O7705 Baptist Health 5/13/08 11:31 AM Page...

SUMMER 2008

O7705 Baptist Health 5/13/08 11:31 AM Page 2

Baptist Health South Florida Chairman of the Board, theRev. David W. Cleeland; President, Brian Keeley. Trustees:Tony Alonso, Calvin Babcock, Wendell Beard, GeorgeCadman III, James Carr, the Rev. William Chambers III,George Corrigan, William Dickinson, Judge Robert Dubé,Herbert Greene, M.D., George Harth, Jay Hershoff, CharlesHood III, the Rev. Dr. Gary Johnson, Norman Kenyon,M.D., the Rev. Richard Ledgister, the Rev. Wilner Maxy,Paul May, Arva Parks McCabe, the Rev. Dr. Marcos Ramos,Aida Shafer, Ronald Shuffield, Roberta Stokes, W. PeterTemling, the Rev. Tom Thompson, Bill Tillett, Scott Weston,the Rev. Dr. William White.

Baptist Hospital of Miami Chairman of the Board,Calvin Babcock; President, Baptist Hospital Medical Staff,Eugene Eisner, M.D.; Chief Executive Officer, Bo Boulenger.

South Miami Hospital Chairman of the Board, JudgeRobert Dubé; President, South Miami Hospital MedicalStaff, Jorge Rabaza, M.D.; Chief Executive Officer, JavierHernandez-Lichtl.

Homestead Hospital Chairman of the Board, the Rev.William Chambers III; President, Homestead HospitalMedical Staff, Theodore Evans, M.D.; Chief ExecutiveOfficer, William Duquette.

Mariners Hospital Chairman of the Board, Jay Hershoff;President, Mariners Hospital Medical Staff, DennisRainwater, M.D.; Chief Executive Officer, Nelson Lazo.

Doctors Hospital Chairman of the Board, Norman Kenyon,M.D.; President, Doctors Hospital Medical Staff, LuisQuintero, M.D.; Chief Executive Officer, Lincoln Mendez.

Baptist Outpatient Services Chairman of the Board,Tony Alonso; Chief Executive Officer, Patricia Rosello.

Baptist Health Enterprises Chairman of the Board, James Carr; Chief Executive Officer, Ana Lopez-Blazquez.

Baptist Health South Florida Foundation Chairman of theBoard, Bill Tillett; Chief Executive Officer, Robert Baal.

Directors of Affiliated Boards Yvette Aleman, RichardAlger, Dick Anderson, George Aronoff, Orlando Bajos,William Baldwin, James Barker, Yerby Barker, RodneyBarreto, Kerrin Bermont, Robert Berrin, Carol Berry,Bonnie Blaire, James Bokor, James Boruszak, Bette Brown,Joseph Buchanan, Mita Burke, Oscar Bustillo Jr., BarbaraCalev, Willie Carpenter, James Carr, Susan Carr, GeraldCase, Ray Castellanos, Joe Catarineau, Mauricio Cayon,Barron Channer, Carol Cianciolo, Pat Dahne, DeniseEhrich, Joyce Elam, Allan Feingold, M.D., Maria Garza,Augusto Gil, William Gilbert Jr., Robert Gintel, GretchenGoslin, K. Lawrence Gragg, Michael Graham, M.D., CurtisGray, David Hallstrand, M.D., Barry Halpern, M.D., KentHamill, Barbara Hanck, James Harris, Elizabeth Hernandez,Agustin Herran, Gerald Hirsch, Nathan Hirsch, M.D.,Jacque Huttoe, David Johnson, Lane Jones, S. LawrenceKahn III, George Kakouris, George Knox, Rudy Kranys,Manuel Lasaga, Katrina Lavene, Maria Camila Leiva, OrlandoLeon, M.D., James Loewenherz, M.D., Miriam Lopez,Bruce MacArthur, Joseph McCain, DMD, Derek McDowell,Stanley Margulies, M.D., Joy Martin, Charlie Martinez, JoMcGregor, Hans Mueller, Patricia Mull, Thomas MurphyJr., Ramon Oyarzun, Martha Pantin, Omar Pasalodos,M.D., Johanna Paterson, Ramón Rasco, Charlen Regan,Ian Reiss, M.D., Bonnie Rippingille, Domingo Rodriguez,Gonzalo Sanabria, Steven Sapp, Betty Schilling, I.E. Schilling, Aida Shafer, Emery Sheer, Steve Shiver,Ronald Shuffield, Paul Soulé, Patricia Stanley, Lee Stapleton,Rene Taylor, Joseph Traina, M.D., Sats Tripathy, WandaTrouba, Victoria Villalba, Warren Weiser, Lisa White,William Wilson III, Philip Wolman, Leonard Zwerling, M.D.

TO SEND COMMENTS, ADDRESS CHANGES OR TO UNSUBSCRIBE, E-MAIL MyResource @ baptisthealth.net

6855 Red Road, Suite 600,Coral Gables, FL 33143www.baptisthealth.net

EDITOR Jo BaxterART DIRECTOR Elizabeth Lane LawhornCONTRIBUTING EDITORS Patty Shillington, Anne Streeter,Adrienne SylverWRITERS Sheila Konczewski, Jennifer Pages, Sharon Harvey Rosenberg, Elizabeth Rosenthal, Bob Ross,Bethany Rundell, Anne Smith, Phyllis TeitelbaumEDITORIAL ASSISTANTS Georgette Koch, Barbara Moore,Dee Moustakas, Laura Pincus, Dorothy SteinPHOTOGRAPHY Fareed Al Mashat, Mabel Rodriguez, Charles Trainor Jr., The Miami Herald

elen Donaldson was traversing the hillystreets of Jerusalem during a trip toIsrael when her moment of truth came.“I had to take a cab at the bottom ofthe street to get to the top,” she said,

recalling her gasps for air. “I knew it wasn’tasthma because my rescue inhaler wasn’tdoing the job.”

