Resource by Sole Sastre

[resource] BAPTIST HEALTH SOUTH FLORIDA

SPRING 2015

Countdown to Stroke Survival New High-Tech Treatments Save Lives

Tiny Innovations Offer Big Improvements Social Networks Help the Healing Process

Letters

[CONTENTS]

6855 Red Road, Suite 600, Coral Gables, FL 33143 • BaptistHealth.net To send comments and address changes or to unsubscribe, email MyResource@BaptistHealth.net.

earning that you have a serious illness or require surgery is an unsettling and very frightening experience. Therefore, it is important that a patient entering a hospital or rehabilitative facility be enveloped in an atmosphere that is professional, reassuring and nurturing. Patients must have confidence in the expertise of the medical professionals, the pristine condition of the facility and the pride in service of the support staff to whom they entrust their health and safety. Thank you to all the professionals at Baptist Hospital, where I had a total knee replacement with Dr. Francisco Borja. They not only made my experience less daunting but also enhanced my journey toward recovery through their superb aptitude and personal commitment to excellence. Despite any difficulties that I experienced (I suffered a fall the day following surgery), these professionals bolstered my confidence and alleviated the enormous weight of uncertainty by allaying my fears. No accolades will ever be enough to laud the following medical professionals: clinical partners Heather Gibson, Frances Medrano and Lorena Espinoza; nurses Hugo Macias, R.N., Liezel Garces, R.N., and Joanne Santiago, R.N.; phlebotomist Irene Plasencia; and assistant nurse manager for orthopedics Renee Culp, R.N. Their compassion touched my heart, their medical expertise attended my body and their encouragement renewed my soul. Each is very special!

Sincerely, Miriam White Williams South Miami-Dade

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BAPTIST HEALTH SOUTH FLORIDA Board Chair, the Rev. Dr. William W. White; President and Chief Executive Officer, Brian E. Keeley; Trustees: Jane Alonso, R.N., Sheldon Anderson, Calvin Babcock, Yerby Barker, George Cadman III, James Carr, the Rev. William Chambers III, George Corrigan, Richard Dailey, William Dickinson, Joyce Elam, Herbert Greene, M.D., Jay Hershoff, Charles Hood III, the Rev. Dr. Gary Johnson, Norman Kenyon, M.D., Rudy Kranys, the Rev. Richard Ledgister, the Rev. Wilner Maxy, Paul May, the Rev. Dr. Marcos Ramos, Aida Shafer, Ronald Shuffield, Janá Sigars-Malina, Roberta Stokes, Bill Tillett, J. Scott Weston, William Wilson III.

New miniature devices help improve patients’ outcomes and quality of life.

BAPTIST HOSPITAL OF MIAMI Board Chair, Calvin Babcock; President, Baptist Hospital Medical Staff, Michael Fili, M.D.; Chief Executive Officer, Bo Boulenger. DOCTORS HOSPITAL Board Chair, Norman Kenyon, M.D.; President, Doctors Hospital Medical Staff, Ruben Penaranda, M.D.; Chief Executive Officer, Nelson Lazo.

04 Just for Women

Though it’s often embarrassing, there’s no need to suffer from incontinence in silence.

HOMESTEAD HOSPITAL Board Chair, the Rev. William Chambers III; President, Homestead Hospital Medical Staff, Jorge Mejia, M.D.; Chief Executive Officer, William Duquette. MARINERS HOSPITAL Board Chair, Jay Hershoff; President, Mariners Hospital Medical Staff, Kenneth Ahonen, M.D.; Chief Executive Officer, Rick Freeburg.

06 Kid Stuff

A local family welcomes healthy quadruplets at South Miami Hospital.

SOUTH MIAMI HOSPITAL Board Chair, Yerby Barker; President, South Miami Hospital Medical Staff, Jeremy Tabak, M.D.; Chief Executive Officer, Lincoln Mendez. WEST KENDALL BAPTIST HOSPITAL Board Chair, Aida Shafer; President, West Kendall Baptist Hospital Medical Staff, Juan-Carlos Verdeja, M.D.; Chief Executive Officer, Javier Hernández-Lichtl.

08 Spotlight

BAPTIST OUTPATIENT SERVICES Board Chair, Roberta Stokes; Chief Executive Officer, Patricia Rosello.

Barbara Russell, R.N., has devoted her life to keeping infectious diseases from spreading.

BAPTIST HEALTH ENTERPRISES Board Chair, James Carr; Chief Executive Officer, Ana Lopez-Blazquez.

16 The Second Act

BAPTIST HEALTH MEDICAL GROUP Board Chair, Herbert Greene, M.D.; Chief Executive Officer, Bernie Fernandez Jr., M.D.

Whether for fun or for health, older adults reap benefits from joining an exercise group.

BAPTIST HEALTH SOUTH FLORIDA FOUNDATION Board Chair, William Wilson III; Chief Executive Officer, William Banchs. DIRECTORS OF AFFILIATED BOARDS Jose Aguirrechu, Kenneth Ahonen, M.D., Yvette Aleman, Richard Alger, Cira Almeida, Anthony Alonso Jr., DMD, Jane Alonso, R.N., Dick Anderson, Sheldon Anderson, George Aronoff, Calvin Babcock, Orlando Bajos, William Baldwin, Oscar Barbara, James Barker, Yerby Barker, Rodney Barreto, Matthew Becherer, Rodney Bell, James Benenati, M.D., Mark Bennington, Robert Berrin, the Rev. Dr. Rick Blackwood, Bonnie Blaire, James Bokor, Joseph Bolton, Steven Brodie, Bette Brown, Joseph Buchanan, Daniel Buraglia, Mita Burke, Robert Burstein, George Cadman III, Barbara Calev-Moran, Willie Carpenter, James Carr, Susan Carr, Missy Carricarte, Gerald Case, Ray Castellanos, Mauricio Cayon, the Rev. William Chambers III, Barron Channer, Griselle Chernys, Neil Chrystal, Phil Conway, George Corrigan, Robert Coward, Richard Dailey, Donald Darrach, Agustin De Goytisolo, Liana De Mena, Elizabeth Diaz de Villegas, William Dickinson, Lani Kahn Drody, Joyce Elam, Tomas Erban, Justo Fanjul, Theodore Feldman, M.D., the Rev. Otto Fernandez, Pedro Fernandez, Armando Ferrer, Deborah Figaro, Michael Fili, M.D., Karel Foti, Arturo Fridman, M.D., Donald Gallo, DMD, Carlos Garcia, Ygnacio Garcia-Saladrigas, Peter Gardner, Maria Garza, Alex Gierbolini, William Gilbert Jr., Robert Gintel, Paul Gluck, M.D., Richard Gomez, Jose Antonio Gonzalez, Gretchen Goslin, Kristina Rae Gossman-Ducanes, Michael Graham, M.D., Herbert Greene, M.D., Leif Gunderson, Ghassan Haddad, M.D., Barry Halpern, M.D., Kent Hamill, Barbara Hanck, James Harris, Ilien Hechtman, William Henneberry, Alysa Herman, M.D., Luis Hernandez, Mark Hernandez, M.D., Agustin Herran, Jay Hershoff, Charlotte Hicks, Audra Hill, Charles Hood III, Sherrill Hudson, Jacque Huttoe, Abel Iglesias, Jeanne Jacobs, Lourdes Jofre-Collett, the Rev. Dr. Gary Johnson, Yvonne Turner Johnson, M.D., Lane Jones, Thomas Jones Jr., S. Lawrence Kahn III, George Kakouris, Barry Katzen, M.D., Judith Katzen, Norman Kenyon, M.D., Hank Klein, George Knox, Robert Kramer, Rudy Kranys, Charles Kropke, Samir Kulkarni, M.D., Jon Landau, Manuel Lasaga, the Rev. Richard Ledgister, Cynthia Leesfield, María Camila Leiva, Orlando Leon, M.D., James Loewenherz, M.D., Miriam Lopez, Carlos Lowell, Victoria Lowell, John Maas, Bruce Wirtz MacArthur, Stanley Margulies, M.D., Michael Marquez, Joy Martin, Charlie Martinez, Miguel Maseda, the Rev. Wilner Maxy, Paul May, Joseph McCain, DMD, Joanne McGregor-Ganus, Cheryl Anne Meads, Jorge Mejia, M.D., Fernando Mendoza, M.D., Juan Antonio Michelena, Niberto Moreno, M.D., Hans Mueller, Patricia Mull, Thomas Murphy Jr., Abe Ng, Paula Owens, Ramon Oyarzun, Martha Pantin, Arva Moore Parks, M. Johanna Paterson, Ruben Penaranda, M.D., Jorge Perez, M.D., Lillian Peters, Ann Pope, Samuel Porco Jr., DMD, Jose Portuondo, M.D., Ramon Quesada, M.D., Juan-Carlos Quintero, DMD, the Rev. Dr. Marcos Ramos, Ramón Rasco, Charlen Regan, Ian Reiss, M.D., Melinda Rich, Raymond Robinson, Ron Robison, John Rock, M.D., Domingo Rodriguez, William Rohrer, David Rosenbaum, Audrey Ross, James Russell, Darren Salinger, M.D., Steven Sapp, Joel Schenkman, M.D., Betty Anne Schilling, I.E. Schilling, Liz Schmier, Aida Shafer, Robert Shafer Jr., Emery Sheer, Joel Shepherd, Ronald Shuffield, Karent Sierra, DDS, Janá Sigars-Malina, Cale Smith, Maria Costa Smith, Albert Sotero, Patricia Stanley, Lee Stapleton, James Stewart, M.D., Roberta Stokes, Cristina Sullivan, Jeremy Tabak, M.D., Rene Taylor, George Tershakovec, M.D., Eris Thomas, Aislynn Thomas-McDonald, Patricia Thorp, Henry Tie Shue, Bill Tillett, Sats Tripathy, Ernesto Valdes, M.D., Chip Vandenberg, Otto Vega, M.D., Agustin Veitia, Frank Veloso, Juan-Carlos Verdeja, M.D., Kristine Wenzel, J. Scott Weston, Lisa Guerrant White, the Rev. Dr. William White, Vivian Williams, William Wilson III, E. Carlton Wilton Jr., Philip Wolman, Lloyd Wruble, DMD, Jack Yaffa, M.D., Marta Yee, Jerrold Young, M.D., Roark Young, Robert Zolten, M.D., Leonard Zwerling, M.D. BAPTIST HEALTH SOUTH FLORIDA EDITORIAL TEAM executive editor: Roymi V. Membiela; associate editors: Dori Alvarez, Christine Kotler; contributing editor: Patty Shillington; assistant contributing editor: KiKi Bochi; contributing writers: Kitty Dumas, John Fernandez, Bethany Rundell, Adrienne Sylver; editorial assistant: Dorothy Stein A COLLABORATION WITH HCP/ABOARD PUBLISHING (A subsidiary of The McClatchy Company) president & publisher: Erin Zilis; chief operating officer: Giovanna Sanchez; copy editor: Sole Sastre; art director: Ethan Duran; production director: Luisa Zelaya-Morillo

