Health News & Recipes

COVID-19 Vaccine: Walk-in Service & Extended Hours

Vaccinations coming to a close at the Treasure Coast Square Mall

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Article by: Gracia Martin Pierre-Pierre, MD CAQSM
Sports Medicine specialist
Specialist in sports concussion

Here are a few tips to decrease the chances of getting an acl tear.

Dynamic Warm-up

Begin each workout with a dynamic warm up. These might include walking lunges, jumping rope, or mountain climbers.

Dynamic Strength Training

After the warm-up, move on to dynamic and functional exercises.
Examples include single-leg balance, heal drops, walking lunges, and physioball hamstring curls.


Examples include lateral hopping, forward and backward hopping, box jumps, and scissor jumps.

Agility and Sport Specific Drills

To improve the dynamic stability of the entire lower body, practice shuttle runs, forward and backward running, running with quick stops, and cutting and bounding runs. You will want to choose drills that closely resemble your daily activities or sport.

Post Work out Stretch

End your workout with simple, passive stretching of all major lower-body muscles. Hold each stretch for 15-30 seconds. Consider adding core strengthening exercises (planks and crunches) to round out your training session.

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Florida Department of Health Update

Governor Ron DeSantis has established a vaccination plan for Florida including allocation, distribution and priority. The Martin County Board of County Commissioners does not control vaccine distribution.

For information on vaccine availability, contact the Florida Department of Health at (772) 221-4000. Floridians are also encouraged to opt-in to receive state updates about the COVID-19 vaccine via text.

To receive state updates, text the word FLCOVID19 to 888777. To receive local, Martin County updates, text the word MARTINVAX to 888777.


All individuals 18 & older are eligible to receive any COVID-19 vaccine. Additionally, individuals 16 & older are eligible to receive the Pfizer vaccine.

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Tobacco Exposure Linked to Elevated Blood Pressure in Pediatric Patients


Article by: Jonathan Alicea
Rebecca Levy, MSc
A new study noted the presence of elevated blood pressure in children and adolescents who have been exposed to tobacco.

The investigative team, led by Rebecca Levy, MSc, Department of Pediatrics, Montefiore Medical Center, used data from the 2007-2016 National Health and Nutrition Examination Survey (NHANES) to determine associations between active and passive tobacco exposure and odds of increased blood pressure in pediatric patients.

Patient ages ranged from 8-19 years old. All participants completed an in-depth interview and underwent an examination consisting of medical and physiological measurements, in addition to laboratory tests.

Tobacco and Blood Pressure

Individuals were considered exposed to tobacco if they reported the presence of at least 1 smoker at home or had a serum cotinine level >0.05 µg/L.

Furthermore, Levy and colleagues defined active smoking as “answering yes to the question ‘During the past 5 days, including today, did you smoke cigarettes, pipes, cigars, little cigars or cigarillos, water pipes, hookahs, or e-cigarettes?’ or having a serum cotinine level greater than 10 µg/L.”

In these studies, serum cotinine levels were measured by isotope dilution high-performance liquid chromatography and atmospheric pressure chemical ionization tandem mass spectrometry.

As such, the cross-sectional study looked at 8520 participants, which represented 41 million US children.

The mean age was 13.1 years, a majority (51%) of the population were male, and 58% were non-Hispanic White individuals.

The investigators noted that those with any tobacco smoke exposure were more likely to be older (mean age, 13.3 years) than those without exposure (12.8 years).

Further, participants were more likely to be male (53% [95% CI, 51-55) vs 49% [95% CI 47-50]) and non-Hispanic Black individuals (19% [95% CI, 16-22] vs 10% [95% CI, 8-12).

Additionally, those who were overweight or obese, had no or public insurance, and had a poverty index less than 130% of the federal poverty threshold were more likelty to have any tobacco exposure.

Following adjustment of covariates, the investigators also found that the odds of having elevated blood pressure was 1.31 (95% CI, 1.06-1.61) for any tobacco exposure. These odds were similar across subgroups (age, sex, race/ethnicity) and sensitivity analyses.


“Our findings are supported by the existence of data showing a biological plausibility for the association between tobacco exposure and blood pressure,” wrote the investigators.

