THIS ONE’S FOR THE GIRLS

TIME FOR TAI CHIIn this issue

Botox®

How can i t he lp a stroke pat ient ?

page 12

TIME OUT FOR

FALL 2013

TIME OUT FOR WOMEN is published as a com-munity service for the friends and patrons of:Holy Cross Hospital4725 North Federal HighwayFort Lauderdale, FL 33308

Patrick Taylor, MD, President and CEOLuisa Gutman, Vice President and

Chief Operating Offi cerChristine Moncrieffe, Director,

Marketing and Public RelationsCarmina Zamora, Editor

FALL 2013

Information in TIME OUT FOR WOMEN comes from a wide range of medical experts. If you have any concerns or questions about specifi c content that may affect your health, please contact your healthcare provider. Models may be used in photos and illustrations.

Copyright © 2013Coffey Communications, Inc.CUM29775

T I M E O U T F O R

To the women in our community,

Fall is here! We hope you all enjoyed your summer and are refreshed and ready to gear up for all that’s coming our way.

The Holy Cross Hospital Auxiliary has been quite busy already as Women Owning Wellness (WOW!) prepares for the “This One’s for the Girl s” luncheon in October (read more on page 14). WOW! is now in its second year as part of the Auxiliary. We are so proud of the work it has accomplished, and we are inspired by the members’ enthusiasm. In fact, the Auxiliary recently donated $390,000 to the Dorothy Mangurian Comprehensive Women’s Center (page 3), and we are so incredibly grateful!

One of the programs at the Women’s Center being funded by WOW! is Partners in Breast Health (PIBH; read more on page 9). Our generous supporter the Harry T. Mangurian, Jr. Foundation recently created a match challenge to benefi t the amazing work being conducted through PIBH ensuring that for another year, underserved women in our community have access to screening and diagnostic services.

Our second exhibition at the Patricia R. Guerrieri Pavilion art gallery, featuring selected works by the Signature Ladies of the Gold Coast Watercolor Society, is open. Read more about the variety of art featured through December on page 3, and then make sure to stop by and see it!

In this edition, you’ll also read more about: ✓ Botulinum toxin for post-stroke patients (page 12) ✓ Super fi ber (page 11) ✓ Tai chi: a low-impact weight-bearing exercise (page 13) ✓ Flu shots (page 14) ✓ Holy Cross Urgent Care and Imaging Center (pages 6 and 7) ✓ Lowering your risk of heart disease—and your weight (pages 4 to 5)Don’t forget to stop by the Women’s Center Café and let us know what you

think!

Warmly,Patrick A. Taylor, MDDoreen Koenig

From the CEO

In this issue

Heart disease: Outrun this killer

Urgent Care: No appointment needed!

Gallbladder removal with hardly a trace

Eat for health: Get your fi ber fi x

4

6

10

11

Doreen Koenig, Dorothy Mangurian Comprehensive Women’s Center Community Leadership Chair

Patrick Taylor, MD, Holy Cross Hospital President and CEO

Time Out for Women2

Holy Cross news

tHe secONd exhibition at the Women’s Center features a variety of works by experienced, award-winning watercolor artists.

The Signature Ladies of the Gold Coast Watercolor Society juried exhibition will run through December 2013. The gallery is located in the Patricia R. Guerrieri Pavilion at the Dorothy Mangurian Compre-hensive 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. ❧

Come see the

art exhibit by the Signature Ladies of the

Gold Coast Watercolor Society

Holy Cross Hospital Auxiliary’sfundraising event

a successHOLY crOss Hospital Auxiliary President Maxine Holzworth (pictured) presented Holy Cross Hospital Chief Executive Offi cer Patrick A. Taylor, MD, with a $390,000 donation for the Dorothy Mangurian Comprehensive Women’s Center.

The Auxiliary is the hospital’s largest donor, and for the past fi ve years, the members have been focused on funding women’s health at the hospital, donating nearly $1.6 million to the Women’s Center in particular. The dona-tion encompassed annual funds raised through the Auxiliary’s Pink Lady Thrift Shop, Lorelei’s Gift Shop, its annual fundraising gala and $40,000 from Women Owning Wellness. This year’s gala, “Epicurean Escapade: A Food & Wine Experience,” raised more than $200,000 alone!

