FALL 2004

B A P T I S T H E A L T H S O U T H F L O R I D A

Quick reaction to stroke is key to recovery Page 4

A frightfully fun experience Page 2

Baptist charity care reaches record Page 10

AAre you feeling like a princess? A dragon? A goblin? Baptist Children’s Hospital is holding itsfree Children’s Health Day the weekend before Halloween� We’re inviting kids to come to our

interactive health fair in costume if they dare� There’splenty of action� and lots of learning about health andsafety� too� But don’t worry — even with our Halloweentheme� the little ones won’t find us too scary�

KKiiddss�� jjooiinn uuss ttoo::Stitch up your favorite doll or stuffed animal atour Doll Clinic�Take a ride into the land of surgery�Pretend you’re flying a medical rescue chopper�Explore the wonderful world of medicine�

It’s all free in tents in front of Baptist MedicalArts Building� ���� North Kendall Drive� There’sentertainment and refreshments� also� No reserva�tions are necessary�

2 R E S O U R C E

Baptist Health South Florida Chairman of the Board, George E. Cadman III; President, Brian E.Keeley. Trustees: Calvin H. Babcock, Wendell R. Beard, H. Robert Berry Sr., James Carr, the Rev.William L. Chambers, the Rev. David W. Cleeland, George Corrigan, William H. Dickinson, JudgeRobert L. Dubé, Herbert Greene, M.D., George Harth, Jay A. Hershoff, Charles Hood III, NormanKenyon, M.D., the Rev. Richard Ledgister, the Rev. Wilner Maxy, Paul May, Arva Parks McCabe, theRev. Dr. Marcos Ramos, Robert Singleton, Roberta Stokes, W. Peter Temling, the Rev. TomThompson, Scott Weston, the Rev. Dr. William W. White.Baptist Hospital of Miami Chairman of the Board, Calvin H. Babcock; President, Baptist HospitalMedical Staff, Sergio Gonzalez-Arias, M.D.; Chief Executive Officer, Lee Huntley. South Miami Hospital Chairman of the Board, Judge Robert L. Dubé; President, South Miami HospitalMedical Staff, George Tershakovec, M.D.; Chief Executive Officer, D. Wayne Brackin. Homestead Hospital Chairman of the Board, the Rev. William L. Chambers III; Chief of Staff, J.Rudolph Gossman Jr., DMD; Chief Executive Officer, Bo Boulenger. Mariners Hospital Chairman of the Board, Jay A. Hershoff; Chief of Staff, Sanford Yankow, M.D.; ChiefExecutive Officer, Robert H. Luse.

Baptist HealthSouth Florida

6855 Red Road, Suite 600Coral Gables, FL 33143-3632

Doctors Hospital Chairman of the Board, Norman Kenyon, M.D.; President, Doctors Hospital MedicalStaff, Jack Cooper, M.D.; Chief Executive Officer, Lincoln Mendez. Baptist Health South Florida Foundation Chairman of the Board, James Carr; Chief Executive Officer,Robert G. Baal. Baptist Outpatient Services Chairman of the Board, George E. Cadman III; Chief Executive Officer,Patricia M. Rosello. Directors of Affiliated Boards Richard T. Alger, Cira Almeida, Tony Alonso, Dick Anderson, GeorgeAronoff, Oscar Barbara, James Barker, Yerby Barker, Rodney Barreto, Jill Beach, James Boilini, O.D.,James Bokor, Joseph Bolton, James Boruszak, Robert Breier, Bette Brown, Oscar Bustillo Jr., BarbaraCalev, A. Ruben Caride, M.D., Thomas Carlos, Willie Carpenter, Gerald Case, John Cassel, M.D.,Mauricio Cayon, Carol Cianciolo, Richard Dailey, Xavier de Amezola, Allan Feingold, M.D., SusanGallagher, Mehdi Ghomeshi, Robert Gintel, Paul Gluck, M.D., K. Lawrence Gragg, Michael Graham,M.D., Curtis Gray, Lisa Greer, David Hallstrand, M.D., Barry Halpern, M.D., Kent Hamill, Barbara Hanck,Dan Hanrahan, Carl Hanson, James Harris, Sarah B. Herald, Elizabeth Hernandez, Agustin Herran,Gerald Hirsch, Nathan Hirsch, M.D., Jacque Huttoe, David Johnson, S. Lawrence Kahn III, GeorgeKnox, Rudy Kranys, Pamela Larcada, M.D., Manuel Lasaga, Cynthia Leesfield, Orlando Leon, M.D.,James Loewenherz, M.D., Miriam Lopez, Bruce Wirtz MacArthur, Michael Marcus, Charlie Martinez,Hans Mueller, Thomas P. Murphy Jr., Louise Orzel, Ramon Oyarzun, Omar Pasalodos, M.D., GordonPresent, Alfredo Quintero, Ramón Rasco, Charlen Regan, Ian Reiss, M.D., Mindy Rich, Ron Robison,Domingo Rodriguez, Ruth Rosenberg, Audrey Ross, James F. Russell, Steven Sapp, Chris Schrader,I.E. Schilling, Ronald Shuffield, Paul Soulé, Karl Smiley, M.D., Henry Tie Shue, Bill R. Tillett, BarbaraTowner, Joesph Traina, M.D., Wanda Trouba, Frederick Vihlen, M.D., Morton D. Weiner, Stuart Weiss,Lisa G. White, Philip Wolman, Stanley Zuba, M.D., Leonard Zwerling, M.D.