Letters edited for clarity and consistency.

SPRING 2015

02 Innovations

cover photo: © Imtek Imagineering / Masterfile

18 Perspectives

Social media, when used appropriately, can play a significant role in the healing process.

20 Making the Rounds Find out what’s happening at Baptist Health.

22 Healthy Gourmet

Chef Adrianne Calvo brings her passion for healthy cooking to West Kendall Baptist Hospital.

23 Health Stat

Cover Story Donna Victor

Dear Baptist Health,

Minimally invasive procedures developed in the last five years have dramatically changed the outlook for stroke patients.

Oral screenings can catch cancer early.

24 Myth vs. Fact

Is your body sabotaging your diet? Learn the facts about metabolism.

25 Baptist Connect Learn what’s new at BaptistHealth.net and connect with us.

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Innovations

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Small wonders Nanotechnology opens a whole new world of cardiovascular treatment By Adrienne Sylver

pacemaker as small as a vitamin pill. A tiny sensor placed in an artery that wirelessly sends vital statistics about heart function to doctors. They sound a bit like science fiction, but physicians at Miami Cardiac & Vascular Institute are using these devices and other innovative treatments to care for patients throughout Baptist Health. Walter Parrish considers himself lucky to be a beneficiary of these advances. As part of a medical trial at the Institute, he received the world’s smallest pacemaker in December. About the size of a vitamin, the Medtronic Micra™ Transcatheter Pacing System (TPS) was implanted in his heart after it was threaded through the femoral vein in his leg using a catheter. Mr. Parrish stayed in the hospital overnight. “It’s so small I can’t tell it’s there,” said Mr. Parrish, a 76-year-old snowbird who comes to Miami from North Carolina each winter. “I feel great.” He required the pacemaker after experiencing a fast heart rate and shortness of breath. “My heart would race, and then slow down too much,” he said. The Institute is one of only 50 U.S. centers taking part in the Micra TPS clinical trial. Usually, traditional

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Fareed Al-Mashat

Efrain Gonzalez, M.D., goes over results with his Medtronic Micra™ TPS patient, Walter Parrish.

pacemakers, about the size of a matchbox, are placed surgically under the skin near the collarbone. They require the use of leads, or wires, that are connected to the heart. But the Micra TPS is securely attached to the heart wall itself with hooks and has no leads. Both types of pacemakers operate in essentially the same way, sending small electrical impulses to the heart to help control abnormal heart rhythms. But the traditional pacemaker can cause complications, including the risk of infection due to the surgical incision. “It’s exciting to be part of this pivotal clinical trial. We are using a minimally invasive procedure to insert a wireless device in the heart that is too small to be felt by a patient but works like a traditional pacemaker,” said Efrain Gonzalez, M.D., the Institute’s medical director of electrophysiology and principal investigator of the study. Co-investigator Hakop Hrachian, M.D., an Institute electrophysiologist at South Miami Hospital, believes the technology will permanently change the pacemaker field. “The results could potentially benefit the more than 1 million people globally who receive pacemakers each year,” he said. Another revolutionary device helps patients with heart failure. Called CardioMEMS, the sensor is about the size of a paperclip. It monitors heart rate and pressure in the pulmonary artery, the vessel that moves blood from the heart to the lungs. The sensor is placed in the artery the same minimally invasive way the tiny pacemaker is implanted — via a small catheter threaded through a vein in the leg. Patients usually go home the same day and then send daily information wirelessly from the sensor to their doctors.

“This technology makes it possible for us to detect a problem a week or two before a patient feels any symptoms,” said Javier Jimenez, M.D., who participated in the device’s initial clinical trials. “By reacting quickly, adjusting a patient’s medications and monitoring them closely, it’s often possible to avoid hospitalization and further tests or procedures,” said Dr. Jimenez, the Institute’s medical director of advanced heart failure and pulmonary hypertension at South Miami Hospital. “It’s a much better quality of life.” Miami Cardiac & Vascular Institute physicians also are on the forefront when it comes to treating peripheral artery disease (PAD), a plaque build-up in thigh or knee arteries. If left untreated, PAD can lead to loss of blood flow to the legs or feet, and eventually, amputation. The Institute was among a select few medical centers in the nation to apply the first drug-coated balloon technology to open blocked arteries. Shaun Samuels, M.D., performed the first procedure at the Institute on a 66-year-old man who had plaque buildup throughout his body. During angioplasty, doctors insert the balloon through a catheter into the clogged artery. The balloon is inflated to open the artery, deflated and removed. The drug, paclitaxel, adheres to the artery walls, and helps prevent the arteries from narrowing again, reducing inflammation and scar tissue. In the past, patients would often have a metal stent placed in the artery to hold it open, but the stent sometimes led to complications. “It’s a wonderful feeling to see innovative ideas put into action,” said James Benenati, M.D., medical director of the Noninvasive Vascular Lab. “This is a promising new technology with very good outcomes.”

Innovations

MIAMI CARDIAC & VASCULAR INSTITUTE Institute services are available at more than 25 locations. To find a location near you, visit BaptistHealth.net/Heart. A $100 million expansion project on the Baptist Hospital campus, expected to open in 2016, will add the most sophisticated technology and equipment as the Institute continues its breakthrough research and treatments for cardiovascular disease.

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Just for Women

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Under control

NEW SUPPORT GROUP Women with bladder dysfunction, including pelvic pain, urinary urgency or frequency, or interstitial cystitis, are invited to a free support group at South Miami Hospital, Victor E. Clarke Education Center, Classroom F. The next session is Sunday, May 3, at 2 p.m. For more information, call 786-662-8751.