Sandra Wallace’s breathless “aha” occurredat a Valentine’s Day party, when she wasdancing to live music. “Suddenly, I couldn’tbreathe,” said the Coconut Grove artist.“I thought, ‘What’s happening? What’shappening?’ It was pretty scary.”

Even after she was told what was wrong,Cindy Smith refused to face the facts. Forthree years, she coughed, missed weeks ofwork and was even hospitalized for breath-ing problems. “I was very ignorant aboutmy disease,” said the Key Largo woman, 46.

“I had to go through pulmonary therapy toget educated.”

These three women have COPD—chronic obstructive pulmonary disease.They are among the growing number ofwomen living with the progressive lung ill-ness, the legacy of smoking. COPD is thefourth leading cause of death in the UnitedStates, claiming 120,000 lives annually.While 20 million Americans have beendiagnosed with COPD, another 10 millionestimated cases are going undiagnosed.

“Women started to smoke later in thelast century and now we are seeing theconsequences,” said Baptist Health pulmo-nologist Javier Perez Fernandez, M.D., aCOPD expert.

Researchers aren’t sure why, but womenare more susceptible to lung damage fromsmoking than men. More women than men

Women & Hea l th

Sandra Wallace is feeling stronger and “breathing better.”

Learning to breathe easier with therapy,exercise

H


R E S O U R C E 3

are dying from COPD and suffering com-plications. And yet many women havebeen misdiagnosed as having asthma,delaying treatment for the real problem.“For some reason, doctors don’t like to sayto their middle-aged women patients thatit’s COPD,” Dr. Perez said.

Though COPD can’t be cured, womencan enjoy a “normal and prolonged life”with the proper medications and lifestylechanges, Dr. Perez said.

But first the disease must be acknowl-edged. COPD is diagnosed with breathingand lung function tests. The disease gener-ally has two components—chronic bron-chitis, which causes congestion andinflammation in the airways, and emphy-sema, which destroys air sacs in the lungs.With emphysema, the lungs lose elasticityand become overinflated, trapping airinside and causing shortness of breath.

“Ever tried breathing through a straw?”asked Mikki Thompson, director of pul-monary services at South Miami Hospital.“Think of that feeling and imagine breath-ing like that all the time.”

Pulmonary rehabilitation is the firststep for many newly diagnosed patients.Ms. Donaldson and Ms. Wallace are gradu-ates of the South Miami Hospital program,which teaches patients how to exercise, eatright and avoid the triggers that exacer-bate COPD. Both women have continuedon a maintenance program at SouthMiami Hospital for several years, exercis-ing under the supervision of respiratorytherapists.

“I have my life back and I attribute thatto the therapists in this department—theeducation and the discipline I havereceived here,” Ms. Donaldson said at arecent workout.

An 18-year volunteer at Metrozoo who

quit smoking 30 years ago, Ms. Donaldsononce was forced to take a motorized cartaround the zoo. “Now, I can walk every-where. There isn’t much I can’t do.”

Dr. Perez said women often facedepression and anxiety after their diagno-sis, but then rebound with a commitmentto change. They quit smoking, take med-ication, get involved in activities and exer-cise. “My personal opinion is they copewith the disease better than men after theirinitial shock,” he said.

Ms. Wallace said her diagnosis and set-backs have been depressing, as is theknowledge that smoking causes the dis-ease. “I’ve felt very embarrassed,” she said.“All my friends are good about it, but it’shard. I don’t like to feel debilitated.”

Exercise—30 minutes on the treadmill,followed by free weights and resistancemachines—has improved her endurance.“One of my big goals is to get my arms inshape for next year’s holiday parties,” saidMs. Wallace, who started smoking at age

13 and is feeling stronger since quitting forgood after a hospitalization in 2007. “I’m avery active person and I’m breathing better.”

Ms. Smith went through pulmonaryrehab at Mariners Hospital and quit smok-ing almost a year ago. “I smoked threepacks a day, at least, for 25 years. I wouldget sick and have trouble breathing andthe doc would tell me, ‘You have to stopsmoking.’ And I would, and then, when Ifelt better, I would start smoking again.”

Tobacco-free, Ms. Smith is now exer-cising regularly at Mariners Wellness Cen-ter and following a healthy diet. “You haveto decide, ‘This is it. Do I want to live ornot?’ My prognosis at my age is good. Ihave a lot to live for.”

Dr. Perez said COPD awareness isfinally spreading. “For whatever reason, wehave neglected this disease,” he said. “Ifwe confront it, we can fight it. We can treatit and control it.”

—Patty Shillington

“I have my life back and I attribute that to the therapists in thisdepartment —the education and the discipline I havereceived here.” Helen Donaldson exercises at South MiamiHospital under the supervision of respiratorytherapists.

r with therapy,exercise

For information about pulmonary rehabilitation, call 786-662-8484 at South Miami Hospital, 305-434-1635

at Mariners Hospital or 786-243-8046 at Homestead Hospital.


You can rattle off your cell phone, zip code

and Social Security numbers.

But cardiologist Theodore Feldman, M.D.,

medical director of South Miami Heart Center,

wants you to be just as familiar with

a different set of figures—

vital statistics that gauge

the state of your heart health.

Know Your Numbers


R E S O U R C E 5

hat’s your LDL (bad) cholesterol; is it up or down from last year? How about your BMI;

is your body mass index less than 25?

You should find out your numbers at age 20, 25 and 30, Dr. Feldman said. After age

30, you need to get them checked every year.

“This is a way to empower people; they need to go to their doctor, find out their num-

bers and see what they need to do, if anything, to get them moving in the right direction,”

said Dr. Feldman, who preaches prevention as a top tool in fighting heart disease, the

number one killer of Americans. “Knowing these simple numbers from a simple medical

exam can save your life.”

From the granddaddy of them all, blood pressure, to the circumference of your waistline

to the amount of sugar in your blood, these numbers can give healthy people an early-

warning heads-up.

