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Global Patient Services Summer 2012


Turning to Cleveland Clinic for Hope

Four year-old Francesca Fernandez de Cordova was just an average child growing up in Ecuador until the fall of 2011 when her life turned upside down. She began experiencing severe headaches and worsening coordination. Her parents, Sandra and Pedro, took her to a local Ecuadorian physician. He diagnosed the cause of her symptoms as a medulloblastoma, a type of malignant brain tumor found in children.

While this was a devastating diagnosis to receive for their daughter, Francesca’s parents were determined to do everything in their power to save their youngest daughter. Their local neurosurgeon initially felt that the tumor was all but inoperable due to its size and location in a critical area of the brain. He was able to remove a small portion of the tumor from Francesca’s brain. But this meant the only option available for treating the remaining tumor were radiation followed by chemotherapy. Francesca’s parents knew that this treatment path might give them more time with their daughter—still, it was not the outcome they were hoping for.

So, Sandra and Pedro began their search for other options for Francesca. Her neurosurgeon in Ecuador recommended that the family visit Cleveland Clinic Florida neurosurgeon, Jose Valerio, MD, whom he met through a Latin American medical association. Soon, the family packed their bags, got on a plane and headed to Weston, Fla., for an appointment with Dr. Valerio.

Following additional brain scans, Dr. Valerio suggested the Fernández family seek treatment for the remaining 4-cm tumor with one of his colleagues at Cleveland Clinic’s main campus in Cleveland, Ohio. Because of Francesca’s age, the nature of the remaining tumor and where it was located, he recommended Violette Recinos, MD, a pediatric neurosurgeon at the Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, who specializes in these types of pediatric brain tumor cases.

Within a few days of seeing Dr. Valerio in Florida, Francesca and her parents met with Dr. Recinos in Cleveland. Dr. Recinos subsequently removed the remaining tumor from Francesca’s brain. “She had a good tumor resection, we were able to get it all,” Dr. Recinos says. “Although Francesca’s tumor is not the most common type, our team has treated a number of these cases and knew exactly how to approach her treatment when she arrived.”

Once the surgery was completed, Tanya Tekautz, MD, took the lead on Francesca’s ongoing care. She recommended a course of radiation followed by chemotherapy to ensure the tumor cells were completely treated.

Francesca’s radiation therapy was aggressive, but like most children, she tolerated this type of intensive treatment very well. Erin Murphy, MD, a radiation oncologist, managed this six-week portion of her treatment. “We were able to perform a very complex treatment plan with the specific goal of reducing the short- and long-term side effects for Francesca,” Dr. Murphy says.

The Fernández family stayed at the Ronald McDonald House for a portion of this treatment before moving their two older children, Eric and Michelle, from Ecuador to the Solon area for the remaining treatment time.

Now, Francesca is about halfway through her chemotherapy treatment and her prognosis is good. Dr. Tekautz has resumed the oversight of her care and helps her manage any side effects she might experience, such as sleepiness or poor appetite. Francesca should complete her final chemotherapy cycles later this year. “While her tumor is aggressive, she has responded remarkably well during the treatment process,” Dr. Tekautz says. “With ongoing monitoring and follow-up we are optimistic for her future.”

Francesca’s parents have a very strong faith and are certain that their journey from Ecuador to Florida, and then to Cleveland, has been a blessing. They believe this treatment path was because God brought them to the right hospital and led them to the best clinical team for their daughter.

Today, Francesca is doing phenomenally well. She recently celebrated her fifth birthday and is looking forward to learning English and visiting the Cleveland Aquarium and Cleveland Metroparks Zoo. Francesca told her mom recently that she feels like a new person. “Cleveland Clinic is my hospital, my home,” she says. “This is where they take care of me.”


Cleveland Clinic Named One of the Top 4 Hospitals in the United States

Once again, Cleveland Clinic was named one of the top 4 hospitals in the U.S. and No. 1 in the U.S. for Cardiology & Heart Surgery for the 18th consecutive year. We are also very pleased to announce that Cleveland Clinic also ranked No. 1 in Nephrology and Urology.

Cleveland Clinic rankings improved in 14 specialties: We were ranked in the top 3 in 10 adult specialties and in the top 10 in 14 specialties.

The national rankings are as follows:

Specialty Areas U.S. Ranking
Cardiology & Heart Surgery 1
Kidney Disorders 1
Urology 1
Gastroenterology 2
Diabetes & Endocrinology 2
Ear, Nose & Throat 2
Rheumatology 2
Pulmonology 3
Orthopaedics 3
Gynecology 3
Geriatrics 4
Neurology & Neurosurgery 5
Cancer 6
Ophthalmology 9

U.S. News also ranked hospitals by region. Seven of our regional hospitals in Ohio — Fairview (4), Hillcrest (5), South Pointe (6), Marymount (8), Lutheran (9), Euclid (10) and Lakewood (10) — ranked within the Top 10 of Cleveland-area hospitals.

