Orlando Medical News December 2021

DECEMBER 2021

Proudly Serving Central Florida, North Central Florida, Volusia & Brevard

An

Inspiration

to Give

A Reflection on Providing COVID-19 Medical Relief

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PHYSICIAN SPOTLIGHT

CONTENTS || FEATURES

The Cutting Edge of Medicine: Dr. Roy Hwang on Deep Brain Stimulation

TBI Traumatic Brain Injury TBI

FEATURES 4 5

COVER STORY An Inspiration to Give PHYSICIAN SPOTLIGHT The Cutting Edge of Medicine: Dr. Roy Hwang on Deep Brain Stimulation

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EOCC The Signals of Change are Approaching

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COVID Year 2: Holiday Stress and Depression

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Taking the Proper Steps in Diagnosing and Treating Achalasia

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The Dangers of Benzodiazepine Misuse

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How to Prevent ‘Cognitive Overload’ in Your eLearning Modules

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GRAND ROUNDS Orlando

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GRAND ROUNDS North Central Florida, Volusia/Brevard ||

PUBLISHER John Kelly jkelly@orlandomedicalnews.com ————————————————— AD SALES John Kelly 407-701-7424 ————————————————— EDITOR PL Jeter editor@orlandomedicalnews.com

CREATIVE DIRECTOR Katy Barrett-Alley ————————————————— CONTRIBUTING WRITERS Dorothy Hardee, Hilary Ortega, Sanjay Pattani, MD; Cheryl Powell, Srinivas Seela, MD; Mary-Catherine Segota, PsyD; Dr. Rebecca WangHarris ————————————————— UCF INTERN Brianna Kirby

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CIRCULATION jkelly@orlandomedicalnews.com ————————————————— All editorial submissions and press releases should be emailed to editor@orlandomedicalnews.com ————————————————— Subscription requests or address changes should be emailed to jkelly@orlandomedicalnews.com

Orlando Medical News January 2021 is published monthly by K&J Kelly, LLC. ©2021 Orlando Medical News.all Rights Reserved. Reproduction in whole, or in part without written permission is prohibited. Orlando Medical News will assume no responsibility unsolicited materials.

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An Inspiration to Give A Reflection on Providing COVID-19 Medical Relief Editor’s note: In this Christmas season, we have reason to celebrate and mourn. The past 23 months have seen us striving to do our best to care for our patients, friends, colleagues and family during a generational crisis of disease – sometimes with success, sometimes not. We have witnessed a revelation in this, the greatest healthcare infrastructure in the world, vulnerabilities that left our system of care hanging by a thread in the largest metropolitan areas of the country and woefully inadequate in the lands in between.

If the world’s best healthcare system was brought to the brink, imagine how tragic these months have been in other areas of the world.

We are facing another surge of Covid but are now better equipped and more knowledgeable in meeting the challenge. Maybe this next year would be a great time to think about how to effect change by taking that knowledge and equipment to areas of the world left nearly helpless in the face of the challenge of this virus. The season of Christmas is for giving and sharing.

We are proud to share with you one story from central Florida that may inspire you to do something special, somewhere in the world.

cantly different and hugely underfunded healthcare infrastructure. The country has almost no emergency medical services (EMS) system — just getting patients to the hospital is a huge barrier to accessing care.

Compounding the challenge, severe staff and supply shortages plagued India’s hospitals before the Delta variant hit. As the virus surged, the healthcare system rapidly became overrun. Two of the greatest challenges that emerged were capacity and lack of oxygen. Quite literally, millions of sick people were starving for air.

I am a physician, trained in emergency medicine, serving as associate chief medical officer for AdventHealth Orlando, a quaternary hospital in the U.S. As an American doctor, I have access to the very best medical resources and the ability to provide the highest level of patient care.

In medical training, we are taught to be proactive, to do no harm and to never give up. I also have an innate humanitarian desire to help others. That is what drew me to a career in medicine in the first place. As the Delta variant was consuming my family’s homeland, I knew I had skills, knowledge, financial resources and the desire to help, but how could I from such a distance? It was an overwhelming and paralyzing feeling.

BY SANJAY PATTANI, MD

Just as Florida came off its second COVID-19 surge this past spring and mass vaccination efforts were in full swing, the Delta variant began ravaging India.

The headlines of death and despair dominated the news, and the impact on one of the most populous countries in the world was devastating. At its peak in early May, India experienced one of the largest COVID-19 surges the world had seen, with more than 400,000 new infections and 4,000 deaths reported each day.

These were more than headlines to me. They hit close to my home and heart. My parents are first-generation immigrants from India, and I continue to have deep roots in the country. Many of my relatives are still there, including two of my cousins who are primary care physicians. I also have numerous physician colleagues I have met and stayed connected with over the years who live and work in India.

As this new stage of the pandemic progressed, I kept hearing more and more first-hand accounts from my family and friends about the tragedies they were seeing and experiencing each day. My wife’s best friend’s grandmother died without family being able to conduct the usual and customary Hindu ceremony and cremation.

Listening to all of their fear and suffering broke my heart and propelled me to find a way to do something to help.

Developing a Plan to Provide Relief Despite the initial despair, I knew I wasn’t alone in my quest to do something to help. When the warning signals began ringing in India early last spring, my AdventHealth colleagues in Central Florida began discussing how we could apply the basic principles we knew as physicians to deliver some sort of relief in a compassionate way. However, with each idea we generated, we encountered obstacles, including travel restrictions, supply chain issues, limited manpower and government regulations. Finding the right contacts and resources would be essential to launching a successful disaster relief effort.

At AdventHealth, I am blessed to work for a faithbased organization whose breadth and depth extends into various programs such as AdventHealth Global Missions. They already had relationships with a number of hospitals in India and helped us to establish direct

The Challenge From a medical standpoint, India was experiencing some of the same issues we had in the U.S. during our first two COVID-19 surges but with a signifi-

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communication with these health care providers to learn how we could best support their most urgent needs.

One of the most heartbreaking things we learned during these initial outreach and conversations was that at some hospitals, despite the tremendous influx of COVID-19 patients, some ventilators were sitting unused simply because of a lack of available oxygen.

With input from our colleagues on the frontlines in India, we decided to focus our combined relief efforts on two critical areas of need: 1) Supplies and equipment, including personal protective equipment (PPE) and ventilators and 2) addressing the oxygen shortage.

Working through AdventHealth Global Missions, we were able to secure and ship five pallets of surgical masks, respiratory circuits and ventilators to Southern India in June. They were also able to connect us with the Adventist Development and Relief Agency (ADRA), a humanitarian organization based in Maryland and operated by the Seventh-day Adventist Church.

Working with ADRA, we set a goal to help them raise enough funds to provide eight hospitals in India with medical oxygen-generating plants. These plants not only met the immediate need, but also ensured the hospitals could meet their long-term oxygen needs as well. The first oxygen-generating plant was quickly established at a hospital in the western Indian city of Surat over the summer, and three more plants are currently in progress.

Maintaining Global Health Connections to Extend Compassionate Care While the COVID-19 pandemic has touched us all in different ways, its effects were felt across the globe, demonstrating just how connected we truly are. The immediate, crushing crisis may have waned, but no doubt our world will continue to experience viral surges and other health challenges. In the years to come,

CONTINUED P.5

PHYSICIAN || SPOTLIGHT SPONSORED BY

The Cutting Edge of Medicine: Dr. Roy Hwang on Deep Brain Stimulation medicine, what led you to specialize in neurosurgery?

