HealthLines - Cleveland Clinic

HealthLines
News and Health Information from Cleveland Clinic Florida Weston Volume 3, No. 3
Take
Heart
New Techniques Clear
Blocked Arteries with Less
Pain, Quicker Recovery
Philip Carr, 75, of Stuart, FL, was
walking briskly one day in May
when he felt a burning sensation in
his chest. The sensation passed, but he
mentioned it to his doctor during a
checkup several days later and his doctor
ordered some tests. The result? Three of
the arteries leading to Carr’s heart were
more than 90 percent blocked.
Carr could have chosen traditional
bypass surgery—where his chest would
be opened wide to expose his heart, his
blood would be filtered through a heartlung
machine and veins for the bypass
grafts would be harvested from his leg.
But at Cleveland Clinic Hospital, in
partnership with Tenet South Florida
HealthSystem in Weston, a combination
of cardiac interventions and minimally
invasive robotic surgery gave Carr an
option for clearing his arteries without
the longer hospital stay, lengthy recovery
and potential complications of traditional
bypass surgery.
continued on page 2
Building
Looking
Medical
3 Back 4 Your Best 5 Minutes 6
Solutions for spine problems
at Cleveland Clinic Florida
and Cleveland Clinic Hospital.
If you don’t have time for
traditional plastic surgery, these
options are for you.
Discover what’s happening
at Cleveland Clinic Florida
and Cleveland Clinic Hospital.
Conquering
Cancer
Two ways to fight this
disease from Cleveland
Clinic Florida.

Take Heart
from page 1
A Better Bypass
Carr chose the less-invasive
option and Douglas Boyd, M.D., a
Cleveland Clinic Florida cardiac
surgeon, performed a bypass on
one artery using the latest techniques.
With endoscopic instruments
and robotic assistance, he
operated through portholes between
the ribs, each no bigger than
two inches long. The robots helped
harvest a vessel from within the
chest cavity for the bypass, and
Dr. Boyd performed the operation while
the heart was beating, eliminating the
need for the heart-lung machine.
“With this method, you don’t have
the physiological or anatomical trauma
of breaking the breastbone or the inflammatory
response and possible neurocognitive
difficulties of the heart-lung
machine,” Dr. Boyd explains. “We avoid
many of the pitfalls of the [traditional]
Make an Appointment
If you would like to make an
appointment with a physician at
Cleveland Clinic Florida, please
call 1-877-463-2010.
ALLERGY AND CLINICAL
IMMUNOLOGY
Frank J. Eidelman, M.D.
ANESTHESIOLOGY
Ira Abels, M.D.
Juan Botero, M.D.
Brian Burnbaum, M.D.
Rafael Cabrales, M.D.
Jeanette Derdemezi, M.D.
George L. De Velasco, M.D.
Safwat Eskandar, M.D.
Cherie Fisher, M.D.
Lawrence P. Frank, M.D.
Ricardo Gerenstein, M.D.
Wagih W. Gobrial, M.D.
Enrique R. Huertas, M.D.
Jeffrey Jacobs, M.D.
2 VOLUME 3, NO. 3 • HEALTHLINES • WWW.CLEVELANDCLINICFLORIDA.ORG
“We’re very excited about this
procedure. It’s revolutionizing
cardiology and the way cardiac
surgery is being performed.”
—Douglas Boyd, M.D.
cardiac procedure while preserving the
documented benefits.”
Clearing a Path
On the day after Carr had his bypass
surgery, Kenneth Fromkin, M.D., an
interventional cardiologist at Cleveland
Clinic Florida in Weston, cleared the
other two blocked arteries with stents.
MEDICAL STAFF DIRECTORY
CARDIOLOGY
Howard S. Bush, M.D.
Kenneth R. Fromkin, M.D.
Gian Novaro, M.D.
Sergio Pinski, M.D.
Michael Shen, M.D.
CARDIOTHORACIC
SURGERY
Douglas Boyd, M.D.
COLORECTAL SURGERY
Juan J. Nogueras, M.D.
Dana Sands, M.D.
Eric G. Weiss, M.D.
Steven D. Wexner, M.D.
DERMATOLOGY
Tamara Lior, M.D.
Carlos Nousari, M.D.
ENDOCRINOLOGY
Jose M. Cabral, M.D.
