Dr. Scott Engel, Plastic Surgeon


engelTo commemorate National Breast Cancer Awareness Month, we asked Dr. Scott J. Engel, a board-certified plastic surgeon at Sarasota Plastic Surgery Center, to enlighten us about breast reconstruction.

What different types of breast reconstruction surgery are available after a mastectomy?

A reconstructive surgeon might work with the patient’s own body tissue, an implant, or a combination of both. When using an implant, the surgeon must often place a temporary saline expander to stretch out the tissue before replacing it with a more permanent implant. Reconstruction of the nipple and areola is the next step. These procedures reflect different options available to the surgeon. The raw materials may change. But rebuilding the breast in the most natural form possible is always the surgeon’s goal.

How soon after breast cancer surgery can breast reconstruction start?

It can begin immediately. When it does, it actually decreases the amount of additional surgeries required. Sadly, a large percentage of patients aren’t given the option to pursue immediate reconstruction due to the lack of coordination between surgeons. This is absolutely unacceptable.

Who is a good candidate for this procedure?

Any healthy woman with realistic expectations can undergo breast reconstruction. Factors like age, medical co-morbidities and the need for other cancer treatments are always taken into consideration.

Many young women at high risk of breast cancer are choosing to have prophylactic mastectomies before cancer develops. Do you recommend this?

Not as a blanket statement, no. It’s a question of risk- and that depends on the individual. Prophylactic mastectomies are generally reserved for women with a strong family history of breast cancer who test positive for the BRCA gene. A woman who fits this description should consult a geneticist, a surgeon and an oncologist before making a decision. But many women don’t know where they stand. Every woman should know what her level of risk is before she makes that choice. That’s my recommendation.

Do you recommend that all women have mastectomies consider reconstruction?

The loss of a woman’s breast can have dramatic effects on a woman’s mental and physical health. All healthy women should consider reconstruction. Some women opt to undergo breast conservation, which often entails postoperative radiation with the belief that the result will be more pleasing. Depending on the amount of tissue present, the results may be more pleasing with a complete mastectomy.

Florida Medical Retreat is proud to partner with Dr. Engel. If you should have addtional qustions or would like to schedule an appointment with Dr. Engel, please contact Florida Medical Retreat.

Original Post: Style Magazine/ Health & Wellness

Doctors Hospital of Sarasota Named Among Top Orthopedic Programs in the Nation - Again


Florida Medical Retreat is pleased to share hospital member, Doctors Hospital of Sarasota's lastest award. Once again, Doctors Hospital has been named among the Top 101 Hospitals with Great Orthopedic Programs by Becker’s Hospital Review.

After analyzing data from highly regarded organizations such as U.S. News & World Report, HealthGrades and Thomson Reuters, as well as the American Nurses Credentialing Center for Magnet status and Blue Cross Blue Shield Association for Blue Distinction status, the editorial staff identified Doctors Hospital of Sarasota to be a national leader in orthopedic treatment.

In addition to examining rankings and accolades, the team at Becker’s performed additional research into each hospital and analyzed the list with industry experts. To be included, hospitals are required to have an emphasis on patient-centered care.

            “The physicians and staff of our orthopedic team work hard every day to provide high quality care in a uniquely specialized environment,” says William Troy, RN, Director of Orthopedic Services at Doctors Hospital. “Our patients are treated by some of the most well respected surgeons in our community and the nation. In addition, we want to make everyone as comfortable as possible. From private suites to concierge services, we take care of everything so that the only thing the patient has to focus on is healing.”        

For more information please contact us!

Keeping Super Woman Super

Career woman, seasoned multi-tasker, the family rock… all women are super women, but only Sarasota Memorial Women’s Health Services has the expertise, advanced technology  and comprehensive services to keep up with your heroically busy lives! Join us for a special two-part Women’s Health Series, where you’ll hear how top physicians from our Women’s Health Services team are helping women like you stay healthy and strong. Medical journalist Heidi Godman moderates both events, addressing current topics with each physician by specialty and concluding with audience questions.

Part 1 – Saturday, Oct. 13 (9-10:30 am) - Learn the latest options and minimally invasive treatments for women’s cancers, common gynecological conditions and breast reconstruction/reduction. Physician panel includes GYN Oncologist James Fiorica, MD; Gynecologist Mike Swor, MD; and Plastic Surgeon Alissa Shulman, MD. Tours of Sarasota Memorial’s Minimally Invasive Surgical Suites will be available following the presentation.

The FREE 2-part series takes place in Sarasota Memorial Hospital’s first floor auditorium, 1700 S. Tamiami Trail, Sarasota. RSVP: 917-7777.

Part 2 takes place Wednesday, Oct. 17 (6-7:30 pm) - Learn how to guard against heart disease and other common conditions that affect women as they age. Physician panel includes: Cardiologist Chippy Nalluri, MD; Internal Medicine Specialist Karen Hamad, MD; and OB-GYN John Sullivan, MD.


