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Colonoscopy Quality and Impact on Cancer Risk: My Experience at Holy Cross

  • Posted Mar 08, 2019
  • hchadmin

By Dr. Patrick Amar
Gastroenterology

Colon cancer is the third leading cause of cancer death and is preventable in up to 95% of cases. The purpose of a screening colonoscopy is to prevent the occurrence of colon cancer in the future. Without screening of any sort, the likelihood of a patient at average risk of getting colon cancer is 1 in 18. Colonoscopy is a tremendously powerful cancer prevention tool but unfortunately suffers from a number of potential pitfalls. It is both appropriate and critically important for patients and referring providers to inquire about quality measures when selecting a physician to perform colonoscopy.

I have collected data on over 1,500 consecutive colonoscopies which I personally performed over a two-year period. For each of these procedures, I collected data on which portion of the colon was reached, the quality of the bowel preparation, the number of polyps removed and the recommended interval for repeat colonoscopy. For any patient with polyps removed, I subsequently correlated these numbers with their pathology results and revised the polyp counts accordingly, to reflect only those polyps which were found to be adenomatous or serrated. These two particular pathology findings are directly correlated with cancer potential and are the target lesions for which we ask patients to undergo colonoscopy.

The first and most obvious measure in assessing quality of colonoscopy is the rate of completion of the exam. Clearly, examining only a portion of the colon leaves patients at risk for precancerous polyps in the areas not visualized. A colonoscopy is considered complete when the cecum (beginning of the colon) is intubated, as identified by several landmarks. The benchmark minimum recommended standard for this measure is 95% cecal intubation. My cecal intubation rate is 99.6%.

Cecal intubation is not a perfect measure of a complete colonoscopy, however. The cecum can sometimes be mistaken for other parts of the colon, especially the hepatic flexure. This leaves the potential for entire large segments of the colon not to be examined at the time of a colonoscopy. The solution that many gastroenterologists have proposed, to ensure 100% certainty of a complete colonoscopy, is intubation of the end of the small intestine (terminal ileum), which has a distinctly different appearance than the colon on endoscopic evaluation. This also affords the opportunity to evaluate for small bowel pathology which may otherwise be undiscovered (I have diagnosed several cases of Crohn's Disease in this manner). There is no recommended benchmark for intubation of the terminal ileum on screening colonoscopies. Nonetheless, I can proudly say that I have a 98% rate of intubating the terminal ileum for screening colonoscopies, thus dramatically reducing the likelihood of an incomplete examination.

The next and perhaps most important measure in determining quality of colonoscopy over a large number of procedures is the likelihood of discovering precancerous polyps. As noted above, these are either adenomatous or serrated on pathology. Patients with numerous or larger polyps are at an especially increased risk of colon cancer. The measure most commonly used is referred to as Adenoma Detection Rate (ADR), or the percentage of patients who are found to have at least 1 precancerous polyp at the time of screening colonoscopy. The minimum benchmark recommended for adenoma detection rates is 25% among male patients and 15% among females. The national average for ADR is 26% among community physicians and 29% among physicians in academic settings. My personal adenoma detection rate (ADR) is 54%.

The reason that this number in particular matters greatly is that there is tremendous variability in adenoma detection rates among different physicians. A recent study published in the New England Journal of Medicine which examined over 300,000 screening colonoscopies revealed Adenoma Detection Rates ranging from 7.4 to 52.5%. Analysis of this data revealed a dramatic decrease in the likelihood of patients being diagnosed with cancer up to 10 years after their colonoscopy was performed ("interval cancers"), if the performing physician had a higher ADR.  For every 1% increase in adenoma detection rate, patients had a 3% decreased risk of cancer over the following 10 years. Patients undergoing screening colonoscopy by the highest-performing physicians by ADR rates had up to a 69% incremental decrease in "interval cancer" risk compared to the average. This is over and above the baseline reduction in colon cancer risk offered by an "average" colonoscopy.

