Get Serious Citrus Begins in June

Beginning on Monday, June 2, 2014, the Citrus Memorial Diabetes Center will begin its summer weight management and weight loss program called Get Serious Citrus. The eight week program does not require a physician referral.

Under the direction of Amy Freeman, Citrus Memorial’s Certified Diabetes Educator, the course will cover the following topics: 

  • ·         Detecting fat and calorie intake
  • ·         How to plan a healthful meal
  • ·         Jump starting your metabolism
  • ·         Talking back to negative thoughts
  • ·         Managing stress
  • ·         Staying motivated

Classes meet in the Citrus Memorial Auditorium at 402 W Grace St, Inverness beginning on Monday, June 2, 2014. Morning classes are scheduled from 9 a.m. to 10 a.m. and afternoon classes are from 4:30 p.m. to 5:30 p.m. The cost is $10 per class. Those interested may pre-register by calling the Citrus Memorial Diabetes Center at (352) 341-6110.

Welcome, Dr. Kamyab!

Citrus Memorial Health System welcomes Mahshid Kamyab, M.D. to its active medical staff.

After earning her Doctor of Medicine, Dr. Kamyab completed a family medicine residency at the University of Saskatchewan in Saskatoon, Canada. She additionally holds a Master of Public Health degree and has specialized in infectious and tropical diseases. Her current area of practice is in family medicine.

Kamyab currently practices at Citrus Primary Care with Dr. Seema Kamat. The facility is located at 450 W Roosevelt Blvd, Beverly Hills. She is accepting new patients. Call (352) 527-6646 for an appointment.

Citrus Recognized for OB Excellence

The Florida Hospital Association today recognized Citrus Memorial Health System as one of only seven Florida hospitals to receive their 39 Weeks Recognition Banner.

Birthing hospitals in Florida recently partnered with the Florida Hospital Association, Florida Perinatal Quality Collaborative, Florida Department of Health and March of Dimes to reduce early elective deliveries. Citrus Memorial was among the seven hospitals statewide to be recognized with the 39 Weeks Recognition Banner for excellence in improving quality and safety for mothers and babies.

Hospitals recognized include:

  • Citrus Memorial Health System
  • DeSoto Memorial Hospital
  • Jackson Hospital
  • Jupiter Medical Center
  • Morton Plant Hospital
  • North Okaloosa Medical Center
  • Winter Haven Hospital

“Unless it is medically necessary for the health of you or your baby, it’s best to wait until at least 39 weeks of pregnancy to deliver,” said Dr. Armando Rojas of Genesis Women’s Center. “Important fetal development takes place in the baby’s brain and lungs during the last few weeks of pregnancy and the medical team here at Citrus Memorial wants to ensure that each infant leaving our Baby Block is as strong and healthy as possible.”

According to studies conducted by the National Partnership for Women and Families, one in four new mothers believe a baby is full-term at 34-36 weeks and more than half believed it was safe to deliver the baby at that point. Citrus Memorial’s efforts successfully prevented 89 early elective deliveries and earned the obstetrics team an invitation to present their work during 2014 Hospital Days in Tallahassee.

“Patients need to understand that although those last few weeks of pregnancy may be uncomfortable, science just doesn’t support early elective delivery,” said Rojas.

Volunteers Earn Presidential Award


Nine volunteers from Citrus Memorial Health System were recently presented with the Presidential Lifetime Service Award. Each volunteer has donated over 4,000 hours at the hospital.

Pictured (from left to right). Seated: Lee Cascio and Evelyn McCaw. Standing: Paul Thomas, Donna Page, Gerry Aron, Bonnie Steffen, and Glenn Smith. Not pictured: Pat Anson and Lee Hamilton

Pictured (from left to right). Seated: Lee Cascio and Evelyn McCaw. Standing: Paul Thomas, Donna Page, Gerry Aron, Bonnie Steffen, and Glenn Smith. Not pictured: Pat Anson and Lee Hamilton

The Presidential Lifetime Service Award was created to thank Americans who have given at least 4,000 hours of their time serving others. This prestigious award has been given to 60 volunteers at Citrus Memorial Health System.

The President’s Council on Service and Civic Participation (the Council) was established in 2003 to recognize the valuable contributions volunteers are making in our communities and encourage more people to serve. The Council created the President’s Volunteer Service Award program as a way to thank and honor Americans who, by their demonstrated commitment and example, inspire others to engage in volunteer service. The program continues as an initiative of the Corporation for National and Community Service (CNCS).

Recognizing and honoring volunteers sets a standard for service, encourages a sustained commitment to civic participation and inspires other to make service a central part of their lives.

