august 2013 global health tribune
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Healthcare Newspaper of Palm Beach countyTRANSCRIPT
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PAIDWEST PALM BCH, FLPERMIT NO. 1340
GLOBAL HEALTH TRIBUNEP.O. Box 213424
Royal Palm Beach, FL 33421
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Serving: Jupi ter n Palm Beach Gardens n Royal Palm Beach n Well ington n Belle Glade n Lake Worth n Lantana n Boynton n Boca RatonAUGUST I SSUE - 2 0 1 3 www. g l o b a l h e a l t h t r i bun e . c om
TattooRemovalNews
RockPurple forthe Cause
Light of The WorldCharities
South Florida RadiationOncology is proud toannouce a new additionto their staff: AndrewO’Leary, M.D.
Andrew O’Leary, M.D.
Robbin Lee, RN, MBAwas promoted to ChiefExecutive Officer ofWellington RegionalMedical Center
Robbin Lee.
Bill Tavernise joinsWellington ChamberPresident's Circle
Bill Tavernise.
Skipping breakfast mayincrease heart attack riskAnother reasonto eatbreakfast:Skipping it mayincrease yourchances of aheart attack.By MIKE STOBBE, APMedical Writer
Astudy of older menfound those whoregularly skipped
breakfast had a 27 percenthigher risk of a heart attackthan those who ate a morningmeal. There's no reason whythe results wouldn't apply toother people, too, the Harvardresearchers said.
Other studies have suggesteda link between breakfast andobesity, high blood pressure,diabetes and other healthproblems seen as precursorsto heart problems.
"But no studies looked at long-term risk of heart attack," said Eric Rimm, one of the study authors at theHarvard School of Public Health.
Why would skipping breakfast be a heart attack risk?
Experts aren't certain, but here's what they think: People who don't eat breakfast are more likely to behungrier later in the day and eat larger meals. Those meals mean the body must process a larger amountof calories in a shorter amount of time. That can spike sugar levels in the blood and perhaps lead toclogged arteries.
Hospitalized Seniors Should WatchOut if They're Under Observation
By S.Z. Berg
NEW YORK (MainStreet)--Anincreasing number ofhospitalized patients age 65 andover are being classified asoutpatients under observationrather than as admitted."When hospitals classify peopleas 'outpatients,' on observationstatus, rather than as admittedinpatients, those patients cannotobtain Medicare nursing homecoverage and may also havehospital bills they would nothave if properly consideredinpatients," says Judith Stein,executive director of Center forMedicare Advocacy.
Medicare will only cover the costof nursing home care when apatient has been hospitalized asan inpatient for three consecutivedays. In these cases, Medicarewill foot the entire bill for thefirst 20 days in an approvedfacility. Patients who have beenclassified as outpatients will haveto pay the entire tab.In addition, Medicare patientswho have been relegated toobservation status may beresponsible for paying costsharing and the unreimbursedcost of prescription drugs underMedicare Part B that under
Hospitalized continued on page 7
Breakfast continued on page 2
www.GlobalHealthTribune.comPage 2 August 2013MEDICAL NEWS
CONTACT USP.O. Box 213424
Royal Palm Beach, FL [email protected]
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Global Health Tribune is a newspaper published every monthin Palm Beach county and surrounding areas. Copyright 2013,all rights reserved by SEA Publications, Inc. Contents may notbe reproduced in any form without the written consent of thepublisher. The publisher reserves the right to refuseadvertising. The publisher does not accept responsibility foradvertisement error beyond the cost of the advertisement itself.All submitted materials are subject to editing.
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Type 2 diabetes doubles therisk for dementia, and alarge new observational
study suggests that treatmentwith metformin maysignificantly lower that risk. Incontrast, other diabetestreatments, including insulin,were associated with increaseddementia risk.
"These results providepreliminary evidence that thebenefits of insulin sensitizersmay extend beyond glycemiccontrol to neurocognitivehealth," said Rachel Whitmer,PhD, senior scientist at theKaiser Permanente NorthernCalifornia Division of Research,Oakland. The results build on a"nice line of evidence" fromanimal models and cell culturestudies showing that metforminmight be neuroprotective bypromoting neurogenesis andameliorating neuronal insulinresistance.Dr. Whitmer presented hergroup's findings here at theAlzheimer's AssociationInternational Conference (AAIC)2013.
New UsersFor this report, researchersstudied a cohort of 14,891patients with type 2 diabetes age55 years and older who begandiabetes therapy betweenOctober 1999 and November2001. In this "new user" cohort,only patients who started a singledrug (metformin, sulfonylureas[SU], thiazolidinediones [TZDs],or insulin) were included.During 5 years of follow-up,dementia was diagnosed in 1487(9.9%) patients.
Compared with patients startingSU, those starting metformin had
about a 20% reduced risk fordementia (hazard ratio [HR],0.79; 95% confidence interval[CI], 0.65 - 0.95), Dr. Whitmerreported.
Compared with patients startingTZD, those starting metforminhad a 23% lower risk fordementia during follow-up (HR,0.77; 95% CI, 0.66 - 0.90).In contrast, starting SU(compared with metformin) wasassociated with a 24% increasedrisk for dementia (HR, 1.24, 95%CI, 1.1 - 1.4); TZD, an 18%increased risk (HR, 1.18; 95%CI, 1.1 - 1.4); and insulin, a 28%increased risk (HR, 1.28; 95%CI, 1.1 - 1.6).The results were the same afterthe researchers took into accountdiabetes duration, age, andglycemic control and when theyconsidered dementia subtypes.The findings provide"preliminary evidence thatmetformin may have benefits onbrain health," Dr. Whitmer said.
Diabetes and DementiaDavid S. Knopman, MD, fromthe Mayo Clinic, Rochester,Minnesota, who moderated apress briefing on this topic, notedthat the relationship betweendiabetes and the development ofdementia has generated "greatinterest" in the scientificcommunity.
This type of epidemiologic study,he noted, is intended to "generatehypotheses that can be tested inproper therapeutic trials." Thefindings from Dr. Whitmer's groupsuggest a rationale for doing sucha trial. Indeed, trials are underwayto evaluate metformin as apotential therapeutic agent formild cognitive impairment anddementia.
Metformin Cuts DementiaRisk in Type 2 Diabetes
But is a stack of syrupypancakes, greasy eggs and lots ofbacon really better than eatingnothing?
The researchers did not ask whatthe study participants ate forbreakfast, and were not preparedto pass judgment on whether afatty, sugary breakfast is betterthan no breakfast at all.
Other experts agreed that it'shard to say.
"We don't know whether it's thetiming or content of breakfastthat's important. It's probablyboth," said Andrew Odegaard, aUniversity of Minnesotaresearcher who has studied a linkbetween skipping breakfast andhealth problems like obesity andhigh blood pressure.
