Space Coast Medicine and Healthy Living

Dr. Henderson In Haiti: “Human Carnage Was Everywhere”

Tom Palermo — Fri, 12 Mar 2010 05:05:26 +0000

BREVARD MEDICAL PROS IN HAITI: First Hand Accounts

"The scene was one of massive destruction of buildings, roads blocked with fallen debris and people lying in the streets."

Having done volunteer work in Haiti prior to the earthquake, I wanted to go help as soon as I heard about the earthquake.

On January 13, 2010 I started looking for a sanctioned group with which to go to Haiti, but couldn’t find one. I tried to contact the American Red Cross, but couldn’t get through their endless loops on the automated phone system and on their website.

Dr. Michelle Henderson discusses a patient's condition with a colleague.

I filled out the volunteer paperwork for the American Academy of Orthopedic Surgeons, but nothing was organized to get a team going. Dr. Anthony Ware called to see if I was going, and another friend, Dr. Lyle Ashberg wanted to go.

A physician assistant friend of mine, Liz VanHorn, had been to Haiti and works for a local doctor who is friends with a Haitian man, Alex Von Lignow, who was visiting his sister in Melbourne.

He is a brother-in–law to Dr. Reynold Savain, a Haitian radiologist who built CDTI (Center for Diagnostic Testing and Imaging) du Sacre Coeur Hospital in Port au Prince in honor of his son, who died of a brain tumor.

His goal was to improve healthcare in Haiti with the state of the art facilities at CDTI. Glen Womble, RN and sales rep, heard I wanted to go, and he wanted to go too. Alex, Liz and Glen set up a team of 11 people, doctors, nurses, PAs, to go to Haiti and work at CDTI.

Getting flights to and from Haiti was difficult. We called several airlines, the air force, private companies, and couldn’t find flights. Finally, Missionary Flight International out of Fort Pierce was able to get us on a flight leaving Jan 17.

We gathered as much medication and equipment as we could, took our own food and water purification tablets, DEET, anti-malarial meds, sleeping bags, and anything in general that we thought we would need to survive.

Smell of Death and Infection Was Everywhere

The founder and owner of CDTI Hospital, Dr. Savain, greeted us with enthusiasm at the airport in Port au Prince. After loading all of the gear and supplies we had brought, we drove into the heart of Port au Prince.

“Tent Cities” were everywhere and made up of conglomerations of people under any tarp/sheet/cloth they could salvage held up with sticks in any open area they could find.

The scene was one of massive destruction of buildings, roads blocked with fallen debris and people lying in the streets.

Tangled webs of the notoriously bad electrical wiring hung everywhere waiting to catch any of the living that wandered into the electrified and deadly lair. The smell of death and infection was everywhere.

There were literally hundreds of people crying and laying on the ground with infected wounds, many with broken bones oozing pus sticking out of the skin.

When we arrived at the hospital, which was surrounded by a wall, we were greeted by armed guards at every gate. Half of the hospital was damaged by the earthquake and unsafe, but fortunately the half with the operating rooms and emergency department was stable.

Human carnage was everywhere in the hospital yard and parking lot. There were literally hundreds of people crying and laying on the ground with infected wounds, many with broken bones oozing pus sticking out of the skin.

Family and friends were carrying patients in, some on pieces of wood, with no pain medication, no splints, and generally no emergency services at all to assist them in transport.

French volunteer firefighters and paramedics were treating patients in the yard. A team of doctors and nurses from Dallas had set up a makeshift operating room in the emergency department, a room 12 feet by 20 feet, and were performing guillotine amputations – a surgical technique used in emergency situations for contaminated wounds or infection as a quick means of removing necrotic or damaged tissue.

There were only a few Haitian doctors working, and initially there was a lot of tension between the Haitian, French and Americans. I worked as a liaison and explained we were all there for the same purpose, and encouraged everyone to work together. Tension lessened as the week went on.

Less Than Optimal Conditions

Our team changed into scrubs and went to work. To say that conditions were less than optimal is a gross understatement. We didn’t have enough sterile equipment and the sterilization processor wasn’t working.

Initially the hospital employees wouldn’t help. We set up several tubs of soap and water and betadine and cleaned the instruments the best we could. We lined up four gurneys in the Emergency department with no room dividers to be used as operating tables.

We performed 60 to 80 amputations and wound debridements a day, triaging and prioritizing injured patients by the severity of their injuries. Some had been lying on the ground for days without treatment, and several died because of infection, myonecrosis, kidney failure and dehydration.

Haitian patients are very stoic and grateful. The only pain meds were Motrin and Tylenol for crush injuries and broken bones. No food or water was available for the patients for the first week.

Disappointed in the US Government

Various church groups and agencies showed up and asked what we needed. I am disappointed in the United States government and I never saw the Red Cross. I saw some Marines once, and told them we needed a MASH tent. They never came back. The LDS church was one of the most giving and organized.

They brought food, water, tents, blankets, medication and encouragement. Direct donations can now be made to the CDTI Hospital in Port au Prince by logging on the their website: www.cdtihospital.com.

Working from 7 a.m. to 10 p.m. every day, we ran out of equipment after five days. We billeted in a house with no furniture except some mattresses on the floor, and were thankful for the security provided by the continuous armed guard at the gate.

There were many cracks in the walls of the house from the first earthquake, the main water pipe was broken, so we only had a trickle of water for 20 minutes a day to flush toilets and take showers, and the electricity was by diesel generator only on for short periods.

Just outside the gate, there were hundreds of homeless people sleeping on the ground with no shelter. The lucky ones had a blanket. During the night we often heard guns being fired.
They were in the distance, but it was still disturbing. In the middle of the night, on several occasions, the street people sang hymns. I was told they sang because they were scared of the evil spirits of the dead, and hymns of praise would keep them away.

Aftershock Scare

At 6 a.m. on the morning of the fifth day, a 6.1 aftershock earthquake hit. I thought it was one of the guys shaking my bed to wake me up, but it didn’t stop. Glen started yelling “GO GO GO” and we all ran out of the house. We were scheduled to leave that day, and the quake solidified the decision. We packed our bags and headed to the airport.

All the way to the airport I had second thoughts about staying. There was so much work to do and so many people in need of care – my heart cried out to them. When we got to the airport, there were some supplies that would allow me to keep working so I stayed with one other physician. The rest of the team left.

Returning to the hospital, we continued to work. Organizing and motivating the few Haitian employees to work productively was a monumental task. The good ones helped right away.

As I needed more things done, such as cleaning, triage, cooking for the patients when we received food, the hospital owner, Dr. Savain, would accompany me when trying to communicate with the employees to tell them to do whatever I asked. After a while, they became friendly and cooperative. Only about one third of the CTDI employees ever returned.

Included in the large contingent of Brevard medical professionals who accompanied Dr. Henderson on her first trip to Haiti were, left to right: Cocoa Beach surgeon Dr. Mike McLaughlin; physician assistants Liz Van Hemel and Brian Janke; and Cape Canaveral Hospital Director of Anaesthesia, Dr. Chris Vonderehide.

Language Barrier

Many Haitian people volunteered to translate. Initially I paid them with food. When we were more organized, and I could see how hard they worked, I started paying them $5 per day to interpret, and help move patients to the OR, pass out food and clean the grounds. Other American volunteers also gave me money to pay them.

Various groups of volunteers from all over the world showed up to help – Portuguese, French, Bulgarian, Israelis, Chilean, Brazilian, Korean, Swiss, German, Spanish, Mexican, and Japanese.

Being a part of the medical relief effort in Haiti was a very moving experience. All different cultures, religions, organizations, just wanting to help, working together through language barriers to care for people suffering from this tragedy of biblical proportion was truly Amazing.

To be continued…

Dr. Michelle Henderson

ABOUT THE AUTHOR

MICHELLE HENDERSON, MD is a board certified orthopedic surgeon at Cape Canaveral Hospital . She specializes in hip and knee surgery. A native of Michigan, she attended Michigan State University College of Human Medicine. An avid sports enthusiast (running, biking, surfing, scuba, hunting, fishing, yoga, kite boarding), she takes personal as well as professional interest in the aging athlete.

Smoking Accelerates Aging Process

Tom Palermo — Fri, 12 Mar 2010 03:16:54 +0000

SKIN CARE

Although wrinkles signify wisdom to some people, most people would rather not have them. Fortunately you don’t have to live with them.

Lots of factors affect your skins’ outward appearance. Lifestyles can greatly influence your skin's age. Smoking rapidly accelerates the aging process, and that is evident in the skins’ appearance.

BECAUSE of variations in the intensity of UV-radiation passing through the atmosphere, the risk of sunburn increases with proximity to the tropic latitudes, located between 23.5° north and south latitude.

Sun exposure is another key factor, particularly in those with lighter skin color. Hormonal loss can affect skin age. Repetitive facial movements also lead to fine lines and wrinkles. Genetics also play a role in the aging process.

Damaged skin can have discolorations, age spots, freckles and appear rough and leathery. The damaged skin losses collagen, elastin and fat beneath the skin which results in sagginess, hollowness and wrinkles.

There are a lot of methods to reverse some of these aging signs. For mild cases, sun avoidance and protection can slow the progression. Smoking cessation can halt the damage.

Topical creams like Retin-A and moisturizers can help reverse mild sun damage. For mild to moderate creases or for sun damaged discolored skin aggressive treatments like laser resurfacing and injections are helpful.

Fraxel laser rejuvenates aging skin. The non-invasive micro lasers removes age spots and discolorations and stimulates the regrowth of collagen and elastin tissue that tightens skin and removes mild to moderate wrinkles.

This is the method used by movie stars and is often referred to as the weekend face life. Mild redness or swelling is present for a day or two after the treatments, similar to a moderate sunburn.

The therapy includes a course of four treatments that have little or no down time. The refreshed appearance of the skin lasts many years (depending on your lifestyle) and can take years off your appearance.

Short of having a face lift either via laser or a surgical procedure, there are injectable treatments that can reverse some of the signs of aging. With time muscles become frozen in position and a person can have the appearance of being angry or worried.

Botox relieves these dynamic lines and removes wrinkles from the brow and corner of the eyes (crow’s feet). Botox can relax these worry and age lines giving you a refreshed appearance. Results generally last three to six months.

With time, much of the collagen tissue and underlying fat is lost. This results in hollowness or wrinkles. This loss of tissue can be replaced by fillers like Restylane or Juvederm that replace lost volume.

It is particularly useful for deep smile lines or other lines that develop around the lips. It can also replace lost tissue in cheeks and eye sockets. Fillers can also be used to augment lips to make them appear more luscious.

To contact Dr. Adamcik call 321-327-2980, or CLICK HERE.

ABOUT THE AUTHOR

Dr. Raymond Adamcik, graduated from Rutgers University and attended medical school at the University of Medicine and Dentistry of New Jersey. He completed his postdoctoral training at Loma Linda University Medical Center and is board certified in internal medicine. Dr. Adamcik has been actively involved in independent research in dietary treatment methods and has reviewed thousands of books, journals and scientific articles in this field. He has been a contributor in medical research with particular experience in cholesterol studies.

Dr. Adamcik is the author of The Globe’s Best Diet, which provides step-by-step, easy-to-follow instructions to changing your habits, developing a healthier attitude, and living a longer, fuller, more active life. Culled from his extensive global research and more than 30 years of medical expertise, The Globe’s Best Diet debunks dangerous fad diets and the low-fat lie and helps you learn how to savor the rich, pleasurable experience of eating well. In addition, Dr. Adamcik delves into ways to control your weight that are effective as well as safe and healthy. The Globe’s Best Diet includes sample menus, nutritious and tasty recipes, and sample exercise regimens to assist you in this long-term journey that will provide you with abundant health, energy, and happiness.

Lapband Procedure Changes Steenhoff’s Life

Tom Palermo — Fri, 12 Mar 2010 02:02:02 +0000

LIFESHAPE SUCCESS STORY

In the beginning of 2006, I realized that the quality of my life was severely hampered. I was fat, and that was an understatement as even my doctor’s scale couldn’t weigh me.

Cliff Steenhoff: Before

Cliff Steenhoff: After

The deterioration of my quality of life was a direct result of my body weight. I wasn’t sleeping very well at night and required naps almost every day.

I couldn’t bend over without being out of breath when I straightened up. If I had to stoop down, it felt like my legs were going to break when I stood up.

I could barely fit behind the wheel of my truck, and could steer with my belly. When I went into stores little kids would stare at me. Some would comment to their mother "he’s fat," as their embarrassed mother would try to quite them or scurry away with them.

After I had an umbilical hernia repair the surgeon commented that he would be seeing me again unless I lost weight, and recommended surgery. I explained that I had previously considered Gastric Bypass, but found the potential complications and risks too great, and would be exchanging one set of problems for another.

Dr. Mark Fusco

The doctor told me about a new procedure called Lapband – a modern surgical technique in which operations in the abdomen are performed through small incisions. He explained that all the problems associated with Gastric Bypass were not associated with Lapband and recommended Dr. Mark Fusco, Medical Director of LifeShape Advanced Bariatrics Center of Florida.

"The Best Money I Ever Spent"

After attending a LifeShape seminar, I decided to have the procedure even though my insurance would not cover it. As it turned out, it was the best money I ever spent. I talked with my internist about having the procedure, and he outlined the pros and cons and the possible complications.

A week before my surgery I saw my internist again to discuss how to handle my diabetic medication. I told him I was going to have Lapband and he was elated, telling me how much my life was going to change. He was right!

On the day of surgery I weighed 402 pounds and I had serious thoughts of calling it off because I was scared. I found the operating team very supportive and reassuring. The operating room personnel talked to me as a person and appeared friendly even through their masks.

The anesthesiologist assured me he was going to take good care of me, which I found very comforting and, Dr. Fusco asked me if I wanted to go through with it. I left the surgical center a few hours later without pain and was walking that day.

I am now 191 pounds lighter, weighing in at 211 pounds! I went from a very tight 56 inch pant size to 34. I basically can eat anything I ate before surgery – just less.

"My Quality Of Life Has Skyrocketed"

I am no longer a diabetic. Although I can't steer with my belly anymore, I can release the parking brake without opening the door. If I drop something on to the floor of the car, I can pick it up without getting out.

I recently repainted a couple of rooms in my house and was able to bend over to tape off the baseboards. I can now climb a ladder once again, which I couldn’t do before because my belly was in the way. I sleep for 6-7 hours per night without waking up and find it impossible to take naps. I just do not need them.

It is so nice to go into my closet and decide I can’t wear something because it is too big, or go to Wal-Mart and take something directly off the rack. Besides losing over 22 inches around my waist, I have gone from a 3XXL shirt to an XL shirt, and my shoe size has gone down one and a half sizes. And, I am now almost at the weight I was during my military basic training.

The best part of this journey is how I feel, not only physically but also psychologically. When I walk, I feel good. When I am talking to people I not longer feel fat.

I remember a joke in which the punch line was, "you shouldn't weigh more than your refrigerator." While I don’t know the weight of my refrigerator, I'm confident I weight less than my refrigerator.

I walk an average of 2-3 miles a day and have taken up kayaking. I have always enjoyed bird photography but was restricted to shooting photos from my truck. Now I get out and walk the trails.

Now when I go out to dinner with friends with the full intention of pigging out, I have to ask for a to-go box. I no longer guard my food and encourage friends to eat off my plate.

Full Service Multidisciplinary Weight Loss Clinic

LIFESHAPE TEAM: (standing, left to right) Dr. Mark Fusco, Medical Director LifeShape Advanced Bariatrics Center of Florida;Vicki Gavaghan, Coordinator of LifeShape Fitness; Christa Bert, Coordinator of LifeShape Patient and Provider Relations; Louise Root, LifeShape Fitness Secretary; and Dr. Peter Marzano, Director LifeShape Medical Weight Loss Program. Seated, left to right, are: Christie Brandolini, LifeShape Fitness Personal Trainer; and Cathy Friesela, LifeShape Patient.

LifeShape Advanced Bariatrics Center of Florida is a full service multidisciplinary weight loss clinic that offers physician supervised medical weight loss programs, personalized fitness training and surgical treatment.

"We specialize in Laparoscopic Gastric Band surgery and long-term patient management to help our patients take control of their obesity and regain their health," said Dr. Fusco.

"We offer both the Allergan LAP-BAND® System and the Ethicon Realize Band surgery.

"With a highly-trained team of surgeons, internal medicine doctors, nurses, nutritionists, personal trainers, and psychologists, Life Shape is able to provide patients with a safe and effective weight-loss surgery, comprehensive pre and post-operative education and ongoing aftercare. We are here to guide you to a happier, healthier life," said Dr. Fusco.

LifeShape Opens a Fitness Center Located at 1130 Hickory St. in Melbourne.

"It’s a personalized exercise facility that has equipment and a trainer available. It’s geared toward the needs of a patient who doesn’t want to go to a large facility or gym," said LifeShape Trainer Christie Brandolini.

“We want to add this fitness center that would be personalized to our patients and also the MIMA employees,” said Christa Bert, MIMA’s coordinator of patient and provider relations.

For more information call 321-725-4500, ext. 3623 or CLICK HERE.

Dr. Levine Among Best Doctors of America

Tom Palermo — Thu, 11 Mar 2010 23:43:29 +0000

eHealthWatch Breaking News

BREVARD COUNTY, FLORIDA – Dr. Richard Levine, President of Space Coast Cancer Center, has been selected as a member of “Best Doctors of America.” This is the third time that Dr. Levine, a Board Certified Medical Oncologist has earned this honor in which physicians are nominated by their peers in their specialty.

Dr. Richard Levine

“Best Doctors” is a national organization whose mission is to recognize physicians who provide state of the art cancer care following evidence-based medicine and using national guidelines.

The physicians and staff at Space Coast Cancer Center are affiliate members of Moffitt Cancer Center, providing radiation oncology, diagnostic imaging, chemotherapy, clinical trials and quality assurance studies.

Space Coast Cancer Center is the first practice in the state of Florida to participate in the American Society of Clinical Oncology Quality Assurance Practice Initiative.

As one of five Moffitt affiliates in Florida that participate in the Florida Initiative for Quality Cancer Care, Space Coast Cancer Center is the first practice in Florida – and the second in the United States – to collaborate with the University of Pittsburgh Medical Center implementing and monitoring clinical pathways for patients’ chemotherapy treatments that are compliant with the National Comprehensive Cancer Network Guidelines.

Appointed To National Advisory Board

Dr. Levine was a guest presenter at the Clinical Breakthroughs and Challenges in Hematologic Malignancy Conference hosted by Moffitt Cancer Center. He provided case presentations of non-Hodgkin lymphoma and multiple myeloma and outlined clinical characteristics, state-of-the-art treatment and clinical trials.

