pilates - private health news

Girlfriend’s club tees off

road to fitnessIn this issue

PilatesNot just for weight loss

page 13

Time ouT for

sPrinG 2013

To the women in our community,

Welcome to our first edition of 2013!

We are excited to see so many things come to fruition after the opening of the Patricia R. Guer-rieri Pavilion, the final phase of the Dorothy Mangurian Comprehensive Women’s Center (more on pages 14 and 15). The Art Gallery debuted in December with an exhibition by Wilma Bulkin Siegel, MD, (more on page 11), local groups have been utilizing the fantastic community education rooms, and our café is up and running!

Fundraising for the Center is also back in full swing with Women Owning Wellness (WOW!). Their most recent event, “Think Pink Basketball,” has partnered the Center with Miami Heat basketball star Mario Chalmers (more on page 8).

WOW! is also providing much-needed volunteers for our Women’s Center. If you are interested in volun-teering at the Center and joining WOW!, please call 954-229-8562.

In this issue, you’ll also read more about:

✓The road to fitness (page 3). ✓The Girlfriend’s Club Golf Clinic (page 4). ✓The Holy Cross Hospital Golf Classic (page 5). ✓Stereotactic breast biopsies (page 6). ✓Women: Three O’s to watch out for (page 7). ✓The Holy Cross Hospital Auxilia-ry’s Epicurean Escapade (page 8). ✓Electrical disorders in the heart (page 9). ✓Fibromyalgia (page 10). ✓Celiac disease (page 12). ✓Pilates-based physical therapy (page 13).Please stop by the café at the

Patricia R. Guerrieri Pavilion and let us know what you think!

Warmly,Patrick Taylor, MD Doreen Koenig

From the CEO

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5

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Girlfriend’s Club third annual Golf Clinic

Holy Cross Hospital Golf Classic was a huge success

Bring your heart back to its regular beat

Women’s health: Complete care in one place

doreen Koenig, dorothy Mangurian comprehensive Women’s center community leadership chair

Patrick taylor, Md, Holy cross Hospital President and ceo

Time ouT for Women is published as a com-munity service for the friends and patrons of:Holy Cross Hospital4725 north federal Highwayfort Lauderdale, fL 33308

Patrick Taylor, mD, President and CeoLuisa Gutman, Vice President and

Chief operating officerChristine moncrieffe, Director,

marketing and Public relationsCarmina Zamora, editor

SPRING 2013

information in Time ouT for Women comes from a wide range of medical experts. if you have any concerns or questions about specific content that may affect your health, please contact your healthcare provider. models may be used in photos and illustrations.

Copyright © 2013Coffey Communications, inc.Cum29233

T i m e o u T f o r

Time Out for Women2

In this issue

By Nelly M. Drevet, NSCA-cpt, Personal Trainer, Holy Cross Zachariah Family Wellness Pavilion

As A personAl trAiner, I repeatedly hear people (in the street, at the gym, my clients) saying, “I used to be fit,” “I used to be an athlete,” or “I used to eat healthy.” Most of the time, I get the same ques-tion: “How do I get my health back?”

Being proactive is the best way to reach your goals and change the way you see yourself. My Fitness Result Triangle consists of simple steps that will lead you to your better self.

The Fitness Result Triangle combines three factors that work together to get the job done. Simple changes in your lifestyle hit the jackpot of getting your health and well-being back! 1. Be active.2. Eat healthy.3. Keep it up.

be activeEngage in physical activity—

cardiovascular, strength training and stretching—every day for 30 minutes with a moderate load.

Cardiovascular exercise will train the heart by:

✓ Improving your stamina. ✓ Improving your VO2 max (your maximum oxygen consumption). ✓Lowering your resting heart rate.At the same time, cardio exercise

will lower your body fat percentage (25 percent is considered healthy) and drop your clothing size.

Strength training (also known as resistance and functional training) will:

✓ Improve your lean body mass (LBM). ✓ Increase your basal metabolic rate, allowing you to burn more calories at rest. ✓ Increase your strength by building

muscle so that you can lift more and shape your body to look good. ✓ Improve your bone structure (bone mineral density—BMD) to prevent the formation of osteoporosis. ✓ Improve your motor skills, agility and hand-eye coordination in your favorite sports, like golf, tennis and kayaking.Stretching will improve: ✓Your flexibility—your body will be more limber and less prone to injury. ✓Your state of mind—when you relax your body structure, it’s easier to rest your mind.

eat healthyEat a variety of nutritious foods

and drink water to obtain the proper nutrients and energy. Good nutrition will improve your overall well-being. Consume foods that contain nutri-ents such as protein, carbohydrates and fat (calorie-dense foods versus empty calories).