The Neurohealth Sciences Center, an affiliate of HCA Healthcare’s Central Florida Regional Hospital, recently welcomed board-certified neurosurgeon Roy Hwang, MD.

As I’ve said, I’m a hands-on person, so surgery always appealed to me. When I got my master’s in biomedical engineering, I worked with a surgeon and focused on robotic surgery, which was just beginning to get really big. Later, I went to Cleveland Clinic for medical school, and I planned to pursue general surgery. That school has a very prominent spine program, focusing on spinal nerve surgery. My mentor was a spine surgeon, and through my classes, I had a lot of opportunities to meet other people who specialized in that field. All those factors together got me to where I am now.

With a background in biomedical engineering, Hwang specializes in deep brain stimulation surgery, a developing therapy that can help reduce symptoms in patients with movement disorders.

What drew you to medicine?

Back in high school, I thought I was going to spend my life building airplanes. That’s why I studied mechanical engineering as an undergraduate, and all the way through college, that was what I planned to do. But during my engineering internship, I found myself working in an office cubicle without really seeing anyone who was benefiting from my work.

I wanted something more hands-on, more interactive – something that helped people directly. I didn’t land on medicine right away. I completed my master’s in biomedical engineering because it was like a hybrid of what I wanted to do and what I was already doing. Over time, though, I started to realize that I really wanted to work directly with patients. Medicine was the next step.

It was a pretty big change to make in just one or two years, but you never really know where life will take you.

Sometimes you just fall into something new.

In your neurosurgery practice, one of the therapies you specialize in is deep brain stimulation (DBS). Tell me a little about what that involves and how it helps your patients.

Deep brain stimulation was initially developed for pain indications. By implanting electrodes into areas of the brain that handle sensory inputs, researchers hoped to block the pain signals. It is no longer primarily used for that purpose, but the technique migrated to treating movement disorders.

For example, patients who have a central tremor or Parkinson’s Disease often have a dysfunction in the brain’s motor circuits. Researchers found that you can use electrodes to manage the signals going into those circuits, correct a patient’s motor function, and improve quality of life.

The precise mechanism is different depending on what we’re treating. tremors are caused by abnormal cerebellar signals going into the thalamus, so we can place an electrode in the thalamus to block those signals. That very effectively stops the tremor. With Parkinson’s, there’s a problem with the basal ganglia. We stimulate the subthalamic nucleus and Globus pallidus all part of the basal ganglia. That alters the circuit, and they're able to get relief from their symptoms – not only the tremor, but also slowed movement and rigidity.

As research continues, we’re also seeing possibility

Has your background in engineering been useful in your current career?

It definitely shaped my outlook. For me, the appealing part of engineering was the theory behind it, more than the practical side. While I may not be designing parts, things like currents, amplitude and frequency come into play a lot with my line of work.

After you made the switch from engineering to

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in some other applications for deep brain stimulation, including epilepsy, depression, addiction, OCD and Alzheimer’s disease.

What do you think are the most important qualities for a neurosurgeon to have? What advice would you give to students considering a specialization in neurosurgery?

Always stay focused on the patient’s perspective. Even if I can’t help a patient with surgery, I always try to listen to them, understand their goals and keep trying to find solutions. It is a partnership, so you have to work together.

Neurosurgery is a field that is always innovating, always trying to make procedures safer and less invasive. If you love to learn, are willing to work hard, and you like taking on a challenge, then it is a great field to be in, because you can make really significant improvements in your patients’ lives.

You previously worked in Pennsylvania. What brought you to Florida?

My wife is from Florida, and we decided that we wanted to live closer to her family. Central Florida Regional Hospital struck me as a great opportunity. The therapies I use are underutilized in the area, so there were a lot of patients who could benefit from having access to them.

And, of course, my colleagues are great people.

How do you maintain a work-life balance?

I’m lucky because I have a great support system: my wife and three kids. Every chance I get, I’m spending time with my family. I also love to travel and, although I’m a little rusty, I really enjoy playing musical instruments like guitar and drums.

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An Inspiration to Give how can we sustain our cooperative efforts and become more proactive and prepared to respond?

As physicians, we are called to communicate and collaborate for the greater good, for the health of people across our planet. It is the oath we take when we put on the white coat and the core of our basic humanity. We can’t afford to stand on the sidelines and watch medical crises occur even if they are an ocean away. We must harness the power and innovation of the virtual world to bridge our geographic divides so that we can connect, organize and work together on plans and processes to address our most pressing needs and better prepare for those yet to come. We must forge new international forums to discuss best practices and develop new ideas. And most importantly, we must continue to share our strengths – our medical expertise, financial resources, leadership skills and intellectual capital – to help each other and find new solutions to our greatest healthcare challenges. Embracing our strength and the common good, our medical communities will continue to advocate for humanity.

Sanjay J. Pattani, MD, is the Associate Chief Medical Officer of AdventHealth Orlando, and Executive Medical Director of AdventHealth’s Mission Control. He is responsible for reengineering patient flow within a health system which necessitates vision and the courage to challenge the current state to promote change. Dr. Pattani led the development of Mission Control, a NASA-like Command Center for AdventHealth – the largest of its kind within the industry.

EAST ORLANDO CHAMBER OF COMMERCE

CALENDAR: Testimonial Tuesday LIVE on Facebook Rosso Specialty Coffee Avalon Park

DECEMBER 14, 2021 9:00 AM – 12:30 PM Live on Facebook Member Exclusive Participation

Misters & Sisters Great Lunch Adventures Nola Avalon Park

DECEMBER 14, 2021 12:30 – 1:30 PM RSVP at eocc.org Participants are responsible for their meals

Local Charities Luncheon “Lights, Camera, Action” featuring Barbara Poma, onePULSE Foundation Sponsored by Orlando Health

NOVEMBER 10, 2021 11:00 AM – 1:00 PM Holiday Inn East UCF Area Celebrating & supporting five local charities during this season of giving $40 for EOCC members | $50 Nonmembers

Coffee Club Nona DECEMBER 16, 2021 8:30 – 9:30 AM Sam’s Club Lake Nona It is Gonna Get Ugly Party - Ugly Christmas Sweater & Trivia that is!

Free for members | FREE Nonmembers as our Gift to You | Discount for College Students

East Orlando Chamber office Closed for the Holidays DECEMBER 24 – DECEMBER 31, 2021

Coffee Club East JANUARY 6, 2022 8:30 – 9:30 AM Bonefish Grill Waterford Lakes Toasting the New Year & kicking off your success Panel. Free for members | $10 Nonmembers | Discount for College Students

Chamber Board Installation & 2021 Volunteer Recognition Luncheon Featuring James Holmes, Journalist & author “The Last Disciple”

JANUARY 26, 2022 11:30 AM – 1:10 PM Bonefish Grill Waterford Lakes. Toasting the New Year & kicking off your success Panel $40 Members | $50 Nonmembers

Visit EOCC.org for a complete listing of December events

EOCC || MEDICAL CITY

PRESENTED BY

The Signals of Change are Approaching

BY DOROTHY HARDEE

“The greatest danger in times of turbulence is not the turbulence – it is to act with yesterday’s logic.”

– Peter Drucker If I had to share one word to describe 2021 it would be “transformation.” COVID has forced us to transform in ways we could never imagine, moving the mark as we enter 2022.