In 2009, Dr. Levine was also appointed to the National Advisory Board of the International Oncology Network which is comprised of 3,000 medical oncologists who collaborate to improve the quality and service cancer patients receive in the community office setting. The advisory board’s primary focus is to establish clinical pathways and guidelines for patient care and to promote practice efficiencies.

The board also help physicians incorporate current health trends in their practice, including the use of electronic health records, e-prescribing, pay for performance protocols and new technology advances.

Dr. Levine is a Past President of the Florida Society of Clinical Oncology, Parrish Medical Center Medical Staff, the Brevard County Unit of the American Cancer Society and is a member of several area and state advisory boards.

The Space Coast Cancer Center Titusville complex opened March of 2008. The 22,000-square-foot, state-of-the-art facility provides a seamless, multi-disciplinary approach to treatment. The elegant facility allows patients to concentrate on recovery by offering easy access to all necessary treatment modalities.

For more information call 321-268-4200 or log on to www.SpaceCoastCancer.com.

Harris Family Medical Center Invests In Employee’s Good Health

Tom Palermo — Thu, 11 Mar 2010 00:34:30 +0000

FACILITIES SPOTLIGHT

THE HARRIS FAMILY MEDICAL CENTER was established by Harris Corporation to provide high-quality, primary health care services to participants in the Harris Corporation Health Plan.

HFMC provides one-stop medical care for patients of all ages, with the integration of the Medical Center, on-site pharmacy and lab and the University Center Imaging.

Lynn Sprunger

LYNN SPRUNGER likes to tell the story of a couple who joined the Wellness Program at Harris Family Medical Center hoping to lose weight and increase their stamina. Nine months later, between them they’d lost more than 100 pounds. “They were able to go on a hiking trip for the first time,” said Sprunger, director of operations at HFMC.

They serve as a success story for their own determination, as well as for Harris Corp. As the Space Coast’s largest employer, the company has a major investment in the wellness of its employees and the community. So it follows that the company would be proactive in helping its employees maintain their health.

To that end, the company operates health services and wellness programs through its corporate-sponsored health clinic. Harris Family Medical Center provides access to primary-care physicians, a full-service pharmacy and a diagnostic imaging center.

The company estimates that 60 percent of the adult population connected to Harris in Brevard County has used HFMC, which opened in November 1997. Results of third-party evaluations of patient satisfaction have been positive. “That tells us that we’re on the mark. Certainly, we’re meeting the employees’ needs,” said Ron Wyse, director of employee benefits for the company.

AS THE SPACE COAST’S largest employer, Harris has a major investment in the wellness of its employees and the community. So it follows that the company would be proactive in helping its employees maintain their health.

The hiker couple took part in HFMC’s Wellness Program, which teams a patient with a registered nurse to develop a personalized diet and fitness plan. More than 700 patients are enrolled in the program, Sprunger said.

When patients join the free program, HFMC asks that they make a one-year commitment. Patients fill out a health-risk assessment, have blood work done and meet with a nurse for a one-on-one counseling session. The nurse works as a sort of health coach to help the patient hammer out goals and a path to accomplish them. “We don’t give them a plan and tell them this is what you need to do,” Sprunger said.

Many patients enrolled in the program are working on lowering their blood pressure, losing weight, controlling diabetes, or a combination of the three. They might be given a food diary and asked to record all that they eat and drink. Or they might agree to walk 10,000 steps a day, as measured by an HFMC-issued pedometer.

If people balk at making major changes, the nurse might make a basic suggestion to start with, Sprunger said. “We’ll take a can of soda out of your diet every day. Just one soda,” she said.

Progress is monitored through further evaluations and more blood work, both as a way to oversee health and encourage more progress for patients whose results are improving. “They tend to be more successful if they actually see the printed number, rather than us just saying, ‘Your cholesterol is down,’” Sprunger said.

The program is part of HFMC’s range of services which also include:

Primary Care
The clinic employs four full-time and one part-time physician to serve as primary care doctors. Mental health services are available through a psychologist, psychiatrist and a social worker who specializes in adolescents.

Pharmacy
Harris employees know a good deal when they see one. The Harris pharmacy fills 75 percent of all prescriptions Harris employees and family members have filled in Brevard, the company said. The pharmacy charges a $7.50 co-payment for generic drugs and $22.50 for preferred brand, compared with $10 for generic and $30 for preferred brand for outside pharmacies. If the prescription is written by a HFMC doctor, the patient can buy a three-month supply of the medication at one time.

University Center Imaging
Though not a Harris-owned center, University Center Imaging operates adjacent to the facility and provides diagnostic imaging to HFMC patients. The center recently added digital mammography to its services.

Wellness Sessions
In addition to the Wellness Program, HFMC offers informational sessions on topics of concern. The schedule generally follows national wellness observances, sponsoring, for example, breast cancer awareness talks during October. The center also responds to patient concerns. “If we have a run of patients who come in with osteoporosis, we’ll put together a lunch and learn,” Sprunger said, referring to the center’s lunchtime educational sessions.

After the MRSA staph infection killed a Central Florida high school football player in September, the office was flooded with calls from concerned parents. Medical director Dr. Marissa Rocourt gave a presentation on the condition to help dispel misinformation.

MEET THE HARRIS MEDICAL CENTER STAFF

Dr. Chrieki

Milad Chrieki, M.D.

Board Certified in Family Practice
Lvov State Medical School, Lvov, Ukraine 1988
Residency in Family Medicine, State University of New York, Buffalo, NY (1992-1995)
Faculty Development Fellowship, Clinical
Assistant Professor, State University of New York Buffalo, NY (1995-2003).

Dr. Fisk

Perry Fisk, R.Ph

College and Degree: Xavier University of Louisiana, BS Pharmacy
Professional Organizations: Brevard County Pharmacy Association
Personal interests: chess, guitar, travel and sports

Dr. Kirwin

June Kirwin, R.Ph.

College and Degree: University of Florida, BS Pharmacy
Lvov State Medical School, Lvov, Ukraine 1988
Professional Organizations: Florida Pharmacy Association, Brevard County Pharmacy Association, Academy of Managed Care Pharmacy
Personal interests: bicycling, travel, cooking

Dr. Rocourt

Marissa Rocourt, M.D.

Robert Wood Johnson Medical School Piscataway, NJ 1996
Residency in Internal Medicine Robert Wood Johnson University Hospital / St. Peter’s University Hospital, New Brunswick, NJ (1996-1999)
Member of American Medical Association (AMA)

Dr. Sum

Suzanne Sum, R.Ph

College and Degree: BS UF Chemical Engineer; UF College of Pharmacy
Professional Organizations: Florida Pharmacy Association
Personal interests: Shopping, working out

Dr. Toth

Paul Toth, R.Ph.

College and Degree: Xavier University of Louisiana, BS Pharmacy
Professional Organizations: Brevard County Pharmacy Association
Personal interests: chess, guitar, travel and sports

Dr. Wolfington

Michael Wolfington, D.O.

Nova Southeastern University of the Health Sciences, Miami, FL 1992
Florida Hospital, Orlando, FL Chief Intern, Internship
St. Vincent’s Hospital Family Practice Residency Program, Jacksonville, FL 1993-1995
Member of American Medical Association (AMA)

Dr. Wright

Nadine Ramdeen-Wright, M.D.

University of The West Indies Medical School Jamaica, West Indies (1997)
Yale University Bridgeport Hospital Program Bridgeport, CT (2001-2005)
Dr. Wright was born in Jamaica and immigrate to the United States in 2000.

Electronic Medical Records Firm Born Out Of Necessity

Tom Palermo — Wed, 10 Mar 2010 19:46:51 +0000

MEDICAL TECHNOLOGY

DOCTORSPARTNER owners Naveen Venkatachalam and Dr. Geetha Priyanka are closely watching the federal government’s efforts to encourage physicians to adopt Electronic Medical Records.

BREVARD COUNTY, FLORIDA – A quiet office doesn’t usually signal a bustling business. But to the founders of DoctorsPartner, the absence of ringing phones at the company’s Melbourne, Florida call center means their product is successful.

DoctorsPartner provides software that helps doctors maintain electronic medical records and manage their practices. The product needs little support, boasts Naveen Venkatachalam, who created DoctorsPartner with his wife, Dr. Geetha Priyanka.

The idea for the software product was born of necessity. Priyanka, an internist, wanted to computerize medical records when she started her own practice. “The prices people wanted to charge were ridiculous,” she recalled, citing figures upwards of $120,000 for the service.

And yet, she was convinced of the need. Priyanka had worked for large groups before branching out on her own, and she’d seen the chaos that paper charts can cause. She remembers when Baycol, a cholesterol-lowering medication, was recalled. Individual paper charts had to be manually consulted so the practice could notify every affected patient of the recall. “It took hours and hours of work,” she said.

If the practice had used electronic medical records, also known as EMR, the same function could have been performed in less than a minute.

She didn’t need to look far for a computer expert to engineer a solution. A former IBM employee, Venkatachalam has a background in finance and worked in business software.

In fact, his computer expertise is somewhat responsible for bringing them together. The two were acquaintances when Priyanka was working in New Jersey and wanted to develop a web site for professional women. “I was the only computer guy she knew,” Venkatachalam said, so she contacted him about the idea. That web site didn’t end up coming to fruition, but they did create a site for pet owners based on their hobby of showing dogs. The couple married in 2002 and moved to Melbourne the following year.

Affordable and Functional

Priyanka wanted to build a top-notch product and make it available to doctors at an affordable cost. They launched the business in early 2003, offering three main product lines:
• Solo doctor and small office system. A small office can get started with the basic product, known as Daylite, which offers just the EMR feature. The company often provides the starter package at no charge, knowing that doctors will like the product, grow their business, and need a more powerful version.
• Mid-level product. The full-blown DoctorsPartner system includes the EMR function, as well as practice management features.
• Large group customization. “Some practices are so big or specialized that nothing fits them out of the box,” Venkatachalam said. They might have multiple offices that provide care for large companies and need customization for their particular business.

Versatile and Efficient

The software performs a variety of functions. In addition to managing a database of electronic medical records, DoctorsPartner can provide automated calling to patients to remind them of upcoming appointments.

It’s also a single source for a variety of hospital and other forms that can be scanned in and signed on-screen. Lab work can be integrated into the system and electronically fed into the EMR. And at the end of the workday, bills are automatically generated.

DOCTORSPARTNER’S practice management solutions – part of its integrated EMR product – ranked Best in KLAS among small doctor offices in the company’s annual ratings in 2007. The Electronic Medical Records side also fared very well, coming in second place.

As a doctor, Priyanka knows that what works for her specialty won’t apply to someone else’s. So DoctorsPartner documents can be modified easily to accommodate an ear-nose-throat specialist or a cardiologist. Different specialties working at the same practice can customize their screens based on a different login.

And patients will appreciate the convenience of being able to fill out medical forms at home and have them imported into the system, instead of the “arrive-15-minutes-early” routine. A portal feature allows a patient who has an account with a doctor to plug into the doctor’s website and fill out forms, request an appointment or ask for a prescription refill.

DoctorsPartner installs a server in the doctor’s office, so that all data is in-house and is not relying on the Internet to be operational. But the system can be accessed by the doctors via the Internet when they’re away from the office, using the same security as Internet banking transactions. Priyanka recently used the feature during a trip to India. She was able to connect with the system and work from there.

“Naveen runs a tight ship. They’re very responsive to what people are looking for,” said Mark Wagner, director of ambulatory research for KLAS. The Orem, Utah-based company monitors healthcare technology products and firms to help healthcare providers make informed technology decisions. KLAS provides annual ratings of vendor performance based on research with thousands of healthcare organizations.

DoctorsPartner’s practice management solutions – part of its integrated EMR product – ranked Best in KLAS among small doctor offices in the company’s annual ratings in 2007. The EMR side fared very well, coming in second place.

Users particularly liked the company’s training support and responsiveness to requests for new features, Wagner said.

Scores slipped in the 2008 ratings, which came out in December. Wagner suspects that users are concerned about where the company fits in the future of healthcare. Its small size makes DoctorsPartner nimble, but also might mean limited resources to address challenges, he said.

DoctorsPartner’s business model counteracts those concerns, Venkatachalam said, by using a subscription system. He explains the benefit by contrasting the company to a system like Microsoft Word. Buy the software, and you’ll incur a one-time fee and get to use the software forever. When there’s an upgrade, you’ll need to invest more – or you can put it off. Many EMR companies operate the same way, charging very high upfront fees and basing their success on continued sales.

That hasn’t worked so well in the current recession, Venkatachalam noted. But DoctorsPartner continues to thrive because of its approach. The company charges much less upfront, but then continues to receive subscription fees. Clients receive frequent upgrades without having to make another big purchase. The result is more staying power. “Our revenue stream is guaranteed,” Venkatachalam said.

Customers particularly like the fact that DoctorsPartner requires little investment after the initial purchase, Priyanka said, and doesn’t nickel-and-dime the customer.

Conform Or Be Penalized

Like all companies, DoctorsPartner is closely watching the federal government’s efforts to encourage physicians to adopt EMR.

NAVEEN VENKATACHALAM created DoctorsPartner with his wife, Dr. Geetha Priyanka.

As part of this year’s stimulus package, doctors can get federal money by meeting meaningful use standards by 2011. If a practice hasn’t met the standard by 2015, they’ll be financially penalized.

The mechanism for the carrot and stick is Medicaid and Medicare reimbursements. Qualifying practices will get a higher percentage in reimbursements, and penalized practices will get a lower percentage. The goal is to improve patient care and reduce medical errors, both results that have been shown to accompany EMR utilization.

The sheer number of practices that have not yet adopted EMR – estimated at 75 percent of the half million practices nationwide – mean that vendors are likely to be overwhelmed once standards are clear and practices move to comply.

DoctorsPartner already anticipates certain requirements and is working those in now, Venkatachalam said. More details about requirements for EMR systems are expected to emerge in the fall. “There’s a mad scramble to find out what the software has to do,” Venkatachalam said.

Beyond the federal standards, his personal vision for the future includes technology that would allow patients to check in and out by a hand-scan device, introducing a new level of privacy for the patient.

CLICK HER FOR RELATED STORY

Regardless of the politics involved in President Obama’s Economic Stimulus Plan, recent legislation tied to this plan begins a long and complex expansion of foundation principles required for increased adoption and usage of electronic medical records by physicians and patients.

All Men At Risk For Prostate Cancer

Tom Palermo — Wed, 10 Mar 2010 18:51:17 +0000

MEN'S HEALTH

PCA Second Leading Cause of Cancer Death in American Men

Dr. Nicola Ally

As a radiation oncologist, I counsel many men with prostate cancer (PCA) about treatment options. After skin cancer, PCA is the most common cancer and the second leading cause of cancer death in American men. The American Cancer Society estimates that over 192,000 men will be diagnosed with PCA in 2009 and about 27,000 men will die.

The hormone testosterone drives the growth and development of the gland and PCA. Medications that interfere with testosterone production or metabolism are used to treat prostate disease and PCA.

The most common type of PCA is adenocarcinoma. In late stages, PCA can spread to the urinary passage, bladder, tissues around the prostate, lymph nodes and/or bone.

Risk Factors & Prevention

THE PROSTATE GLAND is located at the base of the bladder. The urinary passage pierces the gland like a core through an apple, so prostate disease often interferes with urination. The prostate is also a conduit for sperm and the gland produces fluid to support sperm function. Nerves for erection are located near the back and sides of the gland surface.

Vasectomy, prostate enlargement, infection or previous general surgery to the prostate and bladder are not considered risk factors for PCA. Risk factors include:

Aging; risk increases after age 55
African-American heritage; diagnosed with more aggressive and advanced PCA
Family history of PCA
Previous biopsy demonstrating PIN (prostatic intraepithelial neoplasia)
Obesity, high-fat diet
Testosterone supplements; controversial, but short-term use runs low-risk.

PIN is a precancerous change in the gland. It can take up to 10 years for PIN to develop into PCA and 40-60 percent of men with PIN will have PCA on subsequent biopsies.

Finasteride was studied in over 18,000 healthy men in the Prostate Cancer Prevention Trial. The most significant finding was that finasteride reduced the risk of developing PCA by 25 percent. Finasteride interferes with testosterone metabolism.

Selenium and/or vitamin E do not prevent PCA based on the recent SELECT trial. Saw palmetto does not prevent PCA, but it can relieve prostate enlargement.

Annual PSA check and digital rectal exam of the prostate will help to detect prostate problems at an early stage.

Diagnosis & Screening

Prostate glands make the protein PSA (prostate specific antigen). PSA blood levels can be high with prostate enlargement, infection, inflammation or cancer. Digital exam may be abnormal (large gland, nodules). However, men with PCA may have few symptoms, and a “normal” exam and PSA.

In men 50 years or younger, PSA less than 3.0 ng/mL is “normal.” The prostate enlarges with age, so PSA of less than 4.0 ng/mL is “normal” in older men.

In the past, 70 percent of men were diagnosed with extensive PCA. Since PSA testing began in 1988, 75 percent of men are now diagnosed with early disease. Using PSA to “screen” men for PCA is controversial because PCA is usually slow-growing and very common; many men may be treated, but eventually die of other causes.

If the cancer is caught at its earliest stages, most men will not experience any symptoms. Some will experience symptoms that might indicate the presence of prostate cancer, including:

A need to urinate frequently, especially at night;
Difficulty starting urination or holding back urine;
Weak or interrupted flow of urine;
Painful or burning urination;
Difficulty in having an erection;
Painful ejaculation;
Blood in urine or semen; or
Frequent pain or stiffness in the lower back, hips, or upper thighs.

Because these symptoms can also indicate the presence of other diseases or disorders, such as benign prostatic hypertrophy or prostatitis, men who experience any of these symptoms should undergo a thorough work-up to determine the underlying cause of the symptoms.

High-risk disease factors include:

PSA level greater than 10 ng/mL
Prostate digital exam and imaging (CT scan, MRI, bone scan) indicates PCA spread beyond gland, lymph nodes or bones
Gleason score from biopsy of 7, 8, 9 or 10 (more aggressive disease).

I also consider factors related to your fitness and quality of life, such as your age, activity level, medical problems and concerns over urination, enlarged prostate, fertility and impotence.

“Watchful waiting” refers to deferring treatment in early, low-risk PCA until the PSA rises quickly or you develop symptoms of advancing disease. This approach is not recommended for healthy, young men or men with high-risk disease. It is appropriate for those with major illness or a life expectancy of less than 10 years, because they are more likely to die of causes other than PCA.

Treatment Options

Surgery and radiation therapy are the mainstays of treatment. Radical, laparoscopic or robotic prostatectomy are ways of removing the gland (and sometimes, lymph nodes). Radiation therapy involves the use of high-energy, targeted x-rays to damage the genetic material of the gland, resulting in gland death. Radioactive seeds can also be placed in the gland to achieve a similar result.

