ChooseHealth FALL 2023 BayfrontHealth.com/ChooseHealth Countdown to Better Health 7 Ways To Manage Your Diabetes 6 Common Brain Myths Debunked 5 Tricks for Staying Hydrated 4 Heart Habits Couch Potatoes Can Embrace 3 Things To Know About Hemorrhoids 2 Big Impacts on Your Mental Health The Best Reason To See a Doctor When You’re Well Easy Dietary Changes Why Get a Tattoo After Mastectomy?
David Strong President and CEO Orlando Health John A. Moore President Bayfront Health Andrew J. Snyder Senior Vice President Marketing and Communications Choose Health Contributors Jeanne Adam Jennifer Ayscue, MD Bari Becker Tim Barker Amy Bliz, RD Lisa Cianci Liviu Craciun, MD Lowell Dawson, MD William Degan, MD Mary Frances Emmons Rona Gindin Kathy Halley Rachel Impink Rod James Alexander Johnson, MD Melissa Koliha, PA-C Kim Marcum Jonathan Mitchell, PhD Brooke Morton Deepak Naidu, MD Lisa Nickchen Ligia Perez, MD Alexander Ramirez, MD Kristin Sochet, MD Katherine Wojnowich, MD ChooseHealth FALL 2023 BayfrontHealth.com/ChooseHealth Countdown to Better Health 7 Ways To Manage Your Diabetes 6 Common Brain Myths Debunked 5 Tricks for Staying Hydrated 4 Heart Habits Couch Potatoes Can Embrace 3 Things To Know About Hemorrhoids 2 Big Impacts on Your Mental Health The Best Reason To See a Doctor When You’re Well Easy Dietary Changes Why Get a Tattoo After Mastectomy? BayfrontHealth.com/MyChart Scan the QR code to get started today. As part of our new comprehensive health record powered by Epic, we now offer the Bayfront Health MyChart app. It lets you take your health information with you wherever you go. So you can find details about your visit today – and much more. Communicate with your doctors Manage your appointments Manage Your Healthcare Anywhere. Anytime. Check test results Request prescription refills View and pay your bills
ChooseHealth FALL 2023 4 Nutrition Easy Dietary Changes To Feel Better 6 Men’s Health How To Get Rid of Enlarged Breasts 8 Behavioral Health Your Flu Symptoms Could Be Anxiety 9 Guide Countdown to Better Health 7 Ways To Manage Your Diabetes 6 Common Brain Myths Debunked 5 Tricks for Staying Hydrated 4 Heart Habits Couch Potatoes Can Embrace 3 Things to Know About Hemorrhoids 2 Big Impacts on Your Mental Health The Best Reason To See A Doctor When You’re Well 22 Prevention Secret To Stretching Out 24 Women’s Health Why Get a Tattoo After Mastectomy? 25 Spotlight Can Bariatric Surgery Improve Fertility? 26 New Doctors 28 Community Good 30 Spotlight What’s That Whooshing Noise? BayfrontHealth.com/ChooseHealth Proud recipient of the APEX 2023 Grand Award, recognizing excellence in publishing Inside This Issue BayfrontHealth.com/ChooseHealth 3
NUTRITION Easy Dietary Changes Will Make You Feel Better By Mary Frances Emmons | Editorial Contributor Overhauling your diet sounds daunting, right? But small tweaks can make a lasting difference on your health and nutrition. These five changes — plus tips on how to achieve them — can help you score quick improvements in the way you feel and give you the confidence to try for even bigger changes over time. Eat more fiber. “If you’re only going to try one thing on this list, make it adding more fiber. It’s easier than you think,” says Amy Bliz, a registered dietitian with Bayfront Health St. Petersburg. Why does fiber matter? It’s often associated with improved digestion — a big plus for anyone who has issues there — but it also helps with blood-sugar control and weight management. High fiber foods include nuts, beans, fruits like berries and apples, and veggies such as carrots and Brussels sprouts. A word of caution: Go slowly. The goal is 25 grams of fiber a day. Most Americans don’t get anywhere near that, and if you add that much in a hurry, you may feel bloated and uncomfortable while your body adjusts. Instead, aim to add about 5 grams a week until you reach the recommended amount. Easy ways to start: Switch from white bread or pasta to whole wheat. 4
For more nutrition information, visit BayfrontHealth.com/Content-Hub. Drink more water. We know, we know — many people don’t like the taste of water. But being well-hydrated improves brain and digestive functions, maintains your skin’s elasticity and keeps blood sugar better controlled (because it makes your blood more diluted and the sugars less concentrated than if you are dehydrated). You don’t have to guzzle from a jug. Refilling a small cup multiple times a day can seem more doable at first. Try a bottle with a built-in infuser where you can add fresh fruit to flavor the water. Buy in-season foods. Fresh is always going to taste better, so you’re rewarded right away by choosing in-season foods, making it more pleasurable to get those recommended daily minimums. In-season foods also cost less, says Bliz. Pro tip: It sounds counterintuitive, but buying frozen foods can be a way to extend the season, because such foods are generally frozen immediately upon harvesting. What you might give up in taste or texture, you will get back in savings, as frozen food is cheaper and doesn’t spoil as quickly. Another tip: Don’t fall into the boil-or-steam rut. Look for other ways to prepare your favorites, like roasting, which will yield entirely different flavors from familiar foods. Be choosy about your fats. We’re not going to be harsh on fats. Let’s be honest, they’re what make many foods delicious. But if you want satisfaction without the health risks associated with saturated fats (which are always animal-based — meat, butter, cheese), go for fats that come from plants and fish. Avocado, nuts, salmon and tuna are all examples of healthier fat sources that reduce levels of inflammation and cholesterol. It’s not necessary to eliminate animal fats but do keep that intake lower than healthier sources. Remember also that fat is fat — every gram has 9 calories, no matter the source. A serving of nuts is about a quarter cup, or a handful — so don’t take the jar out to watch TV. Eat more (often). Never put off your hunger. Too often folks think, “I had lunch, so I shouldn’t eat until dinner,” by which time you’re ravenous and not really focusing on what’s going in your mouth. Think of healthy snacks or more-frequent smaller meals as a tool for when you need them, to stave off more-intense hunger by your next meal. Being hangry has a bum rap, but eating should not be considered a negative experience — we’ve all gotta do it. Pace yourself. Too often we adopt an all-or-nothing attitude that sets us up to feel frustrated and guilty when we fail. It’s not necessary to make all these changes at once to see a benefit. Pick one thing that would be easy for you to implement in the next week. Then give yourself some grace and have patience. If you stick to it, you will see results. BayfrontHealth.com/ChooseHealth 5