“Nicotine causes acute elevations in blood pressure through stimulation of the adrenergic pathway via epinephrine and norepinephrine,” they continued.

Levy and team also touched on the importance of these findings on public health and the need to address this modifiable risk factor in children.

“With a national adult prevalence of smoking of 15.5%, 5.6 million children can be expected to die prematurely during adulthood from smoking-associated causes,” they wrote.

Nevertheless, they acknowledged greater potential in collecting stronger observational data through prospective, longitudinal studies. These studies can also help elucidate associations with duration and timing of passive tobacco exposure as well as tobacco ingestion method.


Article & Photo: Courtesy of: Gracia Pierre-Pierre, MD CAQSM

I was born in Haiti to an orthopedic surgeon, Jacques Pierre-Pierre and to Eveline Noel Pierre-Pierre that holds a bacc in laboratory sciences on November 11, 1977. I grew up in a medical family where not only my dad, but 3 aunts were also physicians. Therefore, I have been exposed to Medicine and to the right way medical services should be rendered with compassion, care, empathy, professionalism, and respect of patient’s time early on.

As a child growing up, I found myself gravitating towards endeavors that required self-directed motivation and perseverance such as martial arts and medicine.

Because I used to be bullied, I joined a martial arts school at 10 years old, earned my black belt at 13 and started being involved in bodybuilding.

Fast forward to 2004, I graduated top 8 of my medical school class from the Universite Notre Dame d’Haiti. Eager to further my medical education, I left for the US in March 2008 in the quest to complete a post graduate training in Musculoskeletal Medicine. I completed a Family Medicine residency at SUNY Downstate Medical Center in Brooklyn, NY in June 2014 and went on to complete a Sports Medicine fellowship in Tyler, TX at the University of Texas at Tyler in June 2015.

I currently live in Florida with my wife of 12 years and 2 beautiful healthy kids making a living as a Physician of Sports Medicine which has placed me in a position to learn about how pervasive bullying is in school aged kids and how common suicide was amongst these kids. I got angry and decided to do something about it.

As such, I created Black Stallion of America corp. an anti-bullying nonprofit organization on 10/11/2018 which goal is to help kids by nurturing them into selfless, well balanced adults via martial arts and fitness. I was awarded the volunteer of the year award for my collaboration with the Boys and Girls club of America of the St Lucie county in Florida in February 2020.

Although I was financially stable working for my last employer, there was something missing. Me. I was not BECOMING. I had been with my last employer for 18 months and decided that it was about time I went out and started my own medical practice, not based on an entrepreneurial seizure but based on a clear vision of how compassionate a physician is supposed to be. And I am pleased to announce that Hobe Sound Primary Care opened its door on August 31, 2020 and our mission is to render medical services differently.

Glory be to God!

Gracia Pierre-Pierre, MD CAQSM

For more information contact Dr. Gracia Pierre-Pierre,MD CAQSM - 772-932-9310

Hydration During Exercise

21 Jan Don't Forget to Hyderate

Proper hydration throughout the whole day is essential for peek performance even before exercising. Staying hydrated is also particularly important during exercise. Adequate fluid intake is essential to comfort, performance, and safety. The longer and more intensely you exercise, the more important it is to drink the right amount of fluids, along with consuming carbohydrates and minerals like potassium, magnesium, and sodium.1

Dehydration Decreases Performance
Studies have found that athletes who lose as little as two percent of their body weight through sweating have a drop in blood volume which causes the heart to work harder to circulate blood. A drop in blood volume may also lead to muscle cramps, dizziness, fatigue, and heat illness including:

Common Causes of Dehydration:

Inadequate fluid intake (especially before starting exercise and/or not replenishing enough fluids post-exercise)
Excessive sweating
Failure to replace fluid losses during and after exercise
Exercising in dry, hot weather
Drinking only when thirsty

What Should Athletes Drink?
At baseline, the average amount of fluids lost during exercise for an hour is about 0.5 to 2 liters of fluid or about 2–4 cups of fluid. This comes out to about 12-16 ounces every 5-15 minutes of exercise with performance decreasing after 60–90 minutes without replenishing fluids, carbohydrates, and electrolytes. The wide variability is related to sweat rates, losses and hydration levels of individuals, intensity of the exercise, length of exercise, humidity, heat, and elevation.1

Some methods to estimate adequate hydration:

Monitoring urine volume output and color. A large amount of light-colored, diluted urine probably means you are hydrated; dark colored, concentrated urine probably means you are dehydrated.
Weighing yourself before and after exercise. Any weight lost is likely from fluid, so try to drink enough to replenish those losses. For every pound lost, drink about 3 cups of water.

