Journal for encouraging us to update our ads. This has definitely increased our business.” Yvette Schindler – The Present Moment Café “Working with Anthony and The Woman’s Journal has been a tremendously rewarding experience for our clinical counseling practice. We are reaching individuals and families who may or may not have heard of us, but most importantly, by reading our articles, they grow far more comfortable with the counseling process and who we are as therapist. It’s as if we are already having our first session together, addressing expectations and uncertainties that are part of the deeply rewarding experience of psychotherapy. When the phone rings (and it does far more frequently now), our readers already feel a sense of knowing us and, we too, feel a special connection with them when they say they saw us in The Woman’s Journal. Finally, the publishing deadlines become a gift by forcing us to focus on the most important issues impacting individuals and families within our very special community. Thank you Woman’s Journal!” John R. Jones and Kathleen Abbott – The LifeSource Group
- Kelly M. Monroe, The Auto Club Group “Thank you, Woman’s Journal for your many contributions to our community! Your paper is full of important information on issues that affect the quality of life for all of us who live in St. Johns County. I can’t tell you how many times someone has asked me for details about something they read in the COA column in your magazine...probably because the Woman’s Journal is one of only a very few publications that everyone I know reads from cover to cover...and because your distribution is awesome... this magazine is everywhere! People really do come up to me and say, “I read about you in the Woman’s Journal while I was at the library...or waiting at the doctor...or in my dentist’s office...!” Or better yet, “I know you...you’re in the Woman’s Journal!” You rock!” Susan Johnson – Council on Aging The woman’s journal is a superb educational tool and is a great resource for the community at large to gain factual knowledge written by leaders in their field. Dr. Ryan Pereira, DPM, FACFAS I would just like to say thank you very much for the last 3 1/2 years of allowing me to be a Contributor in your magazine. First, I want to say it is the smartest advertising exposure idea that my mother has ever had for my business. She recommended I call the Woman’s Journal when I first decided to go out on my own. When I first met with you your sincerity and genuineness shown through and you truly believed in what I had envisioned for my business. I am now living it and I thank you and the Women’s Journal for every step of my success. You and your magazine have truly let me realize my dream of being of service and providing a business that allows many a freedom to seniors to remain at home as long as they wish. I sincerely thank you. Susie Sullivan, Simply Susie “Over my five years of business, the SAWJ has been the most effective tool to bring customers to the shop. Everyone who opens this publication is impressed with its content and anxiously awaits the next issue. Partnering with Anthony and Suzanne has been an exceptional way to reach new customers and remind existing customers.” Susan Detar, The Pink Door
Legal
Photo by Christine Cousart www.cousartphotography.com
NO WILL, WILL OR TRUST? (It’s really a no-brainer!)
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Joseph L. Boles, Jr
ie without a will (Last Will and Testament) and the State of Florida tells you who your beneficiaries are going to be, it’s called dying “intestate”. Old John Smith doesn’t do a will because he thinks his wife will get everything anyway. WRONG! When he dies his beneficiaries are his wife AND his lineal descendants (offspring) even if they are from a prior marriage. So his estate could be cut in half and his wife and kids share everything. The widow Smith is not happy! Die with a will and at least you get to name your beneficiaries. But if you try to cut your wife out she has rights that she can assert during the “probate proceedings” so she won’t be put out on the street penniless regardless of how you feel about her at the very end! Yes, I just said “probate proceeding” because every Last Will and Testament has to go through a court
procedure called “probate”. Remember, a “will” is nothing more than a letter to the State of Florida telling the State who gets your “stuff ”. It has to be signed and witnessed and notarized, hopefully, but it still has to go before a Judge in the Circuit Court where you reside. You can do a new “will” every day until the day you die and the Court will use the most recent one and then appoint the executor (or “Personal Representative” in Florida terms). The Personal Representative gathers the assets, pays all the claims and valid expenses, then distributes the leftovers to the beneficiaries you have named. It can be costly and time consuming and everyone has to wait to get their money, sometimes longer than they feel like waiting! To avoid probate many, many people are turning to the “trust” as their estate planning device. The full name is an “inter vivos, revocable, living trust” or just “trust” for short. I am my own trustee and my wife Jane is the trustee after my death. It’s a document that takes the place of a “will” but doesn’t have to go to probate court, no probate filing fees, no probate publication in the paper and no 90 day probate Claims of Creditors period before assets can be distributed to your loved ones. A “trust” is just a document that acts like a big “cookie jar” and you put all of your “cookies” (money, property, investments, stocks etc.) in your “cookie jar”. Mine is called the Boles Family Trust because everybody that is a beneficiary is a family member. When I go to “glory” Jane will be automatically in charge of the “cookies” with no court proceedings or judicial action required.
“We should all live like we are going to die tomorrow but plan like it’s going to be fifty years” She can go right on with life, except I won’t be around anymore, a devastating blow but at least she won’t have to worry about access to the support systems we have built. So don’t wait another day before you give some serious thought to what will happen if you die tomorrow. We should all live like we are going to die tomorrow but plan like it’s going to be fifty years, (if you’re my age that is!). When you come into the office, (call Suzi and make your free consultation appointment at
824-4278) and we will also talk about a Durable Power of Attorney, a Health Care Surrogate Designation, a Living Will and a Pre-Need Guardianship Election for you and your kids. No Will is the Worst, A Last Will and Testament is better than no Will but a “Living Trust” is the Best.
“TRUST IS THE KEY”
Have a great day, Joe Boles
Joseph L. Boles, Jr. moved to St. Augustine with his parents in 1967. A native of North Carolina, he attended the University of Florida after graduating from St. Augustine High School in 1970. He initially obtained a Bachelor of Design and Advertising Design from the University of Florida, and also obtained his law degree from the University of Florida College of Law. He was admitted to practice in the fall of 1984 and his areas of interest are Elder law, asset protection, estates and trusts. He is married to Jane Reynolds and they have 7 children between them: Hayley, Molly, and Kirby Catherine Boles and Kara, Willie, Emily and Bridey Masson. His office is located on the corner of Riberia and Saragossa Streets in St. Augustine. The office phone number is 904-824-4278.
