Preventing Blindness in Children

May 14, 2010

Bruce Miller, M.D.
Medical Director of Pediatric Ophthalmology
Broward Health Chris Evert Children’s Hospital


Daddy, Is This Exercise?

May 4, 2010

Richard A. Howard, MD
Medical Director, Cardiovascular Lab
Broward Health
North Broward Medical Center

I recently purchased my daughter a bicycle. I bought it used, on Craigslist (This is not an advertisement for Craigslist, I’m just a spendthrift and they have some great deals!). We were riding around the neighborhood, she on her used bike and me on the bike I bought in college. She was clearly enjoying herself. She suddenly turned to me and asked in an uncertain and inquisitive tone, tinged with surprise “Daddy, is this exercise?!?” I assured her it was and that exercise, perish the thought, could actually be ENJOYABLE. But it got me thinking…

We have evolved into a culture that takes the easy way. We take the elevator instead of the stairs. We drive down the block to the store rather than walk. We play tennis inside on Nintendo rather than outside on a real court. In fact, when was the last time you saw your neighbors and their children outside playing? Probably following the last series of hurricanes! That, my friends and patients is one reason why our American waistlines are bulging. We all have seen epidemic of obesity in our society. 66% of all adults are overweight and 25% are obese. The epidemic begins earlier in life however. In a Time magazine cover story from June 2008, it was revealed that 32% (that’s one in three!) of all American children are overweight and around 15% are OBESE. No wonder we now find ourselves prescribing blood pressure medicine and cholesterol lowering medicine to our children! And no wonder I find myself treating heart attacks and placing stents in younger and younger patients (more on this in a later blog). Being overweight creates hypertension, hyperlipidemia, and diabetes in adults and children too. Staying active burns calories, keeps the weight off and can actually cure hypertension and diabetes.

We have unfortunately, as a culture, accepted obesity as being OK for ourselves. We shouldn’t however accept this for our children. We need to be positive role models for our children in all aspects of their lives. Show them how to swing a baseball bat, kick a soccer ball, take the stairs, walk to the store, and even ride a bike! You can get some great deals if you know where to look and get your kids (and yourself) active in the process. We owe it to them and may even enjoy it ourselves. And you don’t need to wait for the next hurricane either.

CyberKnife® Offers the Latest Cutting Edge Radiation Treatment

April 14, 2010

Anurag Agarwal, MD
Medical Director of Radiation-Oncology
Broward Health

I am proud to say that within our Broward Health system we have assembled the latest cutting-edge radiation treatment options available to fight cancer.

Since acquiring Broward County’s first CyberKnife® Robotic Radiosurgery System in 2008, we have successfully treated patients with a variety of complex tumors, including brain, lung, spine, tongue, pancreas and liver tumors.

CyberKnife® delivers high doses of radiation to tumors throughout the body with sub-millimeter accuracy with no incision, no blood loss, no anesthesia and no recovery time. It is ideal for patients who have inoperable or surgically complex tumors. Through the use of image-guidance technology and intelligent robotics, CyberKnife® pinpoints the position of the tumor then delivers hundreds of tiny beams of radiation from various angles that converge at the tumor site. Any change in target position because of patient movement, such as respiration, is detected and automatically compensated for by the robotic system. Therefore, the tumor receives a concentrated dose of radiation while minimizing exposure to surrounding healthy tissue. CyberKnife® can be used to treat primary CNS tumors, metastatic lesions to the brain, early stage lung cancer, prostate cancer, recurrent head and neck cancer, metastatic liver lesions, and other cancers.

The Broward Health system also has brand new Varian Trilogy and iX Linear Accelerators. IMRT (Intensity Modulated RT) and IGRT (Image Guided RT) allow us to treat the entire spectrum of different cancers with modern technology. Examples include breast cancer, prostate cancer, CNS malignancies, GI cancers, and many others.

