© jackson health system your resource for health and well being ✦ june 2010 heart patient rd takes 3 nationwide children’s summer heart problems ✦ bone marrow transplant cures sickle cell © Madeline Barrios Celebrity Rally Raises Money for Holtz Children’s Hospital Neonatal ICU Baby Is “Miss Congeniality” t ren’t we always told that we can achieve anything with hard work and dedication? Melissa Alonso’s mother can certainly attest to that fact. When Melissa was born with heart problems 15 years ago, she was cared for in Holtz Children’s Hospital’s Neonatal Intensive Care Unit, and was a patient of UM/Holtz pediatric cardiac surgeon Peter L. Ferrer, M.D., over the years. “Other kids made fun of her because she was so skinny,” said Otilia Ramos. “So I thought that maybe she’d like to go to modeling classes.” After only three years of classes, the 8th grade student he first Rally for Kids with Cancer in Miami raised money for Holtz Children’s Hospital, the Jackson Memorial Foundation and IKF Wonderfund. The star-studded event featured nearly two dozen celebrities, who took part in a scavenger hunt throughout Miami. At the “pit stop” in Alamo Park, patients from Holtz were paired with a celebrity and given the task to paint their portrait. Celebrities included Eva Longoria Parker from “Desperate Housewives” (pictured above left), Gilles Marini from “Brothers & Sisters” (pictured left) and Eva La Rue and Sofia Milos from “CSI Miami.” Also participating was international artist Romero Britto, who created the Holtz logo. was named “Miss Congeniality” and “Miss Sweetness” in the Miss Quinceanera Latina 2010 beauty pageant in April. “I give thanks to God every day,” said Otilia. “My daughter wouldn’t be here if it wasn’t for Dr. Ferrer.” a LRphotography ©2010 Ital World Design Madeline Barrios jacksonrounds Remodeled Pediatric ER Welcomes Children i “ t’s just awesome,” said Nurse Manager Vanessa Plunkett, R.N., M.S.N., about the newly remodeled and renovated Harvey & Roberta Chaplin Pediatric Emergency Room at Jackson Memorial Hospital. “It’s kid-friendly with vibrant colors and kid-sized furniture.” Funded by the Jackson Memorial Foundation, the unit was reconfigured to provide more open space and create two private rooms in the triage area. There are colorful prints on all the walls, and even the ceilings have images of birds and balloons for children to see when they’re laying down. jackson health system Jackson Health System Corporate Director Public Relations and Public Affairs Ed O’Dell Editor Pat Morrissey/Havlin Associate Editors Kathleen Rohan Adam Taylor Assistant Editor Madeline Barrios Art Director/Designer Barbara Scheer, M.F.A. Writers Sandra Fiedler Pat Morrissey/Havlin Jennifer Mooney Piedra Kathleen Rohan Public Health Trust Board of Trustees Officers Chairman John H. Copeland III Vice Chairman Angel Medina Jr. Secretary Georgena D. Ford, R.N. Treasurer Marcos José Lapciuc Trustees Stanley H. Arkin Jorge L. Arrizurieta Gladys L. Ayala, Esq. Rosy Cancela Ernesto A. de la Fé Joaquin del Cueto Abraham A. Galbut Saif Y. Ishoof, Esq. County Commissioner Dorrin D. Rolle Judy Rosenbaum, Ed.D. County Commissioner Javier D. Souto Martin G. Zilber, Esq. Ex-Officio Members County Mayor Carlos Alvarez Michael E. Barron, M.D., FAHA County Manager George M. Burgess Pascal F. Goldschmidt, M.D., FACC D. Jane Mass, R.N., M.S.N., NEA-BC Nilda Peragallo, Dr.P.H., R.N., FAAN Janet Perkins Eneida O. Roldan, M.D., M.P.H., M.B.A. Jackson Health System Connections is published twice a year by the Public Relations Department of Jackson Health System. All contents © Jackson Health System. Reproduction in whole or part without written permission is prohibited. Jackson Health System is an Equal Opportunity/Affirmative Action Employer. Comments? Questions? Contact us [email protected] Cover photograph by John DeTemple/d.inc 1611 N.W. 12th Avenue Miami, Florida 33136-1096 Phone: 305-585-1111 www.jhsmiami.org november 2009 ✦ connections ✦ C2 © contents jackson health system your resource for health and well being june 2010 2 Holtz Care Gives Theo’s Heart Extra Mileage ON THE COVER: Theo Koby’s transformation from a boy who couldn’t play any sports to the 3rd place teen winner in a national flowboarding competition is a tribute to the cardiac specialists at Holtz Children’s Hospital. Dr. Robert Sokol 4 Saved from Paralysis When the renowned neurosurgical team at Jackson Memorial Hospital saved his wife from definite paralysis, Henk Milne’s Celtic rock band thanked them with a benefit concert. 5 Free to Eat without Dread 4 Approximately 15 million Americans have daily symptoms of heartburn or acid reflux. Jackson South Community Hospital surgeons used an innovative procedure to banish Madelin Dominguez’s reflux forever. DEPARTMENTS Ask the Doctor: Summer Heart Problems for Kids Close-Up: Jackson Health System’s Response to Haiti’s Earthquake Innovations: Brother’s Gift Cures Sickle Cell 9 Connecting to You WE ARE PROUD TO SHARE WITH YOU some extraordinary stories of people whose lives have been dramatically improved by the medical care they received in Jackson Health System. These stories and more happen every day throughout Jackson. The teenager on our cover, Theo Koby, is winning national flowboarding medals after always being told he couldn’t play sports. Dr. Paolo Rusconi made the difference in Theo’s life. Madelin Dominguez endured daily gastric reflux so severe she could barely eat. Now she can have whatever she wants. Drs. Eddie Gomez and Moises Jacobs used a procedure that didn’t even leave a scar. Our “Close-Up” in this issue features an event that touched all of our lives: the January earthquake in Haiti. Jackson employees were among the “first responders” along with their colleagues at the University of Miami Leonard M. Miller School of Medicine, who had been providing health care on the island for many years. Among those patients airlifted from Haiti to Jackson, you’ll meet two who inspired our nation and will continue to do great things, in part due to the care they