Baptist Health South Florida Chairman of the Board,Judge Robert Dubé; President and CEO, Brian E. Keeley.Trustees: Tony Alonso, Calvin Babcock, Yerby Barker,Wendell Beard, George Cadman III, James Carr, the Rev.William Chambers III, the Rev. David W. Cleeland, GeorgeCorrigan, William Dickinson, Joyce Elam, Herbert Greene,M.D., George Harth, Jay Hershoff, Charles Hood III, the Rev.Dr. Gary Johnson, Norman Kenyon, M.D., Rudy Kranys, the Rev. Richard Ledgister, the Rev. Wilner Maxy, Paul May,the Rev. Dr. Marcos Ramos, Aida Shafer, Ronald Shuffield,Roberta Stokes, W. Peter Temling, the Rev. Tom Thompson,Bill Tillett, Scott Weston, the Rev. Dr. William White.Baptist Hospital of Miami Board Chair, Calvin Babcock;President, Medical Staff, Eugene Eisner, M.D.; Chief Executive Officer, Bo Boulenger. South Miami Hospital Board Chair, Yerby Barker;President, Medical Staff, Guillermo Pol, M.D.; Chief Executive Officer, Lincoln Mendez. Homestead Hospital Board Chair, the Rev.William ChambersIII; President, Medical Staff, George Tershakovec, M.D.;Chief Executive Officer, William Duquette.Mariners Hospital Board Chair, Jay Hershoff; President, Medical Staff, Elisa Brown-Soltero, M.D.;Chief Executive Officer, Rick Freeburg.Doctors Hospital Board Chair, Norman Kenyon, M.D.;President, Medical Staff, Jack Cooper, M.D.; Chief Executive Officer, Nelson Lazo.West Kendall Baptist Hospital Board Chair, Tony Alonso;President, Medical Staff, Juan Carlos Verdeja, M.D.; Chief Executive Officer, Javier Hernandez-Lichtl.Baptist Outpatient Services Board Chair, Roberta Stokes;Chief Executive Officer, Patricia Rosello. Baptist Health Enterprises Board Chair, James Carr; Chief Executive Officer, Ana Lopez-Blazquez.Baptist Health South Florida Foundation Board Chair,Rudy Kranys; Chief Executive Officer, Stephen Parsons. Directors of Affiliated Boards Yvette Aleman, DickAnderson, George Aronoff, Orlando Bajos, James Barker,Matthew Becherer, Robert Berrin, Bonnie Blaire, JamesBoruszak, Steven Brodie, Bette Brown, Joseph Buchanan,Robert Burstein, Miguel Cano, Willie Carpenter, Mark Caruso,M.D., Gerald Case, Ray Castellanos, Mauricio Cayon, BarronChanner, Maria Costa-Smith, Agustin de Goytisolo, ElizabethDiaz de Villegas, Lani Kahn Drody, Joyce Elam, Tomas Erban,Manuel Fernandez, Rev. Otto Fernandez, Armando Ferrer,Ph.D., Carlos Garcia, Peter Gardner, Maria Garza, WilliamGilbert Jr., Robert Gintel, Gretchen Goslin, Michael Graham,M.D., Leif Gunderson, Barry Halpern, M.D., Kent Hamill, JamesHarris, Alysa Herman, M.D., Gerald Hirsch, Nathan Hirsch,M.D., G. Glenn Huber, Jacque Huttoe, Jeanne Jacobs, Ph.D.,David Johnson, Lane Jones, S. Lawrence Kahn III, GeorgeKakouris, George Knox, Manuel Lasaga, Katrina Lavene,Cynthia Leesfield, Maria Camila Leiva, Orlando Leon, M.D.,Andrew Levy, James Loewenherz, M.D., Victoria London,Miriam Lopez, John Maas, Bruce MacArthur, Joseph McCain,DMD, Derek McDowell, Jo McGregor-Ganus, StanleyMargulies, M.D., Joy Martin, Charlie Martinez, AndrewMenachem, Hans Mueller, Patricia Mull, Ramon Oyarzun,Martha Pantin, Johanna Paterson, Ann Pope, Samuel PorcoJr., DMD, Juan-Carlos Quintero, DMD, Ramón Rasco, CharlenRegan, Ian Reiss, M.D., Bonnie Rippingille, John Rock,M.D., Domingo Rodriguez, Steven Sapp, Joel Schenkman,M.D., Betty Schilling, I.E. Schilling, Robert Shafer Jr., EmerySheer, Joel Shepherd, Karent Sierra, DDS, Paul Soulé,Patricia Stanley, Lee Stapleton, Rene Taylor, PatriciaThorp, Bill Tillett, Joseph Traina, M.D., Sats Tripathy, NickWaddell, Jeff Weiner, Warren Weiser, Lisa White, WilliamWilson III, Robert Zolten, M.D., Leonard Zwerling, M.D.

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EXECUTIVE EDITOR Roymi V. MembielaEDITOR Jo BaxterASSOCIATE EDITORS Christine Kotler, Patty ShillingtonCONTRIBUTING WRITERS Liz Doup, Elizabeth Rosenthal,Adrienne Sylver, Phyllis Teitelbaum, Tanya WaltonART DIRECTOR Elizabeth Lane LawhornPHOTOGRAPHY Steven Brooke, Gort Productions, Mabel RodriguezEDITORIAL ASSISTANTS Georgette Koch, Barbara Moore,Laura Pincus, Kelli Romano, Dorothy Stein, Anne Streeter,Shannon J. Zemantauski

At South Miami Hospital’s Center for Women & Infants, our patientcare navigator is your convenient, personal guide to getting thecare you need. From scheduling appointments to helping you findthe right doctor, she will be with you every step of the way. It’s afree service and a valuable resource. To contact your patient carenavigator, call 786-662-8585 or visit CenteredOnMe.com.

Centered on me.

here was one thing lawyer Elizabethdu Fresne knew when she was diag-nosed with breast cancer in 2000: Shedidn’t want all of her underarm lymphnodes removed along with the cancer-

ous lump in her breast. “I had painfulrheumatoid arthritis and fibromyalgia anddidn’t want to risk developing lym-phedema,” she said.

Lymphedema is a persistent and painfulswelling in the hand and arm that affectsabout 15 percent of women whose lymphnodes are removed. The swelling resultsfrom disruption of the flow of lymph fluid inthe arm, caused by the surgery.

Ms. du Fresne’s breast surgeon, RobertDerhagopian, M.D.,was reluctant to leavethe nodes becausecancer was found in a crucial sentinelnode under herarm. Removing theremainder of thenodes would elimi-nate any cancer thatmight have foundits way to them. But

together, Ms. du Fresne and her surgeonsought out research studies, consultedwith several cancer specialists and care-fully weighed the risks and benefits. Theymade a shared decision to leave her lymphnodes intact. After treatment with lumpec-tomy, radiation and chemotherapy, Ms. duFresne is alive and well 11 years later.

Today, based on a groundbreakingstudy published in the Journal of theAmerican Medical Association, that deci-sion would have been easier for Ms. duFresne and her doctor. According to theresearch, it may not be necessary toremove multiple underarm lymph nodesin women with early breast cancer, as hastraditionally been done. If cancer is foundin only one or two crucial sentinel nodes,removing more nodes does not improvesurvival or change the need for radiationand chemotherapy.