The Women’s Center is heartily grateful for the Auxiliary’s continued support of women’s health. ❧

3www.holy-cross.com

Cardiovascular health

Heart disease is the leading cause of death in women worldwide. Women need to understand the major risk factors associated with cardiovascular disease and stroke, since it is estimated that 80 percent of these risk factors can be modified through early screening methods, lifestyle adjustments and medications.

Knowledge is preventionThe major risk factors for heart disease are: ✓ Age ✓ Total cholesterol ✓ HDL cholesterol ✓ Systolic blood pressure ✓ Smoking historyHigh-risk factors include a history of cardiovascular

disease or stroke, peripheral arterial disease, diabetes, and end-stage or chronic kidney disease. Other factors include:

✓ Medical history ✓ Lifestyle and family history ✓ Markers of preclinical disease (such as coronary calcium score or carotid artery plaque) ✓ Blood pressure, body mass index (BMI) and waist size ✓ Obesity ✓ Poor diet ✓ Physical inactivity and metabolic syndrome ✓ Systemic autoimmune disorder ✓Laboratory markers (such as glucose and kidney function)

Dr. Goldman practices

at Holy Cross Medical Group, North Broward Cardiology Practice, located at 2800 N. State Road 7, Suite 101, in Margate. To schedule an appointment, call 954-984-9090.

LOW

ER

not just your weight your risk,

By Richard A. Goldman, MD, PhD, FACC, FACP, Cardiologist, Holy Cross Medical Group

4 Time Out for Women

Many risk factors for heart disease are under your control. Healthy behaviors can prevent it.

Xxxxx xxxx

Get screenedDon’t skip recommended

screenings.Blood pressure: An optimal

reading is less than 120/80.Cholesterol levels: Get them

checked at least once every five years starting at age 20. Children with a family history of heart disease should be checked at a younger age. Women with elevated cholesterol levels should be checked more frequently. The optimal level for total cholesterol is less than 150; for HDL cholesterol, greater than 50; for LDL cholesterol, less than 100; and for triglycerides, less than 150.

Diabetes screening: Check fasting blood sugar starting usually between ages 30 and 40, and retest every three to five years. The optimal glucose level is less than 100. ❧

Reduce your riskYou can make some lifestyle

changes to reduce your risk of heart disease.

Quit smoking: Combine a formal cessation program with group coun-seling, nicotine replacement and drug therapy.

Physical activity: Get 150 minutes per week of moderate aerobic exercise (such as brisk walking) or 75 minutes per week of vigorous exercise—or a combination of the two. Add muscle-strength-ening exercises at least two days per week.

Nutrition: Eat a diet rich in fruits and vegetables, whole grains, higher-fiber foods, fish (oily fish such as salmon and mackerel), poultry, lean meats, dry beans, eggs, and nuts. Avoid saturated and trans fats (partially hydrogenated fats), such as deep-fried foods, bakery products, crackers, margarine, packaged snack foods, red meats, dairy products, and coconut and palm oils.

Lose weight (or maintain a healthy one): Change your habits. Set a goal and combine physical activity with an appropriate caloric intake. Aim for a BMI less than 25, a waist size smaller than 35 inches, or another related weight metric.

REFERENCES1. Go Red For Women editors. (n.d.) Managing heart disease risk at any age. Retrieved from http://www.GoRedForWomen.org.2. Mosca, L. et al. (2011). Effectiveness-based guidelines for prevention of cardiovascular disease in women. Circulation, Vol. 123, 1 2 42-1262..

Manage medicationAsk your doctor about using these

medications to lower your risk. Aspirin: Between 75 and

325 milligrams daily may benefit women with heart disease, stroke or diabetes, unless contraindicated. May be useful in women over 65 who have increased risk for heart disease or stroke.

Lipid-lowering medications: These are recommended for women with coronary disease, stroke or diabetes to reach a goal LDL cholesterol of less than 100 or, in some high-risk patients, 70.

Blood pressure medications: In addition to regular exercise and a nutritious, low-sodium diet (less than 2,000 milligrams of sodium per day), these medications are indi-cated for women with blood pres-sure readings over 140/90 or, for women with diabetes, over 130/80.

One in three women dies each year as a result of heart disease, and 43 million women in the United States are affected by it.

Schedule a screening today. Need a primary care doctor? Find one at 866-988-DOCS (3627).

5www.holy-cross.com

Many risk factors for heart disease are under your control. Healthy behaviors can prevent it.