If you’re a man who has prominent breasts, you might feel uncomfortable and embarrassed. You’re likely suffering from a condition known as gynecomastia, which can occur at three different points in life, says Dr. Deepak Naidu, a board-certified plastic surgeon with Bayfront Health Medical Group Aesthetic and Reconstructive Surgery. It happens during birth for more than half of male babies, who are born with breast buds. It’s related to the mother’s estrogen levels and usually goes away in a few weeks. Then during puberty, more than half of teenage boys develop extra breast tissue because of the wild hormonal swings wreaking havoc with estrogen and testosterone levels. Once those hormone levels get back to normal (a process that can take a couple of years), the condition usually goes away. And finally, after men pass the age of 50, the risk of enlarged breasts returns. That’s because the body’s testosterone production slows, while estrogen production increases along with body fat. How To Get Rid of Enlarged Male Breasts By Lisa Cianci | Editorial Contributor MEN’S HEALTH 6
The condition also can be a side effect of other disorders or factors that disrupt the normal production of estrogen or testosterone. Those include: • Liver disease • Kidney disease • Lung cancer • Testicular cancer • Tumors of the pituitary or adrenal glands • Congenital birth disorders • Thyroid disorders • Obesity • Certain medications, including antidepressants, chemotherapy and prostate cancer drugs • Illegal drugs, including anabolic steroids and heroin How Gynecomastia Is Treated Typically, the first step is to simply observe. That’s particularly true with teenagers, who should wait until 21 or so before considering treatment. During those early adult years, there’s always an opportunity for the situation to resolve itself. If it doesn’t go away on its own, the only treatment option available is cosmetic breast reduction surgery. The type of surgery will depend on the amount of tissue, and possibly skin, that needs to be removed. In most cases, breast reduction can be accomplished through liposuction, the least invasive option. With this procedure, your surgeon inserts a suction device into the breast area to remove the extra tissue. For stage three (and some stage two) cases, liposuction alone will not be enough. Your surgeon also will need to remove some of the extra skin. The treatment is typically permanent, though later weight gain could cause more fat to be deposited in the breast area. Recovery from Breast Reduction Surgery Full recovery from breast reduction surgery will take four to six weeks. If you are athletic, you might be eager to get back to exercising or playing sports. It’s important, however, to follow your recovery plan to avoid post-surgery complications, including fluid buildup. The results of the surgery will be clear shortly after the procedure. You’ll have a flat chest with no more overgrown male breasts. The typical recovery timeline: Days 2 to 3: Your swelling and bruising will reach its peak by day three, and you may need to take painkillers. You’ll be able to do general activities that don’t require you to move your arms a lot or lift heavy objects. And you will be wearing a compression vest that will support your body and limit swelling. Days 4 to 7: You can return to work if your job doesn’t require a lot of lifting or arm movement. You should be able to drive with minimal discomfort. But you should avoid jogging and other sports. Week 2: You can resume jogging, but still should avoid more aggressive exercises, including swimming or weightlifting. You should continue wearing your compression vest, even while sleeping. Weeks 3 to 4: This is when you can resume normal activities, with little or no restrictions. Consult with your doctor before returning to intense sporting activities. You also should continue wearing your compression vest throughout the first month after surgery. For more Bayfront Health news, follow us on social media at Facebook.com/BayfrontHealth. BayfrontHealth.com/ChooseHealth 7
Aches, pains, lethargy and headaches might mean you have the flu. But those symptoms also could be the telltale signs of anxiety. Chronic stress and high stress levels are known to cause symptoms similar to influenza. In severe cases, stress can even lead to chest pain, seizures and difficulty breathing. This is related to the way your body is primed to respond to perceived or actual threats. When threatened, your brain, nervous system and cardiovascular system go into overdrive to keep you safe. “With extreme stress, you can become fatigued, have difficulty breathing and experience mental fogginess,” says Dr. Jonathan Mitchell, a clinical psychologist with Bayfront Health Medical Group Family Medicine. At the same time, flu and other infections can cause an inflammation that creates a similar response. MENTAL HEALTH Think You Have the Flu? It Might Be Anxiety By Tim Barker | Editorial Contributor Looking for a primary care doctor? Find an expert at BayfrontHealth.com/Physician-Finder. Telling the Difference The hallmark difference between anxiety and flu symptoms is the achiness. With the flu, you may feel an all-over discomfort that’s difficult to pinpoint. With anxiety, that achiness is most likely felt in your neck, shoulders and chest. Other differences include the way your breathing is affected. With the flu, the classic respiratory symptoms are coughing and difficulty breathing. With anxiety, the symptoms are more likely to be rapid breathing and a tightness in the chest. And when anxiety is in full swing, you may feel shaky or trembly, which could be confused with chills. But with the flu, those chills are more sensitive to temperature changes. And you are likely to feel cold and not just shaky. Other anxiety symptoms include difficulty sleeping, gastrointestinal problems and sense of impending danger. Having an objective observer like your primary care doctor look at the big picture can help identify anxiety as the root cause. Treatment for anxiety often begins with cognitive behavioral therapy. 8
GUIDE Countdown to Better Health In this guide, we offer expert tips and advice on ways to manage diabetes, tricks for staying hydrated and heart habits couch potatoes can embrace. We also debunk common brain myths, share things you should know about hemorrhoids and let you in on the best reason to see a doctor even when you are feeling great. BayfrontHealth.com/ChooseHealth 9
GUIDE By Tim Barker | Editorial Contributor Diabetes is common, but it’s rare for someone to die from it. Related conditions such as stroke and heart disease are a bigger threat. Over time, elevated blood sugar levels can cause organ damage, not only to the heart, but also to kidneys and eyes. Ways To Manage Your Diabetes That’s why diagnosing and then managing diabetes is so important. With the right approach, you can limit the potential for significant health complications. The key is understanding the disease and how to modify your diet and lifestyle, says Dr. William Degan, a board-certified family medicine physician with Bayfront Health Medical Group Internal and Family Medicine. With that in mind, let’s look at seven strategies for getting (and keeping) diabetes under control. Watch what you eat. Limiting carbohydrates is important, and a good goal is aiming for less than 150 grams of carbs each day. Reading nutrition labels and weighing or measuring your food are easy ways to track your carbs. Sugary drinks and sweets are obvious sources of carbs, which make them easier to avoid. Foods like rice, bread and potatoes don’t taste sweet, but they are packed with carbohydrates, too. Going hand-in-hand with carb counting is choosing foods that are high in dietary fiber. Fiber is actually a type of carbohydrate, but one that your body can’t digest. Where other carbohydrates are broken down into sugar molecules known as glucose, fiber passes through your body. So, these fiber carbs don’t count against your total for the day. For example, the average banana has 28 grams of carbs and 3 grams of fiber. So, the banana counts as 25 grams of carbs. This is one of the reasons fruits and vegetables make healthy snacks, as long as you don’t overdo it. 10