What About Sports Drinks?
Sports drinks can be helpful to athletes who are exercising at a high intensity for 60 minutes or more. If you find yourself exercising in extreme conditions over 3 or 5 hours (a marathon, Ironman or ultramarathon, for example) you may likely want to add a complex sports drink with electrolytes, including magnesium as this is lost through sweat as well.

Fluids supplying 30-60 grams of carbohydrates per hour are needed for continuous performance beyond 60-90 minutes.

General Guidelines for Fluid Needs

Hydration Before Exercise
Drink about 2.5 cups of fluids or sports drink before bed
Drink about 2.5 cups of fluids upon waking up
Drink another 1.5-2.5 cups of fluids 20-30 minutes before exercising
Hydration During Exercise
Drink 12-16 fluid ounces every 5-15 minutes
If exercising longer than 90 minutes, drink 12-16 fluid ounces every 5-15 minutes of a solution containing 30-60 grams of carbohydrates (or 6%–8% carbohydrate solution), sodium (300-600 mg per hour), potassium, and magnesium.
Hydration After Exercise
Weigh yourself before and after exercise and replace fluid losses.
Drink 24 fl oz or about 3 cups of water for every 1 lb lost.
Consume a 4:1 ratio of carbohydrate to protein close to the time when the exercise ends.


20 Aug Recipes

Hash Brown Benedict

Serves 2


2 tablespoons olive oil, divided
yellow onion, halved, diced small
1 ½ teaspoons McCormick® Paprika
1 teaspoon salt
½ teaspoon McCormick® black pepper
3 cups potato, frozen, shredded
2 large handfuls fresh spinach
2 eggs, poached
fresh chive, for garnish


3 large egg yolks
lemon, juiced
½ cup butter, melted
½ teaspoon salt

Heat 1 tablespoon olive oil in a skillet over medium-low heat. When the oil is hot, add the diced onion, McCormick paprika, salt, and pepper. Cook onions, stirring occasionally, until softened, about 5 minutes. Add in frozen shredded potatoes and the remaining tablespoon of olive oil. Cook, stirring occasionally, until potatoes start to turn golden and crisp up a bit.

Within the skillet, divide the potatoes into two piles and place a large, circular cookie cutter ring around each pile. Scoop any potatoes that are outside of the cookie cutters into the center of the rings. Use a spatula to pat down the piles inside the rings to form patties. Turn heat down to low and cook until bottom of hash browns are crispy. Use tongs to remove cookie cutter rings and carefully flip the hash browns to crisp up the other side. Once crispy, remove from the pan.

In the same pan, add the baby spinach and wilt down over low heat. Remove spinach from the pan.

Hollandaise: Place egg yolks and lemon juice in a blender. Blend for 10 seconds, then slowly stream in the hot, melted butter (while blender is still running). Sauce will thicken by the time all of the butter has been added. Blend in salt.

Assembly: Place a hash brown on each plate. Top with spinach, then a poached egg. Spoon hollandaise over the eggs. Garnish with chives.

Vegan Cauliflower Fettuccine "Alfredo"



4 heaping cups (460 g) cauliflower florets (1 small/medium cauliflower)
1/2 tablespoon (7.5 mL) extra-virgin olive oil
1 heaping tablespoon minced garlic
1/2 cup (125 mL) unsweetened and unflavoured almond milk*
1/4 cup (20 g) nutritional yeast
1 tablespoon (15 mL) fresh lemon juice, plus more for serving
1/2 teaspoon onion powder
1/4 to 1/2 teaspoon garlic powder, to taste
3/4 teaspoon fine grain sea salt, or to taste
1/4 to 1/2 teaspoon black pepper, to taste
1 package (350 g/12 ounces) fettuccine or rotini pasta**
Fresh minced parsley, for garnish


Place cauliflower florets in a steamer basket and steam, covered, for 10 to 15 minutes until fork tender. (Alternatively, you can boil the cauliflower in a pot of water for 8 to 15 minutes until fork tender. Drain well before proceeding.)