"Generally, people who eatbreakfast tend to eat a healthierdiet," he added.
The new research was releasedMonday by the journalCirculation. It was anobservational study, so it's not
designed to prove a cause andeffect. But when done well, suchstudies can reveal importanthealth risks.
The researchers surveyed nearly27,000 men about their eatinghabits in 1992. About 13 percentof them said they regularlyskipped breakfast. They all wereeducated health professionals —like dentists and veterinarians —and were at least 45.
Over the next 16 years, 1,527suffered fatal or non-fatal heartattacks, including 171 who hadsaid they regularly skippedbreakfast. In other words, over 7percent of the men who skipped
breakfast had heart attacks,compared to nearly 6 percent ofthose who ate breakfast.
The researchers calculated theincreased risk at 27 percent,taking into account other factorslike smoking, drinking, diet andhealth problems like high bloodpressure and obesity.
As many as 18 percent of U.S.adults regularly skip breakfast,according to federal estimates.So the study could be importantnews for many, Rimm said.
"It's a really simple message," hesaid. "Breakfast is an importantmeal."
Breakfast continued from coverpage
Megan Brooks, Medscape. Jul 16, 2013.
Healthy Heart Health Fairand Screenings at WellingtonRegional Medical Center
Wellington, FL – WellingtonRegional Medical Center(WRMC) will host a “HealthyHeart Health Fair and Forum” onWednesday August 28th from 10am to 2 pm on the hospitalcampus in Wellington. Theobjective of this communityevent is to increase awarenessabout heart disease andencourage people to learn thefacts about prevention andtreatment.
So what is Heart Disease? Heartand blood vessel disease — also
called cardiovascular disease —is a medical condition that refersto numerous problems, many ofwhich relate to atherosclerosis.Atherosclerosis is a conditionthat develops when plaque buildsup in the walls of the arteries.This buildup narrows thearteries, making it harder forblood to easily flow through. If ablood clot forms, it can stop theblood flow and result in a heartattack, stroke or aneurysm.
In addition to free blood pressureand cholesterol screenings andeducational resources, “Lunchand Learn” physician lectures arescheduled for 11:30 am and12:30 pm:
11:30 am – 12:30 pm “RiskFactors and PreventingCardiovascular Disease.” Dr.Michael B. Lakow, board-certified cardiologist, willdiscuss risk factors, prevention,prevalence, diet and exercise.
12:30 – 1:30 pm “CardiovascularDisease Intervention.”Participate in an informal,interactive discussion aboutinterventional treatment optionsand heart-healthy lifestylechoices.
A healthy lunch will be served,so reservations are encouraged.Call 561-798-9880 to reserveyour place.
Get back onyour Feet!
(561) 433 -5577
Podiatric Physicians & Surgeons
Personal & Gentle Care For:
• Diabetic Foot Care• Hammer Toe• Fracture Care• Ingrown Nails, Bunions
• Ankle/Heel/Foot Pain• Poor Circulation• Neuropathy• WOUND Care• Custom Molded Orthotics
• Diabetic Shoes
3347 State Rd 7 Suite 204Wellington, FL 33449
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Page 3August 2013www.GlobalHealthTribune.comTHE FORGOTTEN FOOT
Arthur Hansen DPM, M.S.
“My feet are killing me'' mayvery well be one of the mostcommon health complaints
heard each day. But, let’s face it,who really does anything aboutit? Very few people heed theadvice of their feet and continueto stand, walk and work throughthe pain.
Feet are the most used andabused parts of the human body.According to a study conductedby the Pennsylvania College ofPodiatric Medicine, the averageAmerican walks 115,000 miles ina lifetime. That is the equivalentof more than four times aroundthe world. Each step exacerbatesminor abnormalities in footstructures or shoes that don't fitright, or both, resulting in pain. Ithas been estimated that 87percent of Americans suffer fromsome form of foot problem.
Even though these problems arenot life threatening, they doinhibit the ability to fully partakein daily activities and mostdefinitely take the joy out of
many life-enhancing activities,while making others impossible.
The recent surge of body weightin Americans and the subsequentcraze that has millions ofAmerican feet jogging, running,dancing and jumping havegreatly increased the ranks ofpodiatric and orthopedic patients.In addition, medical problemslike diabetes, obesity andcirculation issues predisposepatients to foot problems thatrequire professional attention.
Before seeking professionalattention for those foot pains,many people try to manage theirfoot problems on their own andunfortunately they usually wastemoney on over-the-counter fixes.Many times self-treatment canmake the problems much worse.Fortunately, many foot ailmentsare avoidable. Shoe gear shouldfit well and feet should bewashed daily with soap andwater. Shoes and socks shouldalso be changed daily.
Some of the most common footcomplaints are corns andcalluses. These are located overhigh pressure areas on the footand are layers of dead skin cells.They are the result of repeatedfriction or pressure against partsof the foot and actually representthe body's attempt to protectsensitive tissue.
Hard corns are usually found on
the top of toes, where skin rubsagainst the shoe. Sometimes acorn will form on the ball of thefoot beneath a callus, resulting ina sharp localized pain with eachstep. Corns are cone-shaped,with the tip pointing into thefoot. When a shoe exertspressure against the corn, the tipof the cone can hit sensitiveunderlying tissue, causing pain.
Self-treatment can be risky, sincethe chemicals used to softencorns also damage healthy tissue.Be sure to follow the directionscarefully and limit self-treatmentto five applications. People withpoor circulation, such asdiabetics, should seekprofessional help. Removal ofcorns with a razor blade shouldnever be attempted. Hard cornsare best prevented by protectingany rubbed area with a pressurerelieving non-medicated cornpad or horseshoe-shaped piece ofmoleskin or foam rubber and bynot wearing the shoes that are theculprits.
Soft corns, which are rubbery,form between toes where thebones of one toe exert pressureagainst the bones of its neighbor.To help prevent their formation,use lamb's wool or cottonbetween toes that rub together.Once established, these corns arebest treated professionally.
Callouses form over a flatsurface and have no tip. They
Your foot… the body’s most used Part?usually appear on the weight-bearing parts of the foot like theball or heel. Each step pressesthe callus against underlyingtissue and may cause aching,burning or tenderness. Callousesmay result from the friction ofloose-fitting shoes or thepressure of shoes that are tootight. Women who wear high-heeled shoes are especiallyvulnerable to calluses.
People with high arches are alsovulnerable since the heel and ballof the foot bear all the weight.Arch supports may help to relievethe pressure and cause the callousto disappear slowly. Cushionedinnersoles may also help.