Cleveland Clinic Florida received a national ranking in gastroenterology (48) and is ranked No. 3 in the Miami-Fort Lauderdale metro area and No. 7 in the state.

In June, U.S. News released rankings for children’s hospitals. Cleveland Clinic Children’s Hospital earned national rankings in all 10 specialties, including No. 3 in neurology and neurosurgery and No. 9 in gastroenterology.

We thank you for making us a Top 4 Hospital in the nation for the ninth year in a row. Your trust in our care is a big reason why Cleveland Clinic is once again ranked in the top four of U.S. News & World Report’s “2012-13 Best Hospitals.”


Touching Hearts in Honduras

We often take for granted the simple medical comforts that afford us a high quality of living: vitamins to fulfill nutritional needs, skin creams to prevent rashes and infection, cold medicine to keep a cough from progressing into something more serious. But life is different in the war-torn country of Honduras, where drinking water comes from the sky and rivers, and malnutrition is rampant.

“They are looking for someone who can give them relief,” says Miryam Perez-Miller, a Patient Service Coordinator with Cleveland Clinic’s Global Patient Services. Perez-Miller embarked on a medical mission to Honduras with a team of doctors and nurses from Cleveland Clinic and Dr. Russell Raymond, who founded The Raymond Foundation and leads annual trips to Honduras. The mission is sponsored in part by The Salvation Army, with coordination efforts through the Ruth Paz Foundation in Honduras, which arranges accommodations and an itinerary of villages the medical team visits.

During the weeklong stay, Perez-Miller and Cleveland Clinic colleagues treated nearly 2,000 Honduran people of all ages. “Some had cardiology problems, gynecological problems, infections,” she says. “They needed vaccinations, vitamins and medications.” Since drinking water in the country’s villages is not purified through septic systems, parasitic illnesses are very common.

The medical team brought the people hope, relief and comfort in the form of shoes and clothing—donations that were gathered in Cleveland before departing on the mission. “Everyone was so thankful,” Perez- Miller says of the people she met in Honduras. “When they see someone who cares about them, they want to thank you all the time.”

A special thank-you came at the airport upon the team’s arrival in Honduras. A patient who met Dr. Raymond in Honduras during a previous mission had received care at Cleveland Clinic in 2010. She learned about the team’s visit through the Ruth Paz Foundation and met the team when they arrived. “She stayed with us for three more days,” Perez- Miller says.

“For me, and for Cleveland Clinic, it was very touching and we felt a great reward when you see the gratitude of someone you helped two years ago,” Perez- Miller says. “Patients never forget when they feel like they’ve been treated so well.”

Every day, the team gathered and prayed with the people in the village. “Their eyes lit up knowing that someone was caring for them,” she says. “We got back a lot more than we gave.”


Spotlight: Digestive Disease Institute

Cleveland Clinic’s Digestive Disease Institute (DDI) is the first of its kind to offer a fully integrated model of care, uniting specialists to cover the full spectrum of disorders related to the gastrointestinal tract. As one of the top digestive disease centers in the country, DDI offers advanced, safe and proven surgical treatments and opportunities for cutting-edge research at its Cleveland and Florida locations.

DDI has been ranked second in the nation by U.S. News & World Report’s Best Hospitals Survey since 2003, and top in Ohio since 1990. The DDI team is comprised of specialists in gastroenterology, hepatology, colorectal surgery, general surgery, hepato-pancreato-bilary and transplant surgery, and nutrition. For patients, this model of care means seamless interaction with specialists, shorter waits for appointments and the most comprehensive care possible.

DDI’s physicians are pioneers in their field. DDI is responsible for the first continent ileostomy in 1977, giving these patients an alternative to the external pouch. And in 1991, surgeons performed the first laparoscopic colorectal surgery. Today, the institute achieves new minimally-invasive surgical milestones to improve quality of life for every patient. Our colorectal surgeons performed the world’s first colon resection entirely through a single incision in the belly button and the world’s first single-incision proctocolectomy and ileo anal pouch anastomosis (removing the entire large intestine and rectum). DDI general surgeons recently performed the world’s first single-port robotic gallbladder removal – and followed it with 12 others.

DDI has an international reputation for excellence in IBD, including: more operations for Crohn’s disease than any other institution, including the bowel-conserving strictureplasty, the world’s highest volume of J-pouch procedure, and the nation’s largest referral center for repairing pelvic pouches.

DDI’s state-of-the-art endoscopy unit is one of a handful of sites nationally that offers three types of deep enteroscopy imaging for imaging the small bowel, and the next generation of 3-D cholangiography to examine bile ducts.