5

tHe HOLY crOss Urgent Care and Imaging Center grand opening celebration off ered our local community members a chance to tour the new facility in the Rio Vista neighborhood of Fort Lauderdale and to familiarize themselves with our convenient services. Attendees enjoyed refreshments, a health lecture, giveaways from Holy Cross and 93.9 MIA radio station, free massages, and paraffi n dips.

Patients no longer have to sacrifi ce quality and convenience when they need immediate care for illnesses and injuries that aren’t serious enough for the Emergency Room.

Holy Cross Urgent Care and Imaging Center off ers:✓ Fast, aff ordable treatment with no need to schedule an appointment✓ Advanced technologies like 64-slice CT scanning and 3T MRIs✓ High-quality compassionate care ✓ Specialized expert physicians and nurses✓ Highly skilled technicians

If your Holy Cross Urgent Care physician orders an x-ray, you can schedule it right here in the same building. Or, if your primary care physician has given you a prescription for an imaging study, you can enjoy the convenience of having it here the same day instead of going to the hospital at a later date. ❧

HOLY CROSS URGENT CARE AND IMAGING CENTER

celebration

From left: Margarita Bazze and Manuela Pujals-Lord, Holy Cross International Services; Manuel Mantecón, MD, Director, Holy Cross International Services; Luisa Gutman, SVP and COO, Holy Cross Hospital

Urgent Care hoursWalk-ins are welcome. ➜Monday through Friday: 9 a.m. to 9 p.m.➜Saturday: 9 a.m. to 5 p.m.

➜Sunday: 9 a.m. to 4 p.m.

Imaging Center hoursSame-day appointments are available.

➜Monday through Friday: 7:30 a.m. to 6 p.m. ➜Saturday: 9 a.m. to 1 p.m.

Mark Dissette, SVP and Administrator, Holy Cross HealthPlex; Kent Mathisen, Executive Director, Urgent Care and Imaging Center; Patrick Taylor, MD, President and CEO, Holy Cross Hospital; Marco A. Muniz, DO, MPH, Urgent Care Medicine; and Sister Genevra Baer, RSM

Care when you need itFor nonemergencies that need

immediate care, we treat:

➜Abdominal pain

➜Allergies

➜Asthma (mild)

➜Bronchitis

➜Cold and fl u

➜Contact dermatitis

➜Cuts and wounds

➜Dehydration

➜Dizziness

➜Heart palpitations

➜High blood pressure

➜ Infections

➜ Insect bites

➜Minor burns

➜Nausea

➜Open wounds

➜Pinkeye

➜Pneumonia

➜Rashes

➜Simple bone fractures

➜Sprains and strains

➜Urinary tract infections

➜And more

Grand opening

Holy Cross news

Radio station 93.9 MIA gave away prizes at the opening celebration.

6 Time Out for WomenTime Out for Women

By Linda Hamilton, RN, Patient Navigator, Dorothy Mangurian Comprehensive Women’s Center

PatieNt NaViGatiON is still a relatively new process in the medical fi eld. Approximately 10 years ago, navigators were just beginning to emerge in the United States as key individuals who guide patients through their medical care. Patient naviga-tion has rapidly become valuable to the healthcare institution—and even more so to patients.

Imagine hearing a diagnosis from your doctor informing you that you are in need of immediate medical attention. You might wonder, where do I turn? Which doctor should I see? What is the next step? Who will orchestrate my appointments and schedule the imaging?

As the Patient Navigator in the Dorothy Mangurian Comprehensive Women’s Center at Holy Cross HealthPlex, much of my day is spent communicating with physician offi ces, informing them of recent mammogram results that need addi-tional recommended imaging or even a biopsy. This is scary news for most people. That is when I step in and try to assist the patient in moving forward with a plan of care. I always have a tissue box nearby for them.

I also spend a lot of time talking with patients who need a breast ultrasound, a diagnostic mammogram or a biopsy. I fi nd that once I establish a relationship with the patient, many (although not all) of her or his fears are relieved. If I can assist even one patient a day by guiding her or him through this experience, my goal is met and the patient has a better perspective of her or his future. I love my job of helping others in their time of need—some of their fears can be relieved just knowing someone cares about them.

This is also an advantage for physicians, because they can rest assured that someone follows their patient closely as they proceed forward in their care. If the need arises and the patient requires surgery or treatment, another Navigator—Bonnie Pesacov, RN, MS, AOCN—in the Michael and Dianne Bienes Comprehensive Cancer Center continues to guide the patient through her or his care.