Camilo A. Leslie, M.D.
EXECUTIVE HEALTH
Jose Muniz, M.D.
FAMILY PRACTICE
Weston Family Health Center
Jessy Casimiro, M.D.
Daniel G. Harwitz, M.D.
Dalia S. McCoy, M.D.
Charles G. Perl, M.D.
For this procedure, Dr. Fromkin
threaded a catheter containing a
small balloon through each of
Carr’s arteries to the blockage,
inflated the balloon to clear the
blockage, then left a metal screen,
or stent, in place to keep the vessel
open. One of the stents, called a
drug-eluting stent, releases medication
to help keep the blockage
from recurring.
“We’re very excited about this
procedure,” Dr. Boyd says. “It’s revolutionizing
cardiology and the way cardiac
surgery is being performed. Cardiac
surgery is getting less invasive, interventional
cardiology is getting more invasive,
and we’re getting the best of both
worlds in one procedure. It’s ultimately
better for the patients—they’re the beneficiaries
of this exciting new procedure.”
Carr can vouch for that. He had his
bypass surgery on a Tuesday, the stents
placed on Wednesday and was home on
Thursday, walking 20 minutes twice
that day and walking up to an hour a
day for the next five days. “I have been
able to get my energy back,” Carr says.
“Now I’m playing golf three days a week
and I feel good.” •
To make an appointment call 1-877-463-2010
GASTROENTEROLOGY
Marcia Cruz-Correa, M.D.
Ronnie R. Pimentel, M.D.
Andrew Ukleja, M.D.
GENERAL, MINIMALLY
INVASIVE AND
BARIATRIC SURGERY
Raul J. Rosenthal, M.D.
Samuel Szomstein, M.D.
GENERAL AND VASCULAR
SURGERY
Mark K. Grove, M.D.
Mark E. Sesto, M.D.

Building Back
Solutions for the Most Difficult Spine Problems
Al Palmer of Parma, OH, knows something about back surgery.
His back problems began in the 1980s with a ruptured
disk that required surgery. Following that, he had seven more
operations to free nerves, realign his back, and insert plates
and screws for support.
In these complicated cases, the entire team evaluates the
For his ninth back surgery, in June, he traveled to Cleveland patient, and if they recommend additional surgery, everyone on
Clinic Hospital in Weston so spine surgeon Robert Biscup, D.O., the team is involved in the patient’s care after the surgery.
could treat him. “Dr. Biscup was the reason I came down here,” Most of these cases of major reconstructive surgery involve
Palmer says.
cleaning out or removing spinal stenosis; cleaning out the
Cleveland Clinic Florida has developed a national center to nerves; inserting screws, rods or plates; and reconstructing the
study and treat spine surgery that’s failed. “We see patients spinal column. Surgeons sometimes insert artificial vertebrae or
who have had one or more operations
and continue to have problems or Back to Good Health
use osteobiologics, bone-growth hormones, to
increase fusion rates. The surgery typically
develop new problems that need further To schedule an appointment lasts two to five hours, and patients spend
intervention,” Dr. Biscup explains.
with a Cleveland Clinic Florida three to five days in the hospital before
The center employs a team of spine physician, call 1-877-463-2010. beginning a rehab program.
surgeons, medical spine doctors, inter-
“Our success rate with these most difvention
pain specialists, physical therapists and psychiatrists. ficult cases is 75 percent, compared to a 20 to 30 percent
“These patients usually have complicated problems and multi- success rate for traditional procedures published in medical litple
complaints,” Dr. Biscup explains. They typically haven’t erature,” Dr. Biscup explains. “The key is using a team
been exercising due to their back problems, and they may be approach to patient selection and being more critical in decid-
taking excessive pain medications. Many patients also suffer ing which patients will benefit and which will not.”
from depression, anger, anxiety and sleep deprivation, and Palmer, still recovering at the time of his interview, is confi-
they have been seeing different doctors without coordination of dent that his surgery will be a success. “I just had X-rays and
their care.
they look good,” he says. “This should be it.” •
For a referral to a Cleveland Clinic Hospital
affiliated physician, please call 1-800-340-9926.
GERIATRICS
Jerry O. Ciocon, M.D.
Diana J. Galindo, M.D.
GYNECOLOGY
Viviane Connor, M.D.
