jackson health system

your resource for health and well being � november 2009

ask the doctor about fibroids � surgery with less pain & quicker recovery

Wiido rehab

plus:baby’s life

savedbefore birth

close-up

Straight tothe Top

WHEN ENEIDA O. ROLDAN, M.D., M.P.H., M.B.A.,was named president and chief executive officer ofJackson Health System earlier this year, it broughther full circle, back to the institution that hasplayed an important role in shaping her medicalcareer. Before taking the helm of one of the nation’smost comprehensive health systems, Dr. Roldanwent through medical residency training at JacksonMemorial Hospital. Her husband was also a medicalresident at Jackson and even proposed to her on thehospital’s campus.

“Back then, I never would have imagined I wouldbe leading this great institu-tion one day,” she said.

Dr. Roldan, who is the firstHispanic CEO of Jackson, wasborn in Cuba and came toMiami when she was 2 yearsold. Since then, she has calledSouth Florida home.

After earning her medicaldegree, Dr. Roldan had asuccessful private medicalpractice for 12 years and thenwas chief executive officerof Metropolitan Hospital ofMiami (formerly Pan AmericanHospital) during a time whenit faced bankruptcy and otherfinancial hurdles. Under herleadership, the hospital

became more lean, efficient and profitable.Dr. Roldan joined Jackson in 2008 as senior vice

president, associate chief medical officer and chiefadministrative officer of Jackson Memorial Hospital.After the former president and chief executiveofficer left the health system, a selection committee

BY KATHLEEN ROHAN

performed a national search for a new leader anddecided she was the best person for the job.

Dr. Roldan spent the first 100 days of her tenureevaluating the system’s financial health in order toformulate a strategic plan for its future. Her maingoals include making sure Jackson is financiallystable and efficient, strengthening profitable servicelines and changing the community perception thatJackson only offers life-saving care.

“At Jackson, we offer almost all medical special-ties for every member of the family, from routinecare, such as immunizations for children, to morespecialized treatment, such as transplant surgeryand trauma care,“ she said. “We are the people’shospital and are dedicated to providing the servicesthat our community needs at six hospitals andmultiple community centers and practices.”

And because of its dedication to the community,Dr. Roldan has no doubt that the health system willflourish.

“Jackson plays such an important role in thecommunity,” she said. “I love coming to work eachday. Despite the challenges Jackson is facing, Iknow it is destined for greater things.”

Top right: With husband Dr. Carlos Valdes Lora, son Carlos and

daughter Carolina, Dr. Roldan celebrates daughter Christine’s

college graduation. Bottom right: Seen here with JMH employees

Karmila Deosaran and Sabrina Veal, R.N., GI Station; and

Glenda Dixon, Cashiers Office, Dr. Roldan is committed to

ongoing communication with all employees.

Above: Dr. Roldan joined her

Pathology colleagues on the

Alamo steps for a portrait

during their Fellowship year,

1985-86. Far right: Her

official CEO portrait was

taken in almost the same spot,

more than 20 years later.

Jackson photos by Scherley Busch. Family and schoolphotos courtesy of Dr. Eneida O. Roldan.

cont

ents

november 2009 � connections � 1

jackson health system

your resource for health and well being

Wii Do RehabThe video game, Nintendo® Wii™, motivates patients to work hard inphysical therapy at Jackson North Medical Center.

New BeginningsThanks to Jackson North’s Weight-Loss Surgery Center, a mom hasembarked on a healthier life for her and her daughter.

Digestive Mystery – Solved!Eating anything caused 1-year-old Drew so much pain that he wouldscream when seeing his mother holding a spoon. He came to HoltzChildren’s Hospital, and the cause was found.

Baby’s Life Saved before BirthFetal surgery pioneer Rubén Quintero, M.D., performed blood transfusionsin utero to treat Bella’s severe anemia and help her to be born.

Surgery with Less Pain and Quicker RecoveryMiami International Surgical Services physicians at Jackson SouthCommunity Hospital were among the first to use various cutting-edge,minimally invasive procedures.

Holtz NICU: Delivering Stories of HopeMedia personality Lourdes Ubieta talks about the successful birth of herson and her participation in a Holtz Children’s Hospital project to givehope to other families.

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november 2009

jackson health system

Jackson Health System

Vice PresidentPublic Relations & MarketingRobert Alonso

EditorPat Morrissey/Havlin

Associate EditorsKathleen RohanAdam Taylor

Assistant EditorMadeline Barrios

Art Director/DesignerBarbara Scheer, M.F.A.

WritersSandra FiedlerPat Morrissey/HavlinJennifer Mooney PiedraKathleen Rohan

1611 N.W. 12th AvenueMiami, Florida 33136-1096Phone: 1-877-JHSMIAMI(1-877-547-6426)www.jhsmiami.org

Public Health TrustBoard of Trustees

OfficersChairman John H. Copeland IIIVice Chairman Angel Medina Jr.Secretary Georgena D. Ford, R.N.TreasurerMarcos José Lapciuc

TrusteesStanley H. ArkinJorge L. ArrizurietaGladys L. Ayala, Esq.Rosy CancelaErnesto A. de la FéJoaquin del CuetoAbraham A. GalbutSaif Y. Ishoof, Esq.County Commissioner Dorrin D. RolleJudy Rosenbaum, Ed.D.County Commissioner Javier D. SoutoMartin G. Zilber, Esq.

