The latest news on the health and wellness issues that matter most • Novem Health Matters The latest ne s the health and wellness issues that matter most • January 2019
Help That New Year‘s Resolution Become A Reality
W ith the beginning of the New Year, a lot of people will decide to try to lose weight. Many of us make that resolution year after year without success and the idea of failing to lose weight once again can lead to depression and low self-esteem, which can contribute to more weight gain.
for weight loss and a nutritionist for diet,” explains Dr. Dailey. “If goals cannot be met, for the morbidly obese or for very overweight patients, then bariatric surgery may be indicated.” Dr. Dailey cautions that even for the right surgical candidates, the surgery is not magic and doesn’t make you automatically lose weight. “The main goal is not cosmetic but rather to be healthier,” says Dr. Dailey. “It takes the cooperation and commitment of otherwise healthy patients to exercise and maintain good eating habits.” When bariatric surgery is combined with intense nutritional training and exercise, patients can expect to lose 70 to 80 percent of excess body weight, explains Dr. Dailey. “With surgery alone, they may lose 40 to 50 percent of excess weight, but we encourage patients to commit to the entire program to get the best results.” Candidates for surgery are those for whom other weight loss strategies have failed. For those with a body mass index (BMI) over 40, the risk of the surgery is less than the risk of living at that weight for the long-term. Persons with a BMI over 35 with obesity–related complications or with a BMI over 30 with refractory diabetes are also candidates.
In the most commonly performed non-reversible, gastric sleeve surgery, 70 percent of the stomach is removed and the remaining portion resembles a much smaller, banana-shaped “sleeve,” Dr. Dailey explains. “Some of the mechanisms that cause weight loss after the sleeve are reduced hunger since the hormones that create hunger pathways in the mind are reduced,” says Dr. Dailey. “The receptive stretch the stomach undergoes when we eat large meals is prevented, which results in the consumption of smaller meals, and it makes the stomach empty faster so that it alters digestion, aiding weight loss.” In gastric bypass surgery, which has been in use as a surgical treatment for obesity for many years, the surgeon makes a small pouch that bypasses most of the stomach and goes straight to the intestine. This limits food intake and lowers the calories absorbed. Dr. Dailey reports that post-surgery, patient satisfaction is extremely high. Not only is significant weight loss seen, but also, expectations for additional weight loss continue for 12 to 18 months after surgery, with diligent exercise and nutrition education.
Bariatric surgery may help you break the cycle. If you are considered clinically obese and have been struggling for years to lose weight without success –NCH Bariatrics may be able to help you. Specializing in bariatric weight-loss surgery, NCH general surgeon Wesley Dailey, MD says that the program is reaping excellent results.
Dr. Wesley Dailey
But Dr. Dailey is quick to stress that surgical options for the clinically obese are a last-resort method of treatment. “Persons should first see a medical doctor to try the least invasive options first, such as medication
For more information about NCH Bariatrics, call (239) 624-0390.
NCH Bariatrics
There are a number of techniques used to perform bariatric surgery:
Medical Weight Loss Program NCH Bariatrics team includes experts from every medical specialty connected to obesity and weight loss. These professionals work together to design the safest, most effective individual treatment plan for you.
Gastric Bypass Gastric bypass surgery is a type of bariatric, or weight loss, surgery. During gastric bypass surgery, your physician makes changes to your stomach and small intestine to change the way they absorb and digest food. Sleeve Gastrectomy Surgeons perform laparoscopic sleeve gastrectomy by removing approximately 75-80 percent of the stomach. The remaining stomach is a tubular pouch that resembles a banana. Orbera ® This procedure involves inserting a balloon into the stomach and filling it. The filled balloon takes up space in the stomach resulting in feeling fuller, faster.