G. Willy Davila, M.D.
Minda Neimark, M.D.
Stephen E. Zimberg, M.D.
HAND & WRIST SURGERY
John A. McAuliffe, M.D.
HEMATOLOGY AND
ONCOLOGY
Chieh-Lin Fu, M.D.
Thomas Niederman, M.D.
Elizabeth Stone, M.D.
INFECTIOUS DISEASE
Lyssette Cardona, M.D.
Margaret J. Gorensek, M.D.
INTERNAL MEDICINE
Stephen Avallone, M.D.
Laurence H. Beck, M.D.
Gregory S. Cohn, M.D.
Ghassan G. Haddad, M.D.
Vinod R. Miryala, M.D.
Paige E. Morris, M.D.
Jose M. Muniz, M.D.
Cristina Pravia, M.D.
Heidi Syropoulos, M.D.
NEPHROLOGY /
HYPERTENSION
Mauro Braun, M.D.
John B. Copley, M.D.
Beth Leventhal Fromkin, M.D.
NEUROLOGY
Néstor Gálvez-Jiménez, M.D.
Eduardo R. Locatelli, M.D.
Virgilio D. Salanga, M.D.
Efrain Salgado, M.D.
NEUROSURGERY
Robert Isaacs, M.D.
OPHTHALMOLOGY
Quentin Allen, M.D.
Joel Glaser, M.D. (consultant)
David G. Hardy, M.D.
David Jones, M.D.
Norman Schatz, M.D. (consultant)
ORTHOPAEDIC SURGERY
Holly Brown, M.D.
Len Remia, M.D.
Lex A. Simpson, M.D.
OTOLARYNGOLOGY (ENT)
Gilberto Alemar, M.D.
PATHOLOGY AND
LABORATORY MEDICINE
Mariana Berho, M.D.
Sherry L. Woodhouse, M.D.
PERIPHERAL
VASCULAR DISEASE
Bernardo B. Fernandez Jr., M.D.
PLASTIC AND
RECONSTRUCTIVE
SURGERY
J. Brian Boyd, M.D.
Michel C. Samson, M.D.
WWW.CLEVELANDCLINICFLORIDA.ORG • HEALTHLINES • VOLUME 3, NO. 3 3

Looking
Your Best
Quick Solutions from Cleveland
Clinic Florida Dermatologists
If you’d like to improve your appearance
but don’t have time to spare for
traditional plastic surgery, Cleveland
Clinic Florida’s dermatologists can help.
“We have new technology, treatment
options without downtime, and quick
solutions to improve patients’ looks,”
explains Tamara Lior, M.D., head of the
section of Mohs and laser surgery in dermatology.
Options include:
• Light- to medium-depth chemical
peels or laser treatments, which can
improve skin texture and clear minor
imperfections such as dark spots
caused by the sun.
•Laser rejuvenation, which works
beneath the skin’s top layer to improve
skin tone and reduce fine lines.
• Collagen injections, which can reduce
lines and make lips fuller.
• Botox injections, which can reduce fine
lines and wrinkles.
•Hair removal with laser treatments.
•Laser techniques for facial blood
vessels and port wine stains.
To schedule your cosmetic consultation,
please call 954-659-5263. •
PODIATRY
Elizabeth Scheiber, D.P.M.
(consultant)
PREVENTIVE CARDIOLOGY
Gregory S. Cohn, M.D.
PULMONARY DISEASE
Eduardo Oliveira, M.D.
Franck Rahaghi, M.D.
Laurence A. Smolley, M.D.
RADIOLOGY
Maria Artze, M.D.
Mark R. Berman, M.D.
Rodolfo J. Blandon, M.D.
Gilbert H. Cohen, M.D.
Arthur B. Sher, M.D.
Jeffrey J. Spreitzer, M.D.
Mitchel S. Whiteman, M.D.
RADIATION
ONCOLOGY
Christopher Chen, M.D.
(consultant)
RHEUMATOLOGY
Trumane J. Ropos, D.O.
SPINE SURGERY
Robert Biscup, D.O.
Robert Isaacs, M.D.