Vitamin and mineral supplements can help, but food is the best source.

Keep it upThe key to success is consistency.

Healthy habits are created and main-tained by incorporating them into your lifestyle. ❧

the best way to train safely and effectively is to hire a personal

trainer, a specialist who will design a program to fit your needs. to begin your journey to fitness, make an appointment with nelly drevet by calling the Zachariah family Wellness Pavilion at 954-229-7950.

The road to

nelly M. drevet, nsca-cpt. Personal trainer Zachariah family Wellness Pavilion

fitnessWellness

3www.holy-cross.com

Time out for Women

Pictured:1. a golf lesson 2. from left, doreen Koenig, terry skuse and sheri Whittington3. Girlfriends were shuttled to their golf lesson.4. Girlfriends enjoyed lunch after the golf lesson.5. Girlfriends group photo6. refreshments and chocolate-covered strawberries delighted golfers on the course.

on thursdAy, Jan. 24, Coral Ridge Country Club hosted more than 30 Holy Cross Hospital Girlfriends and their friends for golf, lunch and laughter. The third annual event included a golf

lesson from Dolph Roder on the green and a delicious meal by Chef Udo. The entire day was gener-ously sponsored by Coral Ridge Country Club.

The Club also hosted the Harry T. Mangurian, Jr. Founda-tion Holy Cross Hospital Golf Classic, sponsored by Stiles, on Feb. 6. The Golf Classic benefited the Dorothy Mangurian Comprehen-sive Women’s Center at Holy Cross HealthPlex. ❧

Girlfriends

for third annual

Golf Clinic

2

4

3

6

1

5

Community giving

Time Out for Women4 Time out for Women

Holy Cross news

Celebrating a great day

on the green

from left, Gordon latz, sheri Whittington, doreen Koenig and steve Mehallis

from left, steve Mehallis, Gordon latz and Phil smith

from left, Kenny stiles, Jorj Morgan, and diana and stephen shelton

Marti Huizenga

Joyce Picou and Marge neily

It takes a team…Co-chairing the Holy Cross Golf Classic with Doreen Koenig was Sheri Whittington. Along with Monica Maroone, they spearheaded the Community Leadership Committee for the Dorothy Mangurian Compre-hensive Women’s Center. Committee members are Lou Anderson, John Caras, Jack Drury, Scott Fox, Susan Holden, Gordon Latz, Lynn Mandev-ille, Steve Mehallis, Natalie Panajotov, Nancy Reierson, Mary Lou Ruderman, J. J. Sehlke and Phil Smith.

In addition to the Harry T. Mangu-rian, Jr. Foundation and Stiles Corporation, sponsors of the Holy Cross Golf Classic included Goldman Sachs, Phil Smith, and Sheri and Don Whittington.

Phyllis thomas

2013 Holy cross Golf classic raises More tHan $100,000 for tHe dorotHy ManGurian coMPreHensive WoMen’s center

the third annual Holy Cross Hospital Golf Classic was once again successful in raising more than $100,000 for the Dorothy Mangurian Comprehensive Women’s Center at Holy Cross HealthPlex.

Presented by the Harry T. Mangu-rian, Jr. Foundation and title sponsor Stiles Corporation, the Golf Classic was held at Coral Ridge Country Club on Feb. 6. Although no one drove away with one of the four hole-in-one opportunities to win a car from Phil Smith Automotive Group, there were prizes awarded in several categories:

✓Taking first place gross were Don Whittington, Jeff Walker, David Obst and John O’Brien. ✓Taking first place net were John F. Shaw, John S. Shaw, Chris Shaw and Nick Adams. ✓Making up the second place gross were Doreen and Keith Koenig, Ryan Cronin and Dale Hendricks. ✓ Second place net went to Cathy O’Connor, Corey Henry, Lou Calisanti and Nettie Turbyfill. The cocktail reception and dinner

following the tournament were the

perfect way for golfers to finish the day and for nongolfers to support the Women’s Center. Live music was provided by the Jimmy Cavallo Combo, and a spectacular buffet was provided by Chef Udo. Guests also had the opportunity to bid on silent auction items and were treated to renowned auctioneer Gordon Latz’s live auction as well.