Sarasota Memorial Earns National Honor for Women’s Services

Florida Medical Retreat is proud to partner with Sarasota Memorial Hospital and congratulates their team on Becker's Hospital Review recently released its list of “100 Hospitals With Great Women's Health Programs”.  Sarasota Memorial Hospital was one of just six hospitals in the state and the only provider in the Southwest Florida region to earn a spot on the national publication’s honor roll.
To compile the list, which recognizes some of the most outstanding providers of women's health in the United States, Becker's Hospital Review consulted a number of resources, including clinical accolades, quality care and women's health proficiencies and awards.
The list reflects hospitals that offer outstanding programs within women's health, including gynecology, obstetrics, reproductive medicine and other gender-specific conditions and health needs. The hospitals additionally have been recognized for excellence in this specialty by several sources, including the U.S. Department of Health & Human Services and its National Centers of Excellence in Women's Health model, U.S. News & World Report, HealthGrades, the World Health Organization's and UNICEF's Baby-Friendly Hospital Initiative, Delta Group CareChex and the American Nurses Credentialing Center.
Becker’s notes that Sarasota Memorial has a long history of responding to women’s unique health needs and that women have played a key role in the hospital’s success over the years.
“Sarasota Memorial Hospital would not be standing without the dedicated women of the community,” Becker’s said. “In 1921, women residents of Sarasota raised money to fund the first hospital in the area, and in 1925, Sarasota Hospital opened as a 32-bed facility. Today, the hospital provides high-quality women's health programs, ranging from gynecological cancer to pain management, and it is the only hospital in the four-county region to have an intensive care nursery for new mothers.”

Becker’s is the latest independent organization to recognize Sarasota Memorial’s exceptional care for women. In July, Sarasota Memorial earned a spot on U.S. News & World Report's 2012 "Best Hospitals" list, ranking #47 in the nation for excellence in gynecological care. Earlier this year, the hospital also received HealthGrades' Women’s Health Excellence and Maternity Care Excellence Awards.

“These honors are a reflection of our commitment to ensure that women in our community receive the most effective, personalized care for all of their health needs in every stage of life,” said Pam Beitlich, director of Women and Children’s Services.

For more information on Sarasota Memorial Hospital or Florida Medical Retreat contact us.

Buyers From Across the Pond Drawn to Sarasota-Bradenton-Venice

Florida Realtors has released its “Profile of International Home Buyers in Florida 2012," which surveyed more than 1,500 Florida REALTORS on their experience with international buyers. The survey conclusions are applicable to the 12-month period ending June 2012 and revealed that of all Florida markets, Sarasota-Bradenton-Venice is ranked as the top destination for Canadian buyers, and second for U.K. and Western European buyers. The area was far less attractive to buyers from Brazil and Latin America in general.

Florida Medical Retreat is located in Sarasota and proud to be of service to our neighbors to the North with their medical needs. For a full list of services, please visit www.floridamedicalretreat.com or call (941) 552-3288 or (800) 643-0529.

To read the full report click.

Sarasota Memorial Hospital Earns EPA’s ENERGY STAR® Certification for Superior Energy Efficiency

SARASOTA (Aug. 15, 2012) – Sarasota Memorial has earned the U.S. Environmental Protection Agency’s (EPA’s) ENERGY STAR certification, which signifies that the organization performs in the top 25 percent of similar facilities nationwide for energy efficiency and meets strict energy efficiency performance levels set by the EPA.
"We are pleased to accept EPA’s ENERGY STAR certification in recognition of our energy efficiency efforts,” said Facilities Director Jim Bugyis. "Through this achievement, we have demonstrated our commitment to environmental stewardship while also lowering our energy costs.”

Sarasota Memorial is the only hospital in Southwest Florida to earn the certification.
Buildings that earn EPA’s ENERGY STAR certification use an average of 35 percent less energy than typical buildings and also release 35 percent less carbon dioxide into the atmosphere.
Sarasota Memorial improved its energy performance by managing energy strategically across the entire organization and by making cost-effective improvements to its buildings.   

“Improving the energy efficiency of our nation’s buildings is critical to protecting our environment, “ said Jean Lupinacci, Chief of the ENERGY STAR Commercial & Industrial Branch. “From the boiler room to the board room, organizations are leading the way by making their buildings more efficient and earning EPA’s ENERGY STAR certification.”

Sarasota Memorial reduced total energy costs by nearly $300,000 a year through a variety of initiatives, including replacing more than 10,000 bulbs with efficient fluorescent lighting (old bulbs are recycled) and upgrading corridor lights to LED lights, which use less electricity and last longer. Earlier this year, SMH also installed 40 solar panels atop the Waldemere Tower, a pilot project designed to produce 1,000,000 BTUs of heated water per day to supplement the hospital’s air conditioning and heating systems’ boilers.
“The savings from our energy efficiency initiatives not only reduce the hospital's carbon footprint, but also help provide additional funds for critical medical services,” said Bugyis.

By:  Sarasota Memorial Hospital

Controversial USPSTF Decision on PSA Screening Worries Patients and Physicians by Dr. John Sylvester

By Dr. John Sylvester

There has been a great deal of attention in the media recently about PSA screening. A few months ago, the United States Preventative Services Task Force (USPSTF) came out with preliminary recommendations that PSA screening should not be done. They have now decided to make this decision final. They recommend no routine PSA blood tests for prostate cancer screening. These recommendations may lead Medicare and private insurance companies to refuse to pay for PSA tests.

Many prostate cancer experts were surprised and frankly upset by the USPSTF recommendations. We feel the USPSTF made some major errors. They made these recommendations after reviewing several articles published in the medical literature. They primarily based their decision on one article published in the New England Journal of Medicine (NEJM) in 2009 "Mortality Results from a Randomized Prostate-Cancer Screening Trial" (the PLCO trial). This paper evaluated whether patients randomized to PSA screening versus "usual care" experienced a reduced risk of death from prostate cancer. It was a poorly run study with major flaws and should not have been used to make any recommendations.

