Category: Health & Wellness

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Reducing your breast cancer risk

October is National Breast Cancer Awareness Month, and the perfect time to learn how to reduce your risk by eating right and engaging in physical activity. While there is no guaranteed way to prevent breast cancer, a healthy lifestyle can help reduce your risk of developing it and boost your odds of full recovery if you are diagnosed with it.

 All women are vulnerable to developing breast cancer, but certain women are at a higher risk. Although some risk factors can’t be controlled, such as family history, gene mutations, and onset of menstruation and menopause, other risk factors can be reduced by focusing on nutrition and lifestyle choices.

Weight is closely connected with breast cancer risk, and risk increases for those with overweight or obesity after reaching menopause. Engaging in regular physical activity is associated with reduced breast cancer risk and is one way to help promote a healthy body weight. For optimal health, aim for at least 30 minutes of moderate-to-vigorous physical activity most days of the week.

Certain foods—high in dietary fiber, vitamins, minerals, and phytonutrients—may help protect against some cancers. The following foods include a variety of vegetables, fruits, and whole grains:

  • Cruciferous and dark, leafy green vegetables:spinach, broccoli, cauliflower, brussels sprouts, cabbage, collards, and kale
  • Fruits:citrus, berries, pomegranate, and cherries
  • Whole grains:oats, whole-grain barley, bulgur, whole rye, and whole-grain breads and cereals
  • Legumes:beans, peas, lentils, and soybeans

Alcohol intake also is linked with breast cancer risk. If you are a female of legal age and choose to drink, limit your intake to no more than one serving of alcohol per day. (A serving of alcohol is considered 1½ fluid ounces of hard liquor, 5 fluid ounces of wine, or 12 fluid ounces of beer.)

An oncology registered dietitian nutritionist (RDN) will do the following:

  • Help individuals find the best food choices and ways to eat based on how they feel and what they like. For example, small, frequent snacks may be easier to tolerate than a few larger meals.
  • Help patients determine if supplements and nutrient-rich beverages and foods are needed to get the nutrition they need.
  • Answer questions about foods, supplements, nutrients, and diet. There is an infinite number of sources of information about diet and cancer.
  • Help patients process the information they’ve found and discuss the options that may be most beneficial.

Food and nutrition are critical parts of successful cancer treatment. Nutrients support healing and the growth of healthy cells in your body; they also go a long way toward helping you maintain energy and strength.

A personalized nutrition plan based on an individual’s likes, dislikes, lifestyle, symptoms, and concerns is an integral part of cancer treatment. An RDN trained in oncology nutrition is a key part of the medical team working with people with cancer.

Once cancer treatment is complete, maintaining a nutritious eating routine can help the body heal and offer protection for the future. Center your plate to focus on fruits, vegetables, and whole grains. Studies have also found that people who limit added sugars, red meat, and alcohol have lower risks of certain types of cancer. Food choices should be easy to chew, swallow, digest, and absorb, even if high in fat.

This type of eating routine is also good for heart health and can help reduce the risk of other chronic diseases.

 

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Healthy habits for the new school year

It’s August, time for our kids (and teachers) to get ready to return to school. Even if your children are excited to begin school, it is typically a big adjustment for everyone. Getting back into the school routine can be difficult, especially after a relaxed summer schedule. Parents, you can assist your children and manage the increased pace by planning ahead, being realistic, and maintaining a consistent, structured schedule until school begins.

The new school year requires changes, which can be difficult for kids, especially for the younger ones. School-aged children who are sensitive or have anxiety issues or developmental delays may need more time to adjust than others. In order to alleviate discomfort and make the transitions easier, I suggest that parents talk to their children about the upcoming school year, the new teachers, and the excitement of making new friends. This type of dialogue is helpful to learn about your kids’ feelings so that you are able to understand their fears and help them move ahead in a positive, nonjudgmental way. Your reaction and response can assist your child in setting realistic goals and reducing internal concern. The conversations will open doors for future interactions.

Getting kids back on the early-morning wake-up routine can be extremely difficult, especially for teens and preteens. An idea that works well in establishing school protocol is to begin having them back into the habit of going to bed earlier and waking up earlier about a week before school starts. This slow change allows them time to adjust so that they are more comfortable and school-ready. It also helps to create a morning schedule in order to keep kids on track. Helping children by practicing the before-school behaviors of getting dressed, brushing teeth, and eating breakfast in a timely manner can help manage mornings in order to avoid stress and tempers. Establishing afternoon and evening schedules ensures that there will be time for homework, screen time, play, baths/showers, dinner, and bedtime. One of our many jobs as parents is to help our children adjust to new routines and to accept responsibility, in age-appropriate ways. A consistent bedtime routine helps to ensure a good night’s rest, which is important in having productive and happy school days.