“The Holy Cross Golf Classic is always a fantastic event for the Women’s Center,” says Doreen Koenig, Co-chair of the tournament. “It is not just a day of golf but golf on a mission for women’s health-care in our community. We are most grateful for our wonderful committee, generous sponsors, and those organizations and individuals who donated to our silent and live auctions.” ❧

www.holy-cross.com 55

Breast health

a

Meet our radiologists

amisha agarwal, Md diagnostic radiology

Hugh G. Jones, Md diagnostic radiology

Howard a. rubinson, Md diagnostic radiology

By Howard A. Rubinson, MD, Diagnostic Radiology, Dorothy Mangurian Comprehensive Women’s Center

the vAst mAjority of women who undergo a screening mammogram have a normal study and return in 6 to 12 months for follow-up. Only 2 percent are usually referred for a biopsy.

Prior to the early 1990s, all biopsies were performed in surgery, removing the part of the breast that contained the abnormality. Surgery could lead to diminished breast size and scar-ring, with the scarring sometimes simulating signs of a malignancy. This then made it more difficult to interpret future mammograms.

things have gotten easierOver the past 20 years, procedures have

changed, and now only a small number of women have surgical biopsies. Stereotactic biopsies (using mammographic guidance), ultrasound-guided biopsies and MRI-guided biopsies—collectively called image-guided biopsies—have replaced surgical biopsies. The newer methods have proven to be just as accu-rate but less disfiguring and less costly.

These procedures are all performed at the Dorothy Mangurian Comprehensive Women’s Center at Holy Cross HealthPlex and at Holy Cross Hospital. All of these procedures are accredited by the American College of Radiology (ACR), and very few centers have achieved this accreditation.

The ACR rigorously evaluates the equip-ment, technical personnel and physicians before granting accreditation. The ACR recommends that the biopsies be done at accredited centers and that the mammograms and ultrasounds leading up to the diagnoses be performed at accredited centers as well.

What is the best kind of biopsy?The type of biopsy a patient needs is usually

the choice of the radiologist and depends on which modality best displays the abnormality. The three types of image-guided biopsies are technically similar:

✓They are done under local anesthesia. ✓The biopsy needles are similar.All three procedures are extremely accurate—

we have successfully removed cancers as small as 2 millimeters with the stereotactic biopsy. And the biopsies result in few complications. Some women develop hematomas, and fewer than 1 out of 1,000 develop an infection.

The good news is that the majority of the biopsies prove to be negative. In large part because of annual screening, of those biopsies that are positive, most are either noninvasive or stage 1 cancer—the earliest stage, with the best prognosis. ❧

The evolving worldof breast biopsies

to schedule an appointment for women’s imaging with the acr-accred-

ited dorothy Mangurian comprehensive Women’s center, call 954-351-7800 or visit www.HolycrossWomenscenter.com.

6 Time Out for WomenTime out for Women

By Fernando Manalac, MD, MMM, Sports Medicine Specialist, Holy Cross Orthopedic Institute

jenny is a mom whose morning routine includes biking or walking for 30 minutes, ironing uniforms and packing lunches for her children, and getting dressed while nudging her husband to get up so that she can make the bed.

She works at a packaging company where she does her fair share of lifting heavy boxes while hoping to get through the day pain-free. For years Jenny has endured osteoarthritis, osteoporosis and overuse injuries.

osteoarthritisJenny wears a medial unloading

brace on her left knee, takes several pills daily, and has undergone multiple knee images and injections.

the problem. Osteoarthritis is “wear and tear” degradation of a joint. It commonly affects the larger, weight-bearing joints, such as the hip and knee; however, it can affect medium and small joints of the upper and lower extremities as well.

prevention. Maintaining a healthy weight, well-cushioned shoes and doing non-weight-bearing exercises

are mainstays of prevention.

treatment. Specific muscle strengthening, bracing, orthotics,

Osteoarthritis, osteoporosis,

overuse injuries

Women: Three O’s to watch out for

fernando J. Manalac, Md, MMM

Holy Cross Orthopedic

Institute5597 N. Dixie Highway

Fort Lauderdale, FL 33334

954-958-4800

cortisone injections, joint conservation and joint replacement surgeries are just some of the common treatments.