The global workforce accelerated this year due to the pandemic and strains experienced by businesses. We had record labor shortages as priorities shifted for workers universally. “The ADP Research Institute found that 64 percent of the global workforce was negatively impacted, including 28 percent who lost a job, were furloughed or were temporality laid off, and 23 percent who took a pay cut.” Employees took this as an opportunity to reprioritize their needs including how and where they work, forcing employers to “transform,” adjusting to current demands.

What does this mean? Fostering connections among hybrid teams is critical to build trust, drive results and engagement. With so many employees remaining remote and hybrid, companies will have to examine their operations and compliance to keep up with regulatory changes. Embracing the evolution into innovation will accelerate growth.

• According to Bernard Marr in Forbes we will see 8 trends emerging in 2022: • Sustainable, resilient operations • The balance between human workers and intelligent robots • The shifting talent pool and changing employee experience • Flatter, more agile organizations • Purposeful business • Co-opetition and integration • New forms of funding Marr adds that “…there will also be transformative technology trends in 2022 including artificial intelligence and increasing digitization, which every company must be ready for.” According to the Orlando Business Journal, COVID made tech a necessity in Orlando real estate creating a new normal with virtual tours up 200percent. This move is not only making it easier for buyers to find their new home, but easier for residential real estate investors too.

Orlando’s entertainment industry embraced technology for the rising demand for convenience. Lake Mary based accesso’s technology used in theme parks, cruise lines and event venues is making a stunning rebound for 2022. Orlando is making its mark in the technology arena proving it is the place to be for tech in 2022 and beyond providing a launching pad for string technology companies.

In keeping with the theme, The East Orlando Chamber’s OPTIC (Orlando’s Professional Technology Innovation Council) will explore Orlando: The place for Tech in 2022 and beyond, December 3. Avani Desai, CEO at Schellman will moderate a panel of dynamic leaders paving the way in technology in our own backyard. Our panelists include Kathy Chiu, Shari Dingle Costantini, Awais Shaikh and Abdullah Tharoo.

Kathy Chiu, Managing Partner for DeepWork Capital offers an engaged approach to investing. DeepWork Capital is a venture capital firm investing in early-stage companies. Under-invested markets like Florida and surrounding regions are their specialty.

Shari Costantini, CEO of Red Meters, illuminates your

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process intelligence improving efficiency and increasing bottom lines. An inline measurement instrument, Red Meter takes continuous readings recording and storing them with their Wi-Fi-based cloud capabilities.

Awais Shaikh, Co-founder & Partner with AWS Capital and Management Data Inc., is a sector specific investment firm focusing on value creation through its direct approach. AWS Capital invests in software, technology, and technology-enabled businesses.

Abdullah Tharoo, CEO & Co-Founder of the Tuesday app, provides a fundraising software for nonprofits, enabling them to invite their network to participate in fun nonprofit auction shopping experience while supporting a humanity cause.

Join us as we see how these forward-thinking leaders built their string technology companies in Orlando and are helping to make Orlando the place to be for tech in 2022 and beyond, December 3, 2021, at 9:00 AM at The Fortress at Full Sail University. $10 for all includes continental breakfast with coffee. Register at eocc.org.

Here is more good news. Did you also know the East Orlando Chamber Foundation, a 501(c)(3) nonprofit organization has launched? Its mission is to provide financial support, mentorship, development, and guidance for small and medium sized businesses starting their business or taking the next step to growth. We are looking for supporters and potential Board Members.

Interested? Call the Chamber at (407)277-5951 or contact Jennifer Englert.

Looking for more ways to highlight your business?

The East Orlando Chamber has a plethora of opportunities to get you noticed, connecting you with your next clients and partners, keeping your business healthy.

For the health of your business reach out to the East Orlando Chamber for a menu of unique offerings elevating your businesses visibility and connect you with others helping your business thrive. We are the first in the state offering traditional Health Insurance plans, as well as supplemental products including dental, vision, critical illness, accidental and more.

For more information or to register call (407) 2775951 or visit our website at eocc.org. The East Orlando Chamber of Commerce everywhere East of I-4.

Dorothy Hardee is East Orlando Chamber Director of Operations

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DECEMBER 2021

COVID Year 2: Holiday Stress and Depression What can we do to help our patients?

BY MARY-CATHERINE SEGOTA, PSY.D.

better fit, rather than one large get-together?

Be respectful of individual differences and acknowledge your own needs.

It is essential to create a holiday experience where you feel safe. In doing so, recognize that others may not share the same beliefs or values. Communication is key. Decide what is important to you and communicate that information before and at the time of arrival. For example, if the get-together will occur outside, it is essential to share that so guests can dress accordingly. If you want everyone in masks, include that in the reminder, and have a basket of masks available at the entrance. Remember that each guest may be at a different stage of pandemic management, and for some, this event may be their first time leaving their home.

Holidays can trigger stress, anxiety, and depression. The pandemic adds another layer. When you have identified that one of your patients may be experiencing stress, anxiety, or depression, it is essential to address this and offer the following – emphasizing that self-care is the priority:

The COVID pandemic has pushed most people to reexamine their lives on some level- their priorities, how they live, and what they want for themselves.

No one could have anticipated the length the pandemic would last, and it certainly has caused significant stress in how we live, love, and how we spend time together. Last year brought about a holiday season with isolation, social distancing, and skipping many holiday traditions. While there have been shifts in the pandemic, some continue to live in isolation, while some have re-emerged with cautious optimism, and others returned to pre-pandemic behaviors. Thinking it through wherever someone falls in this continuum will help ensure the happiest and safest holiday season possible.

For many, last year’s celebrations were conducted with only immediate family present or by zoom, and the season held difficulty and uncertainty for everyone. This year, it is essential to recognize that everyone is in a different stage of coping with the pandemic. Many children have returned to in-person schooling, while some have maintained distance learning. Adults are either juggling work from home or having returned to the office. Different geographical locations continue to have different rules in place regarding masks. It is essential to consider all of these factors in making plans, the most important of which is recognizing and respecting induvial autonomy and community differences regarding pandemic management.

As healthcare professionals, you are in the front line of dealing with individuals at all stages of pandemic management. It is crucial for those who remain isolated to review their coping strategies and ability to handle the separation from others. In social isolation, there is a greater chance of depression and anxiety during holiday time.

It is crucial for those who have begun to re-emerge from social isolation with caution to acknowledge the stress they may experience in straddling two worlds, between self-protection and the desire to connect with others and experiences in person. With that, internal conflict may emerge with increased depression and anxiety as they face these new changes. Those who have returned to pre-pandemic behaviors may experience conflict with others in their immediate community and the world.

Regardless of an individual’s perspective and stage of pandemic management, increased stress, depression, and anxiety are continually a risk.

1. Acknowledge feelings. If someone close to you has recently died or you can’t be with loved ones, realize that it’s normal to feel sadness, and it’s OK to cry or express your feelings.

2. Reach out. If you feel lonely, seek out community, religious, or other social events. Volunteering your time to help others is an excellent way to lift your spirits.

3. Be realistic. The holidays don’t have to be perfect. As families change and grow, choose some traditions to hold on to that can be adapted to the current climate and create new ones.

4. Set aside differences. Try to accept people as they are, even if they don’t live up to all of your expectations. Acknowledge the bridges that connect different beliefs or values.