Another great way to ensure success is to help your kids plan ahead. Encourage them to organize clothing, backpacks, and even lunch before going to bed. This way, an extra minute or two of snoozing eliminates a mad dash around the house and the chance of forgetting something important. I also strongly recommend avoiding screen time before school because it distracts kids from their routines and responsibilities. It also encourages children to stay calm and focused. Once your routine is established, you can slowly make concessions and allow some screen time. However, I would encourage you to save screen activities for after school.

Planning ahead for parents is also helpful as it encourages you to think about what meals you want to serve your family. Planning meals that are healthy and easy to prepare works because kids and families are going to be tired throughout the first few weeks back.

Establishing homework time and a designated place for kids to do their homework is also really helpful. Children thrive with structure and routine, so making sure they know what the expectations are in the afternoon is key to success. Having a set place to do homework, and knowing that they can play afterward, provides kids with the motivation to complete their work earlier in the afternoon.

Overall, it’s an exciting time of year, but also one that can be difficult to adjust to. Having a plan in place to help yourself and your family get prepared for the new school year is the key to less stress and less anxiety for all.

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Dealing with dietary restrictions during the holidays

The holiday season is here, and with that come fancy dinners, work parties, potlucks, and family gatherings. Although breaking bread with your favorite people can be one of life’s simple joys, anxiety over what to make when feeding those with special dietary needs can make things feel complicated. Here are nine tips and tricks for hosting a holiday dinner that everyone can enjoy.

  1. Ask for Advice

Who knows best? The person with special dietary needs! Once you have a menu in mind, discuss it with your guests ahead of time and ask how they can best be accommodated.

  1. Read Labels

Dairy, gluten, and non-vegetarian ingredients are found in many packaged foods. If you are not sure whether an ingredient is safe for your party guests, ask the person you’re accommodating or skip it.

  1. Don’t Cross-Contaminate

Use separate tongs when grilling meat and veggie burgers to spare vegetarian foods from meat juices. Don’t bake a nut-free cookie on the same tray you just roasted almonds. Thoroughly wash the strainer in between draining wheat spaghetti noodles and gluten-free ones. Being mindful of opportunities for cross-contamination can lower the risk of serving foods that your guest might not be able to eat.

  1. Make Simple Swaps

Tossing your veggies with olive oil instead of butter means that vegans and those with dairy allergies can enjoy them too. Use vegetable stock instead of chicken or beef stock in the side dishes so that more people can enjoy them.

  1. Leave the Toppings on the Side

Sometimes it’s just one or two ingredients that rule out a dish for those with dietary issues. If you leave the bacon crumble on the side, those who eat meat can still have it, and vegetarians can eat the dish too.

  1. Build a Bowl

Rather than designing a menu with several parts, build a buffet of toppings and let your guests do the rest. From a yogurt parfait brunch to a smoky burrito bowl, there are many options for having a casual meal that is satisfying for everyone. Having a diverse spread of options will allow your guests to create a meal that fits their needs.

  1. Serve Delicious Drinks

Even those not drinking alcohol enjoy fancy mock-tails. Include everyone in the festivities by making a pitcher or two of fruit and herb-infused waters or a dry bar with seltzer, juices, and herbs.

  1. Polish Your Sales Pitch

We tend to be wary of foods we cannot easily identify. To encourage everyone to try different dishes, write the menu on a chalkboard or place a menu card on the table. On your buffet line, label each dish with enticing adjectives and include ingredients. Not only does this encourage a picky eater to try new things, but it also helps guests avoid food allergens.

  1. Have Fun!

Remember: You don’t have to accommodate your guests for every single dish. If your holiday dinner would not be complete without your grandmother’s Yorkshire pudding, include it. Missing your personal favorites might lower your own enjoyment of the occasion. With a well-planned dinner, all of your guests can be happy and well-fed.

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Shop healthy on a budget

With a little know-how and advanced planning, you can enjoy nutritious foods while sticking to a tight budget.

Plan Around Sales

The key to smart, budget-friendly grocery shopping is planning ahead. Plan meals around fresh produce, lean protein foods, and low-fat dairy items that are on sale and in season to save money while eating healthy.

Check store sale flyers and available coupons on the same items for additional savings. Compare national brands and private store labels for the lowest price. Once you’ve identified sale items, incorporate them into simple meals; baked, grilled, or broiled lean meats or fish served with vegetables and whole grains are delicious and healthy with few added ingredients. Also, use the unit price to compare costs between different-sized packages of the same product.

