Time ou t for
SPRING 2013
Pilates
N o t j u s t fo r we i g ht los s
page 13
In this issue
G i r lf ri e nd’s c l u b
te e s of f
roa d to
f itne ss
In this issue
4
5
9
14
Girlfriend’s
Club third
annual Golf
Clinic
Holy Cross
Hospital
Golf Classic
was a huge
success
Bring your
heart back
to its regular
beat
Women’s
health:
Complete
care in one
place
Time out for
SPRING 2013
Time out for Women is published as a community service for the friends and patrons of:
Holy Cross Hospital
4725 North Federal Highway
Fort Lauderdale, FL 33308
Patrick Taylor, MD, President and CEO
Luisa Gutman, Vice President and
Chief Operating Officer
Christine Moncrieffe, Director,
Marketing and Public Relations
Carmina Zamora, Editor
Information in Time out for Women comes
from a wide range of medical experts. If you have
any concerns or questions about specific content
that may affect your health, please contact your
healthcare provider. Models may be used in photos
and illustrations.
Copyright © 2013
Coffey Communications, Inc.
CUM29233
2
Time Out for Women
From
the CEO
Patrick Taylor, MD, Holy
Cross Hospital President
and CEO
To the women
in our community,
Welcome to our first edition of
2013!
We are excited to see so many
things come to fruition after the
opening of the Patricia R. Guerrieri Pavilion, the final phase of the
Dorothy Mangurian Comprehensive
Women’s Center (more on pages 14
and 15). The Art Gallery debuted
in December with an exhibition by
Wilma Bulkin Siegel, MD, (more
on page 11), local groups have been
utilizing the fantastic community
education rooms, and our café is up
and running!
Fundraising for the Center is also
back in full swing with Women
Owning Wellness (WOW!). Their
most recent event, “Think Pink
Basketball,” has partnered the Center
with Miami Heat basketball star
Mario Chalmers (more on page 8).
WOW! is also providing muchneeded volunteers for our Women’s
Center. If you are interested in volunteering at the Center and joining
WOW!, please call 954-229-8562.
Doreen Koenig, Dorothy
Mangurian Comprehensive
Women’s Center Community
Leadership Chair
In this issue, you’ll also read more
about:
✓✓The road to fitness (page 3).
✓✓The Girlfriend’s Club Golf Clinic
(page 4).
✓✓The Holy Cross Hospital Golf
Classic (page 5).
✓✓Stereotactic breast biopsies (page 6).
✓✓Women: Three O’s to watch out
for (page 7).
✓✓The Holy Cross Hospital Auxiliary’s Epicurean Escapade (page 8).
✓✓Electrical disorders in the heart
(page 9).
✓✓Fibromyalgia (page 10).
✓✓Celiac disease (page 12).
✓✓Pilates-based physical therapy
(page 13).
Please stop by the café at the
Patricia R. Guerrieri Pavilion and let
us know what you think!
Warmly,
Patrick Taylor, MD
Doreen Koenig
The
road to
fitness
By Nelly M. Drevet, NSCA-cpt,
Personal Trainer, Holy Cross
Zachariah Family Wellness Pavilion
As a personal trainer,
I repeatedly hear people (in the street,
at the gym, my clients) saying,
“I used to be fit,” “I used to be an
athlete,” or “I used to eat healthy.”
Most of the time, I get the same question: “How do I get my health back?”
Being proactive is the best way to
reach your goals and change the way
you see yourself. My Fitness Result
Triangle consists of simple steps that
will lead you to your better self.
The Fitness Result Triangle
combines three factors that work
together to get the job done. Simple
changes in your lifestyle hit the
jackpot of getting your health and
well-being back!
1. Be active.
2. Eat healthy.
3. Keep it up.
Be active
Engage in physical activity—
cardiovascular, strength training and
stretching—every day for 30 minutes
with a moderate load.
Cardiovascular exercise will train
the heart by:
✓✓Improving your stamina.
✓✓Improving your VO2 max (your
maximum oxygen consumption).
✓✓Lowering your resting heart rate.
At the same time, cardio exercise
will lower your body fat percentage
(25 percent is considered healthy)
and drop your clothing size.
Strength training (also known as
resistance and functional training)
will:
✓✓Improve your lean body mass
(LBM).
✓✓Increase your basal metabolic
rate, allowing you to burn more
calories at rest.
✓✓Increase your strength by building
Wellness
muscle so that you
can lift more and
shape your body
to look good.
✓✓Improve your bone
structure (bone
mineral density— Nelly M. Drevet,
NSCA-cpt.
BMD) to prevent
Personal Trainer
the formation of
Zachariah Family
Wellness Pavilion
osteoporosis.