osteoporosisBeing in her late 40s, Jenny has

gone through menopause, and the decrease in estrogen likely has facili-tated progression to osteoporosis.

the problem. Osteoporosis, literally meaning porous bones, is a disease that affects two to three times more women than men. It’s a condition in which bones lose calcium content, thereby becoming more apt to fracture.

prevention. Some ways to help prevent osteoporosis are eating a diet rich in vitamin D and calcium, engaging in weight-bearing exercises, and consuming only a moderate amount of alcohol.

treatment. Treatment with medi-cations includes, but is not limited to, vitamin D and calcium supplements, selective estrogen receptor modu-lators, and hormone replacement

therapy. Once a fracture is diagnosed, it can be treated by vertebroplasty and kyphoplasty, which are minimally invasive procedures.

overuse injuriesJenny also has

overuse elbow injuries.the problem.

Overuse injuries are the result of repetitive stress

to the tendons, bones and joints. Whether resulting

from working at a packaging company, repeatedly picking up a

toddler, or cleaning the floor in the home daily, overuse injury is likely to occur at some point in life. Normal daily movements can cause medial or lateral epicondylitis (of the elbow), rotator cuff tendinitis (of the shoulder), De Quervain’s tenosynovitis (of the wrist), patellar tendinitis (of the knee) or Achilles tendinitis (of the ankle).

prevention. Overuse can be prevented with proper warm-up and cool-down activities, allowing the body to rest and recover. Simply listening to your body is important.

treatment. Treatment can include anti-inflammatory medications, activity modification, bracing, phys-ical therapy and Platelet Rich Plasma (PrP) injections, to name a few.

control these problemsOsteoarthritis, osteoporosis and

overuse injuries are conditions that women face daily. But these condi-tions should not keep them from enjoying life. There is a common denominator in controlling these problems—healthy eating and healthy living. If symptoms arise, seek medical attention early. ❧

SourceSwww.sportsmed.org/uploadedfiles/Content/Patient/Sports_

Tips/ST%20overuse%20injuries%2008.pdfwww.medscape.com/viewarticle/777867http://emedicine.medscape.com/

article/330598-treatment#aw2aab6b6b2http://emedicine.medscape.com/article/330598-overviewwww.nof.org/learn/prevention

Prevention

a


the mArio ChAlmers FoundAtion chose the Dorothy Mangurian Comprehensive Women’s Center to benefit from its fund-raising event, “Think Pink Basketball.” The event was held at Specialty Automotive Treatments in Fort Lauderdale on Saturday, March 9.

The Mario Chalmers Foundation focuses on helping women with breast cancer and offers low-cost accessories, like wigs, cosmetics, bras and even prostheses, through Mario’s Closet.

Though he will always be remembered for making the miracle three-point shot that propelled the University of Kansas Jayhawks to the national title in 2008, the Miami Heat guard is now reaching beyond basketball.

Chalmers says he always wanted to learn more about cancer after his childhood friend lost his mother to breast cancer.

“I try to do my best on the basketball court so people will remember me,” says Chalmers. “But off the court, I try to do as much as I can, and it is important to help out the people who are struggling with cancer.”

Proceeds from the event will be shared by the Dorothy Mangu-rian Comprehensive Women’s Center at Holy Cross HealthPlex and the Mario Chalmers Foundation. ❧

Fundraisers

join the holy Cross hospitAl Auxiliary for their annual fundraiser on Saturday, April 13, at the Hyatt Pier 66. “Epicurean Escapade: A Food and Wine Experience” will provide guests with excellent food, wine, an open bar, live music and more. The event will benefit the Dorothy Mangurian Comprehen-sive Women’s Center at Holy Cross HealthPlex.

The evening will begin with a poolside cocktail party and live music. As part of the fun, guests will have a chance to bid on over-the-top

wine bottles. There will be a raffle for a VIP table where waiters will be at the winners’ service and the food and bever-ages will be unlimited.

After cocktails, the party will move to the Crystal Ballroom where deli-cious food and wine pairings will be featured. Dancing to the music of the Jerry Wayne Band will be a highlight of the evening. The Auxiliary is prom-

ising a truly spectac-ular night for its 400 expected guests.