We generally recommend surgery for men younger than 55 years. In older men with early disease, surgery or radiation offer excellent and equivalent cancer control with survival rates approaching 90 percent over 10 years.
For men with more high-risk features, a combination of radiation therapy with anti-testosterone therapy has been shown to improve cancer control and survival.
Men with PCA that has spread to many lymph nodes and/or bones (metastatic disease) are usually treated with anti-testosterone therapy alone. Radiation can relieve pain from enlarged lymph nodes or bone disease.
Chemotherapy is used in metastatic disease when anti-testosterone therapy no longer controls the spread of PCA. There is active research into different chemotherapy combinations and/or “vaccine” trials for metastatic PCA.
I do not recommend anti-testosterone therapy as the only treatment for early PCA. This therapy must be long-term and is associated with many side effects, such as weight gain, hot flashes, impotence, fatigue, osteoporosis, and exacerbation of hypertension, diabetes and heart disease.
Proton therapy (a form of radiation) is expensive and not widely available. It offers a few advantages but the majority of men with PCA can be treated effectively and safely with traditional radiation therapy. Cryosurgery and high-frequency ultrasound (HIFU) are emerging therapies. Compared to surgery or radiation, we do not have long-term data on how effective these therapies are for prostate cancer, particularly in high-risk cases.

This millennium, there are several options for men with PCA and many reasons to have hope for a brighter and healthier future. For more information log on to www.CancerCareBrevard.com or call 321-952-0898.

Dr. Ally is a board-certified radiation oncologist with Cancer Care Centers of Brevard. She specializes in adult oncology and is specially trained in the use of radiation therapy in the management of cancer and benign disease. Dr. Ally enjoys a close relationship with her patients and has a special interest in radiosurgery and prostate, lung, breast, colorectal and skin cancers; and she serves on the Board of the American Cancer Society. Dr. Ally and her colleagues provide state-of-the art radiation therapy in Merritt Island, Melbourne and Sebastian. They are a comprehensive cancer center and also provide medical oncology and hematology services. To reach Dr. All call 321-952-0898.

CLICK HERE FOR RELATED STORY

BREVARD COUNTY, FLORIDA – Cancer Care Centers of Brevard pulled out the stops to welcome Dr. Diely Pichardo – their ninth physician to their staff, during an open house this week. As valets parked cars and guests enjoyed an array of imaginative hors d’oeuvres, Dr. Pichardo mingled with the crowd.

Leadership Coach Linda Cobb On SpaceCoastMedicine.com Radio

Tom Palermo — Fri, 05 Mar 2010 04:46:54 +0000

SPACECOASTMEDICINE.COM RADIO SHOW

SpaceCoastMedicine.com Radio Hour – Saturdays at 10:00 a.m. on ESPN 1560 AM

Log on to http://www.livestream.com/espn1560wint to hear the LIVE STREAM

BREVARD COUNTY, FLORIDA (Feb. 3, 2010) – The SpaceCoastMedicine.com Radio Show will broadcast this Saturday live from the Cumulus Broadcasting studios located in Melbourne, Florida.

: Dr. Pete Weiss

The SpaceCoastMedicine.com Radio Show – hosted by Dr. Pete Weiss, MD, and broadcast veteran Katie Bokunic, features local and national health and medicine experts to educate you about the latest information available to help you remain healthy and vibrant – and fight the aging process.

The show also highlight inspiring guests who have survived cancer, organ transplantation and severe trauma.

Coach Linda Cobb

This week's special guest is Linda Cobb, a personnel psychologist, life/leadership coach, and author who has worked in the field of human development for over 25 years.

: Coach Linda Cobb

She has a longstanding personal interest in wellness and has worked with healthcare organizations for many years including hospital wellness programs, Employee Assistance Programs, and trauma debriefing teams, and was the behavior specialist with the Health First ProFit Program for 15 years.

‘Coach Cobb’ began her private coaching practice in 1997, following her graduation from CoachU, and initiated a ‘coaching skills program’ for supervisors at Health First. She has offered programs at Parrish Medical Center, Brevard Workforce Development Board, Brevard Achievement Center, and others.

A Registered Corporate Coach, Ms. Cobb is a master coach/ facilitator through the Arbinger Institute. Linda also added assessment certifications and uses them to helps leaders better understand themselves and their teams, as well as make better hiring decisions.

Ms. Cobb became certified in Retirement Coaching in 2006, and most recently completed certification in ReCareer Coaching. She now works with leaders to help them re-discover and clarify their dreams, develop ‘personal roadmaps’, and direct change in their lives. Her personal mission is to empower people to fully ‘lead’ their own lives by nurturing choices that best serve them physically, emotionally, and spiritually.

You may ask questions during the broadcast by calling 321-984-1234 during the show.

: Katie Bokunic

"Dr. Pete" (www.drpeterjweiss.com) is a physician, healthcare executive, author, speaker and health coach with a passion for helping others to health and wellness. Dr. Pete has recognized that traditional medical care isn’t helping many people to become well, and his personal mission is empowering individuals to manage their own health. His book on personal health, More Health, Less Care, is due out soon.

Ms. Bokunic, a long-time broadcast veteran, has more than 25 years experience in multimedia advertising, marketing, public relations and radio broadcasting.

The show is broadcast every Saturday at 10:00 a.m. on ESPN 1560 AM, and is also be available via Podcast by accessing http://www.livestream.com/espn1560wint

To advertise, or for sponsorship information, call 321-615-8111, or e-mail SpaceCoastMedicine@gmail.com.

HealthFirstReality.org: Expectant Mother, Experienced Team

Tom Palermo — Fri, 05 Mar 2010 03:32:30 +0000

LIVING PROOF: The Story of Jennifer Gale

What started as a happy pregnancy turned into a race against time. Amidst Jennifer’s emergency C-section, her baby’s life-threatening condition, and 14 units of blood transferred, Health First took the strong, knowing actions to save not one life, but two.

CLICK HERE TO SEE THE STORY>>>

Quick Care Clinic Featues Extended Hours

Tom Palermo — Fri, 05 Mar 2010 03:30:53 +0000

FACILITY SPOTLIGHT

BREVARD COUNTY, FLORIDA – “Minute clinics” are unsurpassed for non-emergency assistance after physicians’ regular office hours. Sore throats, sprains, strains, insect bites or minor burns sometimes happen at the very inopportune time when your family doctor has gone home for the night.

For fast “after hours” treatment of these minor illnesses, nothing can beat minute clinics such as Health First’s Quick Care Clinic, which offers convenience and speed for patients in Melbourne and surrounding areas. The only facility of its type in the area, the clinic opened in November of 2009.

Judy Killebrew

“It’s a walk-in clinic for non-emergency issues,” said Judy Killebrew, chief operating officer at Holmes Regional Medical Center.

Located on the site of Holmes' former emergency room, Quick Care Clinic treats fevers, earaches, coughs and other cold and flu symptoms, as well as urinary tract infections, sinus infections, sprains, strains, rashes, minor burns and small cuts.

“I’ve used it myself for my children,” said Judy Killebrew, chief operating officer at Holmes.

“If you can’t get to a physician’s office the same day, you can come here.”

The clinic’s appeal goes beyond the convenience of extended hours.

“We try to minimize waiting time for patients,” added Killebrew.

Without Quick Care Clinic, patients who needed treatment for non-emergency issues often resorted to the emergency room, geared to prioritize treatment according to the level of illness or injury.

“What was happening was that patients were going to the ER and would have to wait a long time,” said Killebrew.

Extended Hours

Quick Care’s extended hours provides a much shorter waiting time than Holmes’ Emergency Department, the county’s largest and busiest. There is no need for an appointment and clinic treatment costs are usually significantly less than a visit to the ER.

In addition to treating life’s little illnesses and mishaps, the clinic also offers wellness and prevention services that include cholesterol, diabetes and blood pressure screening, as well as sports physicals, pregnancy testing, ear wax and sutures removal and vaccinations for flu, pneumonia, hepatitis, tetanus and MMR.

For added convenience, a full service pharmacy is next door, making filling prescriptions a cinch. The pharmacy also carries over-the-counter medications.

Currently, the clinic is averaging 15 to 20 patients per day. As the clinic gets busier, Killebrew expects to add additional staff to maintain a quick turnaround for patients.

“Patients really appreciate the no-wait.”

The clinic is staffed by licensed advanced registered nurse practitioners and physician’s assistants from Brevard Emergency Services. These professionals are supervised by emergency department physicians.

“We’re not a substitute for your primary care physician, but we offer one-stop, quality care that is very convenient,” said Killebrew.

Quick Care Clinic is located at 1350 S. Hickory Street on the south side of Holmes Regional Medical Center campus and is open from 8 a.m. to 7:30 p.m. Mondays through Fridays and from 9 a.m. until 5:30 p.m. on Saturdays and Sundays. For information, call 434-1735.

Radke Has the Tickets To Grow the “Network”

Tom Palermo — Fri, 05 Mar 2010 02:38:12 +0000

BREVARD PHYSICIANS NETWORK

BREVARD COUNT, FLORIDA – When Brenda Radke took over the helm as CEO of Brevard Physicians Network in July of last year, she brought an impressive background in almost all aspects of the health insurance field.

BRENDA RADKE took over the helm as CEO of Brevard Physicians Network in July of last year.

For almost two decades, Radke was immersed in some of the largest health care groups in the state, including Humana Health Care of Florida, Wellcare of Florida, United Healthcare of Florida and Accountable Health Plans.

She served as director of finance for Humana as well as the corporation’s director of wholly owned affiliated physicians clinics.

She was also regional director of provider operations for Care Plus, executive director of Wellcare of Florida, finance manager for United Healthcare and director of provider operations for Accountable Health Plans.

A Massachusetts Yankee, Radke moved to Brevard not because of the weather, but rather because of love.

“I met my husband while vacationing in Florida,” said Radke. “We married and moved to Orlando.”

When Alexandra arrived, Radke tried the stay-at-home-mom lifestyle, but soon chafed to get back to business. “I just wasn’t designed for it,” she said.

Fortunately, husband Barry decided to put on hold his career in advertising, freeing Radke to return to the healthcare world.

The Radkes moved to Brevard last year when Brenda assumed her new CEO role with BPN.

Transitioning from the world of insurance to the universe of physicians was easy for Radke.

“While I was in the insurance industry, I always had dealings with BPN,” she said. “I’ve known BPN for years and years, except that I was on the other side of the desk.”

While working for CarePlus, Radke met with the BPN board, who were so impressed with her understanding of the complexities of the insurance industry that they suggested she apply for the recently vacant CEO position.

“I was happy with my job, but I thought it wouldn’t be a bad idea to throw my hat in the ring,” said Radke.

She was thrilled with both getting the job and moving to Brevard. “We love it over here,” she said. “This is such a welcoming community.”

Since BPN is a not-for-profit entity, any profits the organization achieves must be distributed to charitable endeavors.

“Because BPN is not-for-profit, we’ve had the opportunity to get to know many charitable organizations in the area,” said Radke.

“It has given us an opportunity to get involved.”

Radke holds degrees in business administration and healthcare management and is currently preparing for coding and billing certification through the American Academy of Professional Coders.

Her comprehensive experience in the field is, as a New Englander would put it, a “wicked” asset to Brevard Physicians Network.

“Spending so many years working for managed care and insurance companies, I know what motivates them and what their expectations are,” said Radke.

“I serve as intermediary so there can be a more harmonious relationship between physicians and insurance companies.”

Kiteboard Outing Almost Ends In Tragedy

Tom Palermo — Fri, 05 Mar 2010 02:21:04 +0000

ALTHOUGH BOARDERS will tell you that it is a sport any physically fit individual can conquer, kiteboarding can be deadly if conditions conspire against you.

I met John Ritter kite boarding on the Banana River. He found out I was a doctor, and came to my office for a second opinion regarding his shoulder. Little did he or I know that he would be saving my life.

Kite boarding is like surfing or wake boarding with a 13 meter kite that looks like a parachute with an inflated edge pulling you along the water.

It was a really windy Sunday. John and his wife Nancy agreed to meet me at the river. Nancy doesn’t kite, but likes to jet ski and was willing to follow me with the jet ski to give me a ride back if I couldn’t get back upwind. I was going to take another lesson that afternoon and wanted to practice before my lesson.

The winds were a little gusty. John was kiting nearby, and would shout out helpful instructions. I was going along pretty well, but started to get tired, so decided to stop. Landing the kite on the water, I released one of the safety lines and started to pull it in.

However, before I had the kite secured, a gust of wind came and re-launched the kite.

Because I had released one of the lines, the lines were uneven, creating a predicament in which the kite was flying wildly. Luckily there was another safety release, and I released the “chicken loop,” a strap that connects the kite to the harness.

The kite crashed down to the water. I was still connected by a leash. I started pulling the kite in, and it launched AGAIN!

This time the kite was spiraling out of control. It would spin around several times and crash into the water. Each time it dove down, it would drag me under water.

The harness was pulling so hard on my chest and jerking so hard, I could hardly breathe when I wasn’t under water. I struggled to release the leash, which would free me from the kite.

The leash was twisted from the spiraling kite and I couldn’t get it. I thought I was going to die, and told God that I was not ready to die. Water was rushing in my mouth and nose. I was gasping for breath.

I Thought, “This Is It, I Am Going To Die”

John heroically flew his kite to me. He ditched his board, and did a body drag to me. He pulled my drowning body from the water while flying his kite and trying not to crash his kite into my kite, which we had no means to control.

He held me out of the water long enough to cough out some water and attempt to get some air, but the harness was still squeezing my chest, making it difficult to breath. He told me to release the third safety on the leash, but the leash had twisted around from the spiraling, and I couldn’t get to the release.

He reached down and tried too, but the pressure from the water and tangled mess prevented him from succeeding. He couldn’t get it. He says he saw water going in my mouth and coming out my nose. Then he let go of me! I thought, “This is it, I am going to die!”

The few breaths of air helped me gain some strength, and I figured out if I pushed down on the leash with one hand and used my other hand as a rudder, I could stay above water a little better. My only chance was to try to make it across the river, and hopefully, the kite would crash into something on shore and stay down.

Bargain With God

Meanwhile, John had landed his kite and detached himself from his kite. His wife, Nancy picked him up on the jet ski. I was going so fast, they had a hard time trying to catch me. Eventually they were able to get past the kite.

I saw what they were trying to do. I was afraid the kite would crash into them, or the lines would behead them. I bargained with God, and said “God, if anybody is going to die today, let it be me not them trying to save me. It’s my fault, not theirs.”

John timed the kite, and just as the kite crashed into the water he jumped from the jet ski onto the kite. Then he slid off! He was able to grab a line and pull himself on the kite, and deflate the kite. I was exhausted, and just laid in the water.

After about a minute, I started winding up the lines while John gathered up the kite. Nancy picked us up on the jet ski. We went back to John’s kite, and eventually back to shore. I thanked them, and God, for letting me live.

I counted as I untwisted my lines, and my kite had spun over 200 times. John went for another ride with his kite. I invited John and Nancy over for wine, relaxation in the hot tub and a lobster dinner that I cooked. We celebrated life.

Thanks, again, John and Nancy!

ABOUT THE AUTHOR

Kite Boarding Docs

Kite Boarding Docs

Tom Palermo — Fri, 05 Mar 2010 02:04:53 +0000

“For whatever reason, doctors seem to gravitate towards the sport.” – Dr. Bjorn Dimberg

Dr. Jim Neel are among a bunch of physician kite boarders who lust for the wind and waves of Melbourne Beach.

BREVARD COUNTY, FLORIDA – Whenever the winds surge and the waves rush, the coconut telegraph lines buzz with activity. It’s kiteboarding weather.

Strapping a powerful giant kite to your body while zipping across the water at 20+ miles an hour atop a board the size of a beach mat may not be some people’s idea of a rational sport, but becoming a human skipping stone propelled by a kite is just the right way to relax for kiteboarding’s many fans, including several Brevard physicians.

DR. BJORN DIMBERG of Atlantis Urgent Care Clinic in Indian Harbour Beach. Dr. Dimberg zealously guards the time he can spend kiteboarding. “I don’t want my wife to learn so it won’t cut into my kite time,” he joked. “Otherwise, I’d have to take care of the kids while she was on the kite.”

“You have the power of a boat on lines attached to you,” said MIMA oncologist Dr. James Neel.

Credit the Europeans in the 1970s and 80s for the idea of using a kite for power, albeit they first used it to propel themselves over the very different terrain of Alpine mountains. “The French brought it to Hawaii then,” said Neel.

Neel always keeps close tabs on the weather, for good kiteboarding opportunities are precious and not to be missed.

“When the weather is right, kiteboarders come out of the woodwork,” said Neel.
“You’re always monitoring the weather. When the wind starts to blow, everyone starts getting anxious about going kiteboarding. The phones buzz, everyone is texting each other.”

A physician’s time is always limited and highly regulated, but when the call of the kiteboard arrives, Neel and other doctors find a way to answer it.

“You find a way to change your plans,” said Dr. Bjorn Dimberg of Atlantis Urgent Care Clinic in Indian Harbour Beach. Dimberg zealously guards the time he can spend kiteboarding. “I don’t want my wife to learn so it won’t cut into my kite time,” he joked.

“Otherwise, I’d have to take care of the kids while she was on the kite.”

Dimberg hangs out with Neel and a bunch of kiteboarders who lust for the wind and waves of Melbourne Beach.

“There might be eight on the water and five or six are doctors,” said Neel. “For whatever reason, doctors seem to gravitate towards the sport.”

Dr. Ralph Zipper

Drs. Lyal Ashberg, Mike Greene and Ralph Zipper are often part of the informal band of kiteboarding brothers who swoop effortlessly downwind for miles along the shoreline to be picked up at a predetermined spot by someone with a truck.

While Neel prefers the thrill of the open water, he also enjoys the relatively calm waters of the Indian River Lagoon.

“I’ve spent tons and tons of time on the water across from the Chart House,” he said. “You can go back and forth there. The whole idea is to jump high and go fast.”

Thrills & Safety

DR. CHRIS VONDERHEIDE is so attracted to the sport that he was actually practicing years ago, even before equipment was readily available and reasonably safe to use. “I started doing it about 20 years ago, with one of the Delta power kits and a plastic snow sled,” he said.

For his money, the ocean provides a combination of thrills and safety, since no buildings can get in the way of a good board day. “The kite pulls you through the water effortlessly,” said Neel. “You can do tricks or just enjoy cruising back and forth.”

Seriously-sized waves present no problem to experienced kiteboarder like Neel. “You can go over the scariest waves and be perfectly safe,” said Neel.