Hysterectomy? Maybe Not
An Alternative to a Common Gynecological Procedure
There’s an alternative to hysterectomy
available at Cleveland Clinic Florida. A
procedure called a hysteroscopy involves
placing a fiberoptic lens with a camera
through the cervix to look at the lining of
the uterus. “If we see a polyp, fibroid or
congenital abnormality, we can go ahead
and remove or correct it by operating
through the scope,” explains gynecologist
Viviane Connor, M.D.
Surgery with the scope can correct
abnormal uterine bleeding, menstrual
bleeding disorders and problems leading
Make an Appointment
Call 1-877-463-2010 to schedule an appointment
with a Cleveland Clinic Florida physician.
UROLOGY
Gamal M. Ghoniem, M.D.
Lawrence S. Hakim, M.D.
Daniel A. Shoskes, M.D.
to infertility. “I’m surprised by the number
of women who come in for a regular
checkup and don’t realize heavy periods
are not normal,” Dr. Connor says.
“The outpatient procedure is very safe
and effective, with no abdominal incision,”
she says. “While it typically takes six weeks
to fully recover from a hysterectomy, hysteroscopy
recovery takes 24 to 48 hours.”
In addition, a new outpatient procedure,
hysteroscopic sterilization, offers a
permanent birth control method. “With
the hysteroscope, we place springs in
the fallopian tubes, and tissue grows
around them and occludes the tubes,”
Dr. Connor explains. Most patients
recover in less than 24 hours. •
Welcome, New Physicians
Cleveland Clinic Florida is pleased to welcome
to its Weston campus the following physicians,
who have recently joined the medical staff.
• Anesthesiology, Ira Abels, M.D.
• Anesthesiology, Juan Botero, M.D.
• Anesthesiology, Jeffrey Jacobs, M.D.
• Cardiology, Michael Shen, M.D.
• Dermatology, Carlos Nousari, M.D.
• Internal Medicine, Stephen Avallone, M.D.
• Internal Medicine, Cristina Pravia, M.D.
• Nephrology, Mario Braun, M.D.
• Orthopedics, Len Remia, M.D.
• Pulmonary Medicine, Franck Rahaghi, M.D.
• Radiation Oncology, Christopher Chen, M.D.
WWW.CLEVELANDCLINICFLORIDA.ORG • HEALTHLINES • VOLUME 3, NO. 3 4

Medical
Minutes
NEW DOC FOR
FLORIDA PANTHERS
Len Remia, M.D., a Cleveland Clinic
Florida orthopaedic surgeon trained in
sports medicine, is a new member of the
Florida Panthers’ medical team, along
with Lex Simpson, M.D. He’ll cover home
games, taking care of any orthopaedic
injuries, documenting what’s going on
with each player, and advising coaches
and owners about how players’ injuries
are progressing.
YOGA
As an integrative approach to healthcare,
yoga can provide treatment to complement
traditional medicine. Restorative
techniques utilized in yoga, such as
guided imagery, meditation and focused
breathing patterns, can bring therapeutic
benefits to people coping with illness
and offer stress relief to all. Yoga also
can assist in increasing strength, flexibility
and balance, as well as to reduce
fatigue and stiffness. Call 954-385-6634
to register for Yoga classes offered at
Cleveland Clinic Florida.
CLEVELAND CLINIC FLORIDA
SKIN CARE CENTER
Within its Aesthetic Surgery Center,
Cleveland Clinic Florida is offering a full
range of skin care and treatments—
including glycolic treatments, permanent
makeup and massage—to help
patients achieve and maintain healthy
and beautiful skin. The center also
offers airbrush tanning—the secret of
the celebrities. The process takes 10
minutes to apply and two minutes to dry,
and doesn’t cause wrinkles
or increase cancer risk.
For information or appointments, call
954-659-5401.
HELPING PEOPLE BEAT CANCER
If you have a family history of cancer,
Cleveland Clinic Florida’s cancer prevention
clinic can help you learn steps
to help prevent the disease. “We created
the hereditary cancer prevention clinic
to provide patients who have a personal
or family history of cancer with a complete
exam and risk assessment,” explains
Cleveland Clinic Florida gastroenterologist
Marcia Cruz-Correa,M.D., Ph.D.
The evaluation starts with a family
tree, or “pedigree,” where the clinic team
asks how many family members have
been diagnosed with cancer, what types of
cancer they’ve had and at what age. “Then
we can determine if there’s any pattern we
can identify,” Dr. Cruz-Correa says.