The Patient Navigator also guides those who need a mammo-gram but are facing diffi cult fi nancial times. Some are without a job or insurance or are struggling to make ends meet. I connect them with Holy Cross Hospital’s Partners in Breast Health program to see if they qualify for a free mammogram.

At a time when patients are overwhelmed or may not know where to start or how their diagnosis may change their future, the Patient Navigator’s mission is to guide them through their care and alleviate their fears and worries, reassuring them that they are in the right place and have the best team on their side to maintain or return to good health.

“I love my job of helping others in their time of need.”

—Linda Hamilton, RN, Patient Navigator954-351-4773

Patient navigationJUST A SHORT WALK FROM HOME

A trusted name in urgent care and imaging is now in

Rio Vista.

The Holy Cross Urgent Care and Imaging Center brings the expertise and compassionate care of nationally ranked Holy Cross Hospital to your neighborhood. When you need immediate care but it’s not serious enough for the ER, just walk in, no appointment needed. Or when you have to fi t a physical, immunization or diagnostic test around your work schedule, we’re here. And we’re fast—we won’t make you sit and stay!

Contact us or preregister online atHolyCrossUrgentCare.com1115 S. Federal Highway, Fort Lauderdale954-764-6646

Urgent Care & Imaging CenterOur mission is you.

77www.holy-cross.com

Community giving

tHe HarrY T. Mangurian, Jr. Foundation heard the need for donations for the Partners in Breast Health program (read more on the next page) at the Dorothy Mangurian Comprehensive Women’s Center and answered the call with a $100,000 Dottie’s Mother’s Day challenge. The community also stepped up and accepted the challenge to double their generous donations.

Donations poured in from Women Owning Wellness (WOW!), Girlfriends and other generous supporters in our community who have a heart for the underserved. Though the full amount of the match was not raised, the

Mangurian Foundation was so moved by the giving that they decided to donate the entire $100,000 to our Partners in Breast Health program. As a result, women in our community will receive much-needed healthcare—care they would have no other means of accessing.

These funds will ensure the run of the program through the end of the year. In addition, we have had tremendous support of this program from the 1000+ Club, Susan G. Komen for the Cure and the American Cancer Society.

Because this program is constantly in need of

Dottie’s Mother’s Day Match a successTHE HARRY T. MANGURIAN, JR. FOUNDATION AGAIN MATCHES FUNDS RAISED FOR WOMEN’S HEALTH AT HOLY CROSS

8 Time Out for Women

The Partners in Breast Health programThe Partners in Breast Health (PIBH) commu-nity outreach program provides women with mammograms in hope of reducing late-stage breast cancer diagnosis and cancer mortality in underserved communities in Broward County through early detection—ultimately saving lives.

Through PIBH, a mobile medical health unit visits underserved communities. On board, a physician and/or an advanced registered nurse practitioner provides one-to-one education, a general health assessment and a mammogram for women age 40 and older and necessary breast imaging for symptomatic women of any age.

Mammography screening is recommended by the American Cancer Society guidelines for women over 40. However, for women without health insurance, only one other program in Broward provides access to mammog-raphy services—but you have to be at least 50 years old. The 10-year gap postpones access to mammography screening services for thousands of women—including those who are symptomatic.

Since the PIBH program began providing access to screening and diagnostic mammog-raphy services in November 2011, more than 1,600 women have received services. Of those diagnosed, more than 50 percent have been under the age of 50. These fi ndings are worri-some and exceed national statistical data. The PIBH program results support the need for improving early detection of cancer through routine mammography, implementing evidence-based community interventions to increase screening and modify risk behaviors, and devel-oping research projects.

PIBH is funded by diversifi ed support, including the Harry T. Mangurian, Jr. Founda-tion; Women Owning Wellness; the 1000+ Club; Susan G. Komen for the Cure; the American Cancer Society; and numerous private donors. Holy Cross Hospital also provides discounted rates that allow for maximization of donated dollars. Together we are making a difference in the lives of the women in our community.

re-funding, WOW!’s “This One’s for the Girls” luncheon this year (read more on page 8) will once again support this program, as will the funds from the fourth annual Holy Cross Hospital Golf Classic presented by the Harry T. Mangurian, Jr. Foundation on Feb. 5, 2014. ❧

Together we built the Women’s Center, and together we can fulfill its highest purpose—caring for all

the women in our community. For more information on supporting Partners in Breast Health or the Women’s Center, please visit HolyCrossDonations.com/women.

www.holy-cross.com 9

Robotic-assisted surgery

a Pear-sHaPed organ under your liver, the gallbladder stores and releases bile (fl uid made by the liver) to digest fat. Your gallbladder may give you trouble if something blocks the fl ow of bile through the bile ducts, which connect your gallbladder and liver to your small intestine. These blockages are usually caused by a gallstone and usually happen after you eat.