Women shouldn’t suffer in silence when it comes to incontinence By Kitty Dumas

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Dr. Yavagal said, more than half of those affected don’t disclose it to their doctor — and untreated, the problem worsens. “It’s an epidemic, a big problem that people don’t want to talk about,” Dr. Yavagal said. Urinary incontinence is defined as any involuntary loss of urine or the inability to hold urine, regardless of the severity. Risk factors include age, childbirth, a history of radiation treatment, obesity and family history. In most cases, the problem is due to weakening of pelvic floor muscles that no longer are able to support the bladder properly. There are two types of urinary incontinence. Stress urinary incontinence causes leaks when pelvic floor muscles are under pressure, such as when we laugh, cough, sneeze and exercise.

“IT’S AN EPIDEMIC, A BIG PROBLEM THAT PEOPLE DON'T WANT TO TALK ABOUT.” — Sujata Yavagal, M.D.

Donna Victor

armen Johnston, a working mother of two young daughters, was standing in a sea of people dressed in shorts and sneakers, ready to participate in a corporate run. At 37, she was a fast walker, not an avid runner, but she was enjoying the camaraderie of colleagues. “I started to run and thought, ‘Oh no, what’s happening?’ ” She felt a warm fluid on her inner thighs and was mortified to realize it was urine, a leak caused by incontinence. Dressed in a long T-shirt and gray shorts, she kept running and hoped for the best. Looking at a photo of herself taken after the run, Ms. Johnston said, “I could see it. My sister said, ‘Don’t worry, it looks like sweat.’ I think that’s when I realized I had a problem.” That was 10 years ago, and she didn’t tell her doctor. Aside from her husband, mother and sister, no one knew what she was experiencing. She had noticed a more frequent urge to urinate and occasional leaking after she had her two daughters and subsequent back surgery, but she attributed the problem to changes caused by childbirth and aging. “I just figured it was a part of life, part of the package of what I was going to have to put up with.” In addition, Ms. Johnston said, “It was embarrassing.” She thought she could handle it, but as time passed the situation intensified. She no longer walked the dog or exercised. Normal occurrences such as sneezing, coughing and laughing were dreaded moments. Finally, she overcame years of embarrassment to tell her doctor, “It’s unbearable.” Today, Ms. Johnston is taking medication for overactive bladder and receiving weekly physical therapy at South Miami Hospital’s Center for Women & Infants. Her condition has improved and she is sharing her experience, hoping to encourage other women to seek help. “Don’t wait, don’t be embarrassed,” she said. “There is help. You don’t have to live like this.” Urinary incontinence is a national public health problem, with 50 percent of women suffering from the condition by age 60, said Sujata Yavagal, M.D., a specialist in female pelvic medicine and reconstructive surgery at South Miami Hospital. Unfortunately,

Just for Women

Carmen Johnston hopes sharing her story will help other women seek treatment.

Urge incontinence, also known as overactive bladder, is brought on by too-frequent contractions of the bladder or dysfunctional nerves signaling the need to urinate often. Patients may suffer from either or both. Ms. Johnston was diagnosed with a combination of stress and urge incontinence, both of which respond well to treatment, said Louise Gleason, the physical therapist who oversees the pelvic health program. To treat stress incontinence, Ms. Gleason helps the patient identify daily patterns that may be weakening pelvic floor muscles or affecting the bladder. “Your diet makes a big difference,”

she explained. Caffeine, alcohol, chocolate, cigarettes, yogurt and artificial sweeteners are among the bladder irritants. People who use the bathroom whenever one is nearby may be setting themselves up for urge incontinence, she added. “You are effectively training your bladder to tolerate less urine,” Ms. Gleason said. Physical therapy treats incontinence by strengthening pelvic floor muscles. It includes many treatment options and exercises such as Kegels, which contract pelvic floor muscles. If the condition does not improve with these treatments, Dr. Yavagal

said, other alternatives include Botox and surgery to strengthen the pelvic floor. Ms. Johnston is glad she finally spoke up and got help. “I see improvement,” she said. “I’m getting control. It’s not controlling me.” Pelvic Health and Continence Testing at South Miami Hospital offers comprehensive diagnostic testing and treatment of pelvic health problems. For information, call 786-662-8751.

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Kid Stuff

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Kid Stuff

Strength in numbers Team of specialists cares for mom and her quadruplets By Bethany Rundell

hen Nelsaelena Suarez, 30, of Homestead checked her pregnancy test, her excitement could not be contained. “I immediately showed my husband and called the fertility specialists,” she remembered. Ms. Suarez, already a mother to 4-year-old Christopher from a prior relationship, had been taking ovulationenhancement medications for four months because she wasn’t ovulating normally. She and her husband, Angel Molina, wanted a child together. Her fertility specialists told her to come in for a blood test to confirm her pregnancy. The test revealed unusually high amounts of the pregnancy hormone HCG, indicating she might be carrying multiples. “I was excited, because if I was having twins, I didn’t have to worry about having more babies,” Ms. Suarez said. “I never thought once that I would be carrying more than two!” Six weeks later, an ultrasound revealed four egg sacs, four placentas and four heartbeats — quadruplets! The whirlwind of a higher-order pregnancy began for her and Mr. Molina. “The doctors talked to us about the risks of carrying four babies,” Ms. Suarez recalls. “They said they may not all survive, they would be born prematurely and some, or all, may have health problems. We accepted these risks.” Ms. Suarez needed to find a new obstetrician who was willing to manage a pregnancy with quadruplets. Her search

Donna Victor

Angel Molina, Nelsaelena Suarez and big brother Christopher are thrilled with the addition of quadruplets to the family: (from left) Christian, Valentina, Angelina and Annabella.

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ended with Francisco Cruz-Pachano, M.D., an OB-GYN in Coconut Grove. “Quadruplets are rare and not all doctors are comfortable taking these pregnancies,” Dr. Cruz-Pachano said. In fact, the U.S. Centers for Disease Control & Prevention’s latest data show that only 239 sets of quadruplets were born in the United States in 2011. Dr. Cruz-Pachano and his partners, including Albert Triana, M.D., who had previously delivered triplets, were willing to help Ms. Suarez — as was perinatologist Carmen Tudela, M.D., who worked with Dr. Cruz-Pachano and his partners to manage Ms. Suarez’s pregnancy. “We knew at the very least we would be dealing with a pre-term delivery, but the longer we can keep the mother pregnant, the better the outcomes of the babies after birth,” Dr. Tudela said. With regular ultrasounds, the doctors and the couple kept watchful eyes on the development of the babies. At 26 weeks, an ultrasound showed Ms. Suarez’s cervix had shortened, an indication that labor might start soon. Armed with that knowledge, the team of doctors decided to admit Ms. Suarez to South Miami Hospital’s Maternal-Fetal Special Care Unit, part of the Center for Women & Infants. There, they would monitor her health and the babies’ growth, while delaying labor as long as possible. “We had weekly meetings at the hospital about these babies,” Dr. Triana said. “In addition to us, her obstetricians, we met with Dr. Tudela,

neonatologists, hematologists and gynecologic oncologists, who specialize in emergency hysterectomies, to prepare everyone for the babies’ arrival and any emergencies that might arise during delivery.” “We even had drills to ensure that the care teams and equipment would be in place for each of the babies, right down to the number of blankets in the warmers,” said Jorge Perez, M.D., medical director of the Center for Women & Infants. “These meetings are not something hospitals typically do, but we’ve implemented them to help us and the parents know what to expect.” “I was so amazed by the teamwork,” Ms. Suarez said. “Even on my chart, a plan was mapped out for when I went into labor so the nurses would know who all should be notified.” On Monday, Nov. 10, 2014, when Ms. Suarez went into labor at 31 weeks and three days of pregnancy, the plan went into action. “Four teams of nurses and doctors waited for each of our babies,” Mr. Molina said. “Dr. Triana announced ‘Baby A’ and Team A came in to care for Christian, followed by Baby B, Valentina; Baby C, Angelina; and Baby D, Annabella.” After six weeks in the Neonatal Intensive Care Unit at South Miami Hospital, the babies were reunited at home with their parents and big brother. Of her instant, enlarged family, Ms. Suarez said: “It’s a blessing.”