Ex-Officio MembersCounty Mayor Carlos AlvarezMichael E. Barron, M.D., FAHACounty Manager George M. BurgessPascal F. Goldschmidt, M.D., FACCD. Jane Mass, R.N., M.S.N., CNAA-BCNilda Peragallo, Dr.P.H., R.N., FAANJanet PerkinsEneida O. Roldan, M.D., M.P.H., M.B.A.

Comments? Questions? Contact usinfo@jhsmiami.org

Cover photography by Tom Elliott

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Jackson Health System Connections is publishedtwice a year by the Public RelationsDepartment of Jackson Health System.All contents © Jackson Health System.Reproduction in whole or part withoutwritten permission is prohibited. JacksonHealth System is an Equal Opportunity/Affirmative Action Employer.

Every effort is made to avoid duplicationof mailing labels; however, occasionalduplications are inevitable. If you receivean extra copy of JHS Connections, please passit along to a friend or colleague. If you donot wish to receive further issues, pleasecontact us by email, and your name andaddress will be removed from our mailing list.

Jackson Wii-hab

Sometimes therapy is not fun.Sometimes patients don’twant to come,” said TracilynUrruela, P.T., associate

chief of rehabilitation. “The video game,Nintendo® Wii™, makes it fun.”

Arturo Carvajal, M.D., 69, agrees. Hesaid his therapy is an opportunity to playa sport he’s adored his whole life buthasn’t been able to play in about 15 years.Dr. Carvajal has had multiple knee injuriesand, although he still needs a cane to walk,the retired surgeon is swinging hits on Wiibaseball.

“I love the baseball. This therapy wasmade for me. It’s incredible,” he said.

Patients Focus on the Game,Not the PainOccupational and physical therapists say“Wii-hab” works because patients enthusias-tically mimic the motions required in real-lifesports, which improves joint mobility,flexibility and overall endurance. They sayone of the best benefits is seeing patientsrefocus their attention on winning a gameinstead of on the hard work they’re doing toheal their bodies. Research shows this typeof therapy is also helping cerebral palsy andstroke patients improve muscle control.

BY SANDRA FIEDLER

PHOTOGRAPHY BY TOM ELLIOTT

Physical therapist Juan

Carlos Cardenas, P.T.A.,

gives a "thumbs up" signal

of success to Dr. Arturo

Carvajal when he strikes

out a batter while pitching

a game of Wii baseball.

People recovering from injuries or medical conditions often dreadphysical therapy. The squats and reps on weight machines healtorn ligaments, broken bones and painful injuries, but therapy canbe tedious and uncomfortable.

That’s why most rehab patients are surprised when their therapyat Jackson North Medical Center’s Rehabilitation Services requiressessions of snowboarding or tennis.

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2 � connections � november 2009

november 2009 � connections � 3

Getting High Scores

Wii therapy helped Patrick Leonardrecover after his dreams of earning a collegedegree and becoming a police officer weredashed at the age of 19. Last October, heknew something was wrong when he startedstumbling and falling frequently, whichwas very odd for a college student whohad always been active playing sports likefootball and basketball.

His condition deteriorated quickly, andhe had to hold on to things to keep hisbalance. His muscles began to feel numb.One day, he couldn’t walk and ended upin the hospital.

“I was scared. I thought it was a stroke,”he said.

Patrick was diagnosed with Guillain-Barrésyndrome, an autoimmune disorder thataffects the nerves, causing pain, weaknessand often paralysis. Doctors at JacksonNorth used medication to help relieve hispain and loosen up his muscles. Then theysent him to physical therapy to rebuild hisstrength, coordination and balance.

Patrick too was surprised that histherapist prescribed games of baseballand tennis, and challenged him to snow-boarding. “Sometimes I’ll stay late and keepplaying,” he said. “The game makes it better.I’m not focused on being tired.”

“It’s fun, it’s effective, and it meetsmultiple goals at the same time,” said SophiaPrassas, P.T., a Jackson North physicaltherapist who says Wii-hab has become animportant tool in their healing arsenal.

Patrick says he’s 90 percent better andcontinues to use Wii and other therapy tobuild up his strength and balance. He saidthat thanks to Jackson North’s great rehabteam and their efforts to keep therapyexciting, his recovery has been remarkableand he is able to walk again.

“All of a sudden, I’m actually starting torun,” he said. “I love everyone in rehab. Theyhelped me get back in shape.”

As for Dr. Arturo Carvajal, he laughs atthe fact that he’s actually enjoying Wii hulahoop and other games that test his balance.

He says he has a new, ambitious goalthat his wife dreams about as much as hedoes.

He said, “By December, I will be dancing!”

FOR MORE INFORMATION ON JACKSON HEALTH SYSTEM’S REHABILITATION SERVICES, OR TO

MAKE AN APPOINTMENT, CALL ONE OF THESE JHS HOSPITALS:

• JACKSON NORTH MEDICAL CENTER, 305-654-5043

• JACKSON REHABILITATION HOSPITAL, 305-585-7112

• JACKSON SOUTH COMMUNITY HOSPITAL, 305-256-5370

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With the help of physical therapist Sophia Prassas,

P.T., Patrick Leonard progresses through a series of

Wii exercises that are designed to improve his balance

and flexibility.

4 � connections � november 2009

for about 10 years, Ana Guimbardwatched as the numbers on thescale continued to rise and her

waistline grew.She tried countless diets and exercises

to shed the weight with little success. Afterthe birth of her daughter, Victoria, she triedharder with still no results. At her heaviest,Ana weighed 335 pounds at5 feet, 3 inches tall. As her babygirl quickly turned into a fast-moving toddler, she knew shehad to take drastic measures.