Meanwhile, cook the pasta according to the package directions. Drain well and add it back to the pot. Set aside.

Add the oil and minced garlic to a small skillet and sauté over low heat for 4 to 5 minutes until softened and fragrant. Be careful not to burn.

Add the cooked cauliflower, sautéed garlic, milk, nutritional yeast, lemon juice, onion powder, garlic powder, salt, and pepper to a high-speed blender. Blend until a very smooth sauce forms. Adjust seasonings to taste.

Add the cauliflower sauce to the pot with the pasta and stir well. Heat over low-medium until heated through. The pasta will tone down the flavours of the sauce so it’s important to taste the mixture and add more seasonings (salt, pepper, lemon, etc.) to taste before serving.

For serving: Divide the warm pasta into bowls and top with more salt and pepper (to taste), along with a squeeze of lemon and some fresh minced parsley. Feel free to add your favourite cooked veggies such as broccoli, peas, leeks, asparagus, butternut squash, etc.

Creamed Curried Spinach

1 1/2 tablespoons extra-virgin olive oil
1/4 teaspoon crushed red pepper
5 thinly sliced garlic cloves
1/2 cup thinly sliced shallots
3/4 teaspoon curry powder
1 pound fresh baby spinach
1/2 cup plain whole-milk Greek yogurt
1/4 teaspoon kosher salt

Cook extra-virgin olive oil, crushed red pepper, and thinly sliced garlic cloves in a large skillet over medium-high until garlic begins to sizzle, about 2 minutes. Add thinly sliced shallots and curry powder; cook 2 minutes. Add fresh baby spinach to pan in batches, stirring until wilted before adding more. Stir in yogurt and kosher salt.

Slow Cooker Pork Chops with Mushrooms and Carrots

1 ½ cups unsalted chicken stock
1 ½ teaspoons sherry vinegar
3 tablespoons all-purpose flour
Cooking spray
¾ pound carrots, peeled and cut into 2-in. pieces
½ pound shiitake mushrooms, stems removed and caps quartered
½ cup chopped onion
2 garlic cloves, minced
4 thyme sprigs
2 oregano sprigs
1 tablespoon olive oil
4 (6-oz.) bone-in center-cut pork chops
¾ teaspoon kosher salt, divided
¾ teaspoon black pepper, divided
¼ cup dry white wine
6 ounces uncooked whole-wheat egg noodles
2 tablespoons heavy cream
2 teaspoons fresh thyme leaves

Combine stock, vinegar, and flour in a 6-quart slow cooker coated with cooking spray. Stir in carrots, mushrooms, onion, garlic, thyme sprigs, and oregano sprigs.

Heat oil in a large nonstick skillet over medium-high. Sprinkle pork chops with 1/4 teaspoon salt and 1/4 teaspoon pepper. Add pork chops to pan; cook 2 minutes on each side. Place pork chops in slow cooker.

Add wine to skillet over medium-high; cook 30 seconds, scraping pan to loosen browned bits. Spoon wine mixture over pork chops in slow cooker. Cover and cook on LOW for 7 hours or until vegetables are tender.

Cook egg noodles according to package directions, omitting salt and fat. Drain.

Slow Cooker Cioppino


2 tablespoons extra-virgin olive oil
1 ½ cups chopped onion
1 ½ cups chopped fennel bulb
10 garlic cloves, sliced
1 cup dry white wine
2 teaspoons tomato paste
½ cup water
2 tablespoons chopped fresh oregano
2 tablespoons chopped fresh thyme
¾ teaspoon crushed red pepper
.38 teaspoon kosher salt
½ pound chopped fresh tomatoes
2 (2-inch) lemon rind strips
2 bay leaves
1 (26-ounce) box chopped tomatoes (such as Pomì)
¾ pound cod, cut into 2-inch pieces
½ pound sea scallops
½ pound peeled and deveined medium shrimp
1 tablespoon fresh lemon juice
¼ cup fresh basil leaves


Heat a large skillet over medium-high heat. Add oil; swirl to coat. Add onion, fennel, and garlic to pan; cook 3 minutes or until soft. Add wine and tomato paste to pan, stirring well; bring to a boil. Cook 2 minutes, stirring occasionally.