Stick with your exercise plan. Exercise is important both for diabetics and for those who are trying to avoid the disease. Your goal should be 30 minutes of aerobic activity each day. For older adults, a brisk walk may do the trick. For younger adults and children, it may require something more intense — jogging or swimming laps, for example. For more health tips, visit BayfrontHealth.com/Content-Hub. Monitor your medications. Medications can affect your glucose levels. There are medications that need to be taken multiple times a day, some that need to be taken with food and others that require an empty stomach. Work with your doctor to make sure you are taking your medications appropriately to get the maximum benefit. Limit alcohol. Even though alcohol doesn’t taste sweet, it raises your blood sugar levels. Drinking too much can also encourage overeating and other bad habits. If you are going to drink, it should be done in moderation — no more than one or two drinks a day. But if you are diabetic, it’s a better idea to treat alcohol the same way you do sugary snacks like cake, pie and ice cream: Reserve it for special occasions. Reduce stress. High stress levels can produce a hormone response in your body that raises your blood sugar. And when people get stressed, they’re more likely to engage in unhealthy behaviors like eating junk food, drinking alcohol and smoking. If you find yourself under too much stress, look for healthier coping mechanisms like exercise, medication and enjoyable hobbies. The key is regularity. Find something you enjoy and make it a habit. “You don’t need to run marathons, but you do need to get your heart rate up and break into a light sweat,” says Dr. Degan. Lose weight. This one may take care of itself if you follow the diet and exercise advice. Excess weight or obesity is a major risk factor for diabetes. It affects the way your metabolism works and limits your body’s ability to control blood sugar. Your doctor can help you find your ideal body mass index, a calculation using your height and weight. A BMI of 30 or higher is considered obese. BayfrontHealth.com/ChooseHealth 11
By Brooke Morton | Editorial Contributor Most people know as much about their brains as they do the deep ocean. In other words: not a lot. In the absence of having the facts about our brain, it’s easy to believe the myths, such as: We Only Use 10 percent of Our Brain This common myth dates back more than a century. As technology with imaging and functional MRIs improves, doctors are finding that we use all of our brain. With just about any activity, multiple lobes could be firing at the same time. Male and Female Brains Process Information Differently We often hear that men and women process information differently, but it’s not entirely true. One common example is that women are more focused on emotions, and men tend to be more pragmatic. However, scientific evidence reveals that the male and female brains are processing information more alike than differently. “When a neurologist looks at a brain scan, we cannot tell if the brain belongs to a male or female,” says Dr. Liviu Craciun, a board-certified neurologist with Bayfront Health Medical Group Neurosciences. Common Brain Myths Debunked GUIDE 12
Need help from a neurologist? Visit BayfrontHealth.com/Physician-Finder. Video Games Rot Your Brain No definitive research shows that occasionally playing video games affects cognitive function in a negative way. In fact, virtual reality can be used in rehabilitation after a stroke, and video games can even help develop strategy and hand-eye coordination. For example, surgeons must manipulate with their hands but watch the results on a screen, which is a skill strengthened by video games. Games like video soccer also strengthen your ability to strategize. Recent studies also have shown that video games can help older adults maintain the health and agility of their brains. Problems can arise, however, if you have no social interaction beyond the screen. You’re Either LeftSide or Right-Side Dominant People use both sides of their brain. Someone’s creativity likely would stem from personal interest or perhaps growing up in a creative family, not simply because one side of their brain is dominant. According to this theory, handedness also correlates to which hemisphere of your brain is dominant. For example, left-handed people supposedly are more right-brained. This is not true. Most people are right-handed, but that doesn’t mean they are more analytical than creative. That’s because there is no correlation between handedness and which side of the brain you use more. Brain Plasticity Stops with Age People widely assume that the plasticity of their brain will decrease with age. The brain, like a muscle, needs to be regularly exercised to maintain strength and agility. When we task our brains with learning new things or doing things in new ways, we help increase its plasticity — which by no means ceases completely with age. To promote brain plasticity, consider activities such as: • Playing tennis. Engaging in regular physical activity and sports can improve your brain’s ability to coordinate movements and increase its ability to strategize. • Trying verbal or math puzzles to strengthen verbal activity, memory and repetition. • Using apps that focus on math and memory to help increase your brain’s ability to adapt and grow new neural pathways. Memory Always Declines as You Get Older Another myth is that everyone loses the ability to recall information as they age. Not so. Being unable to recall information is one of the signs pointing to Alzheimer’s disease or dementia and is not something that will necessarily occur in all adults as they age. Those who do notice a decline in long-term memory should consult with a doctor to find out more. Short-term memory is more commonly affected, but adults tend to have far greater responsibilities as they age: children, grandchildren, jobs and volunteer work, for example. With so much to keep track of, it can be natural to forget something occasionally, and forgetting does not need to be an indicator of anything serious. If you have concerns, see your doctor. BayfrontHealth.com/ChooseHealth 13