received here. Thank you for taking the time to read these stories, and thank you for supporting Jackson. Scherley Busch 7 9 12 Eneida O. Roldan, M.D., M.P.H., M.B.A. President and CEO, Jackson Health System © Holtz Care Allows Theo L IKE MANY 15-YEAR-OLD BOYS, Theo Koby Hercsky likes to play basketball, baseball, soccer and football. He also skateboards and recently ranked third in the country in a flowboarding competition – a sport often referred to as indoor surfing, where participants ride simulated waves. But being able to participate in such activities is new for Theo. Born with a complex congenital heart defect, only one chamber of his heart was pumping blood, instead of the two necessary for normal functioning. Because doctors feared highintensity activities would put too much strain on his heart, Theo has been unable to play sports for most of his life. Since birth, Theo has had several heart operations – including three open heart surgeries – to help treat and manage these defects and other ongoing problems so he could continue to grow. But his heart gradually weakened, he developed heart failure and two years ago while playing a rare basketball game, he collapsed. After a long history of exhausting treatments at other facilities, Theo’s family was referred to Holtz Children’s Hospital’s Heart Failure and Transplant Program at the University of Miami/Jackson Memorial Medical Center, where the innovative treatment provided by the program’s medical director, Paolo Rusconi, M.D., gave them new hope. Specialized Cardiac Care Above: With Sandy Hercsky’s encouragement, Dr. Paulo Rusconi helps Theo stay as healthy as possible. Far right: Now Theo can enjoy skateboarding with his brother, Bubbie. BY KATHLEEN ROHAN PHOTOGRAPHY BY SCHERLEY BUSCH 2 ✦ connections ✦ june 2010 The Heart Failure and Transplant Program is part of The Children’s Heart Center, a joint venture between Jackson’s Holtz Children’s Hospital and the University of Miami Leonard M. Miller School of Medicine. The Children’s Heart Center is internationally respected for the comprehensive care it provides for children with congenital heart disease, as well as other cardiac conditions, caring for them from birth well into adulthood. At Holtz, Dr. Rusconi and his highly specialized team successfully treated Theo for heart failure and implanted a pacemaker to help his heart pump blood properly to all of his organs. The ninth grader at Cutler Ridge Christian Academy said that after receiving the pacemaker he noticed a big difference in his ability to be active. “It made me feel not as tired, and I can do more things,” Theo said. “I don’t have to worry as much anymore.” History of Heart Trouble Theo was born with severe congenital heart disease, but doctors did not know anything was wrong until days after his birth when his mother brought him to a pediatrician because he was not eating. He was rushed to the intensive care unit at a local hospital and immediately placed on life support. They tried to help him gain weight so he would be strong enough to undergo the procedures necessary to save his life. “No one thought he was going to live, he had so many different complications,” said Theo’s mother, Sandy Hercsky. For years, the family lived with worry. Once Theo seemed to be doing better, additional complications would arise requiring more surgeries, which he received at many hospitals in different states. His mother remained at his side, determined to get her son the best medical treatment possible so he could one day live a normal life. She envisioned him free of all the restrictions that children with heart disease often face: No sports. No rough housing. No gym at school. By October 2007, doctors referred Theo to The Children’s Heart Center at Holtz for a heart transplant. But thanks to the innovative heart failure treatment provided by Dr. Rusconi and his team, Theo’s condition improved and he underwent placement of a cardiac pacemaker, which changed his life for the better. Now, three years later, he is able to live an intense and active life with his own heart and can postpone the transplant. “Once they put in the pacemaker, he has been able to do so many © to be a NORMAL KID things, like playing baseball and football,” Sandy said. What Lies Ahead There is no medication or surgery that can permanently correct Theo’s heart defect. Dr. Rusconi says he will eventually need a heart transplant, but they are trying to hold off for as long as possible. “Cardiac transplantation is an extreme solution that replaces one disease with another in the sense that after receiving a new heart, the patient still will need to take medications and remain under the constant care of physicians,” he said. And, it will only be a temporary solution. “Unfortunately, a transplanted heart tends to age much faster than a native heart and after an average of about 14 years, a new cardiac transplant is needed,” said Dr. Rusconi. “This means that a child requiring a cardiac transplant will require more in the future. A child is better off the longer he or she can keep the native heart and live life as close to normal as possible.” So that is exactly what Theo is doing now; living each day to its fullest and preparing to compete in the next national flowboarding competition. “Now Theo feels like a boy,” said his mom proudly. “For kids with defects to be able to do these things, it is just amazing.” ▲ FOR MORE INFORMATION ON HOLTZ CHILDREN’S HOSPITAL’S CHILDREN’S HEART CENTER, PLEASE CALL 305-585-6683 OR VISIT WWW.HOLTZCHILDRENSHOSPITAL.ORG. “It made me feel not as tired and I can do more things. I DON’T HAVE TO WORRY AS MUCH ANYMORE.” june 2010 ✦ connections ✦ 3 © savedfromparalysis BY JENNIFER MOONEY PIEDRA PHILIPPA “PIPPA” MILNE ALWAYS THOUGHT of Jackson Memorial Hospital as a place where people come when they have been shot, seriously burned or critically injured in a car accident. The Coral Gables resident never expected she would need Jackson. But after burning her wrist – and not feeling any pain – Pippa underwent