Carefully pour onion mixture into a 6-quart electric slow cooker. Add 1/2 cup water and next 8 ingredients (through boxed tomatoes) to slow cooker. Cover and cook on LOW for 7 hours.

Uncover; discard lemon rind and bay leaves. Stir in cod, scallops, shrimp, and lemon juice. Cover and cook on LOW 13 to 15 minutes or until fish flakes easily when tested with a fork. Garnish with fresh basil.

Kale Banana Smoothie


1 banana, cut into chunks
2 cups chopped kale leaves, ribs and thick stems removed
½ cup almond milk
8 ice cubes (optional)
2 teaspoons honey (optional)

Berry Beet Smoothie

21 Jan Berry Beet


1/2 cup almond milk, 1/2 cup plain low-fat yogurt, 1 tsp honey, 1 cup mixed frozen berries, 1 cup freshly cooked beets, 3 to 5 ice cubes.

Tropical Carrot Smoothie

2 1/4 cups carrot juice
1 1/2 cups frozen pineapple
1 1/2 cups frozen mango
1–2 kiwi fruits, peeled and sliced

Pour the carrot juice into a blender. Add the pineapple, mango and kiwi and process until smooth.

Serve immediately.

21 Jan Exercise for Healthy Bones

Why Allergies Develop During Middle Age

20 Aug Hay Fever a

Article by: Maria Noël Groves, RH

Ah, when the days of summer are lazy, hazy, and making people crazy—with hay fever. Ragweed allergies hit hard this at this time of year. The unfortunates are easy to spot—their coughing, watery eyes, sneezing, and fatigue give them away. Among the sufferers are a growing number of middle-aged people who’ve never had hay fever before. Why the sudden uptick of seasonal allergies in the middle aged?

Allergy experts posit several reasons. Air pollution has been found to work synergistically with allergens to create more hay fever symptoms. There have also been increasing levels of pollen counts—both in terms of daily averages and “number of days when pollen exceeds a certain limit,” said Harsan Arshad, professor of Allergy and Clinical Immunology at the University of Southampton, in an interview with the Telegraph. In the past, an allergic response may not have been triggered because pollen levels were lower.

Climate change is also causing an increase in allergies. The Union of Concerned Scientists reported that “carbon dioxide, the heat-trapping gas that is the primary cause of our warming planet, increases the growth rate of many plants and increases the amount and potency of pollen. Rising temperatures extend the growing season and the duration of allergy season.”

Fortunately, there are many ways to fight hay fever naturally.

Natural Remedies for Hay Fever
Butterbur & Nettles as an Antihistamine
Extracts of the herbs stinging nettle and butterbur help relieve seasonal allergy symptoms. Nettle decreases inflammation and acts as an antihistamine. Butterbur also works as an antihistamine, and research shows it can be as effective as Zyrtec and Allegra—
without as much drowsiness or fatigue.

If you want to try butterbur, look for Petadolex; this is a special extract of the herb that removes the liver-toxic pyrrolizidine alkaloids from its roots.

Garlic for Sinus Congestion
This common kitchen herb helps treat allergy-related sinus congestion and coughs. With more than 70 active ingredients, garlic can also help reduce inflammation and boost the immune system.

Other remedies for seasonal allergies include Pycnogenol, a pine bark extract rich in antioxidants, and bromelain, an enzyme derived from pineapple that can reduce nasal swelling and inflammation.

Medicinal Mushrooms for Immunity
“Allergies occur when the immune system is irritated and malfunctioning, eliciting an immune response to otherwise harmless substances,” said herbalist Maria Noël Groves. “Over time, you may be able to decrease incendiary inflammation and retrain the immune system so that you’re less reactive to pollen.”

To do so, Groves recommends medicinal mushrooms including reishi, chaga, and shiitake, as well as astragalus root. All appear to strengthen the immune system, she said.