The findings of the study do not applyto all breast cancer patients. They’re lim-

ited to women whose disease meets certain criteria — about 20 percent ofpatients, or 40,000 women annually in theUnited States. The women in the study, likeMs. du Fresne, had small tumors; and biop-sies of one or two nodes found cancer, butthe nodes were not enlarged enough to befelt. In addition, the cancer had not spread.All the women also had lumpectomies andradiation therapy and a majority alsounderwent chemotherapy.

“The study is important,” said Dr. Derhagopian. “But, until we get moreresearch data, particularly on long-termsurvival, I’m going to be cautious and willonly forgo lymph node removal in care-fully selected cases.”

Breast surgeon Cristina Lopez-Penalver,M.D., is taking a similar approach. “Itchanges what I do in a certain group ofwomen—those who meet the study crite-ria.” She added that she makes the deci-sion “after considering all factors, includ-ing the patient’s preference.”

“It’s a big decision that every womanneeds to make with her surgeon,” Ms. duFresne said. “I’m confident that my doc-tor and I made the best decision for me.”

— Phyllis Teitelbaum, R.N.

Women & Hea l th

TLymph node study changes cancer care

Elizabeth du Fresne decided againstlymph node removal.

R E S O U R C E 3

SHARING FAMILY TIME ANYTIMENew mom Stephanie Morales, along with husband Luis Salazar (left), son MiguelMorales, 4, and family members John and Laura Busta, bonds with tiny MasonAndres Salazar at Baptist Hospital. Baptist Health hospitals are moving toward“open visitation” to encourage the inclusion of family and friends at any time.This is part of our patient- and family-centered care philosophy.

Robert Derhagopian,

M.D.

4 R E S O U R C E

An experimental pill — no chemo, no radiation, no surgery — was all

Jorge Averhoff needed to put his cancer into quick and painless remis-

sion. His ongoing treatment for chronic myelogenous leukemia, a blood

cancer that causes an overproduction of white blood cells, has been so

tolerable that the 36-year-old father of two boys has never missed a

day of work or a workout at the gym because of side effects.

Just a few years ago, Mimi Rodriguez’s breast cancer treatment regimen would have includedchemotherapy following her mastectomy. But a new test, Oncotype DX, which analyzed a group of genesin a tumor sample from her breast cancer, showed the odds were very high that her cancer would not recurand that adding chemotherapy to an oral anti-hormone therapy would not benefit her.

“I did not need chemo,” said Ms. Rodriguez, 46, “and that was a blessing.”Nadine Nunberg, 49, opted for a preventive hysterectomy and removal of her ovaries after she was

treated for breast cancer and learned from a genetic test that she had a BRCA mutation associated with ahigh risk of breast and ovarian cancer. The operation, which followed a double mastectomy andchemotherapy, was done by gynecological surgeon Ricardo Estape, M.D., with the help of a robotic arm hecontrolled from a nearby console. Thanks to tiny incisions and robotic precision, Ms. Nunberg had littlebleeding and a very short recovery time.

“It was easier than the cesarean delivery of my daughter,” Ms. Nunberg said.The experiences of Mr. Averhoff, Ms. Rodriguez and Ms. Nunberg reflect the broad new landscape of

cancer care. Research into the genetic underpinnings of cancer is leading to targeted treatments that areless harsh and more effective. New drugs and high-tech tools soften the once-debilitating side effects ofchemotherapy and radiation. Interventional radiologists work with radiation specialists to reach tumorsthat were once inoperable. Surgeons use minimally invasive laparoscopes and robotic arms to improveprecision and lessen the impact of operations.

Baptist Health cancer specialists Grace Wang, M.D., and Leonard Kalman, M.D., have seen the dramaticshifts in cancer care since they began practicing in 1982. At that time, effective treatment options werescarce for some patients with advanced cancer. In addition, patients experienced significant side effectsfrom many chemotherapy drugs, and more invasive surgical procedures required much longer recoveryperiods. When common diseases like lung cancer or colon cancer recurred after surgery, patients survived

Targeting cancer’s molecular tracks

Ricardo Estape, M.D.

R E S O U R C E 5

for only months. “You don’t realize until you think about it how far we’ve come,” Dr. Kalman said. “We nowhave some patients with recurrent colon cancer and lung cancer living for years.”

Dr. Wang, who specializes in breast cancer, notes that the death rate from breast cancer has dropped30 percent since 1990. Five years from now, nine out of 10 women diagnosed with breast cancer will bealive. “We’re talking about survivorship issues now. I spend a lot of time during office visits emphasizinglifestyle changes — a low-fat diet, low alcohol and exercise — because these add to your quality of life andcan increase survival and decreaserecurrence.

“It’s an exciting time in oncology,”Dr. Wang said.

Indeed, one dramatic surgicaladvance now allows certain women tobecome pregnant and give birth via C-section after treatment for early-stagecancer of the cervix. Conventionaltreatment left patients infertile. “Weused to remove the uterus,” said Bap-tist Health gynecologic cancer surgeonManuel Peñalver, M.D., chairman ofobstetrics and gynecology at FloridaInternational University’s HerbertWertheim College of Medicine.

Today, thanks to a special surgicaltechnique and minimally invasiveapproach with a laparoscope, Dr.Peñalver can remove the cervixthrough the vagina and then reattachthe uterus to the top of the vagina.

“Preserving reproductive capacity is a big thing,” said Dr. Peñalver, who, along with his partners, hasspared the fertility of more than a dozen women with early-stage cancer of the cervix.

Minimizing side effectsToday, even people whose cancer can’t be cured are often able to maintain a high quality of life for manyyears. Consequently, there’s a growing focus on preventing or limiting the side effects of treatment, so peo-ple with cancer can more fully enjoy their lives.

Some women with advanced ovarian cancer now can receive chemotherapy as the first course of treat-ment to shrink the tumor before it’s surgically removed. “Reducing the tumor bulk makes surgery lessaggressive and easier on the patient,” Dr. Peñalver said.

The side effects associated with chemotherapy — nausea and vomiting — are largely a thing of thepast, thanks to new drugs such as aprepitant and palonosetron. “My patients are pleasantly surprisedwhen it’s not as bad as they thought,” Dr. Wang said.

Patients on certain cancer drugs are vulnerable to serious infections due to a drop in white blood cellsand may end up hospitalized from this dangerous side effect. But another medication, pegfilgrastim,counters that side effect, stimulating the rapid return of white blood cells after chemotherapy. “Thesegrowth factors for white blood cells are keeping patients out of the hospital,” Dr. Wang said.

Continued on page 6

Nadine Nunberg, now cancer-free, has routine follow-up visits with Grace Wang, M.D.

Manuel Peñalver, M.D.

6 R E S O U R C E

Some cancer treatments, including hormone therapy, certain chemotherapy drugs and radiation tothe pelvis, decrease bone density, putting patients at risk for fractures. But drugs prescribed for osteo-porosis are very effective at stopping bone loss and increasing bone density.