✓✓Improve your
motor skills, agility and handeye coordination in your favorite
sports, like golf, tennis and
kayaking.
Stretching will improve:
✓✓Your flexibility—your body will
be more limber and less prone to
injury.
✓✓Your state of mind—when you
relax your body structure, it’s
easier to rest your mind.
Eat healthy
Eat a variety of nutritious foods
and drink water to obtain the proper
nutrients and energy. Good nutrition
will improve your overall well-being.
Consume foods that contain nutrients such as protein, carbohydrates
and fat (calorie-dense foods versus
empty calories).
Vitamin and mineral supplements
can help, but food is the best source.
Keep it up
The key to success is consistency.
Healthy habits are created and maintained by incorporating them into
your lifestyle. ❧
The best way to train safely and
effectively is to hire a personal
trainer, a specialist who will design a
program to fit your needs. To begin
your journey to fitness, make an
appointment with Nelly Drevet by
calling the Zachariah Family Wellness
Pavilion at 954-229-7950.
www.holy-cross.com
3
Community giving
1
Girlfriends
2
3
4
5
6
4
Time Out for Women
for third
annual
Golf Clinic
On Thursday, Jan. 24, Coral
Ridge Country Club hosted more
than 30 Holy Cross Hospital
Girlfriends and their friends for
golf, lunch and laughter. The
third annual event included a golf
lesson from Dolph Roder on the
green and a delicious meal by Chef
Udo. The entire day was generously sponsored by Coral Ridge
Country Club.
The Club also hosted the
Harry T. Mangurian, Jr. Foundation Holy Cross Hospital Golf
Classic, sponsored by Stiles, on Feb.
6. The Golf Classic benefited the
Dorothy Mangurian Comprehensive Women’s Center at Holy Cross
HealthPlex. ❧
Pictured:
1. A golf lesson
2. From left, Doreen Koenig, Terry Skuse and Sheri Whittington
3. Girlfriends were shuttled to their golf lesson.
4. Girlfriends enjoyed lunch after the golf lesson.
5. Girlfriends group photo
6. Refreshments and chocolate-covered strawberries delighted golfers on the course.
Holy Cross news
From left, Steve Mehallis, Gordon Latz and Phil
Smith
From left, Kenny Stiles, Jorj Morgan, and Diana and
Stephen Shelton
From left, Gordon Latz, Sheri Whittington, Doreen
Koenig and Steve Mehallis
Celebrating
a great day
on the green
Marti Huizenga
2013 Holy Cross Golf Classic raises more than $100,000 for the
Dorothy Mangurian Comprehensive Women’s Center
The third annual Holy Cross
Hospital Golf Classic was once
again successful in raising more than
$100,000 for the Dorothy Mangurian
Comprehensive Women’s Center at
Holy Cross HealthPlex.
Presented by the Harry T. Mangurian, Jr. Foundation and title sponsor
Stiles Corporation, the Golf Classic
was held at Coral Ridge Country
Club on Feb. 6. Although no one drove
away with one of the four hole-in-one
opportunities to win a car from Phil
Smith Automotive Group, there were
prizes awarded in several categories:
✓✓Taking first place gross were Don
Whittington, Jeff Walker, David
Obst and John O’Brien.
✓✓Taking first place net were
John F. Shaw, John S. Shaw, Chris
Shaw and Nick Adams.
✓✓Making up the second place gross
were Doreen and Keith Koenig,
Ryan Cronin and Dale Hendricks.
✓✓Second place net went to Cathy
O’Connor, Corey Henry, Lou
Calisanti and Nettie Turbyfill.
The cocktail reception and dinner
following the tournament were the
perfect way for golfers to finish the
day and for nongolfers to support
the Women’s Center. Live music
was provided by the Jimmy Cavallo
Combo, and a spectacular buffet was
provided by Chef Udo. Guests also
had the opportunity to bid on silent
auction items and were treated to
renowned auctioneer Gordon Latz’s
live auction as well.
“The Holy Cross Golf Classic
is always a fantastic event for the
Women’s
Center,” says
Doreen Koenig,
Co-chair of the
tournament. “It is
not just a day of golf
but golf on a mission
for women’s healthcare in our community.