GUIDE 5 Tricks for Staying Hydrated By Tim Barker | Editorial Contributor Water helps you digest food, lubricate your joints, get rid of body waste and avoid energy-draining dehydration. It can even affect your cognitive functions, including mood, energy and attention. And research suggests drinking water also may offer extra protection against chronic diseases that tend to pop up as we grow older. There are a range of recommendations on how much water you should drink each day. As a rule of thumb, men should consume about 100 ounces (3 liters) and women about 73 ounces (2.12 liters) of water or beverages each day. How To Drink Enough Water It can be daunting to think about drinking multiple liters of water every day. The good news is that you don’t have to do it all in one sitting, says Dr. Ligia Perez, a board-certified family medicine physician with Bayfront Health Medical Group Family Medicine. And you can consume water from a variety of sources. Among the strategies to consider: Carry a bottle. Start carrying a water bottle with you during the day, refilling it as needed. Drinking throughout the day will make it easier to hit your goal. You can even go hightech with a smart bottle to help you keep track of your water consumption. Add some flavor. Lemon, lime and other fruit flavors will improve the taste. Challenge a friend. If you are motivated by competition, find a friend or family member to compete with. Other liquids count. Milk, juice, tea and soda are all high in water content. But don’t go overboard, particularly with liquids that are high in sugar or caffeine. Eat your water. Fruits like watermelon, strawberries and cantaloupe are more than 90 percent water. For more healthy living tips, visit BayfrontHealth.com/Content-Hub. 14
Healthy Heart Habits Even Couch Potatoes Can Embrace By Kim Marcum | Editorial Contributor For more health advice, follow Bayfront Health on Facebook and Instagram. A sedentary lifestyle creates a laundry list of potential problems for you and your body. Lack of activity also contributes to several key cardiac risk factors, including obesity, high blood pressure, elevated cholesterol and diabetes. “To lower risks, you don’t have to run marathons. But you do need to find a way to get your heart active,” says Dr. Alexander Johnson, a boardcertified cardiologist with Bayfront Health Medical Group Cardiovascular. The goal is at least 120 minutes of low-impact, moderate aerobic activity each week. Find an activity you enjoy. You might like walking with a friend, riding a stationary bike, weightlifting, swimming, playing pickleball or jogging. Initially, your goal is to develop a habit that’s going to stick. Once you get going, you can aim for a pace where you get short of breath without being uncomfortable. Try to exercise every day. In a perfect world, you would spread your weekly activity across seven days. But an hour a day on Saturday and Sunday certainly has benefits. Low-impact activities where you start and stop are good for keeping you active, but they don’t provide the sort of boost you need for cardiovascular health. Instead, focus on things that keep your heart rate elevated for a specific period of time. Commit to the program. To leave your sedentary ways behind, make your new exercise routine an integral part of your day. Find chunks of time that are easier to set aside for the cause. For example, you might decide that every night after dinner, you and your partner will take your dog for a walk. Move during your workday. After you’ve been sitting at your desk for a couple of hours, get up and take a 15- to 20-minute walk. Carve out a certain amount of break time each day and get moving, instead of standing around the water cooler talking. GUIDE BayfrontHealth.com/ChooseHealth 15
GUIDE 3 Things To Know About By Lisa Cianci | Editorial Contributor For most people, hemorrhoid troubles are a natural part of life from time to time. So, if you’re having a flareup, take heart in knowing you’re not alone. It’s estimated that three of every four adults will be in your shoes at some point. 16
Technically, everyone has hemorrhoids, which are essentially blood vessels in the anus and lower rectum. They can become bothersome for a variety of reasons — some of which are not well understood. But they can make life miserable, causing itching, pain and bleeding. They’re one of the biggest reasons people visit colorectal specialists, with hemorrhoids getting blamed for pretty much any symptom that happens in the anus. Fortunately, hemorrhoidal flareups often can be treated with over-the-counter medications, lifestyle changes and painless therapies. Treatment options often depend on the severity of the hemorrhoids. What To Do About Them Treating hemorrhoids often starts with over-the-counter medications — such as those that shrink blood vessels, help with inflammation, or soothe or numb the area. When using these creams or suppositories, stick with it for five to seven days, even if you see improvement after a couple days. You’ll get the best results with the full treatment. For more extreme cases, options include: Rubber band ligation: This treatment is only used on internal hemorrhoids. They are wrapped with a rubber band, which cuts off the blood supply, causing the hemorrhoid to drop off after a few days. The procedure may cause mild discomfort and bleeding. Hemorrhoid energy therapy: This is a newer treatment for internal hemorrhoids. It uses thermal energy – applied by a device inserted into the anus – to shrink the hemorrhoids. The procedure is usually done with sedation. Transanal hemorrhoidal dearterialization (THD): Your surgeon uses ultrasound to locate the arteries feeding your hemorrhoids. The arteries are tied off, and a suture is used to lift and choke off the internal hemorrhoids. Hemorrhoidectomy: This is the gold standard for removing troublesome hemorrhoids, both internal and external. The surgery, which involves general anesthesia, removes the extra tissue that’s causing bleeding and/or swelling. This may be the best option if you have severe grade 3 or grade 4 hemorrhoids. Worried about hemorrhoids? Look for a specialist at BayfrontHealth.com/Physician-Finder. Here are three things you should know about hemorrhoids. They Are Graded “Your hemorrhoids, which can be found both inside and outside the rectum and anus, become problematic when swollen and enlarged,” says Dr. Jennifer Ayscue, a board-certified colon and rectal surgeon with Bayfront Health Medical Group Colorectal Surgery. Internal hemorrhoids are evaluated on a four-point scale: Grade 1: These are enlarged enough to protrude into the anal canal. They may bleed, but rarely cause pain. Grade 2: These will pop out of the anus during a bowel movement, but then move back inside on their own. Grade 3: After emerging from the anus, these have to be pushed back inside manually. Grade 4: At this point, the hemorrhoid will not go back into the anal canal, even if pushed. Surgery is often recommended. How To Avoid Trouble There is a lot that’s not known about what causes hemorrhoids to flare up. But your bathroom habits may play a key role. In particular, sitting on the toilet too long may be one of the biggest risk factors. Too many people head into the bathroom with a cell phone in hand. So, even after they’ve finished, they’ll sit there for a while with their phone. The problem is that when you sit on an open toilet, it sends a signal to your body to relax the anal sphincter, which allows the hemorrhoids to fill with blood. The longer you sit there, the greater the risk. So, get in there, do what you need to do and then get off the toilet. You also need to avoid excessive straining while in the bathroom. If you aren’t having easy bowel movements, add more fiber to your diet or consider using a stool softener, or even medication if needed. BayfrontHealth.com/ChooseHealth 17
