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Baptist Health South Florida Chairman of the Board, George Cadman III; President, Brian Keeley. Trustees: Tony Alonso, Calvin Babcock, Wendell Beard, James Carr, the Rev. William Chambers III, the Rev.
Baptist Health South Florida Chairman of the Board, George Cadman III; President, Brian Keeley. Trustees: Tony Alonso, Calvin Babcock, Wendell Beard, James Carr, the Rev. William Chambers III, the Rev. David Cleeland, George Corrigan, William Dickinson, Judge Robert Dubé, Herbert Greene, M.D., George Harth, Jay Hershoff, Charles Hood III, Norman Kenyon, M.D., the Rev. Richard Ledgister, the Rev. Wilner Maxy, Paul May, Arva Parks McCabe, the Rev. Dr. Marcos Ramos, Aida Shafer, Ronald Shuffield, Roberta Stokes, W. Peter Temling, the Rev. Tom Thompson, Bill Tillett, Scott Weston, the Rev. Dr. William White. Baptist Hospital of Miami Chairman of the Board, Calvin Babcock; President, Baptist Hospital Medical Staff, Eugene Eisner, M.D.; Chief Executive Officer, Bo Boulenger. South Miami Hospital Chairman of the Board, Judge Robert Dubé; President, South Miami Hospital Medical Staff, Rodney Benjamin, M.D.; Chief Executive Officer, D. Wayne Brackin. 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Directors of Affiliated Boards Yvette Aleman, Richard Alger, Dick Anderson, George Aronoff, Orlando Bajos, William Baldwin, James Barker, Rodney Barreto, Kerrin Bermont, Robert Berrin, Carol Berry, Marsh Blackburn, Bonnie Blaire, James Bokor, James Boruszak, Robert Breier, Bette Brown, Mita Burke, Oscar Bustillo Jr., Barbara Calev, Thomas Carlos, Willie Carpenter, James Carr, Susan Carr, Gerald Case, John Cassel, M.D., Ray Castellanos, Joe Catarineau, Mauricio Cayon, Barron Channer, John Chidsey, Carol Cianciolo, Pat Dahne, Xavier de Amezola, Denise Ehrich, Joyce Elam, Allan Feingold, M.D., Susan Gallagher, Augusto Gil, Robert Gintel, Gretchen Goslin, K. Lawrence Gragg, Michael Graham, M.D., Curtis Gray, David Hallstrand, M.D., Barry Halpern, M.D., Kent Hamill, Barbara Hanck, Dan Hanrahan, Carl Hanson, James Harris, Steven Hayworth, Sara Herald, Elizabeth Hernandez, Agustin Herran, Gerald Hirsch, Nathan Hirsch, M.D., Jacque Huttoe, the Rev. Dr. Gary Johnson, David Johnson, Thomas Jones Jr., S. Lawrence Kahn III, George Knox, Rudy Kranys, Manuel Lasaga, Katrina Lavene, Cynthia Leesfield, Maria Camila Leiva, Orlando Leon, M.D., James Loewenherz, M.D., Miriam Lopez, Bruce MacArthur, Joseph McCain, DMD, Derek McDowell, Stanley Margulies, M.D., Charlie Martinez, Jo McGregor, Lee Stapleton Milford, Hans Mueller, Patricia Mull, Thomas Murphy Jr., Ramon Oyarzun, Martha Pantin, Omar Pasalodos, M.D., Johanna Paterson, Alfredo Quintero, Ramón Rasco, Charlen Regan, Ian Reiss, M.D., Judge Bonnie Rippingille, Ron Robison, Domingo Rodriguez, Ruth Rosenberg, James Russell, Steven Sapp, Betty Schilling, I.E. Schilling, Aida Shafer, Emery Sheer, Steve Shiver, Ronald Shuffield, Paul Soulé, Karl Smiley, M.D., Patricia Stanley, Rene Taylor, Joseph Traina, M.D., Sats Tripathy, Wanda Trouba, Victoria Villalba, Warren Weiser, Lisa White, William Wilson, Leonard Zwerling, M.D. EDITOR Jo Baxter ASSISTANT EDITOR Patty Shillington ART DIRECTOR Elizabeth Lane Lawhorn CONTRIBUTING EDITORS Anne Streeter, Adrienne Sylver WRITERS John Fernandez, Amanda Gonzalez, Sheila Konczewski, Elizabeth Latta, Martha Martin, Jennifer Pages, Elizabeth Rosenthal, Bethany Rundell, Anne Smith, Phyllis Teitelbaum, Tanya Walton EDITORIAL ASSISTANTS Sheila Fyfe, Georgette Koch, Dee Moustakas, Barbara Moore, Laura Pincus, Dorothy Stein COVER PHOTOGRAPHY Mayra Fernandez, R.N. PHOTOGRAPHY Fareed Al-Mashat, Joshua Prezant, Mabel Rodriguez, Alex Van Clief TO SEND COMMENTS, ADDRESS CHANGES OR TO UNSUBSCRIBE, baptisthealth.net MRI magnetic resonance imaging is now recommended for annual screening of women at high risk for breast cancer, as well as for checking the opposite breast for women newly diagnosed with breast cancer. The American Cancer Society revised its screening guidelines to recommend an annual MRI, along with mammography, for women at high risk for breast cancer, starting at age 30. This includes women who have the BRAC1 or BRAC2 gene mutation, or who have a parent, child or sibling with the mutated genes; those who had chest radiation between the ages of 10 and 30 (such as for Hodgkin s disease); and those whose lifetime risk of breast cancer has been scored at 20 to 25 percent or greater, based on one of several risk assessment tools. (The average lifetime risk for a woman is about 12 percent.) The downside of MRI is that it s so sensitive, it can lead to false positive findings Women& Health MRI aids in finding breast cancer Quilt celebrates life A group of heart disease survivors spent two years sewing a 5-by-5-foot quilt that they presented to Baptist Cardiac & Vascular Institute. Aptly