“We’re trying to predict which asymptomatic persons, those who feel well and think they

are healthy, need to change something about their lifestyle to prevent cardiovascular disease

and stroke,” said Jonathan Fialkow, M.D., a Baptist Cardiac & Vascular Institute cardiologist.

Although heredity plays a role, lifestyle has a powerful effect on these measurements.

Lifestyle changes that improve your numbers and reduce your risk for disease include eating

a healthier diet, exercising regularly, maintaining a healthy weight and dropping harmful

habits such as smoking.

A good place to start is with exercise. “The one thing that makes everything better is

exercise,” Dr. Fialkow said.

“The main benefit of exercise is that you live better every day,” said Dr. Feldman,

emphasizing that you can start small because “90 percent of the benefits of exercise occur

with walking.”

Looking at all the numbers together gives doctors the broadest view of your health,

including whether you have metabolic syndrome, a cluster of high numbers that puts you at

increased risk for heart disease, diabetes and stroke.

But first, the numbers. Turn to next page

C O V E R S T O R Y

Theodore Feldman, M.D.

Jonathan Fialkow, M.D.

WYour Numbers

O7705 USE PAGE 5 ONLY 5/13/08 11:27 AM Page 6

120/80

<200 <100

18.5-24.9

<35-40"6 R E S O U R C E

“Eat less, move more, live better, live longer.”— Dr. Feldman

BLOOD PRESSUREOptimal: Less than 120/80

Prehypertension: 120-139/80-89

High Blood Pressure: 140/90 or higher

Blood pressure measures the force of circulating blood onthe walls of the arteries. Measured in two ways, it should be nohigher than 120 over 80. The first number is your systolic pres-sure, measured when the heart beats and the pressure is great-est. Diastolic pressure is taken between heartbeats, whenblood pressure is at its lowest. When the systolic pressure isbetween 120 and 139, you are considered prehypertensiveand “you don’t need medicine but you need lifestyle changes,”such as exercise, healthy eating and losing weight, Dr. Feldmansaid. The same is true for a diastolic pressure of between 80and 89. A repeated blood pressure of 140 over 90 or highermay require medication, which is typically very effective.

CHOLESTEROL Total Cholesterol: Less than 200

HDL: Over 40 for men, over 50 for women

LDL: Less than 100

Triglycerides: Less than 150

Cholesterol is a type of lipid or fat produced in the liver andalso found in animal-based food, from meat to milk. A fastingblood test reveals four numbers that make up a lipid profile—total cholesterol, HDL (known as the “good” cholesterol), LDL(known as the “bad” cholesterol) and triglycerides, a chemicalform of fat. “You have to look at all these elements together,”Dr. Fialkow said. Low-density lipoprotein (LDL) cholesterolshould be less than 100 and high-density lipoprotein (HDL)greater than 40 for men and over 50 for women. Triglyceridesshould be less than 150 and total cholesterol less than 200.When LDL is high, cholesterol causes plaque to form in thearteries, which over time can cause atherosclerosis, or harden-ing of the arteries. HDL’s important role is carrying choles-terol away from the arteries to be removed from the body.Calories consumed that aren’t immediately used by the bodyare converted to triglycerides and stored in fat cells. “The ratiosand parameters really determine your risk,” Dr. Fialkow said.“You can’t look at any single number,” especially total choles-terol. When the numbers can’t be adequately controlled withdiet and exercise, medications known as statins are prescribedto lower LDL cholesterol.

WAIST CIRCUMFERENCEFor Men: Less than 40 inches

For Women: Less than 35 inches

Waist circumference is important to measure because peo-ple who carry fat predominantly around their waist, ratherthan their hips, are more likely to develop health problems.

BODY MASS INDEXHealthy: 18.5-24.9

Underweight: Below 18.5

Overweight: 25-29.9

Obese: 30 and above

Body Mass Index relates your weight to your height andestimates body fat and associated health risks. A healthy BMIis between 18.5 and 24.9. A BMI of 25 to 29.9 is consideredoverweight; 30 and above is considered obese. Many websites,including the Centers for Disease Control (www.cdc.gov) willcalculate your BMI when you type in your weight, height andage. Charts are also available online or at your doctor’s office toestimate your BMI. If you’re good with figures, you can calcu-late your own BMI by dividing your body weight in kilogramsby the square of your height in meters. So an adult who is 5feet 6 inches and weighs 145 pounds has a BMI of 23.4.

BLOOD GLUCOSE (after an overnight fast)

Optimal: Less than 100

Prediabetes: 100-125

Diabetes: 126 and higher

Blood glucose measures the amount of sugar in the bloodand can determine if someone has diabetes or prediabetes.After an overnight fast, your blood sugar should be less than100. Results between 100 and 126 signal prediabetes, or“impaired glucose tolerance,” meaning you are at risk of devel-oping diabetes. A reading of 126 or higher indicates diabetes,though more than one test is generally necessary to give afinal diagnosis. Diabetes is a complex metabolic disease inwhich the body either does not make or properly use insulin, ahormone that converts sugar into energy. The result is highblood sugar and, although it can cause serious complicationsover time, there may be no symptoms, or subtle ones, foryears. That’s why it’s important to keep tabs on your bloodsugar level.

ll this brings us back to metabolic syndrome—a combi-nation of high blood pressure, high blood sugar, toomuch fat around the waist, low HDL (good cholesterol)and high triglycerides. If you have any three, you are atincreased risk for heart disease, diabetes and stroke.

Eating a low-sugar, low-starch diet rich in fresh fruits andvegetables may lower your risk. “Stay away from refinedfoods,” Dr. Fialkow said. “Corn syrup, corn starch, refined riceand flour—these are the things that are killing us.”

The good news, Dr. Feldman said, is that “the body is veryforgiving.” He has reduced his advice—and the results of fol-lowing it—to eight words: “Eat less, move more, live better,live longer.”