a series of tests that discovered a serious problem. She had an ependymoma, a massive tumor on her spinal cord, and was referred to Michael Y. Wang, M.D., FACS, a University of Miami/Jackson neurosurgeon who specializes in the treatment of complex spinal disorders. Pippa’s case was uncommon because the tumor, which was the size of a spear of asparagus, sat completely within her spinal cord and was running out of room. Had she waited to have surgery, the chances for permanent damage would have dramatically increased. “It was an extremely dangerous tumor,” said Dr. Wang. “If it continued to grow, it would have caused paralysis.” High-Tech, Complex Surgery Only at Jackson 4 ✦ connections ✦ june 2010 Michael Y. Wang, M.D., FACS, and his team performed the complex surgery to remove Pippa’s tumor while protecting her spinal cord. “It is a phenomenal, world-class institution,” she said. “Everybody – from the patient care technician to the nurses to Dr. Wang – was extremely dedicated and compassionate.” A Concert Says “Thanks” As a thank you to Jackson, Pippa’s husband – a lawyer by day, Celtic rock musician by night – organized a benefit concert to raise money for the Jackson Memorial Foundation, the fundraising arm of the health system. His band, The Three Jacks, performed before a large crowd at the Gusman Center for the Performing Arts in downtown Miami. They raised about $75,000 for the hospital. “I was so impressed with everything about Jackson that I wanted to give something back,” Henk Milne said. “This is our way of thanking the institution that did so much for our family.” ▲ In September 2008, Pippa underwent a six-hour surgery at Jackson Memorial Hospital to remove the tumor. During the highly complex operation, doctors used a hypothermic treatment to cool her body to 33 degrees Celsius (91.4 degrees Fahrenheit) to protect her spinal cord from the growing tumor and to minimize damage to the spinal cord and surrounding nerves. Continuous electrical monitoring of her spinal cord, a technique innovated at Jackson Memorial, was used to warn Dr. Wang of any impending nerve damage. Jackson, which is home to some of the world’s most renowned neurosurgeons, is outfitted with state-of-the-art equipment needed for complex spinal cord procedures such as intraoperative CT scanners, advanced microscopes and magnifying systems. “There is no other hospital in the southern half of Florida that has the capability to do this type of complex surgery,” Dr. Wang said. Pippa spent a month recovering at Jackson, including two weeks in Jackson Rehabilitation Hospital. Since the surgery, she has returned to her active lifestyle, which includes regular workouts at the gym and walks around the golf course. Follow-up tests show the tumor is completely gone, and Dr. Wang says the likelihood of it growing back is very slim. Pippa Milne feels very fortunate that Jackson was around to help her. TO LEARN MORE ABOUT THE NEUROSURGICAL OPTIONS AVAILABLE AT JACKSON MEMORIAL HOSPITAL, PLEASE VISIT OUR WEB SITE, WWW.JHSMIAMI.ORG. © Free to Eat without Dread BY SANDRA FIEDLER W hen Madelin Dominguez woke up every morning, she dreaded the traumatically recurring feeling that her mouth was on fire. A TV executive at Telemundo, she had chronic heartburn that was so severe it sometimes left blisters in her mouth. Sleeping had “I would wake up in the middle of the night with a lot of pain in my stomach,” said Madelin. “I had to sleep almost sitting up. It was very uncomfortable.” An estimated 60 million Americans suffer from heartburn or acid reflux at least once a month and, like Madelin Dominguez, about 15 million Americans have daily symptoms. Madelin was tired of taking medicines every day to relieve her discomfort. She missed being able to look at a restaurant menu like everyone else. She had to avoid dishes that were spicy, greasy or contained forbidden ingredients, like tomatoes and garlic. “I really missed my Lebanese food,” she said. New Treatment Fixes Cause of Reflux “I sleep like a baby now, and I can eat all those foods that I had to avoid. I feel great. It was a really great decision.” procedure. It is much less invasive, and patients aren’t dealing with any scars later,” said Dr. Jacobs. Doctors use a small camera to guide a device called EsophyX® down the throat into the esophagus. Surgeons are usually able to re-establish the barrier between the stomach and esophagus in about 30 to 45 minutes. Both Drs. Jacobs and Gomez agree that occasional heartburn is normal. However, when acid reflux becomes chronic and severe, it’s time to see a specialist because it can lead to serious medical problems, including cancer. As for Madelin Dominguez, she is thrilled that she has eliminated all the drugs she once needed for her heartburn. Simple things like sleeping and eating have become effortless pleasures again. “I sleep like a baby now, and I can eat all those foods that I had to avoid,” she said. “I feel great. It was a really great decision.” Madelin Dominguez can now enjoy anything her daughter Hailey wants to eat for dinner. ▲ Madelin decided it was time to turn to Jackson South Community Hospital for a new, innovative procedure called TIF® (Transoral Incisionless Fundoplication). Eddie Gomez, M.D., FACS, a laparoscopic and general surgeon, said the innovative technique is an important advance for those suffering from chronic and severe heartburn, because it gets to the root cause of acid reflux. “We’re recreating the valve of the lower esophagus,” said Dr. Gomez. “It prevents the acids from leaving the stomach and coming back up into the esophagus.” Moises Jacobs, M.D., FACS, medical director of the minimally invasive surgery program at Jackson South, said recovery from this new technique is easier on the body. “Patients can go home just hours after the Scherley Busch become very difficult. FOR MORE INFORMATION OR TO SCHEDULE AN APPOINTMENT, CALL THE DIGESTIVE CENTER OF HEALTH AT JACKSON SOUTH COMMUNITY HOSPITAL AT 305-256-5030 OR VISIT WWW.JACKSONSOUTH.ORG. june 2010 ✦ connections ✦ 5 © IMMEDIATE STROKE INTERVENTION BY JENNIFER MOONEY PIEDRA E jaz Lodhi was watching television when he suddenly lost sensation and strength in the left side of his body. “I couldn’t feel my leg or my arm,” said Ejaz, a businessman. “I thought it was poor circulation, so I started moving around. But that didn’t help.” The phone in his Miami home was broken, so he slowly walked to a neighbor’s home, dragging his leg the entire way. His speech was slurred and his breathing strained, but he managed to tell his neighbor to call 911. When fire rescue arrived, there was no mistaking the diagnosis: Ejaz Lodhi was having a stroke. Stroke is the third leading cause of death and serious, long-term disability in the United States each year. Statistics show that someone BE ALERT TO THESE SIGNS OF STROKE Doctors say the key to combating a stroke is to call 911 immediately if you notice any of these warning signs: ✦ sudden numbness or weakness in the face, arm, leg or on one side of the body suffers a stroke every 40 seconds, and someone dies of a stroke every four minutes. Ejaz was taken to Jackson Memorial Hospital, one of only two hospitals in Miami-Dade County designated as a Comprehensive Stroke Center by the Florida Agency for Health Care Administration – and one of only 16 in the state. At Jackson, a specially trained team of physicians and nurses is ready to treat stroke patients 24 hours a day, seven days a week, using clotbusting medication and advanced catheter-based treatments. “Stroke is painless, so people react to it much more subdued,” said Dileep R. Yavagal, M.D., director of interventional neurology at Jackson Memorial and the University of Miami Leonard M. Miller School of Medicine. “But there are treatments that can reverse stroke in the first few hours.” When Ejaz arrived at Jackson Memorial’s ER, Dr. Yavagal discovered that he had a severely blocked main artery in his brain causing the stroke symptoms. Taking his patient immediately to a neuroangiography suite, Dr. Yavagal used a catheterbased procedure called a stentassisted balloon angioplasty to clear the blockage under local anesthetic. The results were immediate and dramatic. Ejaz, who by that time was completely paralyzed on his left side from the stroke, was able to move his entire body as soon as the procedure was done. Without the emergency treatment, he likely would have remained paralyzed and in need of rehabilitation. “I feel extremely lucky,” he said. “I thought I was going to lose my independence.” Dr. Yavagal says the best way to avoid having a stroke is to stay away from cigarettes, control blood pressure, control diabetes, avoid excessive alcohol drinking and control cholesterol levels by maintaining a low-fat diet. That advice has become a way of life for Ejaz Lodhi. He quit smoking, exercises regularly and eats three healthy meals a day. “I have to take care of myself,” he said. “I’m not going to let stroke control my life.” sudden confusion, trouble speaking or understanding ✦ sudden trouble seeing in one or both eyes ✦ sudden trouble walking, dizziness or loss of balance FOR MORE INFORMATION ON THE STROKE SERVICES OFFERED THROUGHOUT ✦ sudden severe headache with no known cause JACKSON HEALTH SYSTEM, VISIT WWW.JHSMIAMI.ORG. 6 ✦ connections ✦ june 2010 ▲ ✦ Left Photograph by Sandra Fiedler MAKES DIFFERENCE IN MAN’S RECOVERY © askthedoctor What Parents Need to Know about Heart Conditions in Summer many people suffer from heat-related illnesses. Children are especially prone to different heat reactions and sickness, and need to be looked after carefully during the hottest months of the year. Many of these illnesses can be prevented or less severe if caught early and correctly treated. That’s why Mary C. Sokoloski, M.D., of the University of Miami Miller School of Medicine and Holtz Children’s Hospital’s Children’s Heart Center recommends that all parents know the signs and symptoms of heart conditions brought on by heat. WHAT ARE THE MOST COMMON HEART AILMENTS THAT CHILDREN EXPERIENCE IN EXTREME HEAT? Heat-related illnesses can range from dehydration to more serious conditions including heat exhaustion. The most common symptoms cardiologists are asked to evaluate that are brought on by heat are: FAINTING: Usually occurs in adolescents as a normal response to perceived low blood volume in the right ventricle of the heart. It can be caused by dehydration or another cardiac problem, such as an abnormality in the heart. Any fainting should be discussed with the child’s pediatrician, who may recommend further evaluation by a pediatric cardiologist. Children with known heart disease may be more susceptible to fainting in hot weather, because many are on medications that lower their blood pressure. PALPITATIONS: The sensation of a fast heart rate, palpitations are a common complaint and occur more frequently in the hot summer months. They can be normal or due to abnormal rhythms of the heart. It is difficult to tell if there is a problem with heart rhythm without cardiac testing. CHEST PAIN: Most chest pain symptoms are caused by muscular pain, asthma and acid reflux. They should be checked out by your child’s doctor. If the pains occur during exercise and exertion or are associated with fainting, there may be a heart concern. WHAT WARNING SIGNS SHOULD PARENTS LOOK FOR? Symptoms can include dizziness, fainting, palpitations, chest pain, headaches, nausea, excessive sweating and even dry skin if the person has sweated to the point of dehydration. Meet the Doctor MARY C. SOKOLOSKI, M.D., is an associate professor of Clinical Pediatrics, Pediatric Cardiology and Pediatric Electrophysiology at Holtz Children’s Hospital. WHAT IS HEAT EXHAUSTION AND HEAT STROKE? HOW CAN THEY BE AVOIDED? Heat exhaustion and heat stroke are more serious heat-related illnesses brought on by elevated temperature, dehydration and electrolyte (salt) loss. Heat exhaustion occurs when the child can no longer cool themselves due to lack of sweat and the body temperature begins to rise. When cooling does not occur