Sponsors for the event include the Guerrieri Family Foundation, JM Family Enterprises, the Medical Staff of Holy Cross Hospital, AutoNa-tion, Sodexo, Nova Southeastern University, BDC Advisors, Catholic

Health Services and City Furniture. Several sponsorship opportunities are still available. ❧

if you’d like to attend or support the event or if you

need additional information, please call 954-229-8562 or email [email protected].

Embark on an Epicurean EscapadetHe Holy cross auxiliary annual fundraiser Will be a food and Wine exPerience

Think Pink BasketballWoMen’s center benefits froM MiaMi Heat’s Mario cHalMers fundraiser

8 Time out for Women

Heart health

daniel Weitz, Md clinical cardiac electrophysiology Holy cross Medical Group

Electrical disorders of the heartBy Daniel Weitz, MD, Clinical Cardiac Electrophysiologist, Holy Cross Medical Group

hAve you been told that you have difficult-to-control rapid heart rates? Do you experi-ence palpitations or light-headedness?

These symptoms all might be from a heart arrhythmia. There have been considerable

advancements in diagnosing and treating arrhythmia in recent years.

arrhythmiaArrhythmia is a condition in which

the electrical system of the heart malfunctions. Because the heart is an electrical-mechanical pump, electrical disorders cause the heart to function irregularly.

For example, if the heart’s elec-trical system has an interruption in the normal connections, then the heart beats too slowly. Luckily, implanting a pacemaker can restore the regular function of the heart.

The heart’s electrical system can also have a malfunction that creates a “short circuit” that causes very

rapid heart rates. Palpitations, light-headedness, inability to exercise and passing out all can be manifestations of a short circuit in the heart.

Today, it is possible to cure such conditions with safe and effective procedures. In fact, many patients are able to go home the same day.

atrial fibrillationAtrial fibrillation is the most

common electrical disorder of the heart, affecting over 5.1 million people in the United States. Disorganized electrical activity causes irregular heart beats that lead to blood pooling and clotting, which can cause stroke and other serious health issues.

People who have atrial fibrilla-tion may have palpitations (a sudden pounding, fluttering or racing feeling in the chest), lack of energy, dizzi-ness, chest discomfort, or difficulty breathing during normal activities or even at rest. High blood pressure, coronary artery disease, heart condi-tions, obesity, sleep apnea and age are all causes of atrial fibrillation.

At Holy Cross Hospital, we specialize in diagnosing and treating atrial fibrillation. If a physician suspects that you may have this condition, or if you have the symp-toms mentioned above, an elec-trocardiogram (ECG) or a Holter

(24-hour ECG) can assist in making the diagnosis.

Treatment options include medica-tions, a cardioversion to shock the heart back into a normal rhythm and pacemakers to bring the heart back to a proper rate. For those who are very symptomatic, a catheter-based procedure may be the best option.

Most important, if you are diag-nosed with atrial fibrillation, ask your doctor how you can reduce the risk of stroke from atrial fibrillation.

Get expert helpIf you experience the above symp-

toms, it may be time to speak to a cardiac electrophysiologist. A cardiac electrophysiologist specializes in the electrical disorders of the heart. At Holy Cross Hospital, we can make the diagnosis and provide compre-hensive treatment to bring your heart back to its regular beat.

Holy Cross Medical Group,

Cardiology Associates4725 N. Federal Highway,

Suite 401Fort Lauderdale, FL

33308954-772-2136


By Anele R. Manfredini, MD, Family Medicine and Women’s Health, Holy Cross Medical Group

FibromyAlgiA is a chronic condition that affects connective tissues, including the muscles, ligaments and tendons. This condition causes widespread muscle pain and excessive tender-ness in many areas of the body, among other symptoms.

In the United States, fibromyalgia affects about 2 percent of our population by age 20, which increases to approximately 8 percent by age 70. It is the most common cause of generalized muscu-loskeletal pain in women between ages 20 and 55, and it is more common in women than men. ❧

Chronic pain

Understanding f ibromyalgia

anele r. Manfredini, Md family Medicine/Women’s Health Holy cross Medical Group

The cause of fibromyalgia is unknown, but physical or emotional factors can trigger symptoms. Although the pain is felt in muscles and soft tissues, there are no visible abnormalities at these areas.

Some people may have a genetic predispo-sition to fibromyalgia because of a height-ened sense of pain. In other people, various stressors, including infection, physical or emotional trauma, sleep disturbances, or other medical conditions lead to fibromyalgia.