Signs of a gallstone attack include: ✓Nausea ✓Vomiting ✓Pain in the abdomen or back or just under the right arm

Robotic-assisted surgeryThe gallbladder is an organ that you can live without; bile has other

ways of reaching your small intestine. According to the American College of Surgeons, surgery is the recommended treatment for gall-bladder pain from gallstones and nonfunctioning gallbladders. More than one million people in the U.S. undergo cholecystectomy (surgical removal of the gallbladder) each year.

Many of these patients are candidates for a single-site cholecystec-tomy using the da Vinci Si Surgical System. Surgeon Alexander Parr, MD, performs the da Vinci Single-Site cholecystectomy at Holy Cross Hospital using robotic assistance to remove a patient’s gallbladder. Unlike traditional laparoscopy and robotic surgery that require three to fi ve incisions, this technology involves a single incision of approxi-mately 2.5 centimeters (1 inch) through the belly button. The robotic instruments and endoscope are then placed in the incision, and the gallbladder is removed.

“There are many potential benefi ts to this technology,” says Dr. Parr. “The da Vinci Single-Site platform is an innovative technology that improves visualization of biliary anatomy, allowing patients to receive a virtually scarless cholecystectomy. Procedures typically take under an hour, and patients can leave the hospital in less than 24 hours.”

Catherine Hart, 39, of Lighthouse Point, is pleased with the results of her surgery. “There is no scar whatsoever,” says Hart, who acknowl-edges that vanity played a role in her decision to have the single-site surgery. “I’m young, and I do spend a lot of time in a swimsuit. I have a boat. We are in south Florida.”

The single-site surgery appealed to Hart, a registered nurse, for another reason as well: “I feel like it was less invasive because I did not have multiple incision sites compared to a regular lap cholecystectomy. I could have a shower right away—that was a good thing; and I was able to swim about a week later.”

Holy Cross surgeons currently utilize the multiport da Vinci Si Surgical System in urologic, gynecologic, bariatric and general surgery. ❧Source: www.nlm.nih.gov

For a physician referral, call 866-4HC-DOCS ( 866-442-3627).

Single-site surgery:

Alexander Parr, MD, General Surgeon, Holy Cross Hospital

Robotic-assisted surgery

ways of reaching your small intestine. According to the American College of Surgeons, surgery is the recommended treatment for gall-bladder pain from gallstones and nonfunctioning gallbladders. More than one million people in the U.S. undergo cholecystectomy (surgical removal of the gallbladder) each year.

tomy using the da Vinci Si Surgical System. Surgeon Alexander Parr,

Single-site surgery:

Alexander Parr, MD, General Surgeon, Holy Cross Hospital

Gallbladder removal through the belly button

Alexander Parr, MD, General Surgeon, Holy Cross Hospital

10 Time Out for Women

By Elie Schochet, MD, FACS, Colorectal Surgeon, Holy Cross Medical Group

teLeVisiON aNd tHe iNterNet bombard consumers with the next best “super foods” or supple-ments, often claiming benefi ts that are unproven or untested. Products like acai berries, probiotics, lyco-pene and green coff ee come to mind as the most recent darlings of the supplement craze.

Fiber, while not technically a supplement, should be a major part of any well-balanced diet. Its benefi ts in the prevention of gastrointestinal complaints (constipation, hemorrhoids, diarrhea and diverticulitis), heart disease and diabetes are well-studied and accepted. Unfortunately, while fi ber is found in most fruits, vegetables, beans and grains, even those eating a healthy, well-balanced diet are often still fi ber-defi cient.

How to get enough fi berThe recommended amount of dietary fi ber is 20 to 35 grams per day.

It is made up of soluble fi ber and insoluble fi ber. Soluble fi ber dissolves in water and can be found in most fruits, oats, barley, peas and beans. Insoluble fi ber comes from plant cells and does not dissolve in water. It can be found in wheat, rye, vegetables and wheat bran.

The fi ber content of most foods can be found online or on nutri-tion labels. Breakfast cereals and oatmeal can be very good sources of extra fi ber. Another simple solution is to replace white rice and white bread with brown rice and whole-grain breads. For those who do not like high-fi ber foods, there are a number of fi ber supplements on the market, many containing psyllium.