Weight Loss Improves: • Cholesterol • Triglycerides
• Female Fertility • Sleep apnea • Digestive problems like GERD
• Stroke risk • Breathing • Cardiac risk • Cancer risk • Heart rate • Diabetes • Kidney disease risk
Cardiac Procedure Closes Small Hole In Heart With Great Success Rate
One in every four people is walking
air bubbles, tumors or fat deposits can travel to the heart and pass through this PFO, depriving tissues of necessary oxygen potentially damaging vital organs.” Dr. Frank says that the vast majority of people with a PFO have no symptoms. However, for the few others, symptoms can range from stroke-like symptoms to shortness of breath or hypoxia. He said there also appears to be an association with migraine headaches and a strong association with patients who develop decompression sickness while scuba diving. PFO is diagnosed through a transthoracic echocardiogram and can be confirmed on a transesophageal echocardiogram (TEE) as well as a cardiac CT scan or MRI. In addition, Dr. Frank explains that an extensive workup would be required by both a cardiologist and a neurologist to help determine the role that the PFO may have had in a stroke event. “The vast majority of people with a PFO do not require treatment,” says Dr. Frank. “However, in a select group of people between the ages of 18 and Benefits of PFO closure procedure with a transcatheter closure device ♥ Requires only a single overnight hospital stay ♥ Procedure performed while patient is awake ♥ The success rate for device closure is 95% ♥ Closing the PFO significantly reduces the chance for a recurrent stroke for those who had a cryptogenic stroke
60 who have suffered a stroke or have had stroke- like symptoms when there is no other identifiable cause for stroke, and the PFO is a potential contributing factor, the PFO can be closed in most cases by a closure device or surgery.”
around with a hole in their heart. And we’re not talking about the lyrical hole caused by longing for an absent love. This is a PFO hole – or patent foramen ovale, which is a small hole in the wall of tissue between the left and right upper chambers of the
Adam Frank, MD, NCH Interventional Cardiologist
heart. Roughly 25 percent of the population has a PFO, but with the vast majority, it never causes any issues or problems. However, in some, it has the potential to lead to a medical problem – in particular, cryptogenic stroke. PFO is an anatomic or developmental anomaly with no specific cause other than it just doesn’t close normally. PFO has no regard for gender, and in a very great majority of patients, it poses no concerns or health risks. However, there are select circumstances where it can potentially be a problem. “We are all born with a small hole that closes soon after birth, usually in the first year or two of life in the vast majority of us,” explains Adam Frank, MD, NCH Interventional Cardiologist. “But in some people, it will remain open. And, we know that it is a potential risk for a paradoxical embolus which can lead to a debilitating stroke that can occur at any age. Additionally, a paradoxical embolus in the form of blood clots,
Signs you may have a PFO that needs closure ♥ Suffered a stroke or have had stroke-like symptoms for which there is no other identifiable cause and the PFO is a potential contributing factor ♥ Shortness of breath or hypoxia ♥ Migraine headaches ♥ Decompression sickness while scuba diving
For more information, contact Vanessa Russino, APRN-BC, NCH Heart Institute Structural Heart Coordinator, at (239) 624-4274.
Education Is The Key ToDiabetes Prevention
FOOD CONTROL
DIAGNOSTIC
EXERCISE
HEALTH FOOD KEEP NORMAL WEIGHT
Dr. Gilberto Riveron, Family Medicine Physician with the NCH Physician Group
Diabetes is the number one cause of blindness and can cause kidney and nerve damage and can lead to the amputation of limbs. It is also the seventh leading cause of death among Americans. According to the Centers for Disease Control and Prevention, approximately 30 percent of Americans have pre-diabetes and don’t even know it. Dr. Riveron wants to make people more aware of diabetes and the damage the disease can do to a person’s body. African American, Native American, Asian and Latino populations are at higher risk for contracting diabetes, as are individuals with a family history of the disease, or who are obese or lead a sedentary life. “You need to be proactive and have a healthy lifestyle,” he says. “The message I want to send is that the prevalence of this disease is high,” adding that those with an increased risk should see their doctor for diabetes screening. Dr. Riveron says he believes diabetes has become more common because of a change in the American lifestyle. “The tendency for
the last 80 to 100 years has been an increasing access to food and carbohydrates and less exercise,” he explains. While diabetes is more prevalent in people over age 65, Dr. Riveron says he is seeing more patients in their 40s and 50s. One of the biggest keys to prevention, he shares, is educating children in schools, but he admits that is difficult with various cultures and family traditions. “Right now, we are just catching up with this,” says Dr. Riveron. “We are just treating those that are diabetic or close to becoming diabetic and we are not treating the root of the problem.” Dr. Riveron graduated from the Institute of Medical Sciences of Santiago, Cuba. He completed his residency at Bayfront Medical Center in St. Petersburg, Fla. and at the Community Policlinic in Holguin, Cuba. Dr. Riveron specializes in Family Medicine and is board certified by the American Board of Family Medicine.
in Bonita Springs, says he is seeing a startling epidemic in the number of patients being
treated for diabetes. According to a report by the Centers for Disease Control and Prevention, 30.3 million Americans are afflicted with the disease. “What we are doing is catching up right now,” says Dr. Riveron, who specializes in cardiovascular disease prevention, health maintenance and preventative medicine. “We have to put more into prevention. We need to do more than a primary care visit. We need to teach it at work, in schools and in restaurants. We need to teach people how important it is to prevent this.”