New ways to give pain medicine are more convenient and faster-acting. For example, the pain drugfentanyl can be absorbed through a skin patch or inside the cheek as a berry-flavored lollipop.

Technological advancesHigh-tech tools and techniques developed in recent years for radiation help target therapy to the mil-limeter, minimizing damage to healthy tissue.

Both Baptist and South Miami Hospitals offer image-guided radiation therapy, or IGRT, the mostadvanced form of radiation therapy available. IGRT uses CT imaging, known as cone beam CT, to visual-ize a region of the body immediately before and while radiation is delivered. This enhances the accuracyof the radiation dose by allowing doctors in real time to visually track the tumor, which may change posi-tion during the course of treatment.

In addition, Baptist and South Miami also use “respiratory gating,” which pinpoints the slightly chang-ing position of a tumor as the patient breathes. The system turns the radiation beam on and off, accord-ing to the location of the tumor during the breathing cycle. Respiratory gating refines radiation for lung,liver and pancreatic cancer treatment, and further reduces side effects.

New techniques and uses of technology also are easing radiation treatment.Certain early-stage breast cancer patients, for example, can be treated with partial breast irradiation,

instead of radiation to the whole breast, which reduces both the time spent in treatment and the poten-tial side effects. Preliminary results of a research study on partial breast irradiation based at Baptist Hos-pital are “very encouraging” and will be published later this year in the International Journal of RadiationOncology * Biology * Physics, said Andre Abitbol, M.D., Baptist Hospital’s associate medical director ofradiation oncology. Those early results suggest that partial breast irradiation is safe and as effective aswhole-breast radiation with certain patients.

For early-stage, inoperable lung cancer, another innovative treatment, stereotactic ablative bodyradiotherapy (SABR) has had high rates of success in keeping tumors at bay. “This has resulted in signif-icant control of lung cancer,” Dr. Abitbol said. Three years after treatment, tumor control was achieved inmore than 95 percent of cases reviewed in several recent studies. In fact, the effectiveness of SABR inpatients with inoperable tumors is comparable to what is typically achieved with surgery. That finding maygive some patients with operable tumors the choice of having SABR instead of surgery.

Other patients with inoperable tumors have a new minimally invasive option for treatment in thegrowing field of interventional oncology. Baptist Health’s interventional radiologists can freeze, burn or

radiate some types of cancer in the liver,kidney, lung, colon or bone. The doctorsuse real-time images to guide needlesand catheters under the skin to thetumors, where the treatment is delivered.These less invasive techniques are prov-ing to extend and improve life for somepeople with metastatic cancer.

Personalizing treatmentAn explosion of insight into the funda-mental makeup of tumors is fueling thecreation of so-called molecularly targeteddrugs. This is the wave of the future, Dr.Kalman and Dr. Wang agree. As scientistsdiscover more about the molecular path-ways that lead to tumor growth, they cancreate more drugs to block those growthmechanisms. “The hottest topic in cancercare is personalized medicine,” Dr.Kalman said.

Continued from page 5

Leonard Kalman, M.D., confers with nurses in his office.

R E S O U R C E 7

Targeted therapies work in different ways. Some cause the death of cancer cells or help the immunesystem destroy them. Others block enzymes and growth factor receptors or affect the proteins that controlgene expression. (For the National Cancer Institute’s fact sheet on targeted cancer therapies, go to cancer.gov/cancertopics/factsheet/Therapy/targeted.)

One of the first major targeted therapies for breast cancer, what Dr. Wang called “a miraculous breakthroughdrug,” was trastuzumab (more commonly known by the brand name Herceptin). It is credited with the com-plete remission of HER-2 positive metastatic breast cancer in women such as Mayra Blel, who began taking thedrug after breast cancer spread to her lung. Almost a decade later, “I am cancer-free,” said Ms. Blel, 55.

It was also a targeted drug, nilotinib, that stopped Mr. Averhoff’s cancer — most likely by interferingwith the signal to produce leukemic cells. “I am in MMR — major molecular remission. It’s wonderful,” Mr.Averhoff said.

Targeted drugs also are available for some types of colon, stomach, kidney, head and neck, lung,pancreatic and blood cancers. In the case of non-small cell lung cancer with the EGFR mutation, patientscan take an oral drug (Tarceva) and avoid harsher chemotherapy, Dr. Kalman said.

While dozens of targeted drugs already have been devel-oped to address some of the more common characteristics ofmalignant tumors, over time tumors develop additionalmolecular and genetic changes and some patients’ tumorsbecome resistant to their original therapy. A landmark study, inwhich Baptist Health is participating, is underway to create anunprecedented repository of tumor specimens and patientinformation. Moffitt Cancer Center’s Total Cancer Care™ willdevelop a database of the genetic profiles of tumors.Researchers hope to use that data to develop new targeteddrugs.

One day, as tumor analysis becomes even more sophisti-cated, cancer patients may take medicine individuallydesigned for them based on features unique to their tumor.

“We are moving toward understanding the genetic andmolecular profile of an individual patient’s tumor. If weaccomplish this, we will be able to direct our therapy specifi-cally against that tumor, minimizing side effects and avoidingtreatments that will not work,” Dr. Kalman said. “Everyone’strying to get there.”

Some people may avoid cancer altogether through genetictests both existing and on the horizon. For cancer-relatedgenetic mutations that can be confirmed with a simple bloodtest, those at high risk can opt for preventive care. That mayinclude close monitoring, targeted medications such as tamox-ifen (in the case of breast cancer risk) or surgery to remove theorgans. Ms. Nunberg, a strong advocate for genetic testingawareness, wishes she had known about the BRCA test beforeshe was diagnosed with breast cancer. “My cancer was highly preventable,” she said.

A final aspect to personalized medicine is the bond between patient and doctor. Ms. Nunberg said hercancer team specialists — Dr. Wang, Dr. Estape, breast surgeon Robert Derhagopian, M.D., and plastic sur-geon Deirdre Marshall, M.D. — “are the most fantastic human beings who make it their mission to effectchange and educate the public.

“I have access to healthcare anywhere — Johns Hopkins, Georgetown, Sloan Kettering — and I chosethese doctors,” she said. “There isn’t anything better out there as far as their skill, knowledge and human-itarianism.” — Patty Shillington and Phyllis Teitelbaum, R.N.

Research into the genetic underpinnings of cancer is leading totargeted treatments that are less harsh and more effective.

Melanoma Skin Cancer

Jorge Averhoff

Adenocarcinoma Cervical CancerGlioblastomaBrain Cancer

MO

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AN

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Ninety-seven participating surgeons make Baptist Health

one of the top contributors of tumor specimens to Tampa-

based Moffitt Cancer Center’s landmark study, Total

Cancer Care.™ The study is creating a database of tumor

genetic profiles for the development of targeted therapies.

Researchers hope to use that data to develop new

targeted drugs.

8 R E S O U R C E

n mid-February, weeks shy of his thirdbirthday, Georgie Montes was pulledlifeless from a backyard swimming pool.He wasn’t breathing. He had no pulse.Georgie’s outlook was poor, but doctors

at Baptist Children’s Hospital quicklybegan hypothermia, cooling his body tominimize and prevent brain damage. Tendays later, Georgie walked out of the hos-pital. And by the time Georgie turned 3 onMarch 10, he was running, playing andshouting. It was a celebration of not justhis survival, said his parents, but of the fact

that he showed few to no lasting signs ofhis near-death experience.