“I had difficulty walkingand my feet hurt a lot,” Anasaid. “I had trouble evenpicking up my 1½-year-oldchild and that was veryfrustrating.”

After researching her options andtalking to friends and family facing similarweight obstacles, Ana enlisted the help ofJorge L. Sosa, M.D., director of the Weight-Loss Surgery Center at Jackson NorthMedical Center.

On February 10, Ana underwent life-changing laparoscopic gastric bypasssurgery at Jackson North. Six monthsafter her surgery, she had shed more than85 pounds and shrank from a size 32 to asize 20, and could almost zip up a size 18.

“My activity level before [the surgery]was so low, I just wanted to rest. I also hada problem with a lack of oxygen in mybloodstream due to sleep apnea, and itwould sometimes cause me to fall asleepinvoluntarily,” she said. “But since thesurgery, I don’t have that problem anymore.I don’t have the same sluggishness and ammuch more energetic. I feel I have greaterchances of living a longer life than everbefore.”

newbeginningsBY KATHLEEN ROHAN

Dedicated to Life ChangesWhile surgery can help people maximizetheir weight loss in a shorter amount oftime, many are unaware of the drastic lifechanges required to see results.

“Weight-loss surgery is an option forobese people who are dedicated to makinglifestyle changes in order to gain control oftheir weight and their lives,” said Dr. Sosa.

“It was a huge success for Ana, whois still continually losing weight andbecoming healthier every day.”Dr. Sosa and his staff not only

help patients through the actualoperation, but also offer supportservices before and after the surgery.For instance, patients must beginmeeting with a nutritionist, whodetails the strict diet they must followbefore and after the procedure.The center also organizes a support

group, where patients help each other asthey go through the process of relearninghow to eat, losing the weight and keepingit off. And since they change sizes veryquickly, they also share clothing.

While the surgery was a success, Anasaid it did take hard work and devotion.

“The nutritionist really helped me themost,” she said. “She coaches you how toprepare your food and provides you withrecipes that will work for you. You arelearning how to eat again.”

She also had to make a commitment tostart – and stick with – an exercise routine.

Healthy Habits for Her DaughterAna is more aware of how her decisionsand lifestyle will affect her daughter. Sheis determined to teach her healthy habitsearly, so hopefully she can avoid thestruggles Ana has faced.

“I know that having your health, youcan have a better life. Not only for me, butfor my family and my child,” she said. “Idon’t think I would have the same qualityof life if I had continued on the path I wason. It’s more than I dreamed of.”

Ana said she is thankful for all thesupport from her friends and family,Dr. Sosa and his staff, as well as the staffat Jackson North Medical Center whocared for her after her surgery.

“I am particularly grateful to Dr. Sosa,”she said. “And, from my experience, thenurses and staff at Jackson North wereabsolutely fabulous.”

Now Ana is on her way to achievingher weight-loss goal and says she is finallyliving the life she wants to live.

�

DR. SOSA AND HIS TEAM AT THE WEIGHT-LOSS SURGERY CENTER AT JACKSON NORTH MEDICAL CENTER HOST

REGULAR INFORMATION SESSIONS FOR PATIENTS INTERESTED IN BARIATRIC SURGERY. THESE SESSIONS ARE HELD

AT 6:30 P.M. THE FIRST THURSDAY OF EVERY MONTH. FOR MORE INFORMATION, VISIT WWW.JACKSONNORTH.ORG

OR CALL 1-866-931-TRIM (8746). RESERVATIONS FOR THE FREE SESSIONS ARE REQUESTED.

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november 2009 � connections � 5

Digestive Mystery – SOLVED!

When Drew Pham was about a year old, he was playful and happy – except when

it was time to eat. He cried at the sight of food and screamed hysterically

when he saw his mother holding a spoon.

“I had no idea what was wrong,” said his mother,Jeanette. “I never thought that feeding him wascausing him so much pain.”

Doctors initially diagnosed Drew as havinggastroesophagael reflux disease (GERD), a commondigestive disorder that can cause heartburn or acidreflux. They prescribed medication and placed himon a special baby formula to replace solid foods.But even after that, the crankiness didn’t subside,and he regularly vomited after meals.

Desperate for help after more than a year ofwatching Drew suffer, the Phams turned to thepediatric gastroenterology team at Holtz Children’sHospital. Doctors scheduled Drew for an endoscopicbiopsy and, once they received the results, said thediagnosis was unmistakable.

Drew suffers from eosinophilic esophagitis, anallergic inflammatory disease in the esophagus, themuscular tube that carries food from the throat tothe stomach. A biopsy is the only way to diagnosethe disease.

The FactsEosinophilic esophagitis, which is often referred to asEE, is a newly recognized condition that has no curebut has grown increasingly common in children overthe past decade. It is estimated to affect one in every3,000 children, many of whom also have asthma,eczema or other allergies.

But diagnosing the condition isn’t always easy.“It is often misdiagnosed because its symptoms

mimic other conditions,” said Amber Langshaw,M.D., a pediatric gastroenterologist at Holtz.

Most people with EE undergo allergy tests todetermine what foods they need to avoid and respondfavorably to dietary restrictions. Some also useingested or inhaled steroids to reduce inflammationand irritation in the esophagus.

In Drew’s case, he is highly allergic to most foods,including rice, wheat, oats, soy, dairy, eggs andbananas. He can’t eat Halloween candy or popcorn atthe movies. He celebrates his birthday by blowing outcandles on a decorated shoe box, instead of a cake.