Problems with PLCO Article:

-Only 85% of men in PSA screening are actually got PSA tests

-At least 52% of men in non-screening arm received PSA screening

- Length of follow-up was too short to show a survival advantage

- PSA cut-off was too high to detect many cancers when they are most curable

Why the USPSTF chose to ignore these major problems was not explained. Moreover, the USPSTF chose to ignore the positive findings in the PLCO study. The "healthy" men who participated in the PLCO were 44% less likely to die of prostate cancer with screening. The 10% of men in the study that had 1-2 PSA checks prior to entering the PLCO trial had a 25% reduction in prostate cancer deaths.

Positive Studies

Other, cleaner randomized studies have been published on PSA screening. The European randomized study from the same issue of the NEJM as the PLCO study was much larger, had less contamination and showed a 20% reduction in prostate cancer deaths initially, and will longer follow-up now shows a 31% reduction in prostate deaths with PSA screening. The smaller but even better run Goteborg randomized trial showed a 44% reduction in prostate cancer deaths with PSA screening (Lancet 2010). Why the USPSTF chose to de-emphasize these positive studies was, again, not explained.

During the PSA era, prostate cancer mortality in the USA had dropped ~40% and the percentage of men being diagnosed with metastatic (incurable disease) has dropped ~75%. The USPSTF suggests evaluation and biopsies be considered when men develop symptoms of prostate cancer. Every cancer doctor knows it is usually incurable at that point.  But, the USPTF had no cancer doctors on the panel.

PSA Blood Test

The PSA blood test is simply another piece of information a doctor can discuss with his/her patient. Having a rise in PSA does not necessarily mean you need a biopsy A short course of antibiotic may make the PSA fall, in which case a biopsy may not be needed.

Even if a biopsy is done and found to be positive for cancer, many options are available to the individual patient. These options include  active surveillance, Radical Prostatectomy, Image Guided Intensity Modulate Radiation Therapy (IG-IMRT), Radioactive seend implantation (brachytherapy), hormonal manipulation, Cyrotherapy, etc.  If a relatively healthy man is found to have an aggressive cancer, treatment is indicated. If an older less healthy man is found to have a low volume low risk cancer, active surveillance may be the best option.  These treatment decisions are best decided by the patient and his physician, not by some government panel that did not even include any prostate cancer doctors.

If you would like more information on Dr. Sylvester, please contact Florida Medical Retreat.


Sarasota Memorial Hospital Listed Among Nation’s Top Two Hospitals for heart attack, heart failure, pneumonia care

Florida Medical Retreat is thrilled to share this exciting news from our hospital member, Sarasota Memorial Hospital!

Sarasota Memorial Hospital was one of just two hospitals – out of more than 4,000 nationwide – singled out for demonstrating the lowest (best) readmission rates in the nation for heart attack, heart failure and pneumonia patients.

Newly-released data from the U.S. Centers for Medicare and Medicaid Services (CMS) posted on the government’s Hospital Compare website reveals mortality and re-admission rates for more than 4,600 hospitals nationwide. The data shows how often patients died or were readmitted within 30 days of discharge from a previous hospital stay for heart attack, heart failure, or pneumonia.
Sarasota Memorial was one of only two hospitals in the nation to perform well-above the national average in all three readmission categories studied. The data, which covers a three-year period from July 2008 to June 2011, was posted this month on CMS’ Hospital Compare website; an analysis this week by Kaiser Health News spotlighted Sarasota Memorial and Citrus Memorial Hospital (Inverness, FL) as the only two hospitals in the nation that had better than average readmission rates for all three conditions.
According to the Kaiser study, only 1 percent of hospitals were labeled as better than average in heart attack (30 hospitals) or pneumonia cases (33 hospitals) and only 2 percent (94 hospitals) were labeled as better than average in heart failure.

The study, based on the most recent Medicare data available, showed that:
• 19.7 percent of heart attack patients were readmitted within 30 days of discharge
• 24.7 percent of heart failure patients were readmitted • 18.5 percent of pneumonia patients were readmitted
In comparison, readmission rates at Sarasota Memorial were 16.2 percent for heart attacks, 19.7 percent for heart failure and 15.6 percent for pneumonia. Sarasota Memorial also scored well on mortality rates for each of the three conditions.

The rates are all “risk-adjusted” — which means they take into account how sick patients were, to make sure hospitals of different sizes and with different patient populations can be compared fairly.

“Of all the achievements Sarasota Memorial has earned in recent years, we’re particularly proud of our low readmission rates,” said Sarasota Memorial CEO Gwen MacKenzie. “We have many quality goals, but among the most critical are reducing readmissions, complications and mortality.

“Achieving such low readmission rates is a tribute to everyone on our health care team and the continuum of care they provide. It means that we’re following up and communicating well with our patients, their families and each other to make sure everyone is on the same page, that everyone understands our patients’ diagnoses, their medications, their plans of care and how to care for themselves once they leave the hospital.”