Create a Shopping List

Use your weekly eating plan to create a master grocery list and stick to it. Prioritize your food dollars for nutrient-rich vegetables, fruits, low-fat dairy, lean protein foods, and whole grains. To keep your grocery list from growing too long, prepare meals that include similar ingredients throughout the week.

In the Produce Section

When it comes to fresh vegetables and fruits, shop seasonally. Local, seasonal produce is at its peak flavor and is generally more abundant, so it’s usually sold at a lower price.

Frozen or Canned Alternatives

If the produce item you want isn’t in season or doesn’t fit in your budget, consider purchasing it frozen or canned. Fresh, frozen, canned, or dried fruits and vegetables can be good for you. Canned fruits and vegetables are picked at peak freshness and can be just as nutritious as fresh foods because canning and freezing preserves many nutrients. Canned and frozen foods offer an alternative to fresh and may be more budget-friendly. Be sure to check the ingredients list to avoid items with added sugars or salt.

At the Meat Counter

Consider purchasing a larger quantity of meat that is on sale and preparing enough for two or more meals. Enjoy leftovers later in the week or freeze for future use. Because meat is often the highest-dollar ingredient in a recipe, consider planning meatless meals a few nights each week, or try replacing half the meat in dishes such as chili, meatloaf, or burger patties with beans, finely minced mushrooms, or chopped vegetables. Incorporating more non-meat proteins, including beans, nuts, and eggs, can be cost-effective and nutritious.

Whole Grains and Dry Goods

Whole grains and dried beans are generally inexpensive and are an easy way to get more nutrition for your buck. Stock up on these nonperishable items when on sale or take advantage of the bulk bin by purchasing only the amount you need. Dried beans, peas, and lentils are great options to keep on hand. You can buy in bulk, prepare ahead of time, and then freeze so you always have protein and fiber-rich foods on hand.

Reduce Waste

Once you’ve done your shopping, make the most of your food spending by cutting down on waste. Plan to use highly perishable items — such as fish and seafood, salad greens, berries, and fresh herbs — early in the week, and save more hearty items for later in the week. Enjoy leftovers for lunch or create new meals from leftover ingredients. Cooked meat and vegetables can be revamped as a filling for a casserole, frittata, or soup.

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A canine (human) intervention

I have a friend who will remain anonymous. She has read my articles for the past 20 years and had already declared last month’s conversation as article worthy. Literally, she gave me the look like, “You are going to use this as an article,” not as a question but as a statement. With a wink, I told her that this is not the first time I have used her cute-isms, as my wife and l like to call them, as inspirations for an article.

My wife and I have known “L” and her family for a long time. Our kids have grown up together and we view them as family. L looks at the world differently. She is a teacher and a mother and takes care of everyone around her. When her kids or her dog Mello have an issue, she has them diagnosed and treated like a protective mother might, but she also has the tendency to forget about herself.

L has a family history of high blood pressure and heart disease. She hadn’t seen a doctor in years, and at her last physical she was informed that her physician wanted her to see a cardiologist to work up her high blood pressure and new heart murmur. L’s husband called to tell me the news that L vehemently did not want to be discussed with anyone. She told her husband that her physician is an alarmist and came up with a hundred excuses, from caffeine to stress to weight gain, for why her blood pressure was elevated.

L is an amazing pet owner. Mello has been to my hospital for ACL surgery, tumor removals, emergency dental abscesses, and even once he ate those toxic crayons that the babysitter brought over. If there was a problem with Mello, it was addressed quickly and without question.

Mello was in the hospital for a bath and his biannual examination days after I had talked to L’s husband. It was a weekly routine. L picked up Mello after work. She bought herself a medium iced coffee at the coffee shop and brought me one as well. I asked my receptionist to put L in an examination room.

I walked in and told L that during my examination of Mello, I found a new heart murmur. I told her that I had never heard one before in Mello. I also told her that I ran some bloodwork and checked his blood pressure. L repeatedly shook her head and was notably concerned. She wanted to know if I had any results, and I told her that the bloodwork results would be in tomorrow, and his blood pressure was elevated.

L wanted to know if I needed to do an EKG or take chest X-rays, and I told her that I would feel better if she went to the cardiologist because they are the experts, and if there is a problem then they usually recommend an echocardiogram. L took out her notebook to write down the cardiologist’s name and number. She told me that nothing could happen to Mello. He is so important to the family and losing him only midway through what she considered his life expectancy would be devastating.