8900 North Kendall Drive

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Baptist Children’s HospitalBAPTIST

A frightfullyfun experience!

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Are you at risk?

Women who have hereditary muta-tions of the genes known as

BRCA1 or BRCA2 have up to an 87 per-cent risk for developing breast cancer.This compares to the 7 percent risk inthose who have not inherited the genemutation.

Genetic testing can help determine ifa woman (or man) has inherited anincreased risk for breast and other typesof cancer. Baptist-South Miami RegionalCancer Program offers genetic riskassessment and education, and arrangesfor the simple genetic blood test.

“By asking a lot of questions aboutfamily history and other risk factors, wecan determine if genetic testing is appro-priate,” said Rae Wruble, R.N., geneticrisk educator. “Not everyone wants orneeds to have a genetic test.”

While the assessment is free, thereis a charge for the test, which must beordered by a physician. “Knowingwhether you have a certain cancer-related gene mutation can help you andyour doctor develop a strategy for reduc-ing the risk,” she noted.

The Genetic Risk Education Servicereceived $75,000 from the Susan G.Komen Breast Cancer Foundation toprovide genetic testing for breast can-cer to low-income people.

Genetic risk education and testingare also available for melanoma and colorectal, endometrial and pancreaticcancer. For more information, call 786-596-2446.

Women who are considered at high risk forbreast cancer may want to talk to their doctors

about having an MRI — magnetic resonance imagingscan. That’s one of the new recommendations fromthe American Cancer Society in its revised breast can-cer screening guidelines.

“MRI screening for selected patients can be a goodaddition to mammography for high-risk women,” saidGrace Wang, M.D., breast cancer specialist at Bap-tist-South Miami Regional Cancer Program.

Candidates for MRI are women with a close rela-tive (such as a sister or mother) with breast cancer, agenetic tendency (a BRCA1 or BRCA2 gene muta-tion), or those who have had breast cancer.

MRI is not used for the majority of women whohave no known risk factors.

“Because MRI is very sensitive, it picks up cancerearlier, even before it can be seen in a mammogram,but it also picks up changes that are not cancer,” saidradiologist Pilar Martinez, M.D., director of women’simaging for Baptist Outpatient Services. “If we usedMRI to screen the general population, we would be causing needless worry inmany women who would be asked to have follow-up tests, only to find out their fearwas unnecessary.”

Race for the CureBaptist Health is a sponsor of the Race for the Cure, which raises money for the Susan G.

Komen Breast Cancer Foundation. This year’s event is set for Saturday, October 16, at BayfrontPark.

The Survivor Procession and Ceremony gets underway at 7:30 a.m., followed by the 5-K Co-ed Run/Walk at 8:30 a.m., the one-mile Fun Walk at 8:30 a.m., and the Tot Run at 9:45 a.m.

To register, call 305-666-7223, or visit www.baptisthealth.net.

For the first time since 1997, theAmerican Cancer Society hasrevised its guidelines for the early

detection of breast cancer. The changesreflect the use of emerging diagnostictools such as MRI and ultrasound, aswell as a shift from promoting monthlybreast self-exams. The guidelines are:

• Yearly mammograms starting atage 40, and continuing for as long as thewoman is in good health.

• Clinical breast exams about everythree years for women in their 20s and 30s,and every year for women 40 and over.

• Reporting to their doctors anybreast changes. Monthly breast self-exam is an option for women beginningin their 20s. The Society notes thatresearch has shown that self-exam “playsa very small role in detecting breast can-cer compared with self-awareness.”

• Women at increased risk shouldtalk to their doctors about whether tostart mammography screening earlier,having additional tests (such as MRI orultrasound), or having more frequentexams.

— Anne Streeter

MRI used for high-risk women

New breast screeningguidelines promoted

Women&Health

The orange portion of thisMRI scan shows canceroustissue.

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4 R E S O U R C E

One thing above all else can giveyou the best shot at surviving astroke, the third-leading cause

of death in the United States. And onething above all else can improve yourrecovery from a stroke, the number-onecause of disability.

Quick treatment. Dramatic breakthroughs in stroke

treatment are working wonders for somepatients — if they arrive at a specializedhospital emergency center within sev-eral hours of the stroke’s onset. Afterthat, the odds for recovery diminish.

“If you’re having a stroke, you can’tstall. Any delay is potentially a disaster,”said J.J. “Buddy” Connors, M.D., direc-tor of interventional neuroradiology atBaptist Hospital’s Neuroscience Cen-ter and chairman of the AmericanSociety of Neuroradiology’s StrokeTask Force. “You’ve got to dothings amazingly fast. And it takesa huge coordinated effort to dothings fast.”

You can’t get quick treatmentif you don’t realize you’re havinga stroke — a sudden, neurologi-cal change caused by abnormalblood flow in the brain. So know-ing the symptoms is crucial. Theyare: sudden numbness or weak-ness in the face, arm or leg, espe-cially on one side of the body; suddentrouble seeing; sudden confusion or dif-ficulty speaking; sudden dizziness or lossof balance; and sudden, severe headache

with no known cause. Call 911 — notyour doctor — if even one symptom ispresent, said neurologist Paul Damski,M.D., medical director of the Neuro-science Center’s Stroke Program.