This measure, however, also has its limitations. The gastroenterology literature discusses the danger of a "one-and-done" colonoscopy. This refers to the tendency for some physicians to overlook adenomas beyond the first one discovered, either due to inattention or in the interest of moving a colonoscopy along. This gives rise to a measure called "adenomas per positive," which refers to the total number of adenomas discovered in patients who had at least one precancerous polyp. This is meant to counteract the tendency for a "one-and-done" colonoscopy and ensure that patients are getting the best cancer protection possible. The published data reveals a national average of 1.9 Adenomas Per Positive among academic centers and 1.65 among community physicians. My personal Adenoma Per Positive rate is 2.44, meaning that in patients who have at least 1 precancerous polyp, the likelihood is that I will find between 1 to 2 additional precancerous lesions.

There are polyp types which do not present an increased risk of cancer to patients. The most common type is a hyperplastic polyp which carries no precancerous potential unless it is part of a specific and rare polyposis syndrome. Likewise, the finding of a "mucosal excrescence" or other benign pathology findings do not represent precancerous tissue and are not counted in a physician's adenoma detection rate. These polyps most frequently occur in the rectosigmoid colon and are often removed by physicians, inadvertently leading many patients to think that they may beat increased risk of colon cancer. Removal of these polyps does not benefit patients in any way and does place them at some increased risk of post-procedure bleeding.

There are a number of key factors which have been found to impact a physician's adenoma detection rate. These include appropriate withdrawal time of the colonoscope during examination of the colon, the quality of the patient's bowel preparation, irrigation and suctioning of any stool residue at the time of examination and appropriate use of available advanced technologies to improve adenoma detection.

The importance of withdrawal time in assessing quality of colonoscopy became widely disseminated approximately 10-15 years ago. It was apparent that there was a tendency for some physicians to rush the colonoscopy examination, thereby decreasing the likelihood of finding precancerous polyps. The recommended minimum average time for withdrawal of the colonoscope was established at 6 minutes, a threshold which correlated with a significantly increased likelihood of finding precancerous polyps.  My personal average for withdrawal time is 8.9 minutes, which would be expected to result in improved adenoma detection. This is also considered the most important measure of quality of colonoscopy examination at the individual procedure level, ensuring that the examination was not compromised by being unduly rushed.

A significant change in the approach to bowel preparation was instituted several years ago, with patients being encouraged to use a "split-dose" bowel preparation regimen. This means that rather than having patients drink the entire bowel preparation on the day prior to the examination, they are instructed to drink the second half of the bowel cleansing solution on the morning of the procedure itself. By decreasing the time interval between administration of laxatives and the performance of the actual procedure, patients have less time to re-accumulate adherent liquid stool on the bowel wall and have improved visualization at the time of colonoscopy. This greatly increases the likelihood of finding either flat or sessile polyps as well as polyps with serrated pathology. I have utilized a split-dose bowel preparation protocol for over 5 years and have noted dramatically improved visibility at the time of colonoscopy. This has resulted in patients having their preparation rated "good" or "excellent" 94% of the time, improving the likelihood of discovering pre-cancerous polyps.

That being said, no patient has a perfect preparation at the time of their colonoscopy. Adherent liquid stool is especially problematic in preventing detection of smaller or sessile polyps. The tendency is simply to examine the colon "as is" and bring patients back at shorter intervals in order to compensate for less than adequate preparation. It is my opinion that once the patient has made an appropriate effort with bowel preparation and has taken the time and expense to have a colonoscopy performed, it is my duty to "clean up" to the best of my ability, within reason. I typically irrigate the colon with a very generous amount of water in order to remove any remaining adherent stool and thereby further improve adenoma detection.

Holy Cross was fortunate to purchase the newest generation colonoscopes from Olympus approximately 5 years ago, namely the 190 series. There is a specific setting on these scopes called Narrow Band Imaging (NBI) which facilitates the discovery of sessile or serrated polyps. Unfortunately, most physicians utilize this setting very little, if at all. I utilize NBI for the entirety of my colonoscope withdrawal, in order to improve adenoma detection rate and can personally attest that it has significantly impacted my ability to find flat or serrated polyps.

