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NCH becomes first Mayo Clinic Care Network member in Florida.

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www.<strong>NCH</strong>md.org<br />

Health Matters<br />

The latest news on the health and wellness issues that matter most • September 2012<br />

<strong>NCH</strong> <strong>becomes</strong> <strong>first</strong><br />

<strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong> <strong>Care</strong> <strong>Network</strong><br />

<strong>member</strong> <strong>in</strong> <strong>Florida</strong>.<br />

Work<strong>in</strong>g together...the key to better healthcare.<br />

<strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong> and <strong>NCH</strong> Healthcare<br />

System officials today announced <strong>NCH</strong><br />

Healthcare System as a <strong>member</strong> of the<br />

<strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong> <strong>Care</strong> <strong>Network</strong>. <strong>NCH</strong>, based <strong>in</strong><br />

Naples, is the <strong>first</strong> <strong>member</strong> of the network<br />

<strong>in</strong> <strong>Florida</strong> and the Southeast region of the<br />

United States.<br />

The <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong> <strong>Care</strong> <strong>Network</strong><br />

extends <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong>’s knowledge and<br />

expertise to physicians and providers<br />

<strong>in</strong>terested <strong>in</strong> work<strong>in</strong>g together <strong>in</strong> the best<br />

<strong>in</strong>terest of their patients. <strong>NCH</strong>’s physicians<br />

will have access to <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong>, <strong>in</strong>clud<strong>in</strong>g<br />

the ability to collaborate with <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong><br />

physicians on patient care, community<br />

health and <strong>in</strong>novative health care delivery.<br />

“We’re excited to formalize our<br />

relationship with <strong>NCH</strong>,” says William C.<br />

Rupp, M.D., chief executive officer of<br />

<strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong> <strong>in</strong> <strong>Florida</strong>. “Collaborat<strong>in</strong>g with<br />

other medical providers to provide the<br />

best possible care for patients has always<br />

been part of <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong>’s culture, and the<br />

<strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong> <strong>Care</strong> <strong>Network</strong> helps <strong>Mayo</strong> and<br />

community care organizations work closer<br />

together, <strong>in</strong> new ways, to enhance the lives<br />

of patients.”<br />

“<strong>NCH</strong> is honored<br />

to be the <strong>first</strong> hospital<br />

<strong>in</strong> <strong>Florida</strong> selected to<br />

be a <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong> <strong>Care</strong><br />

<strong>Network</strong> <strong>member</strong>,” says<br />

Allen S. Weiss, M.D.,<br />

president and CEO,<br />

<strong>NCH</strong> Healthcare System.<br />

“Shar<strong>in</strong>g a common<br />

philosophy, commitment and mission to<br />

improve the delivery of health care through<br />

the use of best practices and evidence-based<br />

medical care and treatment provides a solid<br />

foundation for this collaboration.”<br />

The network’s primary goal is to<br />

help people ga<strong>in</strong> the benefits of <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong><br />

expertise close to home, ensur<strong>in</strong>g that patients<br />

travel outside the region only when necessary.<br />

“Through the <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong> <strong>Care</strong><br />

<strong>Network</strong>, <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong> is able to develop broader<br />

and stronger relationships with culturally likem<strong>in</strong>ded<br />

organizations,” says Stephen Lange,<br />

M.D., southeast medical director of the <strong>Mayo</strong><br />

<strong>Cl<strong>in</strong>ic</strong> <strong>Care</strong> <strong>Network</strong>. “By work<strong>in</strong>g together,<br />

shar<strong>in</strong>g our expertise, more people <strong>in</strong> more<br />

places can benefit from the specialty knowledge<br />

and expertise that are hallmarks of <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong>.<br />

We are delighted to welcome <strong>NCH</strong> as the<br />

<strong>first</strong> <strong>Florida</strong> location, and we look forward to<br />

work<strong>in</strong>g with them.”<br />

“We want Floridians to live longer,<br />

happier, healthier lives through access to the<br />

highest-level knowledge and expertise,” Dr.<br />

Weiss adds.<br />

The <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong> <strong>Care</strong> <strong>Network</strong><br />

represents non-ownership relationships.<br />

Members share a goal of improv<strong>in</strong>g the delivery<br />

of health care <strong>in</strong> their communities through highquality,<br />

collaborative medical care. Launched<br />

last year, the <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong> <strong>Care</strong> <strong>Network</strong> has<br />

<strong>member</strong>ship that extends to Arizona, <strong>Florida</strong>,<br />