“The kite gives you the power of a boat or a jet ski to turn or go through a big wave. It’s like being on a magic carpet ride.”

Windsurfing had been Neel’s passion before kiteboarding took over the primo spot in his heart. Like Neel, most kiteboarding enthusiasts are seasoned surfers or windsurfers.

Dimberg, for example, has a background in surfing, as well as skate and snowboarding.

“Kiteboarding exceeded my expectations,” said the physician. “I’m fortunate to live beachside so I can go before or after work.”

Brevard offers excellent opportunities to enjoy the sport. “We’ve got more good kiteboarding days than many other places,” said Neel.

For holidays, Neel will pack his kite and head to locations such as Cape Hatteras, the Caribbean and Hawaii. One of the highest points in his kiteboarding career was being part of the Red Bull King of the Air tournament in Maui.

“I got to hang out all week with all of the top kiteboarders in the world,” he said.

Deadly Conditions

Although boarders will tell you that it is a sport any physically fit individual can conquer, kiteboarding can be deadly if conditions conspire against you. Just ask Dr. Michelle Henderson.

It was an unusually windy Sunday when the orthopedic surgeon was boarding across “The Slick,” the nickname for the typically tranquil lagoon waters across from Henderson’s workplace at Cape Canaveral Hospital.

EMILY NEEL is a Dermatology PA with Dr. Larry Bishop.

However, as she released one of the lines to call it quits for the day, a gust of wind enveloped the kite, tossing her aloft wildly and dragging her underwater.

The more Henderson struggled, the more the kite fought. By the time a fellow boarder was able jump onto the kite to deflate it, Henderson had swallowed a good portion of the Banana River.

Now, mind you, Henderson is no slouch in the athletics department. She surfs, skis, scuba dives, you name it, but kiteboarding got the best of her... at least that one time.

“People have died with this sport,” said Neel.

Another kiteboarding doctor, Cocoa Beach’s Dr. Chris Vonderheide, has had his share of close calls.

“I almost had my arm taken off when I tangled with the kite wires,” he said.

A wind gust at The Slick almost smacked Vonderheide onto Cape Canaveral Hospital.

“We’ve all had our share of near-death experiences,” said Vonderheide.

Even though the large kites remain powerful forces, current equipment is years ahead in safety than its predecessors.

“The sport has gotten a lot safer recently with the ability to depower the kite and the quick-release harnesses,” said Dimberg.

Dr. Henderson

Just don’t tell that to Henderson during her “escapade” just a few waves away from the Merritt Island Causeway.

Despite the sport’s inherent dangers, or perhaps because of them, devoted fans of kiteboarding plan long and happy times flying the waves. Henderson has been back up in the air.

Vonderheide is so attracted to the sport that he was actually practicing years ago, even before equipment was readily available and reasonably safe to use.

“I started doing it about 20 years ago, with one of the Delta power kits and a plastic snow sled,” he said.

Like the rest of the kite boarding brethren he has no plans to ever quit.

“It’s almost like grabbing onto a bird,” he said. “It’s an incredible feeling.”

DR JIM NEEL goes airbone off Melbourne Beach.

Eyelid Surgery a Popular Facial Cosmetic Procedure

Tom Palermo — Thu, 04 Mar 2010 00:53:09 +0000

COSMETIC SURGERY

Dr. Fank Venzara

Blepharoplasty improves appearance of your eyes

THE FIRST place one begins to show their age is in their eyes, “the windows of the soul.” The eyes show much about our physical state of being, and over time, the aging process can make you look older, impair vision, and even change the way people perceive you. Cosmetic eyelid surgery, called blepharoplasty, is a surgical procedure performed to improve the appearance of the eyes. It is one of the most popular facial cosmetic procedures and is typically well tolerated by patients.

BLEPHAROPLASTY may be performed under local anesthesia with intravenous sedation or with general anesthesia. The incisions are designed to be concealed within the natural folds of the eyelids in order to keep the scars as invisible as possible. Excess fat, muscle, and loose skin are removed, with the procedure routinely taking approximately one hour to complete.

Loose or sagging skin of the upper and lower eyelids can prematurely age the face. There are two fat pads behind the upper lid and three fat pads behind the lower lids. The fat pads, which bulge out the lower lids, are easily detectable by looking up, and bulging of the lower lid is detectable by gently pressing on the upper lid, which pushes the lower pads out. This is what causes the “bags under the eyes”. In many cases “bags under the eyes” is hereditary and can easily be alleviated with surgery.

The dark circles under or around the eyes are harder to address. If they are caused by shadows from the “bags under the eyes” then the blepharoplasty will help. If the darkness is caused by allergies, then the surgery will most likely not help the color, but by smoothing out the area will be easier to camouflage. Make-up and concealers will go on smoother and more uniform. Blepharoplasty addresses these issues by safely removing above mentioned excess skin and fat pads surrounding the eye area. Meticulous attention must be paid to providing anatomic correction without altering the patient’s natural look.

Because blepharoplasty is typically deemed cosmetic by most insurance companies it is not covered. However, in some cases, the loose or sagging skin of the upper eyelids may impair the field of vision, and if visual field impairment is documented by a visual fields test by your eye physician, the surgery may be covered by insurance. In contrast, the lower eyelids, where the puffiness results in “bags” but does not impair vision, are never covered by insurance. Removing the “bags” and associated excess skin with a lower blepharoplasty results in a more rested and youthful appearance, but is purely cosmetic.

Local Anesthesia
Blepharoplasty may be performed under local anesthesia with intravenous sedation or with general anesthesia. The incisions are designed to be concealed within the natural folds of the eyelids in order to keep the scars as invisible as possible. Excess fat, muscle, and loose skin are removed, with the procedure routinely taking approximately one hour to complete.

Fine sutures are used to close the incisions, thereby minimizing the visibility of any scar, and are removed within 3-4 days. There is very little associated discomfort, but typically there are varying degrees of swelling and bruising under or around the eyes, and downtime is minimal overall. Cold compresses, as well as head elevation when lying down, will enhance healing and relieve discomfort.

Unfortunately no matter how healthy we are or how diligent we are at the gym, there is no way to counteract the effects of aging on the eyelids and face. Facial plastic surgery makes it possible to correct many facial flaws and signs of premature aging that can undermine self-confidence. By changing how you look, facial plastic surgery like blepharoplasty can help change how you feel about yourself and, in some cases where vision is impaired, provide a new outlook on life.

Selecting a Surgeon
Successful facial plastic surgery is a result of good rapport between patient and surgeon. Finding a surgeon you can trust to perform the blepharoplasty procedure is of utmost importance. Trust, based on realistic expectations and exacting medical expertise, develops in the consulting stages before surgery. In order to feel as comfortable and confident as possible with the cosmetic surgeon you choose, be sure you’re familiar with the things you should look for in a surgeon.

When choosing a plastic surgeon make sure that he or she is certified by the American Board of Plastic Surgery, the only cosmetic surgical board approved by the American Board of Medical Specialties, and make your choice of a plastic surgeon based on the extent of his or her experience and qualifications rather than on bargains or promotions.

Dr. Frank Venzara was born in Chicago and has resided for the majority of his life in South and Central Florida. He is a graduate of both University of Miami’s Undergraduate Program and Medical School. He trained as a surgical resident at Jackson Memorial Hospital in Miami and as a plastic surgery fellow at the University of Missouri’s Truman Medical Center in Kansas City, Missouri. He has practiced in the Central Brevard, Florida Area for 25 years as a Board Certified Plastic and Reconstructive Surgeon. When not attending to his surgery schedule, Frank enjoys surfing and fishing. Dr. Venzara can be reached at 321-452-3882, or log on to BrevardPlasticSurgery.com

HealthFirstReality.org: The Rescue That Took Flight

Tom Palermo — Fri, 26 Feb 2010 09:29:53 +0000

LIVING PROOF: The Story of Lisa Goetz

Fatal Crash. Fortunate Survivor. And the Rescue That Took Flight.

I-95. 70 mph. Lisa was steady behind the wheel. Seconds later— pinned helplessly in her car. Broken arm. Crushed legs. Several dislocations. With every minute critical, First Flight transport joined first responders to get her out, and on her way to a safe, sound recovery.

CLICK HERE TO SEE THE STORY>>>

Health First, Precor Sponsors the Florida Anti Aging Expo

Tom Palermo — Fri, 26 Feb 2010 03:40:28 +0000

SPECIAL EVENT PREVIEW

**The 2010 Florida Anti-Aging & Healthy Living Expo will be held June 12-13 at the Clemente Center on the campus of Florida Tech in Melbourne, Florida.**

BREVARD COUNTY, FLORIDA – Health First Health Plans, Health First and Precor will sponsor the 2010 Florida Anti-Aging Expo set for June 12-13 at Florida Tech's Clemente Center.

The evolution of medical technology and science has brought our society to a place where we no longer have to sit back and wait for the onset of “old age.” The Florida Anti-Aging Expo Series is designed and dedicated to educate you about the latest information available to help you remain healthy and vibrant – and fight the aging process.

Prevention remains the number one way to fight against the effects of physical deterioration and disease. The Florida Anti-Aging Expo Series’ mission is to separate fact from fiction, and provide you with the most up to date credible information to help you counteract the forces at play that are lessening your quality of life.

This state-wide series of events promises to be a valuable opportunity for both the health and medical professional, and the consumer, who are seeking the latest procedures and products to maintain or revitalize their vitality.

The Florida Anti-Aging & Healthy Living Expo will showcase hundreds of health and aesthetics-related products and services, and feature national and local experts speaking on dozens of topics to help people maintain or restore their vitality – and zest for life!

For Exhibitors: Incredible Opportunity

The desire to stay young is attracting not only the “Boomers,” but also ever-younger consumers – and this expansion in target audience is expected to drive the Anti-Aging market revenues in 2010 to over $115 billion worldwide, according to market research conducted by Global Industry Analysts.

For the medical and anti-aging professional, the Florida Anti-Aging & Healthy Living Expo is dedicated to providing you an incredible, high quality, upbeat venue and environment for you to meet and interact with thousands of motivated and affluent consumers that are highly interested in your services and products.

The Florida Anti-Aging Expo & Healthy Living Expo offers a multitude of ways to increase the health and medical professional’s show visibility, build booth traffic – and leave a lasting impression on thousands of qualified potential patients, clients and customers who attend the the show.

For information call 321-615-8111, or log on to FloridaAntiAgingExpo.com

Take Care of Your Hedgehog

Tom Palermo — Fri, 26 Feb 2010 02:53:43 +0000

SKIN CARE: Cancer is our most powerful enemy

What causes cancer? For that matter, what is cancer? Those are questions that baffled people for centuries, but the answers are largely known now. This is a significant advantage, because cancer is our most powerful enemy, with the exception of heart disease.

SO HOW DO we prevent skin cancer? Since we know that ultraviolet light damages our DNA, and we know that the DNA controls the Hedgehog system, the best way to keep from getting skin cancer is to protect the skin as much as we can from ultraviolet light.

It kills more Americans than stroke, pneumonia, accidents and Alzheimer’s disease.

Since one of my areas of expertise is identifying and treating skin cancers, I have a unique perspective on what cancer is, and what it does. I hope this discussion will give you insight into how to avoid developing skin cancer, and provide a basis for understanding why cancer acts the way it does.

Noncancerous Skin Cells

Let’s start with noncancerous skin cells. Most of the time, a normal skin cell lies relatively dormant, not really doing much of anything. It serves as a barrier, keeping outside forces such as bacteria, viruses, chemicals and traumatizing objects from harming the tissues underneath. It protects our inner, delicate world.

The skin cell is programmed by its DNA, the software that runs the cell, to not divide (and thus reproduce itself) unless it is signaled to do so. Also, the skin cell is designed to stay in close contact with its surrounding cells, much like kindergartners in a museum might hold hands as they walk, so as not to lose their place.

Roughly every 28 days, the skin cells are signaled to divide, and to replace those cells that are lost through the usual wear and tear of daily life. By dividing every 28 days, the skin cells don’t exceed what the skin needs to remain as an intact barrier, and everything works the way it is supposed to.

If necessary, such as in the case of injury, the body can signal the skin cells to reproduce more quickly, but for the most part, they remain quiet, only reproducing every 28 days.

So that’s the life of a skin cell. Stay in place, don’t bother your neighbors and don’t do anything unless you are told to do so. Once again, sort of like a kindergartner.

Basal Cell Carcinoma

What happens, then, in the case of skin cancer? In the case of basal cell carcinoma, the most common of skin cancers, the process is as follows:

AVOIDANCE OF sunlight when the ultraviolet light is at its most intense, such as midday is a smart strategy, as is using sun protective clothing and last, but not least, wearing ultraviolet blocking sunscreen that filters out the most damaging rays.

Before we start, though, there is something you need to know, to make sense of this whole matter. There is a system that regulates not only where skin cells develop, but also how they behave (especially through the cell replication process of division) called, oddly enough, the Hedgehog system.

The Hedgehog system, like any good kindergarten teacher, tells its charges exactly how to behave. It tells the cells when to divide, where to divide, and, most importantly, when to stop.

Now, picture yourself on Satellite Beach. You are out for a day with the family, perhaps watching a rocket launch, and you forgot your sunscreen. Rather than dive under an umbrella, you think to yourself, “Ah, it’s not that long. I’ll be OK for a short while.”

So you walk around, maybe play a little Frisbee, and enjoy yourself. While you are out, though, your pasty white skin is being bombarded with ultraviolet radiation, and, unlucky you, one of the millions of ultraviolet rays that happen to hit you hits right in the one place you really wish it didn’t – in the gene that controls the Hedgehog system. It causes a mutation, which leads to a dysfunctional control system.

When something goes awry with the Hedgehog system, chaos ensues. A single cell divides in an uncontrolled fashion. Both of the “daughter cells” also divide without the benefit of the Hedgehog guidance, and the process continues so one cell becomes two, then four, then eight uncontrolled cells, and so on.

This continues unabated, until this group of cells – the cancer – is stopped either by surgery, chemotherapy, radiation or, rarely, by the body’s own immune system.

Additionally, as the rampant reproduction of cells is occurring, blood vessels are signaled to grow around the new cells to nourish the growing population of cells. This only encourages more growth and soon a tiny spot grows into a tumor, which, in the case of skin cancer, becomes visible.

Since the Hedgehog system still hasn’t told the rapidly dividing cells to stop reproducing (remember, it is damaged from that stray ultraviolet ray and therefore can’t direct the cell as to what to do), cells continue to divide, the tumor continues to grow, and the new, cancerous cells start to push the other normal cells out of the way.

Since a basal cell carcinoma generally does not spread to distant sites in the body (metastasize), it simply pushes the other normal cells out of the way until, in the worst case scenario, it erodes into a vital structure, such as the nasal passage, the skull, or the orbit of the eye.

So that’s really what cancer is. It is the uncontrolled reproduction of cells that continue to divide, pushing and displacing normal cells. Even though we are talking about basal cell cancer, this concept applies to all cancers.

How Do We Prevent Skin Cancer?

If the cancer cells interfere with a critical function of the body, such as breathing in the case of lung cancer or processing food in the case of colon cancer, we die. In the case of basal cell carcinomas, the tumors displace and erode normal structures of the body surface, resulting in disfigurement and, rarely, death.

So how do we prevent skin cancer? Since we know that ultraviolet light damages our DNA, and we know that the DNA controls the Hedgehog system, the best way to keep from getting skin cancer is to protect the skin as much as we can from ultraviolet light.

Avoidance of sunlight when the ultraviolet light is at its most intense, such as midday is a smart strategy, as is using sun protective clothing and last, but not least, wearing ultraviolet blocking sunscreen that filters out the most damaging rays. That will protect your Hedgehog, and in turn, your Hedgehog will take care of you!

ABOUT THE AUTHOR

Dr. Bishop attended Wright State University medical school and then served nine years in the Air Force as a flight surgeon. An affiliate of MIMA, he specializes in cosmetic and surgical dermatology, including Mohs Micrographic Surgery, and non-surgical rejuvenation of the face. You may call Dr. Bishop at 321-751-9097.

ECUADOR: “The Giants Who Are Angels”

Tom Palermo — Fri, 26 Feb 2010 02:03:49 +0000

MEDICAL MISSIONS

“The Giants Who Are Angels”

CAYAMBE, ECUADOR – Even the offer of a mirror on a stick wasn’t enough to convince seven-year-old Joffre to allow Dr. Jason Ouelette to look into his mouth. The frightened child had been through too much in the past two weeks, since doctors placed a ventricular shunt for his hydrocephalus caused by congenital toxoplasmosis gondii.

Registered Nurse Barb Borman is part of the team that helped the needy of rural Cayambe, Ecuador, a village high in the mountains north of Quito, where they provided primary care to a community of the Quechua culture.

His mother brought him to the clinic because of an eye infection and, after treating it, pediatrician Dr. Ruth Rodriguez-Palermo referred him to the dentists for his severe tooth decay.

Joffre

Joffre’s complex needs accentuate the problems faced by medical mission teams, such as the group of 21 doctors, dentists, nurses and support personnel, primarily from Brevard County, Florida, who in the last week of October traveled from Melbourne (sea level) to Quito, Ecuador, (over 9,000 feet elevation) where they set up a temporary clinic to provide medical, dental, vision and pharmacy care to 465 people in Puengasi, an impoverished neighborhood of the capital city, Quito.

A short-term medical-dental team cannot provide the ongoing care a child like Joffre needs. His immediate complaints could be treated with antibiotics for the eye infection, medication for the intestinal parasite infections typically found in this population, vitamins for his poor nutritional state, and a dental evaluation if he had allowed Dr. Ouelette to touch him.

The little boy will need long-term intervention for his new shunt, seizure disorder and developmental delays. Even if the care is accessible, it will be more expensive than his mother can afford, and special schooling is also not available for him.

Jesus Colona, also seven years old, has a congenital disability, phicomelia of the left lower arm, with a missing index finger. The treatment offered by local doctors involved amputation of the arm.

However, Dr. Rodriguez-Palermo recognized that, in spite of his disability, he can grasp, and she recommended physical therapy to increase his use of his hand, and improve his future.

DR. JASON OUELETTE

The people of Ecuador call the medical mission team “friendly giants,” but the doctors, dentists, nurses and other team members soon proved to be angels instead. With the assistance of a local physician, Jesus will receive the therapy he needs.

A HAND UP

Working with an Alabama-based organization, SIFAT (Servants in Faith and Technology) and an Ecuadoran physician, medical mission teams encourage people to seek ways to meet their own needs instead of developing dependent relationships over time. “A hand up, rather than a handout” is their goal.

For the past three years, teams had been visiting rural Cayambe, Ecuador, a village high in the mountains north of Quito, where they provided primary care to a community of the Quechua culture.