What can we do to help our patients manage the holidays in this new world?

Embrace change: Change is inevitable, and how one manages change determines how one is affected emotionally. Resisting change leads to increased frustration and angst and leads to disappointment. Accepting change leads to happier, peaceful experiences.

Plan: When making plans, it is essential to communicate with all involved regarding expectations and interactions.

Asking questions is key: How comfortable are you in gathering together? What are your expectations about the size of the group? What is your preference regarding masking?

What are ways to incorporate favorite family traditions with the current limitations? Is a hybrid approach possible (both in-person and those participating through video conferencing)? Will several smaller social events be a

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5. Acknowledge financial limitations. Stick to a budget. Before you go shopping, decide how much you can afford. Consider making personalized homemade gifts.

6. Focus on giving. Data supports the old saying, “It’s better to give than to receive.” Sponsor a family, donate to a worthy cause, or give your time to volunteer in the community. Despite avoiding large gatherings and social distancing practices, there are plenty of ways to get involved in your community if you seek them out.

7. Reach out to those who are more isolated. Try to think of family, friends, and neighbors who might have less local social support and offer to include them in festivities or drop something off at their door. Make an art project to give them or invite them to participate in a socially distant outdoor activity.

8. Plan your preparation. Set specific days for shopping, baking, visiting, and other activities. Plan menus and make shopping lists to avoid last-minute scrambling—line up help for party prep and cleanup.

9. Learn to say NO. Saying yes when you say NO can build resentment and overwhelm.

10. Don’t abandon healthy habits. Overindulgence adds to stress and guilt.

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Taking the Proper Steps in Diagnosing and Treating Achalasia And How Not to Mistake it for GERD

BY SRINIVAS SEELA, MD

surgical or non-surgical—depends on the age, health condition and the severity of the achalasia in the patient.

Non-surgical options include medications like nitroglycerin (Nitrostat) or nifedipine (Procardia)—a muscle relaxant before eating, Botox, and pneumatic dilatation. However, these medications have limited treatment effect with severe side effects. Medications are generally considered only if the patient is not a candidate for pneumatic dilation or surgery, and Botox hasn’t helped.

This type of therapy is infrequently indicated.

As for surgical options, there are a couple that are recommended. Heller myotomy is one of them. It’s a procedure that needs to be performed by an experienced surgeon with esophageal training. The surgeon cuts the muscle at the lower end of the esophageal sphincter to allow food to pass more easily into the stomach. The procedure can be done noninvasively (laparoscopic heller myotomy). The downside to this is that some people who have a heller myotomy may later develop GERD. To avoid future problems with GERD, a procedure known as fundoplication may be performed at the same time as the heller myotomy.

Achalasia Achalasia is a rare disorder that makes it difficult for food and liquid to pass from the esophagus into the stomach.

It results from progressive degeneration of ganglion cells in the myenteric plexus in the esophageal wall, leading to failure of relaxation of the lower esophageal sphincter (LES), accompanied by a loss of peristalsis in the distal esophagus. As a result, the esophagus becomes paralyzed and dilated over time and eventually loses the ability to squeeze food down into the stomach. Muscles at the lower end of the esophagus fail to allow food to enter the stomach which causes food to then collect in the esophagus. This sometimes ferments and washes back up into the mouth creating a bitter taste. Some mistake this for gastroesophageal reflux disease (GERD) however, in achalasia the food is coming from the esophagus, whereas in GERD the material comes from the stomach.

Achalasia

Causes of Achalasia It is not well-known what causes achalasia, but different research indicates that there’s either a genetic component, it’s due to impairment of autoimmune system, or that it’s a nervous system disorder that degrades nerves in the chest that affect peristaltic movements. As for secondary achalasia, it’s due to diseases that cause esophageal motor abnormalities similar to those of primary achalasia.

During fundoplication, the surgeon wraps the top of the stomach around the lower esophagus to create an anti-reflux valve, preventing acid from coming back into the esophagus—better known as GERD. Fundoplication is usually done with a laparoscopic procedure.

The final recommended surgery to treat achalasia is peroral endoscopic myotomy (POEM). During the POEM procedure, the surgeon uses an endoscope inserted through the mouth and down the throat to create an incision in the inside lining of the esophagus. Then, as in a heller myotomy, the surgeon cuts the muscle at the lower end of the esophageal sphincter. POEM may also be combined with or followed by later fundoplication to help prevent GERD. Some patients who have a POEM and develop GERD after the procedure are treated with daily oral medication.

Srinivas Seela, MD, co-founder of the Digestive and Liver Center of Florida completed his gastroenterology fellowship at Yale University School of Medicine. His interests include colorectal cancer screening, Gastro Esophageal Reflux Disease (GERD), and other metabolic and liver disorders. Additionally, Dr. Seela contributes his knowledge to the medical community by dedicating time to being an Assistant Professor at the University of Central Florida School of Medicine. Visit www.dlcfl.com

Symptoms Symptoms of esophageal achalasia are usually progressive and can be mild to moderate and severe. Amongst the most common symptoms include: • Trouble swallowing food (dysphagia) • Food or liquid flowing back up into your throat (regurgitation) • Waking up at night coughing or choking due to regurgitation • Heartburn • Chest pain or pressure • Trouble burping • Hiccups • Weight loss

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Diagnosis Achalasia diagnosis can be easily missed as it presents with symptoms similar to other GI disorders. An endoscopy (EGD) should be performed to rule out other GI disorders and to exclude a malignancy at the esophagogastric junction that can mimic achalasia. Once that is done, esophageal manometry is the diagnostic test of choice. High resolution manometry is preferred as it has higher sensitivity compared to conventional manometry in diagnosing achalasia. High resolution manometry also better defines achalasia phenotypes. Diagnostic manometric findings of achalasia are incomplete relaxation of the lower esophageal sphincter with pressures above the upper limits of the normal and aperistalsis in the distal two-thirds of the esophagus.

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Treatment There is low but increased risk of esophageal cancer with achalasia. Without treatment, symptoms can be progressive and devastating. Achalasia treatment focuses on relaxing or stretching open the lower esophageal sphincter so that food and liquid can move more easily through the digestive tract. This can be accomplished by mechanical disruption of the muscle fibers of the LES by medical or surgical treatment options. Precise treatments—whether

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LAKE UNDERHILL RD

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Marie Shorey, CCIM

(407) 383-8142 | marie@palkiper.com

The Dangers of Benzodiazepine Misuse • Disorientation • Esophageal Spasms • Flu-like Symptoms • Gastritis • Intrusive Thoughts • And many more

BY HILARY ORTEGA AND DR. REBECCA WANG-HARRIS

Benzodiazepines fall under the class of medication called anxiolytics.

They are considered schedule IV controlled substances that doctors can prescribe for several conditions. These medications can prove helpful in treating anxiety, insomnia, seizures, and more. Sometimes they can even be prescribed for off-label use, based on the guidance of a physician.

However, the problem is that benzodiazepines can also be heavily abused and can result in severe damage. They are addictive and can harm a person’s body, mind, and family. According to WebMD, if left untreated, abusing benzodiazepines can negatively impact your relationships, career, and physical and emotional health. It is not worth the risk. The risk of Benzodiazepine Withdrawal Symptom is too great.

Withdrawal from benzodiazepines can be a complicated and extended challenge and can have life-altering consequences. If you are in Florida and dealing with benzodiazepine withdrawal, you should consult an accredited, professional program.