We are most grateful for
our wonderful committee,
generous sponsors, and
those organizations
and individuals who
donated to our
silent and live
auctions.” ❧
Phyllis
Thomas
Joyce Picou and Marge Neily
It takes a team…
Co-chairing the Holy Cross Golf
Classic with Doreen Koenig was Sheri
Whittington. Along with Monica
Maroone, they spearheaded the
Community Leadership Committee
for the Dorothy Mangurian Comprehensive Women’s Center. Committee
members are Lou Anderson, John
Caras, Jack Drury, Scott Fox, Susan
Holden, Gordon Latz, Lynn Mandeville, Steve Mehallis, Natalie Panajotov,
Nancy Reierson, Mary Lou Ruderman,
J. J. Sehlke and Phil Smith.
In addition to the Harry T. Mangurian, Jr. Foundation and Stiles
Corporation, sponsors of the Holy
Cross Golf Classic included Goldman
Sachs, Phil Smith, and Sheri and Don
Whittington.
www.holy-cross.com
5
Breast health
Meet our
radiologists
Amisha Agarwal, MD
Diagnostic Radiology
Hugh G. Jones, MD
Diagnostic Radiology
Howard A.
Rubinson, MD
Diagnostic Radiology
The evolving world
of breast biopsies
By Howard A. Rubinson, MD, Diagnostic
Radiology, Dorothy Mangurian Comprehensive
Women’s Center
The vast majority of women who
undergo a screening mammogram have a
normal study and return in 6 to 12 months for
follow-up. Only 2 percent are usually referred
for a biopsy.
Prior to the early 1990s, all biopsies were
performed in surgery, removing the part of the
breast that contained the abnormality. Surgery
could lead to diminished breast size and scarring, with the scarring sometimes simulating
signs of a malignancy. This then made it more
difficult to interpret future mammograms.
Things have gotten easier
Over the past 20 years, procedures have
changed, and now only a small number of
women have surgical biopsies. Stereotactic
biopsies (using mammographic guidance),
ultrasound-guided biopsies and MRI-guided
biopsies—collectively called image-guided
biopsies—have replaced surgical biopsies. The
newer methods have proven to be just as accurate but less disfiguring and less costly.
These procedures are all performed at the
Dorothy Mangurian Comprehensive Women’s
Center at Holy Cross HealthPlex and at
Holy Cross Hospital. All of these procedures
are accredited by the American College of
Radiology (ACR), and very few centers have
achieved this accreditation.
The ACR rigorously evaluates the equipment, technical personnel and physicians
before granting accreditation. The ACR
recommends that the biopsies be done at
accredited centers and that the mammograms
and ultrasounds leading up to the diagnoses be
performed at accredited centers as well.
To schedule an appointment for
women’s imaging with the ACR-accredited Dorothy Mangurian Comprehensive
Women’s Center, call 954-351-7800 or visit
www.HolyCrossWomensCenter.com.
6
Time Out for Women
What is the best kind of biopsy?
The type of biopsy a patient needs is usually
the choice of the radiologist and depends on
which modality best displays the abnormality.
The three types of image-guided biopsies are
technically similar:
✓✓They are done under local anesthesia.
✓✓The biopsy needles are similar.
All three procedures are extremely accurate—
we have successfully removed cancers as small
as 2 millimeters with the stereotactic biopsy.
And the biopsies result in few complications.
Some women develop hematomas, and fewer
than 1 out of 1,000 develop an infection.
The good news is that the majority of the
biopsies prove to be negative. In large part
because of annual screening, of those biopsies
that are positive, most are either noninvasive
or stage 1 cancer—
the earliest stage,
with the best
prognosis. ❧
Prevention
By Fernando Manalac, MD,
MMM, Sports Medicine
Specialist, Holy Cross
Orthopedic Institute
Jenny is a mom
whose morning
routine includes
biking or walking for
30 minutes, ironing
uniforms and packing
lunches for her children,
and getting dressed while
nudging her husband to
get up so that she can make
the bed.
She works at a packaging
company where she does her fair
share of lifting heavy boxes while
hoping to get through the day painfree. For years Jenny has endured
osteoarthritis, osteoporosis and
overuse injuries.
Osteoarthritis
Jenny wears a medial unloading
brace on her left knee, takes several
pills daily, and has undergone multiple
knee images and injections.
The problem. Osteoarthritis is
“wear and tear” degradation of a
joint. It commonly affects the larger,
weight-bearing joints, such as the
hip and knee; however, it can affect
medium and small joints of the
upper and lower extremities as well.
Prevention. Maintaining a healthy
weight, well-cushioned shoes and
doing non-weight-bearing exercises
are mainstays of
prevention.
Treatment.
Specific muscle
strengthening,
bracing, orthotics,
Fernando J.
Manalac, MD,
MMM
Holy Cross
Orthopedic
Institute
5597 N. Dixie Highway
Fort Lauderdale,
FL 33334
954-958-4800
Women:
Three
O’s to
watch
out for
Osteoarthritis,
osteoporosis,
overuse injuries
cortisone injections, joint conservation
and joint replacement surgeries are
just some of the common treatments.
