Preparing for recovery before surgery: A new approach to healing
If you’ve had surgery, you know how important rehabilitation is to recovery. Working with a physical therapist, occupational therapist, and other rehabilitation specialists helps you regain your strength and returns you to your normal activities faster. Traditionally, rehabilitation begins after surgery. The team at Dignity Health Yavapai Regional Medical Center (YRMC) is part of a movement by leading health care organizations to introduce what could be named “prehabilitation.” Enhanced Recovery After Surgery (ERAS®), as it’s actually called, is designed to get you ready for your post-surgery recovery program before you even see the inside of a surgical suite. “ERAS is a way to help people prepare physically and mentally for their postoperative course,” says Pierre Tibi, MD, FACS, Director, the James Family Heart Center at Dignity Health YRMC and a cardiothoracic surgeon. “It’s a partnership that involves patients and every YRMC team member who comes in contact with them as part of their surgery.” That multi-disciplinary team – physicians, nurses, dietitians, pharmacists, rehabilitation specialists, and more – puts into action ERAS protocols that are scientifically proven to curb complications, reduce hospital stays, and accelerate recovery. Education and communication are threads that connect ERAS protocols at every phase. “Patients are at the center of ERAS,” Dr. Tibi says. “They are provided complete information about what to expect during their surgical journey. This empowers people to take an active role in their recovery.” Why is YRMC implementing ERAS? The answer is related to metrics and mission. Data from numerous large studies show ERAS programs: Reduce complications by 50 percent Shorten hospital stays by 30 to 50 percent Improve patient satisfaction “Beyond the data, ERAS demonstrates YRMC’s commitment to ensuring patients have the best experience we can give them during a stressful time,” says Kenneth O’Beirne, MD, a YRMC-affiliated anesthesiologist. “We’re applying the top medical science available and evidence-based practices to improve their care. To me, that shows we take our role as health care providers very seriously.” The ERAS journey ERAS begins as patients are contemplating surgery and continues through recovery. The protocols – developed by the non-profit ERAS Society – focus on improving the delivery of health care for surgical patients throughout the care cycle. This includes a surgery-specific roadmap that covers many phases, all of which involve patients in their recovery. Operation get ready for surgery Before surgery, YRMC clinicians help patients prepare using ERAS strategies that improve nutrition and physical fitness. They also share information on what patients can expect at every phase of their specific operation. “The more patients understand about their surgery, the more they can participate in their healing,” says Olivia Marsh, RN, Nurse Manager, Pre-Admission Testing, Pre-Op, and Post-Anesthesia Care Unit. “During the pre-operative phase of ERAS, we speak to patients about their expectations after surgery. We also discuss pain, which is part of the healing process.” For example, YRMC nurses coach patients undergoing knee replacement surgery to prepare by walking five times a day, even if it’s making loops around their living room. Studies confirm that being active prior to surgery reduces pain following the operation. In addition to engaging in exercise, patients receive information and tools to, for example: Eat a healthy balanced diet Stop smoking or consuming alcohol/drugs Manage blood sugar levels What happens during surgery helps with recovery The surgeon and anesthesiologist collaborate during surgery to reduce the physical stress of the operation on the patient. Fluid management is a good example of ERAS protocols at work in the operating room. Typically, patients receive fluids during surgery to manage their blood pressure. The problem is too much fluid can lead to excessive water weight, which can delay recovery. ERAS protocols call for careful fluid management. During surgery, anesthesiologists combine different types of medications as part of the ERAS protocol. Anesthetic drugs, nerve blocks, and anesthesia that targets specific parts of the body may replace conventional anesthesia. Let the healing continue After surgery, patients are encouraged to both eat and walk sooner. Research shows that the quicker food is re-introduced, the less need there is for intravenous medications and fluids. Additionally, walking reduces muscle loss, improves the respiratory function, and lowers the risk for pneumonia. “Patients also get a psychological boost when they’re up and moving following surgery,” Dr. O’Beirne says. “They think, ‘I can do this.’” Opioids are not part of the ERAS pain management protocol. Instead, combinations of acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), injections of local anesthetics at the incision, and peripheral nerve blocks help ease pain. A patient-provider partnership How has the patient-provider dynamic evolved thanks to ERAS? “Safe and successful surgeries have always been the goal of our team,” Marsh says. “What’s changed is that ERAS challenges us to look at every aspect of the surgical journey from our patients’ perspective. That’s driving us to adopt strategies that involve patients as our partners in new ways that benefit all of us.”
Oh, my aging feet: Five common foot problems and how to manage them
From our first steps as a child, we depend on our feet to carry us through life. For the average lifetime, that’s an estimated 115,000 miles of walking—the equivalent of circling the globe four times on foot. “Our feet are extremely complex structures,” says Richard Amundsen, DPM, a podiatrist affiliated with Dignity Health Yavapai Regional Medical Center (YRMC). “There’s a tremendous amount of mechanical demand on the feet. And after a lifetime of use, things can wear out.” Want to make sure your feet are healthy for the long haul? Here are five common foot problems people experience as they age and suggestions on how to manage them. 1. Osteoarthritis Often referred to as “wear and tear” arthritis, this is a degenerative joint disease that gradually leads to the breakdown of cartilage and other tissue. Symptoms: Decreased range of motion, swelling, bones that seem bigger, and an achiness that intensifies over time. Treatment options: Focus on reducing symptoms, managing pain, and decreasing inflammation through low-impact exercises, like biking and swimming. Your health care provider may also recommend physical therapy, steroid injections, oral steroids, or anti-inflammatory medications. In extreme cases, surgery may be necessary to either replace or fuse joints. 2. Peripheral Arterial Disease (PAD) This is a serious vascular disease that causes blockages or narrowing in the veins and arteries. It also restricts blood flow from the heart to the toes. Symptoms: Fatigue, pain, discomfort, or a heaviness in the legs. Treatment options: Lifestyle changes – a healthy diet and regular exercise – are typically recommended for PAD patients. Some people may also need medication or surgery. Early detection is important as PAD can be dangerous if left untreated. Contact your provider immediately if you experience symptoms. You may be referred to a cardiologist, interventional cardiologist, or a vascular surgeon for treatment. 3. Neuropathy (also known as peripheral neuropathy) This condition occurs when the nerves are no longer able to communicate properly between the feet and the brain. Neuropathy can be caused by diabetes, chemotherapy, immunotherapy, traumatic injuries, infections, metabolic problems, inherited causes, exposure to toxins (such as overuse of alcohol), and more. Symptoms: Numbness, tingling, lack of sensation in the lower extremities, and odd or painful sensations. Treatment options: Embracing preventative measures and addressing the root cause of neuropathy is important. If you have diabetes, work with your health care provider to effectively manage your blood sugar levels. Some people may need to quit consuming alcohol. Once the cause of neuropathy is diagnosed, your provider may prescribe medication or recommend supplements, such as vitamin B complex and alpha lipoic acid. No matter the cause of the condition, everyone with neuropathy should make sure their shoes fit properly. “Something as simple as a tight shoe can cause a blister and lead to a non-healing wound,” Dr. Amundsen says. “It’s important for anyone who has neuropathy to have the right foot gear – shoes and socks – and to check their feet frequently.” 4. Plantar Fasciitis This painful condition flares up when the thick band of soft tissue (fascia) that connects the heel with the rest of the foot becomes irritated and inflamed. Symptoms: Stabbing pain on the bottom of the foot near the heel that may improve with movement and worsen after prolonged periods of standing. Treatment options: Ice, rest, steroid injections, physical therapy, oral steroids, and proper footwear with orthotics to balance the heel are all used to treat plantar fasciitis. 5. Achilles Tendinitis Weekend athletes – especially tennis and basketball players as well as joggers who suddenly intensify their runs – are particularly susceptible to Achilles tendinitis. Symptoms: Achilles tendinitis begins as a mild ache in the back of the leg, or above the heel, and gets worse with prolonged activity. People with the condition also experience painful stiffness in the same area in the morning. Treatment options: Ice, physical therapy, heel lifts, and nonsteroidal anti-inflammatory medications are recommended for Achilles tendinitis. Keeping your feet on a healthy path “I talk to my patients about staying as active as they can,” says Dr. Amundsen. “I also emphasize that foot health is connected to our overall health.” Dr. Amundsen suggests swimming and bicycling to keep your feet – and the rest of your body – healthy and flexible. He also recommends investing in a good pair of supportive running or trail shoes for foot health and comfort.