Additionally, there has been a tendency to overuse colonoscopy and have patients return at intervals which are shorter than recommended by professional societies. Many physicians developed a tendency to have patient's return for their "five-year" repeat examination, even in situations where bowel preparation was adequate and there were no precancerous polyps discovered. The recommended interval in such circumstances is 10 years. Additionally, when patients are found to have precancerous polyps, the recommended intervals are frequently overly-shortened. Use of appropriate intervals for follow-up colonoscopies after index examinations lowers the patient's individual procedural risk and also lowers the cost to a health system, overall. I am mindful to provide patients with a 10-year repeat interval for normal examinations if I can confidently do so, unless personal risk factors dictate otherwise. Likewise, I strive to adhere to the recommended intervals for follow-up of precancerous polyps, rather than bringing patients back more frequently than they truly require.

Achieving excellence when taking care of patients does not occur in a vacuum or with a single person, however. I work alongside a very dedicated staff of endoscopy nurses, technicians and unit managers. I am also blessed with tremendously talented and hard-working office staff, many of whom have worked with me for over 10 years and share my passion for providing excellent care. It is my sincere hope that I can continue to do so and that our endoscopy unit will continue to strive to be a leader in outstanding patient care with the support of a hospital that I am proud to be affiliated with - Holy Cross.

Dr. Patrick Amar practices with the Holy Cross Medical Group in Fort Lauderdale. He may be reached at 954-928-1778.


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Keys to Well-being: Eating Healthier, Getting Regular Screenings, Knowing Your Numbers

  • Posted Mar 05, 2019
  • Christine Walker

Mom was right when she told us to eat all of our veggies and listen to what our doctors tell us to do to maintain our good health. But, according to recent studies from the Centers for Disease Control and Prevention (CDC), it seems that many of us are not taking mom’s advice to heart.

According to the CDC, only 9.3 percent of Americans meet daily intake recommendations for total vegetables (this includes dark green and orange veggies) and just 12.2 percent of Americans eat the two to four recommended daily servings of fruit.

That’s why, during National Nutrition Month, Holy Cross Hospital encourages you to care for yourself and your loved ones by reminding you of the importance of eating healthier and getting regular health screenings.

The federal government has published recommended dietary guidelines designed to promote general health and reduce the risk of chronic diseases and obesity. You can start following the guidelines by:

•    Following a healthier eating pattern across the lifespan
•    Focusing on variety, nutrient density and amount
•    Limiting calories from added sugars and saturated fats and reducing sodium intake
•    Shifting to healthier food and beverage choices
•    Supporting healthier eating patterns for all

Making these changes can help you keep your biometric numbers (like blood pressure, blood sugar, weight, etc.) in a healthier range.

The best way to find out if your numbers are within a healthy range for your gender, height and age is to have annual health screenings with your primary care physician (PCP). Annual health screenings are 100 percent covered by your health insurance as preventive care.

Having a PCP who can coordinate your care is vital to your good health. If you don’t have a PCP, just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions.

As your trusted health partner for life, Holy Cross Hospital is committed to providing resources that promote your well-being though body, mind and spirit.

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Lowering Your Risk for Disease

  • Posted Feb 26, 2019
  • hchadmin



Did you know that according to the Academy of Nutrition and Dietetics eating a healthier diet is one of the first lines of defense in the prevention of type 2 diabetes and heart disease?

March is National Nutrition Month and Holy Cross Hospital would like to encourage you to care for yourself, and your loved ones, by reminding you of the importance of healthier eating, spiritual well-being and preventive care.  

The American Diabetes Association says that healthier eating is one of the most important things we can do to lower the risk for type 2 diabetes and heart disease. Additionally, research by the National Institutes of Health (NIH) shows that following a healthier diet can help prevent high blood pressure and may lower blood pressure that is already over the normal range.    

Below are some tips from the NIH to help you make healthier food choices every day:

•Keep healthier snacks, such as fruit and vegetables, at home and at work

•Pack healthier lunches for you and your family

•Choose low-fat diary products

•Eat whole-grain cereals, breads, crackers, brown rice, pasta or oatmeal

•Select lean meats and poultry

•Choose more fish, beans, peas, nuts and seeds as protein sources

Another great way to reduce your risk of developing disease is by maintaining spiritual wellness. According to Mental Health America, there is a connection between spirituality and health. Spirituality can reduce the stress that often drives disease. Holy Cross Hospital offers the following suggestions to keep your good health:

•Discover and rediscover what makes your life meaningful. Find what brings your life purpose and align your choices with it. Wherever your passion is, there you’ll find your purpose.