named Celebrating Life, the colorful quilt symbolizes the journey they have taken together one that includes heart attacks, angioplasties, surgeries and the search for knowledge about the unanticipated bond between them. Made by local members of Women- Heart: the Coalition for Women with Heart Disease, the quilt depicts women holding hands in a stand against the numberone killer of American women. It is on permanent display at the Institute. We made this quilt together in gratitude to Baptist Cardiac & Vascular Institute that can then lead to unnecessary biopsies, said Baptist-South Miami Regional Cancer Program cancer specialist Grace Wang, M.D. It s important for physicians to carefully select women who should be screened using MRI in addition to mammography. For women newly diagnosed with breast cancer, follow-up MRIs found cancers in the opposite breast that had been missed by mammography and other tests in about 3 percent of women participating in a recent research study. The study involved 969 women who had been diagnosed with cancer in one breast and cleared of cancer in the other breast. If cancer is found in both breasts at the time of the initial diagnosis (which happens in about 10 percent of women), it allows the woman to undergo a single round of treatment, instead of repeating treatment if cancer in the opposite breast is discovered later, Dr. Wang said. Phyllis Teitelbaum for getting us back on our feet, said Susan Yaskin, a survivor of quadruple bypass surgery who began sewing the quilt with fellow members in early Quilters also included Donna Wagner, Rita Hess, Gloria De Casenave, Carol Rhinard and Ann de Velasco,R.N., a heart attack survivor and Institute nurse. The group meets monthly at the Institute, which provides guest speakers. WomenHeart works to improve quality of life and healthcare through early detection, accurate diagnosis and proper treatment, and to provide a support network for women with heart disease. For more information, call Jennifer Pages Fibroid treatment has long-term benefit Anonsurgical method to treat fibroid growths in the uterus has proved successful in the long term, minimizing symptoms such as pain and bleeding, and improving women s quality of life, according to a new study. Fibroids are noncancerous growths that affect up to 40 percent of women over age 35. Until several years ago, the only option was surgery, either removal of the uterus (hysterectomy) or of the fibroids (myomectomy). The lessinvasive treatment, called uterine fibroid embolization, blocks blood flow to the fibroids, causing them to shrink. James Benenati, M.D., medical director of Baptist Cardiac & Vascular Institute s peripheral vascular laboratory, coauthored the study that followed 102 women at four locations for three years after their fibroid embolization. The study was published in the Journal of Interventional and Vascular Radiology. It found that at the three-year mark, 83 percent of James Benenati, M.D., follows up with Lorie McLuskey, one of the first patients to receive uterine embolization. women had great or moderate improvement in pelvic pain and 84 percent were still moderately or very satisfied with the procedure. Only 2 percent still experienced heavy bleeding. Since little has been known about the long-term results of fibroid embolization, some physicians have questioned whether symptom relief lasts long enough to make the procedure worthwhile for most women. This study looked at the patients outcomes three years after their procedure and found that uterine artery embolization has great longterm lasting effects on both the symptoms and quality of life for the patients, Dr. Benenati said. It has proven to be an excellent alternative to surgery for fibroids. Lorie McLuskey, one of the first patients to be treated with embolization at the Institute, is doing well eight years later and has remained symptom-free. When women tell me that they need to have a hysterectomy due to fibroids, I always tell them to look into the less invasive procedure first, Ms. McLuskey said. Institute physicians have performed more than 500 embolization procedures since For a referral to a physician who does uterine fibroid embolization, call Baptist Health s Physician Referral Service at Anne Smith and Patty Shillington CT scan for lung cancer:mixed results Does finding lung cancer early with a CT scan save lives? The verdict is still out on this question, as two recent studies had conflicting results, said Jack Ziffer, M.D., Ph.D., chief of radiology at Baptist Hospital. The spring issue of Resource reported on the first study from the New England Journal of Medicine. A statistical model projected that 88 percent of people treated for early stage lung cancer found in CT screenings would survive at least 10 years much longer than current survival rates. However, a new study