A delicious way to prevent prostate cancer
Prostate cancer is the second most commonly diagnosed cancer worldwide. However, there is good news: extensive research suggests that lifestyle and diet play an important role in prostate cancer prevention and treatment. In our latest Dignity Health Yavapai Regional Medical Center (YRMC) Your Healthy Kitchen video, I make a delicious recipe that is packed with important phytochemicals shown to reduce your risk, plus I explore other protective diet and lifestyle habits. Roasted Tomatoes with Ginger and Garlic Many of the diet and lifestyle recommendations for the prevention of prostate cancer are similar to recommendations for the prevention of cardiovascular disease, diabetes, and other types of cancers. The top five for prostate cancer prevention are: Quit smoking Get regular, if not daily physical activity Maintain a healthy weight Reduce your intake of processed foods and added sugars Eat a big variety of colorful fruits and vegetables There are also several nutrients and foods that have been linked specifically to a reduced risk of prostate cancer, including lycopene and ECGC, or epigallocatechin-3-gallate, a potent phytochemical found in green tea. Lycopene is one of several plant-based chemicals linked to reduced prostate cancer risk. It’s one of about 600 different colorful carotenoids made by plants and is found in red, orange and green vegetables, herbs, and fruits. All carotenoids act as antioxidants – protecting the cells, blood vessels, nerves, and organs in your body from damage – but lycopene seems to be the most powerful one. Good sources of lycopene include: Tomatoes Watermelon Papaya Dried apricots Pink grapefruit Carrots Asparagus Parsley For prevention of prostate cancer and many other chronic diseases, be sure to get a good source of daily lycopene, green tea, and lots of colorful fruits and vegetables, along with regular exercise, and embrace a smoke-free lifestyle. And be sure to check out all of our instructional videos and delicious, health-promoting recipes at yrmchealthconnect.org. You can follow me on Facebook too, at YRMC’s Your Healthy Kitchen, where I post photos and videos of the meals I make in my own kitchen, plus links to my favorite food and gardening destinations on the web.
What should you do if someone is having a heart attack?
You’re having dinner at your favorite restaurant and a guest at a nearby table collapses. You think it’s a heart attack, but what should you do to help? A heart attack is a life-threatening emergency that requires quick intervention. The U.S. Centers for Disease Control and Prevention (CDC) reports that every 40 seconds someone in the U.S. has a heart attack. That’s approximately 805,000 people a year. National CPR and AED Awareness Week (June 1-7) is coming up so it’s a good time to focus on how to help someone who is having a heart attack. Soundos Moualla, MD, FACC, FSCAI, is an interventional cardiologist as well as director of the Structural Heart program and co-director of the Cardiac Catheterization Laboratory at the James Family Heart Center at Dignity Health YRMC. What is a heart attack? Heart attacks are caused by a blockage in one or more of the arteries that supply blood to the heart. The blockage occurs when plaque inside the artery breaks open and a blood clot forms in the artery. “This sudden interruption of blood flow to the heart must be corrected quickly as every minute counts: time equals muscle,” says Soundos Moualla, MD, FACC, FSCAI, interventional cardiologist, the James Family Heart Center at Dignity Health Yavapai Regional Medical Center (YRMC). If the blockage is not treated quickly, the portion of the heart muscle that’s fed by the blocked artery will be severely damaged. How to recognize a heart attack The symptoms of a heart attack vary and may include: Chest pain or pressure Shortness of breath Discomfort in the arms, neck, back, or jaw Feeling lightheaded, dizzy, or passing out Heart palpitations Nausea and perspiration Upper abdominal/stomach discomfort While women may experience chest pain and pressure like men, they’re more likely to have other symptoms, such as shortness of breath, nausea/vomiting, and upper abdominal discomfort. Sixty-five percent of women seeking medical help for heart attack do not experience classic chest pain. CPR saves lives Cardiac arrest/sudden cardiac death can be a devastating result of a heart attack. In that circumstance, CPR should begin immediately by a bystander and be taken over by a paramedic or other emergency medical service (EMS) professionals when they arrive. The American Heart Association (AHA) recommends administering forceful and rapid compressions at a rate of 100-120 per minute. “Learning CPR is critical because it saves lives,” Dr. Moualla says. “CPR mimics the pumping of the heart, delivering blood and oxygen to the brain. It essentially buys time until further medical assistance and intervention can happen. The American Heart Association has sponsored a campaign for the last 20 years to increase awareness of CPR and encourage CPR training among the general population.” The AED comes to your aid An automated external defibrillator (AED) is an easy-to-use device that can revive someone in the event of cardiac arrest. Found in many public places – schools, police departments, police vehicles, grocery stores, airports, and malls – the success of an AED depends on its accessibility. “We need more AED units everywhere and increased public awareness of them,” says Dr. Moualla. “AEDS can be used safely and effectively, even by people who have not been trained.” How can you help someone in distress? Always call 911 first. If other people are present, ask them to look for an AED. If the person is unresponsive, administer CPR and activate the AED. If the person is conscious and breathing, they should slowly chew 325 milligrams of aspirin while waiting for the ambulance. Aspirin can reduce the degree of heart damage and the significance of the blood clot. Be prepared Learning CPR and retaining your certification can make you feel confident in case of a medical emergency. Look for classes through the AHA and the American Red Cross.
Are you at risk for lymphedema?
It wasn’t too many years ago that Lillian Swafford’s days began and ended with a hike of Thumb Butte in Prescott. “I was on the trail by six every morning and sometimes back before sunset to do it again,” Swafford says. “Even if it was snowing, I got my hike in.” Swafford’s daily treks of Thumb Butte ended quickly when her lower extremities, especially her ankles, began to swell. Soon, her legs were aching constantly. The swelling worsened and as it did, the skin around her ankles tightened. “Walking felt like I was wearing ankle weights,” says Swafford. “The pain was relentless. By the time I got home from work, all I could do was sit.” I have lymphedema? Swafford was surprised when a physician diagnosed lymphedema. “I had never heard the word until then.” She’s not alone. The National Cancer Institute calls lymphedema a poorly understood condition, even though an estimated three to five million Americans suffer from it. Getting help for lymphedema at YRMC Fortunately for Swafford, a physician recognized the condition and referred her to Debbie Kooiman, MOTR/L, CLT, a Dignity Health Yavapai Regional Medical Center (YRMC) certified lymphedema specialist and occupational therapist. “Most lymphedema is triggered by trauma to the body,” Kooiman says. “That trauma can slow or damage the lymphatic system, which prevents it from moving the lymph fluid in your body. This is what leads to swelling.” Lymphedema may be related to: cancer heredity infection infrequent leg elevation heart disease kidney disease lack of exercise non-healing wounds obesity radiation treatment for cancer (lymphedema symptoms can appear from three months to 20 years after treatment) surgery (lymph node removal or joint replacement, for example) trauma venous insufficiency (a vein condition) Debbie Kooiman, a Dignity Health YRMC certified lymphedema specialist and occupational therapist, uses compression therapy to treat Lillian Swafford’s lymphedema. Life with lymphedema Swelling that persists three months or more may be lymphedema. And while there’s no cure for the condition, there are treatments. Therapies include compression wrapping, manual lymphatic drainage, decongestive exercises, and use of a pneumatic pump to move fluid. “Decongestive exercises activate the sluggish lymph nodes and help clear the lymphatic pathways,” explains Kooiman. “We combine that with lymph massage and compression to help push the fluid through the open pathways. That’s something Lillian does on her own, too.” At the end of each therapy session, Kooiman wrapped Swafford’s legs in layers of bandages designed to reduce swelling. Kooiman also introduced Swafford to: techniques for cleaning, moisturizing, and protecting her skin from infection exercises that improve circulation low-sodium foods to fend off inflammation After three months of therapy, the swelling was down 18 inches in Swafford’s left leg and 11 inches in her right leg. “Lillian is dedicated to her therapy,” says Kooiman. “These awesome results show that.” Adds Swafford, “It’s a partnership. Debbie has taught me everything about managing lymphedema. She’s my miracle worker.” To learn more about lymphedema, talk to your physician or contact Advanced Wound Care at Dignity Health YRMC, (928) 771-4788. For information about other YRMC services, visit DignityHealth.org/YRMC.