About 85 percent of strokes arecaused by blocked blood flow in thebrain after a clot forms or lodges in avessel; the rest are caused by bleeding inthe brain. One recent study revealed thatonly 30 percent of people questionedcould identify even one symptom ofstroke, said David Nateman, M.D., med-ical director of emergency services atBaptist Hospital. “It’s rare you have painwith a stroke,” Dr. Nateman said.

Consider the stroke of Frank Crip-pen, 74. While at a conference last yearin New York City, the retired car dealer

took a shower, shaved, ate breakfastand went to a two-hour meeting —not realizing his early-morning dizzi-ness and loss of balance were signsof a serious stroke. “I thought if youhad a stroke you had to feel terribleor have pain,” said Mr. Crippen,whose rehabilitation at Baptist Hos-pital is detailed on Page 6.

Because time is of the essencein stroke care, Baptist Hospitalrecently established BEST

(Baptist’s Emergency Stroke Team).The multidisciplinary team launchesinto action when contacted by para-medics that a stroke patient is en route.

Specialists in neurology and radiol-ogy must make a quick but careful diag-nosis, requiring high-tech imagingmachines and lab work to determine thebest emergency stroke treatment. Forexample, a CT scan of the brain must betaken to rule out bleeding. Followingthat, a CT angiogram, requiring an intra-venous injection of dye, gives greaterdetail of the vessels in the brain, help-ing to pinpoint the size and location ofthe blockage, said Kevin Abrams, M.D.,Baptist Hospital’s medical director ofneuroradiology. Most stroke patients

“I thought if you had a stroke you had tofeel terrible or havepain.”

— Frank Crippen

Is it a stroke?Here’s a quick and simple way to

determine if a person might behaving a stroke:

✓ Ask the person to smile.✓ Ask the person to raise both

arms.✓ Ask the person to speak a

simple sentence.If the person has trouble doing

any of these things, call 911 anddescribe the symptoms to theemergency dispatcher.

Quick reaction to stroke sympto

Frank Crippen says a positiveattitude, family support and regularexercise got him back on his feet.

R E S O U R C E 5

also receive a CT perfusion that allowsneuroradiologists “to detect what partsof the brain aren’t getting blood flow,”Dr. Abrams said. “We are one of veryfew institutions performing CT perfu-sions and CT angiography in evaluatingacute stroke.”

New clot-busting drugs thatrestore blood flow to the brain,limiting damage and alleviating

symptoms, make quick treatment essen-tial. TPA (tissue plasminogen activator)is given intravenously — no more thanthree hours after the stroke began. Afterthat, the risk of brain bleeding is usuallytoo high to use it. If TPA fails to unclogthe artery, an interventional neuroradi-ologist such as Dr. Connors can some-times directly deliver clot-bustersthrough a tiny catheter into the brain’sclogged vessel. Or he can break up theclot with special tools (see article on thisadvanced stroke treatment, Page 12).

Baptist Hospital, which treats morepeople for stroke than any other health-care facility in Florida, is completing a$3 million neurointerventional suitewhere Dr. Connors and other specialistswill have the latest equipment for theaggressive treatment and prevention ofstroke.

“There aren’t many places that dothese types of interventions,” Dr. Con-nors said, “maybe 20 or 30 in the country.”

Nationally, only 1-3 percent of strokepatients get TPA, often because theydon’t arrive at an emergency stroke cen-ter in time or because their medical con-dition disqualifies them, Dr. Damskisaid. “But when you see it work,” headded, “it’s dramatic.”

Studies have shown that the clot-buster decreases disability by one-third three months after the stroke.

“My hypothesis is that TPA limits theamount of brain which ultimately diesoff,” Dr. Damski said.

Fewer than half of Miami-Dade’s 23hospitals have the equipment and exper-tise to treat “level one” stroke patients,those whose strokes are less than three

hours old, according to Miami-Dade FireRescue’s “hospital capability chart.” Para-medics transporting level one strokepatients are permitted to bypass closerhospitals to get the patient to a centerthat can offer the most sophisticatedtreatment, said Duke Adkinson, a Miami-Dade Emergency Medical Services chief.Other Baptist Health hospitals that offerlevel one stroke care include SouthMiami and Doctors.

Since the team was set up late lastyear, more patients are receiving TPA,

said Naomi Breiner, a nurse practitioneron the stroke team. In March, for exam-ple, six of 48 level one stroke patients, or12.5 percent, received TPA in the Emer-gency Room.

One of those patients was JohnCarty, 82. As he was preparingto watch the 10 p.m. news

March 12, he “felt funny. I tried to get upbut I couldn’t move my left side. I knewsomething was seriously wrong.” Wisely,the retired Delta Airlines worker called911 and was raced to Baptist Hospital,where the stroke team found him eligi-ble for TPA. “They told me if I was goingto accept TPA it had to happen rightaway.” After receiving TPA intravenously,he spent several days in intensive care,then several weeks in inpatient rehabili-tation. Three months after the stroke,Mr. Carty had made an “almost com-plete” recovery. Said the World War IIveteran, who is back on his feet, enjoyinglife: “Thank God for TPA.”

— Patty Shillington

Need more information?Come to our free programs, “Get the Facts About Stroke:”✓ (In Spanish) Thursday, September 9, 7-8 p.m., Baptist Medical Plaza at

Westchester, 8840 Bird Road, Suite 400. Call 786-596-3814.✓ (In English) Thursday, October 7, 7-8 p.m., Women's Health Resource

Center at Baptist Medical Arts Building, 8950 N. Kendall Drive. Call 786-596-3812.