Center For Sight First in Nation to Launch LensAR Laser for Cataract Surgery

Cataract surgery is about to undergo a revolutionary advance—shifting from the conventional hand-held blade—to an ultramodern blade-free, femtosecond laser procedure which can treat even the hardest cataracts in mere minutes. Not since the “no-stitch” cataract procedure has the ophthalmology profession experienced such a seismic shift in eye surgery; and it’s now in Sarasota.

For nearly two years Center For Sight founder and CEO, David Shoemaker, M.D., has been cautiously monitoring developments related to the use of femtosecond lasers in cataract surgery with a keen interest in the technology offered through the LensAR Laser System designed by LensAR, Inc., an Orlando-based company. He was among a select group of 18 ophthalmologists from the U.S. and abroad who recently traveled to Lima, Peru to help deploy the technology in that country. While there, he performed laser cataract surgery on 20 patients with very dense cataracts and was amazed with the flawless execution of this amazing technology. He will perform the first LensAR Laser Cataract procedure in the United States on August 1st.

“There is no doubt the LensAR Laser System will result in safer and more predictable outcomes for patients throughout the world,” says Dr. Shoemaker. “It is rare to experience a true ‘Wow!’ moment in medicine, and that is exactly what this laser does. We couldn’t be more excited to bring this technology to Sarasota.”

With Laser Cataract Surgery, the hand-held blade will be limited to a supporting role. The LensAR Laser System uses the most advanced scanning beam technology ever offered to surgeons. The system employs a proprietary, high resolution 3D-CSI measurement device combined with an advanced femtosecond laser designed to deliver laser pulse placement and surgical incisions with unsurpassed precision.

“LensAR Laser System has been successfully used outside the U.S. with excellent clinical success and reliability,” says Dr. Shoemaker. “It’s a privilege to be the first in country to offer the genius of this laser technology to our patients.”

For more information, please contact Florida Medical Retreat.

New Valve Clinic at Sarasota Memorial Hospital Helps Patients with Severe Aortic Stenosis

With people living longer, more are becoming susceptible to aortic stenosis (narrowing of the heart vales), but many patients - because of age or other health issues - cannot tolerate open hear surgery to treat it.

Now, a breakthrough procedure that allows doctors to replace the diseased valve without surgery is providing new hope to the estimated 40 percent of people living with the potentially deadly condition.

Bolstered by its collaboration with New York's Columbia University Medical Center, Sarasota Memorial opened a new Heart Valve Clinic in June and is now evaluating patients with valve disorders to identify those who could benefit from a new minimally invasive procedure - Transcatheter Aortic Valve Replacement (TAVR). FDA approved, TAVR is the only catheter-based treatment option for people with severe aortic valve disease who are not eligible for surgery.

Aortic stenosis reduces the valve's ability to open and close completely and can cause severe shortness of breath, chest pain and weakness, said David Patterson, executive director of Sarasota Memorial's Heart & Vascular Services. The condition can result from a birth defect, heart attachk, hypertension, aortic aneurysm or infection; however, some causes are unknown. Left untreated, heart valve disease can result in heart failure, severe infection and sudden death.

"Basically, TAVR allows us to replace the valve through a small opening near the groin, rather than open heart surgery," Patterson said. While there is an increase chance of stroke with TAVR, studies show that for the inoperable, the benefits greatly outweigh the risks.

Original Post: Sarasota Memorial Health Care System, Summer 2012 newsletter

For additional information on Sarasota Memorial Hospital contact Florida Medical Retreat.

US News Ranks Sarasota Memorial Hospital among Best Hospitals

Sarasota Memorial Hospital is the only local hospital on U.S. News & World Report's 2012 "Best Hospitals" list, ranking #47 for excellence in gynecological care. It also ranked #1 again for overall care in the Sarasota-Venice-North Port region, and this year earned a spot on Florida's top 10 hospitals list. Sarasota Memorial was among just 3 percent of the nation's hospitals to earn its spot on the list of 50 Best Hospitals. In U.S. News' 2012 Best Hospitals study, fewer than 150 of roughly 5,000 U.S. hospitals evaluated earned a national ranking in at least one of 16 medical specialties.

Florida Medical Retreat is proud to partner with SMH and congratulate the entire staff on this achievement!

Relief for joints besieged by arthritis

If you live long enough – that is, beyond 50 or 60 – chances are one or more of your joints, probably your knees or hips, will become arthritic. And if pain or stiffness begin to seriously limit your ability to enjoy life and perform routine tasks, chances are you’ll consider replacing the troublesome joint.

“People with osteoarthritis are relying more and more heavily on surgery,” Dr. David T. Felson, a rheumatologist and epidemiologist at Boston University School of Medicine, told me. “The rate of knee replacement is just skyrocketing, out of proportion to increases in arthritic changes seen on X-rays, and replacement surgery is contributing greatly to the rising costs of Medicare.”

Between 1979 and 2002, knee replacement surgery rose 800 percent among people 65 and older. Although Dr. Felson described hip replacement as “dynamite” — highly effective in relieving pain and restoring function — knee replacement may be far less helpful.

“For 10 to 30 percent of patients, the improvement never comes,” Dr. Felson said.

How the Trouble Starts

Osteoarthritis results from wear and tear on the joints. (Rheumatoid arthritis, on the other hand, is an autoimmune disorder.) Some 27 million Americans have life-limiting osteoarthritis, and the numbers are rising as the population gets older and fatter.