Our Radiation-Oncology facilities are housed at North Broward (home of the CyberKnife®) as well as Broward General, but we treat patients from within the entire BH system including Imperial Point, Coral Springs and scores of outpatient facilities. Also, we are routinely treating patients from Dade to Palm Beach Counties, as patients and physicians are realizing the unique cutting-edge treatment options we offer, along with compassionate and professional clinical care.

Our wide range of clinical research studies and affiliation with Moffitt Cancer Center provides our patients with more options and access to the latest advances in cancer treatment.

Dr. Anurag Agarwal is a cancer specialist, board-certified in both Radiation-Oncology and Internal Medicine. His areas of interest include proton-beam radiation, stereotactic radiosurgery and gene therapy. For more information, call 954-786-6838.

Why Cardiac Meds Are Extremely Important

April 6, 2010

David E. Perloff, MD, FACC, FACP
Medical Director of Cardiac Rehabilitation
Broward Health

Symptoms of Heart Attack Can Be Deceiving

March 23, 2010

David E. Perloff, MD, FACC, FACP
Medical Director of Cardiac Rehabilitation
Broward Health

One Heart Attack, Can Equal Two

March 16, 2010

David E. Perloff, MD, FACC, FACP
Medical Director of Cardiac Rehabilitation
Broward Health

Times Have Changed, and So Have Diets

March 3, 2010

David E. Perloff, MD, FACC, FACP
Medical Director of Cardiac Rehabilitation
Broward Health

For so many years, conventional wisdom has taught us that low fat diets are essential to a healthy lifestyle. The latest research is showing that perhaps those diets aren’t the way to go and that some of the supposedly bad stuff might actually be good for you!

All the food you eat is basically made up of three kinds of things: fats, protein and carbs. The key is achieving the right mix. Here are a few things you can switch up to get you headed in the right direction.

  • Try to replace things that are “white” in your diet (bread, rice, sugar, pasta and potatoes) with things that are “brown” (whole wheat, whole grains, sweet potatoes and complex carbs).
  • Reduce your intake of animal fats: butter, cheese, and meat. Instead opt for vegetable, canola, and especially olive oil.
  • Add fish and shellfish to your diet. One to two seafood meals per week will get you plenty of protein and heart healthy fats.
  • Fruits and veggies never hurt, either.

Mediterranean cuisine does a great job of incorporating all of the above, and also reduces your risk for both heart disease and cancer. Broward Health’s website has plenty of heart healthy recipes as well. I personally recommend the quick and easy Grilled Shrimp with Mango Jalapeño Sauce—made it last week.

Heart Attack Signs May Not Be So Obvious

February 23, 2010

Dr. ZelnickKenneth Zelnick, MD, FACC
Interventional Cardiology
Broward General Medical Center

Despite what you see in movies and on TV, heart attacks that send you collapsing to the ground, clutching your chest in agony aren’t really that common. In fact, what we see in the real world very rarely looks like the television heart attack. The pain is classically described as a squeezing sensation or tightness, but the symptoms can really vary. I have even seen a patient come to the hospital with a “tooth ache” that ended up being the way their heart signaled a more serious condition. Listen to your body. Generally, my patients who have had a heart attack look back and recognize that warning signs had been there. They just chose not to listen to them.

The signs that you’re having a heart attack vary greatly from person to person, but here is a list to consider. Not all the warning signs are obvious:

Chest Discomfort
Not everyone who has a heart attack feels chest discomfort, but it still is the most common sign of a heart attack. Sometimes, the chest pain can hang around for months before an actual heart attack. The pain may not be overwhelming, but definitely do not ignore it.

Discomfort in other parts of the upper body
Pain in some unsuspecting places can also be a sign of a potential heart attack. It could be any sort of heaviness, pressure, squeezing, or aching in your upper body. This includes your back, neck, shoulders, arms, wrists, elbows, between your shoulder blades, and even in your earlobes, jaw, throat and gums.