Benefi tsDietary fi ber stays in the intestines and is not absorbed or digested. It

can modulate the digestion of other nutrients and aff ect the consistency of the stool. Fiber adds bulk to the stool, making it softer and easier to pass without needing to use laxatives or stool softeners. In addition, fi ber supplementation can improve cholesterol profi les and reduce the risk of coronary artery disease and stroke by 40 to 50 percent. It has been shown to reduce the risk of developing type 2 diabetes; in patients with diabetes, fi ber can help control blood glucose levels.

Things to considerWhen starting a fi ber supplement, it is important to start slowly and

to use adequate amounts of nondiuretic fl uids. Avoid sugary or caff ein-ated drinks. This will help to avoid the gas, bloating and cramping that can occur if too much fi ber is ingested too quickly. Be wary of pills or fi ber bars, as they are often lower in fi ber than the powders and not enough fl uid is ingested with them. ❧

Dr. Schochet practices at Holy Cross Medical Group Colorectal Surgery Practice, located at 1940 N.E. 47th St., Suite 1, in Fort

Lauderdale. Call 954-772-4553 to schedule an appointment.

Super fi berEating right

www.holy-cross.com 11

Botox®

strOKe is a sudden neurologic injury to the brain which can result in partial or full paralysis of the arm or leg and diffi culty

speaking or swallowing. Each year stroke aff ects more women than men. Statistics show that of 795,000 total strokes each year, 425,000 involve women; it is the third leading cause of death in the United States.

in womenBy Phyllis Bulkan, MD, Physiatrist , Holy Cross Medical Group

REFERENCES1. The Internet Stroke Center. (n.d.). Stroke statistics. Retrieved from http://www.strokecenter.org/patients/about-stroke/stroke-statistics2. Ozcakir, S. and Sivrioglu, K. (2007). Botulinum Toxin in Poststroke Spasticity. Clinical Medicine & Research, Vol. 5(2), 132-138.3. Saul, K. (2009). Botox and stroke. Retrieved from http://www.strokenetwork.org

Stroke and spasticity

Dr. Bulkan practices at Holy Cross Medical Group,

Physiatry Practice, located at 4725 N. Federal Highway in Fort Lauderdale. Call 954-776-6503to schedule an appointment.

Strokes can occur at any age, but the risk of stroke increases with age. Other factors include race, family history and medical conditions.

What is spasticity?The disability related to a stroke

event can be life-changing. Post-stroke paralysis can result in spasticity (abnormal muscle tone). Spasticity aff ects approximately 30 percent of people with strokes and can lead to severe disability, including decreased

range of motion in the arm or leg. This disability results in diffi culty dressing, bathing, maintaining hygiene or getting around.

TreatmentsThe treatments for

spasticity range from conservative to more-invasive management. The goal of spasticity management is to decrease muscle tone in order to decrease pain and improve the movement and func-tion of the aff ected arm or leg. Conserva-tive treatments include range-of-motion exercises, positioning, stretching and the use of splints. In addi-tion, heat or electrical stimulation can be used in conjunction with conservative treatment. Oral medi-cations, or antispas-motics, can also be used; however, these

medications can sometimes result in altered mental activity, such as confu-sion and sedation.

Botulinum toxin treatmentBotulinum toxin, or Botox®, can

also be used to treat spasticity. It is a potent biologic toxin produced by the bacterium Clostridium botulinum. This toxin is purifi ed by pharma-ceutical companies and can be used to decrease spasticity or tone in the aff ected extremity. It inhibits the release of acetylcholine, which decreases the contractions of the muscle.

A stroke survivor who is aff ected by spasticity in her arm or leg should be evaluated for Botox injection, which is a simple procedure done in a physiatrist’s offi ce. A small amount of medication is injected into the aff ected arm or leg. The eff ects of Botox are initially noted in the fi rst 24 to 72 hours. The medication continues to be eff ective for three months. During this time, physical and occupational therapies are recommended. The injection can be repeated after three months.