“There aren’t words to express how hehas recovered,” said his mother, Rita. “It’ssurreal.”

Children who remain in the water for aslong as Georgie (estimated at five to sevenminutes), often don’t live. Or, if they do,many have irreversible brain damage, saidArcenio Chacon, M.D., medical director ofthe hospital’s pediatric intensive care unit.

“A number of factors were in Georgie’sfavor,” Dr. Chacon said. “It was a cold day,

in the 50s in Miami, and the water wascolder than usual. He was a healthy littleboy before he fell in the pool. His outcomemay have been different if he’d had asthmaor some other medical problem.”

As soon as Georgie was resuscitated andthen stabilized in Baptist Children’s Emer-gency Center, he was moved to pediatricintensive care. There, he was sedated andplaced in a coma and on a ventilator to helphim breathe. The cooling blanket wastucked around his body, and his tempera-ture was maintained for two days at around93° Fahrenheit, five degrees lower than the98.6° considered normal.

“Hypothermia slows the metabolicprocess,” explained pediatric neurologistKen Butler, M.D., who also cared forGeorgie. “The belief is that if you can slowdown the mental processing, you can slowthe damage to brain cells. It’s kind of likerunning an engine with no oil. If you keeprunning the engine, there’s permanentdamage. But if you shut the engine down,you prevent the damage.”

Hypothermia is successfully used forinjuries that interrupt the flow of oxygen tothe brain, such as heart attack. Both Bap-tist Hospital’s and South Miami Hospital’sLevel III Neonatal Intensive Care Units forpremature and very ill infants also usehypothermia for some newborns whosebrains are deprived of oxygen during birth.

“We really didn’t know what to expectwhen Georgie woke up,” said his father,George. “When his body was warmer andhe was coming off the sedatives, a physicaltherapist came in and tried to get him tomove his arm to grab a block. He couldn’tdo it. He slept that night and when hewoke up, he grabbed my cell phone,unlocked it, went to his favorite app andstarted playing the game.”

The rest of Georgie’s remarkable recov-ery proceeded in a similar, rapid fashion.“It was astounding,” his dad said. “Eventhe staff was calling him a miracle baby.”

— Adrienne Sylver

I

KidStuff

For Georgie Montes, 3, playing with a puzzle is just fun. But occupational therapistGloria Vignau knows better. Handling small puzzle pieces helped Georgie refinehis motor skills after nearly drowning.

Tot defies odds; survives near-drowning

R E S O U R C E 9

SWIM LESSONS FOR TOTS?Georgie Montes took swimming lessons, received a certificate andwas a natural in the water, said his father, a physical educationteacher. No one knows for sure how Georgie circumvented the fencethat surrounded his uncle’s pool; and a fall into cold water wearingheavy winter clothes is no match for a toddler. Still, his father believesthat small children should learn to swim.

Coach Lou Manganiello agrees. He’s taught kids, although notGeorgie, to swim for three decades and runs AquaKids at the WinstonPark pool and Westminster Christian School. “There’s no such thing asdrown-proofing,” he said. “It’s impossible to duplicate every panic sit-uation. Trying to prepare a child involves having them roll onto theirbacks and float, or kick to the wall. Those are the skills we stress. Andif it gives them an extra minute or two, it could save a life.”

Begin swim lessons when children are between 18 and 24 monthsold, advises Coach Manganiello. The American Academy of Pedi-atrics, a group that used to endorse swim lessons only for kids ages 4and up, changed its opinion recently to say that children ages 1 to 4can benefit from formal swim lessons as long as they are healthy anddevelopmentally ready.

“It’s a skill you can’t be without in South Florida. We talk to the kidsand parents about the rules,” Coach Manganiello said. “You don’tgo in the pool unless an adult is with you. Even during lessons, theyare not allowed to let go of the wall until we give them permission.”

Also important, he adds, is for everyone in the home to know CPRand how to dial 911. Georgie’s uncle started CPR and paramedicstold his father that it may have helped. And finally, don’t forget poolmaintenance, the use of fences and alarms — and sunscreen.

—Adrienne Sylver

Join the parenting experts at Baptist Chil-dren’s Hospital for enlightening conversa-tion and practical advice. Each program isheld in the auditorium at Baptist Hospitaland costs $5, unless otherwise noted. You must reserve your space by calling 786-596-3812.

KEEPING KIDS SAFE ONLINEThursday, June 23, 7-9 p.m.

Having fun on Facebook,in chat rooms and onother social networkingsites may increase yourchild’s circle of friends.But who is “chatting”with your child online, andwhat might their intentionsbe? Sgt. Joseph Bermudez of the Miami-Dade Police Department shares tips forparents and kids to keep your family Internet-savvy and cyber-safe. For parentsand children age 8 and up.

DISCOVERING ART & MUSICTOGETHERThursday, August 25, 7-9

p.m. You might have apetite Picasso or a bud-ding Beethoven in yourhome, but your childdoesn’t have to be a prodigyto benefit from the brain-boost-ing power of art and music. Art therapistPatricia Isis, Ph.D., and music therapistJoseph Goelz take parents and children onan adventure to explore the magical worldof art and music together. For parents andschool-age children.

8900 North Kendall Drive

With a jump, Kelia Mallas, 2, heads toward AquaKids Coach Ellie ina swim class for toddlers.

All about kids

efore Cristina Alejandre started takingher 89-year-old mother for regular footcare, she didn’t think much about agingfeet. “This has made me a lot moreconscious of what can happen,’’ she

said. “I realize I need to take care of them.” At 64, Ms. Alejandre is among the early

wave of 78 million baby boomers now see-ing firsthand how feet change with age andhow time takes its toll.

“The same thing that happens to otherparts of the body happens to the feet,’’ saidpodiatrist Jason Hanft, DPM, medical direc-tor of South Miami Hospital’s Foot andAnkle Residency Program. “The productionof collagen slows and you lose elasticity, justas you do in your face and hands.”

Ultimately, your aging feet become

more sensitive to the outside envi-ronment. The skin no longerresponds as effectively to externaltraumas, such as pressure, abra-sions and cuts. It’s also more dis-posed to fungal problems andviral infections, such as warts.

“That once strong barrier nowhas a chink in its armor,” said Dr.

Hanft, who treats Ms. Alejandre’smother.

In addition, the “fat pad” or cush-ion on the ball of your foot gets thinner

with age, said Thomas San Giovanni,M.D., a Doctors Hospital orthopedic sur-geon who is a foot and ankle specialist.That cushioning functions as a shockabsorber when you walk.

“When you lose it, you can feel as ifyou’re walking on the bones,’’ he said.

Over-the-counter or prescription med-ications can typically handle the skin prob-lems. And corrective shoe inserts usuallycan alleviate the pain caused by the thin-ning “fat pad.”

Some foot problems are inherited,including bunions, the large bony bump atthe big toe joint. People aren’t born withthe problem; rather, they inherit the foottypes that are prone to developingbunions. High-heeled or ill-fitting shoescan irritate bunions, causing redness, painand swelling, but they don’t cause them,Dr. Hanft said.