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Travel
Discover The Caribbean’s Biggest Adventure
Royal Caribbean’s Oasis of the Seas delivers unforgettable family vacations
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Kelly Maguire Monroe, AAA Travel Professional
hen it comes to planning a family vacation, go ahead and erase “you can’t please everyone” from your vocabulary. Royal Caribbean’s revolutionary Oasis of the Seas proves it’s the choice that makes the difference. Oasis of the Seas is the number one ship for families because it takes the roof off what a family vacation can be. Oasis of the Seas becomes the destination! With seven distinct neighborhoods and an unrivaled array of first-at-sea activities and entertainment venues, plus recent updates and upgrades, Royal Caribbean delivers an elevated cruise vacation for your family. DECKS & DECKS OF DISCOVERIES Cruisers can dial up the discoveries on Oasis of the Seas, the ship that originated the neighborhoods concept. Onboard you’ll enjoy from the DreamWorks® Experience parade, shops, bars and more at the Royal Promenade to the colorful kids-only water
park, FlowRider® surf simulator and 82-foot zipline at the Pool and Sports Zone.
connected with video chatting on FaceTime and Skype, texting and e-mail.
BOARDWALK VIEW & PARK VIEW BALCONY ACCOMMODATIONS It’s the view. It’s the vibe. It’s the complimentary extras that come with our two “Eat, Drink, Play” packages, available onboard Oasis of the Seas. Park View Balcony staterooms bring cruisers closer to the greenery, shops and occasional string quartet serenade within Central Park. Accommodations include lunch for two at Giovanni’s Table, a bottle of red wine for the room, and private casino gaming lessons. From high scores at the arcade to high dives at the AquaTheater, Boardwalk View staterooms get families closer to the action they crave. So what’s for lunch? A complimentary meal for four at Johnny Rockets®. And then? Unlimited soft drink refills with our soda package for two. Which is great, because the kids will work up a thirst during the private family session at our 43-foot Rock Climbing Wall.
CARIBBEAN ADVENTURES Beginning November 2016, Oasis of the Seas will be sailing from Port Canaveral (Orlando), Florida. Enjoy island hoping on 7 Night Eastern or Western itineraries onboard a ship that it’s a destination itself. Explore authentic Caribbean itineraries with visits to countries such as Jamaica, Puerto Rico, Mexico and the Bahamas. Including our private paradise, Labadee, nestled along the north coast of Haiti, with both thrilling activities and utter relaxation.
ROYAL SUITE CLASS It’s time to shake up the meaning of upscale. Because luxury should be less about things and more about one-of-a-kind experiences. Introducing Royal Suite Class — more customized adventures. More exclusive access. More inclusive amenities. All designed around you –available onboard Oasis of the Seas. DINING FOR EVERY STYLE The choice is yours with up to 20 different options onboard Oasis of the Seas. Enjoy a six-course seasonal menu at 150 Central Park, by James Beard Award-winning chef Michael Schwartz. Sabor Taqueria & Tequila Bar, serving fresh takes on Mexican favorites, and Japanese grill specialties at Izumi Hibachi & Sushi. Or enjoy family-style Italian dinner at our authentic Giovanni’s Table. STREAM, SURF AND SHARE Oasis of the Seas is powered by VOOM, the fastest Internet at sea. Enjoy all your favorite movies and shows on Netflix, and stream your favorite playlist on Spotify. Share every unforgettable moment of your vacation on Facebook and Instagram. Stay
June/July 2016
All cruise ships are not created equal. When it comes to Oasis of the Seas, the ship is the destination! For rates and more information, be sure to call your AAA Travel Consultant, Kelly Monroe, 904-825-0198, Ext. 2225.
SERVICE WITH A SMILE! Remember those days? AAA Travel St. Augustine does! Call or come by today and let our Travel Professional, Kelly Maguire Monroe, who has been sharing her passion for travel and creating memorable vacations for 30 years do all the work! Research, compare, and negotiate for the most competitive prices in town! Tours, cruises, hotels and cars. AAA Travel is equipped with the most up to date technology to ensure the best pricing for you! No fee to do on-line registrations, boarding passes or print electronic documents for all clients. Serving members and non members Monday thru Friday 8:30AM-5:30PM. Contact Kelly today and allow her to create a memorable vacation for you! (904) 825-0298 ext. 2225.
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Women in Profile
Becca Cady, Owner & Master Designer Flower Works
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ecca Cady has worked in the floral industry since the young age of 16. She received formal training and graduated with a degree in Floral Design from Rittners Floral Design College in Boston, Massachusetts. With over 40 years experience, Becca describes the Flower Works design philosophy as a “focus on the natural beauty of flowers.” Flower Works is a full-service florist providing beau-
Sandy Gorton, Haven Hospice St. Augustine Team Assistant
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fter Sandy Gorton retired in September 2015 from working in the skilled nursing field for 25 years, she found what she was looking for when she accepted the team assistant position at Haven Hospice in St. Augustine. “I needed to get back in the workforce, and I enjoy
tiful arrangements for weddings, everyday celebrations, memorials, events and every occasion in between since 1982. Becca attributes the business’s success to a personal commitment to her trade. She says,” I care deeply about every arrangement and event we create. Flowers should always bring joy to people, and I’m dedicated to making sure that always happens.” Becca spends many hours working out and on physical activities. She loves to garden and has been active in the same book club since 2000! She enjoys participating in the many community activities our town offers, especially the film festival. She was a Junior Service League member for eight years and she also generously contributes to as many charitable events as possible. She is adored by all of her employees and her many loyal customers!
the healthcare setting and assisting people in any way possible. For me, this work is very rewarding.” As the team assistant for the busy Haven Hospice office, Sandy provides reports, assists in verifying documentation and supporting the administrative staff. “I just enjoy the day and whatever it brings to me,” said Sandy. “I am up for any challenges, and I am very grateful for the opportunity. I work with an awesome group of people.” “We are so pleased to have Sandy working with us,” said Haven Hospice St. Augustine Administrator Cathy Johnson. “Her welcoming nature and calm demeanor is very reassuring to our patients, families and the team. Sandy came to us with a wealth of experience working in the healthcare industry, and she is quickly making herself an indispensable member of Team St. Augustine. “ Sandy has enjoyed living in St. Augustine for the last 36 years. On the weekends, Sandy spends time with her family at the beach and working in her garden while being accompanied by her dogs, a long-hair Chihuahua and a Yorkie, which she rescued.