Callouses can be graduallyeliminated by rubbing thecallused area with a pumicestone after soaking or bathinghas softened the dead skin. Thenapply a moisturizing lotion. Donot try to remove too much ofthe callus at once. Diabeticsshould see a professional ratherthan attempt self-treatment.
Bunions appear as swollen andinflamed protrusions on the sideof the foot at the joint of the bigtoe. A similar swelling can occurat the outside of the foot, whereit's called a bunionette. Dynamicforces during the gait cycle causeimbalances at the joints and overtime deformities such as bunionsdo occur. Bunions are mostoften irritated by the persistent
wearing of shoes that are tootight and short. Not surprisingly,bunions are four times morecommon among women, manyof whom wear high-heeled andpointed shoes that cause undopressure on the big toe.
Bunions cannot be self-treatedand only surgery can correct theproblem. However, considerablerelief may be obtained throughconservative measures. Theseinclude devices in the shoes thatchange the foot's dynamic forcesand by wearing shields to protectthe bunion from friction againstthe shoe.
Hammer toes are deformities ofthe toes where the joints bendcausing pressure points.Hammertoe deformities canaffect all the toes but the mostcommon toe affected is thesecond toe, which on mostpeople is longer than the big toe.
Blisters commonly appear wherea shoe rubs against skin that isunprotected by a corn or callus.Ease the friction with moleskinpadding, wear socks and changeshoes. Don't pop blisters, sincethey may then become infected.If a blister breaks on its own,apply an antiseptic and keep thearea covered with a sterilebandage. Remove the bandage atnight to promote healing.
Your feet have a long way to go,so take care of them.
Page 4 August 2013 www.GlobalHealthTribune.comAROUND TOWN
The rain did not put adamper on the LupusFoundation Southeast
Florida Chapter’s “Rock Purplefor the Cause” awareness dinnerheld in West Palm Beach. Lupus is a chronic, autoimmunedisease that currently affects over1.5 million Americans. Thisdisease can damage any part ofthe body with signs andsymptoms often lasting longerthan six weeks. The event was organized andhosted by Michelle and MarshallMeikle, owners of Meikle’sCreative Catering and Rhonda
Davis, owner of RAD EventProduction.Thanks to Michelle, Marshall,and Rhonda, the entire eveningwas a complete success from thechoice of venue, food, guestspeakers to the beautiful songsperformed live. The evening wastruly one of hope for thoseaffected with this disease. Alsoin attendance were FloridaHouse of Representatives, BobbyPowell, Jr. and singing sensationMichaela Paige.For information on this disease,contact the Lupus Foundation ofAmerica at www.lupus.org.
Rock Purple for the Cause
Page 5August 2013www.GlobalHealthTribune.comHEALTHCARE NEWS
Tattoo Removal NewsR. Sabates MD, CLS, CME
Tattoo remorse is leadingmany of the paintedmasses to rethink theirink and opt for increas-
ingly available laser removalprocedures. A recent surveyfound a 34 % increase in tattooremoval in the past two yearsalone. The main reason it con-cluded, was job related issues.In this tight job market, employ-ers of restaurants, hospitals,banks, the armed forces, policeand Disney World are shunningvisible tats on their employees.
It seems that the pendulum isfinally swinging back after yearsof dramatic increases in thenumber of tattoos. This increasehas been mainly driven bycelebrities and in the media. Forexample, 70% of NBA players aresporting tats. Shows like MiamiInk however, are now beingreplaced with the more realisticBad Ink. Unfortunately, in thisTV program, unhappy customersare encouraged to get cover-uptattoos. That is the worst possiblesolution. Not only does it requirean expert artist, but the oldertattoo will always come back inview after a few short years as thebody clears the new ink.
Today, laser tattoo removal isfaster, cheaper, better and with
no more discomfort than puttingon the tattoo.
Laser tattoo removal is the goldstandard for safely andeffectively getting rid of the ink.There are three main laserwavelengths used: Nd:YAG,Alexandrite and ruby lasers.Manufacturers have fine-tunedthe equipment with more powerand better results. In SouthFlorida, the Nd:YAG has theadvantage on darker tanned skin.
A series of laser treatments arerequired to progressivelyfragment the encapsulated inkpigment. Approximately 6 to 10passes are required tosignificantly clear the ink.Because the laser light goes intothe deep skin layer, it doesn’taffect the superficial skin.Therefore, since there isgenerally no bleeding orscarring, the healing time is onlya few days. The laser light does
not really remove the ink. It’s ourown bodies’ specialized immunecells that attack and carry awaythe ink particles that have beenbroken up into smaller particlesby the laser.
The latest big news in tattooremoval was the recent (2012)discovery that dramaticallyspeeds up the whole removalprocess. Instead of having onepass every 4-6 weeks that cantake up to a year to remove, wecan now safely and effectivelydo up to 4 passes only 20minutes apart on the same day.This is called the R20 method.The peer reviewed resultsshowed that 60% of amateurblack ink tattoos were removedin a single day with 4 passeswithout any increase incomplications. This advance hasovercome one of the biggestpatient hurdles – wanting it doneyesterday! In the past, patientsrarely finished all their
recommended treatmentsbecause of time constraints. Thisled to less than optimal resultswith laser treatment.
The R20 technique has alsodecreased the cost as physiciansusually charge less for same-daytreatments.
It is important to note that inFlorida, the tattoo industry aswell as the ink industry, is poorlyregulated. Tattoo artists are nolonger required to have physiciansupervision. While the tattoo“artist” is only required to attendan infectious disease course andhave $150.00 to set-up shop,laser tattoo removal is limited toa physician, a nurse practitioneror a physician’s assistant. Forevery beautifully done tattoo,there are five awful ones - sothink before you ink.
Other news worth mentioning isthat researchers have discovered
there are health related hazardsof tattoo ink. The injected inkacts as a foreign substance whichactivates our immune system tomount an attack on the ink.Researchers have found anincrease health risks in patientsthat have autoimmune diseases,such as lupus, psoriasis, asthma,eczematous dermatitis,rheumatoid arthritis, and so on.The more ink – the worse thereaction. Kidney toxicity hasalso been found. Anotherinteresting fact, if you haverecently applied or removed ink,you cannot be a kidney donor.
The future of laser tattooremoval is bright. Newerequipment (Picosecond) has justcome on the market, althoughright now it’s very expensive.This laser has the ability toremove the harder to removecolors like green, blue, orangeand yellow. Unfortunately, it’snot very good on black. Since95% of tattoos use mostly blackcolor the Nd:YAG does a greatjob on black and red. If you musthave that special tattoo, try tostick to these two colors for now.
To schedule your freeconsultation, please callTropicalaser at 561-753-3336.Or, stop by our office at 2515 S.State Road 7 in Wellington(behind Office Depot).