Earlier this year at Holtz, Drew had a feeding

tube inserted into his stomach to receive all hisnourishment from an amino acid-based formula.At the dinner table, he is only served ice chips.

His mother is committed to promoting researchon the disease in hopes that Drew, who will turn 3 inNovember, will eventually be able to eat food. She isgrateful to the doctors at Holtz for diagnosing herson – and putting an end to his pain.

TO SCHEDULE AN APPOINTMENT WITH A PEDIATRIC GASTROENTEROLOGIST AT

HOLTZ CHILDREN’S HOSPITAL, CALL 305-585-KIDS (5437).

�

The SymptomsChildren suffering from eosinophilicesophagitis, an allergic inflammatorydisease in the esophagus, are oftenmisdiagnosed. This leaves them inpain and their parents frustrated astheir child refuses to eat, loses weightand, in extreme cases, becomesmalnourished and developmentally delayed.

The condition, often referred to as EE, can bemisconstrued as gastroesophagael reflux disease(GERD), because it mimics the symptoms andmany physicians are unaware of the rare disease.

Amber Langshaw, M.D., a pediatricgastroenterologist at Holtz Children’s Hospital,said while the two illnesses can be similar,there are some distinguishing features:

BY JENNIFER MOONEY PIEDRA

Eosinophilic Esophagitis SymptomsSevere heartburnAbdominal or chest painDifficulty swallowingFood impaction in the esophagusNausea or vomitingWeight lossPoor appetiteDifficulty sleepingRefusal to eat

GERD/Acid Reflux SymptomsBelchingChest painHeartburnSour taste in the mouthDry coughHoarsenessRegurgitationWheezing

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Pham

Dr. Quintero discovered theirbaby was in heart failure.

“It was probably the mostsevere case of Rh-sensitization Ihave ever seen,” the doctor said.

That same day, he did ablood transfusion for the baby inthe womb by precisely inserting athin needle into the base of theumbilical cord using ultrasoundguidance.

“Each procedure is risky,”Dr. Quintero said. “But mygoal was to do whatever wasnecessary to have a healthybaby.”

Kristina continued to haveregular visits with Dr. Quintero,sometimes as many as threetimes a week, so he couldmonitor the baby’s progress.He performed a total of threeblood transfusions in utero,until the baby was delivered at33 weeks gestation.

On April 6, Bella Eva AnitaPernfors was born, weighing4 pounds, 4 ounces. She spent11 days in the neonatal intensivecare unit at Holtz Children’sHospital before she was able togo home to her mother, fatherand 4-year-old brother.

Today, Bella is a healthy7-month-old, who is expected

to lead a normal life.“If it wasn’t for Dr. Quintero, our

daughter would not have made it,”Kristina Pernfors said. “He saved her life.”

6 � connections � november 2009

innovationsFetal Surgery Pioneer Saves Baby’s Life before Birth

BY JENNIFER MOONEY PIEDRA

K ristina Pernfors’ motherlyinstinct likely saved her

baby’s life.When she was four months

pregnant, Kristina knew somethingwas wrong when she didn’t feelher usually active baby girl kicking.She went to see her OB/GYN, whoconfirmed her worst fears.

The doctor told her that herbaby was dying because of acondition called Rh-sensitization,which is caused by an incompati-bility of blood types between amother and her baby. Only about15 percent of women are at riskfor this condition.

When Kristina was pregnantwith her firstchild, blood testsshowed that sheis Rh-negative,meaning her bloodlacks a type ofprotein foundon the surface ofred blood cells.Doctors injectedher with antibodiesto prevent Rh-sen-sitization, and shedelivered a healthybaby boy, Figge.

But with hersecond pregnancy,she became immune to the antibodies. Herbody attacked the baby’s red blood cellsand made her unborn child severely anemic.

“Our baby was basically given zerochance of survival,” she said.

Kristina, who lives in Vero Beach, wasreferred to Rubén A. Quintero, M.D., thedirector of maternal-fetal medicine at theWomen’s Hospital Center at JacksonMemorial Hospital. Dr. Quintero is knownas a pioneer in fetal surgery who helped

develop minimally invasive surgicaltechniques to operate on tiny babies stillin the womb.

The day after the grim diagnosis,Dr. Quintero met with her and her husband,Mikael, a retired Swedish tennis star whowas ranked among the Top 10 playersworldwide in the 1980s.

“Dr. Quintero was our only chance atsaving our daughter,” Kristina said. “Hegave us hope.”

After Bella spent 11 days under the care of the

specialists in Holtz's newborn intensive care unit,

she was able to go home to her parents Mikael and

Kristina and brother Figge.

“If it wasn’t for

Dr. Quintero, our

daughter would not

have made it.

He saved her life.”

FOR MORE INFORMATION ON JACKSON’S

FETAL THERAPY CENTER IN THE WOMEN’S

HOSPITAL CENTER, VISIT WWW.JHSMIAMI.ORG

OR CALL 305-585-6636.

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New Surgery Helps Children with Eye Cancer

Groundbreaking HeartDevice Improves Oddsand Increases Freedomfor Heart FailurePatients

three patients at JacksonMemorial Hospital became

the first in South Florida toreceive a new heart pump,which is an important break-through for heart failurepatients.

“Previously, portable pumpswere unavailable to manypatients of small staturebecause there was not enoughroom in the chest cavity,”said Si Pham, M.D., directorof Heart and Lung Transplanta-tion at UM/Jackson MemorialMedical Center and thesurgeon who inserted thepumps. “We hope we canalso help pediatric patientswho have no portable pumpsavailable to them.”