Homeopathy v. Hay Fever
Researchers have found certain homeopathic treatments help with hay fever. One study showed that hay fever symptoms were better reduced by a homeopathic remedy compared to placebo. In another study of patients with hay fever, the authors found that “the homeopathy group had a significant objective improvement in nasal airflow compared with placebo group.”

Lifestyle Hacks for Hay Fever
In the battle of human versus ragweed, more than herbs are needed. Saline sprays or xylitol sprays help unclog the nose, reduce inflammation, decrease postnasal drip, and flush away allergens. A neti pot works similarly.

Wraparound sunglasses can protect eyes from pollen as can eye drops. During a high pollen day, take a shower when you get home and change your clothing. Keep windows shut as much as possible. Avoid doing yard work.

Certain foods fight allergies by boosting immunity and triggering allergy-easing processes in your body. In addition to garlic, eat broccoli, citrus fruits, onion, and leafy greens like collards and kale.

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Lifestyle & Diet Tips for Better Sleep

20 May Better Sleep

Article By: Sara Siskind

Besides creating a comfortable, peaceful bedroom, there are many ways to help induce sleep, starting with diet and daily habits. Preparing for a good night’s sleep should begin at mealtime, especially as it gets closer to bedtime.

There are several foods that help create a calming effect on the brain and body. Here are some practical and easy tips for a restful night.

Rituals to Help Sleep Better
Creating a smarter nighttime routine is one secret to waking up well-rested. What I do in the evening impacts how I sleep.

Exercise at The Right Time
Among its many benefits, such as weight management, stress reduction, and disease prevention, exercise is important to sleep. Without daily exercise, I find myself out of balance.

Even what time I exercise has an impact.

When I exercise in the morning or early afternoon, it helps me fall asleep quicker.
When I exercise within an hour of my bedtime, my body becomes overstimulated, which can lead to insomnia.
I rest more soundly if I stick to a morning routine.

Be Consistent
Try to get up at the same time, whether it’s a weekday, weekend, or vacation. Our body’s internal clock (the circadian rhythm) becomes stabilized with consistent wake-up times. Give it a try for a least 21 days, and you’ll start feeling more rested.

Avoid Electronics and Screentime
I power off my electronics, especially my phone, at least an hour before I want to go to sleep. This helps calm my mind and reduces the strain on my eyes from staring at the screen.

Set the Right Temperature
Next, I make sure the temperature is just right. For me, the perfect temperature is somewhere between 60 and 68 degrees, so my body is neither hot nor cold.

Foods for Better Sleep
Certain foods may help induce sleep. Many of them increase the hormone melatonin that our bodies produce. Some people produce less melatonin than others, so I find it helpful to include these foods in my evening meal or snack.

Tart Cherry Juice
A morning and evening ritual of drinking tart cherry juice has helped me sleep better. Researchers from Louisiana State University found that drinking the juice of Montmorency tart cherries twice a day for two weeks helped increase sleep time by nearly 90 minutes among older adults with insomnia.

Pistachio Nuts
Besides being a powerhouse of heart-healthy fats, protein, and fiber, pistachios also contain a significant amount of vitamin B6, which can help induce sleepiness. According to the Alaska Sleep Clinic, a deficiency in B6 has been linked with lowered serotonin levels and poor sleep. Deficiencies in B6 show symptoms of depression and mood disorders, which can also lead to insomnia. I choose high-quality pistachios like Setton Farms Pistachios sold in convenient 100-calorie packs so you don’t overeat them.

Bananas contain magnesium and potassium, which are natural muscle relaxers.

Chamomile Tea
Chamomile is a soothing herbal tea that naturally lacks caffeine. Having a hot cup before bed sets my body into relaxation mode.

These fruits contain a significant amount of serotonin. Researchers found eating kiwi daily improved both the quality and quantity of sleep.

No Caffeine After 2
Avoid coffee, tea, and sodas in the afternoon. These drinks can cause restlessness at night. I also avoid foods that contain hidden caffeine, including chocolate, protein bars, vitamin waters, and even decaf coffee. I don’t drink lots of fluids, even water, in the evening as it tends to wake me up at night and disrupts my sleep.