Michigan, M<strong>in</strong>nesota, Missouri, New Hampshire<br />

and North Dakota.<br />

What does this<br />

mean for patients?<br />

<strong>NCH</strong> physicians will have access to<br />

the latest <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong> expertise and<br />

cl<strong>in</strong>ical care resources such as:<br />

• Ask<strong>Mayo</strong>Expert, a state-of-the-<br />

art onl<strong>in</strong>e tool that makes<br />

available <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong>’s<br />

knowledge <strong>in</strong> disease<br />

management, cl<strong>in</strong>ical<br />

care guidel<strong>in</strong>es, treatment<br />

recommendations & reference<br />

materials for a variety of<br />

medical conditions.<br />

• eConsults that connect <strong>NCH</strong><br />

physicians with <strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong><br />

experts when <strong>NCH</strong> physicians<br />

want additional <strong>in</strong>put regard<strong>in</strong>g<br />

a patient’s care.<br />

The primary goal of the <strong>Mayo</strong><br />

<strong>Cl<strong>in</strong>ic</strong> <strong>Care</strong> <strong>Network</strong> is to help more<br />

patients ga<strong>in</strong> the benefits of <strong>Mayo</strong><br />

<strong>Cl<strong>in</strong>ic</strong> knowledge and expertise<br />

close to home, ensur<strong>in</strong>g they need<br />

travel outside the region only when<br />

necessary.<br />

For <strong>in</strong>formation on <strong>NCH</strong> and the<br />

<strong>Mayo</strong> <strong>Cl<strong>in</strong>ic</strong> <strong>Care</strong> <strong>Network</strong>, visit<br />

www.<strong>NCH</strong>md.org


Orthopedic Treatment at Its Best<br />

By Jean Amodea<br />

Before Peter Miskech consulted an orthopedic specialist for a possible knee replacement,<br />

he did his homework.<br />

He researched the tra<strong>in</strong><strong>in</strong>g and experience of eight surgeons before choos<strong>in</strong>g H. Kurtis<br />

Biggs, DO, a fellowship-tra<strong>in</strong>ed, board-certified orthopedic surgeon and founder of the<br />

Jo<strong>in</strong>t Replacement Institute <strong>in</strong> Naples.<br />

“It was the process, system and methodology that sold me on Dr. Biggs. The design of<br />

the knee replacement was made with<strong>in</strong> one-half millimeter for precision fit, with virtually<br />

no room for error,” Miskech said. “Today, at eight weeks recovery, I am able to swim,<br />

bicycle, play tennis and golf, and I cont<strong>in</strong>ue to work hard to restore my knee to full mobility.”<br />

Dr. Biggs said that patients who are <strong>in</strong>formed, who know what questions to ask and<br />

who have realistic expectations will atta<strong>in</strong> the best outcomes.<br />

Dr. Henry Kurtis Biggs, DO exam<strong>in</strong>es patient Peter Miskech who underwent a full<br />

knee replacement procedure eight weeks ago, as V<strong>in</strong>cent Schaum, student physician’s<br />

assistant, observes.<br />

CARDIAC REHAB:<br />

An important part of<br />

<strong>NCH</strong> Cardiovascular<br />

Service By Kelly Merritt<br />

David Smith had open heart surgery <strong>in</strong> February. He left the hospital after<br />

one week to recover at home, but then was offered the chance to start cardiac<br />

rehab at four weeks post-op. He arrived as a heart surgery patient and left a<br />

changed man.<br />

“I did all 36 sessions and completed them on June 20. Right now I feel better<br />

than I ever have and I’ll be 81,” says Smith, who formed a close bond with the<br />

staff at <strong>NCH</strong> Cardiac Rehab located <strong>in</strong> the Briggs Health Pavilion.<br />

Smith says cardiac rehab gave him the confidence that he could push himself<br />

to get better.<br />

“Instead of sitt<strong>in</strong>g around and want<strong>in</strong>g to get better, I was put<br />

<strong>in</strong> a system that checked on me every moment I was there, and<br />

therefore I got better quicker,” he says. “Thank goodness my<br />

heart problem was caught before I had a heart attack; but<br />

the people at rehab are very car<strong>in</strong>g, thoughtful and knowledgeable,<br />

and they were there check<strong>in</strong>g every rehab assignment<br />

dur<strong>in</strong>g each session.”<br />

Exercise physiologist Ann Rosenquist says Smith’s<br />

success is the result of a team effort between Smith and<br />

the staff.<br />

“It takes time to establish habits, and while some need a<br />

longer program—typically the full 36 sessions—other people<br />

do less,” she says.<br />

For those like Miskech <strong>in</strong> need of patient-specific knee replacements, Dr. Biggs said<br />

cutt<strong>in</strong>g-edge computer navigation and <strong>in</strong>formation from the patient’s MRI enable him to<br />

custom design precision implants.<br />

Us<strong>in</strong>g the latest techniques, the patient is discharged after just 48 hours compared to<br />

traditional procedures which require a longer hospital stay.<br />

For those requir<strong>in</strong>g patient-specific partial knee resurfac<strong>in</strong>g, procedures are performed<br />

with the newest version of patient-specific implants and cutt<strong>in</strong>g jigs. Because this portion<br />

of the procedure is done before the surgery, this evolution has not only elim<strong>in</strong>ated the need<br />

for the robot-assisted technique but also has shortened the procedure, thereby reduc<strong>in</strong>g<br />

blood loss and lessen<strong>in</strong>g the risk of <strong>in</strong>fection.<br />

Another common procedure, hip replacement, is performed with a direct anterior approach<br />

technique that results <strong>in</strong> less trauma s<strong>in</strong>ce muscles are not cut.<br />

Different from traditional hip surgery, which has a back-entry approach, the surgeon<br />

can better estimate leg length and reduce the risk of dislocation after surgery. There is also<br />

less loss of blood and decreased scarr<strong>in</strong>g around the jo<strong>in</strong>t.<br />