Symptoms of stroke✓ Sudden numbness or weakness

in the face, arm or leg, especially onone side of the body.

✓ Sudden confusion, troublespeaking or understanding.

✓ Sudden trouble seeing in oneor both eyes.

✓ Sudden trouble walking,dizziness, loss of balance orcoordination.

✓ Sudden, severe headache withno known cause.

Source: American Stroke Association

“Thank God for TPA.”— John Carty

ns is key to recovery

John Carty made an “almost complete”recovery after receiving the clot-busting drug, TPA.

S E N I O RF O C U S

Andre Harewood is making one of his favorite soups —Italian white bean. Normally, the amateur chef whipsup gourmet dishes with impressive ease. But today, at

the rehabilitation center at South Miami Hospital, Mr. Hare-wood struggles to remember the soup’s ingredients. And thewrong words sometimes pop out of his mouth.

“Something’s missing. Strawberry jam. No! Raspberryjam. No!” He rubs his forehead in frustration. “I can’t say whatI’m trying to say.”

Mr. Harewood, 54, a cruise ship director, had a stroke onthe job May 27. He was airlifted to South Miami Hospital,where doctors discovered the cause — an aneurysm, or bulge,on his carotid artery. The stroke paralyzed his right side andimpaired his speech and concentration. Surgery repaired theaneurysm. But now the real work — rehabilitation — begins.

Despite effective new treatments for stroke, the reality isthis: Nearly a quarter of the 750,000 Americans who have astroke this year will die, and half of the survivors will have per-manent disability. But beginning rehabilitation quickly andusing the latest techniques give patients the best shot at recov-ery, said Bradley Aiken, M.D., director of rehabilitation at Bap-tist Hospital. At Baptist and South Miami Hospitals, strokepatients are assessed for rehab as soon as they’re stabilized,often within 24 hours.

“It’s a lot of work for the patient and sometimes there areonly little gains day to day,” said Claudia Peñalba, M.D., direc-tor of rehabilitation at South Miami Hospital. “They lose somuch in a matter of seconds, but to get it back can be a longprocess.”

A week into rehab, Mr. Harewood is improving rapidly,but it’s an uphill climb. He’s walking, but bumps into things onhis right. He no longer clenches his right hand to his chest, butstill uses his left hand for eating.

“My patients tell me they feel groggy and displaced after astroke and the feeling doesn’t go away for several months,”said Faith Gleiberman, Mr. Harewood’s recreational therapist.

Ms. Gleiberman,along with Mr. Hare-wood’s occupational andspeech therapists, useseveryday activities tohelp him regain use ofhis right side. Walking,talking, writing, recallinga recipe, cooking andplaying dominoes withhis fiancée are painstak-ing tasks to “reconnecthis brain,” said speechtherapist Rachel Evans.

Ms. Evans offers Mr.Harewood a tip as hecuts up a carrot: “When

you can’t think of the word you want, try to think of anotherword that means the same thing.”

Mr. Harewood is pleased with his progress. “Every day Ifeel stronger. Today, I can write with my right hand; two daysago, I could not. I’m getting back my coordination. I need topush myself to use the right hand.”

Indeed, a positive attitude is key to recovery, Dr. Peñalbasaid.

Frank Crippen, 74, is a perfect example. In early 2003, hespent three weeks at Baptist Hospital’s Davis Center forRehabilitation, followed by a month of outpatient rehab,

after suffering a stroke. “I couldn’t move my whole left side,”he recalled. “It was bad.”

Physical therapists used electrical stimulation to improvemuscle tone, in addition to traditional exercises. Occupationaltherapists helped him learn to comb his hair and dress himself.

“Everything began to come back — slowly. It doesn’t hap-pen overnight,” Mr. Crippen said. “You’ve got to have the rightattitude and desire. I went from a wheelchair to a walker andfrom a walker to a cane. That took a couple of months.”

Eighteen months after his stroke, Mr. Crippen works outregularly with a personal trainer. “I feel great,” he said, esti-mating his recovery at 80 percent. “I don’t think I’ll ever be 100percent, but I thank God for the way I am.”

— Patty Shillington

Stroke rehab can be a long process

Encouraged by recreational therapist Faith Gleiberman,Andre Harewood writes a recipe to practice his coordinationand memory.

Looking for support?Free Stroke Support Groups

meet monthly at Baptist andSouth Miami Hospitals. Strokepatients, caregivers and familymembers are welcome. TheBaptist Hospital group meets6:30-8 p.m. on the secondTuesday of the month in theLake Pavilion Building. Call 786-596-6578 for more infor-mation. The South Miamigroup, for Spanish speakers,meets in the East Tower at 11a.m. on the first Saturday of themonth. Call 786-662-8106.

6 R E S O U R C E

R E S O U R C E 7

BAPTIST MEDICAL PLAZA AT WESTCHESTER8840 Bird Road, Suite 400, Health Resource Center

Get the Facts About Stroke (in Spanish). Thursday,Sept. 9, 7-8 p.m., Dr. Bernard Gran, cardiologist.Healthy Skin at Any Age. Thursday,Sept. 30, 10:30-11:30 a.m., Dr. JavierFlores, dermatologist.Vertebroplasty as a Treatment forBack Pain. Tuesday, Oct. 26, 10:30-11:30 a.m., Deborah Coningsby, nursepractitioner. Generic Drugs vs. Name-brandDrugs: What’s the Difference? (inSpanish). Wednesday, Nov. 3, 7-8p.m., Lisette Requejo, pharmacist.A Surgical Strike Against Stroke. Thursday, Nov. 4,10:30-11:30 a.m., Dr. Athanassios Tsoukas, vascularsurgeon.