The clinic can also offer genetic
counseling, determining whether a genetic
test is available, what a positive
or negative result might mean, and
what the costs and insurance repercussions
might
be. If someone’s
cancer risk is
elevated, the clinic
team can recommend
dietary
changes and additionalscreening
tests such as
colonoscopy and
www.clevelandclinicflorida.org
Log on to find out more about the services at
Cleveland Clinic Florida Weston.
mammography to help locate any cancer
in its earliest stages. They can also
offer patients the opportunity to participate
in clinical studies.
To make an appointment, please call
1-877-463-2010.
SOME EMERGENCY ROOMS
CAN MAKE YOU FEEL BETTER
THAN OTHERS
Cleveland Clinic Hospital has the technology
to diagnose heart attacks in the
ambulance before you arrive at the hospital.
With a 24-hour cardiac catheterization
lab and a reputation for speed in
handling cardiac emergencies, choosing
Cleveland Clinic Hospital may be
the decision of a lifetime. You also can
take comfort in knowing that our cardiac
team has been recognized for their
achievements in the operating room,
and for the technology that helps
make those achievements possible. For
more information, or a referral to a
Cleveland Clinic Hospital physician, call
1-800-340-9926.•
Cleveland Clinic Hospital’s
Community Lecture Series
Join our specialists as they offer the latest information in medical
care on a variety of health topics. For a complete list of lectures,
visit us at www.clevelandclinicflorida.org or call 1-800-340-9926.
Lectures are held at 7 p.m. in the David G. Jagelman, M.D.,
Conference Center at 2950 Cleveland Clinic Blvd. in Weston.
WWW.CLEVELANDCLINICFLORIDA.ORG • HEALTHLINES • VOLUME 3, NO. 3 5

Conquering
Cancer
New Chemo Cocktail for
Battling Stomach Cancer
A new “chemo cocktail” treat- If you’d like to make an appointment
ment available at the Cleveland with a Cleveland Clinic Florida
Clinic Florida may extend the physician, call 1-877-463-2010.
lives of people with stomach cancer.
Cleveland Clinic Florida
oncologist Thomas Niederman, M.D., Ph.D., says the new treatment, a combination of
drugs used to treat stomach cancer, is “statistically significantly better
than the best chemotherapy available out there.” So far, doctors have treated 11 people
with the chemo cocktail, and 10 of them have seen their tumors shrink by
at least 50 percent.
In addition to the life-extending benefits, this treatment is generally tolerated better
than traditional chemotherapy treatments. It takes four to five hours once a week for two
weeks, with the third week off. “For the most part, people don’t lose much if any hair,
nausea is minimal and most people continue to work full time,” Dr. Niederman says.
For more information on this clinical trial, please call 954-659-5838.•
Map to Cleveland Clinic Weston Campus
11/03
Make an Appointment
Breast
Cancer Risk
Genetic Testing at
Cleveland Clinic Florida
Does your mother, sister or daughter
have breast cancer? Cleveland
Clinic Florida can help you
determine your risk for the disease.
“We like to start by testing someone
in the family who’s already had cancer,”
explains Elizabeth Stone, M.D., a
Cleveland Clinic Florida oncologist.
“If she tests positive, we can go back
and test the whole family.” Anyone who
tests negative in a family with an identified
mutation is at the same risk for
breast cancer as the general population.
A positive test would indicate increased
risk. Fortunately, there are
options to help high-risk women reduce
the likelihood that they will develop
the disease. More careful screening, possibly
including MRI, could catch cancer
at its earliest stages. Taking the drug
tamoxifen can cut risk by 40 percent, and
preventive mastectomy also reduces risk.
Screenings and treatment for breast
cancer are available at Cleveland Clinic
Florida Weston. Call 1-877-463-2010 to
make an appointment.•
Find out what’s new at Cleveland Clinic Florida
and Cleveland Clinic Hospital
Look for HealthLines news and health information on our Web site at
www.clevelandclinicflorida.org.
To make an appointment, call 1-877-463-2010
Cleveland Clinic’s HealthLines is a publication of the Marketing Department, providing up-to-date health information and news about our healthcare services. The
information contained in this publication is for educational purposes only and should not be relied upon as medical advice. It has not been designed to replace
a physician's medical assessment and medical judgment.
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