“With every step, the force exerted on weight-bearing joints is one and a half times body weight,” said Dr. Glen Johnson, who reported on arthritis prevention and treatment at the annual meeting of the National Athletic Trainers’ Association in June. “With jogging, the force is increased seven or eight times. Thus, the most effective way to prevent arthritis in knees and hips is to lose weight if you’re overweight and to pursue non-impact activities for recreation.”

While most people think of osteoarthritis as a breakdown of the cartilage that keeps bones from rubbing together, recent studies have shown it is a far more complicated disease that also involves tissues in and around joints, including bone and marrow. Inflammation can be a contributing factor, and genetics play a role. Three genes have been identified thus far that accelerate the development of arthritis in people who carry them.

Any kind of joint injury or surgery, even if performed arthroscopically, raises the risk that a joint will become arthritic. That is why so many professional and recreational athletes develop arthritis at younger ages.

Still, there are many potential remedies short of surgery to relieve arthritic pain and to preserve — and perhaps restore — normal joint function. Even if surgery is needed, it can be postponed for many years with treatments proven to help in well-designed clinical trials.

Artificial joints usually last 10 to 15 years. Delaying surgery is helpful because the earlier in life a joint is replaced, the more likely a subsequent replacement will be needed. And both devices and surgical techniques are constantly being improved; by delaying a joint replacement, you may end up with a simpler operation or more durable device.

Take it from someone who has been there: Joint replacement, especially of the knee, is not a walk in the park. Arduous physical therapy is essential, and recovery can be long and painful. There are limitations after recovery, too, because artificial joints are not as flexible as the ones you were born with.

What Works, What Doesn’t

First things first: If you weigh more than you should, do your best to shed those extra pounds. Even a loss of 10 to 15 percent of body weight can make a big difference to weight-bearing joints.

“I can’t stress enough how important body weight is,” Dr. Johnson said. “With our national crisis of obesity, we’ll see more and more arthritis of the knees, ankles, hips and spine.”

Stephen Messier, a professor of health and exercise science at Wake Forest University, has shown in a trial among 450 men and women with osteoarthritis that a weight-loss diet combined with a well-designed exercise program can significantly reduce knee pain.

The most helpful exercises are those that strengthen the quadriceps (muscles in the front of the thighs), like leg presses, mini-squats and wall squats, and flexion and extension exercises that restore and preserve range of motion, Dr. Johnson said. Several visits to a physical therapist can help assure that you are doing the exercises correctly.

“The severity of pain is directly correlated with the degree of muscle weakness,” Dr. Felson wrote in The New England Journal of Medicine. (If the knee hurts during exercise, he added, then it should be avoided.)

Wearing the right shoes with certain adjustments to the sole and heel, if needed, can help too. Get fitted in a store with expertise in evaluating feet and gait. Are your arches flat? Are you bow-legged or knock-kneed? Wedges specifically designed for you can help take stress off arthritic knees and hips.

Though most experts endorse walking for exercise for its ease, accessibility and low cost, Dr. Johnson instead recommends such non-impact activities as stationary or outdoor cycling, swimming, or working out on an elliptical or rowing machine for cardiovascular fitness. Those who choose to walk, he said, may benefit from runners’ shoes designed to dissipate the force on joints.

Bracing an arthritic knee can help, too, especially with an unloader brace that shifts the stress away from the damaged part of the joint. Most patients are unlikely to wear such a brace all the time, Dr. Felson said. Still, knee braces can help arthritis sufferers continue to participate in physical activities, reduce the use of pain medication and postpone the need for surgery.

Pain relievers usually bring only temporary relief, if any. Daily dosing with acetaminophen (the ingredient in Tylenol) should be tried first, experts say, because it is significantly safer than ibuprofen and other nonsteroidal anti-inflammatory drugs, especially for older people.

Well-designed clinical studies have shown no significant relief of arthritic knee pain from supplements of glucosamine and chondroitin sulfate, taken alone or in combination, though Dr. Felson said that if people feel better taking them, he does not discourage the practice.

Nor is there good evidence of benefit from methylsulfonylmethane, SAM-e or acupuncture. Some evidence suggests that osteoporosis drugs may be helpful, though they have not yet been tested for arthritis relief in a randomized clinical trial, Dr. Felson said.

There are also hints of benefit from vitamin K, an essential nutrient found in cruciferous vegetables (broccoli, kale, cabbage and the like), which are good for health in general (unless you take blood thinners).

Doctor-administered treatments include steroid injections every three or four months to control pain and buy time, and injections of a synovial fluid replacement like Synvisc twice a year. In general, though, these are not very effective when arthritis has reached the bone-on-bone stage, Dr. Johnson said.

Original Post by Jane Brody Herald Tribune

3D Photographic Simulation Brings a New Dimension to Plastic Surgery at Sarasota Plastic Surgery Center

If you are one the thousands of people each year considering aesthetic plastic surgery, Sarasota Plastic Surgery Center has some good news for you. Recent advances in three dimensional (3D) photography combined with revolutionary new software allow prospective patients to preview what they will look like as the result of breast augmentation, facial procedures, and more, well in advance of any surgery.
Both the VECTRA® 3D camera and Sculptor software which make this possible were developed by Canfield Imaging Systems of Fairfield, NJ, the world’s leading provider of medical photography systems. The process starts with a VECTRA 3D session which produces a three-dimensional photograph of the patient. Then, using Sculptor software, the surgeon is able to simulate the expected results of a variety of aesthetic procedures.
“We are truly excited about using this new technology to help our patients,” said Dr. Scott Engel “For the first time, they’re able to see a 3D picture of themselves while we rotate their picture to any viewpoint and examine the desired result. We can make changes and agree on a final look in advance. This significantly helps them make a decision. In addition, we can review their postoperative pictures and analyze their dramatic improvement”.