The President’s Volunteer Service Award recognizes United States citizens and lawfully admitted permanent residents of the United States who have achieved the required number of hours of service over a 12-month time period – or cumulative hours over the course of a lifetime.

About the Citrus Memorial Auxiliary
The Citrus Memorial Auxiliary began in 1957 with 26 volunteers who were affectionately called the Pink Ladies. By 1962 the group had grown to over 200 volunteers and began recruiting candy stripers. Today, Citrus Memorial Health System’s volunteers include over 450 men and women working in locations throughout the county including Citrus Memorial hospital and Citrus Memorial Healthcare Center at Sugarmill Woods. For information on volunteering at Citrus Memorial call 560-6298 or apply online.

Six Volunteers Over 90 Years Young

Pictured (from left to right): Art Mitchell, Sabina Mitchell, Dante Caldera, Glen Bortell, Mary DeWalt and Dot Welsch.

Citrus Memorial Health System is blessed to have six volunteers over 90 years old who are actively assisting patients and families.  They assist with transporting patients, as surgery hosts, admitting assistants, medical records assistants and even in knitting baby items.

Glen Bortell is the “senior” of the group at 99 years old and volunteers two days per week as a transporter for Diagnostic Imaging.  He will celebrate his 100th birthday at the Citrus Memorial Auditorium on September 9, 2014.  Mr. Bortell has been honored as the Volunteer of the Year and has received the Presidential Award.

Dante Caldera, 98 years young, is a host in the surgery area and has logged over 8,000 hours in his 18 years with the hospital. He, too, is a recipient of the Presidential Award.

Arthur and Sabina Mitchell – each 93 years old – have both received the Presidential Award for serving over 4,000 hours.  Art is active in transporting and Sabina makes beautiful items for new babies and patients in the Hospice of Citrus County unit.

Mary Dewalt, 92 years young, has also received the Presidential Award and as a retired employee decided to come back and volunteer for medical records.

The youngster of the group is Dot Welsch who is just a little over 90.  She has logged over 10,000 hours and was recently named Citrus Memorial’s Volunteer of the Year. She has also received the Presidential Award. Ms. Welsch volunteers two days a week – one in the Admitting Department and one as a surgery hostess.  She has been praised by many patients and families for her kind and generous spirit.

Three volunteers remain lifetime members, but due to health reasons, no longer serve an active role.  Agnes Bokus, Dub Miller and Verna Haas have all served over 4,000 hours.

Each of these “senior” volunteers has expressed their happiness at being well enough to still help others.  Mr. Bortell often says that volunteering is what keeps him alive.  Over 400 volunteers serve at the hospital each week.  Of that group, 25% are over the age of 80.


The Science of Sugar Substitutes

By Amy Freeman, RD, CDE

Most of you have heard that sugar-sweetened beverages such as soft drinks, fruit juices, iced tea and energy drinks are associated with weight gain, high triglycerides, inflammation, hypertension, excess fat tissue in our organs, low HDL cholesterol and diabetes type 2.  The logical solution, for most of us, has been to switch from sugar to a sugar-substitute, such as stevia, aspartame (Equal or NutraSweet), or sucralose (Splenda). Let us pause and inquire, “are those sweeteners safe?”

Stevia is obtained from a shrub that grows in Southeast Asia and South America. The sweet taste is attributed to stevioside and rebaudioside A.  Perhaps you remember in the early 1990s stevia was rejected as a food ingredient by the Food and Drug Administration (FDA), Canada and the European Union; the World Health Organization concluded that stevia should not be used as a food ingredient.  High doses of stevia given to rats caused reduced sperm production and increase in abnormal cell growth in the testicles of the rats.  Also, in pregnant hamsters, stevia was linked to fewer and smaller hamster babies.  In the lab, stevia caused mutations to cells; it was hypothesized that these mutations may promote cancer.

Stevia is marketed as a supplement, not a food ingredient.  In 2008, the FDA recognized stevia as a GRAS (generally recognized as safe) supplement.  In the clinical experiments cited above, the animals were fed about 600-970 milligrams (mg) of pure stevia per kilogram of the animal’s weight for weeks, in some studies for the life of the animal. So, my suggestion is to use stevia in moderate amounts and if you have a pet rat or pet hamster, don’t feed it stevia.

Splenda (sucralose) is a synthetic chemical made by treating sucrose with chlorine. Prior to Splenda being approved by the FDA, a study showed that it caused premature shrinkage of thymus glands in rats.  The study was repeated and no issues were found with the rat’s thymus gland.  Further studies were performed on other rodents, and Splenda was cleared for FDA approval.