While team members made lasting friendships with the people of Cayambe, they knew that this year, it was time to move to another area. Cayambe community leaders began building their own clinic, and will soon have a full-time physician and nurse.

ROCKLEDGE PEDIATRICIAN, Dr. Rodriguez-Palermo, and the children of rural Cayambe, Ecuador.

Puengasi provided a new location with different medical and social needs. “Children have no fathers, sometimes, no parents at all. Poverty, malnutrition, and limited opportunity for education are rampant,” Ecuadoran Pastor Oswaldo Buitron said.

He coordinates a feeding program in Puengasi, offering a hot meal every afternoon for 215 children, and jobs for six to eight mothers who work in the kitchen or serve as teachers.

He does not mention the necessity for clean water, lack of sanitation, and the parasitic infections, problems that are so widespread that all patients, except pregnant women and newborns, are treated for intestinal parasites.

The team brings double the amount of parasite medication so that an extra bottle can be left behind for a second treatment six months after the team leaves.

With a year of freedom from parasitic infection and improved nutrition, the children have a better chance to grow, fight off other infections, and enjoy better health.

STATISTICS TELL THE STORY

More than 465 patients visited the mission clinic in five days, 191 adults and 274 children. Patients received parasite medication, antibiotics for eye, ear, throat, dental, pulmonary, skin, and urinary tract infections.

Every child received a three-six month supply of vitamins, pregnant and lactating women took home six months of prenatal vitamins, and the team distributed one thousand toothbrushes and toothpaste.

In addition to treating patients in the clinic, physical therapist Carmen Spector and registered nurse Barb Borman made a house call on a 6-year-old with a fractured femur scheduled for surgery a week later, five months after the injury. They applied Buck’s traction, a procedure Carmen had never done, and Barb had performed many years ago.

Dr. Melanie Rotenberg, geriatric rehab specialist, explains the unique challenges she faced during her second year with the medical mission team. “Most of our patients are little kids, and it’s been 20 years since I’ve done pediatrics. Give me someone with back pain, or arthritis.”

However, knowing she had back-up with Rockledge pediatrician, Dr. Rodriguez-Palermo, working a few feet away, helped to instill confidence as she handled a caseload including children with malnutrition, ringworm, scabies, parasitic bowel infections, pharyngitis, and otitis media.

Dr. Rotenberg felt right at home managing a middle-aged woman with ulnar neuropathy (repetitive stress disorder) related to washing laundry with a washboard and then hanging it up to dry.

However, there was little she could do to treat the patient other than prescribe two weeks of ibuprofen. “Lifestyle changes can be recommended, but the nature of her everyday existence makes it is unlikely she’ll be able to follow through,” Rotenberg commented.

“I recommend an experience like this to anyone for the opportunity to get to know the people of a developing country, not as a tourist, but to learn how they live and cope in real poverty. There is poverty in the U.S., but not like this. It’s important for healthcare professionals to see this,” the doctor added.

TEAM ADAPTS & OVERCOMES

The dentists faced their own challenges on this trip. At a crucial time during a dental restoration, Dr. Ouelette found himself without suction and a drill when the air compressor suddenly quit. Dr. Dave Spector, a Suntree dentist, quickly went to work on the compressor, diagnosing the problem, and then going to a local machine shop for fabrication of a new pressure tube.

With the help of Dr. Paul’s son Jason, a newly-graduated dentist, Dr. Spector repaired the compressor, but not before Dr. Oulette had finished shaping the restored tooth by hand.

On the team of twenty-one, there were eight newcomers to Ecuador, and medical missions. Roberto Hernandez, an engineer without any medical background, proved invaluable as a translator for the pharmacy, and one of the doctors. He was surprised at how quickly and readily doctors and nurses adapted to their work in such limited and rudimentary facilities.

PHARMACY CREW: The team brings double the amount of parasite medication so that an extra bottle can be left behind for a second treatment six months after the team leaves. With a year of freedom from parasitic infection and improved nutrition, the children have a better chance to grow, fight off other infections, and enjoy better health.

Dr. Bill Sherman, and his wife Linda, a nurse, appreciated the opportunity to establish a clinic that stayed in one place all week. Last summer, they traveled by boat down the Amazon providing medical care in different villages at every stop.

Participating on medical mission teams started a life-changing process for another recent graduate, Amy Rogers, who credits the experiences on two previous teams with encouraging her to become a nurse. Two years ago she returned from Ecuador and enrolled in nursing school.

As a new RN, Amy is taking what she has learned about cross-cultural care on medical missions to her job as a Wuesthoff Hospital nurse. “In Ecuador, I don’t know the language, but I have experienced first-hand that sharing love is universally understood.”

Carmen Spector, a physical therapist who doubles as a translator for the team, explains why she returns year after year.

“The need is so immense, and one week barely scratches the surface. You hear people say that it’s better to give than to receive, but serving on a medical mission team lets you really experience that.

We’re giving to people who might not have any other opportunity for medical and dental care, and yet we get far more than we ever give.”

On her fifth mission trip, Donna Lindeman, a home care nurse from Sebastian adds, “The people keep me coming back. Five years ago, I jumped at the opportunity because I had always wanted to go on a medical mission trip. I find that I learn something new every year and my thinking about home re-adjusts.”

Pastor Tom Walker

While three physicians, three dentists, seven nurses, a physical therapist and a dental assistant comprise the professional part of the medical/dental team, additional support personnel are always needed. Prior to the trip, these members often ask, “What can I do on a medical team?”

The answers often surprise them. Tracy Brower, an accountant for MIMA, discovered an affinity for assisting dentists, and before long, had donned a mask and gloves to take on a dental suction machine.

Phil Henderson, a mechanical engineer, checked the temperatures and blood pressures of every patient, while Penny Massey, medical billing collector, was always in demand for crowd control and baby-holding.

“A medical mission is not about what we do or accomplish,” Walker said, “God is more concerned about who we are and who we are becoming.”

A medical mission team is all about “friendly giants” becoming angels to people who need God’s touch in their lives.

ABOUT THE AUTHOR

Joyce Henderson, RN, pictured at right with her husband Phil, and their godson, Kelvin Quishpe, in Ecuador. Joyce has been an operating room and Army nurse during her 40-year nursing career. She is now a home care nurse employed by Wuesthoff Health System. She and Phil have led nine mission teams to Ecuador in the past six years, providing medical, dental and vision care to more than 2,000 people. Joyce is the President of the Space Coast Writer’s Guild, a member of the Cape Canaveral Branch of the National League of American Pen Women, and leader of iWrite Christian Writers.

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Washington Nationals Get Physicals at MIMA Sports Medicine

Tom Palermo — Fri, 26 Feb 2010 01:05:49 +0000

SPORTS MEDICINE

LEFT TO RIGHT: Steve Gober, Dr. Bruce Thomas (MIMA Sports Medicine), Mike McGowan, Dr. James Andrews (American Sports Medicine Institute of Birmingham), Lee Kuntz, Dr. Wiemi Douoguih (Head Team Physician for the Washington National) and Dr. Craig Miller. MIMA Sports Medicine physicians have been providing care to Brevard’s professional baseball teams since 1993.

BREVARD COUNTY, FLORIDA (Feb. 25, 2010) – MIMA Sports Medicine Drs. Schuyler DeJong and Bruce Thomas are once again taking care of the medical needs of the Washington Nationals. The Nationals are back in town for Spring Training to prepare for the 2010 Major League season with 15 home dates at Space Coast Stadium.

Before the major and minor league players hit the field, Dr. Thomas and Dr. DeJong will administer their preseason physicals. The Nationals’ pitchers and catchers received their physicals last Saturday, with position players getting checked out today. The Nationals minor league players will get their exams early next month.

Dr. Bruce Thomas examines Drew Storen, pitcher with the Washington Nationals.

Drs. DeJong and Thomas have worked Spring Training with the Nationals since the team’s move to D.C. in 2005. Prior to that the doctors served as the Spring Training physicians for the Montreal Expos and Florida Marlins.

Dr. Thomas also served as the Expos’ and Nationals’ Head Team Physician from 2003-2006, and split his time between the big league team and his MIMA practice in Melbourne, Florida.

“Brevard is fortunate to have a Major League baseball team in the community,” said Dr. Thomas.

“This is a wonderful entertainment asset to our community. It is also fabulous to see the Nationals’ dedication to our local community by choosing to have their health care needs served right here in Brevard.”

For more information about MIMA Sports Medicine, call 725-4500 ext. 7818, or CLICK HERE.

For Washington Nationals ticket information, CLICK HERE.

Central Florida UroGynecology Grand Opening March 15

Tom Palermo — Thu, 25 Feb 2010 23:39:51 +0000

NEW FACILITIES

BREVARD COUNTY, FLORIDA – Marja Sprock, MD, FACOG, will celebrate the Grand Opening of her new practice, Central Florida UroGynecology, on March 15. Dr. Sprock's new office is located in Rockledge just off US Hwy. 1, and close to the Fiske exit off I-95.

Dr. Marja Sprock

As a fellowship trained UroGynecologist, Dr. Marja Sprock has dedicated her career to treating woman with urinary and fecal frequency, urgency and incontinence, as well as pelvic organ prolapse.

The field of urogynecology is a sub speciality within obstetrics and gynecology and is dedicated to the study and treatment of pelvic floor disorders in women.

"Central Florida UroGynecology focuses on the needs of women – and offers a wide spectrum of urogynecologic and cosmetic surgical procedures," said Dr. Sprock. "I offer conservative to cutting edge technology, dependent on the patient's needs."

Dr. Sprock is a Dutch native, and moved to the United States to do her OB/GYN residency training at Henry Ford Hospital in Detroit. She continued her training in urogynecology at Henry Ford Hospital, one of the major teaching hospitals in the United States, under Dr. David Richardson.

Spending more than a decade at Henry Ford, she also served as the assistant program director of the OB/GYN residency program for five years and as the director of the Urogynecology section. She has been honored with numerous awards during her career, from excellence in laparoscopic surgery, to excellence in patient care.

Central Florida UroGynecology provides care for adult women with urinary, fecal or gynecologic problems. For more information call 321-622-8377, or CLICK HERE.

“The Call” Rings In New Year, New Life

Tom Palermo — Sat, 20 Feb 2010 19:10:56 +0000

ORGAN TRANSPLANTATION: The Joy of Living...Again!

BILL HAHN, double transplant receipient.

Transplant...When you hear the word out loud – and it’s aimed, point blank, right at you, your life stands still … your heart skips a beat … and your mind races: How will this change my life, what is my future, if any?

The word fills your emotions from disbelief, to acceptance, to anticipation, to panic, to joy. It's a journey that takes years…a second at a time.

My journey started 30 years ago when I was diagnosed with juvenile diabetes. I was in shock! Was I really a diabetic?

My lifestyle was an active one – I was an avid runner and I wasn’t overweight. In brief, my lifestyle was not what caused my Type 1 diabetes to occur. It was caused by a genetic pre-disposition.

Fortunately, my lifestyle would serve me well by conditioning me for all I was about to face. But the fact was, I was indeed a diabetic. Try as I did, I still fell victim to some of the many complications of the disease such as blindness, coma and seizures.

Years later I was diagnosed with end-stage renal failure. My kidneys had failed, and I was forced to go on dialysis to stay alive. That started my wait for a transplant...the constant tick, tick, tick of the clock and the endless ring, ring, ring of the phone – wondering if today was the day I’d get "The Call."

"We Have a Match"

It was just another ring of the phone with an unexpected voice, “This is Shands Hospital, we have a match.”

My mind started racing. I had only seconds to gather my thoughts and head to Gainesville, Florida, a three hour drive that seemed like an eternity – then a hush and a blur. That was Dec. 31, 2009 – New Years Eve.

The New Year rang in my new life as I woke up with a new kidney and pancreas. Was I all right?

My family surrounded me with smiles, and I was indeed all right! No more insulin shots. No more diabetes. No more dialysis. I had reached the equinox of my journey where the perils of chronic illnesses are replaced with the promise of a healthy, active future.

But who was responsible for my gift of life?

While you can’t choose your donor family, you can choose your hospital. I chose Shands Hospital in Gainesville. It was, and is, the right choice. They treat my organs as if they are their own. I say this even though I am a Florida State Seminole.

Arts In Medicine

In addition, they offer an "Art in Medicine" program that helps patients cope with the rigors of their journey – something I had practiced all my life. Using my lyrical photography and song writing as healthy treatment to escape from the unrelenting beat of chronic illness.

Exercise and fitness is my other form of self-treatment and has been the other constant in my life. I consider myself a professional in the field having owned and operated Home Fitness Warehouse in Melbourne, Florida for the last 16 years. I currently run 20 miles a day, only 14 months after my transplant by splitting time between the Precor elliptical cross trainer and Precor advanced motion trainer.

What’s next ? The National Kidney Foundation, 2010 U.S. Transplant Games in Madison, Wisconsin that will be held July 31 through Aug. 3.

These games feature recipients, families and donor families who participate in athletic events to demonstrate the success of transplantation and share with the world the gift of life by highlighting the need for more organ donors. The National Kidney Foundation of Florida, an affiliate of the The National Kidney Foundation, will have 200 attendees at the games this year.

Labor Day Surf Festival

The National Kidney Foundation of Florida organizes local events each year with the biggest being the Labor Day Surf Festival, which will celebrate its 25th anniversary this year. The event's need for sponsors and volunteers gives everyone a chance to participate in giving the gift of life. Every donation is a donation of life.

Over 100,000 people are still waiting for their second chance. I celebrate everyday my second chance with the joy of living...again…with my family, friends and God…and it is Oh, so sweet!

Viera VA Clinic Provides High Tech Care

Tom Palermo — Sat, 20 Feb 2010 00:54:10 +0000

FACILITY SPOTLIGHT

VIERA VA CHIEF MEDICAL OFFICER Dr. Thomas Howard

VIETNAM VETERAN William Wright knows his way around the veterans healthcare system. Three or four times each week the former Marine visits his doctor or attends a group counseling session at Brevard County’s (Florida) VA Clinic as he fights his long battle with Post Traumatic Stress Disorder (PTSD), the Vietnam War’s lasting mental health legacy.

FORMER Marine William Wright served in Vietnam from 1964 until 1972. He’s been treated at numerous VA facilities over the years for Post Traumatic Stress Disorder and says the physicians he sees as a patient of Viera’s Apollo care team are “competent, friendly and professional.”

“When we came home no one ever talked about PTSD and we just thought our behavior was how we were supposed to behave,” recalls Wright, who didn’t seek treatment until the 1983 bombing of the Beirut Marine Corps barracks prompted his PSTD to “emerge like an alien.” He’s concerned that today’s Gulf War veterans face a similar fate.

“I think a lot of these young guys are going to try to tough it out just like we did until it becomes so bad that either they recognize it or their spouse looks for help,” worries Wright.

The health care teams at the Department of Veterans Affairs Outpatient Clinic in Brevard County are determined not to let that happen.

Here, and across the VA system, special outreach efforts are underway to convince new veterans, including those from the National Guard and Reserves, to take advantage of the health care benefits available during the two-year period following their discharge date. Even after that deadline, any honorably discharged veteran can apply for care, but the government’s sometimes criticized eligibility process will determine the fee schedule based on whether symptoms are service related.

“The outreach part of my job is trying to get the message to those veterans who think they don’t need the care or who don’t know about it,” explains VA social worker Sandy Teuber, LCSW. “Their plane touches down and they go through a few days of lectures and are told about their benefits at the VA, but they often don’t hear that. They just want to go home.”

Last year, Teuber mailed almost 850 letters to recently discharged local veterans — she heard back from only 35. “More are coming in now and even if it’s past that two year mark, we want to discuss their eligibility and walk them through putting in a claim,” she says.

In addition to PSTD, medical experts are concerned about a condition known as Traumatic Brain Injury or TBI, which may well be the legacy for veterans of the Global War on Terror, referred to in VA jargon as “GWOT Vets.” Because many of these men and women have been exposed to an unprecedented number of roadside bombs, they’re at increased risk for TBI and unless there are obvious external injuries, it may not be diagnosed until they’re home. Memory loss, headaches, disturbed sleep and light or noise sensitivity are common symptoms, along with the potential for behavioral changes such as depression, anxiety and emotional outbursts.

Growing to Serve Veterans
As part of a federal initiative that includes screening for mild to moderate TBI when GWOT veterans visit a VA health care facility, the Viera clinic added 18 employees in September, bringing the staff to more than 250 people. It’s amazing growth since the clinic opened in July 1999 with just 67 employees. Eight years later, they’re serving about 20,000 veterans, the majority of them from the World War II and Vietnam eras who live at least part of the year in Brevard County.

WHY DRIVE WHEN YOU CAN TELECONFERENCE? Each month, the Viera clinic’s leadership team meets with the executives in charge of the Orlando VA Medical Center via this high tech connection, which includes two-way video and the ability to share PowerPoint presentations. Dr. Howard is joined by administrative officer Karen Shamlin, to his left, and Cynthia Johnson, RN, ACNS, the associate chief of nursing services.

“Our mission is to deliver excellent and compassionate care in an efficient way to a population that had to travel lengthy distances before,” says Thomas Howard, MD, a board-certified pulmonologist who became the clinic’s chief medical officer even before it opened. For almost 10 years prior to that, he’d been in private practice with Melbourne, Florida’s Osler Medical Group and had followed the long and often contentious political battle to bring a VA Hospital to the Space Coast. The clinic was a compromise, finally built at a time when the much-criticized VA was transforming itself into a network now viewed as a leader in health care quality.

“One of the transitions as this was built was the change from emphasizing inpatient care to outpatient care,” says Dr. Howard. “We were certainly the recipients of good fortune there. I think this facility has met a great percentage of the needs in this area being purely an ambulatory facility.”

RADIOLOGISTS Philip Fairy, MD and Dennis Flynn, MD (standing), use sophisticated voice recognition software to dictate radiology reports, editing and filing those reports directly into the patients’ electronic medical records at the VA clinic. They also use the agency’s computer network to read x-rays for Orlando and Tampa VA facilities when needed.

As Dr. Howard hired the clinic’s initial staff, he used a team model now standard in VA clinics, with a local twist; the three primary care teams, two specialty teams and mental health clinic all take their names from America’s space program. Once veterans are eligible for treatment, they go through a general orientation session and are assigned to the Gemini, Apollo or Mercury teams for general care. Patients visit the Saturn team for specialized medical or surgical needs and the Endeavour team handles eye and ear care, plus dental check ups, among other care. Discovery encompasses the vast array of mental health services, including private and group counseling.