I looked at her and gave her a hug. I told her that Mello was fine. He was perfect. L was confused. I told her that I had just talked to her husband, and he told me about her heart murmur and high blood pressure. I told her that she should attack her issues with the passion she had for Mello, because her family, students, and friends could not bear losing her midway through her life expectancy.

L was actually more relieved about Mello than angry with me for having the intervention. She walked out of the examination room smiling but telling me that turning 50 sucks.

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Osteoporosis: a ‘silent disease’ that leads to broken bones

Most people don’t care about statistics until they become one. But approximately 10 million Americans have osteoporosis, and another 44 million have low bone density that increases the risk. The importance of regular bone density testing cannot be underestimated, especially for adults over 50 years of age.

Eighty percent of older adults sustaining a broken bone never had a bone density test (BDT) and subsequently were never treated for osteoporosis. A BDT is the best diagnosis. If one’s T-score is –2.5 or lower, chances are that osteoporosis is present and a plan of treatment needs to be developed.

Osteoporosis is called the “silent disease” simply because it’s impossible to know when bones begin to deteriorate. Over time, they can become so brittle that a simple cough or bumping into furniture causes a break. Bone density tests are a vital part of one’s regular healthcare regime and should be repeated at least every two years.

Women are more susceptible to osteoporosis. One in two women will break a bone in their lifespan, and their incidence of breaking a bone is higher than their risk of a heart attack or a stroke — and it’s equal to the combined risk of getting breast, uterine, or ovarian cancer.

Not only is breaking a bone painful, it’s also very costly. The burden on the healthcare system is nearly $20 billion a year and specialists predict a gloomy future — expecting as many as 3 million fractures by 2025, costing patients, families, and the healthcare system as much as $25.3 billion.

Prevention

Bone tissue is constantly being broken down and replaced, and with age the process does not occur as frequently. Peak bone mass is usually achieved by the late 20s, but people can still build and maintain strong bones for the remainder of their lives. Osteoporosis occurs when creating new bone doesn’t keep up with the loss of old bone. Your physician can prescribe medications or other treatment options, but to gain full benefit it’s important to exercise regularly, and be sure to take the recommended amount of calcium and vitamin D obtained from foods and/or supplements.

Symptoms

There are typically no symptoms in the early stages of bone loss. When bones being to weaken, however, one can experience back pain, loss of height, a stooped posture, and bones that break more easily than expected. Women who have experienced early menopause or have taken corticosteroids for several months are highly susceptible to weaker bones. Low sex hormone levels will also weaken bones. A fall in estrogen levels in women at menopause is one of the strongest risk factors in developing osteoporosis. In addition, if a person has taken too much thyroid hormone medication to treat underactive or overactive thyroid conditions or adrenal glands, bone loss is a probability.

Diet

A lack of calcium, eating disorders, and gastrointestinal surgery are issues that can put people in the high-risk category for osteoporosis. A lack of calcium leads to lower bone density, early bone loss, and increases the risk of fractures. Surgery can limit the amount of surface area available to absorb nutrients because the size of the stomach has been reduced.

Medical Conditions

The risk of osteoporosis is higher in people with chronic medical problems. These include celiac disease, inflammatory bowel disease, kidney or liver disease, cancer, multiple myeloma, or rheumatoid arthritis.

May is National Osteoporosis Awareness Month. It’s an opportunity to be proactive about your health and a great time to make an appointment with a primary-care physician and undergo a painless bone density test. For more information, visit the Bone Health and Osteoporosis Foundation at www.bonehealthandosteoporosis.org.

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Shark Valley: the perfect place to see alligators, not sharks

Don’t let the name fool you — you won’t find any sharks in Shark Valley. Named for its location at the head of Shark River Slough, this 15-mile loop trail is the perfect spot to get up close and personal with an alligator (from a safe distance, of course!).

Located inside Everglades National Park, right off U.S. Highway 41 (Tamiami Trail), this paved trail is perfect for biking, hiking, and bird watching. There are also guided ranger and tram tours for those interested in learning more about the Florida Everglades — the only place in the world where the American alligator and American crocodile coexist.

This diverse subtropical wetland, the largest in North America, spans more than 1.5 million acres across central and south Florida — half of its original size. Composed of nine diverse ecosystems, the Everglades is home to more than 360 different bird species, 300 fish species, 20+ snake species, crocodiles, alligators, panthers, otters, frogs, and many other mammals, reptiles, and amphibians.