reported in the Journal of the American Medical Association found that the imaging test doesn t save lives by finding lung cancer early; it may even be harmful by leading to unnecessary surgery. Unfortunately, neither of these studies gives us the final answer as to whether patients live longer by identifying lung cancers while they are small, Dr. Ziffer said. The problem with lung cancer is that despite the small size of the lesions with screening, the spread of the disease may have already occurred. Only when we have the results of a randomized clinical trial, with people assigned to either have lung CT scans or not, will we know the real value of this test, he added. That study is being done by the National Institutes of Health, with results expected in Dr. Ziffer recommends talking with your doctor to determine if you should have a lung CT scan. Anne Streeter RESOURCE 3 NEW WARNINGS FOR SLEEPING PILLS The Food and Drug Administration recently ordered the makers of 13 common sleep medications to add label warnings about unusual side effects. The agency issued the order after reports of complex sleep-related behaviors, such as sleep-driving, making phone calls, eating and cooking, and even painting the front door after taking a sleeping pill. The people had no memory of the events. Though several new sleeping medications have been approved for long-term use, sleeping pills are generally recommended only for the short term. Sleepless insouth Florida If your eyelids get heavy reading this, you re probably like a majority of Americans: You re not getting enough sleep. Perhaps sleep is not high enough on your priority list, or maybe your list of things to do replays in your head when you re finally in bed. Maybe your eyes pop open at 4 a.m. from a hot flash, a hungry infant or a private worry. Perhaps depression, restless legs syndrome or some other medical condition robs you of quality shut-eye, as is true for millions of Americans. Or if you re older, your sleep is less restful, a reality of aging. Insomnia occurs for many reasons, some of them biochemical, some of them psychiatric, said Rodney Benjamin, M.D., medical director of the Sleep Diagnostic Center at South Miami Hospital. Whatever the causes, the result is clear: There are a lot of sleepy people out there, said Jeremy Tabak, M.D., medical director of the Sleep Diagnostic Centers at Baptist, Baptist Children s and Mariners Hospitals. People like to get by with less sleep than they need. It s scary. We are wired to sleep at night. Cycles of slowwave, or deep sleep, and REM (rapid eye movement), or dream sleep, are repeated through the night, offering rest and allowing the brain to process memory. In the morning, light enters the brain through the eyes, hitting a group of cells known as the suprachiasmatic nucleus, which sets the body s internal clock to a day-night schedule. The early to bed, early to rise thing is true, Dr. Benjamin said. Our physiology functions best when we are in sync with the day-night cycle. Still considered a luxury by some, a decent night s sleep (typically seven to eight hours) plays an essential role in health and well-being, as well as the safety of society. Studies testing drivers reflexes show that getting behind the wheel in a sleepdeprived state is akin to driving drunk. Sleepiness was a human-error factor in the Challenger shuttle disaster, the Exxon Valdez oil spill and the nuclear accidents at Chernobyl and Three Mile Island. The personal consequences also can be severe. New research links long-term sleep debt to a range of serious health problems, and even death. The predominant sleep disorder, sleep apnea, is as much a risk factor for heart disease as high blood pressure. It s a huge cardiac issue, Dr. Benjamin said. I think a lot of sudden, unexplained deaths during sleep are apnea-related. Characterized by repeated breathing interruptions during sleep, when excess throat tissue collapses and blocks the airway, sleep apnea has been connected to a heart rhythm disorder called atrial fibrillation. If you don t correct the apnea, Dr. Benjamin said, you can t correct the atrial fibrillation. Sleep debt also is associated with obesity and diabetes. When sleep-deprived, Dr. Tabak said, you are hormonally stimulated to eat more. In the National Sleep Foundation s 2007 Sleep in RESOURCE 5 SO YOU WANT A GOOD NIGHT S SLEEP? The first attempt at treatment for insomnia and for night-shift workers is sleep hygiene, habits to promote healthy sleep. If followed, they usually work. Here are some tips on getting a good night s sleep:» Go to bed and wake up at about the same time every day.» Avoid caffeine and alcohol for several hours before bedtime.» Establish relaxation rituals before bedtime, such as deep breathing, listening to soft music or taking a warm bath.» Exercise daily, but not within a few hours