“As the veterans return and get back into life they’re encountering the issues of life, work, family and then the PTSD can hit,” says Discovery Team neuropsychiatrist Tim Reid, MD. “They tend to be reluctant to get help. Many soldiers or sailors will think they can drive on.”

The Viera facility opened as an affiliate of the James A. Harley Veterans Hospital in Tampa. However, for the past year it’s been transitioning into an affiliate of the Orlando VA Medical Center, enlarging a veterans care network in east central Florida that also includes outpatient clinics in Daytona Beach and Orlando. A full-service inpatient VA Hospital is now planned for the Lake Nona area along State Road 417 in southeast Orlando, with the opening targeted for 2012.

Because of its hospital affiliation, the clinic is accredited by The Joint Commission, the well-known, independent group that surveys most hospitals to ensure they meet accepted quality standards. “As an outpatient clinic we’re essentially perceived as a physician’s office practice,” says Dr. Howard. “But unlike most private practices we face the challenge of accreditation and the obligations that come with that, such as a time out before the use of a local anesthesia as a safety check.”

CLICK HERE FOR RELATED STORY: The Human Side of the Viera VA

RUSS MAREK graduated from Satellite Beach High (Florida) before joining the Army and going off to serve in Kosovo and Germany – and then two tours of duty in Iraq. He’d been promoted to Staff Sergeant just 14 days before that fateful mission.

An Electronic Revolution
Computers also play a key role in the clinic’s approach to quality. Fully electronic medical records are now a hallmark of the VA system and they’ve been in place at Viera since the day it opened.

INTERNIST Roy Thomas, MD considers the VA’s groundbreaking electronic medical record system a plus for patients. He jokes that “with just a few mouse clicks I can order follow-up tests and x-rays, generating a lot of work for other people to do here in the clinic.”

“We had to make the decision from a clinical standpoint whether we were going to do everything on the computer versus what Tampa was doing at the time which was kind of a hybrid and they had many records that were paper. I knew that would be a very difficult way to do it. Even though the way we did it was painful, too,” Dr. Howard recalls.

Among the early growing pains — computer network outages, solved when the Tampa IT team devised a way to dump the records needed for the next day’s patients onto a local server. Not every clinician was initially keen on using computers and Dr. Howard admits some even passed on the chance to work there.

“I think many things that the VA has been cited for in terms of quality — I mean it’s not your grandmother’s VA — spin off the computerized medical record,” he says. “We have a scorecard of 26 quality measures that involve simple things such as how many of your patients who should have received a flu shot, got one. Each of these is data driven based on numerous studies and they’re not debatable in terms of their benefit. Because of the computerized medical records I can know 100 percent of our data on a monthly basis and know how many of our patients have received a flu shot. That’s just one example.”

Read between the lines and that electronic “scorecard” is also an unprecedented look over the doctor’s shoulder.

Internal Medicine specialist Roy Thomas, MD has gotten used to that as he uses the computer located in each exam room to track his patients’ care.

“Reminders will pop up on screen. It might be a vaccine or if you need to tell them to quit smoking, get a mammogram, or cholesterol screening,” explains Dr. Thomas. “We get graded on it and our pay is even related to how well we stay on top of our reminders. There are reminders that I’d just as soon not be in here, but a bunch are good and probably keep me from missing stuff with my patients and so I think overall it’s a wonderful thing.”

Filling a Local Need
Over 200 active volunteers, many, but not all of them veterans, support the clinic by donating their time. “This clinic couldn’t run without them,” says voluntary services specialist Karen Johnson. “They man the information desk, give directions, provide transportation, including van service from home if the patient qualifies. On each clinic team, there’s a volunteer who helps log in patients.”

VA ENROLLMENT COUNSELOR Diane McKay joins volunteers Bert Howard and Nancy Harper at the main information desk. Every honorably discharged veteran is eligible to apply for health care, with eight categories of eligibility then used to determine how much, if anything, that care will cost the patient.

Representatives from a number of local veterans group give the Viera clinic high marks, but some aren’t as gracious about what they still see as too much red tape surrounding eligibility.

“The logjam of paperwork for these kids coming home to get their care declared service related can be overwhelming,” says Jim Rufino, president of the Vietnam Veterans of America Chapter 831 in Rockledge. “I’m concerned that these kids may not even realize they were blown to bits in terms of the impact on their brains.”

Among other local vets, there’s still regret that this area got a VA clinic and not an inpatient hospital. “We have so many veterans here. The clinic’s great and everyone’s satisfied, it just would have been nice to get the hospital here,” says Eddie Weber, the finance officer at Melbourne’s American Legion Post 163. “We just want the Orlando hospital built so you don’t have the hardship of traveling so far to Tampa.”

The Viera clinic team is very aware that it’s a “political animal” as Dr. Howard calls it. Just look at the volunteer list, which includes local congressman Dave Weldon, an Army veteran and physician who still treats patients at the clinic.

“People may come here with perceptions about the VA. I remember early on I made a presentation at a local forum and was personally attacked by an audience member about his experience at another VA facility,” recalls Dr. Howard. “We have a saying, if you’ve been to one VA, you’ve been to one VA. The point being we’re a national organization, but there are a lot of differences from facility to facility.”

One of those differences is that Dr. Howard has been able to tap into the local medical community and convince some well-known, established caregivers to join the VA team. Ricardo Pena, MD spent 15 years in private practice with the Brevard Medical Group before signing on as a primary care physician at Viera.

“I like the federal benefits and the working hours and I love the electronic medical record which makes everything so clear about caring for my patients,” says Dr. Pena, who also loves listening to the stories shared by the veterans.

Also on staff is psychologist Daniel Philpot, who grew up in Brevard County as the son of a well-known pediatrician. During a stint in the Air Force, he found his professional calling. “I stumbled into working with veterans and I love doing this,” says Dr. Philpot. “Most people are changed by combat situations and once they decide they need help, they’re often fearless about pursuing honesty and I enjoy being part of something that makes their life a little better.”

Former Marine William Wright served in Vietnam from 1964 until 1972. He’s been treated at numerous VA facilities over the years for Post Traumatic Stress Disorder and says the physicians he sees as a patient of Viera’s Apollo care team are “competent, friendly and professional.”

Dr. Thomas Howard

THE 411 ON VIERA VA CLINIC

WHO: Thomas Howard, MD joined the Viera Clinic as its chief medical officer during the construction phase, setting up his office in a trailer at the site south of Space Coast Stadium. In addition to overseeing the clinical staff, he continues to treat patients as the clinic’s pulmonologist.

WHAT: Veteran’s Administration Outpatient Clinic is a 107,000 square foot clinic. The facility includes primary care physicians and nurses, psychiatry, gastroenterology, podiatry, optometry, dental services, and a pharmacy.

WHERE: Located on 25 acres of Viera-donated land adjacent to Space Coast Stadium.

COST: The $25 million complex is a technological masterpiece, utilizing the latest in high-tech medical equipment and records keeping.

Dr. Charles Raises $215,000 For Haitian Orphanage

Tom Palermo — Thu, 18 Feb 2010 21:26:43 +0000

PHILANTHROPY: "I am just a spoke in a wheel"

DR. SILAS CHARLES is legendary for his mission work abroad and is currently building a cancer care center in Ethiopia.

BREVARD COUNTY, FLORIDA – Dr. Silas Charles has once again shown himself to be among the leading philanthropist in the area by pledging to match dollar-for-dollar the first $100,000 donated to Ruuska Village, an orphanage on the outskirts of Port-au-Prince run by Reach Out to Haiti.

The orphanage was severely damaged during the earthquake in January.

The final total amount raised was announced at the 2010 Indiafest, and exceeded $215,000 for relief efforts in Haiti – including Dr. Charles' $100,000 donation.

DR. CHARLES, and his sister Rhoda S. Eda, M.D., medical director of the Christian Cancer Centre in India, with hospital nurses and staff.

Dr. Charles is legendary for his mission work abroad and is currently building a cancer care center in Ethiopia. He and his family continue to foster the Christian Cancer Centre, Hope Village and Leprosy Mission, which they founded in India.

Through on-going efforts, orphans and those suffering from cancer, leprosy and AIDS/HIV are cared for. Dr. Charles also leads medical missions to the area to bolster treatment efforts.

Dr. Charles, president of Cancer Care Centers of Brevard, is also a tireless fundraiser for a variety of local, national and international charitable causes. He emphasizes that it takes many people working together to make medical missions successful.

“I am just a spoke in a wheel made up of friends and co-workers that have teamed up to bring hope to the hopeless, not just in India, but where ever our God-given gifts and talents may be utilized,” Dr. Charles said.

Dr. Charles

CLICK HERE FOR RELATED STORY

Bout With Cancer Changes Cancer Doc’s Life: For days, then weeks, and eventually months last year, Dr. Silas Charles shrugged off the rundown feeling that accompanied him everywhere.

Platelet Rich Plasma Therapy Effective Treatment

Tom Palermo — Thu, 18 Feb 2010 19:15:08 +0000

ORTHOPEDICS

PRP Effective In Treating Difficult Tendon Problems

BREVARD COUNTY, FLORIDA – Orthopedic surgeons are charged with treating muscular-skeletal disorders both surgically and non-surgically. Inflammatory conditions involving the tendons can be somewhat more challenging to manage than other problems. Examples of these recalcitrant conditions are Achilles Tendinitis, Trochanteric Bursitis, and Iliotibial Band Syndrome.

JUST PRIOR to the kickoff of Superbowl XLIII, Pittsburgh Steeler wide receiver, Hines Ward underwent PRP treatment to accelerate recovery of a medial collateral ligament sprain.

Treatment of these conditions is limited by the lack of effective surgical options. Physical therapy, activity modification, and anti-inflammatory medications have been mainstays of treatment. Some patients find their symptoms are not fully addressed with these techniques.

PRP Created From Patient’s Blood

Injections of platelet rich plasma (PRP) are being used in sports medicine and other areas of orthopedics to treat these difficult tendon problems.

One of the functions of platelets, a component of blood, is to provide a healing response via recruitment of reparative cells and secretion of proteins that aid in healing. PRP is created out of a patient’s own blood, defined as autologous blood, with a concentration of platelets above baseline values. PRP has been used in medicine since the early 1990’s.

Preparation of PRP is simple

A patient’s own blood is drawn and processed in a centrifuge to separate the platelet-rich plasma from the other components. This maximizes the concentration of healing components in the specimen. The concentrated platelets are then injected into the affected site of injury or inflammation. The growth factors that platelets secrete spur tissue recovery. Generally, no chemicals or drugs are used in the process.

PRP stimulate tendon healing
Laboratory analysis has supported the clinical use of PRP. Studies have shown that human cells treated with PRP stimulate tendon healing. Increased production of blood vessels and repair of inflamed tissue has been shown in experiments on tendon cells. PRP has also been used to speed up the healing of muscular injuries. One study has shown that PRP is most effective in treating high repetition muscular injuries.

Recent clinical studies support the laboratory evidence related to the use of PRP. Elbow conditions, specifically tennis elbow and golfer’s elbow, have shown improvement in pain as well as athletic performance after one PRP injection.

TIGER WOODS received four injections of PRP in his left knee following surgery.

Use of PRP in knee tendinitis, specifically jumper’s knee, showed excellent clinical results with no associated adverse events. Seventy percent of RPR treated patients showed better, more complete functional recovery than without. Additionally, there is one study supporting the use of PRP in plantar fasciitis.

Accelerated Healing

Acute muscle tears and chronic muscle strains can also be treated effectively with PRP. The time to complete healing and relief of pain were shown to be accelerated with this treatment, and recently professional athletes such as Troy Polamalu, Hines Ward and Tiger Woods to name a few, have used this technique to expedite their return to competition

Orthopedic conditions resulting from mechanical interference of anatomic structures are not likely to be helped with PRP. End-stage osteoarthritis of the hip knee or shoulder, rotator cuff tears, impingement syndrome, and carpal tunnel syndrome are the result of significant anatomic changes and are not likely to be helped with simple PRP injections alone.

The use of the platelet rich plasma in orthopedic conditions is becoming more popular. Judicious use of this technique appears to provide more rapid return to function and relief of painful inflammatory symptoms.

Dr. Jeff O'Brien

ABOUT THE AUTHOR

Jeff O’Brien, MD, is a Board Certified Orthopedic surgeon who has practiced in Brevard County, Florida since 1996. He is a graduate of Hahnemann University School of Medicine in Philadelphia, Pennsylvania and completed a Hand and Upper Extremity fellowship at the University of Pennsylvania. He treats patients from all over the county at the Orthopedic Center in Merritt Island.

Running Zone Among 50 Best In USA

Tom Palermo — Thu, 18 Feb 2010 01:11:35 +0000

RUNNING & EXERCISE

BREVARD COUNTY, FLORIDA – Running Zone has been named one of The 50 Best Running Stores in America. The award was presented by Formula 4 Media, producers of The Running Event – the largest conference and trade show for running specialty stores in North America.

The full list of winners is featured in a special published report that appeared in Sports Insight and Footwear Insight, two leading trade magazines serving the sports specialty and footwear markets.

The 50 Best Stores list is the result of a year-long process that rates running stores based on their customer service, their relationship with the community they serve and a number of other key factors.

Starting in the spring of 2008, Formula 4 Media solicited nominations from consumers, members of the trade and even stores themselves. The nominations were edited and vetted and narrowed down to about 120 stores that underwent an intense evaluation process.

The evaluation included a mystery shopping rating that evaluated the store on 20 different points. This was done by a secret shopper who spent $100 in the store and rated it on points ranging from staff knowledge and attitude to "does the store offer clean try-on socks" to how simple was the check-out process and what was the quality of the shopping bag with which you walked out the door.

The mystery shopping was done by Franklin Resource Group, the leading merchandising company in the sports retail business.

How a store supports its local community is another key factor in determining what stores make the list. The community support is evaluated based on sponsorship of local races, support of charities and essentially what the store does for its local community of runners.

"There are hundreds of great running stores in the country, but we believe this list represents the 50 best," said Mark Sullivan, president of Formula 4 Media. "Every store on this list should be proud that they earned their way on to the list based on feedback from the toughest, most objective judges out there, their own customers."

This marks the third consecutive year Formula 4 Media has produced The 50 Best Stores Awards. The awards are presented annually at The Running Event and a full report is published each January.

Formula 4 Media is a B2B publishing and event company that produces The Running Event, The Soccer Event, The Green Event and The Footwear Event. The company publishes a range of leading trade magazines including Sports Insight, Footwear Insight, Textile Insight and Team Insight.

To contact the Running Zone please call 321-751-8890, or log on to www.RunningZone.com.

Dr. Pete Joins Matt Reed On ‘Today In Brevard’

Tom Palermo — Wed, 17 Feb 2010 23:55:34 +0000

HEALTHCARE MULTIMEDIA

BREVARD COUNTY, FLORIDA (Feb. 18, 2010) – Dr. Pete Weiss recently joined Florida Today senior editor and host of "Today In Brevard," Matt Reed, to discuss Dr. Weiss' new book, "More Health, Less Care."

Dr. Pete co-hosts the SpaceCoastMedicine.com Radio Show with broadcast veteran Katie Bokunic. The show is broadcast every Saturday at 10:00 a.m. on ESPN 1560 AM, and is also be available by logging on to http://www.livestream.com/espn1560wint.

Dr. Pete and Katie feature local and national health and medicine experts to educate listeners about the latest information available to help them remain healthy and vibrant – and fight the aging process.

To advertise, or for sponsorship information, call 321-615-8111, or e-mail SpaceCoastMedicine@gmail.com.

Dr. Pete Weiss and Florida Today's Matt Reed on the set of "Today In Brevard."

LISTEN TO THE SATURDAY, DEC. 5, 2009 SHOW

LISTEN TO THE SATURDAY, DEC. 12, 2009 SHOW

LISTEN TO THE SATURDAY, DEC. 19, 2009 SHOW

LISTEN TO THE SATURDAY, JAN. 2, 2010 SHOW

LISTEN TO THE SATURDAY, JAN. 9, 2010 SHOW

LISTEN TO THE SATURDAY, JAN. 30, 2010 SHOW

Lap Band Procedure is Life Saving for Blair, Morgan

Tom Palermo — Wed, 17 Feb 2010 18:37:15 +0000

Blair Becomes Triathlete After Dropping 70 Pounds

Kathy Blair at 256 pounds.

WHEN KATHY BLAIR was at her heaviest weight ever, 256 pounds, she wore a size 22. The 52 year-old mother of six had gone up and down in weight many times during and after her pregnancies.

“When I was young it was no problem to lose weight, but I just couldn’t keep it off. Now I was getting older it was harder to lose the weight, and even harder to keep it off,” Blair says.

The Melbourne resident had developed hypertension, had frequent migraines and constantly felt fatigued. It was becoming ever more difficult to keep up with her grandchildren, and clothes shopping with her daughters was depressing.

Blair feared she was also on her way to developing diabetes, which many of her relatives suffer from.

“I couldn’t believe that food was controlling my life. I knew I had to make a permanent change because going up and down in weight wasn’t good for my health,” says Blair, who serves as insurance coordinator for Lifeshape in Melbourne.

Kathy Blair at 176 pounds.

Solution She Was Looking For

As a Lifeshape employee, Blair had witnessed the long-term weight maintenance success of numerous lapband surgery patients, and came to believe that it could be the solution she was looking for. So she signed up for the outpatient surgery and began to focus on a healthier diet and daily exercise.

After about a year 5-foot, 10-inch Blair had lost 70 pounds, weighed in at 176 and wore a size 12. She’s hovered around that same weight for the past year. Keeping up with her grandchildren is now a joy, and clothing shopping is fun again, Blair says.

She’s pleased that the lapband continues to help her keep off the weight. “Eating more slowly and in small amounts just becomes the way you live,” she says.

After losing the weight, Blair took on the Health First Triathlon and has participated in six other triathlons since then, including one in the Bahamas and one in Seattle, Wash.

“I was in triathlons when I was young, but I never thought I’d be doing them again,” she says.

Blair continues to strive to become more fit so she’ll be more competitive in her biking, swimming and running events. “It’s not about my appearance, it’s about improving my time,” she says.

“They say when you reach a goal you should set another one, and that keeps you going.”

Morgan loses 135 pounds, Becomes "Stud Muffin" Again

Joe Morgan at 320 pounds.

JOE MORGAN used a cane to walk and endured epidural shots to manage his back pain when he topped the scales at 320 pounds.

His weight had crept upwards over the years, and he really packed on the pounds when he served as the mayor of Cocoa Beach from 1993 to 1999. He estimates he gained about 60 pounds during those six years.

“I was first in the buffet line at all the events,” he says. He also was a smoker.

Because of his unhealthy habits the long-time Cocoa Beach community leader and former bank executive developed high blood pressure and type II diabetes.