Shark Valley sits right in the middle of the Everglades freshwater marsh and is an ideal location for viewing wading birds — from herons to egrets, ibises, hawks, owls, and anhingas, along with plenty of freshwater wildlife. But the one animal that cannot be missed along the first half of this trail is the alligator.

These majestic reptiles bask motionless in the sun right along the side of the pavement just steps from visitors. While this may seem like a dangerous scenario, these gators are used to people coming and going and rely on their natural habitat for food, meaning they do not seek out people or pets. As long as visitors do not engage in any reckless behavior, such as feeding or harassing the alligators — behavior that constitutes a criminal offense — Shark Valley is perfectly safe for both adults and children.

Midway through the loop, visitors can stop and rest at the Shark Valley Observation Tower. Standing 70 feet high, it’s the tallest structure in the park, with a viewing platform that offers scenic panoramic views of the Everglades.

For those interested in a more daring adventure, Shark Valley offers guided full-moon and new-moon bike tours. Accompanied by a park ranger, riders embark on a three-hour tour where they can embrace the magic of the Everglades and all its nocturnal creatures, including alligators, after dark. Upcoming tour dates include March 4, March 16, April 1, and April 16. Reservations are required and can be made through the Shark Valley Visitor Center at (305) 221-8776.

Shark Valley is located at 36000 SW 8th Street, Miami, and is open every day from 8:30 a.m. to 5 p.m. in mid-December to mid-April, and 9 a.m. to 4:30 p.m. in mid-April to mid-December. Bike rentals are available on-site.

For more information, tour schedules, and entrance fees, visit www.nps.gov/ever/planyourvisit/svdirections.htm.

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Tips to follow during Prostate Cancer Awareness Month

September is Prostate Cancer Awareness Month. Prostate cancer is common and grows slowly. At onset, symptoms may be absent, but as it progresses, early warning signs include an increased urgency to urinate, frequency, and leaking. In more advanced stages, the cancer can metastasize to other organs such as the lungs, liver, and brain. In a majority of cases, bone pain will occur.

According to the American Cancer Society, cancer of the prostate is the second most common cancer, and men are 44 percent more likely to develop it than women.

Mehmet F. Hepgur, M.D., an oncologist/radiologist at Broward Health in Fort Lauderdale, says that depending on the size of the tumor, a person may feel pain in the prostate and see blood while urinating. “The only way to detect the specific stage is through an examination and taking a test to determine a person’s PSA (prostate-specific antigen) level,” said Dr. Hepgur. “The best chance for a successful treatment is through early detection when the tumor is still confined within the prostate gland.”

The PSA test is not for cancer detection but a means of measuring the levels of a specific antigen in the prostate gland. The PSA numbers can indicate other issues ranging from inflammation and infection to gland enlargement and subsequent cancer. According to the Prostate Cancer Foundation, a high PSA level does not always indicate prostate cancer. There are numerous types of prostate cancer, and there’s a treatment for each type. In summary, one approach doesn’t fit everyone, and treatment is on a case-by-case basis.

“A person in their 40s or 50s with a PSA greater than 3 milligrams per milliliter is abnormal and may need a further workup,” said Dr. Hepgur. “The PSA range is usually less than 1. For a person in their 70s, a PSA above 4 is abnormal, and if it rises above 0.3 milligrams per milliliter a year, additional testing is required.”

It’s important to identify prostate cancer in its early stage and to be aware of any history of cancer in the family, genetics, or abnormal lifestyle habits. “Reports show that African-American men have a higher incidence rate and may have to be screened at a younger age,” said Dr. Hepgur. “There’s no hard data to show why certain ethnicities have higher rates of incidence, but we encourage earlier screenings as the best method of prevention.”

There is debate in some circles about the age at which screenings should begin. The primary recommendation is between 55 and 69 years of age. “Exercise is important, as is cutting down alcohol consumption,” said Dr. Hepgur. “It’s critical to be screened at the proper time and talk to your doctor about treatment options.”

Older men and women with prostate cancer are under “active surveillance.” Specialists find that surgical versus radiation outcomes are very similar. In advanced stages, however, it’s recommended to see an oncologist for treatment protocols.

Dr. Hepgur’s advice is to be aware of any history of cancer in the family and of any genetic predisposition, and to live a healthy lifestyle through exercise and nutrition.

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Get your Wagyu in Coral Springs

It’s 7,500 miles from Coral Springs to Japan, the home of the Wagyu. Wagyu is the Japanese name for beef, but here in the United States, it’s often associated with the well-marbled beef that is commonly found on restaurant menus.

In grocery stores, you will find USDA prime, choice, and select steaks. They are graded based on the fat streaking in the steak. And for those who love barbecue, more marbling often means great flavors and tender meat.