BAPTIST MEDICAL PLAZA AT WEST KENDALL13001 N. Kendall Drive, Suite 300, Health Resource Center

Adding Laughter to Your Life: How It Impacts YourHealth (in Spanish). Monday, Sept. 20, 1-2 p.m., Dr. Gilda

Moreno, psychologist. Clearing the Carbohydrate Confusion.

Monday, Sept. 27, 1-2 p.m., AngiePlaceres, registered dietitian.How Emotions Affect Your PhysicalHealth. Wednesday, Oct. 20, 1-2 p.m.,Dr. Kimberly Kiddoo, psychologist.

The Benefits and Risks of TakingHerbals. Friday, Nov. 12, 1-2 p.m., Dr.

Linda Marraccini, family practitioner.

WOMEN’S HEALTH RESOURCE CENTER8950 N. Kendall Drive, Suite 105, Health Resource Center

Brain Aerobics: Techniques for Improving YourMemory. Tuesday, Sept. 14, 7-8 p.m., Dr. RichardHamilton, psychologist.Get the Facts About Stroke. Thursday, Oct. 7, 7-8 p.m.,Dr. Paul Damski, neurologist.

SOUTH MIAMI HOSPITAL • U.S. 1 and SW 62Avenue, Victor E. Clarke Education Center

Help for High Blood Pressure. Tuesday, Sept. 7, 10:30-11:30 a.m., Dr. Romeo Majano, cardiologist.Taking Care of Your Diabetic Feet. Wednesday, Oct. 6,10:30-11:30 a.m., Dr. Mark Maederer, podiatrist.

HOMESTEAD HOSPITAL • 160 NW 13 Street

Help for Common Prostate Conditions. Wednesday,Sept. 1, 7-8 p.m., Dr. Avelino Piñon, urologist.Getting to the Heart of Diabetes. Wednesday, Nov. 17,7-8 p.m., Dr. Carlos Barrera, internist.

HOMESTEAD SENIOR CENTER • 43 NE 16 Street

Oh My Achin’ Feet. Wednesday,Sept. 22, 10:30-11:30 a.m., Dr. DmitrySandler and Dr. Liana Korytowski,podiatrists.Gotta Go Right Now: Help forIncontinence. Wednesday, Oct. 27,10:30-11:30 a.m., Dr. Avelino Piñon,urologist.Generic Drugs vs. Name-brandDrugs: What’s the Difference?Wednesday, Nov. 10, 10:30-11:30 a.m.,Marie Ade, pharmacist.

BAPTIST HEALTH RESOURCE CENTER AT INFORMED FAMILIES • 2490 Coral Way

How to Help Those You Love Who Suffer with theIllness of Addiction (in Spanish). Thursday, Sept. 23, 7-8:30 p.m., Dr. Omar Mejia, director, South Miami HospitalAddiction Treatment Program.I Can See Clearly Now: Update on Cataract Surgery.Tuesday, Oct. 19, 6:30-7:30 p.m., Dr. Henry Alvarez,ophthalmologist.Herbals: Benefits and Risks (in Spanish). Thursday,Oct. 28, 7-8 p.m., Jesus Ramos, pharmacist.Living Healthy with Diabetes (in Spanish). Tuesday,Nov. 9, 6:30-7:30 p.m., nurse practitioner Matilde Lewis,certified diabetes educator.

MARINERS HOSPITAL • 91500 Overseas Highway,Tavernier

Managing Pain Without Drugs.Wednesday, Sept. 29, 6-7:30 p.m., Dr.Joanne Mahoney, internist.I Can See Clearly Now: Updateson Common Eye Problems.Tuesday, Oct. 19, 6-7:30 p.m., Dr.Stanley Rosenberg, ophthalmologist.Prostate Health: What Every Man(and Those Who Love Him)Needs to Know. Wednesday, Oct.27, 6-7:30 p.m., Dr. Brian Magrane,family practitioner.

F A L L C A L E N D A RIf you’re 55 or older, take advantage of the programs and health screenings offered by Baptist Health. There is a $5 charge formost programs; however, Senior Advantage members attend free unless otherwise noted. To get a Senior Advantage card, call786-596-3895. Registration is required for all programs, including those that are free. Call 786-596-3812. For Spanishprograms, call 786-596-3814.

S E N I O RF O C U S

There’s new evidence that overweight kids will head intoearly adulthood with diabetes, heart disease and otherhealth problems.

In 2000 and 2002, Resource reported the connectionbetween Type 2 diabetes, which used to be considered anadult disease, and childhood obesity. Now, researchers at YaleUniversity have published a study showing that overweightkids develop metabolic syndrome (a host of metabolic disor-ders like insulin resistance and high blood pressurethat lead to serious health problems) at a muchearlier age than their slender peers.

Health experts have promoted exerciseand proper nutrition for kids in order tolower their risk of diabetes. If you’d like tolearn more, attend “The Type 2 DiabetesEpidemic: How to Protect Your Children.”The parenting program on Friday, Novem-ber 19, 7-9 p.m., will feature Lois Exelbert,R.N., director of Baptist’s Diabetes Care Cen-ter. (See Page 9 for more information.)