Orfelina Torres, 58, says theHeart Mate II has given her asecond chance at life. She hadspent most of her days in bedafter a massive heart attack.She eventually would need anew heart but was too sick tobe a transplant candidate. Sheis now well enough.

“I can actually walk in themorning and breathe,” Orfelinasaid. “That’s really powerful.”

Speedy results withnew, high-qualityimaging system

physicians in the emergencyrooms at Jackson Memorial

Hospital and Ryder TraumaCenter are using a new machineto make faster diagnoses,especially when examiningpatients with acute chest pain,abdominal pain and suspicionof stroke.

Jackson is among the firsthospitals nationwide using astate-of-the-art dual sourcecomputed tomography (CT)scanner system, whichproduces higher-quality imagesat a much faster pace thantraditional machines. In lesstime than it takes the heartto beat, the SOMATOM®

Definition completes a scanand provides physicians withimmediate motion-free images.

They are able to then maketreatment decisions, oftenavoiding unnecessary invasivesurgery and diagnosticprocedures, such as cardiaccatheterizations.

Another benefit of the newimaging system is that, unlikeother CT scanners, it does notrequire patients with elevatedor irregular heart rates to takebeta blocker medication to slowthe heart before the exam.

november 2009 � connections � 7

Christina Katsouris

(in the flowered dress)

with her twin Alicia, her

parents Andreas and Ruth,

and her doctors (left)

Ali Aziz-Sultan, M.D.,

and Timothy Murray,

M.D., M.B.A., FACS,

after an innovative

procedure successfully

treated her eye cancer.

CHRISTINA KATSOURIS is a normal 7-year-old.She enjoys riding her bicycle, playing on thecomputer and swinging on the monkey bars.In February, Christina’s father noticed that herright eye was occasionally crossing, but hedidn’t think it was anything serious. Afterundergoing several tests and meeting withTimothy Murray, M.D., M.B.A., FACS, anocular oncologist at Bascom Palmer EyeInstitute, Christina was diagnosed withretinoblastoma, a rare childhood cancer.

In the past, treatment options includedremoval of the eye and using radiation therapyand chemotherapy to attack the tumor, whichoften led to blindness. But Dr. Murray teamedup with two University of Miami/JacksonMemorial Medical Center doctors to implementa new, rarely used technique to treat Christina.

Rather than using traditional chemotherapy –

which affects the entire body, often causingnausea, hair loss and bone marrow suppression –these doctors are directly injecting lower dosesof the chemo through a super-thin catheter intothe artery that feeds the eye.

The 30-minute procedure is performedunder general anesthesia by Ali Aziz-Sultan,M.D., director of neuroendovascular surgery atUM/Jackson, in coordination with Dr. Murrayand Cristina Fernandes, M.D., a pediatriconcologist at Holtz Children’s Hospital.

“It is highly effective,” Dr. Sultan said. “Thismay be a future way of treating these tumors.”

Since April, the doctors have treated10 children, age 17 months to 7 years, fromacross the United States. Most have gone homethe next morning and have no side effects fromthe chemo. Since her procedure, Christina isthriving and entered second grade this fall.

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FOR MORE INFORMATION ON THE SERVICES OFFERED

BY THE MINIMALLY INVASIVE SURGICAL SERVICES

GROUP, VISIT WWW.JACKSONSOUTH.ORG OR CALL

305-251-2500 TO SCHEDULE AN APPOINTMENT.

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PIONEERING SURGEONS OFFER TREATMENTS WITH LESS PAIN AND RECOVERY TIME

Do you suffer from severe heartburnor disease of the colon? Do you needhernia repair? Are you obese andunable to shed your excess weight?

The Miami International Surgical Services (MISS)group – formerly Advanced Surgical Associates atMercy Hospital – has joined Jackson South Commu-nity Hospital to offer minimally invasive proceduresto treat these and other conditions. The group ofsix specially trained surgeons have developed andperform cutting-edge procedures that treat severe

illnesses and diseases with fewerside effects and less pain.

“Our goal is to help patientsget better, quicker, with lesspain,” said Moises Jacobs, M.D.,FACS, one of the medicaldirectors of the MISS group.“We have devoted more than20 years to developing andimproving various treatmentoptions that are less invasivefor patients.”

Minimally invasive surgeryis a medical specialty whereprocedures are performed using

unique tools and techniques that allow doctors tomake smaller, and sometimes fewer, incisions. TheMISS surgeons were one of the first teams of doctorsto use microlaparoscopy, a surgical techniqueutilizing tiny instruments measuring only two orthree millimeters in size. With smaller and smallerincisions, patients are able to heal much faster,endure less pain and have a lower risk of othercomplications. Patients also benefit with shorterhospital stays and quicker recovery times.

Part of the Jackson Medical Group, MISS is ledby Medical Directors Moises Jacobs, M.D., FACS,and Gustavo Plasencia, M.D., FACS, FASCRS, andincludes Eddie Gomez, M.D., FACS, Rene F.Hartmann, M.D., FACS, FASCRS, Henry J. Lujan,M.D., FACS, FASCRS, and Manuel Viamonte III,M.D., FACS, FASCRS.

WEIGHT-LOSS SURGERYIn 1990, the MISS surgeons began performingadvanced laparoscopic procedures including gallbladder, appendix, colon and hernias. They were

the first in Miami to offer various types of laparo-scopic bariatric techniques for weight loss:

• One procedure is the laparoscopic gastricbypass, where they make the stomach physicallysmaller so it holds less food.