The hospital stay is significantly shortened to 24 hours, and the recovery rate and return-to-function<br />

time are shortened to four- to six-weeks as compared to the eight- to<br />

12-week recovery period of traditional surgery.<br />

In addition to his expertise <strong>in</strong> the field of orthopedic implant surgery, Dr. Biggs said the<br />

hallmarks of his practice are his compassion, personal attention and ability to expla<strong>in</strong><br />

complex problems <strong>in</strong> a clear, upfront and simple manner.<br />

Dr. Biggs completed his fellowship at the Cleveland <strong>Cl<strong>in</strong>ic</strong> Foundation and was <strong>in</strong><br />

private practice <strong>in</strong> Massillon, Ohio for five years, perform<strong>in</strong>g more than 400 jo<strong>in</strong>t replacements<br />

each year.<br />

In 2008, he relocated to Naples with his wife and five children and opened the Jo<strong>in</strong>t<br />

Replacement Institute.<br />

Dr. Jamie Weaver, a podiatric surgeon, also works at the Jo<strong>in</strong>t Replacement Institute,<br />

which offers a complete range of services for orthopedic and podiatric care.<br />

For more <strong>in</strong>formation about<br />

the orthopedic unit and rehabilitation<br />

services, call (239) 436-5342.<br />

Sue Howl<strong>in</strong>--Darlene Hadley--Marianne Plamondon--Ann Rosenquist<br />

Marianne Plamondon, RN monitors blood pressure and other vital measures<br />

to ensure patients are ready for the rehab sessions.<br />

“We are look<strong>in</strong>g at the rhythm of the heart and blood pressure;<br />

and if the patient is a diabetic, we’re also look<strong>in</strong>g at blood sugar,”<br />

Plamondon says.<br />

Ultimately, cardiac rehab is a crucial part of recovery<br />

for heart patients—it can mean a major difference <strong>in</strong><br />

quality of life.<br />

“Now we are able to go on a trip for two months,”<br />

Smith says. “And I am very happy to have gone through<br />

cardiac rehab. I’m way past where I would have been<br />

without it. If you have a heart problem, that’s the place to<br />

go. They even conduct a cute little graduation ceremony<br />

when you f<strong>in</strong>ish. I hope to see them aga<strong>in</strong>—but <strong>in</strong> a leisurely<br />

fashion—no more heart problems for me.”


SAVING OUR TINIEST TREASURES:<br />

Expansion is on the Horizon for the <strong>NCH</strong><br />

Neonatal Intensive <strong>Care</strong> Unit<br />

By Kelly Merritt<br />

Take one look at the babies <strong>in</strong> the <strong>NCH</strong> neonatal<br />

<strong>in</strong>tensive care unit (NICU), and it’s not hard to see<br />

why the nurses and doctors call them little miracles.<br />

These t<strong>in</strong>y bundles of joy melt and break hearts at<br />

the same time, as caregivers facilitate their survival<br />

and family <strong>member</strong>s pray for it.<br />

But such small treasures require a lot of care and<br />

lifesav<strong>in</strong>g equipment. It’s worth every penny, but<br />

pennies pile up. That’s why multiple teams of people<br />

are com<strong>in</strong>g together to raise the money needed for a<br />

major expansion of the NICU at the <strong>NCH</strong> North<br />

Naples Hospital.<br />

The <strong>NCH</strong> Healthcare Foundation, the fundrais<strong>in</strong>g<br />

arm of the not-for-profit <strong>NCH</strong> Healthcare System,<br />

is lead<strong>in</strong>g the charge to raise enough money to<br />

<strong>in</strong>crease the square footage for more beds and purchase<br />

additional equipment.<br />

The goal is to literally double the size of the NICU<br />

Gayle Richmond attends to a baby <strong>in</strong> the NICU.<br />

from n<strong>in</strong>e to eighteen beds, as the current number of<br />

beds falls short of the average census on any given<br />

day. When there are no available NICU beds to care<br />

for a sick or premature baby, <strong>NCH</strong> must send the<br />

fragile newborn to other healthcare facilities, sometimes<br />

far from home, creat<strong>in</strong>g a difficult situation for<br />

the entire family.<br />

To help keep babies born at <strong>NCH</strong> near their families<br />

and close to home, the 54th annual Hospital Ball,<br />

to be held on October 27th at the Ritz-Carlton Beach<br />

Resort, will raise much needed money for the expansion.<br />

Each year, a special <strong>NCH</strong> department or program<br />

is the beneficiary of the Ball’s proceeds. On this<br />

special night, more than 600 guests will jo<strong>in</strong> together<br />

to show their support for the NICU.<br />

Another goal of the fundrais<strong>in</strong>g campaign is to raise<br />

dollars for Giraffe® Omnibeds. Actually, NICU Nurse<br />

Manager Cather<strong>in</strong>e Ravelo, BSN, RN would like six<br />

of them. The Unit currently has two.<br />

“Giraffe® neonatal Omnibeds are very special isolettes<br />

that properly position babies and provide a safe<br />

and protective heal<strong>in</strong>g environment that promotes<br />

developmental support. They also allow for quick and<br />

accurate assessment of weight <strong>in</strong> the bed, m<strong>in</strong>imiz<strong>in</strong>g<br />