of bedtime.» Avoid naps longer than 30 minutes.» Get some sunlight or get near a bright light shortly after awakening, and keep your bedroom dark when sleeping. This helps set your biological clock.» Check your iron level. Women with low iron have more trouble sleeping, so consider a supplement, if necessary.» Don t use your bedroom for anything other than sleep or sex. That means no TV or reading in bed. Keep the room cool.» Hide your clock. Watching the clock adds stress and worry, making it harder to sleep.» Eat a snack before bedtime, such as peanuts or milk (which contain the sleep-inducing amino acid tryptophan), but avoid a large or heavy meal.» Head for the bedroom when you re sleepy not before or after. Jeremy Tabak, M.D. Steven Turpin, M.D. Rodney Benjamin, M.D. America poll of women, 67 percent reported frequent sleep problems. The study concluded that lack of sleep diminished every aspect of a woman s life. The sleepless saga of part-time teacher Mikki Feinberg is typical. For years the Miami native was kept awake by her husband s snoring, until he was diagnosed with sleep apnea and successfully treated with a CPAP machine (short for continuous positive airway pressure ). These days, Ms. Feinberg is often working on projects for her kids school late at night, and is jarred awake before dawn either by her earlyrising son or her perimenopausal hormonal shifts. She yawns her way through the day. I didn t used to be like this, Ms. Feinberg said. I just figure when my kids are older and I m older it will change. In her family practice, Baptist and South Miami Hospital physician Marcy Galinsky, M.D., is on the front line of sleep medicine, a multidisciplinary field of pulmonologists, neurologists, psychiatrists, ear, nose and throat doctors, Ph.D. researchers and cardiologists. She hears frequent complaints about sleep. People often are trying to do too much, she said, recalling a teen who wondered why she was tired after getting only a few hours of sleep. It doesn t take a medical degree to figure that out. Some children diagnosed with an attention deficit disorder actually have been found during a sleep study at Baptist Children s Hospital to have a sleep problem. Kids act differently than adults when they are sleep-deprived, Dr. Tabak said. The good news is that insomnia is often no medical mystery, and most people willing to change their sleep habits and practice sleep hygiene get relief (see related article). Cognitive-behavioral therapy for insomnia also has proved successful in studies, especially in older people. In short-term therapy, people are taught to think differently to try to stay awake instead of sleeping, for example, and to restrict sleep following a night of insomnia. And sleep apnea, the predominant sleep disorder affecting 12 million Americans, also can be very effectively controlled once diagnosed by using a CPAP mask to keep the throat open during sleep. Occasionally, surgery is effective. Now that it s becoming clear how crucial sleep is to health, Dr. Tabak said, the question, How are you sleeping? really should be part of every routine medical exam. Patty Shillington WHO NEEDS A SLEEP STUDY? Most people with insomnia do not need a sleep study, or polysomnogram. But when loud snoring is present or breathing problems are suspected, or if other treatments for insomnia have proved ineffective, your doctor may prescribe a sleep study. About 240 sleep studies are done each month at Baptist Health s four Sleep Diagnostic Centers. The new Homestead Hospital features an expanded Sleep Diagnostic Center, overseen by medical director Steven Turpin, M.D. Designed like a hotel, the center has three private rooms, each with a full private bathroom. More than 90 percent of the studies confirm sleep apnea. During overnight sleep studies, a patient s brain waves, breathing, oxygen levels and muscle movements are monitored by a computer. If you need a physician who specializes in sleep, call the Physician Referral Service at or visit 6 RESOURCE SeniorCalendar June, July & August If you re 55 or older, take advantage of the programs and health screenings offered by Baptist Health. While most programs are $5, people 55 and older attend free, unless otherwise noted. Registration is required for all programs, including those that are free. Call For Spanish programs, call For more information on other Baptist Health programs, visit Baptist Medical Plaza at Doral 9915 NW 41 Street, Suite 210, Health Resource Center Treating Balance Disorders and Dizziness (in Spanish), Thursday, June 14, 7-8 p.m., Flavio Leite and Jussara Fleury, physical therapists. Putting Insomnia to Rest, Tuesday, June 19, 7-8 p.m., Dr. Timothy Grant, neurologist. The Latest in Carotid Artery Procedures (in Spanish), Wednesday, July 11, 7-8 p.m., Dr.
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