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Women in Profile
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Dilyn Jackson, Jackson Law Group ilyn Jackson considers herself a St. Augustine local because she has been here almost 10 years and loves this city. But in reality, she was born and raised along with her older brother on Long Island, NY. Venturing away from home to attend the University of Florida, she obtained her Bachelor’s degree in Anthropology and met her future husband, Andrew Jackson. Dilyn is an avid gator fan, mother, volunteer, and full-time employee at her husband’s law firm, Jackson Law Group. She has been working in St. Augustine with her husband since the inception of the law firm in 2007. Dilyn has been an integral part of the growth of the firm, which currently employs six attorneys and eight support staff. She is in admin-
Photo by Christine Cousart www.cousartphotography.com
Chance Backert, Clinical Informatics Nurse, BayView Healthcare
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hance was homegrown in Baltimore “HON”, where Baseball, Crabs, Edgar Allen Poe and vacations to Ocean City are the staples of life. She grew up as the number two in a family of eight children and to this day considers her siblings to be her closest and dearest companions. It wasn’t until she moved to St. Augustine, Florida with her husband in 1992 that she decided to take a career path in healthcare. She began her career in healthcare by becoming a certified nursing assistant and then went on to become a nurse three years later. “I went into healthcare with the simple goal of being able to help support my family and it turned into an amazing journey that has enriched my life in ways I had never expected”. Within a few months of becoming a nurse Chance started working for The St. Johns County Welfare Federation. She started working in 1995 at BayView Assisted living at Buckingham Smith when it was still a skilled nursing facility and was there the day they moved over to the brand new Samantha Wilson Care Center on Marine Street. “It was an
June/July 2016
istrator, IT manager, and bookkeeper. “It is so rewarding to be able to grow a business from the ground up. Working through the difficult times as a team to achieve greatness not only helped grow our business but our relationship as well.” says Dilyn. Dilyn and Andrew proudly welcomed their daughter, Jordan Ella Jackson, into their family in August of 2014. They are excited to be welcoming a son to their family at the end of June. In addition, Dilyn keeps herself busy volunteering for a non-profit endangered species educational wildlife facility called Single Vision. Eight years ago, she started as a hands-on volunteer by cleaning the facility, giving tours, and working with the wildlife. After a short time, she realized that this incredible facility needed more than just some on-site help. It was then that she began her years of social media management, email management, and fundraising, all of which she still does today. “Single Vision reminds me every day that there are bigger issues in our world today then our day to day struggles at home and that helps me to keep those in perspective.” Dilyn explains. The law firm, Jackson Law Group, is also a proud sponsor of BayView Healthcare’s Caribbean Calypso Night, raising subsidized healthcare funds for the senior community. “Our seniors are our history and have paved the path of the future for us. It is our job to thank them and ensure their legacy is recognized.” Dilyn feels. Last year, their sponsorship facilitated a Photo Booth at the event creating quite an enthusiastic and model-esc crowd! With her caring hands in our caring community, Dilyn is one truly remarkable leader. amazing place to work and grow as a nurse. The leadership that was present at that time shaped me into the nurse I am today. Excellence was expected by all of us, and we rose to meet that expectation each and every day. I have carried that expectation of excellence with me into every room of every patient I have cared for”. Over the years Chance has served as a nurse in many different capacities. “The most rewarding job I have had as a nurse was working for Penn-Mar Human Services. I was the nurse responsible for the healthcare needs of individuals living in the community with developmental disabilities. The people that I served at Penn-Mar are the most inspiring and grateful human beings I have ever met. They are my heroes. Despite the challenges they face, these folks get up every day with a smile on their face and a desire to see the world and to go to work. When you see them they hug you and say thank you for helping me and tell you that they love you”. Chance is also a mother to a 12 year old daughter. “Every day I strive and pray that I am setting a good example for my daughter as a strong women of faith, family and hard work. I want her to know that with God all things are possible and that success in life is not defined by what you have but by what you give to others”. Chance also is a furniture artist, amateur jewelry maker and a gardener. “I love to design and create and all of these outlets let me do these things. After moving back to Florida four years ago, Chance has now returned to work for the St Johns County Welfare federation as the Clinical Informatics Nurse. “It has been an exciting thing for me to move into a role behind the scenes where I can still affect patient care in a positive way as well as support the nursing staff to be able to do their jobs in a more efficient and effective way. All of this lends to better patient outcomes and really this is why we are all in healthcare. We do it for the love of the people in our care. Being able to do that at, BayView, again is a bonus. It is just like coming home!
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Women in Profile
Emily Stimler, Flagler Hospital
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mily Stimler is the Senior Manager of Communications & Patient Engagement at Flagler Hospital. In this capacity, Emily handles a broad range of responsibilities that encompass all aspects of strategic communications, creative development and social media engagement both internally and externally. She has been with Flagler Hospital since she joined the organization as the Communications Coordinator in 2008.
Mary McKemy, Volunteer Chaplain at Flagler Hospital
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ary McKemy serves as a Volunteer Chaplain at Flagler Hospital. In this capacity she provides spiritual care for patients, their loved ones and staff members of the hospital. Mary was born in Cleburne, Texas and moved all across the country during her childhood. Her father was a Presbyterian minister and she has been involved serving in the church for nearly her entire life.
Emily attended the University of Florida where she majored in public relations with and minored in business administration. She later pursued her masters at the University of North Florida where she received her MBA in 2014. Emily is actively involved in the St. Augustine community and currently serves on the board of directors of THE PLAYERS Championship Boys & Girls Club. When Emily isn’t working, she’s spending time with her friends and family or attending workout classes at The Bar Method. On the weekends she enjoys traveling, spending time at the beach and attending The Church of Eleven22.