Dr. Riveron’s office is located at 3302 Bonita Beach Rd., Suite 170, Bonita Springs, FL 34134. To schedule an appointment, please call (239) 624-1050
New Gastroenterology Expert to Provide Local Treatment Options For IBD and IBS Patients
N CH recently
often overlap with IBS (irritable bowel syndrome) symptoms, though the treatment of each is very different. Symptoms of both can include stomach pain, cramping, gas, bloating, diarrhea, and/or constipation. IBD (Ulcerative colitis and Crohn’s disease) is the name for a group of conditions that cause inflammation of the intestines. Treatment includes medications that control inflammation and keep the immune system in check. IBS is a condition made up of a constellation of symptoms that are likely explained by a strong connection between the mind and the GI tract. Treatment is aimed at improving symptoms. “Both, IBD and IBS, can have a significant impact on quality of life and can affect a patient physically and emotionally. My role as a subspecialist is to ultimately distinguish between the two conditions and treat the patient accordingly,” explains Dr. Juncadella. “The field of IBD is constantly evolving, as are the therapies. Treatment is provided by a multidisciplinary team, which helps to improve patient outcomes,” says Dr. Juncadella. “I am one part of the team along with radiology, pathology, and surgery,” she adds. As one of the few female gastroenterologists here in Naples, she hopes to use her expertise and passion to better serve the southwest Florida community.
Symptoms of inflammatory bowel disease (IBD) including Crohn's disease and ulcerative colitis: • Abdominal pain, bloating and cramping • Diarrhea • Fever
welcomed Anna C. Juncadella, MD to
its gastroenterology and hepatology team. Splitting her time between the NCH Downtown Baker Hospital and NCH Creekside offices and surgical suites, she is now accepting new patients. A South Florida native, Dr. Juncadella completed her undergraduate education and her medical
• Anemia • Fatigue • Rectal bleeding
Dr. Juncadella
school training as part of the prestigious 7-year Medical Scholars Program at the University of Miami. She completed her internal medicine residency at Harvard University’s Massachusetts General Hospital in Boston, followed by her gastroenterology and hepatology subspecialty fellowship training at Harvard University’s Beth Israel Deaconess Medical Center. She also completed advanced specialized training in inflammatory bowel disease (IBD). “In addition to my general gastroenterology, hepatology, and endoscopy practice, I have a strong interest in IBD (inflammatory bowel disease),” says Dr. Juncadella. According to Dr. Juncadella, IBD symptoms can
• Blood in your stool • Reduced appetite • Unintended weight loss
Symptoms of irritable bowel syndrome (IBS):
• Abdominal pain and cramping • Diarrhea • Constipation • Alternating constipation and diarrhea • Changes in bowel movements • Blood in stool • Gas and bloating • Food intolerance • Fatigue and difficulty sleeping • Anxiety and depression
To make an appointment with Dr. Juncadella, call NCH Physician Group Gastroenterology and Hepatology at (239) 624-8070.
NCHTotal Hip andKnee Replacement ProgramGranted The 2018GoldSeal of Approval By The Joint Commission–The ChoiceOf Over 1600Patients Annually
So, you’ve been told you should consider having a hip or knee replacement. You are not alone. In the United States, more than 700,000 knee replacement surgeries and more than 400,000 hip replacement surgeries are performed each year. With an aging population working longer and rising rates of obesity, those numbers are expected to explode in the next two decades. Once you have decided to move forward with joint replacement surgery in the quest for an improved quality of life, choosing where to have your surgery is the next important decision. That decision is less daunting knowing that a local institution has been accredited by The Joint Commission, an independent organization that certifies
help us identify ways of improving our quality of care, consistency and safety.” Part of The Joint Commission’s focus is on how patients and caregivers are educated and prepared for discharge, and how clinical outcomes and other performance measures are used to identify opportunities to improve care. The commission also evaluates the commitment of an organization’s leaders in improving the quality of care for patients. “The benefit of Joint Commission certification to us and to the patient is that it helps establish a consistent approach to care, which works
(Front, l to r): Katie Matthews, BSN, RN, Nurse Manager, Erin Salvi, RN, Jean Deceus, Social Worker, Maria Leon, RN, Mary Cooper, RN, Natalia Vasquez, OTR/L, Stephanie Segarra, PT, DPT, Judy Post, RN, Raquel C. Moya, Rehab Technician. (Back, l to r): Richard Tillotson, PT, Jesus Martinez, Rehab Technician, Suzanne Camp, PT Manager, Marlane Jerome, RN, Leslie Shaw, PTA, Cerasela Casapu, RN, Jennifer Jimenez, Rehab Technician, Mary Lynn Banfield, PT, DPT, Eileen McMahon, PT, DPT, MSS, Jamie Bizub, PT, Jennifer Miller, BSN, RN, CMSRN, ONC.