•Nurture your connection with God/your Higher Power through regular spiritual practices.  Some people choose prayer, others meditate, some read Scripture, and others walk through nature. Whatever helps you in your relationship with the Divine, make time to foster your awareness of the Sacred.  

•Connect with others who share your values. Having meaningful relationships with others, with focus on what is important to us, reminds us that we are not alone and can often bring joy to our lives.

•Find opportunities to serve. Helping others in need, either through volunteer work or some other means, nurtures our spirit when we feel our actions make a positive difference for other people.  

Last, but not least, getting annual physicals and tests from your doctor is key in sustaining your health and preventing diseases like diabetes and high blood pressure. Having a primary care physician (PCP) who can coordinate your care is vital to your good health. A PCP typically specializes in family medicine, internal medicine or general practice. 

If you don’t have a PCP, finding one is easy! Just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions.

As you’re your Trusted Health Partner for Life, Holy Cross Hospital is committed to providing resources that promote your well-being though body, mind and spirit and is dedicated to helping you Live Your Whole Life.

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For Those Living with Heart Disease

  • Posted Feb 11, 2019
  • hchadmin

Learning that you or a loved one has heart disease can change your life. However, educating yourself about this disease is the first step toward feeling better and making choices that can help you live a longer and healthier life.

According to the Centers for Disease Control and Prevention (CDC), approximately 11.5 percent of Americans have been diagnosed with heart disease. February is American Heart Month. Join us for a health lecture or Mended Hearts Support Group, and heed the following suggestions to help navigate treatment if you or a loved one has been diagnosed:

•Making lifestyle changes. Not smoking, following a heart healthy eating plan, maintaining a healthier weight and becoming more physically active can go a long way in helping to keep your heart disease from worsening.  View Antoinette's Smoking Cessation story | Learn more about free Smoking Cessation help at Holy Cross

•Taking medication. Medications are often used to treat high cholesterol, high blood pressure or heart disease itself. Be sure to take your medication exactly as your doctor prescribes. If you have uncomfortable side effects, let your doctor know. 

•Following doctor’s orders. Your doctor may recommend procedures to open an artery and improve blood flow. These are usually done to ease severe chest pain or to clear blockages in blood vessels.

As you know, having a primary care physician (PCP) who can coordinate your care is vital to your good health. If you don’t have a PCP, finding one is easy. Just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions.

When you’re being treated for a disease or condition, it may not always be easy to decide where to go for care. For anything that is considered a life-threatening situation (like chest pain, major injuries or sudden and severe pain) it’s best to go to the emergency room. 

For less severe matters that still require immediate attention, if you can’t get in to see your PCP, going to an urgent care facility can save you time and money. 

As your Trusted Health Partner for Life, Holy Cross Hospital is committed to helping you Live Your Whole Life by nurturing well-being through body, mind and spirit.

 

Regular Screenings and Knowing Your Numbers Can Help Catch Heart Disease Early

  • Posted Feb 04, 2019
  • Christine Walker



According to the Centers for Disease Control and Prevention (CDC), about 610,000 people die of heart disease in the United States every year – that's one in every four deaths. That’s why, during American Heart Month, Holy Cross Hospital would like to encourage you to care for yourself and your loved ones by reminding you of the importance of regular health screenings.

Heart disease affects different populations in different ways. For example, according to the U.S. Department of Health and Human Services Office of Minority Health, both Hispanic-American adults and Asian-American adults are less likely to have heart disease than non-Hispanic White adults. African-American adults are more likely to have high blood pressure and more likely to die from heart disease than non-Hispanic whites.

For people of all ethnicities, knowing and properly managing your biometric numbers such as your weight, blood pressure and cholesterol levels, can prevent or delay heart disease and its complications.

Of special interest regarding blood pressure numbers, the American College of Cardiology (ACC) and the American Heart Association (AHA) have revised the guidelines for the detection, prevention, management and treatment of high blood pressure. The new guidelines – the first comprehensive set since 2003 – lower the definition of high blood pressure to account for complications that can occur at lower numbers and to allow for earlier intervention. Blood pressure categories in the new guidelines are:

•Normal: Less than 120/80 mm Hg

•Elevated: Systolic between 120-129 and diastolic less than 80

•Stage 1: Systolic between 130-139 or diastolic between 80-89

•Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg

•Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage

The best way to find out if your numbers are within a healthy range for your gender, height and age is to have annual health screenings. 