Wagyu is graded based on the meat yield, from A (highest) to C (lowest); and marbling, from 1 (lowest) to 5 (highest). This is where you may find the highest-grade Wagyu as A5. The Beef Marble Score is often referred to; scored 1–12, the higher the number, the more marbled the meat.

If you have had A5 Wagyu, you know it’s unique. The melting temperature of Wagyu beef is lower than other beef, at 77 degrees F. Extra care is required in the preparation, to provide that buttery, melt-in-your-mouth experience that you will remember long after you wolf down your steak.

Japan has long controlled the export of cattle, as it’s considered a national treasure. The Japanese government put a ban in place in 1997. Before the ban, a few were exported to the United States, and there were 200 full-blood Wagyu in the United States. U.S. ranchers were able to cross Wagyu with other popular breeds, like Angus, and they were referred to as Wagyu-influenced breeds. This is where American Wagyu came from; and to be considered Wagyu, the beef needs to be at least 50 percent Wagyu.

If you want to experience the rich flavor and unique, melt-in-your-mouth experience, you can find Wagyu in many fine restaurants, or you can buy it directly from a local butcher shop in Coral Springs, Meat n Bones. They have a storefront on Sample Road, near city hall.

The proprietors of Meat n Bones provided a sampling of their favorite American Wagyu cuts to try. The Coral Springs store manager, Thomas LoBracco, is a food enthusiast. He comes from a family of butchers, and he loves to explain all the great cuts of beef available at his store.

LoBracco shared a few cuts he wanted us to try. The flap steak, well-marbled and thin, can be prepared quickly over high heat. Denver steak is a tender and economical cut, and it can be braised and cooked like a short rib.

Another good cut that LoBracco has is Picanha. First made popular in Brazil, it is a great steak. It has a fat cap that imparts the steak with an extra oomph of flavor.

Meat n Bones also carries a wide range of non-Wagyu beef. So whatever you are fancying for the weekend barbecue, you will not be disappointed.

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Robotic Surgery is a ‘game changer’ in complex surgeries at Broward Health Coral Springs

For over a decade, Broward Health Coral Springs has provided surgeons the ability to perform complex surgeries using the assistance of advanced robot. Robotic surgery consists of a surgeon console, patient-side cart, and vision cart, allowing doctors to view 3DHD imagery of organs, vessels, and lymph nodes while operating on patients with mechanical arms ingeniously programmed to wield the smallest of tools.

“The whole goal is to enhance medical care,” said urologist Azeem Sachedina, M.D., “and from that perspective, there is no question robotic surgery is an absolute game changer.”

Often using the da Vinci surgical system, robotic-assisted procedures allow surgeons to control mechanical arms that bear surgical instruments and a camera. Robotics can sometimes enable surgeons to make smaller incisions rather than traditional large incisions, which in some cases may lead to a faster recovery with less pain. With surgeries such as hysterectomies and myomectomies, as well as prostate, gastrointestinal and other procedures, outcomes can be a benefit for the patient.

Zoyla Almeida, M.D., a gynecologic oncologist and Chair of Robotics at Broward Health Coral Springs, has done over 2,000 robotic procedures to date. Of those surgeries, there have been few limits to which reproductive health issues she can correct, including hysterectomies for both cancerous and benign conditions, pelvic prolapse, and treatment for endometriosis, which can cause severe blood loss, pelvic pain, and infertility. She said that the da Vinci system in many cases has the ability to sometimes see much more of the human body by using impossibly small cameras that not only capture high definition views of organs but also surrounding blood vessels and tissue. 

Broward Health urologist Michael Tyler, M.D., also continues to see the benefits from technological advantages provided by robotic assisted surgery, saying that “the difference between traditional and robotic surgery is significant. With the robotic technique, we can really control the surgical environment. When I am at the console, it’s basically like I am at the bedside.”  

Dr. Almeida, agrees, adding robotic technology in the operating room may allow her to see and correct endometriosis and ovarian cysts in patients who may have suffered for years before exploring robotic surgery as an option.

“Women know their bodies well, and if they think something is off, they should definitely seek attention immediately and not ignore it,” said Almeida. “With robotic technology like we have today, complex surgeries may no longer need to be invasive as they were years ago.” 

Broward Health Coral Springs has acquired additional and more upgraded robots within the last few years to fulfill patient and physician demand. Broward Health surgeons say the demand for minimally invasive robotic surgery is gratifying. Mark Shachner, M.D., operates at Broward Health Coral Springs on patients experiencing digestive issues with the da Vinci and called it an enormous revolution.