The chance of developing fibromyalgia is eight times more likely for family members of a person with fibromyalgia compared with the general population.

➜Diffused, chronic and persistent pain is one of the symptoms. It is a deep, muscular aching, soreness, stiffness, burning or throbbing. Patients may experience numbness, tingling or unusual “crawling” sensations in the arms and legs. The pain can be aggravated by anxiety or stress, poor sleep, exertion or exposure to cold. Muscle stiffness is often felt upon awak-ening and improves as the day progresses, but it can remain throughout the day as well. Most feel pain in the neck, middle and lower back, arms and legs, and chest wall. ➜Abdominal pain, diarrhea and constipation ➜Bladder pain and urinary urgency and frequency ➜Facial and jaw pain ➜Fatigue and sleep disturbances ➜Depression and anxiety

American College of Rheumatology guidelines suggest that people with fibromyalgia have pain in at least 11 of the 18 tender points (see figure 1) when a doctor applies a certain amount of pressure, and that symptoms have been present at a similar level for at least three months. A diagnosis of fibromyalgia may be made if the patient does not have any other disorders that would otherwise explain the pain.

Three medications are approved by the Federal Drug Administration (FDA) for the treatment of fibromy-algia: pregabalin (Lyrica), duloxetine (Cymbalta) and milnacipran (Savella).

cauSeS

diagnoSiS

treatment

SymPtomS

if you experience the above symptoms of fibromyalgia, speak with your physician or make an appointment with dr. Manfredini

by calling 954-229-8660 or visiting www.Holycross

Womenscenter .com.

figure 1

Source: upToDate. Patient information: fibromyalgia (Beyond the Basics)


Hospital happenings

Understanding f ibromyalgia

the pAtriCiA r. guerrieri Pavilion, which recently opened as the third and final phase of the Dorothy Mangurian Comprehen-sive Women’s Center at Holy Cross HealthPlex, has opened the first exhibition in its art gallery.

“Portraits and Conversations: Veterans Returning From Iraq and Afghanistan,” an exhibition of works by Wilma Bulkin Siegel, MD, brings together paintings and discussions the artist had with returning Gulf War veterans. The exhibition will be on view now through June, and admis-sion is free.

“As a physician as well as an artist, I use my education and my painting to find ways of healing people,” Dr. Siegel notes. “In whatever role I play, I wish to have people think about their unique place as individuals living amongst each other.”

The gallery space and the exhibi-tions it will host are a great example of how the Patricia R. Guerrieri Pavilion addresses the physical and

the first art exhibit!

Don’t miss

spiritual needs of women in the community. The Guerrieri Pavilion includes:

✓Community education rooms for groups varying in size from 10 to 150 people. ✓A café and teaching kitchen. ✓A medical spa. ✓Lifestyle counseling rooms. ✓A volunteer office. ✓Additional physician suites.The $15 million

Women’s Center is funded entirely through philanthropy, including a generous $4 million gift from the Guerrieri Family Foundation. The 55,000-square-foot Women’s Center offers advanced breast imaging, including digital mammography, minimally invasive diagnostic proce-dures, stereotactic breast biopsy, bone density studies and ultrasonography.

the gallery is located in the Patricia r. Guerrieri Pavilion at the dorothy Mangurian comprehensive Women’s center at Holy cross Health-Plex, 1000 n.e. 56th st. in fort lauder-dale. Gallery hours are Monday through friday, from 10 a.m. to 5 p.m. for more information, call 954-351-7800.

Patrick taylor, Md; Wilma bulkin siegel, Md; sheri Whittington; and doreen Koenig

from left, Patrick taylor, Md; Wilma bulkin siegel, Md; alan Guerrieri; cathi Guerrieri; and caroline Koste

Guests view the artwork.emmy and steve ligelkis by Wilma bulkin siegel, Md

Wilma bulkin siegel, Md, with subjects emmy and steve ligelkis

WorKs by WilMa bulKin sieGel, Md, Will HanG in tHe

art Gallery at WoMen’s center tHrouGH June 2013


Celiac disease

By Donald Brust, MD, Gastroenterologist

CeliAC diseAse, also known as gluten enteropathy, is a condition in which the immune system responds abnor-mally to a protein called gluten. Gluten is found in wheat, barley and rye, as well as many other

common foods, medications and supplements.