And know your numbers. — Patty Shillington

A


6 p.m. PRE-GAME SHOW: Boxed dinner

6:30-6:45 p.m. FIRST QUARTER: WelcomeRalph Rios, Assistant Vice President South Miami Hospital

SECOND QUARTER: Staying Positive Through AdversityMario Cristobal, FIU Head Football Coach

6:45-7:30 p.m. THIRD QUARTER: Defensive TeamDouble Coverage: Stress Relief and Living Well Dario Pancorbo, M.D., Internal Medicine

Excessive Time-outs: Helping Problems of theProstateDarren Bruck, M.D., Urology

Extending the Period: Staying Healthy to Live LongerManuel Gonzalez, M.D., Family Practice

7:30-9 p.m. FOURTH QUARTER: ScorecardCheck Up or Check Out! Free screenings for cholesterol, diabetes, blood pressure, body fat analysis and osteoporosis.

U.S. 1 and SW 62 AvenueCommitted to our faith-based charitable mission of medical excellence

A ll right, men…this game is all about your health! Are you up forit? Do you know all the signals? Are you ready to get in there

and win this one for the team? For your families?Come to “Manpower: Tackling Men’s Health Challenges,” and

learn how you can improve your health and fitness. It’s an evening of free health information and screenings. You’ll hear featured speakerMario Cristobal, head football coach of Florida InternationalUniversity. He’s joined by an all-star team of health and fitness expertsfrom Baptist Health.

Dario Pancorbo, M.D.

Mario Cristobal

ss

s

Men and the women who love them are invited to this free program.Reservations are required. Call 786-662-4273.

s

Darren Bruck, M.D.

Manuel Gonzalez, M.D.

ManPowerTackling Men’s Health Challenges

Monday, June 30 n 6:30-9 p.m.

O7705 P7-ManPower Ad 5/14/08 1:39 PM Page 1

wo hours of cheerleading practice wasn’tenough for Adrienne Socorro, 17. Thehigh school junior, determined to per-fect her tumbling skills, headed straightinto an hour-long private tumbling les-

son. Partway through practice, she landedwrong, dislocating her kneecap.

“It’s good to be focused, but sometimesyou need to slow down,” Adrienne said. “Iwas tired after the regular practice, butdidn’t see it.”

Fifteen-year-old Juan Espinosa, a base-ball player since age three, pitches forChristopher Columbus High School andenjoys the sport year-round. A little painin his right elbow didn’t deter him at first.“But when the pain kept getting worseand worse, I had to stop,” he said. “Thedoctors said the inflammation in myelbow was caused by a combination of thepitching and the fact that I’ve grown somuch so fast.”

Both Adrienne and Juan ended up inwhat’s quickly becoming a popular meet-ing place for children—the physical ther-apy gym. With more than 30 million kidsplaying organized sports each year in theUnited States, it’s no surprise that doctorshave observed an increase in sportsinjuries in the past two decades.

“These aren’t the pick-up neighbor-hood kickball games we had as kids,” saidKeith Hechtman, M.D., of Doctors Hospi-tal’s Center for Orthopedics and Sports

Medicine. “These are kids who may playfor a school team, a club team and a travel-ing team. They play multiple sports at avery competitive level.”

While everyone knows exercise is goodfor the body, too much, or the wrong kind,can lead to problems. “Kids are not mini-adults,” Dr. Hechtman said. “They reallycan’t build muscle until they get older,they’re more sensitive to heat and cold and

they have a weak link, the growth plate. Allof those things may make them more sus-ceptible to certain kinds of injuries.”

Growth plates are soft tissues at the endof long bones (such as those in the legs,arms, feet and hands), that become solidbone sometime during adolescence. If agrowth plate is severely injured, it can causelimbs of unequal length or crooked limbs.

The difference between an adult’s andchild’s body sometimes accounts for the dif-ference in treatment, Dr. Hechtman added.“An injury in an adult that may require sur-gery may get a more conservative approachin a child. For those injuries that traditionallyrespond well to therapy, we’ll try that first.”

Cindy Braeckel Larco, manager of out-patient orthopedics at Baptist Hospital,said physical therapists have special chal-lenges when it comes to treating kids.

“Obviously, we need to evaluate andtreat the injury first,” she said. “Then wego through strengthening and mechanics.We concentrate on the sport they are play-ing and develop very specific exercises tohelp them, things that emphasize condi-tioning, balance and coordination. We evenhave a special program designed for base-ball players. And it’s a ton of education. Welet them know that some of the exercisesthey are learning now they will do for therest of their lives if they want to continueplaying sports. Usually, you can motivatethem by explaining that these are skills that

8 R E S O U R C E

Life is GoodThree-year-old Marcus Nawrotkiewicz,

who completed cancer treatment at

Baptist Children’s Hospital, had fun with

his mom, Marta, at the American Can-

cer Society’s Relay for Life, held around

the lake at Baptist Hospital in March.

More than $200,000 was raised for

cancer research, education and patient

services at this annual fundraiser.

KidStuffLittle athletes’ injuries may lead to therapy

T

Adrienne Socorro strengthens her balanceby squatting on the stability disk.


will help them become a better athlete.”It’s not just teenagers therapists are

working with. “We’ve got them at all ages,seven and eight-year-olds through highschool kids,” Ms. Braeckel Larco said. “Andall sports—baseball, football, basketball,dance, soccer, tennis, you name it.”

So how do you keep your little sportsfanatic injury-free? It’s a bit complicated,admits Dr. Hechtman. “Kids don’t developthe same. Unfortunately, most sportsgroup kids by age or weight, not by devel-

R E S O U R C E 9

Teddy bear check-upsDoes your child’s teddy bear need a helping paw? Bring it to

Baptist Children’s Hospital’s beary special Teddy Bear Check-

Up at Miami Children’s Museum, 980 MacArthur Causeway,

on Saturday, July 12, from 1 to 3 p.m. Baptist Children’s Hos-

pital staff will give your child’s favorite stuffed animal or doll a

check-up — and teach your child about medical treatment. There is no charge

for the teddy bear clinic, but the museum does have an admission charge. Call

305-373-5437 for admission information.