• In another technique, they place gastricbands around the stomach via a laparoscopic proce-dure. These are individually tailoredto meet each patient’s personal needs.Laparoscopic banding is reversible,unlike some other bariatric options.

• The MISS group has modifiedthe technique of gastric sleeves.During this procedure, part of thestomach is removed to create asmaller stomach. The part of thestomach that is removed produces thehunger hormone, ghrelin, so manypatients don’t feel hungry and lackcravings for foods after this procedure.

• As part of a research study, thesurgeons are performing a new oralendoscopic procedure for weightloss. The technique does not requireincisions, and patients are onlyhospitalized for a few hours.

OTHER PROCEDURESIn 1990, the MISS surgeons pioneeredlaparoscopic colectomies, a procedurewhere they remove part of the colondue to disease or complications. Theynow teach their technique worldwide.

Currently, they are pioneering a new treatmentfor heartburn, which was developed to emulate moreinvasive surgical techniques, but uses no incisionsand, therefore, leaves no visible scars. The proce-dure takes no more than 30-45 minutes and isperformed through the mouth, rather than throughan abdominal incision. Most patients can go homethe next day and return to work within a few days.

Moises Jacobs, M.D.,

FACS

Eddie Gomez, M.D.,

FACS

BY KATHLEEN ROHAN

Improving Treatment Options

“Our goal is to

help patients

get better,

quicker, with

less pain.”

Members of the MISS group

include (from left) Gustavo

Plasencia, M.D., FACS,

FASCRS, Manuel Viamonte

III, M.D., FACS, FASCRS,

Rene F. Hartmann, M.D.,

FACS, FASCRS, and Henry

J. Lujan, M.D., FACS,

FASCRS.

8 � connections � november 2009

november 2009 � connections � 9

askthedoctorUterine Fibroids Can Be Treated without Surgery

Interventional radiologist AdamGropper, M.D., shares some important factsabout uterine fibroids that every womanshould know and some new, minimallyinvasive procedures offered at JacksonNorth Medical Center that can relievefibroid symptoms and have women backto their busy lives in just a few days.

WHAT ARE UTERINE FIBROIDS?Uterine fibroids are muscle and tissue cellsthat grow into muscular tumors. Theygenerally develop in the uterine wall andcan grow into the uterine cavity. While theyare referred to as tumors, they are almostalways benign (non-cancerous).

Fibroids can either grow as a singletumor or can develop in groups. They canalso vary in size, from as small as an appleseed to larger than a grapefruit.

WHAT CAUSES THEM TO GROW?The cause of uterine fibroids is unknown.But physicians have discovered that womenwith certain risk factors are more likely to

develop fibroids thanothers. Risk factorsinclude:AGE: Women mostlybegin developingfibroids in their 30sand 40s and are at riskthrough menopause.After menopause,uterine fibroids tendto shrink.FAMILY HISTORY: Ifa woman’s mother hadfibroids, her risk ofhaving them is threetimes greater thanfor a woman with nofamily history.ETHNICITY: African American women areat a greater risk of developing uterinefibroids.OBESITY: Overweight women are also moreat risk.EATING HABITS: Some research indicatesthat women who eat a lot of red meat and

ham have a higherchance of developingfibroids, while thosewho eat more greenvegetables seem to beat a lower risk.

HOW CAN I TELL IF I HAVE THEM?Your doctor may find you have fibroidsduring a regular pelvic exam. Imaging tests,such as ultrasounds, MRI or CT scans, canalso be performed to confirm a diagnosis.

WHAT ARE SOME SYMPTOMS?Some women with fibroids do notexperience any symptoms, but othershave abdominal or pelvic pain, a feeling

of fullness in the pelvicarea, heavy menstrualbleeding, frequenturination, pain duringintercourse, lower backpain, enlargement ofthe lower abdomen, orreproductive problems.

WHAT CAN BEDONE?Traditionally, uterinefibroids have beentreated with hysterec-tomy, or surgical removalof the uterus. Myomec-tomy, or surgical removalof specific fibroids, hasbeen another option.

Both could require weeks or even monthsof recovery.

The Fibroid Treatment Center atJackson North Medical Center now offersan innovative, non-surgical treatmentcalled Uterine Fibroid Embolization, orUFE, which is less painful and invasive,and can have women back to their busylives after just a few days of recovery.

The physicians at the Fibroid TreatmentCenter will carefully evaluate your uniqueset of symptoms and concerns and help youpick the best treatment for you.

FOR MORE INFORMATION ON THE FIBROID TREATMENT CENTER AT

JACKSON NORTH MEDICAL CENTER, VISIT WWW.JACKSONNORTH.ORG

OR CALL 305-654-3090 TO ARRANGE FOR A CONSULTATION.

�

ADAM GROPPER, M.D., is an interventionalradiologist at Jackson North MedicalCenter’s Fibroid Treatment Center and chiefof radiology at Jackson North and JacksonSouth Community Hospital. He, along withDr. Peter Swischuk and Dr. Daniel Seckinger,are specially trained physicians who performUterine Fibroid Embolization.

PolyvinylParticles

UterineArtery

FemoralArtery

Catheter

Fibroid

Uterus

Uterine fibroids affect approximately 1 in 4 women and are the leading cause of

hysterectomy (removal of the uterus) in the United States. They are also the

most common non-cancerous tumors found in women of childbearing age.