Symptoms may sometimes be exacerbations of existing medical and psychological issues as well. These symptoms, recorded from those who have experienced benzodiazepine withdrawal, can still occur when taking the medication due to physical dependence – they can also be found during tapering. A professional and accredited taper program can help reduce the dramatic symptoms of withdrawal.

Benzodiazepine Counseling These symptoms are signs that benzodiazepine usage has become a problem, and withdrawal can be dangerous when not handled properly. Chronic use of benzodiazepines may be an indication of a need to taper off the medication as they are intended for short term use. Abruptly stopping the medication can lead to withdrawal which has its risks as well; including but not limited to onset of seizures.

Breaking the Habit Benzodiazepine addiction, like any addiction, can be a tough cycle to break, especially when you factor in the potentially debilitating effects of benzodiazepine withdrawal. These drugs can alter the brain’s chemistry so that your body feels the substance is needed and is prioritized.

No wonder quitting an addiction can be such a challenge.

If you think you are ready to leave the cycle of benzodiazepine addiction for good and want to beat the withdrawal symptoms, you need to take advantage of professional help.

About Benzodiazepines Benzodiazepines can be highly controversial because of their addictive properties and are one of four medications prescribed with caution. Yet, 5 percent of adult Americans are prescribed this medication, resulting in a significant number of cases of withdrawal as prescriptions come to an end. When used appropriately, benzodiazepines can be helpful, however, they always remain a risky prospect with benzodiazepines withdrawal occurring as little as one month after use.

Benzodiazepine withdrawal symptoms can vary based on a number of factors, including the dosage and length of usage. Other factors can include whether there is more than one medication or sedating drug used concurrently and a history of substance abuse issues. Even quitting more than one substance at a time can exacerbate and challenge the quitting process, intensifying withdrawal effects.

Professionals can mitigate such risks, through a medically assisted benzodiazepine taper program.

Anxiety is Manageable Anxiety can be genetic, learned through repeated dysfunctional experiences with family members or other significant people in one’s life, or caused by one or more traumatic events. Anxiety takes many forms. For instance, Post-Traumatic Disorder and Generalized Anxiety Disorder result from emotionally painful experiences which alter one’s brain chemistry and cause various physiological symptoms, such as insomnia, gastrointestinal distress, migraines, and panic attacks. Taking a prescribed or unprescribed anti-anxiety medication is very tempting

Benzodiazepine Withdrawal Symptoms Common benzodiazepines such as Valium and Xanax can be and often are abused by young adults. These drugs are sometimes known as “Benzos” and “Downers” and can be abused, and often a person may not even realize they are addicted. However, one doesn’t need to be addicted to experience the withdrawal symptoms either. These drugs are that influential on the body.

When it comes to withdrawal from benzodiazepines, there is an alphabet’s worth of conditions. These withdrawal and post-withdrawal symptoms are a direct result of stopping benzodiazepines after significant usage. These effects are even the result of stopping common benzodiazepines like Valium, Klonopin, Xanax, Tranxene, Onfi, Librium, and Ativan.

Some of the many symptoms of benzodiazepine withdrawal include, but are not limited to: • Achiness • Agoraphobia • Allergic Reactions • Brain Fog • Breathlessness • Choking • Cramping • Depression

for someone who cannot sleep, who experiences discomfort throughout the day, who has difficulty with work or academics, and who cannot control ruminating, negative, and/or traumatizing thoughts. After a prescribed anti-anxiety medication is taken for even a few months, a person’s brain function becomes dependent on that medication for relaxation and relief of other anxiety symptoms.

Various psychotherapeutic approaches, in these cases, the main goal is to continue to provide support emotionally, mentally, and behaviorally and to enhance and empower toward increased self-awareness. Each person’s history is unique, as is the approach to assist with the development and maintenance of daily coping skills, increased self-awareness, and personal growth. Anxiety can be a lifelong struggle for many people, and prescribed benzodiazepine medications can be very desirable in reducing or erasing anxiety. However, these medications are physically addictive. Tapering off or stopping these medications causes mild to severe withdrawal symptoms, depending on the level of daily dosages taken. The ability to confront and revise one’s thoughts is necessary in the process of anxiety management with the help of psychotherapy. Thoughts and life circumstances are the causes of anxiety. Although we often cannot control circumstances, we can control our thoughts and behavioral responses in every moment.

Hilary Ortega, MSN, is CEO and Owner of New Age Psychiatry with 11 years of experience working in the healthcare industry in both psychiatric and medical fields. Dr. Rebecca Wang-Harris professor and therapist has over 28 years’ experience in providing psychotherapy. New Age Psychiatry provides medication management and counseling at affordable rates for a wide range of psychiatric conditions across the state of Florida virtually. Email her at info@newagepsychiatry.com

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How to Prevent ‘Cognitive Overload’ in Your eLearning Modules learning effectiveness.”

When selecting imagery, you should try to follow these guidelines: Select either illustrations OR photos for your module.

BY CHERYL POWELL

Ever wonder what the rules of engagement were for using text and graphics in eLearning?

• Ensure illustrations are up-to-date and not cartoon style images from more than five years prior.

I see a lot of eLearning where graphics may be distracting FROM the content, instead of engaging the learner TO the content.

For example, should you use illustrations or high-resolution photos? Well, to be honest, you can use either, as long they are high quality, high-resolution, and consistent.

Unfortunately, that means you have to make a choice between the two and use them consistently throughout.

Consistency is key when it comes to any type of learning, but in doing some research about imagery and cognitive learning, I stumbled across an article by Stephen D. Sorden of Mohave Community College/Northern Arizona University entitled, “The Cognitive Theory of Multimedia Learning”. In the article, he asserts: “Multimedia learning happens when we build mental representations from words and pictures. The theory has largely been defined by Mayer’s cognitive theory of multimedia learning.” “…They assert that people learn more deeply from words and pictures than from words alone, which is referred to as the multimedia principle (Mayer 2005a)...Multimedia instructional design attempts to use cognitive research to combine words and pictures in ways that maximize

• Ensure photos are either horizontal OR vertical, but not both.

• Text on the screen should not describe the image.

• Ensure photos are either color OR black and white, but not both.

• Text on the screen should not be in paragraph format, but in brief, key words related to the topic.

• Ensure photos on the screen are 100 percent relevant to the topic being discussed.

• Align text and graphics on the screen to eye-level.

Next, let’s talk a bit more about that ‘cognitive overload.’ In an article by William Swann of MindLeaders, Inc., “The Impact of Applied Cognitive Learning Theory on Engagement with eLearning Courseware,” he states: “Display of visuals and on-screen text at the same time can overload the visual information processing system, but using the audio system for verbal information and the visual system for imagery is a more efficient division of labour (Mayer & Moreno, 1998b, p. 4). In short, words go better through the ears and images go better through the eyes.”

What does this really mean? Well, it ultimately translates to three things: • Text on the screen should not duplicate the audio narration exactly.

The reasoning for this lies in the split-attention principle. In summary: “…the split-attention principle — can be evaluated individually through an additional comparison of two-page designs. The first design is one that shows all linguistic content as text on the page, and, at the same time, provides full audio narration of the on-screen text.

Associated imagery appears concurrently on the screen.

In this design, text is being doubled, with the same words flowing through two modalities.”

These two modalities are the eyes and ears, forcing the learner to listen and read simultaneously.