For more information, contact Florida Medical Retreat.

Sarasota’s First ACR Breast Imaging Center of Excellence is at Doctors Hospital of Sarasota

Doctors Hospital of Sarasota has been designated as Sarasota’s first Breast Imaging Center of Excellence (BICOE) by the American College of Radiology (ACR).

By awarding Doctors Hospital the status of a Breast Imaging Center of Excellence, the ACR recognizes our Breast Care Center as having earned accreditation in mammography, stereotactic breast biopsy, and breast ultrasound (including ultrasound-guided breast biopsy).

“Achieving BICOE status shows the level of commitment our hospital has to fighting breast disease, a social cause and movement that has grown significantly, says Alberto Righi, MD. “It demonstrates that we are performing at a high level and that we are doing our best for the benefit of our patients.”

“Our team of clinical professionals is dedicated to providing each patient with high quality, compassionate care,” says Kay Adkins, Director of the Breast Care Center. “It is exciting to be the first in our area to be recognized as a Center of Excellence, but it is truly rewarding to know that we are consistently doing what is right for our community,”

Peer-review evaluations, conducted in each breast imaging modality by board-certified physicians and medical physicists who are experts in the field, have determined that we have achieved high practice standards in image quality, personnel qualifications, facility equipment, quality control procedures, and quality assurance programs.

The ACR is a national professional organization serving more than 34,000 diagnostic/interventional radiologists, radiation oncologists, nuclear medicine physicians, and medical physicists with programs focusing on the practice of medical imaging and radiation oncology and the delivery of comprehensive health care services.

 For more information on the Breast Care Center at Doctors Hospital of Sarasota, please contact Melissa Morgan at 941-342-1012 or 941-809-9130.

Sarasota Memorial Ranks Among Nation’s Top 5% of Hospitals for Women’s Health and Maternity Care – 10 years in a row

HealthGrades study: If all U.S. hospitals had performed at the level of Sarasota Memorial, about 39,450 women could have potentially survived their hospitalization and 19,062 could have potentially avoided a major in-hospital complication

Sarasota Memorial Hospital ranks among the top 5% in the nation for excellence in women’s health and maternity care, according to a new report released today by HealthGrades, the leading provider of information to help consumers make an informed decision about a physician or hospital.

Sarasota Memorial is the only hospital in the region to receive both the Maternity Care and Women’s Health Excellence Awards since their inception – and the only one to rank in the top 5% in the country in both areas 10 years in a row.

Participation in the study was not voluntary; all 4,783 of the nation’s acute care hospitals were evaluated by HealthGrades as part of its 2012 Trends in Women’s Health in American Hospitals report.

In its Women’s Health study, HealthGrades evaluated 16 women’s medicine, cardiovascular, and bone and joint health treatments and procedures over the years 2008, 2009 and 2010 using data from the federal Medicare program. Sarasota Memorial and the 175 other recipients of the HealthGrades Women’s Health Excellence Award had, on average, women’s mortality rates that were 42 percent lower than the poorest performers across nine diagnoses and procedures, and complication rates were, on average, 14 percent lower than the poorest performing hospitals across seven procedures.

To evaluate maternity care, the 224 hospitals that received the 5-Star rating were evaluated on vaginal delivery maternal complications for single live deliveries; c-section delivery maternal complication rates for single live deliveries; overall volume and volume of low birth weight deliveries; and risk-adjusted infant mortality rates for single live deliveries. The study found that women who give birth at 5-Star rated hospitals experience 62 percent fewer complications than lower-performing hospitals.



SMNeNews Release Page 2 – HealthGrades Women’s Health/Maternity Care Excellence Awards

“In our study, HealthGrades noted the rate of surgical intervention for women suffering a heart attack has increased over the years. This is good news, especially for patients who choose care at hospitals that are top performers in women’s healthcare,” said Divya Cantor, MD, MBA, HealthGrades Senior Physician Consultant and author of the study. “Our goal is to provide current, independent data on clinical outcomes to help prospective patients make informed decisions about their providers while also identifying hospitals that are setting national benchmarks to which other hospitals can aspire.”

If all of the nation’s hospitals had patient outcomes among women that at the level of those receiving the HealthGrades award, 39,450 women could have potentially survived their hospitalization and 19,062 women could have potentially avoided a major in-hospital complication.

The HealthGrades study examined hospitalization records from the MedPAR database in all 50 states, for the years 2008 through 2010. The following procedures and treatments were analyzed: heart attack, congestive heart failure, pneumonia, chronic obstructive pulmonary disease, stroke, coronary bypass surgery, peripheral vascular bypass, coronary interventional procedures, resection/replacement of abdominal aorta, carotid surgery, and valve replacement; total knee and total hip replacement surgeries, spinal surgeries, and hip fracture repair.

To be eligible for the HealthGrades award, hospitals must have met volume requirements in stroke and either coronary bypass or valve replacements; met the volume requirements in at least six additional cohorts of the 16 evaluated; and have transferred out less than 10 percent of stroke patients. Volume requirements are a minimum of 30 female discharges over the three years, with at least five in the most recent year for the cohort.