Preparing for recovery before surgery: A new approach to healing
If you’ve had surgery, you know how important rehabilitation is to recovery. Working with a physical therapist, occupational therapist, and other rehabilitation specialists helps you regain your strength and returns you to your normal activities faster. Traditionally, rehabilitation begins after surgery. The team at Dignity Health Yavapai Regional Medical Center (YRMC) is part of a movement by leading health care organizations to introduce what could be named “prehabilitation.” Enhanced Recovery After Surgery (ERAS®), as it’s actually called, is designed to get you ready for your post-surgery recovery program before you even see the inside of a surgical suite. “ERAS is a way to help people prepare physically and mentally for their postoperative course,” says Pierre Tibi, MD, FACS, Director, the James Family Heart Center at Dignity Health YRMC and a cardiothoracic surgeon. “It’s a partnership that involves patients and every YRMC team member who comes in contact with them as part of their surgery.” That multi-disciplinary team – physicians, nurses, dietitians, pharmacists, rehabilitation specialists, and more – puts into action ERAS protocols that are scientifically proven to curb complications, reduce hospital stays, and accelerate recovery. Education and communication are threads that connect ERAS protocols at every phase. “Patients are at the center of ERAS,” Dr. Tibi says. “They are provided complete information about what to expect during their surgical journey. This empowers people to take an active role in their recovery.” Why is YRMC implementing ERAS? The answer is related to metrics and mission. Data from numerous large studies show ERAS programs: Reduce complications by 50 percent Shorten hospital stays by 30 to 50 percent Improve patient satisfaction “Beyond the data, ERAS demonstrates YRMC’s commitment to ensuring patients have the best experience we can give them during a stressful time,” says Kenneth O’Beirne, MD, a YRMC-affiliated anesthesiologist. “We’re applying the top medical science available and evidence-based practices to improve their care. To me, that shows we take our role as health care providers very seriously.” The ERAS journey ERAS begins as patients are contemplating surgery and continues through recovery. The protocols – developed by the non-profit ERAS Society – focus on improving the delivery of health care for surgical patients throughout the care cycle. This includes a surgery-specific roadmap that covers many phases, all of which involve patients in their recovery. Operation get ready for surgery Before surgery, YRMC clinicians help patients prepare using ERAS strategies that improve nutrition and physical fitness. They also share information on what patients can expect at every phase of their specific operation. “The more patients understand about their surgery, the more they can participate in their healing,” says Olivia Marsh, RN, Nurse Manager, Pre-Admission Testing, Pre-Op, and Post-Anesthesia Care Unit. “During the pre-operative phase of ERAS, we speak to patients about their expectations after surgery. We also discuss pain, which is part of the healing process.” For example, YRMC nurses coach patients undergoing knee replacement surgery to prepare by walking five times a day, even if it’s making loops around their living room. Studies confirm that being active prior to surgery reduces pain following the operation. In addition to engaging in exercise, patients receive information and tools to, for example: Eat a healthy balanced diet Stop smoking or consuming alcohol/drugs Manage blood sugar levels What happens during surgery helps with recovery The surgeon and anesthesiologist collaborate during surgery to reduce the physical stress of the operation on the patient. Fluid management is a good example of ERAS protocols at work in the operating room. Typically, patients receive fluids during surgery to manage their blood pressure. The problem is too much fluid can lead to excessive water weight, which can delay recovery. ERAS protocols call for careful fluid management. During surgery, anesthesiologists combine different types of medications as part of the ERAS protocol. Anesthetic drugs, nerve blocks, and anesthesia that targets specific parts of the body may replace conventional anesthesia. Let the healing continue After surgery, patients are encouraged to both eat and walk sooner. Research shows that the quicker food is re-introduced, the less need there is for intravenous medications and fluids. Additionally, walking reduces muscle loss, improves the respiratory function, and lowers the risk for pneumonia. “Patients also get a psychological boost when they’re up and moving following surgery,” Dr. O’Beirne says. “They think, ‘I can do this.’” Opioids are not part of the ERAS pain management protocol. Instead, combinations of acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), injections of local anesthetics at the incision, and peripheral nerve blocks help ease pain. A patient-provider partnership How has the patient-provider dynamic evolved thanks to ERAS? “Safe and successful surgeries have always been the goal of our team,” Marsh says. “What’s changed is that ERAS challenges us to look at every aspect of the surgical journey from our patients’ perspective. That’s driving us to adopt strategies that involve patients as our partners in new ways that benefit all of us.”
Oh, my aging feet: Five common foot problems and how to manage them
From our first steps as a child, we depend on our feet to carry us through life. For the average lifetime, that’s an estimated 115,000 miles of walking—the equivalent of circling the globe four times on foot. “Our feet are extremely complex structures,” says Richard Amundsen, DPM, a podiatrist affiliated with Dignity Health Yavapai Regional Medical Center (YRMC). “There’s a tremendous amount of mechanical demand on the feet. And after a lifetime of use, things can wear out.” Want to make sure your feet are healthy for the long haul? Here are five common foot problems people experience as they age and suggestions on how to manage them. 1. Osteoarthritis Often referred to as “wear and tear” arthritis, this is a degenerative joint disease that gradually leads to the breakdown of cartilage and other tissue. Symptoms: Decreased range of motion, swelling, bones that seem bigger, and an achiness that intensifies over time. Treatment options: Focus on reducing symptoms, managing pain, and decreasing inflammation through low-impact exercises, like biking and swimming. Your health care provider may also recommend physical therapy, steroid injections, oral steroids, or anti-inflammatory medications. In extreme cases, surgery may be necessary to either replace or fuse joints. 2. Peripheral Arterial Disease (PAD) This is a serious vascular disease that causes blockages or narrowing in the veins and arteries. It also restricts blood flow from the heart to the toes. Symptoms: Fatigue, pain, discomfort, or a heaviness in the legs. Treatment options: Lifestyle changes – a healthy diet and regular exercise – are typically recommended for PAD patients. Some people may also need medication or surgery. Early detection is important as PAD can be dangerous if left untreated. Contact your provider immediately if you experience symptoms. You may be referred to a cardiologist, interventional cardiologist, or a vascular surgeon for treatment. 3. Neuropathy (also known as peripheral neuropathy) This condition occurs when the nerves are no longer able to communicate properly between the feet and the brain. Neuropathy can be caused by diabetes, chemotherapy, immunotherapy, traumatic injuries, infections, metabolic problems, inherited causes, exposure to toxins (such as overuse of alcohol), and more. Symptoms: Numbness, tingling, lack of sensation in the lower extremities, and odd or painful sensations. Treatment options: Embracing preventative measures and addressing the root cause of neuropathy is important. If you have diabetes, work with your health care provider to effectively manage your blood sugar levels. Some people may need to quit consuming alcohol. Once the cause of neuropathy is diagnosed, your provider may prescribe medication or recommend supplements, such as vitamin B complex and alpha lipoic acid. No matter the cause of the condition, everyone with neuropathy should make sure their shoes fit properly. “Something as simple as a tight shoe can cause a blister and lead to a non-healing wound,” Dr. Amundsen says. “It’s important for anyone who has neuropathy to have the right foot gear – shoes and socks – and to check their feet frequently.” 4. Plantar Fasciitis This painful condition flares up when the thick band of soft tissue (fascia) that connects the heel with the rest of the foot becomes irritated and inflamed. Symptoms: Stabbing pain on the bottom of the foot near the heel that may improve with movement and worsen after prolonged periods of standing. Treatment options: Ice, rest, steroid injections, physical therapy, oral steroids, and proper footwear with orthotics to balance the heel are all used to treat plantar fasciitis. 5. Achilles Tendinitis Weekend athletes – especially tennis and basketball players as well as joggers who suddenly intensify their runs – are particularly susceptible to Achilles tendinitis. Symptoms: Achilles tendinitis begins as a mild ache in the back of the leg, or above the heel, and gets worse with prolonged activity. People with the condition also experience painful stiffness in the same area in the morning. Treatment options: Ice, physical therapy, heel lifts, and nonsteroidal anti-inflammatory medications are recommended for Achilles tendinitis. Keeping your feet on a healthy path “I talk to my patients about staying as active as they can,” says Dr. Amundsen. “I also emphasize that foot health is connected to our overall health.” Dr. Amundsen suggests swimming and bicycling to keep your feet – and the rest of your body – healthy and flexible. He also recommends investing in a good pair of supportive running or trail shoes for foot health and comfort.
Healthy Behaviors that Benefit All of You
Have you embraced healthy habits to help prevent breast cancer? Those same behaviors also keep hearts strong, blood pressures in check, glucose levels in the healthy range and more. “You’re a whole person, which means your body’s systems work together,” says LaNette Smith, MD, Breast Surgeon, Dignity Health, Yavapai Regional Medical Group (YRMG). “For example, the same things that lower your risk for cardiovascular disease – exercise, eating a nutritious diet, maintaining a healthy body weight and not smoking – also decrease your risk of breast cancer.” During October – Breast Cancer Awareness Month – Dr. Smith and the YRMG, Breast Surgery team remind you of the collective benefits of a healthy lifestyle and also offer these breast-health tips: Start yearly screening mammography at age 40 and continue screening for as long as you are healthy. Screening mammography is our best tool for detecting breast cancer earlier. Alternative screening methods should not replace screening mammography. Certain tests, like breast ultrasound and breast MRI, are used in addition to mammography. Discuss your personal risk for breast cancer with your physician. Risk assessment is important to creating individualized breast screening plans. Help prevent breast cancer or decrease your risk for recurrence by getting regular exercise, eating a nutritious diet, maintaining a healthy body weight, limiting alcohol and not smoking. Do not let lack of health insurance or financial concerns stand in the way of your yearly mammogram. The YRMG, Breast Surgery team can connect you to resources. Learn more about breast health and YRMG, Breast Surgery here or call (928) 442-8740. To schedule a mammogram, contact your physician or the Breast Care Center at Dignity Health, Yavapai Regional Medical Center at (928) 442-8900.
It’s Official: YRMC’s Breast Care Center is a Center of Excellence!