Cheryl Powell is CEO of GC Learning Services, LLC, dba Learn2Engage, a virtual custom elearning and Training Development Solutions provider for businesses in Healthcare and Pharmaceuticals among others. Educate your employees, new hires, or even clients on a new policy/procedure, product/service, or skill, with engaging, interactive, custom e-Learning modules with high retention rates. Email her at info@learn2engage.info or visit www.learn2engage.info

Advanced Technology for Advanced Healthcare Get the network that can keep up with the rapidly changing health care industry.

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AdventHealth Winter Park - FL

COVID Year 2: Holiday Stress and Depression

SEMINOLE COUNTY AdventHealth Altamonte Springs - FL Orlando Health South Seminole Hospital - FL Oviedo Medical Center - FL Central Florida Regional Hospital - FL

Announcing the PSCF 2022 Annual Meeting MARK YOUR CALENDAR! The 2022 Physicians Society of Central Florida Annual Meeting and Installation of Officers is being held at Interlachen Country Club in Winter Park, FL Tuesday, January 25, at 6:30pm, and we look forward to gathering again with friends and colleagues.

Physician members will enjoy an elegant evening that starts with a cocktail reception and vendor exhibit hall, delicious dinner, live music, and speaker presentations.

Join us as we thank our outgoing President, Dr. Charles Chase and welcome incoming President, Dr. Samuel Jean.

The Annual Meeting usually has over 100 attendees.

The PSCF welcomes business representatives to attend the event through sponsorship. If your company is interested in attending, please see the attached exhibitor prospectus for more details or reach out to Carrie Pope at carrie@pscfl.org

11. Have a healthy snack before holiday parties to reduce eating sweets, cheese, or drinks.

12. Get plenty of sleep. Incorporate regular physical activity into each day by taking a walk with the family.

13. Practice mindfulness. Sit and recognize the world around you: the sounds, sights, and smells you might typically ignore. Mindfulness helps our brains reset and keeps us feeling well.

14. Take a breather. Spend 15 minutes alone each day without distractions to clear your mind, slow your breathing, and restore inner calm. Take a walk, listen to music, get a massage or read a book.

15. Seek professional help if you need it. Despite your best efforts, you may find yourself feeling persistently sad or anxious, plagued by physical complaints, unable to sleep, irritable and hopeless, and unable to face routine chores. If these feelings last, talk to your doctor or call a counselor.

16. This holiday season brings different challenges than the last. The pandemic has sustained longer than anticipated, and each individual is at a different stage of pandemic management. Many of us will face increased stress, anxiety, and depression this holiday season, and intervention is critical. Acknowledging these issues, planning, and focusing on things in one’s control, ensures a more successful holiday experience.

OSCEOLA COUNTY AdventHealth Celebration - FL Poinciana Medical Center - FL Osceola Regional Medical Center - FL AdventHealth Kissimmee - FL Orlando Health St. Cloud Hospital - FL LAKE COUNTY Orlando Health South Lake Hospital - FL AdventHealth Waterman - FL SUMTER COUNTY UF Health The Villages Hospital - FL MARION COUNTY Ocala Regional Medical Center - FL AdventHealth Ocala - FL West Marion Community Hospital - FL VOLUSIA COUNTY Halifax Health Medical Center - FL AdventHealth Daytona Beach - FL AdventHealth DeLand - FL AdventHealth New Smyrna Beach - FL AdventHealth Fish Memorial - FL Halifax Health Medical Center - Port Orange - FL

With a doctorate in clinical psychology and over 20 years of experience in the field, Dr. Mary-Catherine Segota has conducted university-based behavioral medicine research, acted as a consultant to professionals and organizations, and worked with a diverse number of psychological and medical conditions. By identifying unique needs, the source of distress, and what’s perpetuating the problem, she will help develop the tools to overcome seemingly insurmountable circumstances. Visit www.

CounselingResourceServices.com

BREVARD COUNTY Cape Canaveral Hospital - FL Melbourne Regional Medical Center - FL Holmes Regional Medical Center - FL Viera Hospital - FL Central Florida Regional Hospital - FL Parrish Medical Center - FL Across all states, highlights of findings from the fall 2021 Leapfrog Hospital Safety Grade include: Thirty-two percent of hospitals received an "A," 26% received a "B," 35% received a "C," 7% received a "D," and less than 1% received an "F.” The five states with the highest percentages of "A" hospitals are Virginia, North Carolina, Idaho, Massachusetts, and Colorado.

There were no "A" hospitals in Delaware, Washington, DC, and North Dakota.

For more information about the Hospital Safety Grade, including details on individual hospital grades and state rankings, please visit HospitalSafetyGrade.org. You may also view planned changes to the 2022 Leapfrog Hospital Safety Grade and submit public comment on the changes.

Leapfrog Safety Grades for Central Florida Hospitals The Leapfrog Group, a national watchdog organization of employers and other purchasers focused on health care safety, has released the fall 2021 Leapfrog Hospital Safety Grade, which assigns a letter grade to U.S. general hospitals based on how well they prevent medical errors, accidents, injuries, and infections that kill or harm patients. The fall 2021 Hospital Safety Grade represents the largest set of hospitals ever graded with grades assigned to 2,901 facilities. The Safety Grades reflect performance on more than 30 evidence-based measures of patient safety, including for the first time, post-operative sepsis, blood leakage, and kidney injury.

Among the new measures incorporated into the grade is post-operative sepsis, which results in suffering, disability, and sometimes death for an estimated 160,000 people a year in the United States. Overall, sepsis in all settings, including post-operative sepsis, kills over 270,000 people a year and is the costliest condition in U.S. hospitals.

The condition does not affect all populations equally; for instance, Black people are twice as likely as white people to be diagnosed with sepsis. At HospitalSafetyGrade.org, the public can find detailed information about a hospital’s performance on post-operative sepsis and other measures used to grade hospitals.

The fall grades show significant variation in patient safety performance across U.S. hospitals, which underscores the importance of access to information that allows patients to select the safest hospital available to them.

Undocumented Midnight Immigrant Releases in Florida Raise Health Concerns Two federal agencies refused to comment on questions about the Biden administration allegedly flying migrants from the US-Mexico border to Florida in the middle of the night without notice to local authorities, and the state of their health. Questions emailed to the spokesperson for U.S. Customs and Border Protection (CBP) by Orlando Medical News were answered with a denial they conduct flights. Immigrations Customs Enforcement says they cannot provide further information than CBP. OMN has asked about the movement and placement of undocumented immigrants to the central Florida area and to what degree border agencies are able to pre-screen them for vaccinations they may be current with, both typical childhood vaccines and, of course, the Covid vaccine. This information would be intended to help providers understand how well the influx of new potential patients are protected and thus the protection of those around them.

Questions left unanswered for weeks with the agencies: What numbers of immigrants have been released to fly to Florida? Comments on the claims that as of the first of June, there have been as many as 70 flights with about 35

HOSPITAL REPORTS FROM ORLANDO MEDICAL NEWS COVERED COUNTIES ORANGE COUNTY AdventHealth Apopka - FL Orlando Health Health Central Hospital - FL Orlando Health- Orlando Regional Medical Center - FL Orlando Health Dr. P. Phillips Hospital - FL AdventHealth Orlando - FL AdventHealth East Orlando - FL

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people each transported to Jacksonville alone.