and the temperature reaches 107 degrees Fahrenheit, this is a life-threatening situation called heat stroke. Rapid cooling and emergency medical care are necessary in this situation. Children with heat stroke can develop shock and organ failure, so avoiding this extreme situation is the best medicine. While early symptoms of heat exhaustion and heat stroke are listed above, they can also include shaking chills, as if the child was cold, and heat cramps, usually affecting the legs. Parents, teachers, camp counselors and sports coaches should monitor children and their exertion levels during hot weather as well as their fluid intake to ensure dehydration does not reach extreme levels. ▲ THE CHILDREN’S HEART CENTER, LOCATED AT HOLTZ CHILDREN’S HOSPITAL IN AFFILIATION WITH THE UNIVERSITY OF MIAMI LEONARD M. MILLER SCHOOL OF MEDICINE, IS AN INTERNATIONALLY RESPECTED CENTER FOR THE COMPREHENSIVE CARE OF CHILDREN. IT IS THE ONLY CENTER IN SOUTH FLORIDA WITH CARDIAC SPECIALISTS PROVIDING STATE-OF-THE-ART CARDIAC SERVICES FOR BABIES IN THE WOMB, NEWBORNS, CHILDREN AND ADULTS. FOR MORE INFORMATION ON THE CHILDREN’S HEART CENTER, PLEASE CALL 305-585-6683 OR VISIT WWW.HOLTZCHILDRENSHOSPITAL.ORG. june 2010 ✦ connections ✦ 7 Illustration by Michael Sloan T he hot and humid South Florida summer is upon us. During this intense heat, © “Unbearably Painful” Colitis Causes Mom to Miss Son’s First Year of Life BY SANDRA FIEDLER W hen Gina Jones was six months pregnant, the St. Petersburg mom knew she should be celebrating the joy of motherhood for the second time. Instead she was bedridden, hoping someone would make her excruciating abdominal pain go away. “The doctors didn’t know if I would live. I thought I was going to die.” Gina finally agreed with doctors After a year of terrible suffering, Gina can enjoy a normal life with that she should have her colon her family. removed. But during the visit to the surgeon’s office, her husband Dr. Sandler theorized that Gina was persuaded her to get one more opinion, having serious side effects to the medicathis time from tions that should have been making her Raymond B. Sandler, better. Five years later, she tearfully recalls M.D., who is now his reassuring words that day. “He said I medical director of was going to have a normal life. I was going Gastroenterology to enjoy my kids, and he wouldn’t settle for Services at Jackson anything else.” North Medical Center. Sure enough, Dr. Sandler was right. Gina “I didn’t know was enjoying a three-course meal at a great what to think. He said restaurant within days. he had a theory and, if he was right, in three He continues to manage Gina’s colitis days I would be going out to dinner with my with medicines for her immune system and husband,” she said. a diet with increased fiber. “She’s living a completely normal life. That’s what it’s all about,” said Dr. Sandler. “As a physician, that’s very rewarding.” Gina Jones is very grateful she found the right doctor. “He’s a doctor who cares,” Dr. Raymond B. Sandler believes cases like Gina’s are she said. “I can be a mom, a real person. triggered by illnesses such as food poisoning and then made I have my life back.” worse by taking over-the-counter, antidiarrheal medications or prescription pain relievers — a mistake he thinks too many people make. “The bowel is injured and then we take medications FOR MORE INFORMATION OR TO MAKE AN that slow it down, so we are increasing the time our body APPOINTMENT WITH GASTROENTEROLOGY is exposed to molecules to which it then mounts an immune SERVICES AT JACKSON NORTH MEDICAL reaction, setting off a process that may result in full-blown ulcerative colitis," said CENTER, CALL 305-654-3000. JACKSON Dr. Sandler. “Most of the time, the body will heal itself. It’s much better to miss a NORTH IS LOCATED AT 160 N.W. 170TH couple of days of school and work than to create a bigger problem.” STREET, NORTH MIAMI BEACH. Gina, 40, was suffering from ulcerative colitis, an immunologic disease in which the body attacks its own large intestine causing bloody ulcers and severe, chronic diarrhea. Gina was so sick and weak that her son had to be delivered weeks early. She essentially missed the first year of his life. “It was so unbearably painful,” she remembered. “I could barely eat. I spent a year eating only chicken broth and plain yogurt. I went down to 95 pounds.” Gina rarely left home and would race to the restroom as many as 25 times a day. She became so anemic that she needed blood transfusions and, eventually, her kidneys began to fail. “He’s a doctor who cares. I can be a mom, a real person. I have my life back.” Take Time to Heal ▲ 8 ✦ connections ✦ june 2010 © close-up The Story of a Tragedy and How People Came Together to Help BY PAT MORRISSEY/HAVLIN “My experience in that terrible time was one of compassion, helpfulness and a shared sense of humanity. We all felt that the only way to get through this period of fear and chaos was by coming together and each person helping in the way that he could.” — CHRISTA BRELSFORD, HAITI EARTHQUAKE SURVIVOR A REDEEMING FACTOR OF A DISASTER – such as the 7.0 earthquake that devastated Haiti in January of this year – is the outpouring of human kindness and support that manifests in response. Here in Jackson Health System, employees mobilized within hours of the quake. Miami has the largest community of Haitians in the United States, and many work in our hospitals and clinics. Internal counseling personnel – chaplains, social workers and the JHS Employee Work/Life Services-EAP – reached out to our Haitian coworkers to help in any way. Collection sites were established for necessities from first aid kits to shoes to be sent to the island. Organizations that would funnel monetary donations safely to Haiti were promoted to our 12,000 employees. Jackson volunteers joined in the relief efforts as well. Over the years, many Jackson and University of Miami physicians, nurses and healthcare professionals have volunteered to expand medical care in the Caribbean island through Project