The word “excellence” has long been associated with the Breast Care Center at Dignity Health, Yavapai Regional Medical Center. But now it’s official. YRMC’s Breast Care Center was recently designated a Breast Imaging Center of Excellence (BICOE) by the American College of Radiology (ACR). The three-year accreditation recognizes that YRMC’s Breast Care Center excels in all aspects of breast imaging, including these breast imaging modalities: Breast MRI Breast ultrasound (including ultrasound-guided breast biopsy) Mammography Stereotactic breast biopsy ACR accreditation is voluntary and an addition to required imaging licenses, surveys and accreditations. The BICOE application process includes comprehensive evaluations conducted by board-certified physicians and medical physicists in each of the four breast imaging modalities. “Our team decided to pursue BICOE accreditation for our patients and community,” says Kathi Hoffer, Imaging Manager, Breast Care Center at Dignity Health, YRMC. “We were confident that the Breast Imaging Center of Excellence designation would validate the level of care we provide.” BICOE accreditation means YRMC’s Breast Care Center has achieved the highest practice standards in: Image excellence Staff qualifications Facility equipment Quality control standards Quality assurance procedures The ACR is a national professional organization founded in 1923 to advance the practice and science of radiological care. Today, the organization’s more than 41,000 diagnostic and interventional radiologists, radiation oncologists, nuclear medicine physicians and medical physicists work together in support of that mission. For more information about YRMC’s Breast Care Center, visit DignityHealth.org/YRMC or call (928) 442-8900.
YRMC Foundation Provided More than $2 Million in 2021, Supporting a Wide Range of Services for our Community
Pictured above: The Woodruff Family Conference Center in the new Outpatient Services Building West at Dignity Health, Yavapai Regional Medical Center in Prescott. Dave Barrett, Board Chair of the Yavapai Regional Medical Center (YRMC) Foundation, is pleased to report that the Foundation provided $2,128,505 during 2021. The funds will support a wide range of Medical Center programs and services. “The generosity of our community of donors is really quite remarkable,” says Barrett. “Every gift, large or small, touches someone’s life in a positive way.” The variety of initiatives funded by the Foundation in 2021 includes: The purchase of next-generation ultrasound imaging systems for the Breast Care Center and James Family Heart Center Leasing fees for the YRMC COVID–19 Vaccination Center at the Prescott Gateway Mall Construction of the Woodruff Family Conference Center in the new Outpatient Services Building West at the Prescott Campus Planning and operational support for YRMC’s newly established Cognitive Assessment and Support Center and Alzheimer’s and Dementia Care Program Primary care and behavioral health services for children served by YRMC’s Partners for Healthy Students program Essential health support for breast cancer patients who do not qualify for other programs or community services New clean clothing for patients in need so they can be discharged with dignity Diabetes management supplies for financially vulnerable patients Toys for children in our Pediatric Unit and Emergency Department Reflecting on the importance and impact of our community’s charitable support of the Foundation, YRMC President and CEO John Amos stated, “It is vitally important to our mission. I often say that charitable support provides the margin between adequacy and excellence.” You change the world with your giving heart. To learn more about supporting the YRMC Foundation or to speak with a member of our staff, please contact (928) 771–5686 or [email protected], or visit www.yrmcfoundation.org.
Woodruff Family Conference Center Dedicated at Dignity Health, YRMC West
Benny and Ellen Benson at the newly dedicated Woodruff Family Conference Center, Dignity Health, Yavapai Regional Medical Center On December 7th, family and friends of Bob and Margaret Woodruff, together with members of the Yavapai Regional Medical Center (YRMC) Foundation (a member of Dignity Health), the YRMC Foundation Board and YRMC leadership, gathered at YRMC’s new Outpatient Services Building for the dedication of the Woodruff Family Conference Center. The Woodruffs moved to the Prescott community in the early 1980’s. Being recently retired, they quickly adopted Prescott as their new hometown and became involved in many local activities. In addition, they volunteered for community service organizations including Friends of the Library, Meals on Wheels, and Yavapai Regional Medical Center. Their daughter, Ellen Benson, noted, “My mother and father believed that it is through kindness and helping others, using the grace we have been given, that we meet the world in its needs. When my parents decided to include the Medical Center as a beneficiary of their estate, they did so knowing their gift would be invested wisely.” Ellen recognized the knowledge and learning that will be shared in the new Conference Center will enrich the lives of the people of our community and is a wonderful tribute to the legacy of Margaret and Bob. The Woodruff Family Conference Center is located on the first floor of the newly completed Outpatient Services Building at YRMC’s Prescott campus. The Conference Center, fully equipped with state-of-the-art conferencing technology, includes a multipurpose lecture room, two classrooms and a demonstration kitchen. “The Woodruff family has honored our organization and our community through their kindness and generosity,” said YRMC Foundation Executive Director Robbie Nicol. “The Center will serve as the hub for the continuous education of our staff, ensuring the ongoing delivery of quality and compassionate patient care. Additionally, it will be a gathering place for our community, a place for learning where community members can enjoy educational programs such as YRMC’s Healthy Conversations speaker series and the ‘Your Healthy Kitchen’ programs.” To learn more about community education at YRMC or to speak with a YRMC Foundation staff member, please contact (928) 771–5686 or [email protected], or visit www.yrmcfoundation.org.
Preparing for recovery before surgery: A new approach to healing
If you’ve had surgery, you know how important rehabilitation is to recovery. Working with a physical therapist, occupational therapist, and other rehabilitation specialists helps you regain your strength and returns you to your normal activities faster. Traditionally, rehabilitation begins after surgery. The team at Dignity Health Yavapai Regional Medical Center (YRMC) is part of a movement by leading health care organizations to introduce what could be named “prehabilitation.” Enhanced Recovery After Surgery (ERAS®), as it’s actually called, is designed to get you ready for your post-surgery recovery program before you even see the inside of a surgical suite. “ERAS is a way to help people prepare physically and mentally for their postoperative course,” says Pierre Tibi, MD, FACS, Director, the James Family Heart Center at Dignity Health YRMC and a cardiothoracic surgeon. “It’s a partnership that involves patients and every YRMC team member who comes in contact with them as part of their surgery.” That multi-disciplinary team – physicians, nurses, dietitians, pharmacists, rehabilitation specialists, and more – puts into action ERAS protocols that are scientifically proven to curb complications, reduce hospital stays, and accelerate recovery. Education and communication are threads that connect ERAS protocols at every phase. “Patients are at the center of ERAS,” Dr. Tibi says. “They are provided complete information about what to expect during their surgical journey. This empowers people to take an active role in their recovery.” Why is YRMC implementing ERAS? The answer is related to metrics and mission. Data from numerous large studies show ERAS programs: Reduce complications by 50 percent Shorten hospital stays by 30 to 50 percent Improve patient satisfaction “Beyond the data, ERAS demonstrates YRMC’s commitment to ensuring patients have the best experience we can give them during a stressful time,” says Kenneth O’Beirne, MD, a YRMC-affiliated anesthesiologist. “We’re applying the top medical science available and evidence-based practices to improve their care. To me, that shows we take our role as health care providers very seriously.” The ERAS journey ERAS begins as patients are contemplating surgery and continues through recovery. The protocols – developed by the non-profit ERAS Society – focus on improving the delivery of health care for surgical patients throughout the care cycle. This includes a surgery-specific roadmap that covers many phases, all of which involve patients in their recovery. Operation get ready for surgery Before surgery, YRMC clinicians help patients prepare using ERAS strategies that improve nutrition and physical fitness. They also share information on what patients can expect at every phase of their specific operation. “The more patients understand about their surgery, the more they can participate in their healing,” says Olivia Marsh, RN, Nurse Manager, Pre-Admission Testing, Pre-Op, and Post-Anesthesia Care Unit. “During the pre-operative phase of ERAS, we speak to patients about their expectations after surgery. We also discuss pain, which is part of the healing process.” For example, YRMC nurses coach patients undergoing knee replacement surgery to prepare by walking five times a day, even if it’s making loops around their living room. Studies confirm that being active prior to surgery reduces pain following the operation. In addition to engaging in exercise, patients receive information and tools to, for example: Eat a healthy balanced diet Stop smoking or consuming alcohol/drugs Manage blood sugar levels What happens during surgery helps with recovery The surgeon and anesthesiologist collaborate during surgery to reduce the physical stress of the operation on the patient. Fluid management is a good example of ERAS protocols at work in the operating room. Typically, patients receive fluids during surgery to manage their blood pressure. The problem is too much fluid can lead to excessive water weight, which can delay recovery. ERAS protocols call for careful fluid management. During surgery, anesthesiologists combine different types of medications as part of the ERAS protocol. Anesthetic drugs, nerve blocks, and anesthesia that targets specific parts of the body may replace conventional anesthesia. Let the healing continue After surgery, patients are encouraged to both eat and walk sooner. Research shows that the quicker food is re-introduced, the less need there is for intravenous medications and fluids. Additionally, walking reduces muscle loss, improves the respiratory function, and lowers the risk for pneumonia. “Patients also get a psychological boost when they’re up and moving following surgery,” Dr. O’Beirne says. “They think, ‘I can do this.’” Opioids are not part of the ERAS pain management protocol. Instead, combinations of acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), injections of local anesthetics at the incision, and peripheral nerve blocks help ease pain. A patient-provider partnership How has the patient-provider dynamic evolved thanks to ERAS? “Safe and successful surgeries have always been the goal of our team,” Marsh says. “What’s changed is that ERAS challenges us to look at every aspect of the surgical journey from our patients’ perspective. That’s driving us to adopt strategies that involve patients as our partners in new ways that benefit all of us.”