Exercise is already a part of Kelly Barry’s rou-tine. The 13-year-old was diagnosed with Type 1 dia-betes (not caused by weight problems) when she was 8 yearsold. “Besides trying to eat right and exercise, the best thingI’ve done is join the diabetes support group,” she said.

Baptist Children’s Hospital offers two support groups forchildren with diabetes. For younger kids, there’s a

parent/child support group, and for older kids,there’s a teen support group. Kids with Type 1 and

Type 2 diabetes are welcome.“Having diabetes is a heavy burden for a child,” said child

psychologist Gary Lancelotta, Ph.D., who leads the teen sup-port group. “In a group, the kids go over the tricks of thetrade — how do you manage your diabetes if you’re an athlete,how do you get through Halloween? In the group, they feel likethey’re not alone.”

Kelly Barry agrees. “I’ve gone on some of the field tripswith the group, like bowling, swimming with dolphinsand rock climbing. When you’re with other kids

who have diabetes, you don’t feel strange because you all testyour blood sugar together,” she said. “Everybody is helping each other.”

One of the most valuable lessons Kelly learned from hersupport group friends was not to go on a diet. “One of thegirls wanted to lose weight and just tried on her own. Sheended up in the hospital.”

Kids in the support groups may learn more from eachother than they do from the doctors, nurses and educatorswho work with them, Ms. Exelbert said. “We’ve had somekids join the group who had problems controlling their bloodsugars and were admitted to the hospital numerous times.When they started listening to kids their own age about howimportant it is to take care of themselves, they really turnedaround.”

For information about either support group, call 786-596-3696.

— Adrienne Sylver

Overweight kids? Health problems not far off unless parents take action

8 R E S O U R C E

Crowned again!For the second year in a row, South Miami

Hospital was awarded a Gold Crown for “Best Placeto Give Birth” in Miami-Dade County in SouthFlorida Parenting magazine’s Kids’ Crown awards.

Baptist Hospital received a SilverCrown in the same category.

In addition, Baptist Children’sHospital got Silver Crowns for“Best Hospital for Pediatrics” and

“Best Hospital for EmergencyCare.”

Each year, the readersof South Florida Parentingexpress their opinions onthe best healthcare fortheir children. Kids’

Crown winners are chosenfrom write-in ballots.

Kelly Barry, 13, learned dieting can be risky.

R E S O U R C E 9

Join the parenting experts at Baptist Children’s Hospitalfor enlightening conversation and practical advice. Eachprogram is held in the auditorium at Baptist Hospital and costs $5. You must reserve your space by calling786-596-3812.

Boosting Your Child’s Brain Power Through Art and MusicThursday, September 23, 7-9 p.m.

Is there a budding Picasso or Mozartin your house? Your child doesn’thave to be a prodigy to benefitfrom the brain-boosting powersof art and music. Join arttherapist Patricia Isis, Ph.D., andmusic therapist Joseph Goelz fora workshop that will unleash theexpressive and creative energy inyour child and introduce new waysof thinking. For parents of youngchildren.

Children’s Health DaySunday, October 24, 1-4 p.m.

Our boo-fully fun interactivehealth day for kids is back. It’sfree. Join us in costume. NoRSVP necessary. See Page 2 formore information.

The Type 2 DiabetesEpidemic: How toProtect Your ChildrenThursday, November 18, 7-9 p.m.

Childhood obesity is leading to a host of healthproblems and Type 2 diabetes is at the top of the list.Lois Exelbert, R.N., director of Baptist’s Diabetes CareCenter, will talk about the reasons so many children are becoming diabetic and specific steps you can take to lower your child’s risk. For parents of toddlersthrough teens.

BAPTIST CHILDREN’S HOSPITAL PRESENTS

Baptist Children’sHospital

BAPTIST

8900 North Kendall Drive

Jugglers, clowns and face-painters will entertain childrenand parents alike at South Miami Hospital’s annual Neona-tal Intensive Care Unit Reunion. The circus-theme cele-

bration is scheduled for Sunday, September 19 from 1-4 p.m.in the Victor E. Clarke Auditorium.

Baptist Children’s Hospital’s 12th annual reunion of theGeorge Batchelor/Gloria Vasta Lewis Neonatal Intensive CareUnit is set for Saturday, November 13. The celebration willrun from 1-4 p.m. lakeside on the Baptist Hospital campus.

The free reunions celebrate life and health, and give fami-lies a chance to visit with thephysicians, nurses and supportstaff who cared for them.RSVP to the South Miamireunion at 786-662-4295,and to the Baptist Children’sreunion at 305-273-2810.

It’ll be a real circus!

(Left) Sisters Kiki andNichole Maribona share aspecial moment at SouthMiami Hospital’s 2003reunion.

(Below) At Baptist Children’sHospital’s reunion last year,triplets Emmanuel, Ana-Victoria and Gabriel Eliasplay games with occupation-al therapist Isabel Maestu.

Baptist Health will provide morethan $85 million in charity carethis year, up from $57 million in

2003 and $36 million in 2002. The dra-matic growth in charity care reflectsBaptist Health’s commitment to servingthe less fortunate, according to ChaplainRobert Jakoby, director of Pastoral Care,which administers the charity care program.