To learn more about minimally invasive, robotic surgeries offered at Broward Health Coral Springs, click here

 Photo Caption: (l-r) Dr. Zoyla Almeida is presented with a recognition for surpassing over 2,000 robotic cases by Jared Smith, Broward Health Coral Springs Chief Executive Officer.  

Robotic Surgery is a ‘game changer’ in complex surgeries at Broward Health Coral Springs

Photo Caption: The Broward Health Coral Springs surgery team. 

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Growing up with vaccines: a parents’ guide

School doors open soon, and concerned parents should be aware of vaccinations required to protect their children. A vaccination schedule begins long before a child is ready for school — as early as the newborn stage of life. 

“Newborns do not have mature immune systems, and they’re particularly susceptible to certain infections under 3 months of age,” said Matthew Penson, M.D., a pediatrician at Children’s Medical Association in Coral Springs. “During this period, they receive partial immunoglobulin immunity via breast milk, yet it’s advisable not to take a newborn into a crowded environment.”

According to Dr. Penson, appropriate immunizations are a vital component of preventive care and one of the most rewarding aspects of being a pediatrician. “We lay the groundwork to protect a child’s health in the earliest stages, so once they do begin school they’re properly immunized against infections,” he said.

Getting Ready for School 

Learning and socializing enhance growth, but this can only be accomplished in a classroom free of illness. Parents need to check off all the boxes regarding their child’s health and schedule an appointment with a pediatrician to ensure that all required vaccinations have been received. 

Because influenza viruses constantly change, and the body’s immune system becomes weaker with age, flu vaccinations are a necessity. “As children prepare for kindergarten, booster shots are required between the ages of 4 and 5 to strengthen their immune response,” Penson said. “The flu remains a leading cause of pediatric morbidity and hospitalization, and it’s highly contagious in a day-care or school setting. We recommend starting at 6 months with yearly repeat vaccinations in the fall, no later than October.”

For older children, tetanus, meningococcal meningitis, and HPV vaccines are recommended beginning at the age of 11 and up. Parents should discuss all recommended vaccines with a pediatrician and understand their importance, risks, and benefits. Pediatricians at the Children’s Medical Association care for children and young adult patients up to the age of 21.

Importance of Vaccinations

Vaccinations provide immunity before a child is exposed to other diseases. The American Academy of Pediatrics and the Advisory Committee on Immunization Practices recommend a vaccination schedule as early as 2 months to guard against pertussis (whooping cough), pneumococcus (meningitis/bacteremia), polio, rotavirus, and Hemophilus influenza B (epiglottis, meningitis). 

“Several boosters are required to ‘train’ the immune system to recognize and combat those potentially serious illnesses,” said Penson. He says boosters are required at 4 and 6 months, and when children are a year old, the finishing boosters are given. 

The varicella vaccine guards against chickenpox, a contagious illness that can include blisters, fatigue, and fever. It can be even life-threatening, especially in babies and older adults who have weakened immune systems. To protect against this illness, the varicella vaccine is used (two doses, at 12 to 15 months and 4 to 5 years of age).

Measles, mumps, and rubella (MMR) are also highly contagious. Measles is caused by a virus forming in the mucus glands of the nose and throat. It may cause a high fever, rash, runny nose, and red eyes. In some cases, diarrhea and ear infections are also possible. Very severe cases may lead to pneumonia and even brain damage. Mumps is a virus that spreads via coughing and sneezing. Its warning signs include fever, headache, muscle ache, fatigue, and loss of appetite. The MMR vaccine is given at 12 to 15 months and 4 to 5 years. During the first year, the hepatitis B vaccination is given to provide lifelong immunity. 

The COVID Factor

A decrease in COVID-19 infections is heartening, but stressing the value of vaccinations to eligible ages continues to be important. “As children return to school, we expect to see a rise in both typical childhood illness and COVID-19 infections,” commented Penson. “Severe COVID cases among children are relatively rare (compared to the elderly), but it’s important that pediatricians remain vigilant.” 

According to Penson, parents should expect to see a rising number of upper-respiratory infections, influenza, and strep pharyngitis. Differentiating common illnesses from COVID is difficult, and if parents have questions, they are encouraged to call a pediatrician immediately.

Traveling

With the return of increased domestic and international travel, proper immunizations are vital. Most destinations do not require more vaccines than typically given by a pediatrician, but there are certain locations that have more complex requirements. The travel vaccinations can be accessed by going to the Center for Disease Control’s travel website, or you can inquire about them with your pediatrician. Infants 6 through 11 should have one dose of MMR prior to traveling abroad. Some locations recommend the hepatitis A vaccine, others require malaria medication (prophylaxis), and others recommend the meningococcal vaccine.