BEFORE AFTERBEFORE AFTER
Page 6 August 2013 www.GlobalHealthTribune.comHEALTH & WELLNESS
Knee Pain – OsteoarthritisSymptoms and Treatment
By Deborah Lynn
Osteoarthritis is themost common form ofarthritis, whichequally affects men
and women. In the United Statesalone, approximately 27 millionpeople live with this often dis-abling disease. Although com-mon in adults over the age of 65,it can occur earlier in life.
I had an opportunity to ask Dr.Jose Ortega of The Center forBone & Joint Surgery to helpshed some light on this disease,which can have an impact on thelivelihood of anyone affected.As always, Dr. Ortega graciouslyagreed to give some insight onosteoarthritis and even went astep further by focusing on howit can impact your knees.
What is Osteoarthritis?Osteoarthritis, also known asdegenerative joint disease, is acondition that affects the jointsby causing degeneration of thecartilage, meniscus and bone. Iprefer to call it wear and teararthritis.
What causesOsteoarthritis?Osteoarthritis could be seen in
joints that are overloaded due toweight, after trauma, or it couldbe hereditary. It also occurs aspart of the normal aging processand overuse.
Osteoarthritis breaks down thetissue that covers the ends ofyour bones at the joint. Thistough, but cushioning tissue isknown as Cartilage. As you losecartilage, your bones willeventually start to rub togethercausing pain and discomfort.
What are the mostcommon symptoms ofOsteoarthritis in theknee?The most common symptoms arepain, swelling, tightness orstiffness, and in some cases –loss of motion or locking.
How do I know if I haveOsteoarthritis?Patients that have knee painwithout a specific injury orcondition, especially worseningof symptoms over time may haveosteoarthritis. In most cases, asimple x-ray is all theorthopaedic surgeon needs todiagnose the problem.
What will the x-ray showand what are the typical
findings?Typically, there is a narrowing ofthe joint space, bone spurs andmalalignment.
What can I do to get relieffrom the pain?In most cases, we start treatmentthat includes anti-inflammatories, ice, activitymodification and physicaltherapy. Other possibilitiesinclude the judicious use of
corticosteroids orviscosupplementation injections.
How does physicaltherapy help or work?Physical therapy will strengthenthe muscles around the knee.These muscles act as shockabsorbers and joint stabilizers.Therefore, you get better supportand better shock absorbers.Therapy will also help toimprove range of motion on
patients that are stiff.
What isViscosupplementation?Viscosupplementation is aprocedure in which a thick “gel”is injected into the joint. Itworks as a lubricant and shockabsorber. The goal of thistherapy is to relieve pain andrestore function.
Is there anything new oron the horizon?Studies have shown that platelet-rich plasma (PRP) may reducethe rate at which a jointdegenerates. This procedureinvolves harvesting plateletsfrom your blood and injectingthem in the joint. The plateletsare the cells that carry the growthfactors that promote woundhealing.
Can arthroscopy help?In selected patients, in which themain symptom is mechanicallocking or bucking, arthroscopymay help. In some cases, loosepieces of bone or cartilage tearscan be removed or shavedminimizing those symptoms. Ifthe arthritis is advanced and thepatient has failed conservativetreatment, a total kneereplacement may be indicated.
• Arthroscopic Surgery
• Sports Medicine
• Fracture Care
• General Orthopedics
Jose Ortega, M.D., FAAOSDiplomate American Board of Orthopedic Surgery
Same Day Appointments
561-803-8540561-798-6600
440 State Road 7 • Suite E • Royal Palm Beach, FL 33411
www.boneandjoint.org
Page 7August 2013www.GlobalHealthTribune.comHEALTHCARE NEWS
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The hiring of a lawyer is an important decision that should not be based solely upon advertisements. Before you decide, ask the lawyer to send you free written information about their qualifications and experience.
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Robbin Lee, RN, MBA promoted to Chief Executive Officerfor Wellington Regional Medical Center
Wellington, FL – July25, 2013 WellingtonRegional Medical
Center is pleased to announce thepromotion of Robbin Lee toChief Executive Officer ofWellington Regional MedicalCenter, effective August 1, 2013. Lee is a seasoned healthcareexecutive with 30 years ofexperience. She has served invarious senior level positionsthroughout her career and bringsextensive health caremanagement and leadership
skills to the Wellington team.Prior to Wellington, Lee servedas the Chief Operating Officer ofHCA owned JFK Medical Centerand Lawnwood RegionalMedical Center in Florida. Shehas also served as the ChiefExecutive Officer of NorthlakeMedical Center in Atlanta,Senior Vice President ofOperations of Stamford HealthSystem in Connecticut, andAssociate Administrator atEmory Healthcare in Atlanta.Lee is an RN and has an MBA,
having earned her Master’sDegree in BusinessAdministration from EmoryUniversity. A Georgia native,she started her healthcare careeras a unit nurse at Georgia BaptistMedical Center in Atlanta. Leehas earned numerous honors andawards, and has served onvarious community boards. Shecurrently resides in Palm BeachCounty with her husband.About Wellington Regional,Wellington Regional MedicalCenter is a progressive 233 bed
acute-care facility and medicalcenter that has been serving PalmBeach County and thesurrounding region since 1986.We are a thriving communityhospital, proud to offer the"high-tech" advantages of a big-city hospital and the personalizedcare of a hometown provider.
For more information onWellington Regional MedicalCenter and its services, pleasecontact the hospital at561.798.8500.
inpatient status would have beenpaid for by Medicare Part A.In June 2012, a study waspublished in the journal HealthAffairs showing that there hasbeen a sharp rise in the numberof Medicare patients held in thehospital under observation. Thisfinding was accompanied by adownward shift in patientadmissions into the hospital. TheBrown University researchersreported that the ratio of patientsplaced in observation to patientsadmitted into the hospitalincreased 34% between 2007 and2009 and that outpatientobservation hospitalizationsgrew 7% longer, on average,
over the study period.For their part, patients can't tellthe difference between whetheror not they've been admitted intothe hospital or are classified asunder observation as anoutpatient. They lie in the samebeds, wear the same gowns, eatthe same hospital food, receive
the same nursing care and wearthe same ID bracelets.The Brown Universityresearchers, led by ZhanlianFeng, assistant professor ofhealth services, policy andpractice, noted that there was alead up to a shift in Medicarecosts to patients and hospitals,
most recently through theAffordable Care Act, whichincludes a provision thatpenalizes hospitals for highreadmission rates. Hospitals areable to avoid readmitting patientsand dodge the associated penaltyby classifying patients asoutpatients, either on their initialor second visit.In addition to shifting the burdenof costs to Medicare patients,this practice has consequencesfor public health data."When people are classified onobservation status, they are notconsidered hospital inpatientsand, therefore, if they need toreturn to the hospital, thoseadmissions are not consideredreadmissions," Stein says. "Thuswe cannot accurately determinewhich hospitals tend to have a lot
of admissions and readmissions."Last year, the Center forMedicare Advocacy filed a classaction lawsuit against the federalgovernment to get hospitallabeling policy changed. Thefiling for the Bagnall suit notesthat in some cases patients areadmitted into the hospital andtheir status is later changed toobservation, an outpatient status.It goes on to note that under thesecretary's Medicare manual,observation status is generallysupposed to last no more than 24hours, but that "both theincidence of placingbeneficiaries on observationstatus and the average timeperiod in which beneficiaries areon observation status have beenincreasing dramatically in recentyears."