With celiac disease, repeated expo-sure to gluten causes damage to the small intestine. Normally, the small intestine contains fingerlike projec-tions, called villi, that allow it to absorb digested food and nutrients. In celiac disease, however, the villi become damaged, and absorption is impaired.

symptomsWhile each patient has his or her

own unique spectrum of presenting symptoms, some of the more common include bloating, excessive

gas, abdominal cramping or discom-fort, anemia, or weight loss.

Other symptoms may also occur as a result of nutrient and vitamin defi-ciencies. In many cases, symptoms are mild and even absent in the early stages of the disease.

diagnosisIf your doctor suspects that

you have celiac disease, he or she will likely perform a series of blood tests to detect the pres-ence of antibodies that occur in response to the repeated exposure to gluten-containing substances. Over 90 percent of patients who have untreated celiac disease will test positive for one or more of these antibody tests.

It is important that patients continue to consume a normal, unre-stricted diet prior to testing for the presence of the antibodies. Consump-tion of a gluten-free diet prior to testing can cause a false-negative test, resulting in a delay of diagnosis.

If your blood test is positive, you should undergo an upper endoscopy,

which allows your doctor to examine the small bowel and obtain biopsies to confirm the diagnosis. The test is painless; in addition, patients do not feel the effects of the biopsies after they awake from sedation.

treatmentCeliac disease is important to

treat for reasons that extend beyond the resolution of symptoms. If left untreated, celiac disease can progress to become chronic ulcers of the small intestine (ulcerative jejunoileitis) or even lymphoma.

Treatment is relatively straightfor-ward and involves avoidance of gluten-containing foods (a gluten-free diet). Complete avoidance must be adhered to, as exposure to even small amounts of gluten can aggravate symptoms.

Checking periodic blood tests for the continued presence of antibodies in the patient’s bloodstream allows clinicians to assess the effectiveness of the patient’s diet. Over 70 percent of patients will begin to feel better within two weeks of starting the gluten-free diet. ❧

donald brust, Md Gastroenterology, Holy cross Medical Group

May is NatioNal CeliaC Disease awareNess MoNth

12 Time Out for Women

Women’s health

By Beatriz Lizaso, MSPT, Women’s Health Rehabilitation Services, Dorothy Mangurian Comprehensive Women’s Center

every yeAr, millions of women deliver healthy babies and go on with life as it once was before the pregnancy. However, there are many who do not. Some continue to have persistent low-back or pelvic pain, while others silently live with urinary incontinence.

Pregnancy and delivery can significantly alter the anatomy and function of the abdominal wall and pelvic floor muscula-ture. Pregnancy is a major cause of pelvic floor dysfunction in women. With each additional pregnancy, there is greater risk of pelvic floor dysfunction. Pregnancy places increased stress on the pelvic floor

throughout gestation, leaving the muscles fatigued and weak, which can lead to urinary incontinence.

Vaginal birth can be traumatic to the pelvic region and cause damage or tearing to the pelvic organs and muscles. Such damage is a significant contributor to pelvic organ prolapse. While most women experience a separation of their abdominal wall (diastasis rectus abdominis) during the third trimester of their pregnancy that closes naturally in the early postpartum period (three months), some women’s abdominal walls do not close in a timely fashion.

How can Pilates-based physical therapy help?

core trainingThe word core refers to the area of the body between

the diaphragm and the pelvic floor. There are many

muscles that support this region, and in addition to the pelvic floor and breathing diaphragm, the transversus abdominis (deepest abdominal) and the multifidus (deepest back muscle) are known to be key factors.

The Women’s Health Rehabilitation Services at the Dorothy Mangurian Comprehensive Women’s Center uses the Pilates repertoire on the Clinical Pilates Reformer as a therapeutic exercise modality to safely and efficiently train the core musculature.

We are passionate about empowering women, through their pregnancies and postpartum experiences, to be knowledgeable about the natural changes that occur in their bodies. We want to help them increase their body awareness to prevent future musculoskeletal dysfunctions.

body awarenessWhat is not normal? ✓Bulging of the abdomen during any exercise ✓Leaking urine or stool when there is a strong urge to go ✓Leaking urine, gas or stool with laughing, coughing, jumping, sneezing, lifting, walking or running ✓Persistent back, pelvic, groin or abdominal pain ✓Pressure or bulging in the vagina or rectumThese symptoms are not considered normal following

the early postpartum period of three months. If you are experiencing any of these symptoms, please discuss them with your physician. ❧

learn more about the Women’s Health rehabilitation services at the dorothy Mangurian comprehensive

Women’s center by calling 954-229-8685 or visiting www.HolycrossWomenscenter.com.