Additionally, having a primary care physician (PCP) who can coordinate your care is vital to your good health. 

A PCP typically specializes in family medicine, internal medicine or general practice. If you don’t have a PCP, finding one is easy. Just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions.

If you have any changes in your health and you’ve got questions, call the nurse line offered by your medical plan. 

As your trusted health partner for life, Holy Cross Hospital is committed to helping you Live Your Whole Life by nurturing well-being through body, mind and spirit.

 
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Live Healthier and Lower Your Risk for Heart Disease

  • Posted Jan 29, 2019
  • hchadmin

Did you know that according to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death in the United States?

February is American Heart Month and Holy Cross Hospital would like to encourage you to care for yourself, and your loved ones, by reminding you of the importance of preventive care. 

The most common type of heart disease is coronary artery disease (CAD), according to the CDC. The great news is that you can greatly reduce your risk for CAD through lifestyle changes and preventive care, including embracing a healthier spirit.

To keep your heart healthy, the American Heart Association recommends the following:
•    Maintain a healthy weight
•    Quit smoking and avoid secondhand smoke
•    Control your cholesterol levels and blood pressure
•    Drink alcohol only in moderation
•    Get regular exercise and eat healthier
•    Ask your doctor about taking aspirin every day (if you are a man over the age of 45, or a woman past menopause)
•    Manage stress

While controlling physical risk factors is obviously a great way to help prevent any condition, so is maintaining a healthier spirit. For example:
•    Remain optimistic. Research shows that happiness and a positive attitude are associated with lower rates of disease.
•    Control stress. Stress relievers like deep breathing and muscle relaxation exercises, as well as keeping a journal, can be helpful in controlling the impact stress has on your body.
•    Do everything in moderation. Don’t try to do too much at one time – make sure to have time for proper nutrition, sleep, work and play.
•    Create a network. Maintaining a close circle of family and friends can provide you with emotional support when you need it.

Lastly, getting annual physicals and tests from your doctor is key in sustaining your health and preventing heart disease. Having a primary care physician (PCP) who can coordinate your care is vital to your good health. A PCP typically specializes in family medicine, internal medicine or general practice.
If you don’t have a PCP, finding one is easy! Just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions.

As your trusted health partner for life, Holy Cross Hospital is committed to helping you Live Your Whole Life by nurturing well-being through body, mind and spirit.


Feeling Overwhelmed? Strategies for Managing a Busy Life

  • Posted Jan 15, 2019
  • hchadmin

Increasing numbers of women are finding it more and more difficult to achieve a healthier life balance. Juggling a family and a career, while still finding time for social activities and personal time, often means all but the most important things get pushed aside. Women, or the women in your life, may feel that managing it all is a daunting task.

Hectic schedules can lead to minor inconveniences such as missed meals, or more serious issues such as stress and fatigue. All of these things can have a negative impact on women’s health. Additionally, health screenings such as mammograms and pap smears often become less of a priority when your to-do list becomes unmanageable.

Research shows more women feel they are too busy with work or family commitments to see their doctor, even when they are not feeling well. It's important to take care of yourself first, if you are to be the best person possible for the people in your life.

To avoid feeling stressed, broken and not in control of your life, take charge and make some changes. Here are few tips that can go a long way in helping you regain that treasured sense of balance:

·        Strive to live a healthier lifestyle through proper nutrition, engaging in regular exercise and getting enough sleep. This will give you the extra energy you need to tackle life's daily challenges.

·        Renew yourself by scheduling downtime. Your mind and body need an opportunity to re-energize. The practice of mindfulness – staying in the moment and not worrying about the past or future – is helpful for many.

·        Avoid blurring the boundaries between work and home. In our always-connected world, this can be difficult. However, women who achieve this separation tend to do better in both areas.

·        Make a plan for the upcoming day or week. This will give you a sense of structure and direction. If necessary, write down, or use a planning tool, to enter your tasks and goals.

·        Be realistic about the things you can and can't do. There are only so many hours in a day and many women overschedule.

·        Learn to say "no" to those demands that don't align with your goals.