What should you do if someone is having a heart attack?
You’re having dinner at your favorite restaurant and a guest at a nearby table collapses. You think it’s a heart attack, but what should you do to help? A heart attack is a life-threatening emergency that requires quick intervention. The U.S. Centers for Disease Control and Prevention (CDC) reports that every 40 seconds someone in the U.S. has a heart attack. That’s approximately 805,000 people a year. National CPR and AED Awareness Week (June 1-7) is coming up so it’s a good time to focus on how to help someone who is having a heart attack. Soundos Moualla, MD, FACC, FSCAI, is an interventional cardiologist as well as director of the Structural Heart program and co-director of the Cardiac Catheterization Laboratory at the James Family Heart Center at Dignity Health YRMC. What is a heart attack? Heart attacks are caused by a blockage in one or more of the arteries that supply blood to the heart. The blockage occurs when plaque inside the artery breaks open and a blood clot forms in the artery. “This sudden interruption of blood flow to the heart must be corrected quickly as every minute counts: time equals muscle,” says Soundos Moualla, MD, FACC, FSCAI, interventional cardiologist, the James Family Heart Center at Dignity Health Yavapai Regional Medical Center (YRMC). If the blockage is not treated quickly, the portion of the heart muscle that’s fed by the blocked artery will be severely damaged. How to recognize a heart attack The symptoms of a heart attack vary and may include: Chest pain or pressure Shortness of breath Discomfort in the arms, neck, back, or jaw Feeling lightheaded, dizzy, or passing out Heart palpitations Nausea and perspiration Upper abdominal/stomach discomfort While women may experience chest pain and pressure like men, they’re more likely to have other symptoms, such as shortness of breath, nausea/vomiting, and upper abdominal discomfort. Sixty-five percent of women seeking medical help for heart attack do not experience classic chest pain. CPR saves lives Cardiac arrest/sudden cardiac death can be a devastating result of a heart attack. In that circumstance, CPR should begin immediately by a bystander and be taken over by a paramedic or other emergency medical service (EMS) professionals when they arrive. The American Heart Association (AHA) recommends administering forceful and rapid compressions at a rate of 100-120 per minute. “Learning CPR is critical because it saves lives,” Dr. Moualla says. “CPR mimics the pumping of the heart, delivering blood and oxygen to the brain. It essentially buys time until further medical assistance and intervention can happen. The American Heart Association has sponsored a campaign for the last 20 years to increase awareness of CPR and encourage CPR training among the general population.” The AED comes to your aid An automated external defibrillator (AED) is an easy-to-use device that can revive someone in the event of cardiac arrest. Found in many public places – schools, police departments, police vehicles, grocery stores, airports, and malls – the success of an AED depends on its accessibility. “We need more AED units everywhere and increased public awareness of them,” says Dr. Moualla. “AEDS can be used safely and effectively, even by people who have not been trained.” How can you help someone in distress? Always call 911 first. If other people are present, ask them to look for an AED. If the person is unresponsive, administer CPR and activate the AED. If the person is conscious and breathing, they should slowly chew 325 milligrams of aspirin while waiting for the ambulance. Aspirin can reduce the degree of heart damage and the significance of the blood clot. Be prepared Learning CPR and retaining your certification can make you feel confident in case of a medical emergency. Look for classes through the AHA and the American Red Cross.
Serving Our Country: YRMC Emergency Director Promoted to Colonel
Rob Barth, MSN, MBA, RN, CEN, Director of Emergency Services, Dignity Health Yavapai Regional Medical Center, is now also a colonel in the United States Air Force Reserves. That’s a rank only two percent of Air Force officers achieve during their careers. “This promotion is an honor and blessing, especially at this point in my military career,” says Barth. “I’m approaching 21 years of service and eligible for retirement. That makes the promotion even more significant to me.” Rob and Shannon Barth at the recent ceremony to welcome Rob as an Air Force colonel. The promotion ceremony took place on March 4, 2023 at Joint Base Pearl Harbor-Hickam on the island of Oahu in Hawaii. During the ceremony, Shannon Barth – also a YRMC employee – removed the silver oak leaf cluster from her husband’s uniform and replaced it with the new silver eagle. This formalized the promotion from Lieutenant Colonel Barth to Colonel Barth. During a separate ceremony later that day, Barth was named commander of the 624th Aeromedical Staging Squadron at Joint Base Pearl Harbor-Hickam. In that role he will lead approximately 86 Air Force reservists and four active-duty airmen. Barth’s new squadron has a dual of mission. It conducts medical exams on airmen, ensuring they are medically ready for deployment to any location worldwide. Additionally, the squadron must be prepared to set up a hospital anywhere in the world within 72 hours. Years of Stellar Service At age 36, Barth made a life-changing decision: He would serve his country by joining the Air Force Reserves. “I called the Air Force recruiting office the day after 9/11,” he says. “I wanted to do my part.” Commissioned as an officer in 2002, Barth was assigned to the 944th Fighter Wing at Luke Air Force Base in Arizona. He has served there for most of the past 20 years. Barth began his service at the squadron as a critical care and emergency/trauma nurse and concluded as the squadron’s deputy commander. Barth has received numerous awards throughout his Air Force career. The two must important to him are the “944th Fighter Wing, 2004 Company Grade Officer of the Year” and the “Humanitarian Service Medal.” The latter recognized Barth’s role in helping evacuate Haitian citizens who were severely injured during the country’s 2010 earthquake. A Military-Civilian Partnership According to Tracey McCollum, MSN, RN, NEA-BC, CENP, YRMC’s Chief Nursing Executive Officer, both the community and YRMC have benefited from Barth’s service in the Air Force Reserves. “Rob brings best practices from the military and applies them to his work at YRMC,” McCollum explains. “The way we triage patients in the Emergency Department is a good example of that.” She notes that Barth has also developed excellent leadership skills through his military service. This has created a strong, cohesive and high-functioning team in the Emergency Department. The military also understands the benefits of the military-civilian partnership, according to Barth. “The depth of experience reservists bring to their service is valued by the Air Force,” he says. Words of Appreciation Barth also values YRMC’s support of his military service. “YRMC has always been extremely supportive of my military training time,” he says. “As an organization, YRMC is an excellent example of what a strong military-civilian partnership looks like.” As McCollum says, YRMC’s team is proud of Barth’s service to our country. “To be able to say that we have a colonel working in our four walls is actually pretty great.”
A Colorful Twist on the Standard Scrub
How we dress can say something about who we are. At Dignity Health Yavapai Regional Medical Center (YRMC) that’s especially true, thanks to the recent debut of color-coded scrubs and shirts. “Hospitalized patients meet people from many different healthcare services and a variety of support areas,” says Jessica Ryan, Manager of Service Excellence, YRMC. “The color-coded uniforms are designed to give patients and their loved ones information, even if it’s subtle, about their care team.” This uniform look extends to YRMC team members who typically don’t wear scrubs. For example, Physical Rehabilitation therapists are sporting burgundy-colored shirts. And our dietitians and other Nutrition Services team members wear steel gray shirts. The inpatient brochure patients receive includes a list of providers and the color of their attire. Check out the “We Are Your Care Team” chart to see who’s wearing which color at YRMC.