Osteoporosis
Being in her late 40s, Jenny has
gone through menopause, and the
decrease in estrogen likely has facilitated progression to osteoporosis.
The problem. Osteoporosis, literally
meaning porous bones, is a disease that
affects two to three times more women
than men. It’s a condition in which
bones lose calcium content, thereby
becoming more apt to fracture.
Prevention. Some ways to help
prevent osteoporosis are eating a
diet rich in vitamin D and calcium,
engaging in weight-bearing exercises,
and consuming only a moderate
amount of alcohol.
Treatment. Treatment with medications includes, but is not limited to,
vitamin D and calcium supplements,
selective estrogen receptor modulators, and hormone replacement
therapy. Once a fracture
is diagnosed, it can be
treated by vertebroplasty
and kyphoplasty, which
are minimally invasive
procedures.
Overuse injuries
Jenny also has
overuse elbow injuries.
The problem.
Overuse injuries are the
result of repetitive stress
to the tendons, bones and
joints. Whether resulting
from working at a packaging
company, repeatedly picking up a
toddler, or cleaning the floor in the
home daily, overuse injury is likely to
occur at some point in life. Normal
daily movements can cause medial or
lateral epicondylitis (of the elbow),
rotator cuff tendinitis (of the shoulder),
De Quervain’s tenosynovitis (of the
wrist), patellar tendinitis (of the knee)
or Achilles tendinitis (of the ankle).
Prevention. Overuse can be
prevented with proper warm-up
and cool-down activities, allowing
the body to rest and recover. Simply
listening to your body is important.
Treatment. Treatment can include
anti-inflammatory medications,
activity modification, bracing, physical therapy and Platelet Rich Plasma
(PrP) injections, to name a few.
Control these problems
Osteoarthritis, osteoporosis and
overuse injuries are conditions that
women face daily. But these conditions should not keep them from
enjoying life. There is a common
denominator in controlling these
problems—healthy eating and
healthy living. If symptoms arise,
seek medical attention early. ❧
Sources
www.sportsmed.org/uploadedFiles/Content/Patient/Sports_
Tips/ST%20Overuse%20Injuries%2008.pdf
www.medscape.com/viewarticle/777867
http://emedicine.medscape.com/
article/330598-treatment#aw2aab6b6b2
http://emedicine.medscape.com/article/330598-overview
www.nof.org/learn/prevention
www.holy-cross.com
7
Fundraisers
Think Pink
Basketball
Women’s Center benefits from Miami Heat’s
Mario Chalmers fundraiser
The Mario Chalmers Foundation chose the Dorothy
Mangurian Comprehensive Women’s Center to benefit from its fundraising event, “Think Pink Basketball.” The event was held at Specialty
Automotive Treatments in Fort Lauderdale on Saturday, March 9.
The Mario Chalmers Foundation focuses on helping women
with breast cancer and offers low-cost accessories, like wigs,
cosmetics, bras and even prostheses, through Mario’s Closet.
Though he will always be remembered for making the miracle
three-point shot that propelled the University of Kansas Jayhawks
to the national title in 2008, the Miami Heat guard is now reaching
beyond basketball.
Chalmers says he always wanted to learn more about cancer
after his childhood friend lost his mother to breast cancer.
“I try to do my best on the basketball court so people will
remember me,” says Chalmers. “But off the court, I try to do as
much as I can, and it is important to help out the people who are
struggling with cancer.”
Proceeds from the event will be shared by the Dorothy Mangurian Comprehensive Women’s Center at Holy Cross HealthPlex
and the Mario Chalmers Foundation. ❧
Embark on an
Epicurean Escapade
The Holy Cross Auxiliary annual fundraiser
will be a Food and Wine Experience
Join the Holy Cross Hospital
Auxiliary for their annual fundraiser
on Saturday, April 13, at the Hyatt
Pier 66. “Epicurean Escapade: A
Food and Wine Experience” will
provide guests with excellent food,
wine, an open bar, live music and
more. The event will benefit the
Dorothy Mangurian Comprehensive Women’s Center at Holy Cross
HealthPlex.
The evening will begin with a
poolside cocktail party and live
music. As part of the fun, guests will
have a chance to bid on over-the-top
8
Time Out for Women
wine bottles.
There will be
a raffle for a
VIP table where
waiters will be
at the winners’
service and the
food and beverages will be unlimited.
After cocktails, the party will move
to the Crystal Ballroom where delicious food and wine pairings will be
featured. Dancing to the music of the
Jerry Wayne Band will be a highlight
of the evening. The Auxiliary is prom-
ising a truly spectacular night for its 400
expected guests.