The tendency to develop hammertoes,a toe that curls due to a bend in the middlejoint, is also inherited. So the condition

may occur despite wearing appropriatefootwear.

When bunions or hammertoes are sosevere they cause acute pain, surgery maybe necessary for relief. But often, correctiveshoe inserts, which can relieve foot prob-lems, and footwear wide enough toaccommodate bunions and high enoughto accommodate hammertoes are simplerand effective solutions.

Though you can’t stop aging, you cantake precautions to keep your feet in goodform. Wear properly fitted shoes with goodsupport and cushioning. To catch prob-lems early, make a daily foot inspectionpart of your routine, “like brushing yourteeth,’’ Dr. Hanft advised. Clean your feetthoroughly, including between the toes.And once a week spray your shoes with adisinfectant and let them sit for 30 min-utes to kill fungus. Staying active also canhelp promote healthy feet and keep themflexible.

As a young concert pianist, Bess Russi-nof Kronowitz worried more about herhands than her feet. Now 100, she sees Dr.Hanft for her foot care and follows hisadvice concerning hygiene.

“Even a little thing can become a bigthing if you don’t take care of it,’’ she said.“At my age, I feel very fortunate that I canstill walk on both feet.” — Liz Doup

Preventive care can soothe aging feet

10 R E S O U R C E

KEEPING BUSY Val Janik, a lively 93-year-old, says keeping busy keeps her healthy. One way shedoes that is by volunteering at Homestead Hospital’s Gift Shop — something she’sdone for 32 years. “I really enjoy interacting with our customers,” she said. “I don’twant to just sit and watch TV.” For information about volunteering at any BaptistHealth hospital, contact the hospital’s volunteer services department.

B

Senior{Focus

R E S O U R C E 11

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

Dance for the Health of It,Friday, June 17, 1-2 p.m.,Carol Kaminsky, instructor.

Ending Knee Pain,Tuesday, August 23, 7-8 p.m., Dr. Richard Levitt,orthopedic surgeon.

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

Exercises to Avoid Falls (in Spanish),Friday, June 10, 1-2 p.m., Lida Rivera-Perez, physical therapist.

Aging and Spirituality (in Spanish),Friday, July 22, 1-2 p.m., the Rev. Guillermo Escalona, chaplain.

Strike Back Against Stroke (in Spanish),Friday, July 29, 1-2 p.m., Dr. SergioJaramillo, neurologist.

Improve Your Vision With Cataract Surgery (in Spanish),Monday, August 29, 1-2 p.m., Dr. AriadnaGonzalez, ophthalmologist.

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

Living Well: Exercising for BetterHealth, Thursday, July 14, 7-8 p.m., Mary Desimone, exercise physiologist.

The ABC’s of IBS (Irritable Bowel Syndrome), Tuesday, July 19, 7-8 p.m.,Dr. Seth Rosen, gastroenterologist.

Is Your Diabetes Under Control? (in Spanish), Monday, July 25, 7-8 p.m.,Vivian Fernandez, registered dietitian.

Stroke: What to Do When It Strikes,Monday, August 1, 7-8 p.m., Dr. Italo Linfante, interventionalneuroradiologist.

Women’s Health ResourceCenter8950 N. Kendall Drive, Suite 105

What Is Minimally Invasive Heart Surgery? (in Spanish), Tuesday, June 21, 7-8 p.m., Dr. Niberto Moreno,cardiothoracic surgeon.

Vitamins and Your Health, Tuesday,July 12, 7-8 p.m., Julia Khalil, pharmacist.

Diabetes: Focus on Your Health,Saturday, July 23, 9 a.m.-12 noon, diabetes management lectures, nutrition,eye care, health and podiatry screeningsand exercise demonstrations.

Ageless Skin:What’s New inDermatology?Wednesday, July 27, 7-8 p.m., Dr. Deborah Longwill, dermatologist.

Surgical Treatments for Glaucoma (in Spanish), Monday, August 22, 7-8 p.m.,Dr. Carlos Buznego, ophthalmologist.

Stress Less: What to Expect From a Car-diac Stress Test, Wednesday, August 31,7-8 p.m., Dr. Alvaro Gomez, cardiologist.

Baptist Medical Plaza at Coral Gables10 Giralda Avenue

High Blood Pressure: It’s Not Just aNumber (in Spanish), Wednesday, June22, 7-8 p.m., Dr. Mario Almeida-Suarez,internal medicine.

Community Center at Ludovici Park 17641 Old Cutler Road Palmetto Bay Library, 2nd Floor

Vitamins: Clearing Upthe Confusion, Tuesday,June 7, 10:30-11:30 a.m.,Marie-Elsie Ade, pharmacist.

Meditating for Better Health,Tuesday, July 12, 10:30-11:30 a.m., Patricia Isis, art therapist.

Homestead Hospital975 Baptist Way

Diabetes: Focus on Your Health (inSpanish), Saturday, July 30, 9 a.m.-12 noon, diabetes management lectures,nutrition, eye care, health and podiatryscreenings and exercise demonstrations.

Ongoing ProgramsSHINE. Get help with Medicare andother insurance concerns. Free. Call 305-670-6500, Ext. 270, for anappointment with a bilingual counselor.

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

June, July & AugustIf you’re 55 or older, take advantage of the programs and health screenings offered by Baptist Health just for you. Programs are free (unless otherwise noted). Space is limited and registration is required for all programs. A tour of the host facility may follow. For programsin English, call 786-596-3812; for programs in Spanish, call 786-596-3814; or e-mail us at programs@baptisthealth.net. For more information on other Baptist Health programs, visit baptisthealth.net.

SeniorCalendar

‘Simply Spectacular!’ West Kendall

12 R E S O U R C E

est Kendall Baptist Hospital has everything you’d expect in a new facility —advanced diagnostic tools, a critical care unit packed with the latest technol-ogy, an emergency center equipped to handle 40,000 patients a year and careprovided by skilled, compassionate doctors and employees. But the first newnon-replacement hospital in Miami-Dade County in more than 35 years hasa few surprises, too. Opened April 27, West Kendall Baptist Hospital featuresroom service so that patients can eat when they feel hungry, bedside computerdocumentation in every patient room and numerous “green” advances like a

charging station for electric vehicles.Located off North Kendall Drive at 9555 SW 162 Ave., the $210 million hospital was built

on a 30-acre parcel of land largely in response to community demand. “Our neighborsinvited and encouraged us to build a hospital,” said Javier Hernandez-Lichtl, CEO. “Theywrote 4,500 letters in support of our application to the state, many of them telling stories ofhow long it took them to reach Baptist Hospital in congested traffic. It’s wonderful to beable to serve them now.”

In fact, weeks before West Kendall Baptist Hospital opened its doors, people werealready coming to the hospital, hoping to get care. Some were sick enough to have to makethe trek to Baptist Hospital via ambulance.

Something to celebrate!

The new West Kendall

Baptist Hospital is affiliated

with FIU's Herbert Wertheim

College of Medicine.