YRMC Announces the 2021 Volunteers of the Year
What’s the best job in the world? Working with volunteers, of course! Just ask Nancy Thomes, the Director of Volunteer Services at Dignity Health, Yavapai Regional Medical Center (YRMC). “I am so fortunate to be where I am because I work with top-notch people every day,” says Thomes. “It takes a giving heart to be a volunteer, and I’m surrounded by hundreds of volunteers with very generous hearts.” The volunteers are an integral part of the hospital, enhancing the patient experience and providing much needed support to YRMC staff. While the pandemic restricted their involvement over the past 2 years, YRMC is currently working to reopen additional service areas. Along the way, volunteers build friendships and enjoy the sense of purpose that volunteering provides. Each year, YRMC Volunteer Services recognizes three volunteers whose service to the hospital, its patients, and the community embodies the Mission and Vision of Dignity Health, Yavapai Regional Medical Center. Each recipient is recognized for the unique ways in which they make YRMC a better place. YRMC East Volunteer of the Year, Maggie Goltra “Nancy had asked if I could attend a meeting at the West Campus, and of course, if I can help in any way, I will be there,” recalls Goltra. “When we walked into the room, I recognized some of the staff, but still couldn’t figure out what I was doing there. When Nancy told me that I was Volunteer of the Year – East Campus, I was completely shocked – that never entered my mind! What an honor!” Goltra started volunteering at YRMC in 2007. Over the years, she has worked in Admitting, Care Management, and the Family Birthing Center, and now works at the East Campus Front Lobby. Volunteer Services Manager, Victoria Spears says that Goltra is one of those kinds of people that you just love being around. As the first point of contact when you walk through the hospital doors, the Front Desk volunteers have an important role. They can often set the tone for the patient or visitor’s experience, offering information and assurance. Duties include helping patients check in at the kiosk, helping visitors sign in, escorting patients and visitors throughout the hospital, delivering items, and regularly sanitizing the area. “Maggie does all of this with a big smile and gracious attitude,” notes Spears. “Everyone who is around Maggie cannot help but smile. She is a joy to be around!” Goltra gives credit to her fellow volunteers as well. “It’s nice to work with a group of people who are there because they want to be,” she says. “I work with Debbie, Wayne, and Gus, who are always there with a friendly hello and a readiness to help all of the patients and visitors who come in. These are the type of volunteers I would like to have welcome me to the hospital.” With more than 1,850 volunteer hours under her belt, Goltra is a true asset to YRMC. Yet she describes her role in simple terms: to be helpful, even if in a small way. “The best part about volunteering at YRMC is just being able to help make our patients’ time at the hospital a bit easier, in our small way,” she explains. “It’s important to be able to help where you can, especially if it is making someone’s day easier or less stressful.” YRMC West Volunteer of the Year, Mary Kerper Mary Kerper worked for 42 years for an international mechanical parts distributor, overseeing operations, training, auditing, and continuous improvement for more than 400 locations. Retirement brought her and her husband to Prescott in 2019. Their desire was to continue to contribute to their new community. “I have had chores, responsibilities, and jobs since elementary school,” says Kerper. “I was taught that work is important, and contribution is necessary to help others, as well as yourself. Volunteering helps me to maintain my sense of self while I provide support to others.” Nancy Thomes recognizes Kerper’s strong work ethic as she looks back on the past few years. “Mary is one of the volunteers who didn’t let COVID stop her from volunteering,” recalls Thomes. “She stayed active until we suspended all volunteers and returned immediately when we could open up the Information Desk – our only service area for a while. She took on an extra shift and was a ‘rock’ throughout that very uncertain time.” Staff and fellow volunteers agree. When asked why she is a stand-out volunteer, responses include: Mary is so vigilant – always alert to who is coming through the doors. She consistently subs for her fellow volunteers when she is available. One of Mary’s responsibilities is training new volunteers. They consistently remark how thorough she is with her training. She is helpful, compassionate, and caring, along with a friendly smile! The Front Desk is a challenging area of service, and she has remained calm throughout. Mary is a problem solver extraordinaire! “It is so amazing to come to a place of healing and do what I can to contribute to the patients, visitors, staff, and my fellow volunteers,” says Kerper. Yet on a larger scale, she reflects on the importance of her award. “This award reinforces the importance of the role of volunteers. It really shows the value that YRMC leadership places on the contributions the volunteers make. I love being part of this team. Leadership here at YRMC clearly includes volunteers as valuable members of their team.” “The new relationship between Dignity Health and YRMC has brought change, and will no doubt bring more change. But the community will benefit greatly,” she continues. “What I feel will not change is the commitment our leadership has to the hospital and to our community. The volunteers will always be here to help.” The Sandy Zinn Martin Award, Norma Bauer When describing Norma Bauer and her dedication to YRMC patients, staff, visitors, and fellow volunteers, Nancy Thomes is reminded of a television show. “There is a show called New Amsterdam. The setting is in a hospital, and the Medical Director is often seen moving about the hospital asking, ‘How can I help?’ The writers may not know this, but they must have fashioned that character after Norma Bauer.” Thomes continues, “She has been SUPER flexible, changing service areas often, and always willing to go where needed. When I ask for favors of volunteers, I often begin with a reminder that ‘No’ is an acceptable answer. That is a word that Norma rarely uses.” The award is named after a former volunteer, Sandy Zinn Martin, whose spirit lives on in the selfless service that Bauer demonstrates. It’s often the little things that show the true character of a person – the things that go unnoticed by most people. Thomes shares a brief but telling story. “A staff member sent me an e-mail after observing Norma assisting a patient who was having trouble getting something from a vending machine. Norma was a patient coach, gentle and kind.” “This award is a humbling honor; there are so many dedicated volunteers,” says Bauer. “I believe it indicates that staff and other volunteers have considered my presence and efforts in a positive light and kindly took the time to ‘say so.’” “Nearly every shift includes at least one interaction that stands out from the rest,” Bauer reflects. “What makes the greatest impact on me usually comes from a patient who expresses apprehension approaching a procedure. A brief suggestion to expect the staff to be caring and understanding can often serve to lessen the patient’s anxiety.” Bauer has been called a true role model in the Volunteer Services program, with some affectionately referring to her ‘old-world mannerisms.’ According to staff and fellow volunteers, Bauer’s gracious, polite, and professional approach informs everything she does. Comments include, “It was a privilege to be tutored and to subsequently work with Norma,” and, “She deserves this recognition.” When she was invited to consider volunteering at YRMC, Bauer didn’t hesitate. She was impressed with the quality of care given to her friends and family. “Volunteering at YRMC is an opportunity to support and give back to an organization that benefits our community,” she explains. “It gives me a sense of purpose and provides interests beyond myself. YRMC values its volunteers and demonstrates their appreciation of them.” “I sincerely enjoy volunteering at YRMC. It has become an enriching part of my life.” To learn more about becoming a volunteer at Yavapai Regional Medical Center, visit DignityHealth.org/YRMC. Or you can call Volunteer Services in Prescott at (928) 771-5678, or in Prescott Valley at (928) 442-8683.
YRMC 2020 Volunteers of the Year: Service, Friendship, Family
There are as many reasons to volunteer as there are volunteers. Some who step up are looking for added meaning to their lives. Some are hoping to find new friends. Some wish to continue using the skills they developed during their professional careers. Some want to feel like they are part of a larger effort. And some simply want to give back. Described as “the cream of the crop” by Nancy Thomes, Director of Volunteer Services, YRMC volunteers enhance the patient experience and provide much needed support to YRMC staff and physicians. They work in a myriad of ways across the hospital to keep things running smoothly. Recently, YRMC Volunteer Services named its choices for the 2020 Volunteers of the Year. An annual tradition, it celebrates three deserving volunteers whose service to the hospital, its patients and the community at large embodies the Mission and Vision of YRMC. While the top picks for 2020 have a wide range of reasons for volunteering, they share one impressive trait: a true passion for the work they do. Tom Hubbard – West Campus 2020 Volunteer of the Year Hubbard was not new to volunteering when he joined YRMC. He had previously volunteered for Meals on Wheels and the Lions Club. In 2012, his wife died after a long illness. “After a while, I decided that I could either sit at home doing nothing or get out and get busy. I got on with the Emergency Department at YRMC,” Hubbard says. He has been a volunteer at YRMC for 8 years and has logged more than 4,000 hours. Hubbard had continued his involvement with the Lions newspaper recycling project as well, collecting newspaper from around town and making sure the shredded documents from YRMC are bagged and out to the curb for pick up each week. “As COVID 19 restrictions started lifting and we started to re-open some of the volunteer service areas, Tom was first to say, ‘put me where you need me,’” Thomes recalls. “We were so grateful. He is now supporting the Information Desk, which is where we had the greatest need.” “I like this job because I’m up and moving all the time,” says Hubbard. “I get to the various departments and see lots of people. We help with registration, get authorization for early visitors, log people coming and going, and deliver flowers