Mary earned a BA from Sterling College where she studied Christian & Elementary Education and then onto Princeton Seminary in Princeton, New Jersey where she earned a MRE/MA in Christian Education. Mary spent the next 42 years serving in the Presbyterian Church as a local educator and chaplain. In 1999 Mary moved to St. Augustine where she became the director of Christian Education for Florida’s first Presbyterian congregation, Memorial Presbyterian in the historic downtown. In 2002, Mary joined the Flagler Chaplain program, where she could serve the entire community. In her free time, Mary enjoys being hospitable, welcoming new residents to her small beachside community, with welcome bags. She loves household projects, especially painting her walls; her favorite color is aqua blue, like the ocean.
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Women in Profile
Susan Johnson, Communications Coordinator, Council on Aging
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usan heard about St. Augustine from a friend and, once she discovered it was the home of the Fountain of Youth, she quit her job, packed a few clothes and made a beeline for the water! That was back in 1982, and Susan has lived and worked in St. Augustine ever since. She remembers how difficult it was in the beginning and how many people helped her along the way. “My first apartment was on Water Street and my landlords lived right next door. After a few weeks, when they never saw a moving van, they
brought over almost everything I needed but didn’t have, including furniture. And the very first person I ever talked to about a job was Kenny Pearce (owner of PotBelly’s). He didn’t have any openings but he called everyone he knew until he found someone who did! It’s that kind of ‘heart’ that made me want to stay in St. Augustine.” Susan has served as the Communications Coordinator for the Council on Aging for 15 years and enjoys helping the community understand what the COA has to offer. “Most people are very surprised to learn the scope of the services at the Council on Aging. We have such a dedicated team and a virtual army of volunteers. It’s a real circle of giving and, for me, that’s what St. Augustine has always been about. ” Susan is also a contributor to The Woman’s Journal, editor of Gus! Magazine, a writer for Old City Life Magazine, co-host of the Joe and Susan Show on WFOY, and a part-time brand ambassador at Publix! But most importantly, she is Mom to Peter Melfi, Daniel Melfi and Herschel Johnson-Pollack, three of the “very best kids any parent could hope for.”
Find us on the web at: staugustinewomansjournal.com
June/July 2016
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Community
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Community
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Find Your Park Plein Air Awards Announced
o celebrate the National Park Centennial, the National Park Service and St. Johns Cultural Council teamed up to coordinate Find Your Park Plein Air, which was a nine-day event where artists created art “in the open air” at the Castillo de San Marcos and Fort Matanzas National Monument. At the end of the nine-day event, participating artists submitted up to two pieces of artwork created during Find Your Park Plein Air to be part of a juried show at the Lightner Museum, which is the America’s Parks exhibition. A total of 56 works were submitted, and 18 works were selected to be part of the upcoming exhibition. Of the 18 works, five were selected to receive awards. The recognized artists include: Lyn Asselta of St. Augustine Best of Show ($1,000) Gail Beveridge of Jacksonville Best of Media: Painting ($500) William Lurcott of Flagler Beach Best of Media: Pastel ($500) Roger Bansemer of St. Augustine Honorable Mention ($250) Claire Kendrick of St. Augustine Honorable Mention ($250)
Artists selected to be part of the juried show include: Ray Brilli of Palm Coast; Martha Ferguson of St. Augustine; Valarie Forrester of St. Augustine; Linda Holmes of St. Augustine; Karlene McConnell of Ormond Beach; Denis Pellerin of St. Augustine; Randy Pitts of Jacksonville; Elbert Shubert of Jacksonville; Teri Tompkins of St. Augustine; and Leah Wiedemer of Deland. Nelda Damiano, associate curator of the Cummer Museum, served as the juror. All 18 works selected to be part of the
Five artists received awards as part of the Find Your Park Plein Air juried show, pictured from left to right Andrew Witt, executive director of St. Johns Cultural Council; Gordon Wilson, superintendent of Castillo de San Marcos and Fort Matanzas National Monuments; Lyn Asselta, best of show award recipient; Gail Beveridge, best of media: painting award recipient; Claire Kendrick, honorable mention award recipient; William Lurcott, best of media: pastel award recipient; Amy Crane, program director at The Community Foundation for Northeast Florida; and Steven Roberts, chief of interpretation and education at Castillo de San Marcos and Fort Matanzas National Monuments.
juried show will be on display as part of the America’s Parks exhibition from June 10 to Aug. 31, 2016, at the Lightner Museum. The America’s Parks exhibition is a traveling display of 50 original artworks of parks in
Eighteen works from the Find Your Park Plein Air event were selected to be included in the America’s Parks exhibition, which opens at the Lightner Museum on June 10, 2016. Pictured are many of the artists who have works in the upcoming exhibition.
About the National Park Service The National Park Service, www.nps.gov, cares for special places saved by the American people so that all may experience our heritage. It cares for more than 400 national parks and helps communities preserve their historic places and open spaces. The National Park Service is celebrating its 100th Anniversary in 2016.
June/July 2016
North America. The Find Your Park Plein Air artwork will complement the works of the America’s Parks exhibition. Find Your Park Plein Air was made possible through a grant from the Crisp-
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Ellert Fund of The Community Foundation for Northeast Florida. The St. Johns Tourist Development Council and St. Johns Cultural Council’s ArtReaches Program provided support for the event. The project would not have been possible without the cooperation of the National Park Service at the Castillo de San Marcos and Fort Matanzas. Tickets for the opening reception of the America’s Parks exhibition are available through the St. Johns Cultural Council and https://celebrating100years.eventbrite.com. The event will feature “food bites” based on National Parks from many of the St. Johns County independently owned and operated restaurants, including Collage, Blackfly, The Reef, Culinary Outfitters, La Pentola, O. C. Whites and Michael’s Tasting Room.
About the St. Johns Cultural Council The mission of the St. Johns Cultural Council, www.stjohnsculture.com, is to promote St. Johns County as a premiere arts destination where the lives of both residents and visitors are enriched through arts and culture. The St. Johns Cultural Council was established 15 years ago and proudly provides support for youth arts programs, artists and arts organizations, and professional development workshops.