Moraima Lugo Morales and her husband, Ruben,attended the grand opening. “We live just a few milesaway and we have been waiting for this day,” she said.“We were here for the groundbreaking and we partici-pated in many of the community talks where we wereasked for our input. We are thrilled to have such an out-standing facility close to home.”

The hospital has 133 private patient rooms, a 24-hour emergency center with 34 private exam rooms foradults and children, outpatient surgery and diagnostics,inpatient medical and surgical services for adults andmaternity care. It already has approval from the state toadd beds when necessary for the fast-growing WestKendall community.

The Baptist Diagnostic Center located in the MedicalArts Building adjacent to the hospital offers CT, mam-mography, ultrasound, bone density scanning, X-ray,electrocardiogram and lab services.

Baptist Hospital Opens

R E S O U R C E 13

4,500 Letters received from residents insupport of building the new hospital

1,100+ Direct workers involved in constructing the hospital

18,000 Cubic yards of concrete used for construction

1,720,112 Feet of cable installed for computers and other technology (that’s enough to reach from Miami to Jacksonville)

900+* Employees working on-site

133* Inpatient beds

34 ER treatment rooms

100% Room service for meals

*Expected to increase with future growth.

By the numbers

Continued on page 14

14 R E S O U R C E

Baptist Health has implementeda number of “green” measuresat West Kendall Baptist Hospital.In fact, the hospital was built toLeadership in Energy and Environmental Design (LEED)standards and is awaiting itsfinal green-level rating. Here area few of the environmentallyfriendly features:

• Building placement and largewindows were chosen to useas much natural light as possi-ble.

• First hospital in Florida to offera charging station for electricvehicles.

• Preferential parking for hybridand other fuel-efficient cars.

• Dual-flush toilets, 226 in all (less water is used to flush liquid waste).

• Special white roofing productsused to reflect light and heat.

• Low-flow fixtures such asfaucets and shower heads.

• Construction debris was recycled.

• Recycled materials used in much of the furniture.

Going for the green

West Kendall Baptist Hospital is the first Baptist Health hospital with an aca-demic affiliation, housing an accredited family medicine residency program throughan affiliation with Florida International University’s Herbert Wertheim College ofMedicine. FIU students will become residents at the hospital when they graduate.Already, more than 100 of the hospital’s 500 physicians have teaching positions at themedical school.

“There is a shortage of primary care in South Florida and nationwide,” said BrianE. Keeley, president and CEO of Baptist Health. “Patients end up in the ER for evenminor illnesses. It’s much more expensive to be treated in an ER instead of in a doc-tor’s office or an urgent care center. As we train more family medicine physicians, thehealthcare needs of those in West Kendall will be better served.”

The hospital also is focused on patient- and family-centered care, said Mr. Hernandez-Lichtl. It is open to visitors around the clock, and features a philosophy ofinvolving the entire family in care decisions with the direction of the clinical staff.While some hospitals are difficult to navigate, West Kendall Baptist Hospital has afriendly environment. An information desk sits in the main lobby and one bank of ele-vators behind it leads to every patient area.

Built to withstand Category 5 hurricane winds, the hospital was also designed toLeadership in Energy and Environmental Design (LEED) standards. Even detailssuch as positioning the hospital to take advantage of natural daylight in order to useless electricity were taken into consideration. (See related article.)

“My family has always relied on Baptist Health hospitals,” said Ixamar Palumbo atthe grand opening. “But we live near 152nd Street, so this is far more convenient. Andit’s simply spectacular.”

For more information, go to westkendallbaptisthospital.com. — Adrienne Sylver

A spacious lobby awaits hospital visitors.

Continued from page 13

R E S O U R C E 15

Trumpets blared. Children reached new heights. And, in the end, fire-works exploded in gold, red and white in the night sky. It was all part of thecommunity grand opening celebration of West Kendall Baptist Hospital onSunday, April 17.

Approximately 10,000 people joined the fun, which included rides, bouncehouses, magicians, face-painting, a carousel and a climbing wall for kids.Bands entertained the crowd and Miami-Dade County Commission Chair-man Joe Martinez said, “It’s a beautiful hospital. Hopefully, we will neversee you here because that means you are healthy. But the people of WestKendall deserve the opportunity to have top-notch healthcare withouthaving to travel so far.”

Area residents got a sneak peek of the first floor of the hospital. “Thisis less than five minutes from our house,” said Jackie Blanco, who cameto the opening with her husband, Chris, and their 6-year-old daughter,Sofia. “It’s much more convenient. And it’s so nice.”

A grand,grand opening

FIU President Mark B.Rosenberg,West KendallBaptist Hospital Board Chair Tony Alonso,Miami-Dade County Commission Chairman Joe A. Martinez, and West Kendall BaptistHospital CEO Javier Hernandez-Lichtl

Here & There

16 R E S O U R C E

n January, after crossing the finish line of his first half marathon,Saad Ismail hugged his running partner, then cried.

“I couldn’t believe it,’’ he said. “Two years before that race, Iwas almost dead.”

In January of 2009, Mr. Ismail, a Coconut Grove financialadviser, carried 450 pounds on his 5-foot-9 frame and sufferedmultiple health problems related to his obesity.

That same month, Anthony Gonzalez, M.D., medical director ofSouth Miami Hospital’s Weight-loss Surgery Program (786-662-8745), performed gastric bypass surgery to help him lose life-threatening weight.

Today, Mr. Ismail weighs 175, having shed 275 pounds. The 55-year-old father and grandfather no longer takes medication for highblood pressure, diabetes, sleep apnea, asthma, depression, lowerback pain and plantar fasciitis. His waist shrank from 77 inches to 32.Once sedentary, he now runs and works out almost daily.

“The surgery gave me the chance to alter my life,’’ he said. “Ifeel so much healthier.”

Before surgery, Mr. Ismail interviewed eight or nine doctors,then chose Dr. Gonzalez. “He answered every question in detailand was straightforward and honest,’’ Mr. Ismail said.

Dr. Gonzalez explained that the surgery involves creating asmall pouch at the top of the stomach,which limits food intake, and attaching thesmall intestine to it. Food goes directly fromthe pouch into that portion of the smallintestine, bypassing most of the stomach.Dr. Gonzalez also emphasized that the sur-gery helps patients lose weight only if theyeat healthy and exercise afterward.

“There’s great success with bariatricsurgery but also failure if patients don’tchange their habits,’’ Dr. Gonzalez said.“Saad is dedicated and hard-working andthat’s the key.”

The Weight-loss SurgeryProgram uses a team approach,with psychologists, nutrition-ists, social workers, plastic sur-geons and physical and respi-ratory therapists working withpatients. The program also offersa monthly support group, whichMr. Ismail attends.

“It’s helpful, because forsuccess you must change yourattitude, and I did,’’ Mr. Ismailsaid. “I don’t diet. Now, this isjust how I eat.”

Several times daily, he consumes small portions of healthyfood: vegetables, fruits, whole grains, chicken and fish. No friedfood, sweets or alcohol. He also started exercising, increasing thetime and intensity as he shed pounds.