Other questions asked by OMN that went unanswered include: Is it the goal of CBP to screen 100 percent of people before they are relocated? If someone is obviously sick, are they quarantined before being relocated? Once relocated, are they screened at that point before being released on their own or are they advised where to go for medical care and, if so, is it mandatory they do so?

Typically, do the undocumented immigrants bring with them any kind of vaccination records? Of screenings that may be done for their health, what are some of the most frequently found issues they need care for?

The State of Florida has filed a lawsuit against the Biden Administration over the releases. “Here’s what happens with these flights,” Gov. Ron DeSantis said during a press conference. “There’s no notification to the state of Florida. These are done mostly in the middle of the night.

And it’s clandestine.

Christina Pushaw, press secretary for the Governor added, “The Biden Administration flights that were transporting illegal migrants into Jacksonville have stopped for about a month. We do not know the reason for this, because Biden’s DHS and HHS have always conducted these operations in a clandestine manner without informing state authorities of their plans for the flights.

Therefore, it’s possible that the flights could resume, but we cannot predict when or if that might happen.”

In a statement, Jacksonville Mayor Lenny Curry said he’s spoken with Gov. Ron DeSantis about the issue.

“Planes dropping off those that have crossed our borders illegally in the dead of the night violated the rule of law,” Curry said. “I have been working with @GovRonDesantis to stop this recklessness. To be specific, this is happening in Jacksonville without any communication with us. We hear about it after they land.”

“Mayor Curry met with Governor DeSantis, law enforcement and the CEO of Jacksonville International Airport Friday, November 19th, to discuss the many flights coming into Jacksonville, most landing in the middle of the night without confirmation of who is on board or whether they entered the city, or country, legally,” a statement from the mayor’s office said.

“Mayor Curry is concerned about the secrecy of these flights as his top priority has been, and continues to be, public safety. While the flights appear to have stopped for the time being, Mayor Curry, like the governor, is seeking transparency and supports the lawsuit filed by The State of Florida seeking more information.”

Lake-Sumter Medical Society Hosts Happy Hour Pisces Rising, in charming downtown Mount Dora, was the setting for the first live event for Lake and Sumter County physicians in over a year! It was a wet, soggy day but these hearty souls weren’t going to let sideways rain stop them! And they were greeted with laughter, cocktails, great food and warm hugs.

Dr. Wendy Lavezzi (Leesburg) was quick to say “we need-

ed this!” with a resounding “cheers to that!” by Dr. Ken Stark (Tavares). “Its so good to see everyone!” said Dr. Shelley Glover (Clermont) as she greeted colleagues.

The Lake-Sumter Medical Society wishes to thank Barrett, Liner & Buss, LTD for their sponsorship and announces an upcoming virtual CME event in January as well as a social event in February.

New Covid Testing Site Opens in The Villages Genesis Reference Laboratories opened anew community Covid-19 testing site in The Villages off 466 and Buena Vista. We have partnered with Dr. David Kuhn, Covid Test Express and a property developer to bring another centralized and convenient testing location to Lake County.

Location: 11714 NE 62nd Terrace, The Villages FL 32162 Hours: Monday-Friday 8am-4pm, Closed Saturday & Sunday

company’s commitment to the innovative and economic growth of the Central Florida region,” states Rubin.

Operating under the name Smart City Metro, Smart City delivers enterprise-class network and business communication services, including Fiber Internet Access, Ethernet Access, Hosted Voice and Unified Communications, Managed Services, SD-WAN, and colocation. With a proven history of experience building and maintaining custom telecommunications services for businesses in Central Florida, Smart City provides reliable, technologically advanced communication services, dedicated account management, professional 24x7x365 technical support, and the most responsive, locally based customer care available.

For more information, visit https://smartcitymetro.com

Smart City Expands Its Footprint to More of Central Florida With a laser-focus on meeting the communication needs of the healthcare community, Smart City, an established Orlando based-telecommunications provider, is now expanding its footprint throughout Central Florida to deliver services to businesses in Orange, Seminole, Osceola, and Brevard counties. Smart City has built over 700 additional miles of fiber network to begin offering fiber and voice services beyond its current serviceable areas of Lake Buena Vista and Celebration, including the Walt Disney World properties.

“We are excited to be growing our service area to serve more businesses in this region, including fiber from Palm Bay to Cape Canaveral. We are putting a laser-focus on meeting the communication needs of the healthcare community” states Marty Rubin, CEO of Smart City.

Smart City has a long history of innovation in Central Florida, including delivering the first fiber optic network in the country and the first 911 service in Florida. Smart City has been a trusted partner of the Walt Disney World Company and the neighboring hotels, restaurants, homes, condos and multiple dwelling units, retail stores, and other businesses since 1971, and the Orange County Convention Center since 2003.

“While Smart City is a national company with operations in 17 states, Orlando is our home headquarters.

This fiber network expansion is another example of the

January 19 3:00PM-5:00PM TOPIC

SO THE PANDEMIC PANIC IS OVER, NOW WHAT?

INDUSTRY LEADING SPEAKERS VOLUSIA/BREVARD || GRAND ROUNDS Medication-Assisted Treatment Center Now Open in Port Orange Port Orange — Adults in the Port Orange area who have been struggling with addictions to heroin, prescription painkillers, or other opioids now have access to a highly effective form of outpatient treatment.

Volusia Comprehensive Treatment Center (CTC) opened November 8. Located at 3928 South Nova Road, Port Orange, the center provides medication-assisted treatment (MAT) for adults age 18 and older.

“Opioid addiction continues to have a devastating impact on a staggering number of people across the country,” said Volusia CTC Clinic Director Ashley Dale. “Volusia CTC provides adults with personalized, compassionate care that sets the groundwork for lasting recovery from

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Clinical Perspective Tony Cowan, Certified Senior Clinical Research Associate Contractor at Cowan Research & Consulting, LLC Human Resource’s Perspective Wendy Sellers, MHR, The HR Lady, LLC Financial Perspective - Jeffrey Holt, VP, CMPE, Senior Healthcare Business Banking Advisor at PNC Bank

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Parrish Healthcare Center at Port Canaveral Reopens to the Public

opioid addiction.”

The U.S. Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) are among the many respected organizations that recommend MAT as a safe and effective means of achieving recovery from opioid addiction.

Outpatient MAT at Volusia CTC incorporates medication and counseling.

Following a thorough assessment and a consultation with one of the center’s doctors, patients at Volusia CTC may receive a prescription for methadone, buprenorphine, or Suboxone. When used as directed within the context of a licensed MAT program, these medications allow people to end their opioid abuse without experiencing the powerful cravings and painful withdrawal symptoms that would otherwise occur.

In addition to receiving medication, Volusia CTC patients will also participate in individual and group counseling. These sessions can help patients identify and address the many factors that may have contributed to their opioid abuse and other self-defeating behaviors. During counseling, patients can begin to develop the skills and strategies that will empower them to achieve successful long-term recovery from opioid addiction.

To schedule an intake appointment at Volusia Comprehensive Treatment Center, call (855) 370-8100.

Titusville — After a 21-month closure due to the COVID-19 pandemic, Parrish Healthcare Center at Port Canaveral has reopened.

Parrish Healthcare Center at Port Canaveral hours of operation are Monday-Friday from 8 a.m. – 5 p.m. and is located at 390 Challenger Road, Cape Canaveral, Florida.