Medishare for Haiti, Inc., which was established in 1994 by Drs. Barth Green and Arthur Fournier of the UM Leonard M. Miller “I felt guilty for School of Medicine. That network was activated leaving, feeling I immediately after the hadn’t done enough. earthquake to create a You’re not supposed field hospital because to get emotionally the existing Haitian hospital had crumbled. involved, but you do.” When patients were — ANTHONY MENENDEZ, R.N., airlifted out of Haiti, RYDER TRAUMA INTENSIVE those most seriously CARE UNIT NURSE wounded came to Jackson’s Ryder Trauma Center and the UM/JM Burn Center. Others were treated at Holtz Children’s Hospital, Jackson Memorial Hospital, Jackson North Medical Center and Jackson South Community Hospital, for a total of more than 200 patients with an array of injuries. At Ryder, a “command center” was established where trauma surgeons could communicate directly with the field hospital and help with diagnoses and treatment suggestions. The world’s eyes were focused on the tragedy in Haiti, and hearts were uplifted by the stories of the survivors. Media from Japan, London and throughout the United States came to Jackson to hear these stories, some of which are shared in these pages. Clockwise from top left: Alonzo Mourning was especially helpful hanging IV bags on the tent's ceiling poles, said Karen Chamuel, A.R.N.P.; pediatric nurse practitioner Ann-Lynn Denker, A.R.N.P., and friend; the field hospital in Haiti june 2010 ✦ connections ✦ 9 © The Story of a Tragedy and How People Came Together to Help Violinist Romel Joseph: A Story of Survival BY JENNIFER MOONEY PIEDRA W hen Romel Joseph was pulled from underneath a mountain of concrete 18 hours after the devastating earthquake in Haiti, he questioned whether he would live for much longer. Both feet were broken, his left hand had swollen to twice its normal size, metal nails were embedded into his back, and parts of his body were starting to go numb. An American citizen who was born in the rural Haitian town of Gros-Morne, Romel was taken to the U.S. Embassy, where the military arranged for him to fly to Miami for emergency medical treatment. “Take Me to Jackson” When asked which hospital he wanted to be taken to, Romel had one request: “I told Music Saved Him from the Pain them to take me to Jackson Memorial Romel Joseph and his wife, Myslie, who was Hospital because it is the best. I knew that seven months pregnant, were at the school if I didn’t get there quickly, I wouldn’t when the January 12th earthquake shook survive.” the ground. Romel was thrown from the Romel Joseph, 50, spent two months third floor of the school and buried. As he recovering at Jackson, where he underwent lay pinned underneath concrete blocks, he more than a dozen surpassed time by praying, geries on his hand and “Now, more than ever, the visualizing a concert hall in feet. He also had daily his head and replaying children there need an sessions in the hyperconcertos he’d performed education, My goal is to open in the past. baric chamber, a form of therapy that “It removed me from the the school again with a focus increases the amount space I was in and took me on music, art and culture. of oxygen in the blood somewhere else,” he said. All children will be welcome, and helps wounds heal “Because of the music, including those who are I didn’t feel any pain.” faster. But what he wanted Although Romel was orphans and disabled.” more than anything rescued, his wife did not was for his hand to heal, so he could play survive. Because of the injuries to his hand, his beloved violin again. Born legally blind, he worried that he had also lost his ability to Romel is a professional violinist who trained make music. But after his surgeries and two at the Julliard School in New York City. weeks of therapy in Jackson Rehabilitation Though he could have pursued a career perHospital, he began moving his fingers and forming in symphony orchestras, he instead practicing chords and songs on the violin. chose to build The New Victorian School in “His chances of playing again are very Port-au-Prince, so that Haitian children good,” said Patrick W. Owens, M.D., an could also develop a passion for music. orthopaedic surgeon at the University of 10 ✦ connections ✦ june 2010 Above: CBS Evening News anchor Katie Couric visited Romel Joseph and his daughter Victoria while he was recovering at Jackson Memorial Hospital. Left: As soon as he could go back to Haiti, Romel started to rebuild his school. Miami/Jackson Memorial Medical Center who operated on Romel’s hand. “X-rays show his bones are healing straight.” An Inspiration to Many Romel Joseph’s inspiring story of survival touched many, including CBS Evening News anchor Katie Couric and music legend Stevie Wonder, who donated two of his personal keyboards to the earthquake survivor. Student violinists from South Miami Middle School visited Jackson to perform for Romel, as did 8-year-old violin prodigy Brianna Kahane. The Miami Symphony Orchestra – where his daughter Victoria plays the viola – also performed a benefit concert. Romel said he is extremely grateful to the physicians, therapists and nurses who cared for him during his stay at Jackson. He feels extremely blessed – and is determined to rebuild his school in Haiti. “Now, more than ever, the children there need an education,” he said. “My goal is to open the school again with a focus on music, art and culture. All children will be welcome, including those who are orphans and disabled.” © “It was a catastrophe of unimaginable proportion, but undoubtedly the most rewarding thing I have done as a physician and surgeon. I have newfound admiration and respect for the Haitian people.” One Volunteer’s Story — CARL I. SCHULMAN, M.D., MSPH, FACH, UM/JM BURN CENTER SURGEON T “When we arrived, we threw our bags in he earthquake rocked Haiti on a pile and went to work,” she said. “The Tuesday, January 12, 2010. On Haitian people are very resilient. We were Friday, Karen Chamuel, A.R.N.P., was on a working on a little boy