Here’s a spotlight on two DDI services:

Pancreas Clinic

As one of the few centers in the nation specializing in multidisciplinary, patient-centered treatment, Cleveland Clinic Pancreas Clinic addresses every type of pancreatic disease and disorder, including complicated disease like acute pancreatitis. Our clinic unites specialists from across Cleveland Clinic, including pancreatic surgeons, gastroenterologists, radiologists, anesthesiologists, psychologists and oncologists from Taussig Cancer Institute when needed, who together work to customize the best possible treatment for patients. And, for select patients who have not responded to medical and surgical management, the Pancreas Clinic offers auto-islet transplantation.

Pouchitis Clinic

As the largest national and international referral center for repairing failed pelvic pouches, people come from around the world to the Digestive Disease Institute for reoperations. Cleveland Clinic established the the world's first and largest Pouchitis Clinic at which a variety of pouch-associated disorders, such as pouchitis and Crohn's disease of the pouch, are diagnosed and treated by a team of inflammatory bowel disease specialists, colorectal surgeons, gastrointestinal pathologists and gastrointestinal radiologists.


Destinations for Downtime

Cleveland Clinic Florida is a destination for patients and families seeking world-class care in South Florida, with access to 200 of the world’s top physicians and specialists who focus on 35 different medical disciplines. And while loved ones are receiving quality, compassionate care, South Florida offers plenty of options for enjoying beaches, boating, shopping and culture during downtime.

We know your loved ones are first priority, and they’re getting the best care possible at Cleveland Clinic Florida. While you’re here, why not spend the time in between appointments taking in some of the area’s attractions?

Soak in the Sun

Wear your SPF, of course—then take advantage of the miles of beaches in Miami, Fort Lauderdale and West Palm Beach. Fish or dive, try water sports, go boating or cruising.

Shop & Dine

Escape with some retail therapy and vibrant shopping districts in Miami, Fort Lauderdale and West Palm Beach. Clematis Street in historical West Palm Beach stretches from the Intracoastal waterfront to the heart of downtown and boasts boutiques, dining venues, historical points of interest and live music. CityPlace offers 600,000 square feet of retail in an old-world architecture setting; and Sawgrass Mills is one of the largest retail outlet malls in the country. Meanwhile, Bal Harbour Shops in Miami offers upscale shopping that rivals Beverly Hills.

Take a break from window shopping (or splurging) to enjoy meals at chef-owned restaurants that serve up fresh catch and other South Florida specialties.

Natural Diversions

Take in South Florida’s naturescapes at its renowned national parks. The Everglades National Park is the largest subtropical wilderness a couple of hours from Cleveland Clinic Florida. Check out Biscayne National Park, which is within sight of downtown Miami. Or, enjoy the attractions at Zoo Miami and Palm Beach Zoo.

Art & Science

The South Florida Science Museum in West Palm Beach features a planetarium, aquarium, observatory and exhibits. Or try the Miami Museum of Science & Planetarium with nationally traveling shows and more than 140 hands-on exhibits. The Norton Museum of Art in West Palm Beach has more than 5,000 works on display – or catch a show at the nearby Kravis Center for Performing Arts, one of the Southeast’s premiere performance centers.

For more ways to enjoy South Florida during your stay, visit www.southfloridaonline.com.


Chat with Us…On the Weekends

Have a question about your visit to Cleveland Clinic? Need help making travel arrangements? Call us any day—even over the weekend. Now, our Global Patient Services Coordinators are standing by to take your telephone calls during the week from 6:30 a.m. – 5:30 p.m. and on Saturdays and Sundays from 8 a.m. – 12 p.m. ET.

Weekend hours allow Global Patient Services to offer real-time assistance with direct admits, appointment rescheduling and transportation arrangements due to flight delays. Aside from this assistance, the full-service department has more than 70 patient service coordinators, financial counselors and support staff that work to meet the needs of international patients and their families.

Call Global Patient Services at +001.216.444.6404.


Recipe Corner: Phyllo Chicken Pie

Try this unique twist on chicken pie using phyllo dough. With ground chicken breast, olive oil, feta cheese, scallions and egg beaters, your family will enjoy the flavor – with fewer calories and less fat.


Cleveland Clinic Global Patient Services

Telephone: 800.884.9551 (+ 001 631.439.1578 if calling from outside the United States)
9500 Euclid Avenue
Cleveland, OH 44195
Email: clevelandclinicgps@ccf.org
Web: www.clevelandclinic.org/gps

Cleveland Clinic Florida Global Patient Services

Telephone: 877.463.2010 (+ 001 954.659.5080 if calling from outside the United States)
2950 Cleveland Clinic Boulevard
Weston, FL 33331
Email: flgps@ccf.org
Web: www.clevelandclinic.org/flgps