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Spotlight

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Spotlight

First line of defense Nursing legend has been battling germs for a half-century hen Barbara Russell, R.N., was going through her nurse’s training, there was only one area that repelled her. The isolation unit. It wasn’t because she was afraid of contagious illnesses — quite the contrary, in fact. But the isolation unit brought back painful memories of her own battle with polio as a child, when she was segregated for weeks from everything and everyone she loved. “I saw the isolation unit, and I said the one thing I don’t want anything to do with is infection control,” she recalled. Ms. Russell loves the irony of that story, considering she has spent almost her entire 50-year nursing career in that very field. As director of infection control at Baptist Hospital, Ms. Russell is in charge of strategic planning to prevent and contain outbreaks at the hospital. But her reach is far greater than that. She has served on local, state, national and international panels, has testified before Congress three times and helped develop infection control policies that have become the international standard. “She’s a legend,” said Becky Montesino-King, R.N., vice president and chief nursing officer at Baptist Hospital. “She has international renown because of her knowledge, as well as her historical perspective.” Ms. Russell, who has spent 47 years with Baptist Health, took a leadership role at the dawn of the AIDS epidemic in the 1980s, when little was known about HIV transmission and patients were treated as pariahs by some. “In the early days of AIDS, it was hard to convince healthcare professionals to take care of these patients,” she recalled. To her, that was

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unacceptable. She remembered what it felt like to be shunned when she returned to school after overcoming polio and her fourth-grade teacher told her classmates to stay away from her. She was no longer in the isolation unit, but she was still very isolated. “I wanted to make sure people were treated right.” Ms. Russell served on panels to help the American Nurses Association develop protocols that would protect healthcare workers while preserving the dignity of the patients. She even traveled to Geneva to help establish international standards. She continues to participate in policy-making, always working to stay one step ahead of infection outbreaks. “I love my work so much,” she said. “To me it’s like a hobby to learn more and to teach others.” Establishing infection control is a very deliberate process that takes into consideration what an illness is, how it affects people, how it is transmitted and how it can be contained. It may not sound like a glamorous field, but its critical importance became clear last year when the Ebola virus was the top story on every news report. One test of Ms. Russell’s planning came at the height of the Ebola scare, when she was awakened by a call from the MiamiDade Health Department, advising her a patient who might be infected was on the way to the Baptist Hospital Emergency Center. The hospital’s response plan was activated, and Ms. Russell was “front and center.” “There was no panic whatsoever among our staff. Our employees and physicians felt so well prepared that we had staff come forth and ask to take care of the patient,” Ms. Montesino-King said. “We didn’t

Donna Victor

By KiKi Bochi

From her office in Baptist Hospital, Barbara Russell, R.N., formulates strategy to keep patients and staff safe.

have to worry about assigning someone; they volunteered. That is to Barbara’s credit.” The patient was found to be negative for Ebola, but until that was determined every precaution was required. Two nurses in Dallas had contracted Ebola after caring for a patient from West Africa in October. “When the problem in Dallas happened, there was an outcry that hospitals needed an Ebola plan. We already had one,” Ms. Russell said. She had been tracking the illness since it first was mentioned on reports by the Centers for Disease Control & Prevention about six months earlier, and began developing a plan last summer. “There’s always the chance that any disease can show up here, and I knew we had to be prepared.” Ms. Russell is quick to point out that everything she does is

part of a team effort, but her personal contributions have not gone unnoticed. In addition to many past accolades, she was named Nurse of the Year by the Florida Nurses Association and was inducted into the Florida Nursing Hall of Fame in 2014. “It’s the highest nursing honor in Florida,” Ms. Montesino-King said, adding the value of Ms. Russell’s input can’t be overstated. “When she calls me and has concerns, I drop everything,” Ms. Montesino-King said. “I would describe her as insightful, deliberate, caring, compassionate — very much so, actually. She’s an excellent communicator, a great leader. She has a good sense of humor and she is always, always composed. Her composure is her greatest strength, because it inspires confidence in others.”

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procedures that open blocked blood vessels and remove blood clots in the brain. They do this by threading a catheter from an artery in the groin up to the brain, while watching the action inside the blood vessels on a giant monitor showing a live digital X-ray called fluoroscopy. At the end of the catheter is a tiny wire coil, called a stent, made of platinum-titanium that opens the artery and snags the clot. “With this third-generation of stent,

the studies show that you can open up the artery in 90 percent of patients,” Dr. Linfante said. “When the stent is removed, the clot comes with it.” Four recent studies, three of which were published in the New England Journal of Medicine, confirmed the brainsaving benefits of minimally invasive interventional procedures to remove stroke-related blood clots. Endovascular treatment is “effective and safe” when performed within six hours of a stroke’s

Be Stroke Smart Learn more about stroke at a free program Saturday, May 30, 8:30 a.m.-12 noon, at Baptist Hospital Auditorium. The program includes free screenings for cholesterol, blood sugar, blood pressure and body mass index. Reservations are required. To reserve your space, email Programs@BaptistHealth.net or call 786-596-3812.

This tiny stent is used to remove blood clots in the brain.

TINY STROKES OF GENIUS By Patty Shillington

When

ot that many years ago, people who suffered a severe stroke were often left in a state of permanent, life-changing disability — if they survived at all. Today, due to recent breakthroughs, patients with quick access to highly specialized care are making full recoveries from massive strokes. Among them is 64-year-old Oliver “Rocky” Smith of South Miami-Dade (see related article).

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“This is a success story of the last five years,” said Italo Linfante, M.D., medical director of interventional neuroradiology at Baptist Health Neuroscience Center. “Things have changed dramatically. It’s very exciting. The outcomes are incredible.” Still the fifth leading cause of death in the United States, stroke is a sudden decrease in blood flow to the brain, usually caused by a clot or blockage. Without blood and oxygen, neurons in the affected

part of the brain die quickly — about 2 million every minute. That can result in memory loss and other cognitive problems, as well as difficulty walking, talking and moving. It’s why neurologists have come to call a stroke a “brain attack.” Dr. Linfante and Guilherme Dabus, M.D., director of the Neuroscience Center’s Interventional Neuroradiology Fellowship Program, have been at the forefront of advances in hightech, minimally invasive endovascular

Donna Victor (2)

your life is on the line following a stroke, the smallest things can make a big difference. Dramatic advances in high-tech procedures mean today’s chances of recovering are better than ever.

Guilherme Dabus, M.D. (left), and Italo Linfante, M.D., use an interventional neuroradiology suite to clear blockages in the brain with a minimally invasive procedure.

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Act F.A.S.T. According to the Centers for Disease Control and Prevention, each year stroke kills nearly 130,000 of the estimated 800,000 people who suffer from one, and it is the leading cause of disability.

FACE:

ARMS:

SPEECH:

TIME:

Ask the person

If you observe

to smile. Does

to raise both

to repeat a

any of these

one side of the

arms. Does

simple phrase.

signs, call 911

face droop?

one arm drift

Is their speech

immediately.

downward?

slurred or strange?

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Comprehensive Stroke Center in Florida is the Mayo Clinic in Jacksonville. “This is the highest level of certification that can be achieved,” said Sergio Gonzalez-Arias, M.D., medical director of Baptist Health Neuroscience Center. It signifies that Baptist Hospital has a highlevel infrastructure, including advanced imaging equipment and a neurointensive unit, as well as a staff specially trained to handle every type of stroke, as well as rehabilitation care. “I think this is proof that we are doing the things on the best level compared to any other place in the country,” Dr. Dabus said. “When a stroke patient comes here, he is going to receive unparalleled care and a better chance for a good outcome.” Now that specialized treatments for complex strokes are available to save lives, the biggest challenge is getting patients to the hospital in time to receive the lifesaving care. In fact, the key to surviving and recovering from a stroke begins with recognition that a stroke is occurring (see related FAST box). Some 60 percent of stroke patients brought to the hospital never called 911, according to the National Stroke Association. “The signs of a stroke should be recognized as early as possible,” said neurologist Javier Lopez, M.D., medical director of the stroke program at South Miami Hospital, which is designated a primary stroke center capable of treating most strokes and transporting the most severe cases to Baptist Hospital. South Miami and Baptist Hospitals are part of the countywide stroke network established by the Fire Officers Association of Miami-Dade. Its mission is to make sure 911 patients with stroke symptoms are transported to the closest primary stroke center. “It’s a matter of educating the public to look for the signs of stroke and to

Precious Moments

Oliver “Rocky” Smith plays golf and travels following a full recovery from a major stroke.