Sponsors for the
event include the
Guerrieri Family
Foundation, JM
Family Enterprises,
the Medical Staff
of Holy Cross
Hospital, AutoNation, Sodexo, Nova
Southeastern
University, BDC
Advisors, Catholic
Health Services and
City Furniture. Several sponsorship
opportunities are still available. ❧
If you’d like to attend or
support the event or if you
need additional information, please
call 954-229-8562 or email
donations@holy-cross.com.
Heart health
Electrical disorders of the heart
By Daniel Weitz, MD, Clinical Cardiac
Electrophysiologist, Holy Cross Medical
Group
Have you been
told that you have
difficult-to-control
rapid heart rates?
Do you experience palpitations or
light-headedness?
Daniel Weitz, MD
These symptoms
Clinical Cardiac
all
might be from a
Electrophysiology
heart arrhythmia.
Holy Cross
There have been
Medical Group
considerable
advancements in diagnosing and
treating arrhythmia in recent years.
Arrhythmia
Arrhythmia is a condition in which
the electrical system of the heart
malfunctions. Because the heart is an
electrical-mechanical pump, electrical
disorders cause the heart to function
irregularly.
For example, if the heart’s electrical system has an interruption
in the normal connections, then
the heart beats too slowly. Luckily,
implanting a pacemaker can restore
the regular function of the heart.
The heart’s electrical system can
also have a malfunction that creates
a “short circuit” that causes very
rapid heart rates. Palpitations, lightheadedness, inability to exercise and
passing out all can be manifestations
of a short circuit in the heart.
Today, it is possible to cure such
conditions with safe and effective
procedures. In fact, many patients are
able to go home the same day.
Atrial fibrillation
Atrial fibrillation is the most
common electrical disorder of the
heart, affecting over 5.1 million people
in the United States. Disorganized
electrical activity causes irregular heart
beats that lead to blood pooling and
clotting, which can cause stroke and
other serious health issues.
People who have atrial fibrillation may have palpitations (a sudden
pounding, fluttering or racing feeling
in the chest), lack of energy, dizziness, chest discomfort, or difficulty
breathing during normal activities
or even at rest. High blood pressure,
coronary artery disease, heart conditions, obesity, sleep apnea and age are
all causes of atrial fibrillation.
At Holy Cross Hospital, we
specialize in diagnosing and treating
atrial fibrillation. If a physician
suspects that you may have this
condition, or if you have the symptoms mentioned above, an electrocardiogram (ECG) or a Holter
(24-hour ECG) can assist in making
the diagnosis.
Treatment options include medications, a cardioversion to shock the
heart back into a normal rhythm and
pacemakers to bring the heart back
to a proper rate. For those who are
very symptomatic, a catheter-based
procedure may be the best option.
Most important, if you are diagnosed with atrial fibrillation, ask your
doctor how you can reduce the risk
of stroke from atrial fibrillation.
Get expert help
If you experience the above symptoms, it may be time to speak to a
cardiac electrophysiologist. A cardiac
electrophysiologist specializes in the
electrical disorders of the heart. At
Holy Cross Hospital, we can make
the diagnosis and provide comprehensive treatment to bring your heart
back to its regular beat.
Holy Cross
Medical Group,
Cardiology Associates
4725 N. Federal Highway,
Suite 401
Fort Lauderdale, FL
33308
954-772-2136
www.holy-cross.com
9
Chronic pain
Understanding fibromyalgia
By Anele R. Manfredini, MD, Family Medicine and Women’s Health,
Holy Cross Medical Group
Anele R.
Manfredini, MD
Family Medicine/
Women’s Health
Holy Cross
Medical Group
Fibromyalgia is a chronic condition that
affects connective tissues, including the muscles,
ligaments and tendons. This condition causes
widespread muscle pain and excessive tenderness in many areas of the body, among other
symptoms.
In the United States, fibromyalgia affects about
2 percent of our population by age 20, which
increases to approximately 8 percent by age 70. It
is the most common cause of generalized musculoskeletal pain in women between ages 20 and 55,
and it is more common in women than men. ❧
causes
The cause of fibromyalgia is unknown, but
physical or emotional factors can trigger
symptoms. Although the pain is felt in
muscles and soft tissues, there are no visible
abnormalities at these areas.
Some people may have a genetic predisposition to fibromyalgia because of a heightened sense of pain. In other people, various
stressors, including infection, physical or
emotional trauma, sleep disturbances, or
other medical conditions lead to fibromyalgia.