In 2012 a study was released and reported by Dr Xiaofa Qin linking inflammatory bowel disease in humans to sucralose use around the world. What may be the most damaging publicity is a 2012 Italian study linking Splenda to leukemia in rats exposed to Splenda in utero (before birth).  On another note, one of the emerging environmental contaminants is Splenda. In some areas, Splenda is among the highest measured pollutant found in surface water, ground water and drinking water.

Lastly, we will review aspartame.  Equal and NutraSweet have been around since the 1970s.  Since its introduction, it has been plagued with rumors surrounding brain tumors, hallucinations, cancer, and neurological issues in those who used it.  It is true that in a study done in 2005, rats given aspartame starting at 8 weeks of age and continuing through their lifetime developed lymphomas, leukemias, and breast/liver/lung and kidney tumors.  Scarier yet is the 2010 studies performed by Danish researchers that found the consumption of the sugar-substitute aspartame was linked to pre-term delivery of babies.

I will end on this very interesting note. There are a few clinical studies that demonstrate the consumption of sugar- substitutes promotes over-eating, increase in body weight, and accumulation of body fat.  The negative changes are related to a change in how the body “senses” food intake, leading to a dysfunction in the reflex to stop eating.  Studies have demonstrated that certain sugar-substitutes inhibit the release of gastrointestinal hormones and inhibit stimulation of the gastrointestinal “taste” receptors. The end result of the cascade of misfortunes in the gastrointestinal tract is an increase in eating, body weight, and body fat.

What we eat does impact our health and well-being.  Make it a point to try to limit processed foods in your diet, including sugar-substitutes.  Remember our friend, the rat – he didn’t do too well in these studies.

Amy Freeman is the Diabetes Educator for Citrus Memorial Health System. Under her direction, the Citrus Memorial Diabetes Center offers classes in both Inverness and Homosassa and works with local health care professionals to aid families in becoming independent in managing diabetes. To sign up for a Diabetes Education class call (352) 341-6110. A physician’s referral is required.


Stroke: Preventable, Treatable, Beatable

By Cheryl Love, RN

To begin to understand the impact that stroke can have in our lives, it is important to know the statistics. The American Stroke Association reports that one in six people will have a stroke in their lifetime;  stroke is the fourth leading cause of death in the United States; and worldwide, stroke is the number one cause of preventable disability.

As healthcare providers we have a responsibility to promote awareness in the community on the warning signs of stroke as well as the fact that stroke is largely preventable, treatable and beatable.

What is a stroke? One way to understand a stroke is to think of it as a “brain attack”. A stroke can occur when a vessel in the brain either ruptures or develops a clot which can block circulation to an area of the brain.

Recognizing the signs and symptoms of a stroke quickly is important because treatment alternatives are time-sensitive.  If you or someone you know shows any of these signs and symptoms of a stroke, call 911 immediately.  An easy way to remember the signs and symptoms of a stroke is to use the letters F.A.S.T.

Face Drooping — Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?

Arm Weakness — Is one arm weak or numb? Ask the person to raise both arms.  Does one arm drift downward?

Speech Difficulty — Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.”  Is the sentence repeated correctly?

Time to call 9-1-1 — If someone shows any of these symptoms –  even if the symptoms go away -call 9-1-1 and get the person to the hospital immediately.  Check the time so you’ll know when the first symptoms appeared.

Of course, it is best to live a healthy lifestyle that reduces your risk for stroke.  How can stroke be prevented?  Follow “Life’s Simple Seven”.

  1.  Eat better
  2. Manage your blood pressure
  3. Get physically active
  4. Lose excess weight
  5. Lower cholesterol
  6. Reduce blood sugar
  7. Don’t smoke

If you are the one in six that experiences a stroke, get to the nearest hospital designated as a Stroke Center as quickly as possible.  The more quickly you receive evaluation and treatment, the better your chances for recovery without significant loss of function.

For stroke survivors and their caregivers, please remember, you are not alone.  The community offers Stroke Support Groups and additional online resources to help you and your loved ones.

Remember….stroke is preventable, treatable and beatable!

For more information on stroke and Stroke Support Groups, please contact Citrus Memorial Health System at (352) 344-6596.

Celebrate 10 Years of Heart

On Saturday, February 22, the Citrus Memorial Heart and Vascular Center will host a Heart Health Celebration to mark its ten year anniversary as well as inform and educate the community about the importance of heart health.

The event, which will include free health screenings for the public will be held from 10am- 2pm at the main Citrus Memorial campus at 502 W Highland Blvd in Inverness.