unnecessary baby stimulation, and other specialized<br />

functions that result <strong>in</strong> better outcomes for the babies,”<br />

Ravelo said.<br />

These hardwork<strong>in</strong>g Omnibeds carry a hefty price<br />

tag, upwards of $45,000 each. “It’s an <strong>in</strong>vestment<br />

worth mak<strong>in</strong>g, and the <strong>NCH</strong> Foundation is turn<strong>in</strong>g<br />

to the community for help. Gifts, large and small,<br />

add up quickly and make a big impact on our ability<br />

to provide these special beds to the babies who need<br />

them most,” says Jim Mart<strong>in</strong>, Chief Development Officer<br />

for the <strong>NCH</strong> Healthcare Foundation.<br />

“The Hospital Ball is just the beg<strong>in</strong>n<strong>in</strong>g. The NICU<br />

expansion and its future success rely on the generosity<br />

of those who want to provide a healthier future for<br />

children <strong>in</strong> our community. It’s an ongo<strong>in</strong>g need,” says<br />

Mart<strong>in</strong>.<br />

Ravelo adds, “I firmly believe that Collier County<br />

deserves to have a family-centered facility. And these<br />

babies are not just a diagnosis--they become family.”<br />

For those who are <strong>in</strong>terested <strong>in</strong> support<strong>in</strong>g the lifesav<strong>in</strong>g<br />

work of the NICU, the <strong>NCH</strong> Foundation’s<br />

website www.nchmd.org/give is the best place to start.<br />

There, you can learn more about attend<strong>in</strong>g the Hospital<br />

Ball, mak<strong>in</strong>g a tax-deductible donation or help<strong>in</strong>g<br />

to fund a specific need by designat<strong>in</strong>g your gift towards<br />

the purchase of an item like a Giraffe® Omnibed.<br />

For questions, please call<br />

the <strong>NCH</strong> Healthcare Foundation<br />

at (239) 436-4511<br />

or visit<br />

www.nchmd.org/give


Gett<strong>in</strong>g Over the Goal L<strong>in</strong>e -<br />

Occupational therapist Ashley Johnson works with Kora Sizemore, aged 14 months, on reach<strong>in</strong>g, grasp<strong>in</strong>g and f<strong>in</strong>e motor skills.<br />

<strong>NCH</strong> Pediatric Therapy helps children push past developmental obstacles<br />

By Lance Shearer<br />

Understandably, new parents are overwhelmed when<br />

they learn their child is not reach<strong>in</strong>g certa<strong>in</strong> milestones<br />

or has been diagnosed with developmental delay. Developmental<br />

delays can range from mild to severe and can<br />

<strong>in</strong>clude challenges with crawl<strong>in</strong>g, walk<strong>in</strong>g, speak<strong>in</strong>g, and<br />

learn<strong>in</strong>g to name a few.<br />

Pediatric services of the <strong>NCH</strong> Outpatient Rehabilitation,<br />

located <strong>in</strong> the Green Tree Center, offers a full range<br />

of multi-discipl<strong>in</strong>ary therapy programs to help children<br />

overcome developmental challenges and other diagnoses.<br />

<strong>NCH</strong> pediatric physical, occupational, and speech therapists<br />

are car<strong>in</strong>g professionals who can make a difference <strong>in</strong><br />

your child’s future.<br />

Accord<strong>in</strong>g to pediatric physical therapist Beth Hardt,<br />

early <strong>in</strong>tervention through therapy is crucial. “We want parents<br />

to know developmental delays don’t have to mean their<br />

children will show delays throughout their lives,” she said.<br />

The American Academy of Pediatrics stresses the importance<br />

of start<strong>in</strong>g therapy early for the best outcome,<br />

and a child’s pediatrician is the key to identify<strong>in</strong>g and<br />

access<strong>in</strong>g the services pediatric therapists can provide.<br />

“If you have concerns, br<strong>in</strong>g them up with your pediatrician<br />

so he can make further assessments,” Hardt<br />

said. “It’s never too soon.”<br />

Ashley Johnson is a pediatric occupational therapist<br />

at <strong>NCH</strong> Outpatient Rehabilitation. A recent morn<strong>in</strong>g<br />

found her sitt<strong>in</strong>g <strong>in</strong> a playpen full of brightly colored<br />

balls, work<strong>in</strong>g with a young child, Kora Sizemore, <strong>in</strong><br />

ways that looked like playtime.<br />

“One of the occupations of children is play, so us<strong>in</strong>g<br />

play, we motivate children <strong>in</strong> order to help them reach<br />

their goals,” she said. “Therapy should be engag<strong>in</strong>g and<br />

fun. Occupational therapists work on improv<strong>in</strong>g f<strong>in</strong>e<br />

motor skills necessary for functional tasks <strong>in</strong>clud<strong>in</strong>g selffeed<strong>in</strong>g,<br />

dress<strong>in</strong>g, and tak<strong>in</strong>g care of one’s self.” Another<br />

important component of the service the pediatric therapist<br />

provides, Hardt said, is <strong>in</strong>volv<strong>in</strong>g the patient’s family<br />