Uterine fibroids are muscle tumors that grow in and around the wall of the uterus and

can become quite painful, causing excessive bleeding and other disruptive symptoms.

Many women suffering with fibroids find they are unable to live with them, but do not want

to undergo invasive surgery to have them removed.

During Uterine Fibroid Embolization, tiny

particles the size of grains of sand are injected

into the uterine artery, blocking the blood

supply to the fibroids.

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Meet the Doctor

10 � connections � november 2009

BY SANDRA FIEDLER

PHOTOGRAPHY BY DONNA VICTOR

T H E H O LT Z

Delivering

W hena new parent has a

critically ill baby, it is often

complete strangers who offer the greatest

hope. It was for this reason that staff and

families of babies treated in The Project:

Newborn Neonatal Intensive Care Unit

(NICU) created the “Hero’s Journey: Where

Hope Is Embraced through the Arts.”

Together with a local artist, the group

turned the NICU entrance in Holtz Children’s

Hospital into a comforting, healing place.

Parents say seeing and hearing other parents’

experiences help them understand that they

are not alone and encourage them

to remain hopeful.

Mosaic-tiled columns,

artistic benches and

hand-made quilts on

the wall tell their stories.

“Hope is the only word that exists to cope

with this situation,” said Lourdes Ubieta,

whose thoughts about her family’s experience

in the NICU are shared on one of the quilts.

“Hoping for the best is sometimes the only

thing you have.”

W

november 2009 � connections � 11

From Celebration to DevastationLife couldn’t have been any sweeter for Lourdes. She had anexciting job as a TV and radio anchor, a great family and herbiggest dream was coming true. She was pregnant with her firstchild. But her celebrating suddenly turned to fear and anxietywhen, at 22 weeks into her pregnancy, Lourdes began havingsigns of pre-term labor. She was in and out of a local hospitalfor several short stays and soon got the worst news from herobstetrician. She was probably losing her baby, and he couldn’tdo anything else for her. His advice: Go to Jackson.

“I was absolutely devastated,” said Lourdes. “If I was beingtransferred to Jackson, I knew the situation was serious.”

Gene Burkett, M.D., an obstetrician/gynecologist specializingin high-risk pregnancy at the Women’s Hospital Center atJackson Memorial Hospital, reviewed all of her files. He had onesimple question: “How much do you want to have this baby?”

“That’s all I want in life,” Lourdes remembers responding. “Hetook my hands in his hands and said, ‘Then we’re going to takecare of you and your baby. We are going to help you.’ I just cried.”

Lourdes was immediately admitted to the Women’s HospitalCenter on 24-hour bed rest with her bed tilted at a 35-degreeangle with her head down. “The first four weeks were the worst,”she said. “We needed to reach 26 weeks to give my son a chance.”

She cherished the almost daily 6 a.m. visits by Dr. Burkett.FOR MORE INFORMATION ABOUT HOLTZ CHILDREN’S HOSPITAL

AND THE NEONATAL INTENSIVE CARE UNIT, PLEASE VISIT

WWW.HOLTZCHILDRENSHOSPITAL.ORG OR CALL 305-585-KIDS (5437).

�

They talked a lot and even watched soccer games together.“He always gave me tips,” she said, “like taking naps when thebaby takes naps. He would talk about what I should do whenmy baby was born. He is a very smart man.”

Soon Lourdes made it past the critical 26-week gestationmark, a point at which mortality and complication ratesimprove dramatically. Four weeks later, Dr. Burkett deliveredGabriel Alejandro with words Lourdes will never forget,“Welcome to the world, you miracle baby!”

Lourdes says the months she spent at Jackson made herrealize the world-class maternity and neonatal care availablethere, a point she now regularly makes to her radio show listeners.

“If I get pregnant again, no doubt about it, I will go toJackson,” she said. “I trust them. I know they give their bestto their patients. I know this NICU is the best place to be.”

A Mission of Family-Centered CareDr. Gene Burkett says having stories likeLourdes’ on the walls at Holtz will make adifference to future families. It is why heloves what he does. “The reward is seeingthe happiness Lourdes feels and seeingthe bond between mom and baby,” he said.

The NICU nurses and staff – alongwith all the caregivers in Holtz Children’s Hospital– are dedicated to providing family-centered care. “This projectis powerful and uniquely supports our mission to help not onlythe tiny babies here in our NICU, but also their families,” saidneonatologist Teresa del Moral, M.D.

There is also a quilt created by the NICU staff in thedisplay. One of its quotes says, “We work in a field where mira-cles can happen, and we are fortunate enough to be a smallpart in those miracles.”

N I C U :

Stories of Hope

Far left: Lourdes Ubieta is grateful to Dr. Gene Burkett for helping to safely

deliver her son Gabriel into the world.

This page: Lourdes created this quilt to share her story with other families

who have a child in the Holtz newborn intensive care unit.

jacksonroundsPartnership PumpsNew Life into CardiacPatients

jackson Memorial Hospitalis the only hospital in Floridato partner with the Larry KingCardiac Foundation, an organi-zation that provides funding forlife-saving cardiac proceduresfor people who have no healthinsurance or cannot afford topay.

The foundation was startedby media legend Larry Kingafter he underwent quintuplebypass heart surgery as aresult of cardiovasculardisease.