Gastrointestinal problems
If you have a family history of heart disease or of high blood pressure and cholesterol, stomach pains and nausea may be a cause for concern. It’s not always an ulcer.

Flu-like symptoms
A routine EKG may indicate that you had a heart attack, but never knew it happened. Instead, when patients come in for check-ups and report they felt sick and exhausted for several days, they often write it off as the flu. This isn’t always the case. Flu-like symptoms can be signs of a heart attack and are easy to miss.

Shortness of breath
Shortness of breath is another extremely common warning sign of a heart attack, but it doesn’t always accompany chest pain. If you are having uncharacteristic breathing issues after exercise, act on it.

This list should not scare you but should illustrate that we all must take our hearts seriously. You only get one heart. The great news is that there are things we can all do to identify if we are at risk for heart disease. I encourage you to have a conversation with your doctor with regard to your heart risk and, if indicated, more testing can be done.

C’mon People, Let’s Move!

February 14, 2010

David E. Perloff, MD, FACC, FACP
Medical Director of Cardiac Rehabilitation
Broward Health

Face it folks, we are becoming an increasingly sedentary society. We’re sitting down most of the day either in the office or in the car. When we go to the grocery store, we will drive around the entire lot to find the closest spot to the entrance instead of taking the open one near the back and walking.

Even our kids don’t have mandatory Physical Education in school anymore. Instead of going outside to play, they are glued to video games.

All that sitting around eventually takes it toll. People come in to my office all the time complaining that their knees are hurting, or they are short of breath. Well, the reality is, some of them are 350 pounds. If you think your body will be able to carry around that much weight for 70-80 years you got another thing coming. It’s like leaving your bike or car in the garage for decades without oiling it or refilling the tires and expecting it to ride like new. No way.

In all seriousness, if you lose some body function after having a stroke or heart attack, there really isn’t much you can do to get it back. So at this point, prevention is the name of the game.

Even just a moderate amount of exercise should get you on the right track to a healthier heart. You don’t have to be a marathon runner. Research shows that working out just 3-5 days a week for 30 minutes a day can help reduce your risk of high blood pressure and cholesterol, colon cancer, depression, fractures, heart attack, stroke, diabetes and eventually, ending up in a nursing home.

I know what you’re going to say: I don’t have time to exercise. I’ll be the first to tell you, exercising isn’t my favorite activity either and I’m plenty busy. I know it’s a struggle. But, I can always make time to care of my body — and so should you.

Nagging Chest Pain? Don’t Ignore It!

February 5, 2010

Kenneth Zelnick, MD, FACC
Interventional Cardiology
Broward General Medical Center

Are you at risk for heart disease? Why not find out? A few simple tests can save your life. Believe me, I know.  In my role as an interventional cardiologist, my first encounter with patients is often when a nagging little pain in the chest leads to a completely closed vessel and a heart attack.  Unfortunately this can occur in men and women and at an age — much younger then you might think.  

Just this month the call came in for a heart attack on a 37-year-old man. He had none of the traditional risk factors and like many others was shocked when I told him he was in the midst of a heart attack.  Fortunately, he did get to the hospital in time and we were able to restore blood flow to his heart with minimal damage.  

In reality the time to intervene is before this happens and a few simple measures can help prevent this dreaded disease.  Heart disease kills nearly one million Americans each year, more than cancer, trauma, pneumonia, influenza and AIDS combined.  Yet, a brief physical by a quality cardiologist and a simple EKG can detect most serious conditions or at least signal a need for further tests.  

Heart disease is treatable if detected early and the best time to look is before anything happens.  This is a good time to not be shy and take control of your own heart health.  Make an appointment at Broward Health this month (bring your family and friends as well) and take advantage of the free screenings. The screenings include: blood pressure test, BMI (body mass index) and comprehensive cholesterol check (triglycerides, LDL and HDL). Visit to schedule your appointment.