Many patients benefi t from Botox treatment for spasticity related to a stroke. We discuss the procedure in detail beforehand with each qualifi ed patient. ❧

Time Out for Women12

Fitness

By Gisela Ortega, DPT, Holy Cross Hospital Rehabilita-tion Institute

tai cHi is an ancient martial art

that involves mental concentration, deep breathing and meditation while adding slow, coordinated and gentle movements. Tai chi can be practiced by anyone, but it is highly recom-mended for people with osteoar-thritis, osteoporosis, diabetes, sleep disorders, stress, depression, fibro-myalgia, cardiovascular conditions, and weight disorders. Tai chi can be used in conjunction with other exercise routines.

Unlike other practices, tai chi does not require any special equipment, making this practice very afford-able. From the physical therapy point of view, tai chi involves weight-shifting the body’s center of mass through the whole array of

movements. It involves static and dynamic balance; proprioceptive awareness (knowing where the body is in space); muscle elongation and flexibility; and isometric, concentric, and eccentric contractions of different muscle groups.

The benefits of tai chi have been investigated, and although research is ongoing, some studies revealed that tai chi helps improve strength, condi-tioning, coordination, balance, flex-ibility and cardiovascular function. In addition, using tai chi as an alternative exercise prescription decreases pain and lowers the risk of falls. Though there are benefits to this practice, it is essential to consult with your primary care physician before engaging, espe-cially if you have severe osteoporosis or an active infection or are pregnant. To inquire about tai chi classes, contact the Holy Cross Zachariah Family Well-ness Pavilion at 954-229-7950 or your local arthritis foundation or recre-ation center. ❧

Ortega practices at Holy Cross Hospital Rehabilitation Institute,

located at 4725 N. Federal Highway in Fort Lauderdale. Call 954-492-5738 to schedule a physical therapy appointment.

A low-impact, weight-bearing exercise

REFERENCES1. WebMD. (2012) Health benefits of tai chi and qigong. Retrieved from http://webmd.com2. Sarnataro, B. (2006).Tai chi exercises both mind and body. Retrieved from http://webmd.com3. Ellen, D. (2000). Tai chi: The more you sway, the less you’ll fall. 4. Downs, M. (2002). Arthritis—therapy in motion—tai chi. Retrieved from http://www.webmd.com5. Wolf, S.L.; Barnhart, H.X.; Kutner, N.G.; McNeely, E.; Coogler, C.; Xu, T. (1996). Reducing frailty and falls in older persons: An investigation of tai chi and computerized balance training. Journal of the American Geriatrics Society, Vol. 44(5):489-97.6. Yan, J.H.; Gu, W.J.; Sun, J.; Zhang, W.X.; Li, B.W.; Pan, L. (2013). Efficacy of tai chi on pain, stiffness and function in patients with osteoarthritis: A meta-analysis. PLoS One, Vol. 8(4):e61672.7. Wolf, S.L.; Coogler, C.; Xu, T. (1997). Exploring the basis for tai chi chuan as a therapeutic exercise approach. Archives of Physical Medicine and Rehabilitation, Vol. 8(8):886-92.8. Kim, S.H.; Schneider, S.M.; Kravitz, L.; Mermier, C.; Burge, M.R. (2013). Mind-body practices for post-traumatic stress disorder. Journal of Investigative Medicine, April.

www.holy-cross.com 13

Autumn offerings

PLease JOiN us for the Women Owning Wellness “This One’s for the Girls” luncheon presented by Morgan Stanley and bene-fi ting the Partners in Breast Health program at the Dorothy Mangurian Comprehensive Women’s Center. The event will be held on Thursday, Oct. 17, at the Hyatt Pier 66. Major sponsors include AutoNation, City Furniture and Ashley Furniture.

This year’s guests will enjoy a fabulous lunch and shopping opportunities at several boutiques on-site, including Angelic Accents, Cathi’s, QBS Designs, Stella & Dot, GRAAL Distri-bution, Anne’s Florist, Casbah, Sun Bead Bracelets, Salon Bark Lifestyle Boutique, and Country Squire. Portions of the proceeds from the shopping boutiques will also benefi t the Center. The event will be chaired by Carrie Stiles Tidwell, Libby West and Laura Minor. Community Leadership Chairs Doreen Koenig, Monica Maroone and Sheri Whittington are serving as chairs emeritus.

Starting at $2,500, sponsorship opportunities off er special event recognition, advertising options and gifts for guests. Table sponsors are $1,500, and individual tickets start at $85. ❧

For additional information on the luncheon or on Women Owning Wellness, please contact 954-229-8562 or email

donations@holy-cross.com.

Our mission is you.

DON’T FORGET, IT’S FLU SEASON:THE PERFECT TIME OF YEAR FOR A CHECKUP.