and other items to the patients. But I especially like helping the patients and visitors feel comfortable.” Hubbard’s fellow volunteers look forward to their shifts together. Comments include: If the afternoon volunteers are running late, he stays at the desk longer to ensure things progress as smoothly as possible. He is always the first to offer to fill in if there is a shift that isn’t covered. Tom is a can-do, proactive person who treats patients like his own family members. He is a great teacher, willing to share his knowledge. Tom is a great partner. Beyond the superb effort, his humor makes the shift seem too short. Hubbard chuckles at the comment about his sense of humor and casually describes the camaraderie he has with his fellow volunteers. “I’m very copasetic with the people I work with. We have a lot of fun,” he says. “I guess I have to admit, even though I’m 83 years old, I have a case of arrested adolescence.” With his signature humility, Hubbard reflects on what this recognition means. “I feel very proud, but I have to say that the notoriety makes me uncomfortable,” he says. “I just enjoy working with the patients, visitors and the staff. I don’t have any family here in the area – they’re all out of state, so I consider the folks I work with as part of my family. It’s very rewarding on so many levels.” Micki Freshour – East Campus 2020 Volunteer of the Year “I’m a natural caregiver and I’m very compassionate,” Freshour states. “I naturally take people under my wing, like a mother figure. That’s why I needed to be in a volunteer job where I could work one-on-one with patients. The Breast Care Center was a perfect fit. I wouldn’t want to be anywhere else.” Like Hubbard, Freshour is a long-time volunteer. Prior to her work at YRMC, she spent 14 years volunteering at a hospital in California and 11 years at a hospice in Arizona. She has been with the YRMC Breast Care Center since January, 2014 and has given more than 1,500 hours. “My job is to bring the patients back, show them the dressing area and keep them company while they’re waiting,” Freshour explains. “When they’re finished with their procedure, I cut their wrist band off and walk them out. Then I clean and sanitize everything and prepare the room for the next patient.” “But really, the main thing I do is help our patients feel comfortable. It can be stressful for our patients, particularly those who are having biopsies. I explain what they can expect and try to comfort them.” The added companionship and reassurance that Freshour offers helps to make the Breast Care Center patient experience brighter and easier. Her fellow volunteers and staff are grateful for the role she plays during her volunteer shifts. Comments include: Micki is very comforting to our patients. Micki goes above and beyond. She will not leave until all the patients have left, even though it is after her scheduled time frame. She is joyful and happy to help. Micki keeps things flowing smoothly. We love having her, she makes our days easier. She is a hard worker, she is compassionate, a pleasure to work with and a valued member of our team. Freshour was blindsided by the award. “Nancy called me and asked me to come to the West Campus because they needed some photos taken. It seemed odd, but I agreed,” Freshour recalls. “I met her in the lobby with two other volunteers, then we went into a conference room. Oh my goodness, there were whistles, balloons, yelling and screaming. And I couldn’t figure out why! When they introduced Tom Hubbard as the West Campus Volunteer of the Year, I thought, ‘Well, that is so nice. It’s like something you always dream of!’ But it still didn’t register why I was there.” “Then when they said my name, I just cried, I was so humbled. It’s so special, I can’t put it into words. I couldn’t wait to get my pin on my badge. I’m so proud of it!” “When people say that it’s ‘just’ volunteering, I immediately disagree,” Freshour continues. “The staff and patients count on me. I always say that I do get paid, but the payment I get is not monetary – It’s emotional. And that’s better than gold.” Carol Shepherd – Sandy Zinn Martin 2020 Award Winner “Carol embodies the spirit of this award. Like Sandy Zinn Martin, the former volunteer for whom this award was named, Carol is quick to extend support and assistance to other volunteers,” says Thomes. “Whether it’s taking meals over after a volunteer has had a procedure, offering to take in a volunteer’s dog after a volunteer injury, picking up volunteers for social gatherings, or regular calls to check in, she is always ready with a meaningful and timely offer.” Shepherd’s response to this generous description? “Well, I just do these things – it’s in my nature!” “It’s my way of giving back,” she continues. “I have so many things to be grateful for, both in my working career and my personal life. I’ve always worked with the public, so this is a natural thing for me. Volunteering is just a part of me. I love helping people, showing compassion, and offering a gentle word or gentle touch to our patients and visitors. I get more out of it than they do.” Shepherd has been volunteering at YRMC for three years, working in the Cath Lab, Registration, and as an Escort at the Front Desk. “You get to know the people you work with. They become family,” Shepherd says. “If I don’t see someone for a couple of weeks, I get concerned and will check in or ask about them. We’re a source of emotional support for each other when we have personal issues.” In true form, Shepherd initiated ‘Thursday Night Hamburger Nights’ with her fellow volunteers. On Thursday evenings, they’d meet for a burger and socializing, which led to taking turns hosting everyone in their homes, not to mention lasting friendships. “Volunteering is a great way to make new friends, and they’re always there for you,” she continues. “In fact, my husband said yesterday, ‘Two days a week, you’re up at 7 AM and out the door with a smile on your face!’ Well, those are the days I volunteer at YRMC.” There are even more YRMC friendships on the horizon for Shepherd. She explains: “A few days ago, a fellow volunteer handed me a nice card congratulating me on the Sandy Zinn Martin award. She said that she had gotten the same award in a previous year and said with a smile, ‘Welcome to our Club!’” “So now I’m determined to track down all the other recipients so that we can all celebrate together!” To learn more about becoming a volunteer at Yavapai Regional Medical Center, visit yrmc.org. Or you can call Volunteer Services in Prescott at (928) 771-5678, or in Prescott Valley at (928) 442-8683.
Patient Blood Management: Taking Charge of a Precious Resource
Patient-shared decision making is an important aspect of healthcare today. However, advocating for yourself – or someone you love – requires information, especially with a relatively new concept like patient blood management (PBM). This is one reason the Society for the Advancement of Patient Blood Management (SABM) is sponsoring Patient Blood Management Awareness Week®, November 7-11, 2022. This worldwide awareness week is dedicated to informing patients about the importance of blood health. Prescott City Council member, Steve Sischka – who also serves on the Dignity Health, YRMC Board of Trustees – presents Beth Black with a mayoral proclamation declaring Patient Blood Management Awareness Week. In our community, Dignity Health, Yavapai Regional Medical Center (YRMC) is home to Arizona’s only PBM program that’s recognized by SABM. Local leaders also understand the importance of PBM. Prescott Mayor Phil Goode, for example, has signed a proclamation declaring November 7-11, 2022, “Patient Blood Management Awareness Week” in Prescott. “Dignity Health, YRMC has been forward-thinking in its implementation of PBM,” says Dale Black, Program Coordinator, Patient Blood Management at Dignity Health, YRMC. “The people of Yavapai County are fortunate that YRMC has embraced blood conservation. This means residents have access to local providers for information about PBM.” The Pillars of PBM What is PBM and why is it important to you? “PBM is about keeping your blood in you and keeping it working well,” explains Beth Black, Administrative Assistant and Program Data Manager, Patient Blood Management at Dignity Health, YRMC. YRMC’s PBM program uses a team approach to: Manage anemia Ensure that bleeding is under control and blood is clotting appropriately (not too much, not too little) Utilize blood-conserving measures during surgery Involve patients in decision making about their blood Blood tests – particularly during hospitalization – give your provider important information about your health. However, drawing too much blood can lead to anemia in hospitalized patients. That’s why “phlebotomy stewardship” is becoming more and more important. This means taking only the needed amount of blood for testing in order to avoid hospital-acquired anemia. A Few Words About Anemia When you have anemia, your body lacks the healthy red blood cells needed to carry oxygen to your body’s tissues. Symptoms of anemia include, for example: Fatigue Weakness Cold hands and feet Dizziness Irregular heart rhythm Shortness of breath Headache Pale or yellowish skin “Once a year, ask your physician to order a complete work up of your blood,” Dale Black says. “If you are anemic, work with your doctor to learn the underlying cause of your anemia.” Prepping for Surgery with PBM If a surgery is in your future, ask your physician to order blood work two to four weeks before the procedure. If your blood counts are low, your doctor may recommend dietary changes. You may also need iron, vitamin B-12 or folic acid to fuel red blood cell production before surgery. “You’ll also want to discuss any herbals you take, along with other over-the-counter medications, such as ibuprofen,” says Beth Black. “These can all affect your body’s ability to clot.” Before your operation, talk to your surgeon about strategies that reduce blood loss. If you’re undergoing heart or orthopedic surgery – which are known to cause blood loss – discuss collecting blood lost during surgery for immediate post-operative reinfusion, if needed. Medications and blood products that promote clotting and reduce bleeding are also available. PBM is About You, the Patient Want to ensure blood conservation is part of your healthcare? Talk to your providers about PBM, especially prior to hospitalization. “Let your team know that you want to be treated in a manner that conserves your blood,” says Dale Black. “You can even mention your desire for minimal blood draws – just what is necessary for testing – during your hospitalization. With PBM, you are in charge of that precious resource, your blood.” Interested in learning more about YRMC’s PBM program? Get answers to your questions here or call (928) 771-5109.