Retraining your muscles after pregnancy

Pilates-based WoMen’s HealtH PHysical tHeraPy

beatriz lizaso, MsPt Women’s Health rehabilitation services, dorothy Mangurian comprehensive Women’s center


the third and final phase of the Dorothy Mangurian Compre-hensive Women’s Center at Holy Cross HealthPlex was completed in November 2012 with the opening of the Patricia R. Guerrieri Pavilion.

Thanks to a generous $4 million gift from the Guerrieri Family Founda-tion, the Guerrieri Pavilion offers:

✓Community education rooms for groups varying in size from 10 to 150 people. ✓A café and teaching kitchen. ✓A medical spa. ✓Lifestyle counseling rooms. ✓An art gallery. ✓A volunteer office. ✓Additional physician suites.“The Patricia R. Guerrieri Pavilion

is an amazing resource for the women in our community,” says Patrick Taylor, MD, Holy Cross

Women’s services

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All-in-one resource for women

Hospital President and CEO. “As we talked to women about our plans for a women’s health center, it was clear what they wanted. An educational component, counseling rooms and rehabilitative services all were impor-tant, and those are among the needs we addressed in building the Patricia R. Guerrieri Pavilion.”

The Guerrieri family was recog-nized for its support during a recent reception to celebrate the opening.

“My family and I are privileged and honored to be here to honor the memory of our mother,” said Michael Guerrieri, who spoke on behalf of his father, Alan; his brother; and three sisters. “Mom would have been honored to have her name on this facility.”

Guests were invited to tour the 55,000-square-foot Women’s Center,

which includes, in addition to the Patricia R. Guerrieri Pavilion:

✓The Hudson Family Foundation Physicians Suite. ✓The Jan Moran Reception Suite. ✓The Jeane M. Dorini Women’s Imaging and Diagnostic Suite, which serves as the nucleus of the comprehensive center, offering advanced breast imaging—including digital mammography, minimally invasive diagnostic procedures, stereotactic breast biopsies, bone density studies and ultrasonography. ✓The Marti Huizenga Meditation Chapel and Healing Garden, avail-able to patients for quiet reflec-tion, meditation and prayer. It also serves as a place of peace and serenity away from the concerns and worries of the day, which is critical to healing.

tHe Patricia r. Guerrieri Pavilion oPens its doors at tHe WoMen’s center


Pictured:1. the Guerrieri family2. from left, alan Guerrieri; Jan Moran; and Patrick taylor, Md3. steve Mehallis and John Johnson4. from left, terry stiles; Jamie stiles; Jan Moran; Mike Maroone; Monica Maroone;

and Patrick taylor, Md5. from left, Monica Maroone, doreen Koenig and sheri Whittington6. from left, alan Guerrieri; cathi Guerrieri; and Karan Munuswamy, Md

“We are humbled by the support from the Guerrieri family and our other caring, compassionate donors, including the Harry T. Mangurian, Jr. Foundation, Jan Moran, the Huiz-enga Family Foundation, Jeane M. Dorini, the Hudson Family Founda-tion, Holy Cross Hospital Auxiliary, Girlfriend’s Club and our Rever-ence Wall donors,” says Dr. Taylor. “Together we have built an extraordi-nary Women’s Center that promotes women’s health in our community and one that serves a woman’s healthcare needs physically, emotion-ally and spiritually.”

The $15 million Women’s Center is funded entirely through philanthropy, including $1 million from 200 women in the community who each pledged $5,000 as lifetime, founding members of the Girlfriend’s Club in support

Women’s services

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of the Dorothy Mangurian Comprehensive Women’s Center.

donor opportunities are still available. for

more information, please call 954-229-8569 or email [email protected].


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➜April 13: Holy Cross Hospital Epicurian Escapade benefiting the Dorothy Mangurian Comprehensive Women’s Center ➜ July: New exhibition opening at the Patricia R. Guerrieri Pavilion Art Gallery ➜October: This One’s for the Girls Luncheon

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