Hospitalized continued fromcover page
to excellence and commitment tothe profession of nursing. Neddoserves as the EmergencyDepartment Director at WestBoca Medical Center and wasnominated for the LeadershipAward by her peers.
“Margaret joined West BocaMedical Center as Director ofEmergency Services, after 27years with our parent company,Tenet Healthcare, the last eightas the Clinical Manager ofEmergency Services at DelrayMedical Center,” commentedMitch Feldman, chief executive
Page 8 August 2013 www.GlobalHealthTribune.comONCOLOGY NEWS
Kishore K. Dass, MDBoard-Certified Radiation
Oncologist
Andrew O’Leary, M.D.Board-Certified Radiation
Oncologist
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South Florida Radiation Oncology is proudto annouce a new addition to their staff
Andrew O'Leary was aprofessional firefighterbefore electing to pursue
a career in medicine. He receivedhis A.S. from Florida Institute ofTechnology in Melbourne, Fla.,graduating with honors. He thenobtained his B.S. from theUniversity of Miami, graduatingwith distinction. Dr. O'Learyreceived his medical degree fromOhio University College ofOsteopathic Medicine in Athens,Ohio. After a one-year traditionalinternship, he started hisradiation oncology residency at
the University Hospitals ofCleveland/Case Western ReserveUniversity in Ohio, which hecompleted in 2000.
During his four years ofresidency, Dr. O’Leary presentedseveral abstracts at nationalmeetings, including theAmerican Radium Societyconference in Hawaii, and threetimes at the InternationalProstate Cancer Update in Vail,Colo. He has been published inthe International Journal ofRadiation Oncology, Biology and
Physics and the InternationalBrachytherapy Journal.
Before joining South FloridaRadiation Oncology, Dr. O'Learywas the primary radiationoncologist and medical directorof Mercy Cancer Center inElyria, Ohio, from 2007 to 2013.
Dr. O'Leary is board certified inradiation oncology and has aspecial interest in prostate cancerand lung cancer. He sees patientsat SFRO’s Boynton Beach –West and Wellington offices.
Boca Raton, FL (May 2013) –West Boca Medical Center joinsthe Palm Healthcare Foundationin celebrating Margaret NeddoMSN, RN, as the recipient of the2013 Leadership Award. Theannual Nursing DistinctionAwards ceremony, hosted by thePalm Healthcare Foundation,was held on May 3rd at theBreakers Palm Beach andhonored several nurses from ourcommunity for their dedication
West Boca Medical Center Emergency Department DirectorRecognized by the Palm Healthcare Foundation
officer at West Boca MedicalCenter. “Her level ofcommitment to patient care isunwavering. She has over 20years of emergency nursingexperience and serves as atremendous role model foreveryone in our hospital and inthe nursing community.
Neddo holds multiplecertifications including, BasicLife Support, Advanced CardiacLife Support, Pediatric AdvancedLife Support, Trauma NursingCore Course and EmergencyNursing Pediatric Course. She
earned a bachelor of sciencedegree in Nursing from Novaand a master’s of science degreein Nursing from Florida AtlanticUniversity.
Neddo is also a member ofseveral organizations, includingthe Healthcare EmergencyResponse Coalition for PalmBeach County, EMS FireCouncil for Palm Beach County,EMS Provider Council of PalmBeach County, EmergencyDepartment Nurses Forum forPalm Beach County and theEmergency Nurses Association. Margaret Neddo MSN, RN.
BELLE GLADE | BOCA RATON | WEST BOCA | BOYNTON BEACH | JUPITER | PALM BEACH GARDENS | PORT ST. LUCIE | STUART | WELLINGTON
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Page 10 August 2013 www.GlobalHealthTribune.comCOMMUNITY EVENTS
August 13Junior League of the PalmBeaches. Happy Hour for aCause. Blue Martini, City Placein West Palm Beach. $10.00 formembers and $15.00 for non-members. For additionalinformation, go towww.westpalm100.org.
August 20Mac and Cheese Charity BlockParty: Benefitting Team Molly.5:30 – 7:00pm at Whole FoodsMarket in Wellington. $10.00donation per person at theproduce section entrance. All theproceeds to Team Molly at theLeukemia and LymphomaSociety. Visit the website atwww.wholefoodsmarket.com.
August 28Healthy Heart Health Fair andForum. Wellington RegionalMedical Center. In addition tofree blood pressure andcholesterol screenings andeducational resources, physicianlectures are scheduled for11:30am and 12:30pm. Ahealthy lunch will be served, soreservations are encouraged. Call561-798-9880 to reserve yourplace.
ONGOING EFFORTSDisaster Relief Fund. To donatemoney to the victims of therecent tornado in Oklahoma, visitthe American Red Cross websiteat www.redcross.org
Send us your information [email protected]
Upcoming Charity, Medicalor Fundraising EventsAugust 1 – 31, 2013 By Deborah Lynn
In 1999, Light of the World Charities was formed by co-founders the lateReverend Bernard Powell and Mrs. Theresa Banks. As a registered nurse andparishioner at Holy Redeemer Catholic Church in Palm City, Theresaparticipated in other medical missionary trips prior to being invited by FatherPowell to help promote a new stewardship program he was establishing,Light of the World Charities (LOTWC).
Their initial mission was to Chiclayo, Peru, where they sent a surgical groupwith the help of a Peruvian Priest. They have also visited Tanzania, Africa,the Republic of Haiti and Nicaragua. However, it was with the help of theCongregation of the Franciscan Friars of the Renewal that they were affordedan opportunity to send a surgical team to Honduras.
It was there that Dr. Yvette Laclaustra traveled on her latest mission. Havingfirst traveled to Honduras and Haiti as early as 2002, these patients have trulybecome part of her. She had asked that I not focus on her in this article, butinstead bring to light the need for additional funding in order to continue andgrow the missions that are put together by this amazing not-for-profitorganization.