The chance of developing fibromyalgia is
eight times more likely for family members
of a person with fibromyalgia compared with
the general population.
diagnosis
American College of Rheumatology
guidelines suggest that people with
fibromyalgia have pain in at least 11 of
the 18 tender points (see figure 1) when
a doctor applies a certain amount of
pressure, and that symptoms have been
present at a similar level for at least three
months. A diagnosis of fibromyalgia may
be made if the patient does not have
any other disorders that would otherwise
explain the pain.
Source: UpToDate. Patient Information: Fibromyalgia (Beyond the Basics)
10
Time Out for Women
figure 1
symptoms
➜➜Diffused, chronic and persistent pain is one of the symptoms.
It is a deep, muscular aching, soreness, stiffness, burning or
throbbing. Patients may experience numbness, tingling or
unusual “crawling” sensations in the arms and legs. The pain
can be aggravated by anxiety or stress, poor sleep, exertion
or exposure to cold. Muscle stiffness is often felt upon awakening and improves as the day progresses, but it can remain
throughout the day as well. Most feel pain in the neck, middle
and lower back, arms and legs, and chest wall.
➜➜Abdominal pain, diarrhea and constipation
➜➜Bladder pain and urinary urgency and frequency
➜➜Facial and jaw pain
➜➜Fatigue and sleep disturbances
➜➜Depression and anxiety
If you experience the above
symptoms of fibromyalgia, speak
with your physician or make an
appointment with Dr. Manfredini
Three medications are approved
by calling 954-229-8660 or
by the Federal Drug Administration
(FDA) for the treatment of fibromyvisiting www.HolyCross
algia: pregabalin (Lyrica), duloxetine
WomensCenter
(Cymbalta) and milnacipran (Savella).
.com.
treatment
Hospital happenings
Don’t
miss
the first
art exhibit!
Works by Wilma Bulkin
Siegel, MD, will hang in the
art gallery at Women’s
Center through June 2013
The Patricia R. Guerrieri
Pavilion, which recently opened
as the third and final phase of the
Dorothy Mangurian Comprehensive Women’s Center at Holy Cross
HealthPlex, has opened the first
exhibition in its art gallery.
“Portraits and Conversations:
Veterans Returning From Iraq and
Afghanistan,” an exhibition of works
by Wilma Bulkin Siegel, MD, brings
together paintings and discussions the
artist had with returning Gulf War
veterans. The exhibition will be on
view now through June, and admission is free.
“As a physician as well as an artist, I
use my education and my painting to
find ways of healing people,” Dr. Siegel
notes. “In whatever role I play, I wish to
have people think about their unique
place as individuals living amongst
each other.”
The gallery space and the exhibitions it will host are a great example
of how the Patricia R. Guerrieri
Pavilion addresses the physical and
Wilma Bulkin Siegel, MD, with
subjects Emmy and Steve Ligelkis
Emmy and Steve Ligelkis by Wilma Bulkin Siegel, MD
From left, Patrick Taylor, MD; Wilma Bulkin Siegel,
MD; Alan Guerrieri; Cathi Guerrieri; and Caroline
Koste
spiritual needs of women in the
community. The Guerrieri Pavilion
includes:
✓✓Community education rooms
for groups varying in size from
10 to 150 people.
✓✓A café and teaching
kitchen.
✓✓A medical spa.
✓✓Lifestyle counseling
rooms.
✓✓A volunteer office.
✓✓Additional physician
suites.
The $15 million
Women’s Center
is funded entirely
through philanthropy,
including a generous
$4 million gift from the
Guerrieri Family Foundation. The
55,000-square-foot Women’s Center
offers advanced breast imaging,
including digital mammography,
minimally invasive diagnostic procedures, stereotactic breast biopsy, bone
density studies and ultrasonography.
Guests view the artwork.
Patrick Taylor, MD; Wilma Bulkin Siegel, MD;
Sheri Whittington; and Doreen Koenig
The gallery is located in the
Patricia R. Guerrieri Pavilion at
the Dorothy Mangurian Comprehensive
Women’s Center at Holy Cross HealthPlex, 1000 N.E. 56th St. in Fort Lauderdale. Gallery hours are Monday through
Friday, from 10 a.m. to 5 p.m. For more
information, call 954-351-7800.
www.holy-cross.com
11
Celiac disease
May is National Celiac Disease Awareness Month
By Donald Brust, MD, Gastroenterologist
Celiac disease,
also known as gluten
enteropathy, is a
condition in which
the immune system
responds abnormally to a protein
Donald Brust, MD
called gluten. Gluten
Gastroenterology,
is found in wheat,
Holy Cross
barley and rye, as
Medical Group
well as many other
common foods, medications and
supplements.