Speedy stroke care gives one semiretired grandfather a new lease on life By Patty Shillington

Donna Victor

Sergio Gonzalez-Arias, M.D.

onset, concluded the trial known as Mr. CLEAN (Multicenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands). The Mr. CLEAN study involved 500 stroke patients, 90 percent of whom received tPA, a drug to dissolve their clot. Half of the patients who received tPA also had their blood clot removed using a stent. Those patients recovered their ability to live independently at significantly higher rates than the patients who only received tPA. “This is a historic moment in stroke treatment,” Dr. Linfante said, adding that the new success is due to the better design of the retrievable stent. Being able to offer this sophisticated treatment for the most complex strokes is rare. And it’s one of the main reasons that late last year Baptist Hospital, home of Baptist Health Neuroscience Center, became the first hospital in South Florida to be certified as a Comprehensive Stroke Center by The Joint Commission and the American Heart Association/American Stroke Association. The only other certified

ne night as he was getting ready for bed, Oliver “Rocky” Smith suddenly found himself on the floor of his bathroom. “There was no blackout, no pain,” recalled Mr. Smith, 64, a semiretired air conditioning mechanic. “I tried to get up but I couldn’t. I thought it was my socks slipping on the tile.” Alerted by the family cat’s screeching meows, his wife got out of bed to investigate. Rene Smith recognized the symptoms of stroke immediately — her husband was slurring his speech and couldn’t move his left side. She called 911; minutes later, paramedics were racing Mr. Smith to Baptist Hospital, bypassing closer hospitals that did not have comprehensive stroke centers. The stroke team leaped into action when Mr. Smith arrived. “Everything they did, they were literally running down the hall — because every single second counts,” Ms. Smith said. A CT scan of her husband’s brain showed a complete blockage in his right carotid artery and a clot in his brain. He was given the clot-busting drug, tPA, but it didn’t help. “He had a very bad stroke,” said Italo Linfante, M.D., medical director of interventional neuroradiology at Baptist Health Neuroscience Center. “tPA doesn’t work with a big clot.” By 2 a.m., less than three hours after his stroke began, Dr. Linfante was performing a minimally invasive endovascular angioplasty to open the blocked carotid artery with a tiny balloon and then remove the clot in the right middle cerebral artery. When he awoke, Mr. Smith was well on his way to a full recovery. “Dr. Linfante is a guardian angel who has been given a gift, this ability to salvage someone’s life with this procedure,” Ms. Smith said. “It saved Rocky’s life, and it saved his quality of life.” Today, about a year and a half after his stroke, Mr. Smith said he has recovered “100 percent.” He plays golf about once a week, travels around in his RV with his wife and enjoys time with his three grown children, six grandchildren and three great-grandchildren. “I’m out in the world, mobile, doing what I was doing before,” he said. Ms. Smith is grateful that paramedics followed the county’s stroke network guidelines and sought help for her husband at such a wellprepared facility. “The Stroke Center at Baptist Hospital makes a difference,” she said. “It gave us a real quality of life that we don’t take for granted any longer.”

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Javier Lopez, M.D.

seek medical attention right away,” Dr. Lopez said. “The treatment depends a lot on time. The faster it’s administered, the more effective it’s going to be. Some people arrive outside the time window that anything can be done.” The gold standard clot buster, tPA, has to be given within three hours of symptom onset or, in some cases, within 4½ hours. But first a CT scan must rule out any bleeding in the brain and doctors must determine that the patient is a good candidate for the drug. For most patients with small strokes and for about 20 percent of patients with major strokes, tPA is able to restore blood flow. However, many patients with the most severe strokes would benefit from the procedure to remove the blood clot — but only if they can get to a comprehensive stroke center like Baptist Hospital within six hours of the stroke’s onset. “For every half-an-hour delay from symptom onset until the artery

is opened, you have a 10 percent less chance of a good outcome,” Dr. Linfante said. “Patients need to get here as fast as possible.” Baptist Health has a system in place to quickly transfer from South Miami to Baptist Hospital those patients who need comprehensive stroke care. “They will start the patient on a tPA drip at South Miami and then transport them over to Baptist,” Dr. Dabus said. Once the patient is in the procedure room, “it takes about 15 minutes to open the artery,” Dr. Linfante said. While Baptist Hospital sees about 1,000 stroke patients a year, only about 70 receive the endovascular treatment to remove a blood clot from the brain. That’s because most stroke patients don’t need it — and because some who do need it do not arrive in time. “When the patients can get here,” Dr. Dabus said, “we can give them the best chance possible.” n

Stroke of Luck Quick access to advanced treatment helps restore speech and mobility By Patty Shillington

ablo Pereira was in the right place at the right time when he suffered a major stroke — especially considering that neither he nor his significant other, Paula Diaz, knew what

was happening. Residents of Puerto Rico, the couple was at their second home in Miami, where Mr. Pereira visits his grandsons and does business regularly. One morning before dawn last September, Ms. Diaz returned to bed to find Mr. Pereira, 78, breathing in an unusual way. “It was like a strange snoring,” she said. She woke him up. “He tried to respond but he couldn’t talk, and he couldn’t sit up,” she said. Ms. Diaz called his son, who told her to call 911. “I knew something was wrong, but I didn’t know it was a stroke,” Ms. Diaz said. Paramedics rushed Mr. Pereira to nearby Baptist Hospital, where a CT scan showed a blockage in his neck’s right carotid artery. He couldn’t move the left side of his body. He wasn’t a candidate for the clot-buster, tPA, because the last time he was known to be symptom-free was at 10 p.m. the night before, and the drug must be given within a few hours after the symptoms start. So Mr. Pereira’s

The Telestroke Program Expands

only option was to have the blockage mechanically removed in a minimally invasive procedure. “¡Rápido, rápido! He went straight to the operating room,”

By Patty Shillington

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program soon will expand to South Miami Hospital and Homestead Hospital, Ms. Gross said. “We foresee it being used across the Baptist Health system,” she said. West Kendall Baptist Hospital is a primary stroke center that doesn’t always have a neurologist on-site to immediately assess a stroke patient brought into the ER, so when a patient with stroke symptoms arrives, the ER’s stroke team calls the Telehealth Center. “We’re the communication hub, like air traffic control,” Ms. Gross said. “We bridge everybody.” West Kendall Baptist’s ER uses a telestroke cart, equipped with a videocamera, to connect the patient, the ER team and the neurologist, who uses a special iPad to see and speak with the patient and access the patient’s CT scans and labwork. The neurologist decides whether the patient needs comprehensive stroke care at Baptist Hospital or can be treated successfully at West Kendall Baptist Hosptial. Before the program was in place, some stroke patients were sent to Baptist Hospital as a precaution, in case they needed comprehensive care. “There were a lot of unnecessary transfers, which are disruptive, costly and scary to the family,” Ms. Gross said. The telestroke program enables the patient to get the correct level of care — quickly. “It’s good for everybody.”

Interventional neuroradiologist Guilherme Dabus, M.D., accessed the blockage in Mr. Pereira’s neck through a vessel in his groin. He placed a stent in the carotid artery to open the blocked vessel. Then he removed a large blood clot using a retrievable stent, restoring normal blood flow to Mr. Pereira’s brain. “He was able to move his left side immediately after the procedure,” Dr. Dabus said. “And he continues to do very well.” After four days in the neuroscience critical care unit, Mr. Pereira spent three weeks at Baptist Hospital in Baptist Health Neuroscience Center’s neuro-rehabilitation program. He completed outpatient rehabilitation therapy in January. “I speak perfectly,” Mr. Pereira said at one of his final therapy sessions at Baptist Hospital. Occupational therapist Darcie Garcia Hendricks guided him through various exercises, including raising a hand weight over his

Mabel Rodriguez

hen it comes to making immediate decisions about stroke treatment, information technology is one of the newest — and most effective — tools. The quickest way some stroke patients get specialized care is through Baptist Health’s telestroke program, which links an on-call, off-site neurologist with an ER patient and healthcare team. In its first year of operation, the telestroke pilot program cared for more than two dozen ER patients at West Kendall Baptist Hospital, said Leslee Gross, R.N., the assistant vice president who oversees Baptist Health’s Telehealth Center. While some patients needed to be transferred to Baptist Hospital, a comprehensive stroke center, most could be successfully treated at West Kendall Baptist with immediate direction from the neurologist, who was linked to the patient and ER healthcare team using a specially programmed iPad and a hightech telestroke cart. “The telestroke program supports high-quality care, is cost-effective, improves access to care and has high patient satisfaction,” said Louis Gidel, M.D., medical director of Baptist Health’s Telehealth Center and chief medical informatics officer. “You need everybody to be a team player to make it work.” Operated by Baptist Health’s Telehealth Center, the telestroke

Ms. Diaz said.

head with his left arm. “He’s doing very, very well,” she said. Mr. Pereira agreed. “I feel fine; and every day, a little better.” The couple understands that being near a comprehensive stroke

Occupational therapist Darcie Garcia Hendricks leads Pablo Pereira in exercises to restore strength and mobility in his left hand and arm, which were initially paralyzed from the stroke.

center when Mr. Pereira fell ill may well have saved his life. “We were very lucky,” Ms. Diaz said. “We’re very grateful to everyone at the hospital. It’s a success story.”