At first, he could walk only for 10 minutes a day around hisneighborhood. But as his fitness level improved, he wanted anew challenge and signed up for the ING Miami Half Marathon.With his friend and trainer Richard Desautels, he ran the 13.1-mile course in 2 hours, 21 minutes and 12 seconds. He finishedjust minutes ahead of Dr. Gonzalez who was running his firsthalf marathon.

During the run, Mr. Ismail found himself thinking: “Why did Ilet myself go?” He was lean and physically fit as a youth. But kneeinjuries ended his career as a professional soccer player in Ger-many by age 25. Over time, the pounds piled on.

“If there was a diet, I tried it,” he said. But he always regainedthe weight and added more.

Now at his goal weight, he’s training for more races and ulti-mately wants to run the Boston Marathon to mark the fifthanniversary of his surgery.

“I’m living proof,’’ he said. “You can change your life.”— Liz Doup

Man sheds 275 pounds, gains a new life

I

Saad Ismail gives a thumbs-up as he finished the half marathon last January.After losing 275 pounds, he's less than half his former self (see photo inset.)

aptist Health has been named one of the 2011 World’s MostEthical Companies by the Ethisphere Institute, a think tankdedicated to advancing best practices in business ethics,corporate social responsibility and anti-corruption and sus-tainability.

Ethisphere reviewed thousands of companies and chose 110businesses that surpassed their peers in corporate responsibility,including 43 organizations headquartered outside the UnitedStates. To evaluate the companies, Ethisphere looked at codes ofethics, litigation and regulatory infraction histories, investment ininnovation and sustainable business practices and corporate cit-izenship.

“Over the years, we have developed and nurtured a corporateculture of integrity,” said Brian E. Keeley, Baptist Health presi-dent and CEO. “We expect all employees to behave in a mannerthat reflects these high standards. Our volunteer Board mem-bers, who serve without compensation, agree to adhere to a rig-orous conflict of interest policy. Our pledge to honesty andintegrity is part of our commitment to excellence that results in

the high-quality care we deliverto every patient.” On average,Baptist Health hospitals scoremore than twice as high as otherhospitals in Miami-Dade andMonroe counties on numerousmeasures of quality compiled bythe U.S. government.

Approximately 14,000 employees work for Baptist Health atseven hospitals and numerous outpatient locations. A Code ofEthics manual serves as a standards guide, addressing issuessuch as how to report perceived ethical or legal violations andrestrictions on the acceptance of gifts and honorariums.

“We put our patients first, above all else, and we are committedto the core values of honesty, integrity and transparency,” said Mr. Keeley. “These are the cornerstones of our corporate culture.”

This is the fifth year Ethisphere has published its World’s MostEthical Companies list. Other winners include American Express,Adidas, Ford Motor Company and Starbucks. —Adrienne Sylver

or years, doctors have warned patients with pacemakers not to undergo an MRI for fear that the powerful magnet in themachine could interfere with the pacemaker’s operation, causing an irregular heart rhythm, burns from the electronic leadsor other problems. Today, there’s a new, MRI-safe pacemaker, and in April, doctors at Baptist Cardiac& Vascular Institute became the first in South Florida (and were among the first in the nation) toimplant the device in a patient.“This is groundbreaking technology,” said Efrain Gonzalez, M.D., medical director of electrophysi-

ology at the Institute and the doctor who performed the procedure. “MRI is becoming our imagingchoice for many, many diseases, and now we’re able to send our patients safely for the procedure.”

About 30 million MRI scans are done each year in the United States. Medical experts say that of the1.5 million Americans who have pacemakers, more than half will someday require an MRI because ofits ability to show detailed and clear images of soft tissues. MRI scans are used to diagnose many dis-eases including cancer and diseases of the liver, pancreas, kidneys, heart, brain and spinal cord.

Pacemakers are most commonly implanted to treat a slow or irregular heartbeat, congenital diseaseand congestive heart failure. The new device, developed by Medtronic, can be placed into “safe” modefor patients who need an MRI.

For 82-year-old Carmen Suarez, the new technology came just in time. “For the past three years, my heart has been gettingworse and worse,” she said. “Sometimes it pumps too fast, sometimes too slow. The doctors said I could not wait any longer toget a pacemaker. But I also have a brain aneurysm and they like to do an MRI every six months to make sure it has not gotten big-ger.” Now, Ms. Suarez can have both the pacemaker and the necessary brain scans.

“It’s exciting to be part of something that enables us to improve care for our patients,” said Ricardo Cury, M.D., medical direc-tor of cardiac imaging for the Institute.

The new pacemaker can be implanted in 30 to 45 minutes, the same time as required for the old technology. Usually,patients go home the next day. — Adrienne Sylver

R E S O U R C E 17

Baptist Health cited as ‘Most Ethical’

MRI-safe pacemaker a breakthrough

B

F

Efrain Gonzalez, M.D.

18 R E S O U R C E

Who’s Who of premier professionalathletes joined Baptist Health doc-tors, therapists, community leadersand others at the March opening ofDoctors Hospital Sports Medicine &

Rehabilitation in Coral Gables, an expan-sion of Doctors Hospital Outpatient Reha-bilitation Center.

The 10,000-square-foot facility featuresthe latest high-tech equipment and is twicethe size of the previous center, which islocated in the hospital. Doctors Hospitalphysical therapists treat patients recover-ing from injuries or surgeries of the knee,shoulder, foot and ankle and back, as wellas other orthopedic problems.

At the event, former Miami DolphinsDwight Stephenson, Dick Anderson and

Nat Moore joined New Orleans Saints line-backer Jonathan Vilma, Baltimore Ravensrunning back Willis McGahee, Detroit Lionsrunning back Kevin Smith, Miami Heat for-ward Udonis Haslem and Baseball Hall ofFame member Andre Dawson in viewingthe facility. Mssrs. Anderson, Vilma, McGa-hee, Smith and Dawson are among manypro athletes who have been treated by theDoctors Hospital rehab team, which haslong attracted outstanding athletes fromacross the nation.

“It was an honor for us to have themcome out and support us,’’ said EdGarabedian, a veteran physical therapistand Doctors Hospital’s assistant vice pres-ident, who oversees the center. “We areproud to be an elite rehab facility serving

the community with the latest equipment.People also come from out of the countryto get care here.”

The physical therapists, all with master’sdegrees or higher, emphasize manual ther-apy techniques and incorporate the Pilatesmethod, which uses a whole-bodyapproach to rehabilitation. A certified handtherapist is also available. Physical thera-pists and certified strength and condition-ing specialists offer assessments and train-ing for specific sports, including football,baseball, tennis, cycling and running.

The center, at 1222 S. Dixie Highway,offers easy accessibility and free parking.It’s open weekdays, 7 a.m. to 7:30 p.m. Formore information, call 786-467-5160.

— Liz Doup

APro athletes celebrate new rehab facility

READER WINS $1,000 Ofelia Rodriguez, who works the night shift at an animal hospital, was soundasleep when the phone rang with the news that she had won $1,000 in Resource’s website contest.

“I was thinking that it was a beautiful dream,” Ms. Rodriguez recalled. When it all sank in, “I wasspeechless.”

As required to be entered into the drawing, Ms. Rodriguez correctly answered all six questionsdesigned to test readers’ ability to use the Internet to learn about health issues. The contest was part ofthe cover article in the spring issue of Resource.