Join the parenting experts at Baptist Chil-dren’s Hospital for enlightening conversa-tion and practical advice. Each programis held in the auditorium at Baptist Hos-pital and costs $5, unless otherwise noted.You must reserve your space by calling786-596-3812.

HOME ALONE: BE SAFE. BE SMART.Thursday, June 26, 7-9 p.m.Do your children know whatto do in an emergency?Or how to escape fromyour home in a fire?What if a stranger isat the door orapproaches themonline? During thesummer, many parentstrust their kids to stay bythemselves for just a short while, oreven all day. Detective Rafael Paganand Sergeant Joseph Bermudezfrom the Miami-Dade Police Depart-ment and David Muñoz from Miami-Dade Fire Rescue share importantinformation to help keep your kidssafe, whether you’re home or not.For parents and children ages 8-13.

RAISING HEALTHY EATERSThursday, August 28, 7- 9 p.m.Your son turns his nose up at fruitsand veggies. Your daughterlives on fast food.Maybe your life seemstoo busy to preparehealthy meals. Helpis on the way! Regis-tered dietitian SusanNowrouzi helps youget cooking with tips formaking good nutrition a part ofeveryday eating. For parents of kidsof all ages.

All about kids

8900 North Kendall Drive

Prevent Injury You can help reduce the chance of an injury by:

• Evaluating a league or team to determine how com-petitive it is. If your child has never played a sportbefore, try it as an after-school activity before signingup for the most competitive league in town. Also,make sure there are water breaks and stretchingbefore play.

• Encouraging cross-training. If your child plays base-ball, find another activity that is completely differentfrom his or her normal routine.

• Taking some downtime. Even year-round sportsshould have some time where flexibility, agility andconditioning are stressed rather than competitiveplay.

• Listening to and observing your child. “Kids this agewant to excel. They don’t want to be left behind. Theymay not look tired, but if they come off a long prac-tice, don’t send them directly into another one,” saidCarmen Socorro, Adrienne’s mother.

opment. While one 12-year-old may havethe body of an adult, another may just bestarting to grow.”

Both Adrienne and Juan feel they’reimproving and hope to be participatingfull-out in their sports soon.

Baptist Health offers outpatient phys-ical therapy for children with a doctor’sprescription at Baptist Hospital, BaptistChildren’s Martha Ware RehabilitationCenter and Doctors Hospital.

— Adrienne Sylver

Juan Espinosa’s pitchingelbow is on the mend.


10 R E S O U R C E

Senior{Focus

our to-do list is packed with exercise. The gym is your secondhome; your trainer is a confidante.

But even a diverse workout program may falter in thearea of balance training, which consists of exercises designedto strengthen core muscles, nerves and joints that preserve

equilibrium. Balance—whether you are moving or standing still—is one key to the preservation of physical fitness and generalhealth as you age.

Every year, roughly one out of every third person over the ageof 65 takes at least one tumble. And even a minor spill can result inlost confidence, bruises or surgery. More importantly, a balancedeficit—including dizziness and instability—could indicate minororthopedic problems or major health issues, according to FlavioLeite, a physical therapist at Baptist Outpatient Center.

There are several tests designed to measure balance. A typicaltest will require you to stand on one foot with eyes closed. Soundssimple, but within seconds, your well-toned arms may flail forstability. The diagnosis: A balance deficit. The prescription: Visityour primary care doctor or physical therapist.

“The only way to know where the balance deficit is comingfrom is to have an evaluation,” said Jussara Fleury, a physicaltherapist at Baptist Outpatient Center. “We need to see the patientto determine where the problem is coming from.”

Recognition and treatment of balance disorders is not a one-size-fits-all process. Instability can be sparked by environmentalfactors such as poor home lighting or loose carpets in the livingroom. But weak ankles, a poor grip, medication or impairedreflexes may also contribute to accidents.

Consider this scenario: You are adjusting to a new dosage ofhigh blood pressure medicine. After taking the medication, youstand on a chair to change a light bulb. But the chair is unstableand your knees are weak. Those external and internal factorscontribute to a fall or injuries.

In addition to orthopedic problems, a balance deficit can becaused by problems in any of the major body networks, includ-ing the vision, inner ear (vestibular) and nerve systems. The lossof balance can even signal the presence of a brain tumor or theaftermath of a stroke.

But that’s on the extreme end of the health scale. The bottomline: Regardless of the cause, a loss of balance demands attention.Your doctor or physical therapist may recommend a variety ofchanges in your home, lifestyle or medical treatment. Your medicalprofessional may even recommend tai chi-style exercise thatinvolves low-impact poses performed in slow motion.

Although rigorous academic studies have not yet been done,informal research indicates that tai chi-style exercise diminishesfalls and stumbles by 35 to 45 percent among those who are age65 and over. And that’s good news. — Sharon Harvey Rosenberg

Step by step: Finding your balance

Y

TEST YOUR BALANCE

1 Stand in flat shoes. Fold arms over chest. Lift one leg, with knee bent at 45-degree angle.

2 Start stopwatch. Shut eyes.

3 Halt stopwatch if :

1) arms become uncrossed,

2) body sways more than 45 degrees,

3) standing leg shifts, or

4) raised leg touches the floor.

4 Switch legs. Repeat process.

5 Compare results:

SOURCE: Marilyn Moffat and Carole B. Lewis, authors of Age-DefyingFitness, and featured in the New York Times, January 8, 2008.

A G E S S E C O N D S

20 - 49. . . . . . . . . . . . . . . . . . . . . .24 to 28

50 -59 . . . . . . . . . . . . . . . . . . . . . .21

60 -69 . . . . . . . . . . . . . . . . . . . . . .10

70 -79 . . . . . . . . . . . . . . . . . . . . . .4


R E S O U R C E 11

Baptist Medical Plaza at Doral9915 NW 41 Street, Suite 210Health Resource Center

Insomnia: Get a Better Night’s Sleep,Tuesday, June 17, 7-8 p.m., Dr. TimothyGrant, neurologist.