Free health screenings at the fair will include:

  • Coronary Risk Profile
  • Blood Pressure and Heart Rate Screening
  • Body Mass Index Screening
  • Oxygen Level Saturation Screening


Heart health information and resources will also be available including:

  • Heart Health Self Risk Assessment
  • Smoking cessation education from Tobacco Free Florida
  • Mended Hearts support group
  • Jazzercise
  • And more!

During the fair, physicians and nurses will be on-hand to speak with patrons on heart-related topics including cardiopulmonary rehabilitation, women’s heart disease, and diabetes.

Join the conversation on Twitter and Facebook at #10YearsofHeart

Citrus Health Patient Portal Now Available

Citrus Memorial is pleased to announce the release and availability of the Citrus Health patient portal. Citrus Health is a web based tool which allows you to gain access to key elements of your medical record.  The portal is easy to use.  All you need to do is sign up, create your logon credentials and you have instant access, anytime and anywhere you have access to the Internet.

Here’s what you need to do:

 1.     Call (352) 560-6887 to provide your home email address and answer a couple of security questions.

2.     You will then receive an email invitation which will include a link that will take you to the portal web page.

3.     Provide the answers to the security questions you answered during the sign-up process,

4.     When prompted, create your password.

5.     That’s it. You’re done!

 Once you’ve logged in you will be able to securely access your medical records.

After you create your account, we recommend you bookmark the Citrus Health webpage so you can return to it whenever you need to check on your results or other components of your medical record.

Cardiovascular Disease and Diabetes

By Amy Freeman, RD, CDE

“One of the most serious consequences of diabetes is the elevated risk of cardiovascular disease and cardiac events”, said Dr R. Scott Wright, Professor of Medicine at Mayo Clinic College of Medicine in Rochester, Minnesota.  Dr Wright’s statement speaks volumes to those who have diabetes, perhaps leading to feelings of dread in those who have diabetes and heart disease.

Cardiovascular disease in diabetes is not just the result of poorly controlled blood sugar levels or hyperglycemia, the risk for heart disease goes beyond the blood sugar level.  In fact, cardiovascular risk involves terms such as insulin resistance, inflammation, dyslipidemia, and adiposity.  Together, these factors cascade into a big mess that may end in atherosclerosis (abnormal thickening of an artery wall), plaque rupture, and cardiac events.

Diabetes type 2 involves changes in how our body metabolizes fats, not necessary the fat that we eat, but “blood fats”, such as very low-density lipoprotein (VLDL), low-density lipoprotein (LDL), high density lipoprotein (HDL), and triglycerides.  High levels of VLDL, small and dense LDL particles, and triglycerides contribute in damaging the lining of the vascular system, liver cells, muscle cells, and pancreatic cells.  The high level of these blood fats is termed dyslipidemia.  Dyslipidemia not only promotes atherosclerosis but also inflammation.  Inflammation, in turn, promotes further atherosclerosis and plaque formation. The plaque is made up of immune response cells, fatty acids, calcium, and oxidized LDL cholesterol.  The unstable plaque may occlude the artery or rupture.

Insulin resistance contributes to the risk of cardiovascular disease.  One of the common causes of insulin resistance (a resistance of the body to use its own insulin to correct high blood sugar) is excess weight, medically referred to as adiposity.  Extra weight is not just extra “stuff” the body carries around, adipose tissue is organ; it produces its own hormones, has its own blood supply, and synthesizes substances that also contribute to inflammation.

There are numerous medications that can treat insulin resistance and assist in treating dyslipidemia.  Outside of pharmaceuticals, there are 3 important tactics we can employ to assist in reducing risk for cardiovascular disease. First, if you do have diabetes strive for an A1C goal of 7% or less. Second, have a goal of 30 minutes physical activity most days of the week. Third, think before you eat. Have a goal of reducing how much processed food you eat.  Rather than take a vitamin supplement, improve your eating habits.

Cardiovascular disease and diabetes are both serious topics. Be thankful that Citrus Memorial Heart and Vascular Center, one of Florida’s best cardiovascular centers, is right here in Inverness.  Inverness is also the home of Citrus Memorial Health System’s cardiopulmonary rehabilitation program and the diabetes center. Cardiovascular disease and diabetes are serious topics, but they don’t have to be scary.


Amy Freeman is the Diabetes Educator for Citrus Memorial Health System. Under her direction, the Citrus Memorial Diabetes Center offers classes in both Inverness and Homosassa and works with local health care professionals to aid families in becoming independent in managing diabetes. To sign up for a Diabetes Education class call (352) 341-6110. A physician’s referral is required.