GUIDE 2 Big Impacts on Your Mental Health — and How To Cope By Tim Barker | Editorial Contributor Two big areas in your life can affect your mental health: the home you live in and the place where you work. Chaotic surroundings can make you depressed, anxious and stressed. Consider the way you feel when your living space is a wreck. It may seem impossible to relax or think clearly. But as soon as you clean and organize your home, life feels more manageable. That’s because people often see themselves as a reflection of their environment. When your surroundings become chaotic, that chaos can spread to your brain. Your Home Environment It’s not always possible to control your home environment. Relationship struggles, issues with children, financial hardships and housing insecurity can hammer away at your mental health. “It’s difficult to feel safe and secure when you don’t have a place to retreat,” says Dr. Jonathan Mitchell, a clinical psychologist with Bayfront Health Medical Group Family Medicine in St. Petersburg. A Stressful Workplace The same goes for a stressful workplace. Waking up every day and dreading what’s about to happen will take a toll. It may be a toxic workplace, where you encounter frequent conflicts. Or you might not have healthy interactions and relationships with your coworkers or boss. These are such powerful components of our lives that trouble in one area can easily bleed over into the other. If you’re having a conflict with someone at work, that can put stress on your relationships with your partner, friends and children. 18
How To Cope It’s important to remember that environmental stressors are seldom permanent. Change doesn’t always occur as quickly as we might want it to, but there are coping strategies you can use, including: Connect with family and friends: Reach out to the people you care about and who care about you. Don’t be afraid to ask for help when you need it. Go outside: We often spend too much time cramped indoors. Sunlight and fresh air can do wonders for your mental well-being. Enjoy a hobby: Taking part in a favorite past-time can give your mind time to relax and recharge. Exercise: Physical activity relieves stress and boosts self-esteem. Find a connection: Activities like volunteering help give you a stronger sense of purpose. Avoid alcohol: Alcohol can make depression symptoms worse. Change jobs: If you have the freedom to consider a change, this could help you escape a toxic environment. Talk to your boss/coworkers: If you are having issues at work, it may help to raise your concerns. It could be that the person causing your stress isn’t aware of the impact. Do you need to talk to someone about your mental health? Find a doctor at BayfrontHealth.com/Physician-Finder. Signs of Depression Among the common symptoms of depression are: Keeping a Journal If you’re having difficulty pinpointing the source of your discomfort, try keeping a journal. It could be as simple as sitting down and recording your thoughts and what’s happening whenever you feel bad. Or you could take a more structured approach (a therapist can help you with this) where you record specific information about each of these incidents — where you are, how you are feeling, what your brain is doing, etc. Journaling can help you get a better handle on the parts of your life you can control. For example, you may realize that a particular co-worker is causing turmoil in your life. You can then explore options for countering that. But you may also find that some of your stressors — housing insecurity, for example — are beyond your control. Even if you can’t make that go away, you might be able to draw upon social support to help manage your emotions. Frequent or constant feelings of sadness or anxiety Finding no joy in favorite activities Feeling restless, irritable or easily frustrated Difficulty falling asleep Sleeping too much or waking up too early Having no appetite Aches and pains that don’t get better with treatment Difficulty concentrating or making decisions Constantly feeling tired Feeling guilty or helpless Thoughts of suicide or hurting yourself BayfrontHealth.com/ChooseHealth 19
GUIDE The Best Reason To See a Doctor Even if You Feel Great By Tim Barker | Editorial Contributor It may sound surprising, but one of the best times to start seeing a doctor is when there’s nothing wrong with you. This becomes even more important as you move out of your carefree 20s and into your 30s and beyond. 20
As you get older, routine checkups with your doctor can be key to a long and healthy life. “Checkups often can catch problems long before you notice any symptoms,” says Dr. Kristin Sochet, a board-certified family medicine physician with Bayfront Health Medical Group Family Medicine. “That’s particularly true with silent diseases like diabetes and hypertension.” Establishing a Baseline Regular physical exams offer what is essentially a snapshot of your current health. A series of these snapshots over time will make it easier to track changes as they occur. That helps you and your doctor fine-tune your diet, exercise routine and medications to increase your odds of avoiding some preventable diseases, including diabetes, obesity and cancer. The frequency of your follow-up visits will depend on your own situation and symptoms. For the healthiest of patients — particularly those who would rather not see the doctor — a visit every other year may be adequate. For people of average health, an annual checkup is ideal. But if you have ongoing health conditions, it’s better to have three- to six-month checkups, particularly if you’re on medications that require more frequent monitoring of kidney and liver functions. Vital Signs The physical exam will start with what might be the most important aspect of your visit. In just a few minutes, your vital signs will be measured and recorded. These can offer a quick look at some of the most important outward displays of your body’s health and provide a warning that something is amiss. These signs include: Body temperature: The normal temperature will fall in the range of 97.8 to 99 degrees. One degree or more over that normal rate indicates a fever, while a temperature below 95 is hypothermia. Pulse rate: This measurement of your heart rate is typically in the range of 60 to 100 beats per minute. Females over the age of 12 tend to have faster heart rates than males. Changes in the pulse rate can be caused by exercise, illness, injury and emotions. Respiration rate: This is the number of breaths you take in a minute. For adults, this is typically 12 to 20 breaths. Rates may be higher because of exercise, illness or injury. Blood pressure: This measures the force of the blood pumping through your body. Normal is a systolic/diastolic rate of less than 120/80. You are considered to have high blood pressure if systolic tops 130 or diastolic rises above 80. Body