<strong>member</strong>s <strong>in</strong>to their child’s therapy.<br />

“We want to educate the family <strong>member</strong>s so they can<br />

carry over the skills learned <strong>in</strong> therapy and <strong>in</strong>corporate<br />

them <strong>in</strong>to daily family life,” she said.<br />

“Success for me is see<strong>in</strong>g children meet their goals<br />

and achieve their milestones,” Johnson said.<br />

<strong>NCH</strong> offers multi-discipl<strong>in</strong>ary outpatient pediatric<br />

physical, speech, and occupational therapy at Green<br />

Tree Center and at the outpatient rehabilitation<br />

center <strong>in</strong> Immokalee.<br />

TELL YOUR CHILD WHY YOU ARE<br />

CONCERNED ABOUT BULLYING.<br />

• “It’s hard to know what to do if someone is pick<strong>in</strong>g<br />

on you. If you ever have a problem, we can figure<br />

out what to do together.”<br />

• “In our family, we believe that everyone deserves<br />

respect. When you say mean th<strong>in</strong>gs, don’t let other<br />

children play with you, or push and hit others, that’s<br />

not be<strong>in</strong>g respectful.”<br />

PLAY THE “WHAT IF” GAME WITH<br />

YOUR CHILD.<br />

“What would you do if:<br />

• you saw someone<br />

gett<strong>in</strong>g picked on?”<br />

• someone was<br />

spread<strong>in</strong>g mean<br />

rumors about you?”<br />

• you hurt someone’s<br />

feel<strong>in</strong>gs?”<br />

For more <strong>in</strong>formation<br />

on Pediatric<br />

Outpatient<br />

Rehabilitation<br />

Services,<br />

call<br />

(239) 436-6898.<br />

PREVENT BULLYING:<br />

Quick tips for parents<br />

LOOK FOR SIGNS OF BULLYING.<br />

Talk with your child about what’s go<strong>in</strong>g<br />

on at school. Your child might be be<strong>in</strong>g<br />

bullied if he or she:<br />

• Doesn’t want to go to school<br />

• Has cuts or bruises<br />

• Is act<strong>in</strong>g unhappy or depressed<br />

• Compla<strong>in</strong>s of headaches or stomachaches<br />

Your child might bully other children if<br />

he or she:<br />

• Enjoys teas<strong>in</strong>g other kids<br />

• Has a hard time controll<strong>in</strong>g anger<br />

• Is very rough or aggressive<br />

LEARN MORE ABOUT BULLYING.<br />

Talk to other parents and your child’s school<br />

to f<strong>in</strong>d out how they handle bully<strong>in</strong>g.<br />

• Ask about the school’s policies on bully<strong>in</strong>g.<br />

• Talk to your child’s teacher or school counselor<br />

if you th<strong>in</strong>k your child is <strong>in</strong>volved <strong>in</strong> bully<strong>in</strong>g.<br />

For more <strong>in</strong>fo about prevent<strong>in</strong>g bully<strong>in</strong>g, visit<br />

• http://www.stopbully<strong>in</strong>g.gov/parents/<strong>in</strong>dex.html<br />

• http://kidshealth.org/parent/emotions/behavior/<br />

bullies.html


Help Control Your Weight<br />

KEEP<br />

RECORDS<br />

OF WHAT<br />

YOU<br />

EAT!<br />

For more <strong>in</strong>formation call the<br />

von Arx Diabetes & Nutrition Health Center<br />

at 239-436-6755<br />

Dear Diary,<br />

Keep<strong>in</strong>g a record of what you eat can help control weight (whether you want to ga<strong>in</strong>, lose or<br />

ma<strong>in</strong>ta<strong>in</strong>), better manage blood pressure and help with glucose control.<br />

How? You’ll want to keep a record via the format that best fits your busy life. For some that<br />

might be via a Smart Phone or website, others a Word document and for some maybe even<br />

good old fashioned pen and paper.<br />

Record as you go While it may be more time consum<strong>in</strong>g, the s<strong>in</strong>gle best way to<br />

record is <strong>in</strong> “real time.” Sure, you have the best <strong>in</strong>tentions of record<strong>in</strong>g your <strong>in</strong>take “later tonight,”<br />

but most people just seem to forget what they’ve actually consumed.<br />

Its all <strong>in</strong> the details How detailed you get is up to you, but the more details you<br />

provide the better we can assist you. Estimate portion sizes (i.e. ½ cup, 1 fistful, etc.), <strong>in</strong>dicat<strong>in</strong>g<br />

mealtimes is also helpful. You can even note your mood before and after meals, (i.e. starv<strong>in</strong>g,<br />

bored, happy, etc.). The goal is to tell a tale without becom<strong>in</strong>g obsessive.<br />

Self review Ly<strong>in</strong>g on your food diary is like ly<strong>in</strong>g to yourself. S<strong>in</strong>ce you want the best<br />

feedback available, you’ll want to be as honest as possible. Before submitt<strong>in</strong>g your diary, you’ll<br />

want to do a self review. Take a look at your fruit and vegetable <strong>in</strong>take, are you gett<strong>in</strong>g enough<br />

whole gra<strong>in</strong> foods, how about water consumption. You might f<strong>in</strong>d some trouble spots to work on<br />

over the next few days.<br />

Based on a 2,000 calorie diet here’s the average amounts for your weekly menu:<br />