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The Second Act

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On the move Recipe for enduring health mixes fitness, friendship and fun By Patty Shillington

he stores of Dadeland Mall are still locked shut when dozens of people, mostly retirees, slip into an entrance with the early-morning window washers and gather in the hallway between Saks Fifth Avenue and Macy’s. It’s a rich mix of veterans and newcomers ready to get moving in a fitness ritual that has evolved from simple walking 20-plus years ago to structured exercise classes three mornings a week. “It’s as much a support system as exercise,” said Bonnie Glover, a retired county employee. The free classes are led by certified exercise instructors from Baptist Health. “We know that physical activity is critical to keeping the community healthy,” said Danny Elfenbein, Community Health manager for Baptist Health. “That’s why we have expanded our offerings to more than 100 free exercise classes every week at locations across South Florida.” At Dadeland Mall, the Monday and Wednesday class at 9 a.m. is aerobics and

strength training; Friday’s class is tai chi. One recent Wednesday, instructor Nan Imbesi turned on her MP3 player and led the class in lunges to the beat of the 1960s classic, Put a Little Love in Your Heart. Some participants held two-pound hand weights. Shoulder presses came next, followed by triceps and rowing exercises. “Keep your spine long,” Ms. Imbesi said. “We’re working the back and shoulders now.” Monday’s class with instructor Faby Yasky is more dance-oriented, with some stimulating Latin rhythms. “We each do something a little different,” Ms. Yasky said. When the 30-minute class is over, most participants walk in small groups around the mall — some at a near jog and others at a leisurely, window-shopping pace.

Then at 10 a.m., they meet in the Food Court for their “happy hour.” For years, studies have detailed the benefits of exercise. One of the more recent ones, published in The Journal of Physiology, found that older people who stayed very active did not show physiological signs of aging; their measurable functioning (such as balance, reflexes, metabolic numbers and memory) remained the same as that of younger people. Maybe that helps explain why many of the Dadeland exercisers do not look their age. Bateman Blair, for example, is 74 but could easily pass for a middle-age man. “I don’t feel it,” he said of his age. He and his daughter aspire to race-walking

The free exercise classes offered by Baptist Health range from yoga and aqua Zumba® to Pilates and high-intensity body boot camp. Run clubs also are available. For a list of the classes, visit BaptistHealth.net/Wellness.

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Certified instructor Faby Yasky (left) leads the dance-oriented Monday morning exercise class at Dadeland Mall. At age 90, Roy Peltz (above) is one of the older exercise enthusiasts.

Donna Victor (2)

FREE CLASSES

The Second Act

a marathon in every state. “We have 34 states so far,” he said. Mr. Blair heard about the Dadeland classes from a friend a few years ago. “These classes are really good. All the instructors are great. It helps you stay toned and it’s good for your balance. And the price is right!” Virgin Vandervlugt, a retired educator who comes with her husband, Peter, said the Dadeland Walkers group means more to the participants than just the exercise. Many of them get together monthly to celebrate birthdays and for holiday parties. Some of them also drive to breakfast together after the class. A study published in the Journal of Health and Social Behavior found that seniors who stay socially active as they age also stay healthier longer than those whose social engagement declines as they age. “As you get older, your friends are moving away and getting sick,” Ms. Vandervlugt said. “I have made friends here I otherwise would never have met. I tell everyone I know who is retired how important it is — the physical part and the social part. That’s how you get to be 90 years old and social and alert and happy.” Roy Peltz, 90, would agree. The retired pilot has been coming to the Dadeland classes for several years. “My daughter got after me; she wanted me to get out here with all these young people and exercise,” he said after a Monday morning class. “I look forward to it. It’s a nice group of people.” The World War II and Korean War veteran said he has been active all his life and except for some stiffness in his arm, he feels as healthy as ever. And he isn’t the class elder. One snowbird who turned 93 in February attends class with her daughter when they are in town.

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Perspectives

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Perspectives

Social media savvy Online communities offer education and support when used wisely rlene Mion-Pestano never set out to be part of the social media revolution. As a breast cancer survivor and a person of strong religious faith, Ms. MionPestano said she simply shared her story in an effort to help others. After undergoing a mastectomy at South Miami Hospital five years ago, she began sharing in person with members of her church. Then, as she sipped her morning coffee, she started posting her thoughts about life, faith and health on Facebook and Twitter. “You think you may not be affecting people, but you find that you are,” Ms. Mion-Pestano said. Her friends and followers respond to her posted words with comments of their own, like this recent post: “You’re an example of strength and inspiration to many.” Earlier this year, Ms. Mion-Pestano, 50, whose cancer was discovered two weeks before her wedding, was featured in “Faces of Breast Cancer,” a Baptist Health video. Each year, she said, she also posts information on her Facebook page about Baptist Health’s reduced-cost mammograms in October, during Breast Cancer Awareness Month. Just 10 years ago, social media and healthcare may have seemed like an odd combination. Today, it’s hard to imagine a time when patients, families and hospital staff could not connect to Baptist Health’s website, Facebook page, Twitter feed and YouTube channel. For updates and information on a host of health topics, from the Ebola virus and high blood pressure to breast cancer and addiction treatment, thousands of people connect every day.

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However, the opportunity to seek and share information with people around the world, via laptop, smartphone or other portable devices, is a gift marked “handle with care.” Without education and oversight, social media postings and information sharing — even by well-meaning patients, families and other sources — can spread inaccurate information or invade personal privacy, said Mercedes del Rey, Baptist Health’s chief privacy officer. “We have to meet our patients where they are, including online, and do it safely, securely and professionally,” Ms. del Rey said.

CONSIDER THE SOURCE When gathering medical information online, remember that the Internet is unregulated. Not all Web content is accurate, and some may even be harmful. • M ake sure the website is maintained by a reputable health company or organization or reviewed by Board-certified doctors. Government sources, such as the U.S. Centers for Disease Control & Prevention and the National Institutes of Health, offer a broad range of evidence-based health information. • B e wary of information found on Internet chat sessions and websites selling or advertising products they claim will improve your health. • I f online content contradicts information you receive from a healthcare provider, talk to your doctor.

Donna Victor

By Kitty Dumas

Understanding how to use social media to educate and inspire, as well as to protect private information, was the focus of a Baptist Health seminar. Ms. del Rey and Raul de Velasco, M.D., chairman of the Baptist Health Bioethics Committee, spoke to a packed audience of affiliated physicians, nurses and staff. Some 1,300 hospitals had Facebook pages as of February 2014, Dr. Velasco said. And, according to a study by the Pew Research Center, 59 percent of U.S. adults reported searching online for health information. “What is interesting to note,” he said, “is that 41 percent of patients who find online diagnoses have their conditions confirmed by their physician.” Patients who seek information from any of Baptist Health’s online avenues can be confident that they are accessing carefully vetted, accurate and up-to-date information. “We want to embrace the power that social media brings with it,” said Ms. del Rey, “but with it we all have to think about the responsibility.” For a complete list of Baptist Health’s online resources, see page 25.

Breast cancer survivor Arlene Mion-Pestano, pictured with her dog, Trixie, uses social media to inspire others with health challenges.