mass index (BMI): While not considered one of the four traditional vital signs, this measurement (calculated using a person’s height and weight) is important. A BMI over 30 indicates you are obese and at much greater risk for several diseases, including heart disease, diabetes, stroke and some cancers. Creating a Health Picture During the rest of your exam, which should take 30 minutes to an hour, your doctor will look at your eyes, ears, throat and lymph nodes. Your doctor will listen to your heart and lungs, and will check the sensations in your hands and feet. Routine bloodwork may be ordered to take a peek at things like cholesterol and blood sugar levels — either of which could indicate potential problems. You should also expect detailed questions about your medical history and your family’s medical history. This can help guide decisions on if or when to get screened for cancers and other diseases that have a known genetic component. As you age, the content of your exams may change. You will get more questionnaires to fill out. Eventually, cognitive tests will enter the equation, along with tests to monitor your gait and stability. Your doctor also will keep track of your various immunizations and recommended screenings for colon cancer and breast or prostate cancer. Think of these steps as a roadmap to helping you live the longest and healthiest life possible. For more tips on healthy living strategies, follow us on Facebook and Instagram. BayfrontHealth.com/ChooseHealth 21
PREVENTION A Secret To Improving Your Health? Stretching By Kim Marcum | Editorial Contributor Taking Care of Your Fascia “If you are feeling tight and stiff, you need to give your fascia attention when stretching, just as you do your muscles,” says Dr. Katherine Wojnowich, a boardcertified sports medicine physician with Bayfront Health Medical Group Sports Medicine. By taking good care of your fascia, you will gain a variety of health benefits: • You will feel better overall. • Your sleep will be higher quality. • Your body will have an easier time staying in alignment. • You will gain improved vascular function. Stretching helps in other ways, too. Nerves and blood vessels travel together. Constriction around the nerves can occur, which affects the fascia, which can raise your blood pressure and heart rate. Stretching gives your blood vessels room to work. The more relaxed they are, the less likely they are to chronically send a message of inflammation. In every movement you make, from walking to throwing a football, the connective tissue known as fascia plays a role. It runs through the whole body, linking the base of your skull to the tips of your toes. Fascia, pronounced fay-shee-uh, is crucial in facilitating healthy movement. Its job is to transfer energy from one part of the body to another. 22
Exercises for Plantar Fascia in the Foot Your plantar fascia is a band of tissue connecting the heel bone to the base of the toes. Many people suffer from plantar fasciitis, which causes sharp pain in the bottom of your foot and heel. Plantar fasciitis is associated with tight calves, so remember to stretch the Achilles tendon and calf. Some core exercises for the foot can help prevent this condition by strengthening the arch. • With your toes, practice picking up a small object such as a marble. • Pick up a towel with your toes. • Curl your toes. • Try toe yoga. While standing, lift each individual toe, spreading it apart from the others. • You also can purchase special stretchers, like night splints, to help do this work while you sleep. Exercises for the IT Band The iliotibial tract, or IT band, extends from the hip to just below the outside of the knee. The more you work your IT band, the stronger your pelvic stability muscles become. • Stand on right leg and lift the left leg to the side. Move the leg from 9 o’clock, back to 6 o’clock, then to noon and then across to 3 o’clock. Repeat on the other side. • To stretch hip flexors, start by kneeling on the floor. Bring right leg in front of you while keeping your right thigh parallel to the floor; knee should be bent at 90-degree angle and foot flat on the floor. Keep left knee on the floor with shin pointing straight back (not toward the left or right). Place hands on hips, contract your glutes and feel your pelvis tuck under you. With your back straight, shift your weight forward until you feel a stretch through the front of the left thigh and groin. Stretch both sides of your body. • For the clamshell, lie on your side with both knees bent. Raise the top leg, keeping it bent. Repeat, then switch sides. For an exercise program targeted to your specific needs, make an appointment with a sports medicine doctor or physical therapist by calling (727) 893-6333. Stretching Your Fascia Before a workout, you do not need to hold deep stretches for long periods of time. Instead, try dynamic stretching, which is stretching while gently moving. An example of a good dynamic warm-up stretch is walking lunges. After your workout, move slowly. Exaggerate the motions of your stretches to gain the full benefit. This is when you will want to incorporate tools to help you stretch, including: • Foam rollers • Mobility spheres • Massage roller sticks • Lacrosse balls Get Proper Rest and Sleep Getting the right amount of rest is another good way to take care of your fascia. The healthier and more relaxed your fascia is, the better you will be able to rest. This is because nerve endings pierce through the fascia. If your fascia is super tight, it will send messages of pain and heighten your awareness, nudging your system closer to a stress response, such as fight or flight. The more you stretch, keeping your fascia relaxed, the more you build what is called parasympathetic tone, which tells your body to relax. BayfrontHealth.com/ChooseHealth 23
WOMEN’S HEALTH Replacing Nipples with 3D Tattoos After a Mastectomy By Tim Barker | Editorial Contributor It’s a topic not a lot of people like to talk about: What happens to your nipples during a mastectomy? For some women, depending on the location and size of a tumor, preserving the nipple isn’t possible. But there are options available for replacement. The more common approach has been nipple reconstruction, which uses tissue taken from elsewhere on your body. There are some disadvantages to the procedure, including having another surgery. The reconstructed nipple also will flatten out over time, losing its projection. The second option, and one that is gaining popularity, is a 3D nipple tattoo. What Are 3D Nipple Tattoos? “After your reconstructed breasts have had time to heal, you work with a tattoo artist to recreate the appearance of the nipple and areola,” says Melissa Koliha, an advanced practice provider at Bayfront Health Medical Group Aesthetics and Reconstructive Surgery. The artist works with pigments and shading to give the nipple a three-dimensional look. There are several advantages to this option, including: Avoiding surgery: Many patients never get a nipple reconstruction because they don’t want to deal with another surgical procedure. Simple procedure: With tattooing, the procedure can be over in a couple of hours and often requires nothing for pain management since the skin is often numb from the original surgery. Easy healing: Since this isn’t a surgical procedure, there are no new scars to deal with, allowing for a quicker recovery. Psychological: After dealing with the trauma of breast cancer and mastectomy, this is a way to get back to a feeling of normalcy. It can make you feel whole again. It also may be less intimidating to work with your doctor’s office rather than seeking out a tattoo artist on your own. Some women may be uncomfortable walking into a tattoo parlor. If your care team includes a tattoo artist, this can make the process easier. To learn more about options after a mastectomy, contact Bayfront Health Medical Group Aesthetics and Reconstructive Surgery at (727) 893-6370. 24