Charity care is defined as “free serv-ices to uninsured patients who do nothave the ability to pay for their health-care,” said Ralph Lawson, BaptistHealth’s chief financial officer. “This iscare we provide, knowing we will not billfor it.” He explained that in addition tocharity care, Baptist Health also providesabout $270 million in uncompensatedcare, which includes shortfalls in Medi-caid reimbursement and bad debt.

Mr. Lawson said the record lev-els of charity care reflect theneed in South Florida. “With

more than a quarter of the population inMiami-Dade County without insurance,it is clear that the need is growing,” hesaid. He pointed out that Homestead

Hospital in Miami-Dade County andMariners Hospital in Monroe Countyprovide the highest percentage of char-ity care in their counties, except for gov-ernment-operated hospitals.

Nilda Soto, M.D., has seen first-hand the results of Baptist’s char-ity care program. She is the med-

ical director of the Open Door HealthCenter in Homestead, which treats hun-dreds of people who do not have, andcannot afford, health insurance.

“Baptist Health is a godsend,” Dr.Soto said. “We send all of our patientswho need specialized diagnostic tests ortreatment to Baptist Health doctors andhospitals. Baptist never says no.”

Roberto Santiesteban, M.D., a Bap-tist physician who volunteers much of

his time to treat indigent patients,agrees. “Baptist has been wonderful tohelp so many of the working poor,” hesaid. “So many patients have beenhelped.”

One of these patients is LoraineLaRue of south Miami-Dade,who works as a greeter for Wal-

Mart but can’t afford health insurance.In 2001, she was referred to the OpenDoor Health Center with diabetes andhigh blood pressure. At the clinic, doc-tors also discovered Ms. LaRue had aserious heart condition.

She was sent to Baptist Hospital fordouble bypass heart surgery. A team ofdoctors — cardiac surgeon JosephLamelas, M.D., cardiologists Jorge Pas-toriza, M.D., and Orlando Almanza,M.D., and pulmonologist Raul Valor,M.D. — volunteered their services tocare for Ms. LaRue.

“It’s been three years since I had myheart operation and I’m doing fine,” saidMs. LaRue, 62. “I’m still going to theclinic and the heart doctor, Dr. Pastoriza,once a year. They help me with what-ever I need.”

Baptist Health also supports theGood News Health Center inFlorida City and the Good Health

Clinic in Tavernier, which treat peoplewithout health insurance.

Under the Baptist Health charityguidelines, uninsured people whosehousehold income is up to three timesthe federal poverty level qualify for freecare. For a family of four, the federalpoverty level is $18,850, so a family offour with income under $56,550 wouldqualify.

A key part of Baptist Health’s abilityto provide free care is the willingness ofits affiliated physicians to care forpatients without being paid. Virtually allof the 1,800 physicians on staff at BaptistHealth hospitals are in private practice,not paid employees. The value of charitycare that doctors provide in their officesand in Baptist Health hospitals cannotbe measured. But it amounts to millionsof dollars of free care each year.

— Jo Baxter

10 R E S O U R C E

Baptist’s charity care reaches recordHERE&THERE

Wal-Mart greeter Loraine LaRue (left) chats with shopper Nancy Krupa. Ms.LaRue continues to do well three years after her heart surgery at BaptistHospital.

“Baptist has beenwonderful to help somany of the workingpoor.”

— Roberto Santiesteban, M.D.

R E S O U R C E 11

Cardiac center of excellence

Baptist Cardiac & VascularInstitute has been named aCardiac Center of Excellence byUnited Healthcare, whichrecognized hospitals thatachieved a high level of qualityand efficiency compared toother hospitals. Baptist Cardiac& Vascular Institute is one ofonly five hospitals in SouthFlorida to be named.

Free screenings at Mariners

When was the last time you checked your blood pressure and cholesterol— and do you know how well your bones are holding up to aging? Youcan get free health screenings at Mariners Hospital’s “Dimensions of

Wellness Day” on Saturday, November 6at the Tavernier hospital, Mile Marker

91.5 in the Upper Keys.The Wellness Day, from 9 a.m.-

1 p.m., also will feature a cookingdemonstration on preparing healthy

food. Community organizations willbe on hand to distribute information.

Sponsored by the Mariners HospitalFoundation Wellness Fund, the free event focuses on social,

physical, emotional, occupational, spiritual and intellectual fitness.

Minimally invasive surgery thatuses tiny incisions to treatcolon cancer is just as effec-

tive as traditional surgery that requires alarger incision, a study published in theNew England Journal of Medicine hasfound.

The seven-year study found similarrates of cancer recurrence between tra-ditional “open” surgery and laparoscopicsurgery. It also found that patients whohad laparoscopic surgery for colon can-cer recovered more quickly and tookfewer drugs for pain. In 1990, the mini-

mally invasive technique for colon can-cer treatment was pioneered by BaptistHealth surgeons Gustavo Plasencia,M.D., and Moises Jacobs, M.D.

“I think this will increase dramati-cally the number of colon resectionsdone laparoscopically now that peopleknow it’s OK to do for cancer,” Dr.Plasencia said. “For 14 years, we’ve beendoing the same thing that’s done in theopen procedure — just with a smallerincision and a quicker recovery withless incidence of complications.”

Flu vaccinesoffered

No one wants to get bugged bythe flu. You can protect yourselfduring flu season by getting an

influenza vaccination. Prevention is espe-cially important for people over age 65and those with medical conditions andweakened immune systems.