With celiac disease, repeated exposure to gluten causes damage to the
small intestine. Normally, the small
intestine contains fingerlike projections, called villi, that allow it to absorb
digested food and nutrients. In celiac
disease, however, the villi become
damaged, and absorption is impaired.
Symptoms
While each patient has his or her
own unique spectrum of presenting
symptoms, some of the more
common include bloating, excessive
12
Time Out for Women
gas, abdominal cramping or discomfort, anemia, or weight loss.
Other symptoms may also occur as
a result of nutrient and vitamin deficiencies. In many cases, symptoms
are mild and even absent in the early
stages of the disease. Diagnosis
If your doctor suspects that
you have celiac disease, he or
she will likely perform a series
of blood tests to detect the presence of antibodies that occur in
response to the repeated exposure
to gluten-containing substances.
Over 90 percent of patients who
have untreated celiac disease will test
positive for one or more of these
antibody tests.
It is important that patients
continue to consume a normal, unrestricted diet prior to testing for the
presence of the antibodies. Consumption of a gluten-free diet prior to testing
can cause a false-negative test, resulting in
a delay of diagnosis.
If your blood test is positive, you
should undergo an upper endoscopy,
which allows your doctor to examine
the small bowel and obtain biopsies
to confirm the diagnosis. The test is
painless; in addition, patients do not
feel the effects of the biopsies after
they awake from sedation.
Treatment
Celiac disease is important to
treat for reasons that extend beyond
the resolution of symptoms. If left
untreated, celiac disease can progress
to become chronic ulcers of the small
intestine (ulcerative jejunoileitis) or
even lymphoma.
Treatment is relatively straightforward and involves avoidance of glutencontaining foods (a gluten-free diet).
Complete avoidance must be adhered
to, as exposure to even small amounts
of gluten can aggravate symptoms.
Checking periodic blood tests for
the continued presence of antibodies
in the patient’s bloodstream allows
clinicians to assess the effectiveness
of the patient’s diet. Over 70 percent
of patients will begin to feel better
within two weeks of starting the
gluten-free diet. ❧
Women’s health
Retraining your muscles
after pregnancy
Pilates-based Women’s Health physical therapy
By Beatriz Lizaso, MSPT, Women’s Health Rehabilitation
Services, Dorothy Mangurian Comprehensive Women’s Center
Every year, millions of women
deliver healthy babies and go on with
life as it once was before the pregnancy.
However, there are many who do not.
Some continue to have persistent lowback or pelvic pain, while others silently
live with urinary incontinence.
Pregnancy and delivery can significantly
Beatriz
Lizaso, MSPT
alter the anatomy and function of the
Women’s Health
abdominal wall and pelvic floor musculaRehabilitation
ture. Pregnancy is a major cause of pelvic
Services, Dorothy
floor dysfunction in women. With each
Mangurian
Comprehensive
additional pregnancy, there is greater risk
Women’s Center
of pelvic floor dysfunction. Pregnancy
places increased stress on the pelvic floor
throughout gestation, leaving the muscles fatigued and
weak, which can lead to urinary incontinence.
Vaginal birth can be traumatic to the pelvic region and
cause damage or tearing to the pelvic organs and muscles.
Such damage is a significant contributor to pelvic organ
prolapse. While most women experience a separation of
their abdominal wall (diastasis rectus abdominis) during
the third trimester of their pregnancy that closes naturally
in the early postpartum period (three months), some
women’s abdominal walls do not close in a timely fashion.
How can Pilates-based physical therapy help?
Core training
The word core refers to the area of the body between
the diaphragm and the pelvic floor. There are many
muscles that support this region, and in addition to the
pelvic floor and breathing diaphragm, the transversus
abdominis (deepest abdominal) and the multifidus
(deepest back muscle) are known to be key factors.
The Women’s Health Rehabilitation Services at the
Dorothy Mangurian Comprehensive Women’s Center
uses the Pilates repertoire on the Clinical Pilates Reformer
as a therapeutic exercise modality to safely and efficiently
train the core musculature.
We are passionate about empowering women, through
their pregnancies and postpartum experiences, to be
knowledgeable about the natural changes that occur
in their bodies. We want to help them increase their
body awareness to prevent future musculoskeletal
dysfunctions.
Body awareness
What is not normal?