Entering the contest was doing what comes naturally to Ms. Rodriguez. “I always read Resource,”she said, “and the reason is because it’s very, very informative.”Ofelia Rodriguez

Here & There

Marking the opening of the new Doctors Hospital rehab facility were (left to right) Ed Garabedian, who oversees the center; pro athletes Kevin Smith, Udonis Haslem, Nat Moore, and Jonathan Vilma; hospital CEO Nelson Lazo; Willis McGahee and Dick Anderson. Team mascots (far right) tried out the new equipment.

R E S O U R C E 19

Life-preserving Lung Cancer SurgeryThursday, June 16, 4 p.m.

BaptistHealth.net (in English) � BaptistSalud.net (in Spanish)

Witness robotic surgery in action. Baptist Health Cardiac & Thoracic Surgical Group surgeon Mark Dylewski, M.D., will use the da Vinci robot toperform surgery to treat early-stage lung cancer.

The surgery is minimally invasive. That means shorter recovery time, allowing the patient to resume a normal lifestyle more quickly, with lesspain. In addition to the surgery itself, you’ll hear from a patient who has previously undergone the procedure.

Join the webcast, presented in English and Spanish, and prepare to be fascinated.

Grab your mouse. Prepare for surgery.

Thoracic surgeon Mark Dylewski, M.D. U.S. 1 and SW 62 Avenue

HAVE DIABETES? JOIN US!A free half-day program covering avariety of topics to help you managediabetes is planned by Baptist Health.The program will be offered in Englishon July 23 at the Women’s HealthResource Center in Baptist Hospital’sMedical Arts Building, and in Spanishon July 30 in the Homestead Hospitalauditorium. The program begins at 9 a.m. both days and will featurephysicians, diabetes educators andnutritionists who will discuss ways tokeep your eyes healthy, tips for ahealthy diet and ways to manage thedisease. There will be exhibits, fitnessdemonstrations and free screeningsfor glucose (blood sugar), foot checksand body fat analysis.

Space is limited and reservationsare required. Call 786-596-3812 toreserve your space for the Englishprogram. Call 786-596-3814 to RSVPfor the Spanish program.

Free oral cancer screeningsOral cancer may not be something that you think about, but it’s a cancer that’son the rise. “It’s usually not difficult to diagnose, but frequently goes unnoticeduntil after the cancer has spread,” said oral surgeon Joseph McCain, DMD, chairof Baptist Hospital’s Head and Neck Cancer Support Team.

That’s why Dr. McCain and other oral surgeons are offering free oral cancerscreenings on Thursdays, June 16, July 21 and August 18, 6:30-7:30 p.m., at thehospital’s Radiation Oncology Department.

Oral cancer has a good prognosis if caught early. It includes cancers of the lips,tongue, cheeks, floor of the mouth, hard andsoft palate and the throat. Risk factorsinclude tobacco use, excessive consumptionof alcohol, a family history of oral cancer andfrequent sun exposure. Historically, the dis-ease has occurred mainly in those over age50, but in recent years, younger non-smokersincreasingly have been diagnosed. It’sbelieved that infection with the sexuallytransmitted human papillomavirus (HPV) isthe culprit in this younger age group.

Symptoms of oral cancer include a whiteor red patch in the mouth or a small ulcer that does not heal. It’s important tohave any sore or discolored area of the mouth that does not heal within 14 daysexamined by a health professional. Other symptoms are a lump inside themouth or in the neck; pain or difficulty swallowing, speaking or chewing; andhoarseness or numbness in the mouth or face.

To register for the screening, call 786-596-5539. —Phyllis Teitelbaum, R.N.

14-year-old Bolivian girl is tak-ing her first steps in four yearsthanks to an intricate procedureto treat a tangle of blood vesselsthat had grown and wrapped

dangerously around her spinal cord.Doctors in Bolivia and elsewhere hadtold Maria Choma and her family thatthe arteriovenous malformation(AVM) was inoperable, that it couldbleed and cause her death and thatshe definitely would never walk again.Fortunately, Italo Linfante, M.D., med-ical director of interventional neuro-radiology for Baptist Hospital’s Neu-roscience Center, suggested a newapproach.

“An AVM is basically a ticking timebomb,” Dr. Linfante said. “It has thepotential to burst at any moment,often resulting in death. Surgery wasn’tpossible in Maria’s case due to the sizeand location of the AVM deep withinher spinal cord.”

Although Dr. Linfante had littlehope that Maria would regain thefunction of her legs because of the sig-nificant spinal cord damage she suf-fered, he decided to proceed in anattempt to save her life.

In January, Maria came to the hos-pital thanks to the efforts of a mis-sionary who was helping the family. In a four-and-a-half-hourprocedure, Dr. Linfante threaded a catheter not much wider thana human hair into a tiny incision in Maria’s groin and up throughan artery to the AVM in her spine. There, he injected a glue-likesubstance called Onyx that successfully blocked the blood supply.

A day after surgery, Maria began to feel her legs for the firsttime in four years; 10 days later, she took her first tentative stepswith the support of parallel bars. In March, Maria returned for asecond procedure to block off more of the blood supply to theAVM. She is now standing unsupported and is able to walk shortdistances with a walker.

“That my daughter can walk is truly a miracle,” said hermother, Marciana Guasase.

“I would like to play soccer and ridemy bike again,” Maria said from herwheelchair.

Because the AVM compressed thespinal cord and damaged nerve tissuefor so many years, it’s uncertain ifMaria will accomplish her goals. “HerAVM was very large and was beginningto cause weakness in her arms,” Dr.Linfante said. “I wasn’t certain she’dwalk at all. But when I saw her stand-ing without support, it gave me greathope.”

AVMs can appear anywhere in thebody. Sometimes they cause no harmand doctors simply monitor theirgrowth. “AVMs in the central nervoussystem — the brain and spinal cord —are particularly ominous because ofthe chance of rupture,” Dr. Linfantesaid. Doctors can use a similar glue-like substance to treat AVMs in thebrain.

Maria was only a few months oldwhen her parents noticed what theythought was a small birthmark on herback. They saw, however, that it pul-sated with each heart beat. Her raretype of AVM was congenital, meaningit formed while she was still in thewomb. As the years passed, althoughMaria grew, walked and played like any

other child, the AVM also grew. By about age 10, she could nolonger walk. Eventually, she couldn’t even sit upright.

“Her quality of life had deteriorated to the point where herparents had to carry her,” said Beverly Smith, the nurse and mis-sionary who helped get her to Miami for care. “In their tiny, remotevillage, she would lay in a hammock while they worked.”

Maria, an 8th grader, faces months of physical therapy to learnto walk again. She must rebuild muscle strength in her legs andcore, and regain the stamina required to support herself. Becauseshe is still growing, there’s a chance she may need another proce-dure in the years ahead, Dr. Linfante said.

But for now, “I am happy to be more independent,” Maria said. — Adrienne Sylver

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AParalyzed teen regaining ability to walk

Physical therapist Sandy Malek guides Maria Chomaas she uses a walker to take some steps.

20 R E S O U R C E