the only one in southwest Florida,” says Jennifer Miller, MSN, RN, CMSRN, ONC, NCH Total Joint Coordinator. “We take a comprehensive and holistic approach to the care of each patient. Every patients’ recovery will be different depending upon their medical needs and internal and external motivations. We adapt to meet each patient’s needs and expectations. Although hospital lengths of stay for total joint replacements have decreased over time, we are not a drive-through service. That is important for patients to understand.” With a holistic focus on the patient as an individual, a team consisting of physical and occupational therapists, clinical technicians, case managers, registered nurses, a medical doctor and a surgeon sees the patient daily. “As part of the review and renewal of our disease- specific certification, The Joint Commission conducts an on-site review every two years,” explains Miller. “With a collaborative effort, they
to reduce the risk of errors and improve patient outcomes, allows for collaboration of teams across the continuum of care and demonstrates the commitment to higher standards of care.” Reasons to choose NCH Orthopedic Center of Excellence for your total knee or hip replacement • Joint Commission Gold Seal of Approval certification • Over 1600 total hip and knee replacements yearly performed by board certified orthopedic surgeons • Demonstrated commitment to quality and patient satisfaction • Two hour presurgery class for patients and family • Offers comprehensive, holistic care to the patient • Interdisciplinary, collaborative team approach from presurgery to post surgery care
nearly 21,000 healthcare facilities and programs throughout the United States. Joint Commission certification is awarded for meeting the highest standards in the delivery of quality patient care. The NCH orthopedic program was recently re- certified by The Joint Commission as an Orthopedic Center of Excellence, offering the highest in quality care and patient satisfaction for total hip and total knee replacement. As a prospective patient, you can have security and peace of mind knowing that since its initial Joint Commission accreditation in 2014, the NCH Orthopedic program has demonstrated exceptional quality and patient outcomes. The focus on comprehensive care of every patient sets the NCH program apart from area “quick-stop” surgical facilities. “There are only 40 hospitals in Florida that have this prestigious certification, and we are
For more information, contact Jennifer Miller, NCH Total Joint RN Coordinator at (239) 624-3998, email Jennifer.Miller3@nchmd.org
The Growing NCH Palliative Care Team Offers End of Life Planning for Patients, Family Members and Caregivers
Palliative care is not only about death and dying. This is a concept that NCH Palliative Care physician Ryan Nicole Perdzock, MD, wants the community to understand. “We aim to offer an improved quality of life, helping patients to live better, by being realistic about how to make the best experience with the time they have left and to help patients in the community improve their experience,” says Dr. Perdzock, who was trained in palliative care at the
decisions they are required to make. Palliative care can assist in having these discussions and in making informed medical decisions. “I am sensitive to the fear in some patients who do not want to die in a hospital,” explains Dr. Perdzock. “They want to be at home, kept comfortable and be with their family. When medicine cannot offer any further interventions to make the disease better, we then have to focus on symptoms.” If patients do not qualify for hospice services, they can opt for outpatient palliative care. This allows patients to stay at home while seeing their regular physician during scheduled office visits. Extra palliative services are then available on an outpatient basis either at the NCH clinic or at community-based outpatient palliative care services. • Patients with any type of chronic or complex medical illness • Kidney disease and dialysis patients • Curable and non-curable cancer, including metastatic cancer patients • Cancer patients receiving chemotherapy to help symptom control • Patients with dementia and advanced neurologic diseases • Patients with congestive heart failure • Patients with end-stage COPD NCH Palliative Care Program: • Assists patients and family in sound medical decision-making • Can extend lives by treatment and management of symptoms • Helps to decrease limited mobility that hinders ability to get treatment • Assists family members in the difficult end-of-life planning discussions • Offers spiritual guidance and counseling • Improves quality of life, helping patients to live better Those who would benefit from palliative care include:
Dr. Perdzock