Morgan, then 67, was warned by his doctor that he’d never reach 70 if he didn’t lose weight and quit smoking. In fact, Morgan’s three brothers, all younger than 70, have died from diabetes and other health problems within the past five years.

Fortunately Morgan took his physician’s recommendations to try lapband surgery as a means of spurring gradual and permanent weight loss and to stop smoking. “I knew it was do or die,” he says.

Joe Morgan at 180 pounds.

After the surgery Morgan began a healthy diet and exercise regimen and participated in a educational weight-loss program. He lost 135 pounds and 16 inches off his waist over about two years. Now he maintains of weight of about 185 pounds.

Morgan’s back pain, diabetes and hypertension went away as he lost weight. His recent blood pressure reading was 112 over 80.

“It’s good to be a stud muffin again, and have the energy of a younger man,” the 73 year-old says with a laugh and a twinkle in his eye.

Morgan’s appearance has changed so dramatically that often he isn’t recognized by former associates.“Folks are shocked when they learn it’s me,” Morgan says.

Morgan, an ordained deacon, now is more active in his church, Riverside Presbyterian Church in Cocoa Beach. He has participated in missionary trips to Mexico and Brazil. As a sideline, he performs weddings on the beach. “I enjoy getting out and being active,” he says.

To keep the weight off Morgan continues to eat a healthy diet and exercises three times a week at the gym. Plus he dances, kayaks and swims in his community’s lap pool.

“My dear mother lived to be 91, and I’d like to live that long as well. I have a lot of living left to do,” he says.

Obesity: It’s the Environment

Tom Palermo — Sat, 13 Feb 2010 20:42:24 +0000

DR. PETE'S PERSONAL HEALTH BLOG

I feel compelled to write more on obesity having just seen this headline on MSNBC.com, "Path to obesity may begin before age 2 - doctors may need to address weight problems in infants."

The article reports on a study showing that obesity often begins very young, at around three months of age or so, and that by the age of two many children are on a path towards being obese.

The lead author of the work, pediatrician Dr. John Harrington said, "I really think this should be a wake-up call for doctors. Too often, doctors wait until medical complications arise before they begin treatment. What this study suggests is that prevention of obesity should begin far, far earlier."

Only Half Right

The results of this research should not surprise anyone with their eyes open. But Dr. Harrington is only half right. True, prevention of obesity must start earlier in life. It's not all about the choices we adults make for ourselves, it's about the environment in which we live and are raising our kids.

Michelle Obama is on the right track. We need get real about this as a country.

Here is where Dr. Harrington has it wrong: "...this should be a wake up call for doctors." Wrong, wrong and wrong! This should be a wake up call for America.

Looking at obesity as a medical problem is killing us! Mostly obesity is a lifestyle problem. If you're obese it is not your doctor's job to make you thin through "treatment." I'm letting doctors off the hook here, but I'm putting the rest of us on it.

Where do we get our lifestyle?

Go Michelle Obama, go!

Let's face it, to a certain extent we are all products of our environment. Why are we becoming a fatter and more sedentary nation in recent decades? Our genetics didn't change. Our character didn't change. But our environment changed around us, and we can't handle it.

Giant portion sizes, easy availability of harmful foods, increasing affluence, and labor saving technology leading to less exercise - it's all killing us, and we have demonstrated that are unable to resist.

Yes we are responsible for our own behavior, but let's stop blaming bad individual choices for obesity. Or are we going to blame the two year olds? Instead let's start focus on our toxic environment.

What we can do as a society to create an environment that supports our health? Let's make it easier for us and for our kids to live healthy lifestyles. We need to get unhealthy foods out of schools; we need to get PE back into schools, and we need to make a host of changes to help us adults live better too.

When it comes to children, I see it as a moral issue. They are depending on us to give them a good start.

Go Michelle Obama, go!

RELATED STORIES & LINKS

Michelle Obama Says 'Let's Move' On Obesity In American kids

Obesity Rates Show Hard Work Ahead For Michelle Obama’s Program

Dr. Pete Weiss

ABOUT THE AUTHOR

Dr. Pete Weiss (www.drpeterjweiss.com) is a physician, healthcare executive, author, speaker and health coach with a passion for helping others to health and wellness. "Dr. Pete" has recognized that traditional medical care isn’t helping many people to become well, and his personal mission is empowering individuals to manage their own health. Dr. Pete, whose book on personal health, More Health, Less Care, is due out in May, can be reached at 321-794-0298 or pete@drpeterjweiss.com.

Anchor Breakfast Set for March 18

Tom Palermo — Fri, 12 Feb 2010 19:23:12 +0000

Central Florida UroGynecology Grand Opening March 15

Dear Mrs. Obama, Obesity Needs A Ribbon

Tom Palermo — Fri, 12 Feb 2010 17:49:38 +0000

DR. PETE'S PERSONAL HEALTH BLOG

Finally obesity is getting some respect. Michelle Obama is kicking off an anti-obesity campaign for children this week. And it's the right thing to do.

BREVARD COUNTY, FLORIDA – Many people don't seem to understand that obesity is a killer.

"I'm fat, so what," seems to be their attitude. A lot, that's what. In no particular order here is a list of diseases associated with obesity: stroke, gout, coronary artery disease including angina and heart attack, type 2 diabetes, high blood pressure, elevated cholesterol, fatty liver disease, gallstones, sleep apnea, degenerative arthritis, abnormal menses, infertility, endometrial cancer of the uterus, breast cancer, colon cancer, kidney cancer, and esophageal cancer.

Is that surprising? In order to understand how this can be, start by thinking about being obese as similar to driving your car with a load of bricks in the trunk. Driving with the extra weight will stress all parts of the vehicle - the engine, transmission, tires, shocks, and struts. With time the entire car will wear out more quickly. Same with your body.

But it's worse than that. Fat cells are not just inert "bricks in your trunk." The fat you carry is metabolically active, and not in a good way. The fat cells produce harmful hormones that travel throughout the body and can cause diseases like cancer. According to the National Cancer Institute’s web site, as much as 10 to 20 percent of cancer deaths in the United States may be due to excess weight. Back to our car analogy, it's as if the bricks in the trunk were releasing harmful chemicals into the gas tank too.

So How Come Obesity Gets No Respect?

Perhaps we too often consider it a personal failing rather than understanding the major role our surroundings play in causing this epidemic. Yes people have choices, but people also need help. We adults created the American environment that is causing our children to be fat. It's time we fix it. We need to treat obesity like the public health problem it is, stop blaming individuals, offer support, and search for environmental solutions.

But what stands for the fight against obesity? In today's world, marketing is everything. Could the lack of respect be due to lack of a symbol or logo? At the time of this writing, Wikipedia lists 18 different awareness ribbons for over 50 diagnoses and causes. These include many diseases that are tied to obesity, but obesity itself has no ribbon. So Bravo to you Mrs. Obama, you have chosen a worthy issue and you have my support, but my advice is "Get a ribbon!"

P.S. - Mrs. Obama, I am sending you a copy of my book More Health, Less Care. I think it can help America be healthy. Please keep an eye out for it.

RELATED STORIES & LINKS

Michelle Obama Says 'Let's Move' On Obesity In American kids

Obesity Rates Show Hard Work Ahead For Michelle Obama’s Program

Dr. Pete Weiss

ABOUT THE AUTHOR

Mathews Special Guest on SpaceCoastMedicine.com Radio

Tom Palermo — Fri, 12 Feb 2010 02:45:29 +0000

SPACECOASTMEDICINE.COM RADIO SHOW

SpaceCoastMedicine.com Radio Hour – Saturdays at 10:00 a.m. on ESPN 1560 AM

Log on to http://www.livestream.com/espn1560wint to hear the LIVE STREAM

BREVARD COUNTY, FLORIDA (Feb. 11, 2010) – The SpaceCoastMedicine.com Radio Show will broadcast this Saturday live from the Cumulus Broadcasting studios located in Melbourne, Florida.

The show also highlight inspiring guests who have survived cancer, organ transplantation and severe trauma.

Cristy Mathews

Cristy Mathews, MBA

This week's special guest is Cristy Mathews, President of Synergistic Health. She earned a B.S. in Exercise Management from Stetson University, and a Masters in Business Management from Florida Institute of Technology.

Ms. Mathews has worked in both preventive and reactive healthcare, and has over 20 years experience in exercise science, fitness development and nutrition counseling – combined with over eight years experience in the pharmaceutical industry. She has developed a very keen sense of the needs of being able to work synergistically with nature and science.

"Synergistic Health hopes to bring about a paradigm shift for people of how they treat themselves and think of disease in their lives and bodies," said Ms. Mathews. "We bring together a group of specialized people to help create a provider network for our clients to come to for all of their healthcare needs."

You may ask questions by calling 321-984-1234 during the show.

Peter Weiss, MD

Katie Bokunic

Bokunic, a long-time broadcast veteran, has more than 25 years experience in multimedia advertising, marketing, public relations and radio broadcasting.

The show is broadcast every Saturday at 10:00 a.m. on ESPN 1560 AM, and is also be available via Podcast by accessing http://www.livestream.com/espn1560wint

To advertise, or for sponsorship information, call 321-615-8111, or e-mail SpaceCoastMedicine@gmail.com.

LISTEN TO THE SATURDAY, DEC. 5, 2009 SHOW

LISTEN TO THE SATURDAY, DEC. 12, 2009 SHOW

LISTEN TO THE SATURDAY, DEC. 19, 2009 SHOW

LISTEN TO THE SATURDAY, JAN. 2, 2010 SHOW

LISTEN TO THE SATURDAY, JAN. 9, 2010 SHOW

LISTEN TO THE SATURDAY, JAN. 30, 2010 SHOW

MRI Scanners Generate Three Dimensional Images

Tom Palermo — Thu, 11 Feb 2010 22:02:25 +0000

MEDICAL TECHNOLOGY

MRI SCANNERS, or Magnetic Resonance Imaging scanners, like X-rays and CT scanners, are machines doctors use to take pictures of the inside of the body so that they can figure out what’s ailing you.

PET SCAN is 90 percent or better sensitive in detecting most cancers, especially solid cancers including lung, breast, head and neck, ovarian etc. In recent months, Medicare has expanded its coverage for PET scans to improve the diagnosis and care of patients with suspected or known cancers.

MRI doesn’t involve ionizing radiation like X-rays and CT scans. Rather, MRI takes advantage of something you already have in your body – water. Another benefit to MRI is its ability to generate three dimensional images in any orientation and at any depth in the body.

While X-rays remain useful for looking at bones, MRI scans are the diagnostic tool of choice for soft tissue – the circulatory system, ligaments, organs and the spinal column and cord. MRIs help physicians identify multiple sclerosis, tumors, tendonitis, strokes and many other conditions. For most applications, MRI is far superior to other imaging tools in providing non-invasive images (and even chemical information) at high resolution.

MAGNETIC FIELD STRENGTH
The strength of the MRI signal is influenced by the “magnetic field strength” of the MRI magnet. The magnetic field strength of an MRI magnet is measured in a unit called the “Tesla (T).” For example, a 1.5 T MRI scanner has a field strength of 1.5 Tesla

1.5T MR vs. 3T: To most physicians and hospitals, 1.5T MR is the most reliable field strength. With a wide variety of coil options, 1.5T has the potential for better image quality across a variety of imaging applications in comparison to 3T. Imaging departments and imaging centers, like Rockledge MRI & PET Center, recognize that 1.5T simply has a more proven track record than its higher field strength cousin, the 3T.

A challenge for higher strength magnets is the interaction with metal implants such as stents, aneurysm clips and even prosthetic devices. With the Siemans 1.5T, Rockledge MRI patients who have these safety concerns are not an issue and imaging can be done without an increase in metal artifact.

“1.5T has now struck upon the highest level upon which you can achieve good imaging for the array of imaging applications, such as abdominal, neuro, cardiac, chest, spine, peripheral, and joint imaging—without one of those groups falling off the map,” according to Alan R. Moody, radiologist in chief, department of diagnostic imaging, at Sunnybrook Health Sciences Centre in Toronto. “The reason 1.5T is so successful is that it works for all of those applications,” he says.

“As you go to the higher field strengths, because of the physics, some of the artifacts that you get start to impact on the image quality that you don’t get at 1.5T and you have to work harder to get your images out at 3T,” adds Moody.

Another limitation of 3T, and thus a benefit of 1.5T, is related to its energy deposition. 3T might enable faster and higher resolution imaging, however, the restriction is in how much energy can be put back into the patient.

“With 3T you have to ease back on the throttle, and you potentially lose some of the advantages you had of ramping up to that field strength in the first place,” Moody says, who adds that there seems to be a slight plateauing of that linear progression of the low field strength. Instead of racing to the next level in magnet strength, the imaging community has hit a plateau, staying strong with 1.5T MRI for its applicability across imaging applications.

SHORT BORE MRI VS. OPEN MRI
Many existing open MRIs are originally designed to accommodate larger or claustrophobic patients. Conventional MR scanners are cylindrical in shape, while an open MRI is usually open on two or three sides. Most claustrophobic patients want to automatically gravitate toward “Open MRI’s” without even considering other options.

While, a patient could use an Open MRI, these systems bring with them a couple of compromises. Scan times are much longer. Additionally, the image resolution offered by these systems can be less than optimal when certain parts of the body (most notably, the brain, vascular, abdominal and spine) are being scrutinized.

Rockledge MRI & PET Center

“Open MRI” scanners generally have field strengths of 0.2-0.3 T, and are considered to be “low-field” systems. “Mid-field” systems have field strengths of 0.5-1.0 T. “High-field systems” are MRI scanners that operate at or above 1.5 T.

Rockledge MRI & PET Center addressed this issue, with the Siemans Short Bore MRI, and enabled all patients a comfortable solution. Short bore systems are 50 percent shorter and five percent wider than conventional MRI setups.

These altered dimensions make for a much less claustrophobic experience for our patients. Scanning time is the same as with conventional MRIs. Best of all, short bore MRIs offer first-rate image quality with superior resolution.

Now, claustrophobic patients need not compromise. Rockledge MRI also offers oral and IV sedation and a patient may bring their own choice of music-all for added comfort.

Dr. Wasim Niazi

ABOUT THE AUTHOR

Dr. Wasim Niazi is a neurologist who has practiced in Rockledge, Florida for the last 15 years. Board Certified in Neurology, Pain Medicine and Electro-diagnostic Medicine, Dr. Niazi also has special interests in epilepsy with video and ambulatory monitoring, PET scan of brain for diagnosis of dementia and Sleep Medicine. Dr. Niazi has privileges at Wuesthoff and Cape Canaveral Hospital. For more information call 321-636-6599 or log on to www.RockledgeMRI.com.

PET/CT Scan Useful In Diagnosis of Alzheimer

Q&A: Bioidentical Hormone Replacement

Tom Palermo — Thu, 11 Feb 2010 21:51:17 +0000

Q&A: With Women’s Health Nurse Practitioner Kristine Maki

Hormone replacement therapy (HRT) was for many years a standard approach to managing peri-menopausal and menopausal symptoms, and protecting women against heart disease, building stronger bones, maintaining youthful skin, and supporting healthy brain function.

Millions of women in America were prescribed Premarin or Prempro, without much question, to replace the human sex hormones that naturally taper off in menopausal women — primarily estrogen and progesterone.

This standard use of HRT changed when data from the Women’s Health Initiative (WHI) study was made public in 2002. The evidence from this study set off a firestorm of controversy, and healthcare providers and their female patients were shocked to learn that HRT was not as protective, or as safe, as they had once assumed.

Since the results of the WHI were released, several alternatives to traditional (Premarin and Prempro) HRT therapy have taken center stage. SpaceCoastMedicine.com welcomes Women’s Health Nurse Practitioner Kristine Maki to address questions related to one of these alternatives—bioidentical hormone replacement therapy (BHRT).

SCM&HL: The results of the WHI set Women’s Health back on its heels in 2002. What are the take-aways from that multi-center research study?

Ms. Maki: WHI is a long-term national health study that focuses on strategies for preventing heart disease, breast and colorectal cancer and fracture in postmenopausal women. This 15-year project involves over 161,000 women ages 50-79, and is one of the most definitive, far reaching programs of research on women’s health ever undertaken in the U.S.

The Estrogen plus Progestin Study arm of the WHI was stopped in July 2002 because of increased risks of cardiovascular disease and breast cancer in women taking active study pills (Premarin and Provera), compared with those on placebo (inactive pills).

This aspect of the study focused on the synthetic hormones Premarin (conjugated equine estrogen) and Provera (progestin) rather than hormones that mimic those that our younger bodies actually make. The WHI involved older women, who were beyond the point where hormone replacement is most beneficial.

Recent studies suggest that STARTING hormone replacement more than 10 years after menopause (average age 51) may be harmful. Additionally, the women participating in the WHI took oral pills instead of applying the hormones to their skin.

Oral estrogens change as they pass through our stomach and liver and cause an increase in bad cholesterol and decline in good cholesterol, which can increase our risk for heart disease. The study, while thought provoking, caused women to reexamine the need for hormone replacement.

It also points to the fact that scientific medical studies are rarely easy to interpret and that most women need a health care provider who can spend the time with his or her patients to help them decide what is right for them.

SCM&HL: What was the reaction to and impact of the WHI?

Ms. Maki: The WHI influenced many practitioners to stop prescribing and women to stop taking hormone replacements, which had been prescribed by physicians for years. The media and many practitioners painted all HRT with the same broad stroke, advising in medical alerts that the risks apply regardless of the type of hormones.

After hearing that hormones caused an increase in cancer and heart disease, I personally discontinued my Prempro immediately. Initially I did not feel much of a change, but as time passed, my lack of hormones was more and more noticeable. I became tired quickly, felt more anxious, and noticed that I was losing both a lot of hair as well as my temper.

Suzanne Somers published several books and I read them, but wasn’t convinced; after all she was an actress, not a medical professional. Nonetheless she had excellent medical references and the doctors she saw for hormone replacement after she was diagnosed with breast cancer were well recognized for their excellence. I decided to get more information and for years went to medical conferences and found out what was really going on with hormone replacement therapy.

My focused review of the literature on the topic and the reanalysis of the WHI showed associated risks only for conjugated equine estrogens and synthetic progestins — not bioidentical hormones, and that BHRT was a great option for women.

SCM&HL: What is bioidentical hormone replacement therapy (BHRT)?

Ms. Maki: BHRT is a prescription alternative to conventional hormone replacement therapy that has existed for over 20 years, is molecularly identical to the hormones that are produced in the body, and is characterized by individual treatment doses which are not commercially available.

For example, Premarin contains synthetic estrogens originally produced from horse urine. It does contain several types of estrogen, but none that are found in a human. On the other hand, Estradiol (E2) is made in our body and has over 400 specific uses.