✓✓Bulging of the abdomen during any exercise
✓✓Leaking urine or stool when there is a strong urge to go
✓✓Leaking urine, gas or stool with laughing, coughing,
jumping, sneezing, lifting, walking or running
✓✓Persistent back, pelvic, groin or abdominal pain
✓✓Pressure or bulging in the vagina or rectum
These symptoms are not considered normal following
the early postpartum period of three months. If you are
experiencing any of these symptoms, please discuss them
with your physician. ❧
Learn more about the Women’s Health Rehabilitation
Services at the Dorothy Mangurian Comprehensive
Women’s Center by calling 954-229-8685 or visiting
www.HolyCrossWomensCenter.com.
www.holy-cross.com
13
Women’s services
1
All-in-one
resource for women
The Patricia R. Guerrieri Pavilion opens its
doors at the Women’s Center
The third and final phase of
the Dorothy Mangurian Comprehensive Women’s Center at Holy
Cross HealthPlex was completed in
November 2012 with the opening of
the Patricia R. Guerrieri Pavilion.
Thanks to a generous $4 million gift
from the Guerrieri Family Foundation, the Guerrieri Pavilion offers:
✓✓Community education rooms for
groups varying in size from 10 to
150 people.
✓✓A café and teaching kitchen.
✓✓A medical spa.
✓✓Lifestyle counseling rooms.
✓✓An art gallery.
✓✓A volunteer office.
✓✓Additional physician suites.
“The Patricia R. Guerrieri Pavilion
is an amazing resource for the
women in our community,” says
Patrick Taylor, MD, Holy Cross
14
Time Out for Women
Hospital President and CEO. “As we
talked to women about our plans for
a women’s health center, it was clear
what they wanted. An educational
component, counseling rooms and
rehabilitative services all were important, and those are among the needs
we addressed in building the Patricia
R. Guerrieri Pavilion.”
The Guerrieri family was recognized for its support during a recent
reception to celebrate the opening.
“My family and I are privileged
and honored to be here to honor
the memory of our mother,” said
Michael Guerrieri, who spoke on
behalf of his father, Alan; his brother;
and three sisters. “Mom would have
been honored to have her name on
this facility.”
Guests were invited to tour the
55,000-square-foot Women’s Center,
which includes, in addition to the
Patricia R. Guerrieri Pavilion:
✓✓The Hudson Family Foundation
Physicians Suite.
✓✓The Jan Moran Reception Suite.
✓✓The Jeane M. Dorini Women’s
Imaging and Diagnostic Suite,
which serves as the nucleus of the
comprehensive center, offering
advanced breast imaging—including
digital mammography, minimally
invasive diagnostic procedures,
stereotactic breast biopsies, bone
density studies and ultrasonography.
✓✓The Marti Huizenga Meditation
Chapel and Healing Garden, available to patients for quiet reflection, meditation and prayer. It
also serves as a place of peace and
serenity away from the concerns
and worries of the day, which is
critical to healing.
Women’s services
3
2
4
5
6
“We are humbled by the support
from the Guerrieri family and our
other caring, compassionate donors,
including the Harry T. Mangurian, Jr.
Foundation, Jan Moran, the Huizenga Family Foundation, Jeane M.
Dorini, the Hudson Family Foundation, Holy Cross Hospital Auxiliary,
Girlfriend’s Club and our Reverence Wall donors,” says Dr. Taylor.
“Together we have built an extraordinary Women’s Center that promotes
women’s health in our community
and one that serves a woman’s
healthcare needs physically, emotionally and spiritually.”
The $15 million Women’s Center is
funded entirely through philanthropy,
including $1 million from 200 women
in the community who each pledged
$5,000 as lifetime, founding members
of the Girlfriend’s Club in support
of the Dorothy Mangurian
Comprehensive Women’s
Center.
Donor opportunities
are still available. For
more information, please call
954-229-8569 or email
donations@holy-cross.com.
Pictured:
1. The Guerrieri family
2. From left, Alan Guerrieri; Jan Moran; and Patrick Taylor, MD
3. Steve Mehallis and John Johnson
4. From left, Terry Stiles; Jamie Stiles; Jan Moran; Mike Maroone; Monica Maroone;
and Patrick Taylor, MD
5. From left, Monica Maroone, Doreen Koenig and Sheri Whittington
6. From left, Alan Guerrieri; Cathi Guerrieri; and Karan Munuswamy, MD
www.holy-cross.com
15
Nonprofit Org.
®
U.S. Postage
PAID
4725 North Federal Highway
Fort Lauderdale, FL 33308
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For a Holy Cross Medical
Group Physician Referral,
call 866-988-DOCS
(866-988-3627).
Girlfriend’s Club
events and happenings
➜➜April
13: Holy Cross Hospital
Epicurian Escapade benefiting
the Dorothy Mangurian
Comprehensive Women’s Center
➜➜July: New exhibition opening at
the Patricia R. Guerrieri Pavilion
Art Gallery
➜➜October: This One’s for the
Girls Luncheon