This site offers primary care and occupational health services to those ages 18 and up as well as sports physicals to individuals of all ages.

Denise McBroom, PA, will be the onsite provider at the Port Canaveral location. McBroom is a graduate of the Medical College of Georgia and has over 22 years of experience. She has a strong history of success in meeting patients needs by leveraging her healthcare expertise to diagnose and treat conditions.

Additional services offered at Parrish Healthcare Center at Port Canaveral are medication management, wellness programs, x-rays, EKG’s, vision screening, drug and alcohol testing, immunizations and lab services. New patients welcome. Most insurances accepted.

For more information about Parrish Healthcare Center at Port Canaveral or to make an appointment, call 321-6338640 or visit parrishhealthcare.com/portcanaveral

Dr. Andreoiu explained how her associates take the time to sit down and understand what the patient’s goals are before deciding on a variety of treatment plans.

“The whole urogynecology department is absolutely wonderful, from the people who check you in to the people who check you out,” Liz said. “In fact, to be honest with you, I look forward to going to their appointments.

I'm like, ‘I can't wait to see all my friends, including Dawn, Rosemary, Megan, Suzanne and Dr. Tieu, because we’ve really become friends after all these years.”

Take back control of your body. Start by taking the Health First incontinence assessment at https://hf.org/ womenandchildren/quiz/urinary-incontinence.cfm

Health First Urogynecology Department First in Florida to Receive Center of Excellence Accreditation

St. Francis Reflections Lifestage Care Announces New In-Patient Unit

Melbourne – Having urinary incontinence is something that can feel embarrassing, but it need not be – especially with personalized care provided by providers who specialize in such a sensitive issue. Just ask Liz Unger, who feels lucky to have found Dr. Aimee Tieu with the Health First Urogynecology Department. She is one of the 25 million adult Americans (of whom 75-80% are women) who suffer from some form of urinary incontinence.

Things most people wouldn’t even think of come to light with treatment. For example, Dr. Tieu advised Liz how to deal with the “Lock and Key” effect she sometimes experienced – once Liz pulled her car in the driveway and got out, her incontinence would strike.

“I was taught that when your brain sees the front door of your house, the ‘key’ does whatever it wants to do,” Liz said.

“This is nothing to be ashamed of, and I learned from Dr. Tieu that as you get older, these problems are more common.”

Dr. Tieu and her team helped put Liz on the path to being worry free and unashamed when it comes to her bladder woes. Helping Liz and countless others with their incontinence issues is one of the many reasons Health First’s Viera Hospital is the first team in Florida to ever be designated a Center of Excellence in Continence Care for Women by the Surgical Review Corporation, a nonprofit safety organization recognizing best-in-class safety and quality of patient care. The accreditation program leads to top-class safety measures, and the excellence award shows a commitment to lower costs associated with proven treatments.

Dr. Tieu is joined by Dr. Carey Andreoiu, Medical Director of the Pelvic Center of Excellence, and a highly skilled staff including Suzanne Schoenrock APRN who was nominated by SRC as a Continence Care Specialist.

The team takes part in continuing education throughout the year to ensure they are up to date on all treatment options, both conservative and procedural. This training includes not only the office staff, but all associates who participate in the care of patients from the time they enter the office until they are discharged from the hospital if they have surgery, ensuring patients receive exceptional care every step of the way.

“Our entire team is immensely proud to be recognized for the hard work and excellent care we provide every day,” Dr. Andreoiu said. “The staff and our patients are aware of the excellent care that we give, and I am so happy to see this standard of excellence recognized and rewarded.”

Titusville - St. Francis Reflections Lifestage Care, in partnership with Courtenay Springs Village, is pleased to announce a newly renovated hospice care center that will be open to the public on November 15, 2021. The in-patient unit will bring hospice and respite care closer to home for all residents of central Brevard, Merritt Island, and the beaches.

“Our nonprofit was founded on the philosophy of neighbors helping neighbors,” said Joe Killian, President and CEO of St. Francis Reflections Lifestage Care. “We are committed to providing the most compassionate and comfort-focused care in all of Brevard County. Our neighborhood is growing! Given recent population surges and an increase in demand for our services due to the pandemic, we must continue expanding to meet the needs of our neighbors, which is exactly what we will do.”

The in-patient unit is intended for the short-term management of complex symptoms and periods of respite where families can rest knowing their loved ones are being cared for with compassion and dignity. Located at 1100 South Courtenay Pkwy in Merritt Island, the St. Francis Reflections in-patient unit at Courtenay Springs Village will feature private rooms with en suite bathrooms, 24/7 facility access for family members, a shared kitchenette with food provided by the facility for family members, and tranquil outdoor space for mediation and reflection.

The 24/7 family access will be offered in accordance with current health guidelines and safety protocols from the U.S. Centers for Disease Control and Prevention.

“Courtenay Springs Village is happy to announce their partnership with St. Francis Reflections Lifestage Care. St. Francis Reflections will be opening their new in-patient unit within our Skilled Nursing Facility,” said Michael Rivera, East Coast Regional Administrator. “Together we can provide the care and services that our patients and families need. We are honored to be a part of this collaborative effort to help better serve our community.”

The in-patient unit will be entirely staffed by St. Francis Reflections staff, including its board-certified hospice and palliative medicine physicians, social workers, and chaplains.

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DECEMBER 2021

New Trauma Surgeons Join UF Health Trauma Surgery at Halifax Health Daytona Beach – Halifax Health collaborates with University of Florida Health to bring the most elite trauma surgeons to our community. Joe Olivi, MD, Loretta L. Brestan, MD, Jens B. Flock IV, MD, and Joseph Lewis, DO, are joining UF Health Trauma Surgery at Halifax Health to play a critical role in saving lives in Volusia, Flagler and Brevard counties.

Joe Olivi, MD, is a board-certified general and critical care surgeon assuming the role of medical director for UF Health Trauma Surgery for Halifax Health. Dr. Olivi attended Ross University School of Medicine before completing a general surgery internship at St. Luke’s-Roosevelt Hospital for Physicians and Surgeons and a general surgery residency and critical care surgery fellowship at the University of Missouri School of Medicine.

Board-certified general surgeon, Loretta L. Brestan, MD, went to medical school at the University Of Miami Miller School Of Medicine before attending University of Alabama at Birmingham School of Medicine for her surgical internship and residency.

With over 20 years of experience in the field, Dr. Brestan specializes in traumatic surgery and critical care medicine.

Jens B. Flock, IV, MD, is a board-certified general surgeon specializing in traumatic and laparoscopic surgery.

After attending Florida State University’s College of Medicine, Dr. Flock pursued a general surgery residency at New Hanover Regional Medical Center before relocating to Florida to complete a surgical and critical care medicine fellowship at the University of Florida College Of Medicine.

After obtaining his doctor of osteopathic medicine at the University of Pikeville, Joseph Lewis, DO, pursued a general surgery residency at Stony Brook Medicine and a surgical critical care fellowship at Orlando Health, respectively. As a board-certified general surgeon, Dr. Lewis specializes in critical care medicine and traumatic surgery.

UF Health Trauma Surgery at Halifax Health prioritizes patient care by employing the most experienced, passionate professionals in the field. To learn more about the services offered by Dr. Olivi, Dr. Brestan, Dr. Flock or Dr. Lewis, please visit UF Health Trauma Surgery at Halifax Health at halifaxhealth.org/trauma

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DECEMBER 2021