Her video can be seen on Baptist Health’s YouTube channel at YouTube.com/ArleneMion-Pestano.

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Making the Rounds

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Making the Rounds

Making the rounds Baptist Health news and updates Revolution CT scanner Doctors at West Kendall Baptist Hospital were the first to use a new, advanced CT scanner to see inside the body. The world’s first clinical trials for GE Healthcare’s Revolution™ Computed Tomography scanner were conducted at the Baptist Health hospital, enabling physicians to see very high-resolution images of body organs, soft tissues, vascular structures and bones. The machine was recently approved for use by the FDA. “We are grateful to West Kendall Baptist Hospital’s physicians for their collaboration and rigorous testing during the trial,” said Jeffrey Immelt, GE chair and CEO. Mr. Immelt visited the hospital in January to celebrate the unveiling of the scanner. The new technology is faster than other scanners, taking just one second to complete an image of the entire pelvis and abdomen or one heartbeat to create detailed pictures of the heart. Because of its speed, it reduces exposure to radiation. In addition, there’s no need to sedate children who need a CT scan. “This is innovation at its best,” said Ricardo Cury, M.D., chairman of radiology and director of cardiac imaging at Baptist Health. “It’s a significant advancement that provides us with the most accurate diagnostic images.”

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A new name in orthopedics and sports medicine For many years, Doctors Hospital served as the renowned hub of Baptist Health’s orthopedics and sports medicine program. Now, Baptist Health has integrated its expert orthopedic and sports medicine services under one new name: Miami Orthopedics & Sports Medicine Institute. The name reflects a team approach to providing patients with the highest quality care.

Miami Orthopedics & Sports Medicine Institute combines the resources of experienced physicians and leading-edge technology to provide care at five locations — Baptist Children’s Hospital, Baptist Hospital, Doctors Hospital, South Miami Hospital and West Kendall Baptist Hospital. Founded by UHZ Sports Medicine Institute, Miami Orthopedics & Sports Medicine Institute continues to provide sports medicine services for the Miami Dolphins, Florida Panthers,

Baptist Health President and CEO Brian E. Keeley (left) recently signed an agreement that will bring the first proton therapy treatment to South Florida. Proton therapy is a highly advanced cancer treatment that beams radiation directly to tumors while avoiding nearby healthy tissue. The contract, with Belgium-based IBA, will bring the Proteus®PLUS technology to Baptist Health’s Miami Cancer Institute, currently under construction and expected to open in 2016. IBA CEO Olivier Legrain (right) lauded Baptist Health for making this highly accurate form of cancer treatment more accessible. The proton therapy system is expected to treat its first patients in 2017.

Miami Heat, Florida International University athletics, Orange Bowl, Miami-Dade County Public Schools athletics, Miami Open Tennis, World Golf Championship-Cadillac Championship, and Miami Marathon and Half Marathon.

Another Magnet recognition for nursing excellence West Kendall Baptist Hospital has achieved Magnet® recognition as a reflection of its nursing professionalism, teamwork and superior patient care. The Magnet designation is determined by the American Nurses Credentialing Center, which uses rigorous standards to evaluate nursing excellence. Only about 6 percent of healthcare facilities nationwide have achieved this honor. “Magnet recognition provides our community with the ultimate benchmark to measure the quality of patient care,” said Javier HernándezLichtl, CEO of West Kendall Baptist Hospital. “Achieving Magnet recognition reinforces the culture of excellence that is a cornerstone of how we serve the West Kendall community.” Magnet recognition has become the gold standard for nursing. U.S. News & World Report’s annual showcase of “America’s Best Hospitals” includes Magnet recognition in its ranking criteria for quality of inpatient care. To earn the designation, organizations

must pass a detailed and lengthy evaluation, including a thorough site visit. Two other Baptist Health hospitals, Baptist Hospital and South Miami Hospital, also have achieved Magnet recognition. And, as a rural hospital located in the Upper Keys, Mariners Hospital has received the American Nurses Credentialing Center’s Pathway to Excellence designation for nursing excellence and maintaining an environment of collaboration.

Nurse Residency Program is accredited

Homestead Hospital welcomes community

Baptist Health’s program to support and train newly graduated nurses for different clinical settings was among the first to achieve accreditation from The American Nurses Credentialing Center. Training through Baptist Health’s Versant R.N. Residency Program takes a year. The program helps nurses develop clinical and leadership skills through supportive mentoring, instruction and coaching. It was accredited by the Practice Transition Accreditation Program. “Our program gives our graduates the confidence to enter into any clinical setting knowing they were trained with the most current, evidence-based best practices,” said Marjorie Lima, R.N., Baptist Health’s program manager. “Achieving accreditation with distinction is a groundbreaking moment.”

There was something for everyone at the recent Homestead Hospital Family Health and Wellness Fair. More than 500 attendees participated in free health screenings, received information on local health and family resources, and visited a Children’s Expo dedicated to newborn care and pediatric health and wellness. A Teddy Bear Clinic, face painting and obstacle courses added to the fun. One of the many highlights was a cooking demonstration by Thi Squire, manager of the Grow2Heal community garden at Homestead Hospital. The garden will help the community from the inside out by providing fresh fruits and vegetables to patients, visitors, employees and local organizations in need.

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Healthy Gourmet

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Health Stat

Asian Marinated Salmon with Mango-Kiwi Relish

Donna Victor

Recipe courtesy of Chef Adrianne Calvo

West Kendall Baptist Hospital Executive Chef Edgardo Llopiz and Chef Adrianne make a healthy team.

Ingredients: › 1 pound salmon › 3 tablespoons honey › 3 tablespoons light soy sauce › 1 tablespoon extra virgin olive oil › ½ tablespoon minced garlic clove › 1 teaspoon black pepper › ½ cup mango, peeled and diced › 1 kiwi fruit, peeled and diced › ¼ cup red onion, minced › 1 tablespoon cilantro, chopped › 1 tablespoon orange juice › 1 teaspoon jalapeño pepper, seeded and minced (optional) Makes 4 servings Method:

Inspired by nature By KiKi Bochi

hef Adrianne Calvo’s passion for food is exceeded only by her passion for life. “What you put in your body is very, very important to how you live,” said Chef Adrianne, a local restaurateur who recently came on board as culinary ambassador for West Kendall Baptist Hospital. Known for combining natural flavors in fresh ways, Chef Adrianne became devoted to healthy, whole foods when her younger sister, Jennifer, was battling a rare form of tongue cancer. “That was the first time I became very aware of what we put in our bodies and the body’s natural ability to heal itself,” she said. Her sister succumbed to her illness at age 19, making Chef Adrianne

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even more determined to spread the message of healthy eating. Flavor doesn’t have to be sacrificed when you use whole foods the way nature made them, she said. Her preference is for locally sourced, sustainable ingredients that have minimal processing. “I like ingredients that come from a tree, or the ground, or a seed,” said the owner of Chef Adrianne’s Vineyard Restaurant and Wine Bar. When it comes to meats, she likes them as natural as possible. West Kendall Baptist Hospital Executive Chef Edgardo Llopiz is looking forward to collaborating with Chef Adrianne. “I am excited to be working together as a team,” he said. “I always look forward to learning what others are bringing to the table.”

1. Whisk together honey, soy sauce, garlic, olive oil and black pepper. Place in a large, resealable plastic bag and add the fish. Seal and marinate 20 minutes. 2. C ombine mango, kiwi, cilantro, onion, orange juice and jalapeño pepper for relish and set aside. 3. R emove the fish from bag and discard the marinade. Place fish in a pre-heated non-stick pan coated with cooking spray. 4. C ook over medium heat for about 10 minutes, flipping once. When fish flakes easily with a fork, serve with relish.