Even though you may have a lot going on in your life, it's still important to remember that having a primary care physician (PCP) who can coordinate your care is vital to your good health. If you don’t have a PCP, finding one is easy! Just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions.

As your Your Trusted Health Partner for Life, Holy Cross Hospital is committed to helping you Live Your Whole Life by nurturing well-being through body, mind and spirit.


Enjoy a Healthier 2019 with Lifestyle Improvements and Self-Care

  • Posted Jan 08, 2019
  • hchadmin

A healthier body, mind and spirit are goals many of us strive to reach. However, the pressures of daily life make can it difficult for many women to achieve these aims. Trying to do it all – maintain a successful career, sustain stable relationships, raise children, care for aging parents – can take a serious toll on your physical and emotional health. 

Therefore, it's important that women, or the women in your life, take the time and make the effort to focus on themselves without feelings of guilt. Holy Cross Hospital would like to take this opportunity to encourage you to take the necessary steps to jumpstart positive lifestyle changes by taking better care of all aspects of your well-being.

Lifestyle modification can consist of a variety of strategies such as healthier eating, exercise and physical activity, getting adequate sleep, reducing stress and spiritual fulfillment. However, it's important to remember that no two women are the same and you should tailor whatever strategies you use to your own life and goals. 

Ensuring that you get enough physical activity will go a long way toward improving your overall quality of life. Although the benefits of physical activity far outweigh the possibility of adverse outcomes, you should still start gradually and perform the types of physical activity that are appropriate for your current fitness level. However, because we are designed to use our bodies and inactivity can be a contributing factor to many health issues, you should strive to meet the following recommendations:

•Do at least 150 minutes (two hours and 30 minutes) per week of moderate-intensity, or 75 minutes (one hour and 15 minutes) per week of vigorous-intensity aerobic physical activity.

•Perform muscle-strengthening activities that are moderate or high intensity and involve all major muscle groups on two or more days a week.

•Do activities that you enjoy, be it weightlifting, walking, yoga, swimming and biking because almost any exercise is helpful.

Women's busy schedules can sometimes make it difficult to eat correctly. Proper nutrition is a key component of any strategy to live healthier. Keep these guidelines in mind when planning your meals:

•Eat three meals a day. Meals should consist primarily of fruits, vegetables and whole grains. Choose lean meats, poultry, fish, beans, eggs, and nuts.

•Control portion sizes. Take time to enjoy smaller amounts of food.

•Limit foods high in salt, saturated fat, trans fat, cholesterol and added sugar.

•If you drink alcohol, drink it in moderation – up to one drink a day for women.

•Stay hydrated by drinking enough water.

Poll results of all adults have shown women are more likely than men to have difficulty falling and staying asleep and to experience more daytime sleepiness at least a few nights/days a week. Additionally, new research shows that when women lose sleep they're at higher risk for diabetes, heart disease and depression. Here are a few tips to help you get a better night's rest:

•Establish a regular sleep/wake cycle. Avoid taking naps, which can make falling asleep more difficult.

•Make your bedroom an inviting place. However avoid use of the bed for watching TV, eating or working.

•Avoid caffeine, alcohol and nicotine as these things can make it difficult to fall or stay asleep. Also avoid stimulating activities close to bedtime and instead engage in calming, relaxing activities.

Making changes to improve the physical aspects of your well-being are great. But what can women do to enhance their mental and spiritual health? Physical, mental and spiritual health are deeply intertwined and have a profound effect on one another. Even though it may seem hard to find ways to de-stress with all the things you have to do, it's important to find those ways. The following suggestions can help:

•Stress relievers like deep breathing and muscle relaxation exercises and keeping a journal, can be helpful in controlling the impact stress has on your body.

•Don’t try to do too much at one time – make sure to have time for proper nutrition, sleep, work and play.

•Maintaining a close circle of family and friends can provide you with emotional support when you need it. 

•Make time for meditation and/or prayer. Spend time in nature.

•Strive to practice compassion, love, forgiveness, altruism, joy, and fulfillment.

•Work to increase the positive moments in your work and your life, while reducing the negative.

Last but not least, your lifestyle improvement program should always include getting annual physicals and tests from your primary care physician (PCP). Finding a PCP is easy! Just visit your insurance carrier’s website, look for the “find a doctor” area and follow the instructions.