Mayo Clinic. “For family and caregivers, palliative care facilitates the difficult conversation about end-of-life planning, while their loved one is still able to communicate their wishes.” Patients with chronic illnesses like congestive heart failure, COPD, kidney failure, dementia or cancer often suffer with symptoms like pain, shortness of breath, nausea and vomiting or constipation due to pain medications. Frequently, they are also immobile and / or nutritionally challenged. “We have an outpatient clinic and are available for consultations in the hospital,” says Dr. Perdzock. “We can assist with symptom management, goals of care and other discussions with which patients and family struggle.” NCH’s interdisciplinary Palliative Care team consists of three physicians and nurse practitioners who address medical issues, and a social worker and chaplain who address stress management, emotional suffering, anxiety, pain and depression. Working together, these professionals consider the whole person in a comprehensive approach to providing the best possible life experience for their patients. Many times, the family has not had advanced planning discussions with their loved one and do not understand the impact of the medical
For more information, contact the NCH Palliative Care team at (239) 624-8490
Rubber Duck Race Helps Draw Attention To Drowning Prevention
A bout 10,000 yellow rubber ducks will float down the Lazy River at Sun-N-Fun Lagoon on Saturday, February 2, to raise money for the NCH Safe & Healthy Children’s Coalition. “This is the first Duck Race for us,” says Paula DiGrigoli, executive director of the NCH Safe & Healthy Children’s Coalition. After seeing the duck race success in cities around the nation like the one in Chicago, DiGrigoli decided this was a great fit for Southwest Florida. “This will be our main fundraiser,” she says. “We want to encourage everybody to go to the website, GreatNaplesDuckRace. com, to adopt the ducks.” All of the money raised goes toward drowning prevention and other coalition initiatives.
Each numbered yellow rubber duck will be wearing their sunglasses as they bob and zip down the Lazy River, carried by the current. The owner of the first duck to cross the finish line wins $10,000; second place is $5,000 and third place is $2,500. Participants get free admission for the family fun event that includes a water safety festival where families can learn how to be safer in and around the water. You do not have to be present to win. The NCH Safe & Healthy Children’s Coalition was founded in 2010 after an increase in drowning deaths in Collier County. Drowning is the leading cause of injury death for children ages 1-4 in Florida and it is preventable. This year, 83 children have drowned in Florida.
Paula DiGrigoli
Twelve ducks for $100 pays for seven water safety presentations at preschools.
Buying 24 ducks for $200 funds 33 door and window alarms to help prevent children from wandering into pools, lakes or canals.
A $10 duck pays for a life jacket that is available for free use at 15 Collier County locations.
$50, buys six ducks that pays for 10 swimming lessons for a child.
Great Naples Duck Race Water Safety Festival Saturday, February 2, 2019 Sun-N-Fun Lagoon
To Adopt a Duck or to become a Quacker Backer corporate sponsor go to GreatNaplesDuckRace.com
NCH and the NCH Physician Group
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Academic Internal Medicine Clinic Charles Graeber, MD
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Leniesha Ferringon, MD Angeline Galiano, MD
Larry Kohn, MD David Linz, MD Pedro Martin, MD Bryan Murphey, MD Gregory Rubin, DO Robert Sadaty, MD Joseph Stafford, MD Tracy Walsh, MD David C. White, MD
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Lirka Gonzalez-Rodriguez, MD Erik Hiester, DO Karen Hiester, DO
David Linz, MD
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Mark Josephson, MD Mark McAllister, MD Brian Menichello, MD Monica Menichello, MD
Medical Resident Physicians Behavioral Health Esther Mugomba-Bird, APRN
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Carlo Santos-Ocampo, MD Maurice Schneider, MD Dinesh Sharma, MD Herman Spilker, MD David A. Stone, MD Hillary Tassin, MD Silvio C. Travalia, MD Shona Velamakanni, MD
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General Surgery Wesley Dailey, MD Robert Grossman, MD David Lamon, MD Luigi Querusio, MD Geriatrics Joseph Bandeira, MD Infectious Disease Gary A. Bergen, MD Vato Bochorishvili, MD
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Center for Breast Health Sharla Gayle Patterson, MD Concierge Medicine Robert E. Hanson, MD
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Urology Paulos Yohannes, MD
Janice King, APRN Family Medicine Andrew M. Bernstein, DO Christian O. Beskow, MD
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Mark A. Brown, MD
Miguel Madariaga, MD
Internal Medicine Susan Best, DO Elisabeth Broderick, MD
Jerry G. Best, MD
Rasai Ernst, MD Emily Essert, DO
Diana Daoud, MD
For an appointment with a physician, please call (239) 624-8106 Consult with a healthcare provider 24/7 from anywhere in Florida for only $45, visit NCHmd.org/VirtualCare to start your treatment.