Faith and Healing: The Power of Prayer(in Spanish), Wednesday, July 16, 7-8 p.m., Chaplain Jessie Perez.

Feet for Life: Common Foot Problems(in Spanish), Wednesday, August 6, 7-8 p.m., Dr. Monica Andres, podiatrist.

Prostate Health: Get the Facts, Tuesday,August 19, 7-8 p.m., Dr. Darren Bruckand Dr. Martin Madorsky, urologists.

Baptist Health Resource Center at Informed Families2490 Coral Way, 2nd Floor

Resilience: Build Skills to Endure Hard-ships (in Spanish), Wednesday, June 4,7-8 p.m., Teresa Moreira, licensed clinicalsocial worker.

Advice and Tips for Managing the Issuesof Aging Parents, Thursday, June 12, 7-8 p.m., Nida Recabo, licensed clinicalsocial worker.

Changing Your Future by Changing YourPast: The Role of Memory, Tuesday, July8, 7-8 p.m., Dr. Albert Zbik, psychologist.

Tummy Troubles: Living with a Diges-tive Disorder (in Spanish), Wednesday,July 23, 7-8 p.m., Dr. Eduardo Ruan, gastroenterologist.

Baptist Medical Plaza atWestchester8820 Bird Road, Suite 400Health Resource Center

Resilience: Build Skills to Endure Hard-ships, Tuesday, June 10, 7-8 p.m., BeatrizLowell, licensed clinical social worker.

Your Personal Safety: Avoid Being a Victim (in Spanish), Tuesday, June 24,10:30-11:30 a.m., Detective Rafael Pagan,Miami-Dade Police Department.

Preparing for a Positive Retirement (in Spanish),Thursday, July 24,7-8 p.m., AnaPadilla, licensedclinical socialworker.

Cultivate Confi-dence: SupersizeYour Self-esteemin Any Situation, Thursday, July 31, 7-8p.m., Dr. Kaia Calbeck, psychologist.

The Ups and Downs of Pelvic Prolapse(in Spanish), Thursday, August 7, 10:30-11:30 a.m., Dr. Jaime Sepulveda-Toro,gynecologist.

Women’s Health Resource Center8950 N. Kendall Drive, Suite 105

Your Personal Safety: Avoid Being a Victim, Tuesday, June 3, 1-2 p.m., Detective Enrique Cuevas, Miami-DadePolice Department.

Headache Helpers: The Latest Treat-ment Options (in Spanish),Thursday, June 5, 7-8 p.m., Dr. JorgePardo, neurologist.

Are You a Good Candidatefor Lasik Eye Surgery?Tuesday, July 15, 7-8 p.m., Dr. CharlesKaiser, ophthalmolo-gist.

Small Fixes, Big Results:What’s New in the Dermatologist’sOffice? Tuesday, August 5, 7-8 p.m., Dr. Deborah Longwill, dermatologist.

Ongoing ProgramsOsteoporosis Screening.Screening and consultationavailable by appointment. Fee $15. Call 786-596-3812.

SHINE. Get help withMedicare and other insuranceconcerns. Free. Call 305-670-6500, Ext. 270, for an appoint-

ment with a bilingual counselor.

Senior Advantage. Offering adults 55*and older a dining discount at most ofour hospitals, volunteer opportunities atlocations close to your home and freeparticipation at most educational programs. No enrollment necessary. For information, call 786-596-3895.*Proof of age required.

AARP Driver Safety Program. Fee $10.Call 305-382-5331.

Senior Aerobics—Total Body Condi-tioning Classes, Mondays and Wednes-days, 11:30 a.m.-12:30 p.m. at Home-stead Hospital. The cost is $32 for eightweeks. Call 786-596-7044 for dates and to register.

June, July & AugustIf you’re 55 or older, take advantage of the programs and health screenings offered by Baptist Health. While most programs are $5, people55 and older attend free, unless otherwise noted. Registration is required for all programs, including those that are free. Call 786-596-3812.For Spanish programs, call 786-596-3814. For more information on other Baptist Health programs, visit www.baptisthealth.net.

SC


For the second year in a row, Baptist Health has made the list of the Top Five

Non-profit Companies for Female Executives from the National Association of

Female Executives. The group is the largest women’s professional and business

association. At Baptist Health, about 9,000 of the nearly 12,000 employees are

women. Of these, 21 are senior executives, including Chief Executive Officers Ana

Lopez-Blazquez of Baptist Health Enterprises and Patricia Rosello of Baptist Outpatient Services.

12 R E S O U R C E

Here & There

t one time, strict dieting and drugs gave obese adults withdiabetes their only chance for a normal life. But recentstudies confirm the value of another treatment option—stomach-shrinking surgery—in actually causing diabetesremission.

The Journal of the American Medical Association (JAMA)added to the body of evidence early this year by publishing astudy in which all signs of the disease disappeared in 73 percentof those who had surgery. At the same time, only 13 percent ofthose given conventional therapy had complete remission. Thedifference was because of weight loss.

Ofelia Gongora of Miami Gardens has been living diabetes-free since her gastric bypass surgery at South Miami Hospital inAugust 2004. Once weighing 500 pounds, she recalls having “somany symptoms of so many things” that she couldn’t even isolateany particular ill effects from the diabetes she’d been diagnosedwith a couple of years earlier. It was just another serious healthrisk that she faced, alongside congestive heart failure and seriousdepression.

“I didn’t have a life,” she said. “I sat on the couch 24/7. Icouldn’t lay down, couldn’t walk, couldn’t breathe, couldn’t doanything.”

She reports that within a month or two after her surgery, theweight started melting off. “The faster it came off, the moreenergy I had.”