The Women’s Health and Maternity Care Excellence Awards are the latest in a series that Sarasota Memorial has received from HealthGrades so far this year. In February, Sarasota Memorial earned the elite “America’s 50 Best Hospitals” designation, placing Sarasota Memorial in the top 1% of hospitals for consistently superior clinical outcomes. Indeed, Sarasota Memorial is one of just five hospitals in the nation to receive the organization’s two top awards six years in a row.

In 2012, Sarasota Memorial also received HealthGrades’ “Distinguished Hospitals for Clinical Excellence,” Emergency Medicine Excellence award, with five-star ratings in 23 specialty areas.

The HealthGrades 2012 Trends in Women’s Health in American Hospitals report, including the methodology, and other reports, can be found at http://www.healthgrades.com.

Longboat Key Club Receives TripAdvisor® Certificate of Excellence

Please join all of us at Florida Medical Retreat in congratulating Longboat Key Club & Resort!

Longboat Key Club & Resort has been awarded the TripAdvisor Certificate of Excellence. The award is given to establishments that consistently achieve positive reviews on TripAdvisor. The resort has received multiple accolades for excellence within the hospitality industry,  including being named Tennis Magazine's #1 Tennis Report on the Gulf Coast of Florida in 2012; being honored as a 2012 Gold Metal Resort by Tennis Resorts Online; and receiving the AAA Four-Diamond Award for the 29th consecutive year!

Florida Medical Retreat is proud to partner with Longboat Key Club & Resort. If you would like to learn more about incorporating a stay during your Florida Medical Retreat contact us!

June is Men's Health Month!

Celebrated across the country with screenings, health fairs, media appearances, and other health education and outreach activities. The centerpiece of this observance is National Men’s Health Week, a recognition event proposed by Congress and signed into law by President Bill Clinton on May 31, 1994. This year, National Men’s Health Week begins June 11th and ends on Fathers’ Day, June 17th.

Men's Health Network is a national non-profit organization whose mission is to reach men, boys, and their families where they live, work, play, and pray with health prevention messages and tools, screening programs, educational materials, advocacy opportunities, and patient navigation.

MHN’s goals are to save men’s lives by reducing premature mortality of men and boy, to foster health care education and services that encourage men of all ages to implement positive lifestyles for themselves and their families, to increase the physical and mental health of men so that they can live fuller and happier lives, to significantly reduce the cycles of violence and addiction that afflict so many men, to energize government involvement in men’s health activities so that existing government health networks can be utilized to increase the health and well-being of men and boys and to encourage women to expand on their traditional role as the family’s health care leader and activist for enhancement of health care services.

MHN’s research indicates that some of the reasons men are less healthy than women are because men:

  • Die younger – and in greater numbers – of heart disease, stroke, cancer, diabetes, and many other diseases.
  • Don’t take care of themselves as well as women do.
  • Are more likely to engage in unhealthy behavior.
  • Don’t seek medical attention when they need it.
  • Are less likely than women to adopt preventive health measures.
  • Are less likely to have health insurance.
  • Are more likely to work in dangerous occupations.

Original Post: HCA.com

New Valve Clinic Helps Patients with Severe Aortic Stenosis

Florida Medical Retreat is pleased to partner with Sarasota Memorial Hospital to offer the most advanced procedures and treatments available. For more information, please contact Florida Medical Retreat.

With people living longer, more are becoming susceptible to severe aortic stenosis (narrowing of the heart valves), but many patients – because of age or other health issues – cannot tolerate open heart surgery to treat it.

Now, a breakthrough procedure that allows doctors to replace the diseased valve without surgery is providing new hope to the estimated 40 percent of people living with the potentially deadly condition.

Bolstered by its collaboration with New York’s Columbia University Medical Center, Sarasota Memorial opened a new Heart Valve Center this month and has begun  evaluating patients with valve disorders to identify those who could benefit from a new minimally invasive procedure – Transcatheter Aortic Valve Replacement (TAVR) – the only catheter-based treatment option for people with severe aortic valve disease who are not eligible for surgery. FDA approved, TAVR has been shown to dramatically improve a patient’s quality of life.

Aortic stenosis reduces the valve’s ability to open and close completely and can cause severe shortness of breath, chest pain and weakness, said David Patterson, executive director of Sarasota Memorial’s Heart & Vascular Services. The condition can result from a birth defect, heart attack, hypertension, aortic aneurysm or infection; however, some causes are unknown. Left untreated, heart valve disease can result in heart failure, severe infection and sudden death.

“Basically, TAVR allows us to replace the valve through a small opening near the groin, rather than open heart surgery,” Patterson said. While there is an increased chance of stroke with TAVR, studies show that for the inoperable, the benefits greatly outweigh the risks. For older, inoperable heart patients, some of whom would not last a year with the blockage, the procedure can be life-saving.

Surprising Sarasota Opera a testament to ambition

Wondering what there is to do in Sarasota, FL? William Littler,  music columnist for The Star.com shares one, the opera!

Insanity takes many forms, some of them blessedly benign, such as the one affecting the conductor Victor DeRenzi. He wants his opera company to become the first to perform everything Giuseppe Verdi ever wrote. Where is that opera company located? Sarasota, Fla.