whose broken bone donated, 12-passenger airplane bound for stuck out of his leg. He Port-au-Prince. Also aboard was smiling.” were two trauma surgeons, Expecting to spend at two orthopaedic surgeons least the weekend in the and two other nurses, all field hospital, Karen volvolunteers from the Uniunteered to accompany a versity of Miami/Jackson baby back to Jackson. Memorial Medical Center. Found under the ruins of “When I heard about her home after being the earthquake, I knew I buried for 85 hours, the had to help,” Karen rememinfant needed immediate bered. So she made some care. CNN senior medical inquiries and went home correspondent Elizabeth to pack. The perfect volun- Karen Chamuel, A.R.N.P., and “Baby Cohen followed Karen to teer for a disaster, Karen is Jenny” the airplane, all the while a nurse practitioner and reporting her story, “Baby Rescued Alive.” former trauma nurse at Ryder Trauma On April 6th, “Baby Jenny” was reunited Center, who also has experience in neurowith her parents, who flew to Miami after a surgery and emergency medicine. CHRISTA BRELSFORD, AN ARIZONA STATE UNIVERSITY graduate student volunteering with a community literacy program in Haiti, was caught in her building during the earthquake. Through a series of selfless acts by coworkers and complete strangers, she was dug out of the rubble, taken on a motorcycle to a Sri Lankan U.N. peacekeeping mission for first aid and was one of the first Americans airlifted to Ryder Trauma Center. Her injuries were so severe that trauma surgeons were forced to amputate her lower right leg. A situation that would have daunted most everybody else was put in perspective by the Alaskan-born athlete. “I feel every day thankful to be alive,” she said. “I expect it to be a challenge, but I’m extremely confident that I will have no limitations.” Following four surgeries in 20 days at Jackson Memorial Hospital, Christa returned to Arizona to catch up in school and continue rehabilitation. After receiving her prosthetic leg, she immediately participated in an ice-climbing event sponsored by an amputee group. In gratitude for her life, Christa has established a fund called Christa's Angels to help rebuild the community learning center in Darbonne, Haiti, as well as help support Haitian friends and colleagues who saved her and her brother during the earthquake. “Getting caught in a house was just timing,” she said. “However, the good luck that I had was the result of deliberate human choices to be kind and compassionate.” Photography by Ethan Coon (left) and Sean Suddes Photography (right) Human Kindness Saved Christa’s Life DNA test verified she was their missing child. International media carried the heart-warming story, along with some quotes from Karen. “This child is a metaphor for Haiti,” said Arthur M. Fournier, M.D., one of the founders of the University of Miami’s Project Medishare. “She was just about dead. Everybody counted her out, and she is back – and Haiti will come back.” Earthquake Changes Volunteers’ Lives Many medical personnel from Jackson and the University of Miami used personal vacation time to volunteer in Haiti, and many more helped the Haitian victims who were brought to the medical center. “When our first physical therapists arrived (in Haiti), they wasted no time in helping patients, many of whom had crush injuries and burns,” said Lynn Neifeld, M.H.M., P.T., chief physical therapist at Jackson Rehabilitation Hospital. “They created leg braces out of shoe laces and rope. Foam cut from swimming noodles positioned broken hands in braces.” “When Jackson began receiving patients from the earthquake, our social workers played an integral part in helping them,” said Shirley Jackson, L.C.S.W., M.H.M., CCM, social work supervisor at Jackson Memorial Hospital. “They required more attention and assistance than usual, because many of them came with no family and no idea what would happen to them once they were discharged.” “The four days I spent in Haiti were an eye-opening and humbling experience,” said Aman D. Sabharwal, M.D., CPHM, chief utilization officer and corporate medical director, JHS Revenue Cycle Management. “I truly hope that no one ever again has to experience what the Haitians endured.” june 2010 ✦ connections ✦ 11 © innovations Brother’s Generous Gift Cures Sickle Cell BY JENNIFER MOONEY PIEDRA T Photo by Shirley Ambrister RAVIS WASHINGTON WAS DIAGNOSED with sickle cell disease as a newborn and spent much of his childhood in and out of hospitals. He suffered excruciating pain from the disease, an inherited blood disorder that affects the red blood cells. The “pain crises” Travis experienced were accompanied by regular headaches and stomach aches. By age 15, he had suffered two strokes – one of which left him with permanent brain damage and Travis Washington (right) is free of sickle cell disease – and no longer experiencing any pain – thanks to his brother Trevis (left). ▲ 12 ✦ connections ✦ june 2010 partial paralysis. He underwent intense rehabilitation to once again learn how to walk, speak, sit up, use the bathroom and eat. Doctors in Palm Beach County, where Travis lives and was being treated, referred him to Holtz Children’s Hospital at the University of Miami/ Jackson Memorial Medical Center to determine if he was a candidate for a bone marrow transplant. UM/Jackson, which has among the largest sickle cell treatment and research programs in the United States, is one of only 11 centers funded as a Basic and Translational Research Program in Sickle Cell Disease by the National Heart, Lung, and Blood Institute. “Getting a bone marrow transplant was really our only hope left,” said Travis’ mother, Shirley Ambrister. Travis began seeing Martin Andreansky, M.D., Ph.D., director of the pediatric bone marrow transplant program at Holtz and assistant professor of clinical pediatrics at the University of Miami Miller School of Medicine, in early 2007. Dr. Andreansky determined that Travis’ younger brother, Trevis, was a perfect match. Last August, Dr. Andreansky performed