According to Dr. Laclaustra, there are normally four surgical teams that aremade up of a number of specialized physicians. Those include generalsurgeons, orthopedic surgeons, gynecologists, urologists and dentists and more.
In the past, they would put an ad in local papers stating the American doctorswere coming and the lines would start to form. These days, there is a naturalstructure to it all as the patients are seen privately, prior to the arrival of theteam of physicians. Once they arrive, they will review the patient assessmentand if they agree, they will proceed.
The most recent trip to Honduras was a special one for Dr. Laclaustra as herson Adrian Vinas, a pre-med student was also in attendance. He capturedphotos from the mission and we are pleased to share some with you at thistime. The surgical team from this trip came from Atlanta, New York, Texasand Florida. In addition to Dr. Laclaustra and Adrian, there was also a fatherand daughter team and as she explained, it truly is something that is handeddown from generation to generation.
During the Honduras trip, they were able to see 81 patients and did 95procedures over the four and a half days. “We tried to do as much as we can.We built operating rooms and recovery rooms. There is also a clinic andexamining rooms, all of the money was raised through the annual fundraiser”stated Dr. Laclaustra.
There are currently over 400 medical and non-medical volunteers of whichgive their time, money and expertise in the United States and abroad. It isbecause of these amazing individuals that LOTWC continues to providesurgical treatment to the poor and needy.
Most of the money they receive to organize and carry out these missions isthrough their annual charity event. However, they are always in need ofadditional funds in order to continue their humanitarian missions.
If you would like to help LOTWC or to simply find out more information,please visit their website at www.lightoftheworldcharities.com. To viewadditional photos from the most recent trip to Honduras, go towww.lotwhonduras2013gallery.weebly.com.Americans Living
Longer, HealthierLives: StudyMONDAY, July 29 (HealthDay News)
Not only has Americans'life expectancy increasedin recent decades, they
also are healthier later in life, anew study shows.
"With the exception of the yearor two just before death, peopleare healthier than they used tobe," study author David Cutler, aprofessor of applied economicsat Harvard University, said in auniversity news release.
"Effectively, the period of time inwhich we're in poor health isbeing compressed until justbefore the end of life," Cutlersaid. "Where we used to seepeople who are very, very sickfor the final six or seven years oftheir life, that's now far lesscommon. People are living toolder ages and we are addinghealthy years, not debilitatedones." Increased access to andimprovements in health care areamong the reasons people arehealthier later in life, but furtherresearch is needed to identify allthe factors.
Light of The World Charities
Light of the World Charities Brightens the Lives of Others
Page 11August 2013www.GlobalHealthTribune.com
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We are conducting a clinical researchstudy of an investigational medicine.If you meet the following criteria, youmay be interested in participating in this clinical trial.• Age 18 – 79 inclusive• At least 28 stools over a 7-day period• Moderate to severe Pain in your abdomen associated with:
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Participants receive study related care, diagnostic tests, and study medication at no cost. Payment for time and travel to the study centermay be provided
For more information about the research study, please contact:
What Every Man Should Know About Prostate Cancer Screening
By Ross A. Cohen, M.D.
Prostate cancer is themost common canceramong men (behind skincancer), and the second
leading cause of cancer death inmen. One in six men will be di-agnosed in his lifetime. In 2012,more than 240,000 men were di-agnosed with prostate cancer andabout 28,000 died of the disease.Prostate specific antigen (PSA)is a protein secreted by theprostate gland and is detected inthe blood. Since the late 1980’s,
PSA has emerged as the most im-portant tumor marker for screen-ing, detection, staging and moni-toring of prostate cancer. Thistest when used with a digital rec-tal examination (DRE) of theprostate has been the mainstay ofdetecting prostate cancer in itsearliest, therefore most curablestage. In May of 2013, the Amer-ican Urologic Association re-leased a new Clinical PracticeGuideline on the Early Detectionof Prostate Cancer.
The previous AUArecommendation was PSAtesting and DRE annually formen 50 years or older. ForAfrican American men or men ofany race with a family history ofprostate cancer, testing wasrecommended to begin at age 40.The new guideline does notrecommend routine screening inmen of all ages, but, ratherrecommends that health careprofessionals utilize a moretargeted approach to screening.The decision to test should bemade in the context of aconversation between a man andhis health care provider. The keypoints of the guideline include:
• Routine screening is notrecommended in men under age 40.
• For men 40-54 there was
insufficient evidence torecommend routine screening,and the decision to screenshould be discussed with theirprovider.
• The greatest evidence of benefitof routine prostate cancerscreening was found in menages 55 to 69.
• Men with risk factors includingrace, family history or urinarysymptoms should talk withtheir health care providerregarding testing.
• Routine screening is notrecommended in men over theage of 70, or in men with a lessthan 10 – 15 year lifeexpectancy. They alsoconcluded, however, some menover age 70 could benefit fromtesting.
If prostate cancer screening ischosen, a PSA and DRE areperformed by your health careprovider. An abnormal PSA,DRE or both usually leads to aconsultation with a Urologist. Itis at this visit that it would bedetermined if further testingwould be beneficial indiagnosing prostate cancer early,before it has spread. Transrectalultrasound and biopsy toevaluate the prostate further andobtain tissue for diagnosis is
usually the first diagnostic test.This is an office basedprocedure, performed under localanesthesia and is the only testthat can truly differentiateprostate cancer from benignconditions of the prostate such asbenign prostatic hypertrophy(BPH) or prostatitis.
If one is diagnosed with prostatecancer, the decision whether,when and how to treat it needs tobe addressed. The treatmentrecommended depends onwhether the cancer is thought tobe localized (confined to theprostate) or if it is metastatic(spread beyond the prostate).This is usually determined with aCT scan or MRI of the pelvis anda Bone Scan. These are usuallydone at an imaging center.Treatment options must also takeinto consideration other factorsincluding age of the patient, thepresenting PSA, aggressivenessof the cancer on biopsy, theoverall health of the patient, andthe life expectancy of the patient.
The most appropriate treatmentfor localized prostate cancercontinues to be debated.Treatment options for localizedprostate cancer include:
• Watchful Waiting• Robotic, laparoscopic or openradical prostatectomy
• External Beam radiationtherapy• Brachytherapy (high doseradiation or low dose seedimplantation)• Proton Beam Therapy• Cyberknife• Cryotherapy• HIFU (High Intensity FocusedUltrasound)
Treatment options for metastaticprostate cancer include:
• Hormone therapy• Chemotherapy• Immunotherapy
Prostate Cancer screening carrieswith it potential benefits andrisks. Benefits include stressrelief if the screening is normal,minimizing the chance of cancerspreading if detected early andpotentially helping some menlive longer. Possible risks ofscreening include a “falsenegative” result in which someprostate cancers may be missed,a “false positive” result whichcan lead to needless stress and anunneeded prostate biopsy.