Food group<br />

Food GRAINS group (mostly from whole gra<strong>in</strong>s)<br />

GRAINS VEGETABLES (mostly from whole gra<strong>in</strong>s)<br />

Average<br />

6 Average ounces daily<br />

6 2.5 ounces cups daily<br />

This is what your plate should<br />

look like:<br />

VEGETABLES<br />

Vegetable subgroups (amount per week)<br />

2.5 cups daily<br />

Vegetable Dark green subgroups (amount per week) 1.5 cups per week<br />

Dark Red/Orange green 1.5 5.5 cups per week<br />

Red/Orange Starchy 5.5 5 cups cups per per week<br />

Starchy Beans and Peas 5 1.5 cups cups per per week week<br />

Beans Other Vegetables and Peas 1.5 4 cups cups per per week week<br />

Other FRUITS Vegetables 4 2 cups per daily week<br />

FRUITS DAIRY 2 3 cups daily<br />

DAIRY PROTEIN FOODS 3 5.5 cups oz daily<br />

PROTEIN Seafood FOODS 8 5.5 oz oz per daily week<br />

Seafood 8 oz per week<br />

What foods are <strong>in</strong> each group?<br />

FRUITS<br />

Any fruit or 100% fruit juice counts as part of the Fruit Group. Fruits may be fresh, canned, frozen, or dried, and may be whole, cutup,<br />

or pureed.<br />

VEGETABLES<br />

Any vegetable or 100% vegetable juice counts as a <strong>member</strong> of the Vegetable Group. Vegetables may be raw or cooked; fresh, frozen,<br />

canned, or dried/dehydrated; and may be whole, cut-up, or mashed.<br />

GRAINS<br />

Any food made from wheat, rice, oats, cornmeal, barley or another cereal gra<strong>in</strong> is a gra<strong>in</strong> product. Bread, pasta, oatmeal, breakfast<br />

cereals, tortillas, and grits are examples of gra<strong>in</strong> products.<br />

Gra<strong>in</strong>s are divided <strong>in</strong>to 2 subgroups, Whole Gra<strong>in</strong>s and Ref<strong>in</strong>ed Gra<strong>in</strong>s.<br />

Whole gra<strong>in</strong>s conta<strong>in</strong> the entire gra<strong>in</strong> kernel - the bran, germ, and endosperm.<br />

Examples <strong>in</strong>clude:<br />

whole-wheat flour bulgur (cracked wheat) oatmeal whole cornmeal brown rice<br />

Ref<strong>in</strong>ed gra<strong>in</strong>s have been milled, a process that removes the bran and germ. This is done to give gra<strong>in</strong>s a f<strong>in</strong>er texture and improve<br />

their shelf life, but it also removes dietary fiber, iron, and many B vitam<strong>in</strong>s.<br />

Examples of ref<strong>in</strong>ed gra<strong>in</strong> products are:<br />

white flour de-germed cornmeal white bread white rice<br />

Most ref<strong>in</strong>ed gra<strong>in</strong>s are enriched. This means certa<strong>in</strong> B vitam<strong>in</strong>s (thiam<strong>in</strong>, riboflav<strong>in</strong>, niac<strong>in</strong>, folic acid) and iron are added back after<br />

process<strong>in</strong>g. Fiber is not added back to enriched gra<strong>in</strong>s. Check the <strong>in</strong>gredient list on ref<strong>in</strong>ed gra<strong>in</strong> products to make sure that the word<br />

“enriched” is <strong>in</strong>cluded <strong>in</strong> the gra<strong>in</strong> name. Some food products are made from mixtures of whole gra<strong>in</strong>s and ref<strong>in</strong>ed gra<strong>in</strong>s.<br />

PROTEIN<br />

All foods made from meat, poultry, seafood, beans and peas, eggs, processed soy products, nuts, and seeds are considered part of<br />

the Prote<strong>in</strong> Foods Group. Beans and peas are also part of the Vegetable Group. For more <strong>in</strong>formation on beans and peas, see ChooseMyPlate.gov<br />

Select a variety of prote<strong>in</strong> foods to improve nutrient <strong>in</strong>take and health benefits, <strong>in</strong>clud<strong>in</strong>g at least 8 ounces of cooked seafood per week.<br />

Young children need less, depend<strong>in</strong>g on their age and calorie needs. The advice to consume seafood does not apply to vegetarians.<br />

Vegetarian options <strong>in</strong> the Prote<strong>in</strong> Foods Group <strong>in</strong>clude beans and peas, processed soy products, and nuts and seeds. Meat and poultry<br />

choices should be lean or low-fat.<br />

DAIRY<br />

All fluid milk products and many foods made from milk are considered part of this food group. Most Dairy Group choices should be<br />

fat-free or low-fat. Foods made from milk that reta<strong>in</strong> their calcium content are part of the group. Foods made from milk that have little to<br />

no calcium, such as cream cheese, cream, and butter, are not. Calcium-fortified soymilk (soy beverage) is also part of the Dairy Group<br />