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The sad truth: Vision problems have no age boundaries

From young children to the elderly, no one is immune from vision problems. For some, it’s genetic; for others, it’s a part of the aging process. Four of the most common eye problems are cataracts, floaters, macular degeneration, and glaucoma. 

The National Eye Institute says that in the U.S., at least 24 million people over age 40 have cataracts, 11 million have age-related macular degeneration (AMD), and nearly 3 million have glaucoma. Eye floaters affect nearly 30% of the general population.

The sad truth: Vision problems have no age boundaries
Phoropter, ophthalmic testing device machine

Cataracts

“Routinely, people over 60 develop cataracts, but they can also occur among children,” says David Rand, M.D., a specialist at the Rand Eye Institute, a premier eye-care facility that for 35 years has treated thousands of people throughout South Florida and around the world. “Cataracts cloud the natural lens inside the eye and can be caused by sun exposure, trauma, a medical condition, genetics, and aging.” 

Warning signs include a need for more light, a lack of clarity, and glare from car lights or lampposts when driving at night. “Regardless of the degree, vision can be restored surgically,” Dr. Rand said. “There is more urgency among young children because their vision can be affected permanently.” Mild cataracts can be temporarily treated by changing the prescription of one’s glasses, but once visual quality becomes a problem, surgery is the definitive treatment.

Floaters

Millions experience eye floaters or “shadows” on the retina, and it’s a chronic problem that can impact the quality of life. Most are caused by age-related changes in the eye’s vitreous, a jelly-like substance that deteriorates over time. They occur primarily during middle age, or earlier, and develop due to an inflammatory condition. 

“As a physician, I’m concerned that a patient who has an acute increase in flashes or floaters may have a retina tear or detachment,” said Carl Danzig, M.D., a vitreoretinal specialist at Rand Eye Institute. “It’s very important to seek a diagnosis as early as possible.” 

Age-Related Macular Degeneration (AMD)

When new blood vessels grow under the eye’s retinal tissue, it’s referred to as “wet” AMD. When there is a thinning of the macula, a part of the retina responsible for clear vision in direct line of sight, it’s referred to as “dry” AMD. 

“If you have trouble reading a menu, small print, or have problems driving at night, dry AMD may be the cause,” said Dr. Danzig. Vitamins with the AREDS2 formula are used for both types, but they’re especially recommended for patients with intermediate-stage AMD or worse. “The standard treatment for wet AMD is intravitreal injections; surgery is not a first-line treatment.” 

The sad truth: Vision problems have no age boundaries

Glaucoma

When there is damage to the optic nerve due to high or fluctuating eye pressure, glaucoma can occur, and if untreated it can lead to vision loss. Although diabetes, high blood pressure, heart disease, and a history of trauma are contributing factors, a genetic predisposition is also common. “If a family member has glaucoma, it’s very important to be examined and monitored to be certain that glaucoma does not develop,” says Dr. Rand. “The important point common to all treatment options is to adequately lower and maintain the eye pressure to an acceptable level to prevent progression well before it becomes advanced enough to threaten the vision.”  

Glaucoma can be asymptomatic in its early stages, but gradual vision loss may still occur. “Sadly, many patients are unaware they have glaucoma until they lose their vision,” he said. According to the specialist, certain types produce painless vision loss, while other forms cause significant eye pain, pressure, and/or headaches. Among young children, it may lead to tearing or excessive eye rubbing.  

David Rand, M.D.

Dr. Rand completed his undergraduate education at the University of Miami and received his medical degree from the university’s Miller School of Medicine, Honors Program. He completed his postgraduate internship in internal medicine at the Staten Island University Hospital and completed his residency at the State University of New York, Downstate Medical Center. He has published scientific papers and presented before prestigious organizations, including the Association for Research in Vision and Ophthalmology and the Radiological Society of North America.  

Carl Danzig, M.D.

Dr. Danzig is a vitreoretinal disease specialist with experience treating a variety of complex eye disorders. He graduated cum laude from Tulane University and was accepted into the Phi Eta Sigma National Honor Society. After receiving his medical degree from Temple University, he completed an internship at Crozer-Chester Medical Center and residencies at Martin Luther King Jr. Hospital/Charles R. Drew University in Los Angeles and the State University of New York-Downstate, Brooklyn. He also enrolled in the University of Texas/Southwestern Medical Center’s vitreoretinal fellowship program.

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