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Tampa General nurses record the last heartbeats of dying patients, making a family memory

By Justine Griffin for the Tampa Bay Times

TAMPA — As John Reisinger waited with family at Tampa General Hospital, grief settled in like a fog. So some of the details are hazy.

But he remembers the moment when three women in white lab coats approached him.

The day before, his niece, Jessica Raubenolt, had been struck and killed by a speeding car as she legally crossed Bayshore Boulevard with her 21-month-old daughter, Lillia.

A bystander had kept the girl’s heart beating. But now, in the neonatal intensive care unit, she was fading.

The women had some paperwork. They asked for permission to record Lillia’s heartbeat.

“Of course with the emotional state of the immediate family, I told them to go ahead and record it, that we’d have the paperwork signed in time,” Reisinger said.

That night, a team of nurses and staff from Tampa General captured audio from the dying child’s heart. They later added music and offered it to the family as a keepsake — part of the hospital’s Beats of Love program, which began last year, with a focus on critical patients.

Anthony Goodwin, a musician by trade who plays guitar for Tampa General patients, uses his audio engineering experience to save the heartbeats for families to listen to on their own.

“We wanted to help families cope with the unfathomable loss of a child,” said Dr. Maya Balakrishnan, a neonatologist at the hospital and an associate professor of pediatrics at the USF Morsani College of Medicine.

She described Goodwin’s role as “creating magic.”

Reisinger remembers Goodwin asking if the family would like the sound of Lillia’s last heartbeats set to music. They said yes, and requested Over the Rainbow.

“It was one of the first songs David and Jessica sang to Lillia when she was born,” he said of Lillia’s parents. “And it was one of the last things David was able to do before she died, is sing it to her again, and then she was taken away for organ donor surgery.”

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In Florida and everywhere, a big shift is underway. It’s changing the way we go to the doctor.

Jewell Hamilton, left, and Andre Curry attend the front desk at Florida Blue in Tampa, where consumers can get wellness checks in addition to buying insurance. [MARTHA ASENCIO RHINE | Times]

By Justine Griffin for the Tampa Bay Times 

The health care business in Florida and across the nation is the midst of monumental change as insurers, hospital chains and even retailers begin to venture outside their traditional roles.

Hospitals are getting into the insurance end of the business. Insurers, along with drug stores, are delivering front-line health care.

And consumers, confronted with blurring lines and a host of new options, may need a scorecard to keep up. The shifting ground continues to change where and how they go to the doctor.

BayCare, which operates 15 hospitals in Tampa Bay and the surrounding area, next month will become the second health system in the state to sell Medicare Advantage plans, the privately offered insurance policies through which many people receive their Medicare benefits.

Two other chains, Florida Hospital and Orlando Health, are providing HMO insurance plans to thousands of Disney employees this year, with hopes of expanding the model to include other employers.

Meanwhile insurance companies, from Florida Blue to UnitedHealth, are gobbling up physicians practices and creating large networks of doctors offices that offer clinical services under new company banners.

And retailers like CVS and Walgreens continue to push more toward the front lines of health care, offering online doctors’ visits and an expanding list of other medical services.

It all adds up to an industry in the middle of a shake out, executives and experts say, with players on all edges trying to stay relevant by expanding what they do.

“This is a trend that’s been emerging over the last five years,” said Peter Young, a hospital consultant. “It’s increasing each year as providers discover that they need to move up the food chain.”

Driving many of the changes is the Affordable Care Act, which helped usher in a shift in thinking about the cost of health care. Hospitals are penalized more often by insurance companies and the government when patients have more frequent stays. The focus now, Young said, is keeping patients out of the emergency room.

“What we’re seeing is that ER visits are flattening or declining all over America as health systems begin to focus on prevention,” he said. “They are redirecting non-emergent people to urgent care, and urgent care is perfect for that. That’s also why you see CVS and Walgreens getting into and expanding their clinic business.”

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Lyme disease is on the rise in Florida, but experts don’t know why

Lyme disease cases are up across the nation, but notably in states like California and Florida, where the disease has not been an issue in the past. The disease comes from bacteria carried by ticks like this one that get it by feeding on an infected animal. Inftected ticks can then transmit it to humans through bites. [Times files]

By Justine Griffin for the Tampa Bay Times 

When Jackie Dube found circular rashes with bullseye points on her stomach, she went to the hospital. Doctors told her she had an allergic reaction to flea bites.

A year later, she became seriously ill. Flu-like symptoms and chronic joint pain would continue on and off for years until she’d eventually be diagnosed with Lyme disease. More than a decade after her misdiagnosis, the 37-year-old Pinellas Park resident says she suffers “flair ups” from Lyme disease annually.

“In the beginning, doctors told me it was psychosomatic, that all of this was in my head,” Dube said. “After years of hearing that, but dealing with my eyes swollen shut, a dislocated jaw and shoulder, fistulas in my thighs, I was finally tested for Lyme and was positive.”

Dube is one of a growing number of Floridians who suffer from Lyme disease, part of a nationwide increase that has researchers stumped.

Historically concentrated in New England, the disease has mostly been a seasonal issue in warmer months when ticks are prevalent in wooded areas. But data collected by Quest Diagnostics, a national clinical laboratory, found increasing Lyme disease cases in all 50 states, with a significant rise in places like California and Florida. Until recently, those two large states have never been associated with high rates of the disease.