Today, Ofelia weighs 248 pounds and has a much more fulfill-ing life. She breathes easily, walks her 5-year-old granddaughterto the playground and enjoys “being around” now. And aftersurgery, her diabetes-hyped blood sugar levels quickly returnedto normal.

Her surgeon, Dr. A. Enrique Whitwell, reports that about halfthe patients he sees for weight-loss surgery have diabetes. “Inthose patients, the symptoms are likely to disappear within amonth after surgery. While the JAMA study showed completeremission in 73 percent of diabetes patients, other studies haveshown success rates of up to 90 to 95 percent.”

If given the option of diet and exercise versus surgery, sur-gery gives a much better outcome, agrees Dr. Robert Aden, med-

ical director of the Diabetes Care Center at South Miami Hospital.“Surgery for diabetes treatment is not as common as it should

or could be,” said Dr. Aden, adding that the major inhibiting fac-tor continues to be the reluctance of insurers to pay for it.

— Bob Ross

A

Ofelia Gongora has energy to play with her granddaughternow. (Inset, before surgery.)

Weight loss may ‘cure’ diabetes


hen parents welcome their newborn babies into the world at South MiamiHospital, they have the chance to change the lives of strangers worldwide.Thanks to the vision of cardiologist Harry Aldrich, M.D., the hospital has set upthe region’s first umbilical cord blood collection center for public use.

Dr. Aldrich’s son was diagnosed with leukemia at the age of 8. The boyreceived a transplant of umbilical cord blood and his leukemia went into remis-sion. Umbilical cord blood can be used to treat adults and children with lym-phoma, sickle cell disease, aplastic anemia and multiple myeloma. Cord blooddoes not require as close a match as bone marrow, so it provides a more flexibleoption for patients seeking donors.

“Hispanics, African Americans, Asians and other minorities have not beenwell-represented in donor registries, so it’s often challenging to find compatiblebone marrow donors for those ethnicities,” Dr. Aldrich said. “Our diverse commu-nity in Miami and the South Miami Hospital Center for Women and Infants nowplay a leading part in collecting cord blood to add to the donor registry.”

Cord blood is collected immediately after birth. “Instead of discarding theumbilical cord as medical waste, as usually happens, a specially trained technicianharvests the blood from the cord and sends it to a cord blood storage facility,where its properties are entered into a donor registry database,” explained neona-tologist Jorge E. Perez, M.D., medical director of South Miami Hospital’s NeonatalIntensive Care Unit.

“Most pregnant mothers have seen advertisements for umbilical cord bloodstorage companies,” said Denise Woods, R.N., who oversees South Miami Hospital’sCenter for Women and Infants. “Unlike companies that collect and store cord bloodfor a family’s personal use for a fee, our center collects and stores the blood at no costto the family and makes the blood available to any patient in need worldwide.”

Prior to the establishment of South Miami Hospital’s cord blood collectioncenter, there were only 25 public cord-blood banks nationwide. The closest centerto South Florida was in Sarasota.

“We’re filling a tremendous void in the donor registry,” Dr. Aldrich said. “Withmore than 4,100 babies being born at South Miami Hospital each year, our collec-tion center stands ready to give hope to hundreds of people fighting for their lives.”

— Bethany Rundell

R E S O U R C E 13

SHORTER TREATMENT WORKSA five-day radiation treatment is just as

effective in treating early breast cancer as

conventional radiation that takes weeks,

recent research concludes.

In 2002, when the

MammoSite technique

was approved, studies

indicated that it had the

potential to be as good

as traditional radiation

treatment in halting the

recurrence of early

breast cancer, said Maria-Amelia

Rodrigues, M.D., South Miami Hospital

radiation oncologist. “It’s reassuring that

more recent studies confirm this, including

an important one reported in The Ameri-

can Journal of Surgery.”

MammoSite delivers radiation using a

soft rubber catheter with an inflatable bal-

loon tip placed directly into the cavity

where the cancerous lump was removed.

A radioactive seed is threaded into the

catheter, targeting any remaining cancer

cells. After 10 minutes, the seed is

removed. This is done twice a day for five

days. Traditional breast cancer radiation

treats the entire breast over a six- or

seven-week period.

Not all women with early breast cancer

are candidates for the quicker radiation

technique; it depends on the size, location

and type of tumor. For more information,

call the Cancer Resource Service at

786-596-2430. — Phyllis Teitelbaum

Dr. Rodrigues

Dr. Harry Aldrich’s vision led to the umbilical cord blood collection center.

WA lifeline of hope

The

Mia

miH

eral

d


14 R E S O U R C E

Here & There

TOBACCO-FREE POLICY EXPANDSMariners Hospital and South Miami Hospital are now tobacco-free campuses, which means the use of any tobaccoproduct is prohibited anywhere on the property, including parking lots and outdoor areas. The two hospitals, alongwith Baptist Health’s corporate headquarters on Red Road and a data center in Doral, implemented tobacco-free poli-cies May 31 to coincide with World No Tobacco Day.

These four locations joined Homestead Hospital, which put its policy in place last year with the opening of its newhospital facility. The tobacco-free policy applies to everyone—employees, patients, physicians, volunteers and visitors.

“Tobacco use remains the No. 1 preventable cause of premature death and disease in the United States,” said Nel-son Lazo, Mariners CEO. “As a responsible healthcare organization, Baptist Health is committed to creating environ-ments where visitors and staff can enjoy clean, healthy air away from the harmful effects of second-hand smoke.”

Before going tobacco-free, Mariners and South Miami provided smoking cessation programs for employees andthe public. For information about these ongoing smoking cessation programs, call 786-662-8484 at South Miami Hos-pital or 305-434-3700 at Mariners. — Sheila Konczewski

Baptist Health hospitals are among the first medical centers in the

nation to use new software to reduce radiation exposure for CT

scans of the heart. In just seconds, the 64-slice CT scanner pro-

duces hundreds of high-resolution images of the coronary arteries.

These detailed images are used to create a

three-dimensional view of the heart, giving

doctors a clear view to detect blockages in

the heart.