Community
Sixty-Six Seconds
by Susan Johnson, Communications Coordinator Council on Aging
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lot can happen in a minute. For example: 250 babies are born every minute; lightning strikes the Earth 6,000 times every minute; there are 5 earthquakes every minute and Americans eat 21 thousand slices of pizza every single minute. (Yep, you read that right!) That’s what the statistics say, anyway. The statistics also say that, if you add just six seconds to that minute, someone in the United States will develop Alzheimer’s disease. Every time. Every sixty-six seconds. But let’s stop the clock for a minute and take a quick look at how these sixty-six seconds are adding up. How are they affecting our lives and the lives of our friends, neighbors and family members? According to the Alzheimer’s Association (www.alz.org), more than 5 million Americans are living with Alzheimer’s disease at this very moment, making it the 6th leading cause of death in the United States. Unfortunately, here in St. Johns County, we are keeping a steady pace with the national count; over
4,000 residents are dealing with a diagnosis of Alzheimer’s disease or another form of dementia, brain trauma or memory loss. That means you probably know someone who is either personally challenged by the medical issues of dementia, or providing care for a loved one who is. Got another minute? Let’s look more closely at two words in that last sentence: providing care. In 2015, family caregivers provided 18.1 billion hours of unpaid care at an estimated economic value of $221.3 billion. And that’s not all. They also spent, on average, more than $5,000 every year on the cost of that care. For some, this means doing without “luxuries” like vacations and new cars; for others, it means cutting back on essentials like food, medications and recreation. In addition, many caregivers opt to work at home during the hours when their loved one is less active just to make ends meet. The facts are that Alzheimer’s disease is costing our nation approximately $236 billion annually and those costs are increasing...well...every minute. Council on Aging Executive Director Becky Yanni has made addressing the issue of memory loss, dementia and caregiver support a priority in our community. According to Yanni, “The Council on Aging is dedicated to promoting the health, dignity and social engagement of all older residents in our community, including those challenged by memory disorders. Our county statistics are sobering. At COA, we recognize the importance of nurturing the personal value and unique gifts of each individual – regardless of barriers or diagnoses. It is our mission to provide opportunities for everyone to live their best possible lives. Professional, compassionate adult day care is a key component to quality of life, and COA has taken the lead in addressing this community issue by providing, in two locations, the only licensed, therapeutic adult
“The statistics also say that, if you add just six seconds to that minute, someone in the United States will develop Alzheimer’s disease. Every time. Every sixty-six seconds.” day care centers in St. Johns County: the COA Sunshine Center, 180 Marine St., and the COA Ponte Vedra Adult Day Care Center, 1048 A1A north in Ponte Vedra Beach.” But why is adult day care so important when we talk about dementia care? Well, we’re not eating all that pizza alone! The truth is, we all need the company of others to whom we can relate and with whom we feel comfortable. Socialization is crucial to quality of life at any age, no matter our particular issues. It is important that each of us feel connected to our environment. And, as Becky Yanni pointed out, every one of us is of value, each of us has gifts to give, and all of us have a desire to feel useful. A professional, licensed, adult day care center provides all that and more. There are specially designed activities and exercises that focus on stimulation while encouraging a sense of accomplishment; there are field trips and parties and a rhythm and routine that give the participants a feeling of security and comfort. Another big advantage of adult day care
is that it provides the caregiver with time free from the stress that accompanies the job of caregiver. Caregivers can continue to work without worrying about how Mom or Dad are doing at home; they can meet a friend for lunch (more pizza, anyone?); schedule their medical appointments; take a class or simply relax and listen to music or read a book. The hard truth is that caregivers are great at caring for others but not so great at caring for themselves! So, by allowing for regular respite time and knowing their loved one is in a safe and secure setting, caregivers can do whatever they need to do to rejuvenate and re-energize. The COA welcomes all those who are interested in learning more about memory loss, Alzheimer’s disease and other dementias to call us at (904) 209-3700 any Monday through Friday from 8 am until 5 pm. Ask questions, access resources or schedule a visit to either one of our adult day care centers. Sixty-six seconds. Just enough time to make a phone call. Because a lot can happen in a minute!
Susan Johnson is the Communications Coordinator for the Council on Aging, 180 Marine St., the host of “The Joe and Susan Show” Thursday mornings at 8am on 102.1 FM WFOY, and the editor of gus! magazine, a publication of the COA, and the St. Augustine Record. She can be reached by phone at (904) 209-3700 or by e-mail to sjohnson@stjohnscoa.com.
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Community
Mertz in meinem Herzen - The Guitar Music of Johann Kaspar Mertz (1806-1856)
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ertz in meinem Herzen is a program of the solo guitar works of the nineteenth century Hungarian guitarist-composer Johann Kaspar Mertz. The works in the program range from quaint, artful character pieces to dazzling opera fantasies, all of which comprise a riveting collection of virtuosic nineteenth-century salon music.
“Fortna’s rendering of works...displayed impressive attention to detail and nuance.” - Soundboard Magazine “Great understanding, tone, dynamics...” - Owen Middleton, ASCAP Award Winning Composer “Such a beautiful sound, and sense of style!” - Elizabeth Brown, Composer Educator, performer, and composer Loren C. Fortna holds a BA in Music Theoretical Studies from Susquehanna University, where he studied guitar with Jay Umble and Stan Mullen. He earned his Master of Music at the University of Akron, studying with Stephen Aron and James Marron, and continued his performance studies with early music specialist Dennis Cinelli earning an Artist’s Diploma from the John J. Cali School of Music at Montclair State University. In 2012 Loren began further studies at Shenandoah University with Glenn Caluda and Julian Gray. Loren has performed throughout North America, from New Jersey to Vancouver (BC) as a soloist, accompanist, ensemble member, and conductor. He has worked with award winning conductors and composers, most notably Owen Middleton, Patrick Burns and William Payn. Loren was a featured “Spotlight” performer at the 2000, 2006, and 2012 Triennial National Assemblies of Phi Mu Alpha Sinfonia, and the 2007 University of Akron Alumni Guitar Festival. Since 2001 Loren has taught vocal and general music in the New Jersey public schools. In 2004 he joined the Springfield Public Schools where he was named District Teacher of the Year for the 2008-2009 school year. From 2009 to 2014 Loren was part of the Montclair State University guitar faculty teaching applied guitar, performance masterclass, and directing the MSU Guitar Orchestra, and serving as Faculty Advisor for the Lambda Mu Chapter of Phi Mu Alpha Sinfonia.