FROM CHOOSEMYPLATE.GOV


<strong>NCH</strong> and the <strong>NCH</strong> Healthcare Group<br />

Cardiology -<br />

Naples Heart Institute<br />

David Axl<strong>in</strong>e, MD, FACC<br />

Francis C. Boucek, MD, FACC<br />

Michael S. Flynn, MD, FACC, FSCAI<br />

Adam J. Frank, MD, FACC<br />

Bruce A. Gel<strong>in</strong>as, MD, FACC<br />

Ronald L. Lev<strong>in</strong>e, MD, MS, FACC<br />

Tracey Roth, MD, FACC<br />

Carlo Santos-Ocampo, MD, FACC<br />

Herman Spilker, MD, FACC<br />

David A. Stone, MD, FACC<br />

Silvio C. Travalia, MD, FACC<br />

Shona Velamakanni, MD, FACC<br />

James Venable III, MD, FACC<br />

L<strong>in</strong>da Cifani, ARNP<br />

Susan Gill, PA-C<br />

Daniel M. Moore, PA-C<br />

Michelle Br<strong>in</strong>k, ARNP<br />

Matthew Palicka, ARNP<br />

Family Medic<strong>in</strong>e<br />

Cynthia S. Bell, MD<br />

Andrew M. Bernste<strong>in</strong>, DO<br />

Christian O. Beskow, MD<br />

Jennifer A. DiRocco, DO<br />

Richard S. Gould, MD<br />

Robert E. Hanson, MD<br />

Jesse H. Haven, MD<br />

Mark E. Josephson, MD<br />

Ashley L. Tunkle, MD, FAAFP<br />

Angela B. Beckwith, PA-C<br />

Jennifer Canfield, ARNP-BC, MSN<br />

Jill M. Hefti, ARNP<br />

Kearston Perfetto, ARNP<br />

Gastroenterology &<br />

Hepatology<br />

Jan M. Barrios, MD<br />

Guy R. W<strong>in</strong>zenried, MD<br />

Beth Diamond, ARNP<br />

Directory of ServiceS<br />

Geriatric Medic<strong>in</strong>e<br />

Angel H. Herrera, MD<br />

Obayedur R. Khan, MD, FACP, CMD<br />

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Hospital Medic<strong>in</strong>e<br />

Manuel Batlle, MD<br />

Carlos B. Qu<strong>in</strong>tero, MD<br />

Vladimira “Vladi” Valova, ARNP<br />

Infectious Diseases<br />

Gary A. Bergen, MD, FACP<br />

Vato Bochorishvili, MD<br />

Mark A. Brown, MD<br />

Internal Medic<strong>in</strong>e<br />

George T. Crabb, DO, FACOI<br />

Mark R. Goldste<strong>in</strong>, MD, FACP<br />

Karen Henrichsen, DO<br />

Fritz F. Lemo<strong>in</strong>e Jr., MD<br />

Mary Ann M. LoMonaco, MD<br />

Gary A. Parsons, MD<br />

David I. Sommerfeld, MD<br />

David C. White, MD, FACP<br />

Doreen Cassar<strong>in</strong>o, ARNP<br />

Kelly Fennemore, ARNP<br />

Melanie Makar, ARNP<br />

Victoria Wadsworth, ARNP<br />

Orthopedic Surgery<br />

Jon S. Dounchis, MD<br />

Howard J. Kapp, MD<br />

Erik Benson, PA<br />

Gerard Fischer, PA<br />

Pediatrics<br />

Reisha F. Brown, MD, FAAP<br />

Dulce V. Dudley, MD, FAAP<br />

Andrew P. Podos, MD, FAAP<br />

Gloria Ribas-Shultz, MD, FAAP<br />

Debra G. Shepard, MD, FAAP<br />

Todd Vedder, MD, FAAP<br />

Physical Medic<strong>in</strong>e &<br />

Rehabilitation<br />

E. Sean Kelley, MD<br />

David Pitts, MD<br />

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Psychiatry<br />

Damian McGovern, MD<br />

Samuel P<strong>in</strong>osky, MD<br />

Thomas Sokol, ARNP<br />

Pulmonary, Critical <strong>Care</strong> &<br />

Sleep Medic<strong>in</strong>e<br />

Lawrence H. Albert, MD, FCCP<br />

Kenneth Bookman, MD, FCCP<br />

Howard L. Cohen, MD, FCCP<br />

Douglas Harr<strong>in</strong>gton, MD, FCCP<br />

David H. L<strong>in</strong>dner, DO, FCCP<br />

Ismael Mart<strong>in</strong>, DO, FCCP<br />

Christopher A. Mendello, MD, FCCP<br />

Bruce G. Roy, MD, FCCP, DASM<br />

Maria Ciferni, DNP, ACNP-BC<br />

AnnMarie Morisseau, ARNP<br />

Pamela Sans, ARNP<br />

Radiology<br />

Adam Fueredi, MD, FACR<br />

Daniel V. Tufariello, MD<br />

Stephen V. Veigh, DO<br />

Rheumatology<br />

Eric J. Hochman, MD<br />

Jay Bombero, PA<br />

Urgent <strong>Care</strong><br />

Karl Korri, MD<br />

Steven A. West, MD, FACEP<br />

Barbara Hulser, PA<br />

Michael Tanner, PA<br />

For an<br />

appo<strong>in</strong>tment<br />

with an<br />

<strong>NCH</strong><br />

Healthcare<br />

Group<br />

physician<br />

please call<br />

(239)436-2855.<br />

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<strong>NCH</strong> Downtown Naples<br />