Studies have found that weight loss through bariatric surgery boosts sexual function and overall fertility factors, including higher sperm count in men and more healthy pregnancies in women. Other cascading health improvements that accompany maintaining a healthy weight — such as a lower risk for hypertension and diabetes — combine to boost fertility, paving the way for more familyplanning dreams to come true. SPOTLIGHT Fertility in Obese Men “Too often, fertility is associated solely with women. This is only one-half of the fertility story, however. Lifestyle choices made by men, and some genetic predispositions, can hurt fertility, too,” says Dr. Alexander Ramirez, a board-certified bariatric surgeon with Bayfront Health Weight Loss and Bariatric Surgery Institute. Obesity can fall into either of those categories and impede a couple’s efforts to conceive. Obesity has the following adverse effects on men’s fertility: • Decreased testosterone levels, leading to lower libido and desire to have sex • Increased instances of erectile dysfunction • Lower sperm count The weight loss that accompanies bariatric surgery can improve all these conditions — leading to improved male fertility. Fertility in Obese Women Women who are obese struggle with some of the same fertility issues as men as well as additional complications when it comes to conceiving and carrying a healthy child to term. Some of the ways obesity affects women’s fertility include: • Hormonal imbalances leading to lower libido and sex drive • Irregular periods, making it difficult to conceive • Increased instances of polycystic ovary syndrome (PCOS), which affects 1 in 10 women of childbearing age and is a known challenge to fertility Obesity in women also increases the chance of pregnancy complications, such as preeclampsia and gestational diabetes, and accompanies higher rates of stillbirths. Women who reached a healthy weight after weight-loss surgery reported lower instances of major birth defects in infants than other women, research shows. Weight loss improves the fertility outlook for women who have struggled to conceive or have a pregnancy planned in the future. Will Bariatric Surgery Improve My Fertility? By Rona Gindin | Editorial Contributor The aesthetics of weight loss is a major draw for many Americans seeking bariatric surgery, but that’s not the only reason to have this life-changing procedure. It also can improve fertility. Continued on page 27 BayfrontHealth.com/ChooseHealth 25
Primary Care St. Petersburg (727) 553-7420 Dr. Finer is a family medicine physician who joined Bayfront Health Medical Group Internal and Family Medicine in July. She received her medical training from Lake Erie College of Osteopathic Medicine (Bradenton, Florida) and completed her residency at Bayfront Health (St. Petersburg). Christa Finer, DO Diagnostic Radiology St. Petersburg (727) 553-7801 A board-certified and fellowship-trained diagnostic radiologist, Dr. Hwang joined Bayfront Health Medical Group in April. He received his medical training at Michigan State University (East Lansing). His diagnostic radiology residency was completed at Nova Southeastern University (Fort Lauderdale) and a breast imaging fellowship at the University of North Carolina (Chapel Hill). Michael Hwang, DO Family Medicine St. Petersburg (727) 893-6116 Dr. Marsh is a family medicine physician who joined Bayfront Health Medical Group Family Medicine in August. He received his medical training at Lake Erie College of Osteopathic Medicine (Bradenton, Florida) and completed his residency in family medicine at Bayfront Health (St. Petersburg). Timothy Marsh, DO Psychology St. Petersburg (727) 893-6116 In January, Dr. Mitchell joined Bayfront Health Medical Group Family Medicine as a clinical psychologist. He also consults for Bayfront Health Weight Loss and Bariatric Surgery Institute. Dr. Mitchell earned dual master’s degrees in clinical psychology at the University of Central Florida (Orlando). He completed a residency in clinical psychology at Brown University (Providence). His PhD in clinical psychology and fellowship in integrated primary care were completed at UCF. Jonathan Mitchell, PhD Primary Care St. Petersburg (727) 893-6060 Dr. Perez is a board-certified family medicine physician who joined Bayfront Health Medical Group Family Medicine in July. She received her medical training at the University of Brasilia (Brazil). Dr. Perez completed a residency in family practice at Saint Mary of Nazareth Hospital Center (Chicago). She performed a fellowship in rheumatology and clinical immunology at the University of Florida (Gainesville). She is fluent in English, Portuguese and Spanish. Ligia Perez, MD Surgery and Critical Care St. Petersburg (727) 893-6185 Board certified in general surgery and surgical critical care, Dr. Price joined Bayfront Health Medical Group Trauma and Critical Care Surgery in September. He received his medical training at Nova Southeastern University (Davie, Florida). He completed general surgery residencies at Halifax Medical Center (Daytona Beach) and UF Health Jacksonville, and fellowships in surgical critical care, trauma and acute care surgery at Jackson Memorial Hospital (Miami). Dustin Price, DO 26 Welcome New Doctors* The doctors at Bayfront Health are part of a collaborative network that works toward one common goal: your health. *New doctors from December 2022 through September 2023
Obstetrics and Gynecology St. Petersburg (727) 893-6198 A board-certified obstetrician and gynecologist, Dr. Vallejo joined Bayfront Health Medical Group OB-GYN in December 2022. She received her medical training at the Institute of Health Sciences (Colombia). Her residency in obstetrics and gynecology was completed at Mount Sinai Hospital (Chicago). She is fluent in English and Spanish. Elvia Vallejo, MD To learn more about bariatric options, join one of our virtual information sessions in English or Spanish. Visit BayfrontHealth.com/WeightLoss or call (727) 893-6550 for details. Bariatric Surgery and Pregnancy Weight loss alone will improve fertility and the chances for healthy, full-term infants, but you must consider a few more factors before trying to conceive. Specifically, women should: • Refrain from getting pregnant for 18 months following bariatric surgery. Protein, folate, iron and calcium are among common nutrient deficiencies after surgery — and all are vital to the health of a growing fetus. You should ensure your own levels of these and other necessary nutrients are stable before becoming pregnant. • Incorporate prenatal vitamins in your routine in the months leading up to conception so the baby has proper nutrients, and the risk of congenital disabilities is reduced. • Pay attention to your body during pregnancy for signs of internal hernias or bowel obstructions and seek emergency help if either symptom arises. • Speak with a psychologist or other mental health professional about expected pregnancy body changes, weight gain and potential mental health effects. The desire to start or increase a family is a great reason to want to maintain a healthy weight, and bariatric surgery provides a path to improved fertility. Find the Doctor that Is Right for You Scan the QR code to find the right physician for you. Continued from page 25 BayfrontHealth.com/ChooseHealth 27