NCH Baker Hospital Downtown NCH Downtown Naples Hospital: 624-5000 Academic Internal Medicine Clinic: 624-0940 Business/Occupational Health: 624-4630 Community Blood Center: 624-4120 Dr. John N. Briggs Wellness Center: 624-2750 Emergency Department: 624-5000 NCH Heart Institute: 624-4200 NCH Imaging: 624-4443 Outpatient Cardiac Rehabilitation: 624-1680 Outpatient Infusion Services: 624-4370 Outpatient Oncology Navigator: 624-4988 Outpatient Rehabilitation Center: 624-1600 Palliative Care Clinic: 624-8490 vonArx Diabetes & Nutrition Health Center: 624-3450 NCH North Naples Hospital Campus NCH North Naples Hospital: 624-5000 Emergency Department: 624-9199 Center For Breast Health: 624-8120 NCH Imaging: 624-4443 NCHWound Healing Center: 624-0630 Outpatient Pulmonary Rehabilitation: 624-6800 Pediatric Emergency Department: 624-5000 The BirthPlace: 642-6110 The Brookdale Center: 624-5722 NCH Marco Island Campus Marco Urgent Care Center: 624-8540 Outpatient Cardiac Rehabilitation: 624-8590 Outpatient Pulmonary Rehabilitation: 624-8595 Outpatient Rehabilitation Center: 624-8580 NCH Healthcare Bonita Emergency Department: 624-6900 NCH Imaging: 624-4443 NCH Healthcare Northeast Emergency Department: 624-8700 Outpatient Rehabilitation Center: 624-8790 NCH Imaging: 624-4443 NCH Healthcare Southeast NCH Immediate Care: 624-8220 NCH Sleep Center: 624-8220 Outpatient Rehabilitation Center: 624-1900 NCH Imaging: 624-4443 NCH Imaging: 624-4443 NCHWound Healing Center: 624-0650 NCH Central Campus: 513-7144 White Elephant Thrift Store: 624-6690 Outpatient Rehabilitation Center: 624-6820 WhitakerWellness Center: 624-6870
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Outpatient Rehabilitation Center: 624-0970
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NCH Immediate Care: 624-8220
Marco Island
NCH I magin g: 624-4443
For information on any of the NCH Healthcare System services, please call 624-1999 or visit us online at www.NCHmd.org
NCHWound Healing Center: 642-0630 Outpatient Rehabilitation Center: 624-0380 NCHHeart Institute: 624-1000 Outpatient Cardiac Rehabilitation: 624-1080 NCH Immediate Care: 624-1050
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The NCH Health Matters is a bi-monthly publication of the NCH Healthcare System. Every effort is made to ensure information published is accurate and current. NCH cannot be held responsible for any consequences resulting from omissions or errors. NCH Healthcare System, 350 7th Street North, Naples, FL 34102, Telephone: (239) 624-5000, www.nchmd.org
Immediate Care Urgent care services for you and your family.
Walk-in care • No appointment needed
Visit NCH Immediate Care for:
•Sore throat •Mild asthma •Eye irritation •Insect stings •Sports injuries •Urinary infection
•Nose bleeds •Minor stitches •Animal bites •Sprain/strain
•Fever
•Cough/cold
•Diarrhea •Vomiting
•Flu
•Earache
•Rash
•Minor burn
•Allergic reaction/rash only
NCH Immediate Care - Bonita 3302 Bonita Beach Rd. • Bonita Springs 239 • 624 • 1050 Hours: Mon-Sat: 9am-7pm • Sun: 12noon-7pm NCH Immediate Care - Vanderbilt 801 Vanderbilt Beach Rd. • Naples 239 • 624 • 8220 Hours: Mon-Sat: 9am-7pm • Sun: 12noon-7pm NCH Immediate Care - Southeast 7717 Collier Blvd., #100 • Naples 239 • 624 • 8220 Hours: Mon-Sat: 9am-7pm • Sun: 12noon-7pm
NCH Marco Urgent Care - Marco Island * 40 Heathwood Dr. • Marco Island 239 • 624 • 8540 Hours: 7 days a week: 8am-7:30pm *facility charges may apply
NCHmd.org
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