The partnership has alreadybenefitted dozens of cardiacpatients at Jackson MemorialHospital, including RitaHurtado, a Miami housekeeperand grandmother of five. Shewas diagnosed with aorticstenosis, a form of heartdisease that impedes blood

by Brooke Steinberg, a 12-year-old from Davie who wanted tohonor her beloved grandmotherwho died of heart disease.Brooke sold red “Be Smart Savea Heart” wristbands, set up

a lemonade stand in herneighborhood and collecteddonations from family andfriends.

FIU Medical StudentsOrient at JacksonNorth

august 3, 2009, was anhistoric day for Florida

International University andJackson North MedicalCenter. The first class of theFIU Herbert Wertheim Collegeof Medicine began their questto become physicians withorientation at FIU and JacksonNorth, their major teachinghospital.

While the 43 students willspend part of their time atJackson North now, they willbegin working with patientsin 2011, when they entertheir third year of medicalschool.

Many of the college’s facultyalready have joined the

Holtz Children’s Hospital is among the nation’s elitewhen it comes to treating kidney problems in children

and providing intensive care to the tiniest babies, according toU.S.News & World Report’s “America’s Best Children’s Hospitals2009-10.”

Holtz ranked on the specialties list for kidney disorders andfor neonatal care out of the 160 facilities that U.S. News feltwere most likely to provide exceptional pediatric care.

In adult services, the U.S. News list of “America’s BestHospitals” placed two UM/Jackson Memorial Medical Centerprograms in the top 50 out of 4,861 hospitals evaluated:the ear, nose and throat program (otolaryngology) andgeriatrics. The University of Miami’s Bascom Palmer EyeInstitute was named the No. 1 hospital in the country forophthalmology (diseases of the eye) for the sixth year ina row.

flow from the heart to the restof the body.

Rita had valve replacementsurgery at Jackson, paid forby the Larry King CardiacFoundation and money raised

Members of a Jackson Memorial committee who work with the Larry King Cardiac Foundation join Larry King Jr., president

of the foundation, and Jackson President and CEO Dr. Eneida Roldan (left) and patient Rita Hurtado (fourth from left) in

thanking Brooke Steinberg (front row, fourth from left) for her hard work and generous donation that helped save Rita’s life.

U.S. News Ranks Holtz Children’s Hospitaland JMH among America’s Best

12 � connections � november 2009

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november 2009 � connections � 13

Jackson North staff and arepracticing at the medicalcenter, bringing cutting-edgetechniques, treatment andresearch to the north Miami-Dade and south Browardcommunities.

JHS Opens NewCardiac and StrokeOutpatient Center

jackson Health Systemrecently opened a “one-stop”outpatient facility for theprevention and treatment ofvarious manifestations ofcardiac, neurological andperipheral arterial disease.

The Cardiac and StrokePrevention, Diagnosis andTreatment Center is conve-niently located at Jackson’sBiscayne Medical Plaza at3801 Biscayne Blvd. in Miami.Specialists provide treatmentto patients with risk factorssuch as high cholesterol andhigh blood pressure. Patientscan also receive initial assess-ments, consultations withleading experts in heart diseaseand stroke, and noninvasivestudies.

DOCTORS AND STAFF at Holtz Children’sHospital had a huge birthday surprise for patientGlen Charlet. He had been receiving treatment forleukemia for five months at Holtz and wasn’t wellenough to get out and celebrate his 18th birthday.

But G. Patricia Cantwell, M.D., director ofpediatric critical care (pictured here), wasn’tabout to let hospital walls stop a celebration.Dr. Cantwell knew Glen’s passion in life was saltwater fishing, so she personally brought back livefish and bait from the Florida Keys in a largecooler of water. Martin Andreansky, M.D., Ph.D.,director of the Pediatric Bone Marrow TransplantProgram, rounded up some fishing poles, andGlen and the Holtz team had a blast fishing rightfrom his bedside.

Barth A. Green, M.D. (center),

Carrie Feinroth, R.N. (third from

right) and Mark McKenney, M.D.

(far left), co-director of Ryder Trauma

Center, accept their awards as

2009 Health Care Heroes.

Leading the center areAlexandre Ferreira, M.D.,FACC, clinical chief of cardiol-ogy for Jackson Health System,and Alejandro Forteza, M.D.,founder of the Jackson Memo-rial Hospital Stroke Center,both of whom are well knownfor their medical expertise.For more information or toschedule an appointment,call 786-466-8490.

Congratulations,Heroes!

barth A. Green, M.D.,Carrie Feinroth, R.N.,

and the Ryder Trauma Centerwere honored as 2009 HealthCare Heroes by the GreaterMiami Chamber of Commerce.

Dr. Green, chief of neuro-logical surgery at JacksonMemorial Hospital and profes-sor and chairman of theDepartment of NeurologicalSurgery at the University ofMiami Miller School ofMedicine, was presented withthe lifetime achievementaward.

Ms. Feinroth, nurse man-ager of the pediatric intensivecare unit at Holtz Children’s

Hospital, was named top nurse,and the Ryder Trauma Centerwas recognized as the topinstitution.

Jackson NorthReceives SecondStroke Recognition

the Joint Commission hasrecognized Jackson North

Medical Center as a PrimaryStroke Center, a certificationgiven to hospitals with careprograms that follow nationalstandards and guidelinesthat can significantly improvethe outcomes for strokepatients.

Stroke is the third leadingcause of death in the UnitedStates, with about 700,000people nationwide experienc-ing a new or recurrent strokeeach year.

The Joint Commission is oneof the most widely known andrespected healthcare accredita-tion organizations in the nation.

Holtz Patient Goes “Fishing” for18th Birthday

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