St. Pete Pride Parade Bayfront Health team members participated in the St. Pete Pride Parade in June along with partners Tampa Bay Rays and Tampa Bay Rowdies. Community Good Bayfront Health is dedicated to improving the health and quality of life of the individuals and communities we serve. Not only do our physicians, team members and volunteers go above and beyond their daily contributions to support our community, but so do our community partners. With this collaboration, we all make a difference in the lives of the individuals and communities we serve. 28
Fort DeSoto Triathlon As the Official Medical Team, Bayfront Health provided support at the postrace recovery area for the dedicated athletes at the Integrity Multisport 2023 Fort DeSoto Triathlon. Malnutrition Awareness Week Bayfront Health team members volunteered at a St. Petersburg Free Clinic food bank in honor of Malnutrition Awareness Week. This annual campaign by the American Society for Parenteral and Enteral Nutrition (ASPEN) highlights nutrition’s crucial role in health and recovery, emphasizing the importance of discussing nutrition with healthcare professionals. Over 550 food bags were packed and over 100 compassionate notes were written to support our community members. Bayfront Health Emergency Room - Crossroads A ribbon-cutting ceremony was held with a visit from the Tampa Bay Rowdies and the Tampa Bay Rays mascots to celebrate the opening of the new Bayfront Health Emergency Room – Crossroads in west St. Petersburg. Men’s Health Month Tampa Bay Rowdies players Leo Fernandes and Forrest Lasso visited Bayfront Health team members to spotlight Men’s Health Month. Dr. Steven Seltzer, a board-certified internal medicine physician, also discussed men’s health topics. Superhero Night with Tampa Bay Rowdies A heartfelt thank you to our healthcare superheroes! Superhero Night with the Tampa Bay Rowdies presented by Bayfront Health started with players visiting our teams and ended with a night of recognition and celebration. Women CFOs To Know for 2023 Recognized for leadership in healthcare finance, LaTasha Barnes, chief financial officer with Bayfront Health, earned her spot among Becker’s Hospital Review Women’s Hospital and Health System CFOs to Know for 2023. The list recognizes the success and leadership of 182 female CFOs who are driving financial strategy at their organizations. BayfrontHealth.com/ChooseHealth 29
SPOTLIGHT What’s That Whooshing Noise? By Tim Barker | Editorial Contributor A ringing, hissing or buzzing sound in your ear could be tinnitus, which affects nearly 50 million Americans and usually isn’t severe. But there is a potentially more serious type of tinnitus, called whooshing syndrome, in which you actually hear the sound of blood flowing near your ears in time with your heartbeat. What Causes It? Among the causes of whooshing syndrome is a buildup of cerebrospinal fluid around the brain. If left untreated, it can lead to permanent vision loss, says Dr. Lowell Dawson, an interventional neuroradiologist with Bayfront Health Medical Group Neurosciences. The condition is most common in women aged 20 to 50 and with a body mass index above 30. Although rare, more cases are being diagnosed as Americans struggle with weight issues. With this form of hypertension, the buildup of cerebrospinal fluid puts increasing pressure on the sinuses at the back of your head and on the optic nerves behind your eyes. This constricts blood flow, creating the sound in your ears and disrupting vision. Double vision or blindness can result in one or both eyes. The first line of treatment involves weight loss and medications to reduce the body’s production of cerebrospinal fluid and retention of fluids. If those options don’t work, a minimally invasive procedure is available that eliminates the whooshing sound and vision symptoms for 90% of patients. A Sign of Something Else? Like other forms of tinnitus, whooshing syndrome isn’t a condition, but a symptom of another disorder. The syndrome is caused when another condition affects blood flow around your ears. Besides high blood pressure, those conditions include: • Tangled blood vessels known as arteriovenous malformations near your ears • Hardening of your arteries • Sinus wall abnormalities • Middle ear tumors • Head trauma Find a doctor who can help at BayfrontHealth.com/Physician-Finder. 30
Bayfront Health Emergency Room – Pinellas Park The first free-standing ER in Pinellas Park, the 11,400-square-foot facility is equipped to handle any emergency, 24 hours a day, seven days a week, utilizing a Fast Track system for minor emergencies that delivers personalized emergency care in less time. Connected, Convenient and Expert Healthcare Bayfront Health St. Petersburg is a comprehensive emergency, medical and surgical acute care facility serving residents of St. Petersburg and the surrounding region for more than 100 years. With advanced technology and expertise in numerous specialties, including cardiovascular, neuroscience, obstetrics, orthopedics, surgery, emergency and trauma, and acute rehabilitation, Bayfront Health provides a complete continuum of care. 701 6th St. South | St. Petersburg, FL 33701 BayfrontHealth.com Bayfront Health Emergency Room – Crossroads The three-story, 42,000-square-foot facility includes a 14,000-square-foot emergency room located on the ground floor and space for future medical offices located on the second and third floors. The emergency room has 12 exam rooms, including two resuscitation rooms, six areas where patients can comfortably wait for their results and an ambulance bay.
If you do not wish to receive mailings, please visit OrlandoHealth.com/Unsubscribe. 701 6th St. South St. Petersburg, FL 33701 Non-Profit Organization U.S. Postage PAID Permit No. 3459 Orlando, FL You are one click away from finding a doctor Your partner in wellness. Your care is our priority. At Bayfront Health Medical Group Family Medicine, our primary care offers a full range of healthcare services from annual wellness exams and immunizations to treatment options for chronic or acute illnesses. With multiple convenient locations and online scheduling available, getting the care you deserve has never been easier. Giving you more reasons to choose well. BayfrontHealth.com/MedicalGroup choose well.