The 64-slice CT scanners at Baptist

Cardiac & Vascular Institute, South Miami

Heart Center and Homestead Hospital

now have new software that cuts a patient’s

radiation exposure from the CT scan by up to 80 percent.

Here’s how the software works: The 64-slice scanner synchro-

nizes with a patient’s heart rate, turning X-rays on only when needed

and turning them off at all other times. This new technology can be

used for most patients and allows the scanner to target a more

focused area.

“Even though the prior radiation dose for heart scans was in

line with other diagnostic tests like nuclear scans, the radiation

exposure was a shortcoming of this excellent diagnostic tool,” said

Constantino Peña, M.D., medical director of vascular imaging at

Baptist Cardiac & Vascular Institute. “By greatly reducing the radia-

tion exposure, the scans are now even safer for our patients.”

— Anne Smith

Heart scan radiation reduced

CEOS CONFER General Electric CEO Jeff Immelt(right) received a crystal pineapple from Baptist HealthCEO Brian E. Keeley when Mr. Immelt visited BaptistHealth headquarters recently. The two leaders discussedthe importance —and rising expense—of healthcaretechnology. Baptist Health was among the first in thenation to acquire GE’s 64-slice CT scanner, which pro-duces amazingly detailed images of the heart. ThreeBaptist Health hospitals now have the million-dollarscanners. (See related story, left.)


Shoulder surgery webcast

Wednesday, June 18, 4 p.m.www.baptisthealth.net

You’ve seen plenty of doctor shows on TV. Now you can see what it’s really like in an OR.

Watch renowned orthopedic surgeon John Uribe, M.D., medical director of theCenter for Orthopedics and Sports Medicine at Doctors Hospital, as he performs shoulder rotator cuff repair surgery. Dr. Uribe is teamphysician for the Florida Panthers and theUniversity of Miami athletics department. Thewebcast will be moderated by Tampa BayBuccaneers team physician John Zvijac, M.D.,and simultaneously translated in Spanish byLuis Vargas-Ortiz, M.D., director of sportsmedicine education.

Rotator cuff injuries are among the mostcommon shoulder injuries, affecting people of all ages. They occur when one or more of thegroup of four muscles and tendons in the shoulder are torn.

Join the live webcast. You’ll be right therein the OR in real time — without ever leavingyour computer.

It’s not a medical drama. It’s the real thing.

www.baptisthealth.net


or the first time in decades, new evi-dence is changing the way doctors helpstroke patients recover. “Rather thansimply teaching stroke victims how tocompensate for what they’ve lost, we

are learning how to activate new pathwaysin the brain to help recover lost function,”said Bradley Aiken, M.D., medical director ofthe Baptist Hospital Rehabilitation Center.

For years, therapy was geared towardstrengthening muscles that were still work-ing. If patients had one weak arm, theywere taught how to better use the otherarm. But now, patients are retraining theirbrain—and regaining their independ-ence—with the help of new rehabilitationdevices that use mild electrical stimula-tion. Short bursts of electricity cause thehand to open and close or the foot to lift.Studies have shown that constant repeti-tive motion helps the brain activate newareas that can take over the lost function.This process is called plasticity.

Functional electrical stimulation hasbeen used in rehabilitation since the1960s, but these newer devices are muchmore portable and easier to use. Someonewith hemiplegia, or one-sided paralysis orweakness, can put on the devices at homewith one hand. Exercise equipment,braces and walkers still have a role in reha-bilitation, but new treatments are aimed atmaximizing brain plasticity, Dr. Aiken said.

Avelino Hernandez suffered a stroke 11/2

years ago at age 34 that robbed him of hisability to talk, walk and use his right arm. Hetook his first step two months later but con-tinued to struggle with foot drop, an inabilityto lift the front of the foot, causing it to drag.Months later, he still couldn’t raise his arm.

Mr. Hernandez, who has made strideswith his speech therapist, has noticed an

improvement since using the devices,especially with walking. “I don’t limp asmuch anymore.”

The wireless computerized leg unitmakes walking easier and safer. The leg cuffsits just below the knee and delivers mildstimulation. The gait sensor attaches to theshoe and lets the leg cuff know if the heel ison the ground or in the air. A hand-heldremote turns the device on or off.

“The leg device can sometimes correct thefoot drop that often occurs in stroke, elimi-nating the need to wear a brace,” Dr. Aikensaid. Other benefits include increased rangeof motion, better blood circulation, fewermuscle spasms and less muscle atrophy.

The arm unit attaches to the forearmand wrist, allowing patients to practicegrasping and releasing objects. “It trainsyour hand so that one day it might workbetter on its own,” Dr. Aiken said.

Pat Bell, 60, suffered a stroke a year agothat affected his speech and right arm.“Mentally, it’s good to see your limb work-ing, even if it’s the device that’s doing it.That alone does wonders for your motiva-tion,” said his wife, Mary Ann. He’s alreadybetter able to open and close his hand andgrasp objects.

These devices are just the first in aseries of new treatments. With modifiedconstraint-induced therapy, the unaffectedarm is constrained, forcing use of the weakarm to improve motor function. Robotictherapy uses motor repetition throughinteractive video games. And at Baptistand Mariners Hospitals, patients arealready playing Nintendo Wii video gamesto improve their movement, coordination,balance and endurance.

“Baptist has really tried to stay on top ofnew things,” Ms. Bell said. — Jennifer Pages

Retraining the brain after a stroke

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6855 Red Road, Suite 600, Coral Gables, FL 33143

Health Scan

Resource is printed on recycled paper.

COPYRIGHT © 2008 Baptist Health South Florida. All rights reserved.None of the contents of this publication may be reproduced ortransmitted without the prior written permission of the publisher.However, in most cases we’re happy to approve the noncommer-cial use of this educational information.

(Left) Pat Bell practices grasping objects with occupational therapist Isabel Maestu.(Right) Physical therapist Judy Velasquez assists Avelino Hernandez.


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