June/July 2016
Music at Grace presents Loren Fortna, Classical Guitar Saturday, August 6 at 5 pm Grace United Methodist Church 8 Carrera St St Augustine, FL 32084 Free program - a free-will offering will be collected
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Contact: music@gracestaugustine.org 904.829.8272
Community
Adoption: A Beautiful Option Choosing Life and Choosing Parents
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By Caroline A. Wolff, Founder, St. Gerard Campus, St. Augustine
hen women come to St. Gerard Campus for a pregnancy test, we find all too often that what should be happy news is met with fear and panic. For some women, abortion can seem like a quick and “easy” solution to an unwanted pregnancy. We give these women hope, love and practical options that will enable them to give their baby life. One of those options is adoption and at St. Gerard’s, we are proud of the work we do to bring birth mothers and adoptive parents together. We have so many wonderful couples ready and waiting to give their love and homes to a special little one. Through our adoption program, birth mothers get to choose the adoptive parents, so they feel comfortable that their child will be loved and cared for. The selection begins by reviewing scrapbooks that are put together by adoptive parents. These books are full of family history, photos, stories and letters about why the adoptive parents want to adopt. They give the birth mother a peek into the home, family and love that will be given to her child. She can even see photos of the family dog that her child may grow up playing with! All the prospective parents have had background checks and are cleared through the FBI. They have had a home study by a licensed social worker to qualify as fit to be parents. Mothers may choose to meet the adoptive parents and ask questions;
allowing the birth mother to have serenity concerning the parenting philosophy of the adoptive parents. The birth mother may also allow the adoptive parents to be present or absent during labor and delivery. It is her decision. Financial support is often given to the birth mother during her pregnancy. At St. Gerard, in most of the cases that we have handled, there is a strong display of love, and a bond, between the birth mother and the prospective parents that demonstrates a very deep gratitude in both parties. If the birth mother wishes to receive pictures of her child, they can be sent from the adoptive family at certain time intervals. All of these decisions are granted to the birth mother in order to give her peace of mind as to the well- being of the baby, but also allowing and ensuring privacy for the adoptive couple. An adoption attorney (family law specialist) coordinates all of the legal exchanges. Through this adoption process, we have seen the formation of so many happy families, with happy children, many already in their late teens or in college now! What a wonderful experience it is to share in such loving decisions made on behalf of the adopted children! If you are considering adoption, either for your child, or you would like to adopt a child of your own, please contact the St. Gerard Campus at 904-829-5516. Information is also on our website, www.stgerardcampus. org. St. Gerard will be hosting an adoption seminar July 9. If you would like to receive an invitation, please call us. One of the bravest and most unselfish acts a mother can do is to choose life for a child she does not feel she can raise. These mothers can take heart from knowing that they did not end their child’s life and that they helped to create a family and bring joy into the world. We have so many happily ever after testimonies from couples that were blessed with an unwanted child. Blessed are these mothers in the eyes of our Lord that loved enough to give their child a life through adoption.
Adoption Seminar
If you are interested in adopting a child through St. Gerard Campus, you are invited to attend a required adoption seminar. When: Saturday, July 9, 2016, from 1 pm to 4 pm. Where: St. Gerard Campus, 1405 US Hwy 1 South, St. Augustine across from Target and next door to Destiny Church. How wonderful that you have made the decision to adopt a child through the St. Gerard Campus! Congratulations on this very important decision. St. Gerard Campus has been counseling adoptions for many years. Finding the perfect home for a child that needs to be adopted has brought great joy not only to us and the adoptive parents, but to the young woman who painfully must make this most difficult decision of love. There is no greater love than wanting to open your hearts and homes to a newborn that otherwise might not have blossomed in God’s Garden. You will have a presentation and hear speakers from all aspects of the adoption process, including, two attorneys, and a home study specialist, and parents that have adopted children. All your questions will be answered regarding the procedure: Letters of Intent, Letters to the birth mother, biographical, medical information, counseling for birth mothers and adoptive families, scrapbooking, adoption timetable, adoption laws, fees, your home study, and budgeting for adoption and grants available for adoption. If you have a current home study and/or your completed scrapbook, please bring these to the seminar. The cost of attending is $100.00 per couple payable at the door either by cash or check. We would also like to kindly ask each couple to bring a covered dish for all to enjoy during our seminar. We will supply the plates, utensils, beverages and desserts. Contact Caroline Wolff at St. Gerard Campus at 904-829-5516 to reserve your seats. Seating is limited so we must have a confirmation to guarantee a seat. We look forward to meeting you and may God’s blessings be with you as you journey this path.
“Through our adoption program, birth mothers get to choose the adoptive parents, so they feel comfortable that their child will be loved and cared for. The selection begins by reviewing scrapbooks that are put together by adoptive parents. These books are full of family history, photos, stories and letters about why the adoptive parents want to adopt. They give the birth mother a peek into the home, family and love that will be given to her child. She can even see photos of the family dog that her child may grow up playing with!”