In addition, treatment of prostatecancer can cause problems witherectile, urinary and bowelfunction. This is why men shoulddiscuss prostate cancer screeningwith their health care providerand see if it is right for you.
Ross A. Cohen, M.D.,Ross A Cohen, M.D., is a Board
Certified Urologist who has been
in practice here in Palm Beach
County for 23 years. His new
office is located at 5065 State
Road 7, Suite 203, Lake Worth,
Florida. Call (561) 432-0067 to
make an appointment or more
information.
PALM BEACH PRIMARY CARE ASSOCIATES, INC.
Page 12 August 2013 www.GlobalHealthTribune.comPRACTICE TRENDS
3347 State Road 7 Suite 200
Wellington, FL 33449Tel: (561) 795-9087 • Fax: (561) 753-8730
1200 South Main Street Suite 101
Belle Glade FL 33430Tel: (561) 996-7742 • Fax: (561) 753-8730
State of the Art Office Building with Imaging Center,
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SPECIALIZING IN:• Diagnosis of Complex Illnesses
• Cholesterol Management • Diabetes • Cardiac Care • EKG/24-Hour HeartMonitoring/Spirometry • Hypertension • Geriatric Concerns • Osteoporosis
Monday - Friday from 9:00 am - 5:00 pmSame Day Appointments and 24-Hour Service Available
On staff at Palms West Hospital andWellington Regional Medical Center
Forest Hill Blvd.
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Shekhar Sharma M.D.Ebonee Johnson A.R.N.P.
Shekhar V. Sharma, M.D.Board Certified in Internal Medicine
Diabetes Mellitus a silent malady
Diabetes Mellitus canbe defined as a dis-ease where an indi-vidual’s overnight
fasting blood sugar is more than125 mg. Impaired blood sugaris defined as blood sugar levelsbetween 110 mg. and 125 mg. Adiabetic can only be diagnosedby the checking of blood sugars.Diabetes Mellitus is definitely asilent disease that can hurt anindividual without their knowl-edge. In fact, most of the time,one could be totally unawarethat one has it. It is a conditionthat could become worse if leftundiagnosed, untreated, andmishandled.
How does one get DiabetesMellitus? One of the reasons isimpairment of insulin secretionfrom a group of cells in thepancreas called the ‘Islets ofLangerhans’.
One of the most commonsymptoms of Diabetes Mellitusis polyuria which means frequenturination on a daily basis. Othersymptoms are excessive hungercalled polyphagia and excessivethirst polydypsia when onedrinks a lot of water.
Failure to diagnose DiabetesMellitus can be due to variousreasons such as: individuals notseeking medical attention, or thephysician not doing a simpleblood sugar level. Persons withdiabetes usually presentthemselves to a physician feelinggood, with no symptoms.Sometimes the individual maysay that they have blurry vision,numbness of the extremity, andfeeling weak and fatigued.Studies have shown thatcomplications of DiabetesMellitus, especially microvasculardisease (which means bloodvessel disease) has a directcorrelation with control of one’sblood sugar. Cardiovasculardisease also remains a leadingcause of death in DiabetesMellitus Type II individuals.Other risk factors likehypertension, (which meansblood pressure) high cholesterol,and obesity in Diabetes Mellitusshould be taken into considerationin coordination with good controlof one’s blood sugar.
Individuals with impaired fastingblood sugar are at high risk forthe development of diabetes and
arterial disease. Approximatelyone-third of patients withimpaired blood sugar developfull blown Diabetes Mellitus.
Diabetes Mellitus also runs infamilies and family history is animportant indicator of thisdisease.
Complications of DiabetesMellitus are strokes, heartattacks, kidney disease,peripheral arterial disease,especially of the lowerextremities and retinopathy ofthe eyes which can lead toblindness if left untreated.Treatment for Diabetes Mellitusis first of all DIET CONTROL -
controlling what you eat. Thisway, you will not only loseweight, but you can also controlyour diabetes. Eating the rightfoods and avoiding foods such ashigh carbohydrate/starch, dietand sweets with high sugarcontent is important. Reductionof saturated fat intake and theaddition of high fiber in one’sdiet have become criticallyimportant. Exercise has beenshown to be beneficial in theprevention of the onset ofDiabetes Mellitus Type II. Theadded benefits of exercise islowering of one’s blood pressure,improving cardiac performanceand raising the good cholesterolcalled HDL in the blood. If blood
sugars are still high despite dietand exercise, I wouldrecommend a continuation of adiet and exercise program alongwith pharmaco therapy.
There are various ways oftreating Diabetes Mellitus witheither tablets or with insulin andblood sugars can definitely becontained.
We all need to be aware thatthere is so much more to thisdisease that is not understood bythe lay person. This is where thephysician who is well-versed andexperienced in the disease stepsin and this can be beneficial toany individual with this disease.
Page 13August 2013www.GlobalHealthTribune.comHEALTHCARE NEWS
Mike Corvaia has been inhealthcare administration forover ten years and is currentlythe Director of BusinessDevelopment for SelectSpecialty Hospital in PalmBeach. He holds a Bachelor’sdegree from the University ofFlorida and is completing hisMaster’s Degree this year inBusiness Administration, withan emphasis on HealthcareAdministration.
Please feel free to send anyhealthcare related questions [email protected]
Select Specialty HospitalDo you have a success story?
Ventilator CareJudy Barth was working in heryard when she experienced whatshe thought was heartburn. Thepain increased to the point thatshe called for help. The lastthing she remembers isscrambling for her insurancecards and passing out. Her nextmemory is one month later whenshe woke up at Select SpecialtyHospital- North Knoxville. Judyhad gone into cardiac arrest andwas admitted to the local medicalcenter where she was treated and
stabilized. Doctors wereconcerned that a lack of oxygenmight have affected her brain.Judy had spent almost a monthunconscious and on a ventilatorin the ICU when she wasreferred to Select SpecialtyHospital to get her off theventilator and functioning again.During her two week stay atSelect Specialty Hospital, Judywoke up, got off the ventilatorand beat the odds by discharginghome. She has since returned towork and walks one to two milesevery day.
Wound CareEugene Harris and his wifeJerlean were working on hisantique truck, trying to get it tostart. He was working with thecarburetor when it blew up.Eugene was sent to the burn unitin Memphis in critical conditionwith twenty-four percent of hisbody burned. His family wastold he might not survive. Amonth and a half later, stillunconscious and having survivedseveral life-threateninginfections, Eugene wastransferred to Select SpecialtyHospital in Memphis. He was ona ventilator with pneumonia andrequired dialysis. Eugene waswith Select for nearly twomonths, his wife by his sideevery day. While he was atSelect, he weaned from theventilator and saw his kidneyinjuries resolved. He no longerneeded dialysis. His burnscontinued to heal and he wasdischarged to a rehab facility
with the goal of returning homeas soon as possible. Almost fourmonths after the accident,Eugene returned home. He saysnow he plans to enjoy thecomforts of home with his wifeof 46 years.