Hospital Campus<br />

<strong>NCH</strong> Downtown Naples Hospital: 436-5000<br />

Breast Health Navigator: 593-4204<br />

Bus<strong>in</strong>ess/Occupational Health: 436-6033<br />

Community Blood Center: 436-5455<br />

Dr. John N. Briggs Wellness Center: 436-6770<br />

Naples Diagnostic Imag<strong>in</strong>g Center: 593-4200<br />

Naples Heart Institute: 436-5634<br />

Outpatient Infusion Services: 436-5460<br />

Outpatient Rehabilitation Center: 436-6712<br />

Physician Referral / Access Healthl<strong>in</strong>e: 436-5430<br />

vonArx Diabetes & Nutrition Health Center: 436-6755<br />

<strong>NCH</strong> North Naples<br />

Hospital Campus<br />

<strong>NCH</strong> North Naples Hospital: 552-7000<br />

The BirthPlace: 552-7724<br />

Naples Diagnostic Imag<strong>in</strong>g Center: 593-4200<br />

<strong>NCH</strong> Wound Heal<strong>in</strong>g Center: 596-8814<br />

Outpatient Infusion Services: 552-7747<br />

The Brookdale Center for Healthy<br />

Ag<strong>in</strong>g & Rehabilitation: 552-7222<br />

<strong>NCH</strong> Marco Island Campus<br />

Marco Healthcare Center: 394-8234<br />

Naples Diagnostic Imag<strong>in</strong>g Center: 593-4200<br />

Outpatient Rehabilitation Center: 393-4079<br />

Naples Diagnostic Imag<strong>in</strong>g Center: 593-4200<br />

<strong>NCH</strong> Wound Heal<strong>in</strong>g Center: 403-2600<br />

<strong>NCH</strong> Central Campus: 513-7144<br />

White Elephant Thrift Store: 513-7111<br />

Outpatient Rehabilitation Center: 596-0834<br />

Whitaker Wellness Center: 596-9200<br />

Outpatient Rehabilitation Center: 657-2228<br />

Community Blood Center: 495-1138<br />

Outpatient Rehabilitation Center: 947-4440<br />

<strong>NCH</strong> Wound Heal<strong>in</strong>g Center: 495-4995<br />

<strong>NCH</strong> Healthcare Group Vanderbilt Urgent <strong>Care</strong> Center: 596-9482<br />

<strong>NCH</strong> Healthcare Group Edison Family Medic<strong>in</strong>e: 403-6350<br />

For <strong>in</strong>formation on any of the<br />

<strong>NCH</strong> Healthcare System services,<br />

please call 436-5430 or visit us onl<strong>in</strong>e<br />

at www.<strong>NCH</strong>md.org.<br />

Bonita Spr<strong>in</strong>gs<br />

1<br />

41<br />

9<br />

8<br />

Goodlette-Frank Rd.<br />

Gulf of Mexico<br />

2<br />

5<br />

6<br />

Airport Pull<strong>in</strong>g Rd.<br />

75<br />

Alico Rd.<br />

846<br />

Davis Blvd.<br />

4<br />

Corkscrew Rd.<br />

Bonita Beach Rd.<br />

Immokalee Rd.<br />

P<strong>in</strong>e Ridge Rd.<br />

Golden Gate Pkwy.<br />

3<br />

846<br />

29<br />

Marco Island<br />

951<br />

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846<br />

Naples 75<br />

41<br />

29<br />

7<br />

Immokalee<br />

Vanderbilt Beach Rd.<br />

The <strong>NCH</strong> Health Matters is a bi-monthly publication of the <strong>NCH</strong> Healthcare System. Every effort is made to ensure <strong>in</strong>formation<br />

published is accurate and current. <strong>NCH</strong> cannot be held responsible for any consequences result<strong>in</strong>g from omissions or errors.<br />

<strong>NCH</strong> Healthcare System, 350 7th Street North, Naples, FL 34102, Telephone: (239) 436-5000, www.nchmd.org<br />

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5 star rated for cardiology<br />

Naples Heart Institute is a<br />

center of excellence for stateof-the-art<br />

cardiovascular<br />

care <strong>in</strong>clud<strong>in</strong>g the nationally<br />

recognized Code Save-<br />

A-Heart program. NHI<br />

physicians specialize <strong>in</strong> the<br />

management of chest pa<strong>in</strong>,<br />

heart attacks, coronary<br />

artery disease, heart valve<br />

disease, congestive heart<br />

failure, palpitations, atrial<br />

fibrillation, and peripheral<br />

vascular disease. Offices <strong>in</strong><br />

Naples & Bonita Spr<strong>in</strong>gs.<br />

For more <strong>in</strong>formation or to<br />

make an appo<strong>in</strong>tment, call<br />

436-5634.<br />

*by HealthGrades 2012<br />

10 years <strong>in</strong> a row.<br />

*<br />

David Axl<strong>in</strong>e, MD Francis Boucek, MD Michael Flynn, MD Adam Frank, MD Bruce Gel<strong>in</strong>as, MD<br />

www.<strong>NCH</strong>md.org/NHI<br />

Ronald Lev<strong>in</strong>e, MD Tracey Roth, MD<br />

Carlo Santos-Ocampo, MD Herman Spilker, MD David Stone, MD<br />

Silvio Travalia, MD Shona Velamakanni, MD James Venable, MD

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