Get ready for fl u season

‘This One’s for the Girls’Join us for the annual luncheon

tHe 2013–2014 fl u season vaccine is now available at Holy Cross Medical Group physician offi ces.

Flu viruses are constantly changing. That’s why the Centers for Disease Control and Prevention recommends this vaccination to everyone on a yearly basis. Schedule an appointment for a fl u shot, and while you’re here, complete your yearly checkup to make fl u season a healthy season. ❧

Call 866-988-DOCS (3627) to make an appoint-

ment with a Holy Cross Medical Group Primary Care Physician, or visit HolyCrossMedicalGroup.com for a map of our primary care physician offi ces.

14 Time Out for Women

tHe NeW caFÉ and Teaching Kitchen at the Patricia R. Guerrieri Pavilion, located in our Women’s Center, is a spacious, quick-service restaurant with made-on-site menu items such as Starbucks coff ee and espresso, fresh fruit cups and parfaits, omelets and buttermilk pancakes, grilled chicken quesadillas and burritos, hot soups and grab-and-go sandwiches, and wraps and salads. Nutritional information is available for most items. The Café is open to the public for breakfast and lunch from 7 a.m. to 4 p.m. on Mondays through Fridays.

Once a month, free Healthy Cooking Demos with varied, themed recipes are off ered to the community from 3 p.m. to 3:45 p.m. Attendees receive free take-home recipe cards and samples of healthy meals from the demo. ❧

New Café

At left: Free Healthy Cooking Demos are held once a month at the new Café.

THE CAFÉ IS OPEN TO THE PUBLIC AND OFFERS FREE HEALTHY COOKING DEMOS

dOes tHis look like your to-do list? ◽Reduce respiratory symptoms ◽Quit smoking ◽Require less-frequent hospital admissions

◽Manage pulmonary diseaseHoly Cross Hospital’s Pulmonary

Rehabilitation program may help restore your quality of life.

Who benefi ts?Pulmonary Rehab helps people with

chronic lung diseases, such as COPD, emphysema, asthma and cystic fi brosis sarcoidosis, and those preparing for or recovering from lung surgery.

What is it?We are staff ed with critical care

nurses, exercise physiologists and registered respiratory therapists. We work together with our medical directors, who are pulmonary medi-cine specialists.

We are located on the fi rst fl oor of the main hospital, in the Zachariah Family Wellness Pavilion.

You can be referred by your primary care physician or other specialty

physician with a signed prescription. Our staff will contact you to set up an appointment as soon as we receive the required information.

We recommend that new patients attend Pulmonary Rehab two to three times per week for approximately three months. This can vary based on individual needs and availability.

Is it covered?Pulmonary Rehab is recognized and

covered by most insurance carriers. We recommend that you check with your individual carrier. Our “Maintenance,” or“Phase 3,” program is not a covered insurance benefi t. It is off ered for a minimal fee per session. ❧

For more information about Pulmonary Rehabilitation, please

call 954-229-7961.

Above: The Café team includes (from left) Fran Acquavella, Cashier/Barista; Patrick Wood, Cook; Adrian Gilbert, Utility Worker; Daniel Hendon, Executive Chef/Manager; David Palmieri, Cook; and Kathleen Kane, Cashier/Barista.

at Women’s Center

With us, you can breathe easy

Visit HolyCrossWomensCenter.com to view the full

schedule and sample recipes, or call 954-351-4782 for more information.

Holy Cross news

www.holy-cross.com 15

Follow Holy Cross on:➜www.facebook.com/

holycrossfl ➜www.twitter.com/holycrossfl ➜www.youtube.com/

holycrosshospitaltv

For a Holy Cross Medical Group Physician Referral,call 866-988-DOCS(866-988-3627).

➜Through December 2013: New Exhibition at the Patricia R. Guerrieri Pavilion Art Gallery

➜Oct. 17, 2013: “This One’s for the Girls” luncheon at the Hyatt Pier 66 benefi ting the Dorothy Mangurian Comprehensive Women’s Center

➜Feb. 5, 2014: Holy Cross Hospital Golf Classic benefi ting the Dorothy Mangurian Comprehensive Women’s Center

➜March 8, 2014: Holy Cross Hospital Auxiliary’s Epicurean Escapade benefi ting the Dorothy Mangurian Comprehensive Women’s Center

Girlfriend’s Club events and happenings

4725 North Federal HighwayFort Lauderdale, FL 33308

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