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St. Gerard Campus 1405 US Highway 1 S St Augustine, FL 32084 (904)829-5516 www.stgerardcampus.org
Community
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Lincolnville Festival
T. Paul Development Center Announces The 37Th Lincolnville Festival, September, 2016, In Celebration of Lincolnville’s 150 Anniversary. “We are celebrating the 37th year of the historic Lincolnville Festival and ask all of St. Augustine and our visitors to join us,” invites Festival supporter, Rev. Ron Rawls of St. Paul AME Church. This popular event, initially called the Washington Street Festival originated in 1979 on Labor Day weekend. From the beginning, its objective has been the revitalization of the Lincolnville community. Around 1981, the name was changed to the Lincolnville Festival. This year’s Festival celebrates an important milestone for the neighborhood. 150 years ago, in 1866, Lincolnville was founded by recently freed slaves and later played a major role in the Civil Rights Movement. The Rev. Dr. Martin Luther King, Jr. was called upon to come to St. Augustine by Dr. Robert Hayling, a local dentist, to aid the residents of St. Augustine in their fight for equality. The Lincolnville community served as the centerpiece for the movement led by Dr. King in St. Augustine, which caught national attention and helped trigger the signing of the Civil Rights Act of 1964. To tell the entire story of Lincolnville’s history, from Native American hunting ground, to today’s fast-growing community, a historic timeline will be presented to the City by Lift Up Lincolnville Revitalization Corp. and installed in The Galimore Community Center hallway. “We invite everyone to attend the debut of the timeline on Friday, September 16th during a 150th Birthday Celebration fundraiser at the Galimore Center. There will be food, drinks, music and dancing, plus a huge birthday cake, so we hope everyone will come out. We are raising funds so we can carry on the tradition of keeping the Festival free,” said Rawls. This year’s Festival is scheduled a week after the Birthday celebration, Saturday, September 24 and Sunday, September 25, 2016 at Eddie Vickers Park (Little Links), located at 399 Riberia Street. One of the founding fathers of the Lincolnville Festival, internationally known jazz musician Doug Carn, will be one of the featured artists, joining several regional talents performing throughout the weekend. The weekend will include: • Live music and dancing • Great food and drinks • Local vendors • Fun activities for the children The Festival returned to its roots in Lincolnville last year and drew over 2,000 guests from the surrounding areas. This year’s event, tied to our 150th Birthday Celebration is expected to draw more attention and much higher attendance. For more information about becoming a sponsor or for receiving a vendor application, please contact Alice Long Owens at 904-829-3918, or e-mail office@ saintpaulfamily.com.
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Community
St. Francis House Holds Ribbon Cutting for Rotary Funded Kitchen Renovation
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epresentatives of St Johns County’s four Rotary Clubs joined with supporters, staff, board members and volunteers of St. Francis House for a Chamber of Commerce ribbon cutting on Thursday, April 7, 2016. The event honored the Rotary Club of St. Augustine, Rotary Club of St. Augustine Sunrise, Rotary Club of St. Johns, Rotary Club of Coastal St. Johns County and Rotary District 6970 Foundation for funding the renovation of the St. Francis House commercial kitchen. The project included a new commercial fan and ductwork, and the replacement of major equipment and new air conditioning. Along with a comprehensive array of services for those facing the crisis of homelessness, St. Francis House serves more than 60,000 meals annually to the homeless and less-fortunate. The meal program includes; 3 meals a day for residents of the program and a lunch meal that is offered for anyone who is hungry. Between 80 and 130 people eat lunch at St. Francis House each day.
St. Francis House is deeply grateful to our local Rotary Clubs and District 6070 Foundation for funding this important project that helps meet the basic needs of our most vulnerable citizens.
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St. Francis House is a comprehensive housing crisis center providing supportive programs, services and shelter for families and individuals facing the crisis of homelessness. For more information about St. Francis House and how you can help, visit stfrancisshelter.org, contact 904-829-8937 or visit us on facebook.
Fashion & Beauty
Relationship, Relationship, Relationship!
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Christine Cousart
Owner, Cousart Studios
s real estate agents will often say “location, location, location”, I might do the same with the word ‘relationship’! As a photographer who frequently develops a client to friend, it is so important to me to be in good relationship with the people I do business with. It begins with honesty, communication and the golden rule “Do unto others as you would have them do to you”. One of the benefits to having an ongoing relationship with the ones that I photograph is that I get to watch their children grow up (the only bad thing is I’m growing older with them!!). The Hirko family is a local family who I have walked with through many changes in their lives. When I first met Andy, he was our son Christian’s kindergarten teacher who switched careers and became our daughter’s college pastor at church, who then became a pastor and is now our pastor and also a mentor to our son Dylan who is youth pastor at the same church. I was one of the mom’s in the kindergarten
class, then a helper at the college ministry and have always been his family photographer. One of the benefits to this is being great friends with him and his wife and their extended family. I know their children and have photographed them from day one. The photos are so meaningful to me and I believe that this makes it easy for them when they want photos because I can slip in without a big fuss and do the photos without the kids getting crazy. They know me and so it helps when it comes to the pics. Another family is from New Jersey. It began by him calling me out of the blue wanting me to help him with an early morning sunrise photo session on the beach with his girlfriend who he wanted to propose to. We collaborated and I brought the champagne and glasses (my assistant was the wine steward) and we had a successful launch with great photos to tell the story. Wind forward four years, I have since done one more session with them and will be doing another one this July with his wife and two children! I love this couple and keep up with their lives on Facebook and the occasional communication via email. I look forward to many more sessions with them in the future! You may be hoping to have a family photo. I would love to help you with that! As an incentive, I would like to give you a free 8X10 photo if you mention this story when you call to book your session! Cousart Studios of Fine Art & Photography 320 Hightide Drive #101 Saint Augustine, FL 32080 www.cousartphotography.com 904.687.7700
Christine Cousart has lived in St. Augustine since 2004 and says that it is the closest to the life she had when growing up in New Zealand. She owns Cousart Studios of Fine Art & Photography. She enjoys painting in all mediums as well as photographing a variety of subjects. She and her husband Kevin have two children that have graduated from Flagler College and one child who attends Palm Beach Atlantic University. The family loves to travel frequently and loves their relationship with many friends in the community. Cousart Studios of Fine Art & Photography | www. cousartphotography.com | 904.687.7700 | 320 Hightide Drive #101 | Saint Augustine, FL 32080
June/July 2016
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Fashion & Beauty
Why Hair Consultations are Needed Before You Cut or Color!