a successful transplantation, which replaced Travis’ unhealthy cells with healthy stem cells from his brother’s bone marrow. As a result of the transplant, Travis is free of sickle cell disease and no longer “My sons were experiencing any pain. “Clinically, he is doing already close, very well and is symptom free,” Dr. Andreansky but this said. More than 70,000 people in the United experience has States have sickle cell disease, according to the brought them Sickle Cell Disease Association of America. About 1,000 babies are born even closer. with the disease in the country each year. This is truly Travis, who is now 19, is being home-schooled and undergoes regular a miracle.” physical therapy sessions to regain his strength. As for Trevis, a junior at Palm Beach Gardens High School, he is focused on maintaining his 3.4 grade point average, in hopes of earning a football scholarship to the University of Miami. Trevis, who is willing to be a bone marrow donor again, hopes he inspires others to do the same. “My sons were already close, but this experience has brought them even closer,” their mother said. “This is truly a miracle.” FOR MORE INFORMATION ON BONE MARROW TRANSPLANTATION AT HOLTZ CHILDREN'S HOSPITAL, VISIT WWW.HOLTZCHILDRENSHOSPITAL.ORG OR CALL 305-585-5437. © d Jackson’s Women’s Hospital Center. Her son, Andre Pearson, was born in January. “If it wasn’t for this surgery, my son would not have survived,” Carla said. Without treatment, 90% of the babies affected by LUTO die. Those who survive often require critical care including treatment for renal failure and lack of lung development. The condition leads to approximately 700 fetal deaths per year nationwide. For more information on Dr. Quintero’s services or to schedule an appointment, please call 305-585-6636. uring a routine ultrasound, doctors determined that Carla Datorre-Pearson’s unborn son suffered from a lower urinary tract obstruction (LUTO). The condition, which affects 1 in 3,000 babies in utero, prevents a fetus from eliminating urine from its body while developing in the womb. Carla was referred to Rubén A. Quintero, M.D., director of the Division of MaternalFetal Medicine and the Fetal Therapy Center at the University of Miami/Jackson Technique to Treat Memorial Medical Center. Burn Patients Is First Dr. Quintero and his team in the World recently invented a thimble“ sized shunt that uses a double wo things stop an operation disc mechanism to treat LUTO. on a burned patient: blood Unlike shunts in the past, loss and hypothermia,” said Dr. Quintero’s invention Carl I. Schulman, M.D., MSPH, cannot become dislodged, FACS, a surgeon in the UM/JM therefore eliminating the need Burn Center, “and we’ve almost to repeat the procedure. eliminated the second.” “In the past 30 years, this Hypothermia is familiar to is a major breakthrough in most people as what happens the field,” when a person Dr. Quintero is in very cold said. “Although water too long we have been and their body using shunts loses too much to treat this heat. In the condition since operating the 1980s, the room, hypohigh failure thermia is rate of the associated with Carla Datorre-Pearson credits previous increased Dr. Rubén A. Quintero for saving shunts did wound infecher son's life. not solve the tion, additional problem.” bleeding and need for transfuDr. Quintero, a worldwide sions, adverse cardiac events leader in fetal therapy, and a change in the way drugs performed the procedure work. External temperature on Carla in September at management methods, such as t The Latest Options for Weight-Loss Surgery CURRENTLY, ONE IN THREE adults in the United States is overweight. Obesity can not only diminish a person’s quality of life, but can also put them at further risk for developing additional health problems, including high blood pressure, heart disease, diabetes, stroke and sleep apnea. While exercise and proper nutrition help many to achieve weight loss, it is often ineffective for those who are morbidly obese. At Jackson South Community Hospital’s Gastric Sleeve Center for Weight Loss, experienced surgeons offer the latest surgical techniques in the field of weight-loss surgery. One of these procedures is Vertical Gastric Sleeve surgery, which is quickly becoming the most commonly performed and preferred weight-loss procedure. The vertical sleeve helps patients achieve long-term weight loss by decreasing the stomach volume by 85%, leaving it to contain about 1 to 2 ounces. The part of the stomach that produces hunger hormones is also eliminated. But unlike gastric bypass, which also limits the stomach’s size, this procedure does not interfere with or change the digestive tract, therefore eliminating many of the unpleasant side effects patients can experience with bypass surgery. Jackson South offers support services to make the weight-loss journey a success, including free seminars, counseling, support groups, nutritional guidance and rehabilitation services. For information, please call 305-271-0774. warming blankets, are usually effective. However, when a person is burned, skin is destroyed and external temperature management is limited. Dr. Schulman is the first physician in the world to use an internal warming method on burn patients and the first to publish this application. It’s called Thermogard XP™ and basically circulates warm water through a series of balloons threaded into the patient’s veins through a catheter. “Heat loss in patients with large burn injuries is common and preventing it is especially challenging. This intravascular warming is a state-of-the-art technology,” said Dr. Schulman. “Here at Jackson, we’ve used this method to warm trauma patients – and our neurosurgeons have used it to cool patients – and we’ve also had the world’s first experience with burn patients. We are able to maintain a stable temperature while keeping our patients safe.” june 2010 ✦ connections ✦ 13 Illustration by Joyce Hesselberth New Life-Saving Device Invented by Fetal Surgery Pioneer at UM/Jackson ©
© Copyright 2024