Cardiac CareThirty eight year old MyrtleMason had been struggling forbreath for about a month. Herbody was swollen from fluidretention due to congestive heartfailure and she had been sleepingupright in a chair so she couldbreathe at night. When she couldno longer take it, Myrtle soughtthe help of a physician. She wasadmitted to the local medicalcenter with acute respiratoryfailure and was placed on aventilator. Doctors told herfamily that getting off theventilator would be a long shotand she might not survive. Then,Myrtle was transferred to SelectSpecialty Hospital- Fort Smith.At Select, the team got her up andmoving again. Her congestiveheart disease, diabetes and bloodpressure were brought undercontrol and she was weaned fromthe ventilator. Myrtle wasoriginally scheduled to go torehab, but she surprised everyoneby walking out of the hospital onher own and discharging home. Itwas her son’s 18th birthday.Myrtle feels like she has learnedthe importance of taking care ofherself and is grateful for asecond chance. “They gave memy life back. They were there forme.”
The Wellington Chamber ishonored to announce theappointment of Bill Taverniseto the Trustee level President’sCircle. Bill is the ManagingBroker of Keyes Real Estate,Mortgage, Title and Insurance.He has spent over 26 years inthe Real Estate Industry inboth NY and Florida.
His ProfessionalAccreditations include RAPBGovernment AffairsCommittee ( 2011-2012),Broker-Owner “LifestyleUnder The Sun Real Estate,Inc.”, and “Florida Style RealEstate, Inc.”(2001-2008),Wellington Chamber ofCommerce Past- President andcurrent Board Member as wellas past Chairman of theBusiness and EconomicDevelopment Team.
In addition, Mr. Taverniseserves on the Board Of
Directors for Palms WestHospital, the AdvisoryCommittee for Kids CancerFoundation of The PalmBeaches and was Past-President of the " LittleSmiles" organization.
Bill and his wife Andreacurrently reside in Jupiter andhave been South Floridaresidents since 1994.
Please join us in welcomingBill Tavernise to our illustriouslist of trustees!
Bill TaverniseKeyes Real Estate, Mortgage,
Title and Insurance
Managing-Broker, DSM, CDPE, CAIS
561-209-8304
Bill Tavernise joinsWellington ChamberPresident's Circle
Page 14 August 2013 www.GlobalHealthTribune.com
Dear Deborah is a monthly advice column written by Deborah Lynn with a commonsense approach to dating. If you have any questions or comments, please forward
them to: [email protected] as we would love to help.
DEAR DEBORAH:
A relative recently introduced me to asingle guy that works with him. Oneday, when I was e-mailing him, I put hise-mail address in the search line bymistake. Well, I was shocked with whatcame up. He has a few profiles on escortdating web sites that show what he wantsfrom a woman! I tried to pull up hiscomplete profile, but it did not allow meto look further. So, I took a fewkeywords that were listed in the visibleportion of his profile and searched a littledeeper. He listed himself as a “hobbyist”and what I found when searching wouldmake anyone blush. He actually postedreviews about the women that he sleptwith! What’s worse, he is a partner in alaw firm and this was all visible onlinefor anyone to see since he uses hispersonal e-mail address. Is he thatclueless or just not care that anyone cansee what he has been doing? Needless tosay, he is out of the potential dating pool.
- Risky Business
Dear Risky Business:
That is quite an interesting story. Onecan only hope that he is indeed naïvebecause who in their right mind, and insuch a position, would be so carelesswith their behavior? The Hobbyistdesignation refers to a man that makes alifestyle out of sharing time with escorts,in essence, it’s a hobby. Some peopleenjoy painting, he enjoys sex. Hobbyistsput reviews on web sites, blogs andmessage boards basically rating thewomen they have been with. Since he issingle, this is obviously his lifestylechoice. You did not mention if you toldhim what you found. If you haven’t andfeel the need – tell him. First, explain tohim that you are not passing judgment,however he should be more aware ofwhat information is out there that wouldreflect poorly on his character. You canfurther state that his law partners,associates, and clients can easily see
what type of behavior hemaintains and that would not befavorable to his career. By no meansam I condoning this type of lifestyle.People need to realize that nothing ishidden these days, true or untrue, and ifhe plans to continue, he needs to createa separate e-mail address that is notlinked to everything else that he does ona daily basis. I commend you foreliminating him from your dating poolas you will never feel comfortable withhis loyalty to you.
DEAR DEBORAH:
I recently started dating someone whomI met on a dating site. He seems to be agreat guy and has his head on straight.He has children as do I. After a fewdates, he mentioned that he is notinterested in dating anyone else, but stillhas his profile up. Being the snoop thatI am, I have been checking to see if hehas been online and sure enough, he hasbeen on daily. Do I tell him that Iknow? Or, do I just ignore that heobviously DOES have an interest inother women and has clearly lied to me.I am so tired of wasting time on menthat are not being honest. Should I walkaway?
- Hanging on for Love?
Dear Hanging on for Love:
I am one to give people the benefit ofthe doubt; however you are alreadyquestioning his behavior. My advice toyou is to be upfront and ask him if hewould like to be exclusive. If he doesnot and you do, you have a choice tomake. If he does, simply ask him to puthis profile on hold or delete it for now.You may already feel close to him, butyou truly have nothing invested if youjust started dating him. At this point,you can always walk away. I am alwaysupfront with what I am looking for in apartner and will only date those of thesame mindset.
Dear Deborah
AROUND TOWN
It is our pleasure to announce abeautiful addition to our extendedfamily. Michael Joseph Corvaiawas welcomed into this world onJune 23, 2013 weighing in at 7lbs,4oz. and 20 inches long. He is thefirst child for Michael andMarianne Corvaia.Congratulations and may you havemany - many wonderful yearsahead.
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Orthopedic Program
To read more of McLain’s story, visitWellingtonLivingProof.com
A few months before the summer Olympics, I fell off my horse and completely shattered my knee. When the doctors told me I needed surgery, I was devastated. How could I recover in time to qualify for the U.S. team? To give me my best shot, I needed a stellar orthopedic team and found it at Wellington.
My surgery was on January 14 and by April, I was back in the saddle. Thanks to specialized care, I qualified for the Olympic team and went on to compete in London. I am living proof of first-class orthopedics at Wellington Regional.
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