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Lisa Harris, Hair by Lisa
onsultations allow us to talk and figure out how to get hairstyles that work for you 365 days a year - not just the day after a trip to the hair salon! I will help you be realistic about what hairstyles will work for you, as well as those that might be too challenging for your type of hair or for your schedule. We’ll start by discussing the texture of your hair and what it can do. Then we’ll discuss color; from highlights, to low lights, to all over color, or no color changes at all. Have you ever had your hair dresser ask you how much time you have to devote to your hair in the morning? That’s ex-
actly the kind of thing that is discussed in the consultation! Are you aware that 9 out of 10 bad hair days are due to people using the wrong shampoo and conditioner? In your consultation we will discuss exactly what products you use on your hair, including shampoo, conditioner, styling products, blow dryers, irons and more! What you use will make a huge difference! If you are using the wrong tools, you will be constantly fighting with your hair to get it to do what it will not do! The benefits of hair consultations services • A consultation helps to ensure that your hair “goals” are realistic for your hair type and that the style is maintainable for you. • Your hair style will be “do-able” for you and not just something that only looks good after a salon visit. • Shampoos, conditioners, styling products and tools will be customized to make sure your hair style works for you - not against you! • The style guessing game is over - we know what will work and how to get there • No more wondering about when to come in for a cut, or trim or touch up. • Your maintenance is customized for you so that you can always have
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gorgeous looking hair - both in style and color. Consultations include all kinds of tips to looking your best. You’ll end up loving your hair style! You’ll end up loving your hair color!
• You’ll end up trusting your hair dresser! Give me a call for your free consultation; your hair will thank you! Best Regards, Hair By Lisa, 904-334-6888
Let me help you look your best! A great haircut can take you anywhere! And it’s important that you find a professional hair stylist that will not only listen to you, but one that will give you realistic advice about what can be achieved with your hair. You need to be able to tell your hairdresser what you like and don’t like. You want to build a good, long term relationship with them so that you can have a hair style and hair color that works for you, 365 days a year. I am originally from Jacksonville, Florida, and received my initial beauty school training at Brevard Community College. Very quickly I realized that I was truly passionate about learning the art and skill of professional hair cutting and hair styling. While living in Melbourne, Florida, I met my mentor. She encouraged me to continue training in my profession. I travelled to Miami on a monthly basis and began extensive Paul Mitchell training. Eventually I became a certified Paul Mitchell Educator. During my career I have been fortunate to be able to spend time in London, England. There I learned about the differences in techniques and consultations. The Vidal Sassoon academy in Santa Monica, California is the creme de la creme of hair cutting schools. It was there that I greatly expanded my horizons and my skill set in this wonderful world of hair! Over the years I have immersed myself in advanced training in hair coloring, hair cutting and hair design. Paul Mitchell conducts extensive educational events in Las Vegas, Nevada and Miami, Florida. I have attended their Hair Camp seven times and participated in advanced classes at their Signature Gathering on three occasions. I constantly strive to increase not only my abilities in this field, but also my creativity in all aspects of hair coloring, cutting, and styling. I now live in St. Augustine, Florida and work out of St. Augustine. My education: Paul Mitchell trained, Vidal Sassoon, and MBA in Business, St. Leo University. Are you ready to make a change? My specialty is making you look your best! Call me at 904-334-6888! Check out my website. Hairbylisaharris.com
Hair by Lisa
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HAIR DESIGNER • COLOR SPECIALIST • MAKEUP ARTIST By Appointment Only • On Location Available
904-334-6888 • Hairbylisaharris.com 5543 a1a South • Suite #101 • Saint Augustine Beach, FL 32080
Fashion & Beauty
June/July 2016
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Food & Entertainment
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Food & Entertainment
June/July 2016
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Food & Entertainment
Treat Your Taste Buds at PJ’s Asia One Market advice from PJ’s proprietor, Thailand native and culinary school graduate Praphaphan “PJ” Johnson. After several years as a chef in St. Augustine, PJ and her husband Bob decided to open the grocery store in December 2009 and have been serving the community ever since. So send out the summer with a bang by picking up some special ingredients for your next meal at PJ’s Asian One Market!
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njoy a taste of cultural zest from PJ’s Asia One Market. St. Augustine’s only Asian grocery store offers a wide variety of ingredients from fresh produce to frozen seafood for some delicious dishes from around the globe. PJ’s Asia One Market carries 10 different styles of Thai curries and a fully stocked condiment section featuring many types of spices, sauces and dips from several Asian countries. If you’re a sushi enthusiast, PJ’s has all the ingredients you need to create your own sushi feast including rice, vinegar, nori, wasabi and flash frozen “sushi grade” seafood. Also available in the frozen section are packaged seafood items such as gyoza, lumpia along with an assortment of Asian flavored ice cream and icy treats. For soups and pasta dishes, a variety of noodles in both dry and refrigerated forms are available from Thailand, Japan, the Philippines, Korea, China and Indonesia. PJ’s also offers several different types of rice including Jasmine, sticky (sweet), brown, red and Basmati. You can also find a large selection of fresh Asian vegetables and fruits in PJ’s produce section. If you’d like to try your hand at a special Asian recipe or need some help with a special ingredient, make sure you get some
Green Papaya Salad For those extra hot Summer afternoons, try this cool dish for a special treat! Ingredients: 1 Small green papaya (Peeled and shredded to small thin strips it should measure about two cups) 2 Fresh Thai chili 1 clove Garlic Juice from 1/2 Lemon or lime or 1 tablespoon of tamarind paste 1/2 Teaspoon palm sugar 2 Tablespoons fish sauce 1/4 Cup toasted chopped peanuts 1/4 Cup ripe tomato cut into wedges 2 Tablespoons dry shrimp--optional Using a pestle and mortar, crush the toasted peanuts, then remove from mortar and set aside. Next, crush the chili, dry shrimp (optional) and garlic in the mortar and then add sugar, lime, lemon juice or tamarind paste, fish sauce, tomato, papaya and half of the crushed toasted peanuts. Gently mix everything together until papaya is well coated. Place the mixture on a serving dish and sprinkle remaining crushed peanuts on top. Serve at room temperature or cold with an optional lettuce garnish.
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Recently, I decided to prepare a special meal for my girlfriend. Since she really enjoys Asian food, I went to PJ’s market looking for some great ideas. PJ was really helpful; she gave me her own recipe for a Thai curry chicken served with a cold papaya salad. I was able to get almost all the ingredients I needed for the meal at PJ’s, plus some advice on how to prepare everything. My girlfriend was seriously impressed, and I owe it all to PJ! Thanks! -Ty Moore