For two years, Oprah suffered from menopausal symptoms and a low thyroid condition. She wasn’t feeling herself, and doctors she consulted had no answers. In less than three days after starting on bioidentical hormones, her menopausal problems were gone and she was singing praises. Now, Oprah is bringing her experiences into the national consciousness with her Jan. 15, 2009 television show which highlighted bioidentical hormones.

Bioidentical E2 is made from natural plant compounds and synthesized to the exact structure and function as the E2 produced within the human body. We also have progesterone (the hormone of pregnancy, but important throughout our lives) and testosterone (important for sex drive and other good things). Everyone has different needs, so it’s important that everyone has personally dosed BHRT based on her lab values, symptoms and other needs.

SCM&HL: Are BHRT better than synthetic hormones?

Ms. Maki: The great advantage of bioidentical hormones is that they are more natural, and our body can metabolize them as it was designed to do, minimizing side effects. Moreover, the compounded bioidentical hormones can be matched individually to each woman’s needs — something that’s not possible with mass-produced products.

SCM&HL: How safe are BHRTs?

Ms. Maki: The issue of safety keeps arising from the critics of BHRT, as well as the argument that they are not specifically “approved” by the FDA. The FDA has approved the same types of hormone molecules that act as messengers that turn on and off productions of bodily functions. The FDA is a federal agency and does a good job regulating manufactured drugs.

The FDA is not given the job to regulate BHRTs. That job is given to state agencies, and in many states the BHRTs are monitored even more closely than the FDA does. The FDA will make comments on BHRT manufacturers that make exorbitant claims, but does not act as a watchdog, as the states do an excellent job of that. The DEA (Drug Enforcement Agency) does watch over BHRTs, especially those that are considered controlled substances, such as testosterone.

The PCCA (Pharmaceutical Compounding Centers of America) is very involved in all compounded drugs, especially BHRT, and reputable compounding pharmacies are part of it. A good compounding pharmacy has just as good internal quality controls as those found in large pharmaceutical companies. You can rest assured that if you get BHRTs from a reputable compounding pharmacy you will have a top notch quality product that has been thoroughly tested and safe.

European medical studies suggest that BHRT are safer than synthetic versions. BHRT are much closer to what your body actually makes and it’s logical that they would be safer than synthetic hormones whose structures are different than those our bodies contain.

Although the drug companies and their sales people imply that BHRT medications aren’t manufactured carefully and lack quality control, that simply isn’t true about the majority of registered compounding pharmacies. They have excellent quality control and produce medications that pass rigorous testing standards

SCM&HL: In your practice, how do you approach the management of peri-menopausal and menopausal symptoms?

Ms. Maki: Most women are happy when their periods are over and some minimize their symptoms of menopause, but each woman is different. Some women barely notice the changes as they are occurring, but unfortunately many suffer later in life with heart disease, osteoporosis, Alzheimer’s etc. that may have been avoided or minimized through proper hormone replacement given at the appropriate dose in a timely fashion. Others go to their doctors and take hormones just to get through the bad times and quit, but still may be facing future problems with hormone lack.

There continues to be a lot of confusion and even fear related to hormone replacement. I am devoted to clearing up the HRT story and setting the record straight for women. In my case, it took a couple years without hormones to recognize their importance.

Through extensive personal research, watching Oprah and Robin McGraw, but especially listening to my patients’ feedback (some say it gave them their life back) I became convinced again of the importance of BHRT. I am glad to be back on my BHRT, and enjoy discussing how it can be extremely beneficial to most women.

Women who approach age 50 and beyond may be greatly benefited by estrogen and progesterone. In my practice I recommend estrogen to be applied on the skin (transdermally) or vaginally, whereas progesterone can be taken both orally and transdermally.

We use Hobbs Pharmacy in Merrritt Island as our local compounding pharmacy. Additionally we have found MedRX in Orlando to be excellent. They both have very stringent control policies and have a superior safety rating.

My goal is to help inform women about their options so that they can make the choice that’s best for them. The final decision remains with the individual.

If you don’t like how you feel and want to regain a sense of being in balance with the hormones that control so much of our well being, BHRT may be for you. Our hormones don’t decline because we age; rather we age because our hormones decline.

To reach Ms. Maki call 321-305-5970 or e-mail KristineMaki@gmail.com

ABOUT THE AUTHOR

KRIS MAKI is licensed in Florida as a Registered Nurse and Nurse Practitioner, and is a Registered Nurse Certified Women’s Health Nurse Practitioner. She was educated at Methodist Hospital in Lubbock, TX and Ball State University in Indianapolis, IN. Ms. Maki practiced as a labor and delivery nurse and maternal fetal intensive care nurse from 1988-2004, and is a member of the American Academy of Anti-Aging Medicine and the International Society for the Study of Women’s Sexual Health. She has been married to Lance Maki, MD, for 44 years and they have five adult children and six grandchildren – and counting. You may reach her at KristineMaki@gmail.com or 321-305-5970.

Editor’s Note: Sobering, Exciting Time For Healthcare

Tom Palermo — Thu, 11 Feb 2010 20:00:07 +0000

EDITOR'S NOTE

BREVARD PHYSICIAN NETWORK'S Dr. Nabil Aziz, Dr. Doug Barimo, Dr. Kiran Modi, Dr. Gopal Gadodia and Brenda Radke.

This is both a sobering and exciting time for healthcare in this country.

The need for reform is undeniable, but the approach to, and politics and economics of this process are so complex that it will require many more months, if not years, to establish a system that genuinely addresses how best to effectively enhance the value variables of healthcare and truly improve the health of all Americans.

To move medicine into the 21st century, we have to give healthcare providers the freedom to re-price and re-package their services in ways that neither increase the cost nor decrease the quality of service to the patient.

Engagement and a legitimate collaboration of all stakeholders including providers, payers and patients, in innovative, equitable and more effective models of health maintenance and care are the keys to success.

A group of Brevard physicians were focused on finding a better way of dealing with payers and patients as early as 1995. The Brevard Physicians Network was founded on the principle of equitable pricing for high quality patient care and services, and the now 287-member organization affords more effective business relations with payers and economy of scale advantage for cost efficiencies in their practices.

“The Giants Who Are Angles”

ROCKLEDGE PEDIATRICIAN, Dr. Rodriguez-Palermo, and the children of rural Cayambe, Ecuador.

The incredible same outpouring of concern, charity and action by Brevard healthcare providers generated by the tragedy in Haiti is evident in Joyce Henderson’s first person chronicle of “The Giants Who Are Angles” to the people of Quito, Ecuador.

In October of last year, Henderson and her team of 21 saw over 460 patients over a period of five days in their mission clinic and made many “house-calls.”

Counterbalance To Stress

Kiteboarding has become the preferred activity to counterbalance the stress of a busy medical practice for many Space Coast physicians.

An exhilarating avocation, it takes skill, courage and at times, as described in the first person by Dr. Michelle Henderson, can be dangerous. Because of strong forces that can be generated by sudden wind gusts, a kiteboarder can be lofted, carried off, dashed against water, buildings, terrain or power lines, resulting in what’s termed a “kitemare” (kite + nightmare).

"Happy Medicine"

Dr. Carol Armon expected to pursue a career in medical research, but as part of her medical school training, she saw a baby being born.

“This is cool! It’s happy medicine,” she remembered thinking. It was the 1970s, and women didn’t go into gynecology. “We were pioneers,” she said of herself and her comrade at arms.

Q&A: Hormone Replacement Therapy

Space Coast Medicine and Healthy Living welcomes Women’s Health Nurse Practitioner Kristine Maki to address questions related to one of these alternatives – bioidentical hormone replacement therapy.

The traditional standard use of hormone replacement therapy to manage peri-menopausal and menopausal symptoms changed when data from the Women’s Health Initiative study was made public in 2002.

The evidence from that study set off a fire storm of controversy, and healthcare providers and their female patients were shocked to learn that HRT was not as protective, or as safe, as they had once assumed. Over the past eight years several alternatives to traditional (Premarin and Prempro) hormone replacement therapy have taken center stage.

H.O.P.E Morphs Into Brevard Health Alliance

LEADERS Lisa Gurri, left, and Tom Culbreth. “It’s a challenge that when we get up in the morning, it’s going to be bigger than when we started,” Culbreth said. And yet, he and other BHA doctors and staff get up every day, ready to address the growing need.

Accessible, quality, patient-centered care and healthcare education for the needy and less fortunate members of our community was a vision of a handful of Brevardians in 1993. That vision came to fruition, and with the dedication, commitment and altruistic participation of healthcare providers across the county has, over the past 17 years, evolved into Brevard Health Alliance.

Our Flashback relates the history and evolution of the HOPE clinic from its inception to today’s federally qualified and funded Brevard Health Alliance, a network of community partners that enable Brevard county citizens, regardless of their ability to pay, to access expanded primary health care, dental health, mental health, health care education and preventive health services.

Striving To expand Our Reach

For 2010, SpaceCoastMedicine.com Magazine will strive to expand our reach through our ever-growing multimedia channels including this magazine, our website SpaceCoastMedicine.com, radio show and our event series – the Florida Anti-Aging & Healthy Living Expos, which will kickoff at the Clemente Center at Florida Tech on June 12 & 13.

As always, we will continue to engage, educate and entertain by featuring informative, inspiring and timely content focusing on people, and their healthcare providers, dealing with, and overcoming, all types of healthcare and medical challenges.

CLICK HERE TO READ THIS EDITION OF SPACECOASTMEDICINE.COM MAGAZINE

Dr. Jim Palermo

ABOUT THE EDITOR-IN-CHIEF

Jim Palermo, MD, touched the lives of countless Brevardians during his 20 year practice of general, vascular and non-cardiac thoracic surgery. In 2002, after a 30 year career in clinical medicine in which his impact was on an individual patient level, he accepted a position as full-time chief quality officer and vice president of quality management of a local healthcare system.

Dr. Palermo made this career transformation based on his certainty and conviction that he could personally have a greater impact on improving the quality of healthcare on the Space Coast by more globally addressing quality and patient safety issues as a physician healthcare executive. An accomplished author and sought-after expert in the healthcare industry, Dr. Palermo has written extensively on quality healthcare and medical topics.

Dr. Palermo is a graduate of the University of Missouri School of Medicine, did his surgical residency in the U.S. Army at William Beaumont Army Medical Center, is a Fellow of the American College of Surgery, and also attained a Masters Degree in healthcare management at the University of Texas at Dallas.

Newest Aesthetic Techniques To Maintain Your Youth

Tom Palermo — Wed, 10 Feb 2010 23:42:30 +0000

COSMETIC SURGERY & AESTHETICS

BREVARD COSMETIC SURGICAL CENTER: Dr. Frank Venzara, right, and Dr. Robert Bashore, left, with Physician Assistant Dan Daniels, center, in one of their two fully equipped surgical suites. Drs. Venzara and Bashore are Board Certified Plastic and Reconstructive Surgeons, and have over 50 years cumulative experience. Daniels is a member of the American Academy of Physician Assistants and holds hospital privileges with several local hospitals.

BREVARD COUNTY, FLORIDA – I attended the Aesthetic Meeting given by and for members of the American Society of Aesthetic Plastic Surgeons (ASAPS). It was a busy meeting and I took several courses on the new techniques and technology that have arrived on the scene in this ever-changing world of Cosmetic and Aesthetic Plastic Surgery.

With that said, the main focus was economy, economy, economy! What are the best ways for you to use your money? Everyone is cutting back but still want to maintain his or her youth.

Best bang for your buck

Botox is still the number one seller. The more it is used, the more uses we find for it. It's not just for the forehead and crow's feet anymore. ASAPS members have found many uses for Botox in the lower face as well. It must be used cautiously, but in the hands of a skilled injector, the results are amazing.

Botox should have some competition real soon. There are several new companies ready to release their new botulism toxin A products, such as Dysport, Reloxin and Purtox to name a few. Keep an eye out for these products. Perhaps the competition they bring to the market will help bring down the cost.

Dermal fillers are still big. Juvederm is releasing their product with lidocaine (a local anesthetic) which should make the injections much more comfortable. However, one of the other players in the filler market, which manufactured Artefill, became a casualty of the economy and went out of business last year.

There are many products on the market to enhance your eyelashes such as lash extensions and transplants. These are invasive procedures, which tend to be more popular on the West Coast and which we do not offer to our patients.

My office staff has started using a product called LATISSE by Allergan to stimulate lash growth. Our patients have had very favorable outcomes with this FDA approved product. We are now carrying LATISSE, which requires a physician's prescription, in our office. Although there are other less effective lash stimulators available over the counter, they run about the same price as the LATISSE.
Lasers continue to become more advanced, but I believe there is still nothing better than fractionated CO2 for facial resurfacing. People who want their tattoos removed have something to look forward to with the new multi-wavelength technology. It has definitely improved the removal of the blacks, dark blues, reds and green colors, however there is presently still no laser that will take out the yellows or light blues.
With all the new trendy names in liposuction such as Smart Lipo, Smooth Lipo, Slim Lipo, Laser Lipo, just to name a few, one can get very confused as to what gives the best results. Most new techniques are now using laser light to add a touch of heat for dissolving fat that still must be suctioned out by the traditional method. These "laser lipos" are effective when used as an adjunct to the traditional liposuction procedure.

The newest and most unusual technology presented at the meeting was Cryolipolysis. This external cooling technique is an innovative technology that uses precise cooling rather than traumatic heating or shock waves to reduce fat layer thickness. Although Cryolipolysis is still under research investigation, it appears to have great promise and is certainly a concept to watch.

Trends & Fads
The meeting was fun and informative, and I look forward to the next one. There are trends and fads in Aesthetics Surgery, more so than any other medical specialty. It will be interesting to see which concepts, products and techniques stay the course and which ones fall by the wayside. Our office will continue to be vigilant at closely investigating and assessing the value of new techniques and technologies to ensure we are providing the most up-to-date, cost effective, quality service to our clientele.

Dr. Fank Venzara

ABOUT THE AUTHOR

Dr. Frank Venzara was born in Chicago and has resided for the majority of his life in South and Central Florida. He is a graduate of both University of Miami's Undergraduate Program and Medical School. He trained as a surgical resident at Jackson Memorial Hospital in Miami and as a plastic surgery fellow at the University of Missouri's Truman Medical Center in Kansas City, Missouri. He has practiced in Brevard County, Florida, for 29 years as a Board Certified Plastic and Reconstructive Surgeon. When not attending to his surgery schedule, Frank enjoys surfing and fishing. Dr. Venzara can be reached at 321-452-3882.

Space Coast Medicine and Healthy Living

Dr. Henderson In Haiti: “Human Carnage Was Everywhere”

BREVARD MEDICAL PROS IN HAITI: First Hand Accounts

Dr. Michelle Henderson

ABOUT THE AUTHOR

Smoking Accelerates Aging Process

SKIN CARE

ABOUT THE AUTHOR

Lapband Procedure Changes Steenhoff’s Life

LIFESHAPE SUCCESS STORY

Dr. Levine Among Best Doctors of America

eHealthWatch Breaking News

Harris Family Medical Center Invests In Employee’s Good Health

FACILITIES SPOTLIGHT

MEET THE HARRIS MEDICAL CENTER STAFF

Milad Chrieki, M.D.

Perry Fisk, R.Ph

June Kirwin, R.Ph.

Marissa Rocourt, M.D.

Suzanne Sum, R.Ph

Paul Toth, R.Ph.

Michael Wolfington, D.O.

Nadine Ramdeen-Wright, M.D.

Electronic Medical Records Firm Born Out Of Necessity

MEDICAL TECHNOLOGY

All Men At Risk For Prostate Cancer

MEN'S HEALTH

PCA Second Leading Cause of Cancer Death in American Men

Leadership Coach Linda Cobb On SpaceCoastMedicine.com Radio

SPACECOASTMEDICINE.COM RADIO SHOW

HealthFirstReality.org: Expectant Mother, Experienced Team

LIVING PROOF: The Story of Jennifer Gale

Quick Care Clinic Featues Extended Hours

FACILITY SPOTLIGHT

Radke Has the Tickets To Grow the “Network”

BREVARD PHYSICIANS NETWORK

Kiteboard Outing Almost Ends In Tragedy

ABOUT THE AUTHOR

Kite Boarding Docs

“For whatever reason, doctors seem to gravitate towards the sport.” – Dr. Bjorn Dimberg

Eyelid Surgery a Popular Facial Cosmetic Procedure

COSMETIC SURGERY

HealthFirstReality.org: The Rescue That Took Flight

LIVING PROOF: The Story of Lisa Goetz

Fatal Crash. Fortunate Survivor. And the Rescue That Took Flight.

Health First, Precor Sponsors the Florida Anti Aging Expo

SPECIAL EVENT PREVIEW

The 2010 Florida Anti-Aging & Healthy Living Expo will be held June 12-13 at the Clemente Center on the campus of Florida Tech in Melbourne, Florida.

Take Care of Your Hedgehog

SKIN CARE: Cancer is our most powerful enemy

ABOUT THE AUTHOR

ECUADOR: “The Giants Who Are Angels”

MEDICAL MISSIONS

“The Giants Who Are Angels”

ABOUT THE AUTHOR

Washington Nationals Get Physicals at MIMA Sports Medicine

SPORTS MEDICINE

Central Florida UroGynecology Grand Opening March 15

NEW FACILITIES

“The Call” Rings In New Year, New Life

ORGAN TRANSPLANTATION: The Joy of Living...Again!

Viera VA Clinic Provides High Tech Care

FACILITY SPOTLIGHT

CLICK HERE FOR RELATED STORY: The Human Side of the Viera VA

Dr. Thomas Howard THE 411 ON VIERA VA CLINIC

Dr. Charles Raises $215,000 For Haitian Orphanage

PHILANTHROPY: "I am just a spoke in a wheel"

Dr. Charles

Platelet Rich Plasma Therapy Effective Treatment

ORTHOPEDICS

PRP Effective In Treating Difficult Tendon Problems

ABOUT THE AUTHOR

Running Zone Among 50 Best In USA

RUNNING & EXERCISE

Dr. Pete Joins Matt Reed On ‘Today In Brevard’

HEALTHCARE MULTIMEDIA

Lap Band Procedure is Life Saving for Blair, Morgan

Blair Becomes Triathlete After Dropping 70 Pounds

Morgan loses 135 pounds, Becomes "Stud Muffin" Again

Obesity: It’s the Environment

**The 2010 Florida Anti-Aging & Healthy Living Expo will be held June 12-13 at the Clemente Center on the campus of Florida Tech in Melbourne, Florida.**

Dr. Thomas Howard

THE 411 ON VIERA VA CLINIC

Dr. Wasim Niazi

ABOUT THE AUTHOR