Now before you collapse over your spilled bottle of Chianti in a fit of uncontrollable giggling, let me assure you — as Canadian snowbirds have already discovered — that the city on the shores of Sarasota Bay offers visitors much more than a winter tan and condo prices unavailable at the corner of Avenue Road and St. Clair.

One of the great collections of Baroque art resides in the Ringling Museum (yes, that Ringling; a circus museum shares real estate on the late millionaire's waterfront estate). There is also a resident symphony orchestra, a ballet company, professional theatre and a multi-purpose performing arts centre, boldly painted in lavender and purple (don't ask!), where the Toronto Symphony Orchestra performed under Peter Oundjian's direction during the course of its 2011 Florida tour.

Perhaps most remarkable of all is a building in a vaguely Spanish colonial style stretching along North Pineapple Avenue and listed on the National Register of Historic Places. Built in 1926 as a legitimate playhouse, it was purchased, renovated and expanded to become the elegant asylum for Victor DeRenzi's insanity, the 1,100-seat Sarasota Opera House.

It is there, every year for more than two decades, that one version of one of Verdi's 30-odd operas (if we count various revisions) has occupied an honored place in a repertory winter festival season of four operas (a fifth appears now in the fall). This season's Verdi installment was Otello, next season it will be the Italian master's almost completely unknown comedy Un giorno di Regno (King for a Day).

The Verdi cycle began almost acccidentally when DeRenzi staged Rigoletto in 1989 in the style of the 1850s and followed it a year later with a similarly staged production of the virtually unknown Aroldo. “At the end of one of the big finales our audience actually stood up and cheered,” he recalled the other day, “so I thought to myself, if a completely unknown Verdi opera gets that kind of response, maybe the others will too.”

If DeRenzi has a strategy in his ongoing Verdi campaign, it is the same one he uses for the other operas mounted on Sarasota's stage over the past 30 years of his artistic directorship.

At a time when many sister companies are modernizing the look of traditional operas (the Canadian Opera Company's current double bll of Zemlinsky's A Florentine Tragedy and Puccini's Gianni Schicchi at the Four Seasons Centre has been moved forward in time by director Catherine Malfitano from the Renaissance to the twentieth century), he tries to remain faithful to the composer's original intentions.

He characterizes this historically determined approach, without irony, as avant garde and it seems to be appreciated by his audiences. “The aesthetic of this company is not determined by the directors,” he insists. It is determined by me.”

As someone who has visited opera houses in dozens of countries on five continents I found this approach refreshing. The four operas I heard in Sarasota really looked the way they sounded and DeRenzi's practice of employing highly engaged young singers facilitated dramatic credibility.

True, Otello could have benefitted from a larger orchestra, but as conducted by DeRenzi and directed by Stephanie Sundine (a well- remembered Salome in the Canadian Opera Company's 1986 production of Strauss's opera and Katya in its 1994 production of Janacek's Katya Kabanova), with a heroic tenor in the title role (Puerto Rican-born Rafael Davila), it worked surprisingly well on Sarasota's less than commodious stage.

The agile coloratura of soprano Kathleen Kim in the ritle role helped animiate Donizetti's Lucia di Lammermoor. The sexy Carmen of Fredrika Brillembourg failed to exert a similar influence on a rather ordinary account of Bizet's opera (staged, naturally, in the original opera-comique manner, with spoken French dialogue).

What stood out for me this season was a rare revival of an opera that won Samuel Barber the Pulitzer Prize in 1958, the Metropolitan Opera-premiered Vanessa, part of Sarasota Opera's recently inaugurated American Classics series, with Kara Shay Thomson a powerful interpreter of the title role.

Not bad for an enterprise operating on an $8.6-million (U.S.) budget. Like most opera companies facing the economic downturn of recent years, Sarasota Opera has had to trim sails, but by making what executive director Susan Danis calls “a pre-emptive strike” on its budget following the 2008 season, this company has preserved its financial viability and retained its status as one of the best reasons for a visit to the welcoming west coast of Florida.

Original Post by William Littler Music Columnist, The Star.com

Orioles' Markakis Has Surgery In Sarasota with Orthopaedic Surgeon, Dr. Brian Schofield

Sarasota's Dr. Brian Schofield will perform wrist surgery on Orioles right fielder Nick Markakis, MLB.com reports.

Baltimore Oriole Nick Markakis is briefly returning to Sarasota for right wrist surgery due to broken hamate bone, according to MLB.com.

Sarasota surgeon Dr. Brian Schofield removed the bone during a surgery Friday, June 1,MLB.com reports:

"A broken hamate bone is a fairly common baseball injury, and X-rays typically don't pick it up -- which explains why Markakis' X-rays on Wednesday were negative. He was examined in Sarasota by specialist Dr. John Hand on Thursday afternoon. The procedure is brief and typically under 20 minutes with an estimated recovery timetable of from 2-4 weeks. It's relatively good news for the Orioles, who were fearful Markakis -- their most durable player -- would be out for the rest of the season."

Markakis will be placed on the disabled list, according to the Orioles.

Markakis felt the injury Tuesday while in Toronto, according to MLB.com, and luckily, the Orioles were on their way to St. Petersburg this week to play the Tampa Bay Rays.

For more information, or to make an appointment with Dr. Brian Schofield, contact Florida Medical Retreat.

 Original Post by: Charles Schelle


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