“As things get warmer, one would think that the ticks would migrate more north, to Canada, not necessarily to Florida,” said Dr. Harvey Kaufman, senior medical director at Quest. “We’re seeing a rise in cases in Canada and in Florida, but with Florida we’ve got to think of a reason other than climate change.”

While the number of diagnoses in Florida is comparatively small, the steep increase in cases has triggered some concern. Last year, according to Quest, 501 cases of Lyme disease were reported in the state — triple the number five years ago and a spike of 77 percent since 2015.

About 30,000 cases nationwide are documented each year by the Centers For Disease Control and Prevention, but the agency admits many go unreported.

In 2015, researchers from Johns Hopkins estimated that Lyme disease costs the U.S. health care system up to $1.3 billion a year.

“The CDC has some older data that shows that the blacklegged tick is spreading into more parts of the U.S., so that’s likely one explanation for the rise,” Kaufman said. “But Lyme disease has really taken off in the last several years. There is generally more awareness of Lyme disease in places like Florida where you see ticks year-round because there’s no winter freezing.”

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When suicide threats come calling: ‘I try to make a connection.’

Taylor Turosz, 27, of Tampa listens to a caller during an evening shift earlier this month at the Crisis Center of Tampa Bay. When celebrities commit suicide, she says, the number of crisis calls goes up. "People are hurt, and those of that particular fan base feel it more deeply," she said. "They identify more. But we're glad people do call. I always hope they do rather than not." [TAILYR IRVINE | Times]

By Justine Griffin for the Tampa Bay Times

TAMPA — At first glance, it’s a typical office with more than a dozen cubicles under florescent lights. The operators wear headsets and stare into computer screens, some tinkering with handheld toys, others browsing Facebook or chatting with colleagues when the phones go quiet. The faint sound of tapping keyboards is nearly constant.

Then a burst of classical music plays — loudly — and the energy in the room goes still.

Along the cubicles, their eyes shift to one another until someone speaks up.

“I got it,” says Taylor Turosz.

The musical ringtone carries a particular urgency — that a call from the National Suicide Prevention Hotline has been routed here, to the Crisis Center of Tampa Bay. The center also handles a half-dozen other hotlines dealing with sexual assault, veterans issues and substance abuse, among other topics, but suicide calls take priority.

Suddenly, Turosz is talking to a man who says he’s holding a loaded gun. His sister just died; now he wants to die too.

Turosz pulls her knees up to her chest in the rolling office chair. She tucks a long strand of red hair behind her ear. The rings on her fingers clink against the keys as she takes notes, the letters on the screen spelling trouble on the other end of the line.

He felt like people are better off without him. He’s very distraught.

“Where are you now?” Turosz asks him more than once.

She speaks softly, calmly, maternally. But most of the time, Turosz, a 27-year-old University of South Florida student, just listens.

“I can hear that you’re really upset,” she tells him. “I want to understand what’s going on around you.”

Read more here. 

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HIV is on the rise in Florida and young people don’t seem to care

Robert Marquez of Tampa was diagnosed with HIV at 18. He didn't know much about the disease at the time, but quickly did his research. "It didn't make me feel better," said Marquez, now 20. "But it gave me hope." [BRONTE WITTPENN | Times]

By Justine Griffin for the Tampa Bay Times 

Robert Marquez was 18 when he got the news that would change his life forever.

He was HIV positive.

“I knew nothing about it outside of it being a ‘gay disease’ like my conservative parents and pastor said about it,” said Marquez, now 20. “But now, I know that’s not true. It can affect anyone. But it’s also possible to live a long, normal life.”

His case is one example of a double-edged reality that has raised concern among advocates as HIV makes an unwelcome comeback in Florida. While the stigma has lifted somewhat and effective treatments have lessened much of the danger, the disease no longer presses on the public consciousness like it once did.

That and a lack of public information have contributed to a rise in cases among a new generation of young people who never knew the fear that HIV evoked in earlier times.

Florida continues to rank at or near the top nationally for HIV diagnoses, with Pinellas and Hillsborough counties among the regions that are considered hotbeds of activity. And local health officials say they are seeing more cases among people in their early teens to early 20s.

“Yes, HIV is more manageable these days, but it’s on the rise again. Younger people are being diagnosed and don’t seem to understand the consequences or know the history of the stigma behind HIV and AIDS,” said Lorraine Langlois, CEO of Metro Wellness & Community Centers, a network of health care facilities that specialize in LBGTQ services around Tampa Bay.

While state health officials typically don’t release HIV data in real time, many available numbers support what advocates say they are seeing in their centers.

According to the Florida Department of Health, the number of HIV diagnoses:

• Increased 8 percent statewide among people of all ages from 2014 to 2016.

• Shot up 20 percent from 2007 to 2016 for people in their 20s across the state.

• Rose significantly over the same nine years for people in their 20s in Tampa Bay. The increase was 28 percent in Pinellas and Pasco counties, and 23 percent in Hillsborough County.

Nationally, people ages 13 to 24 accounted for 21 percent of all new HIV diagnoses in the U.S. in 2016, with most of those occurring among those who are 20 to 24, according to the Centers for Disease Control and Prevention.

Many of them are not using condoms, a problem that has only worsened in the last decade. In a CDC survey last year, only 54 percent of sexually active high school students said they used condoms the last time they had intercourse, down from 61 percent in 2007.

Read more here.