NUTRITION FACTS Serving size: 4 servings (4 oz.) Calories: 279; Saturated fat: 1.1 g; Total fat: 10.6 g; Cholesterol: 50 mg; Sodium: 177 mg; Carbohydrates: 24 g; Sugar: 21 g; Protein: 22 g

Smart mouth Beating head and neck cancer starts with awareness and sceenings By Bethany Rundell

hen actor Michael Douglas revealed in 2010 that he had oral cancer, he began a public awareness campaign about head and neck cancer that today is saving lives. Mr. Douglas’ cancer was not caused by smoking or heavy alcohol use — the previously known risk factors for this type of cancer. Instead, a strain of the human papillomavirus, or HPV, was to blame. The same strain, HPV-16, has been linked to cervical cancer. According to the National Cancer Institute, 3 percent of all cancers in the United States occur in the head and neck. These include cancer of the mouth, the larynx or voice box, pharynx or throat, the salivary glands, the nose, or nasal and sinus passages.

that success comes with significant effects on our patients’ quality of life.” That’s why Baptist Health has weekly meetings among radiation and cancer specialists; ear, nose and throat doctors; oral surgeons and dentists; gastroenterologists, nurses, radiation therapists, pathologists, dietitians, speech-language pathologists and social workers. This multidisciplinary team discusses these cases to decide the best treatment with the least impact on the patient’s quality of life. Miami Cancer Institute hematologist and oncologist Michael Troner, M.D., also a member of Baptist Health Medical Group, said that early detection contributes to survival. Fortunately, he added, HPV-related head and neck cancers tend to show symptoms earlier than HPV-negative cancers.

“WE HAVE SEEN AN 80 PERCENT CURE RATE OF THESE HPV-RELATED CANCERS AT BAPTIST HEALTH.” — Andre Abitbol, M.D.

While the National Cancer Institute reports that the incidence of head and neck cancer has declined steadily over the last 30 years, a study published in the Journal of Clinical Oncology noted that HPV-related oropharyngeal cancers increased 225 percent between 1988 and 2004. During that same period, the incidence of tobacco-related head and neck cancer, or HPV-negative cancer, declined by 50 percent. Baptist Health Medical Group radiation oncologist Andre Abitbol, M.D., of Miami Cancer Institute, says that HPVrelated cancer of other parts of the head and neck also are on the rise. HPV-related cancers respond best to treatment, which may include a combination of surgery, radiation therapy and chemotherapy. “We have seen an 80 percent cure rate of these HPV-related cancers at Baptist Health,” Dr. Abitbol said. “But

“We have been encouraging dentists and primary care physicians to perform regular screenings, which can detect this type of cancer even before symptoms show up,” Dr. Troner said. Screenings involve examining the mouth and mucous membranes for abnormal growth or lesions. With an HPV vaccine now available for young people, the incidence of HPV-related head and neck cancers will likely decline over time, said Lisa Reale, M.D., a hematologist and oncologist with Miami Cancer Institute and Baptist Health Medical Group. “Because the vaccines are systemic, they decrease HPV transmission from all over the body,” she said. “Kids vaccinated to prevent sexually transmitted HPV infections will, theoretically, be protected from head and neck cancer — something we will track over their lifetime.”

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In the Know

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Myth VS.

By KiKi Bochi and John Fernandez

Are you stuck with a slow metabolism? t can be frustrating — not to mention disheartening — to sit across the table from someone who seems to eat anything and everything without gaining a pound. You, meanwhile, have to battle against every ounce. Is your metabolism stuck in low gear? Not necessarily.

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Metabolism is the chemical process that converts the food and drinks we consume into the energy that fuels every process in our bodies. It is like a furnace that burns around the clock, sustaining everything from our breathing to our blinking. The number of calories your body uses to carry out basic functions accounts for about 70 percent of the calories you consume daily. The rest is either burned off through activity or stored as fat. If you battle with your bathroom scale, it’s only natural to assume that skinny people must be blessed with a faster metabolism. But that is not always true. In general, larger people actually have a higher metabolism due to their size. “We tend to define people by body type — large or skinny — but there isn’t necessarily a correlation between body size and metabolism,” says Maryanne Samuel, D.O., an internist with Baptist Health Medical Group. People often blame their struggles with weight on their metabolism, but it is rare to have a medical problem that slows metabolism, such as an underactive thyroid gland. Although metabolism typically does slow as we get older, this is usually due to reduced activity and loss of muscle tone,

not the aging process itself, according to the National Institutes of Health. Metabolism can be affected by gender, body size, genetics, hormones and other factors. But the good news is you do have some power over it. One way to rev up metabolism is through strengthbuilding activities. Here’s why: Muscles burn about five times more calories a day than fat tissue. So increasing your muscle density results in burning more calories around the clock — not only while you exercise, but also when you are at rest. A recent study supported by the National Institutes of Health confirms this. After following 10,500 healthy men for 12 years, Harvard researchers found that subjects who did 20 minutes of daily weight training had less abdominal fat than those who spent the same amount of time doing aerobic activities. The reason: Strength training builds more muscle, which keeps your metabolism running at a higher gear. “Many patients don’t understand that you can alter your metabolism,” Dr. Samuel said. “Muscle is more metabolically active than fat. Ruling out any underlying health issues, the more lean muscle you have, the higher the metabolism.” So while you may think your friends eat whatever they want without gaining a pound, they are probably maintaining their weight through proper nutrition, portion control and physical activity. Those factors should be everyone’s focus, rather than blaming your metabolism. “It’s important to be transparent about eating and lifestyle habits that need to change,” Dr. Samuel said. “Keep a food journal, for example. Start an exercise program. Take the stairs more often. Remember, you can change your metabolism.”

In the Know

INFORMATION AT YOUR FINGERTIPS PINEAPP Find the closest locations to you and shortest wait times at Baptist Health Emergency and Urgent Care Centers. Download PineApp for free in the iTunes Store and Google Play for Android.

FACEBOOK Join Baptist Health’s Facebook page to learn about services and events across the healthcare organization and to RSVP to special events.

TWITTER Follow @BaptistHealthSF to receive timely news about Baptist Health healthcare, wellness and fitness.

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Subscribe to Baptist Health’s YouTube channel for engaging videos about programs, the latest health-related technology and special community feature stories.

Get to know your virtual source for healthcare news and information

Whether on a computer or on a mobile device, you can learn more about Baptist Health by visiting its Google+ profile.

BaptistHealth.net/News Here’s what’s coming up on the Health, Life & Community blog: ›HEADS UP: BRAIN INJURY AWARENESS IN TEEN ATHLETES As teenage athletes continue to push the limits of strength and speed, the risk for concussions is an ever-present danger. One school is taking a team approach to preventing these serious injuries through a special partnership with Baptist Health. Find out more at BaptistHealth.net/Concussions. © hartphotography1 / iStock

RESOURCE //

›COLORECTAL CANCER: TAKE CHARGE WITH A SCREENING It’s the second leading cause of cancer deaths in the United States, but there is something everyone can do to prevent it.

Know the causes, the symptoms and how early detection can help save lives. Find out more at BaptistHealth.net/ColonScreening . ›POISON PREVENTION: IT STARTS AT HOME Did you know that more than 90 percent of accidental poisonings occur in the home? Learn the simple steps you can take to make sure your children are safe from the hidden dangers lurking in your cabinets. Find out more at BaptistHealth.net/PoisonPrevention. SAVE THE DATE: For the most up-to-date information on all the events taking place throughout Baptist Health, visit Events.BaptistHealth.net.

YOUTUBE

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PINTEREST Pinterest lets you organize and share all the beautiful things you find on the Web. Browse Baptist Health’s boards to get the latest updates.

INSTAGRAM It’s a fast and fun way to share your photos with friends and family. Post your images at Baptist Health’s Instagram page, #teampineapple.

FOURSQUARE Let your friends know when you are at a Baptist Health hospital or any other Baptist Health facility by simply checking in.

BLOGS Find news and information at Health, Life & Community (BaptistHealth.net/ Baptist-Health-News). The blog allows visitors to interact with a team of writers and health experts. Sign up to receive the blog by email.

THE JOURNEY A Baptist Health Breast Cancer blog (BaptistHealth.net/Breast-Cancer/Blog), it’s an online community where patients, physicians and others can share thoughts about the breast cancer journey.

SHARECARE Find answers to your health questions by connecting with the nation’s leading health experts, care providers and organizations for an interactive social Q & A. This platform is designed to empower users by simplifying the search for high-quality healthcare information.

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BELIEVE IN HEALTHCARE THAT CARES At Baptist Health South Florida, we’re more than a healthcare organization – we’re a family of world-class caregivers brought together by a passion for compassionate care. Baptist Health has a proven record of exceptional patient satisfaction, and is the most highly awarded healthcare organization in the region by U.S. News & World Report. We are committed to caring for our neighbors and improving the health and wellness of the communities we serve. BaptistHealth.net

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