As your Trusted Health Partner for Life, Holy Cross Hospital is committed to helping you Live Your Whole Life by nurturing well-being through body, mind and spirit.

 

Tips for Giving Wisely

  • Posted Nov 27, 2018
  • hchadmin

South Floridians and the Holy Cross community are very generous and we want to make a difference in our communities. However, with thousands of giving opportunities out there, all vying for our money and time, how do we decide which charities or organizations to support? How do we determine whether or not the group we want to donate to is doing its job and fulfilling its mission? This is especially important now during the month of December, (and today- Giving Tuesday) when giving typically increases.

Do your research. It's important to know more information about charitable organizations than just their name. Consumer Reports suggests checking out these three charity watchdogs, which can help you feel confident that a group you're donating to deserves your support:

BBB Wise Giving Alliance

Charity Navigator

Charity Watch

If the watchdogs haven't evaluated a group you're considering supporting, you can research it yourself. Check the group's website for information about its mission, board of directors, and its latest financial reports.

Consumer Reports also offers these tips that you should keep in mind when considering a giving opportunity:

•Verify tax-exempt status. If you're not sure whether donations to a particular charity are tax-deductible (don't assume they are), confirm a group's tax-exempt status by checking with the group or by going to the IRS website.

•Give directly. If you're contacted via phone by a charity you want to support, hang up and give directly instead.

•Request privacy. If you don't want to receive requests from other organizations, tell groups you support that you don't want your name and contact information sold, exchanged, or rented.

•Be on guard for sound-alikes. Some low-rated charities have names that resemble those of high-rated ones.

Holy Cross Hospital would like to take this opportunity to encourage you to Live Your Whole Life by thinking about the giving opportunities available to you that lift up individuals and communities, both locally and afar.

 

[Disclaimer: Trinity Health is a Catholic health care organization that is firmly committed to maintaining fidelity to its Catholic identity by closely conforming to the Ethical and Religious Directives for Catholic Health Care Services (ERDs). 

Consumer Reports and the other organizations linked to in this article are independent sites and have no obligation to provide information that is always congruent with the ERDs. Trinity Health cannot guarantee their content and ask your discretion when using information from these sites.]


Photo by Kat Yukawa on Unsplash


The Act of Giving Brings You More in Return Than You Might Realize

  • Posted Nov 20, 2018
  • hchadmin

Greetings from Holy Cross' Thanksgiving dinner baskets collection and Prayer Service.


We know that giving of our time and financial resources benefits the recipients. Our acts of charity, generosity and kindness can make tangible, positive differences in the lives of others. Plus, giving actually feels good. Helping others gives many of us that "warm glow." But did you know there may be a biological basis for the increase in happiness and health that comes from generous behavior?

The National Institutes of Health (NIH) and the National Science Foundation were involved in a study that showed the brain's pleasure centers became activated when people donated money to charity. Researchers took advantage of a brain imaging technique known as functional magnetic resonance imaging (fMRI), which shows when specific regions of the brain are activated. The higher brain response to voluntary giving might correspond to the “warm glow” people reportedly experience when they’ve donated money to a good cause.

In addition to increasing your feeling of gratification, studies have found other mental health benefits including lowered levels of stress and anxiety. Giving and volunteering can have physical benefits as well. Some studies have shown a decrease in blood pressure and a strengthening of the immune system when we give of ourselves. And this is not simply a case of healthier people being more generous. The health benefits are clear.

Remember though, it's not all about money nor the amount. Donating your time and energy counts just as much. It could be something as simple as giving up your seat on the bus.  Holy Cross Hospital would like to take this opportunity to encourage you to Live Your Whole Life by thinking about the ways you might give of yourself to better the circumstances of individuals or your community. This is your chance to not only improve the lives of others, but to improve your own health, sense of well-being and happiness as well. Everybody wins.


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About Holy Cross Hospital

Holy Cross Hospital is a nonprofit, Catholic hospital in Fort Lauderdale, Florida, dedicated to innovative, high quality and compassionate care. For nearly six decades, Holy Cross has continuously expanded its services to provide leading-edge care for their patients in Florida and for those from elsewhere in the United States. Holy Cross also offers an International Services program to ensure that patients from outside the U.S. receive the care they need.

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