©
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
©