Baptist Outpatient Services will giveflu vaccines between October andDecember on Saturdays at various loca-tions, including Baptist Medical Plazasat Doral, 9915 NW 41 Street; PalmettoBay, 8750 SW 144 Street; Westchester,8840 Bird Road; and West Kendall,13001 North Kendall Drive.

The cost is $20. To schedule anappointment, call 786-573-3755.

Baptist Health South Florida’s 2004 Reportto the Community focuses on the healthcareorganization’s goal to move toward great-

ness. “Greatness is a journey that begins when‘good’ isn’t good enough. It’s a journey thatnever ends,” writes Baptist Health CEO BrianE. Keeley in an opening letter.

The report highlights Baptist Health’s char-ity care program, new technology, growth and awards, andprovides an overview of the organization’s hospitals and affiliates. If youwould like the community report mailed to you, check the box in the reader surveycard inside this magazine.

Study supports less-invasivecolon surgery

2004 Report: From Good to Great

The day began as usual for El Salvador insurance brokerRicardo Hill, a former college athlete who remained fit atage 57. He went to early mass before work. At 9 a.m.,

when he bent down to tie his shoe, he felt dizzy. By noon, he couldn’t speak clearly and was losing his bal-

ance — classic signs of stroke. He was admitted to a hospital inSan Salvador last December 11, with his speech and mobilitygradually failing. But the care he needed was unavailable in hishomeland. The next day, an air ambulance flew him to Miami.

Even the Baptist Hospital doctors who first saw Mr. Hillthought he was beyond much medical help. The critical treat-ment window had passed by more than a day, virtually dis-qualifying him for emergency stroke therapy.

By the time J.J. “Buddy” Connors, M.D., met Mr. Hill in

intensive care the following night, his condition was grave.“All he could do was blink and move one finger,” Dr. Connorsrecalled. As a leading expert in interventional neuroradiology,Dr. Connors specializes in stroke prevention and rescue.

Though a routine scan of the brain was normal, furtherimaging studies showed “a huge clot” in the brain stem’sbasilar artery, choking the lower brain at the upper

spinal cord. “We were in big trouble,” Dr. Connors said.Mr. Hill remained conscious. He communicated by using

his sole mobile finger to touch keys on a mini-electronic label

maker that his wife, Lorena, had rushed out to buy. Thoughsuccess was a long shot, Dr. Connors told Mr. Hill he could tryto break up the clot and restore blood flow to the spinal cordby snaking a tiny tube up into the clogged brain stem artery.Dr. Connors was blunt: The risk of fatal bleeding was highand the paralysis might be irreversible. “Dr. Connors nearlytold me to say goodbye to my family,” Mr. Hill said.

With little to lose, Mr. Hill laboriously typed a messagewith his one finger to Dr. Connors: “Go ahead. God bless you.”

From midnight until 8 a.m., Dr. Connors worked on Mr.Hill, whose arteries were magnified on computer screens inthe high-tech stroke treatment suite at Baptist Cardiac & Vas-cular Institute. When the catheter, inserted through a groinartery, reached the brain stem, Dr. Connors gave a direct doseof medication to dissolve the clot. Then he picked at the clot,slowly breaking it up, using a tiny wire inside the catheter —largely the same way a plumber unclogs much bigger pipes.More clot-busting drugs eventually restored normal bloodflow. “Then it was just a matter of which brain cells were aliveand which were dead,” Dr. Connors said.

Mr. Hill’s recovery was slow but remarkable. Threedays after the procedure, he wiggled his hand; onday five, he moved his arms. On day six, he talked.

A few days later, interventional cardiologist Ramon Quesada,M.D., repaired a usually harmless heart defect that had causedMr. Hill’s stroke.

When he started his month-long rehabilitation at BaptistHospital, “I couldn’t swallow and my left side was still para-lyzed,” Mr. Hill said. He told his physical therapist he wanted towalk out of the hospital when he was ready to leave. And onFebruary 14, using a cane, he did just that.

Today, Mr. Hill has resumed his active life without disabil-ity. For Dr. Connors, Mr. Hill is proof that recovery from themost devastating stroke is possible with bold treatment —and luck. “With most strokes, intervening after 12 to 24 hoursis by far too late,” said Dr. Connors, author of the only textbookdescribing interventional stroke therapy. “In this case, 60 hourshad passed and he was quadriplegic. It’s unbelievable.”

Mr. Hill returns to Baptist Hospital for checkups, and keepsin touch with Dr. Connors and Dr. Quesada. “The last time Iwas there I went to the chapel to give thanks — because Ialmost didn’t make it,” Mr. Hill said. “But now I’m back tonormal. I really am a living miracle.”

— Patty Shillington

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Editor: Jo Baxter. Art Director: Martha Hesse. Associate Editor: Anne Streeter.Writers: Martha Martin-Allen, Tom Neile, Tanya Racoobian,Patty Shillington, Adrienne Sylver.Editorial Assistants: Georgette Koch, Barbara Moore, Laura Pincus, Dorothy Stein.Photography: Pyramid Photographics, Mabel Rodriguez.Cover illustration: ©Dave Cutler/Images.com.Visit us: www.baptisthealth.net

Copyright © 2004 Baptist Health South Florida. All rightsreserved. None of the contents of this publication may be reproduced or transmitted without the prior written permission of the publisher.

The miraculous recovery of Mr. Hill

By summer, Ricardo Hill was riding his personal watercraftwith his three young sons, Ricardo, 7; Alejandro, 6; andDiego, 4.