Taking Charge of a Precious Resource with Patient Blood Management
Patient-shared decision making is an important aspect of healthcare today. However, advocating for yourself – or someone you love – requires information, especially with a relatively new concept like patient blood management (PBM). This is one reason the Society for the Advancement of Patient Blood Management (SABM) is sponsoring its 15th annual SABM Patient Blood Management Awareness Week®, November 1-5, 2021. This worldwide awareness week is dedicated to informing patients about the importance of blood health, particularly when it comes to hospitalization and surgical procedures. In our community, Dignity Health, Yavapai Regional Medical Center (YRMC) is home to Arizona’s only PBM program that’s recognized by SABM. Local leaders also understand the importance of PBM. Mayor Greg Mengarelli, for example, is continuing a 10-year tradition by issuing a proclamation declaring “Patient Blood Management Week” in Prescott. “Dignity Health, YRMC has been forward-thinking in its implementation of PBM nearly a decade ago,” says Dale Black, Program Coordinator, Patient Blood Management at Dignity Health, YRMC. “The people of Yavapai County are fortunate that YRMC has embraced blood conservation. This means residents have access to local providers for information about PBM.” In fact, he notes that in October 2021 – nearly 10 years after YRMC introduced PBM – the World Health Organization (WHO) released a policy brief titled, The Urgent Need To Implement Patient Blood Management. Getting to Know PBM What is PBM and why is it important to you? “PBM is about keeping your blood in you and keeping it working well,” explains Beth Black, Administrative Assistant and Program Data Manager, Patient Blood Management at Dignity Health, YRMC. This Healthy Conversations – Patient Blood Management: Your Blood, Your Call – focuses on how PBM supports your good health by preventing anemia, an underdiagnosed condition among people of all ages. And, because PBM is patient-centered, you’ll learn how to put PBM into practice before, during and after surgery. The Pillars of PBM YRMC’s successful PBM program uses a team approach to: Manage anemia Ensure that bleeding is under control and blood is clotting appropriately (not too much, not too little) Utilize blood-conserving measures during surgery Involve patients in decision making about their blood Blood tests – particularly during hospitalization – provide your physician important information about your health. However, drawing too much blood can lead to anemia in hospitalized patients. That’s why “phlebotomy stewardship” is becoming more and more important. This means taking only the needed amount of blood for testing in order to avoid hospital-acquired anemia. A Few Words About Anemia When you have anemia, your body lacks the healthy red blood cells needed to carry oxygen to your body’s tissues. Symptoms of anemia include, for example: Fatigue Weakness Cold hands and feet Dizziness Irregular heart rhythm Shortness of breath Headache Pale or yellowish skin “Once a year, ask your physician to order a complete work up of your blood,” Dale Black says. “If you are anemic, work with your doctor to learn the underlying cause of your anemia.” Prepping for Surgery with PBM If a surgery is in your future, ask your physician to order blood work two to four weeks before the procedure. If your blood counts are low, your doctor may recommend dietary changes. You may also need iron, vitamin B-12 or folic acid to fuel red blood cell production before surgery. “You’ll also want to discuss any herbals you take, along with other over-the-counter medications, such as ibuprofen,” says Beth Black. “These can all affect your body’s ability to clot.” In the Operating Room Before your operation, talk to your surgeon about strategies that reduce blood loss. If you’re undergoing heart or orthopedic surgery – which are known to cause blood loss – discuss collecting blood lost during surgery for immediate post-operative reinfusion, if needed. Medications and blood products that promote clotting and reduce bleeding are also available. PBM is About You, the Patient Want to ensure blood conservation is part of your healthcare? Talk to your providers about PBM, especially prior to hospitalization. “Let your team know that you want to be treated in a manner that conserves your blood,” says Dale Black. “You can even mention your desire for minimal blood draws – just what is necessary for testing – during your hospitalization. With PBM, you are in charge of that precious resource, your blood.” Interested in learning more about YRMC’s PBM program? Check out these PBM resources or call (928) 771-5109.
Prostate MRI: Detecting Cancer Early
Men of Yavapai County, here’s some important health information: Our county has the second highest rate of prostate cancer among Arizona’s 15 counties, according to the National Cancer Institute. Nationwide, one in eight men in the United States will be diagnosed with cancer of the prostate – a small gland below the bladder – during their lifetimes. But, there’s also reason to be optimistic. A non-invasive imaging study called prostate MRI (Magnetic Resonance Imaging) is finding prostate cancer early, when it’s most treatable. Even better news? Prostate MRI is available at Dignity Health Imaging Center in Prescott and Prescott Valley. “Prostate MRI is the most sensitive study available for detecting cancer in the prostate,” says Deven Cox, DO, Diagnostic Radiologist, Dignity Health Imaging Center. “If a patient has a lesion that’s very anterior in the prostate gland, a clinical exam will never detect that lesion. But prostate MRI does reveal those difficult-to-detect anterior tumors and others, too.” Should you have a prostate MRI exam? Dr. Cox – an expert in the non-invasive study – has reviewed more than 1,000 prostate MRI studies during his career. During National Prostate Cancer Awareness Month in September, he’s encouraging men ages 55–69 to talk to their physicians about whether prostate cancer testing is right for them. For men at high risk for prostate cancer – African-American men or males with a family history – discussions should begin between ages 40–54. Men with rising prostate-specific antigen (PSA) levels in their blood and struggles with “urinary retention” are also candidates for prostate MRI. In addition to diagnosing cancer, prostate MRI detects other conditions, including: Benign Prostatic Hyperplasia (BPH) – An enlarged prostate, which is most common in older males. Prostatitis – Inflammation or an infection of the prostate. “Prostate MRI studies provide important information that physicians use to develop treatment plans,” explains Dr. Cox. “These studies pinpoint the tumor location, determine its size and show if the cancer has spread outside of the prostate gland.” Contact us For more information about prostate MRI, speak to your physician or contact Dignity Health Imaging Center in Prescott or Prescott Valley at (928) 771-7577.
New Names for Prescott Medical Imaging and Prescott Valley Medical Imaging
Prescott Medical Imaging (PMI) and Prescott Valley Medical Imaging (PVMI) are introducing new names as part of Yavapai Regional Medical Center’s (YRMC) affiliation with Dignity Health. The outpatient imaging facilities are now: Dignity Health Imaging Center, Prescott Dignity Health Imaging Center, Prescott Valley “This change is part of the rebranding rollout plan launched in conjunction with the YRMC–Dignity Health affiliation,” says Ken Boush, Director of Marketing and Communications at Dignity Health, YRMC. “Patients and community members will begin to see new signage at both imaging centers. We want them to be aware that the name change is related to YRMC’s network-wide rebrand. It will not affect the care or services at our Imaging Centers in Prescott and Prescott Valley.” Local Radiologists Provide Exceptional Service For example, experienced, local radiologists will continue to interpret imaging studies and procedures performed at both locations, according to Mary Sterling, Imaging Services Director at Dignity Health, YRMC. “Our locally based radiology team has always differentiated us from other imaging centers, many of which use radiologists based in markets outside of Yavapai County to interpret imaging studies,” says Sterling. “At our Imaging Centers in Prescott and Prescott Valley, an imaging study performed in our community is interpreted by radiologists who live and work in our community.” Sterling adds that Dignity Health Imaging Center radiologists have long-established, working relationships with physicians throughout the area. This collaboration, she says, is a benefit to both individual patients and overall quality of care. Dignity Health Imaging Center radiologists and radiologic imaging technologists also are: Certified by the American College of Radiologists (ACR) and the American Registry of Radiologic Technologists (ARRT) Experts in advanced radiology modalities Graduates of leading medical schools and radiologic technology programs Accredited & Comprehensive Imaging Services Michael Locke, Operations Manager, Dignity Health Imaging Center, notes that the Imaging Centers have also earned ACR accreditation. “This means our Prescott and Prescott Valley facilities have undergone rigorous, objective evaluations by board-certified radiologists and medical physicists,” Locke explains. He also emphasizes that both facilities – along with the Breast Care Center at Dignity Health, YRMC – will continue to offer an all-inclusive menu of computer-enhanced, digital imaging services. YRMC’s Imaging Center facilities – both of which may be reached at (928) 771-7577 – are located in: Prescott – 810 Whipple Street Prescott Valley – 7700 East Florentine Road, Building B, Suite 105 Learn more about YRMC’s Imaging Centers and all YRMC services at DignityHealth.org/YRMC.
A delicious way to prevent prostate cancer
Prostate cancer is the second most commonly diagnosed cancer worldwide. However, there is good news: extensive research suggests that lifestyle and diet play an important role in prostate cancer prevention and treatment. In our latest Dignity Health Yavapai Regional Medical Center (YRMC) Your Healthy Kitchen video, I make a delicious recipe that is packed with important phytochemicals shown to reduce your risk, plus I explore other protective diet and lifestyle habits. Roasted Tomatoes with Ginger and Garlic Many of the diet and lifestyle recommendations for the prevention of prostate cancer are similar to recommendations for the prevention of cardiovascular disease, diabetes, and other types of cancers. The top five for prostate cancer prevention are: Quit smoking Get regular, if not daily physical activity Maintain a healthy weight Reduce your intake of processed foods and added sugars Eat a big variety of colorful fruits and vegetables There are also several nutrients and foods that have been linked specifically to a reduced risk of prostate cancer, including lycopene and ECGC, or epigallocatechin-3-gallate, a potent phytochemical found in green tea. Lycopene is one of several plant-based chemicals linked to reduced prostate cancer risk. It’s one of about 600 different colorful carotenoids made by plants and is found in red, orange and green vegetables, herbs, and fruits. All carotenoids act as antioxidants – protecting the cells, blood vessels, nerves, and organs in your body from damage – but lycopene seems to be the most powerful one. Good sources of lycopene include: Tomatoes Watermelon Papaya Dried apricots Pink grapefruit Carrots Asparagus Parsley For prevention of prostate cancer and many other chronic diseases, be sure to get a good source of daily lycopene, green tea, and lots of colorful fruits and vegetables, along with regular exercise, and embrace a smoke-free lifestyle. And be sure to check out all of our instructional videos and delicious, health-promoting recipes at yrmchealthconnect.org. You can follow me on Facebook too, at YRMC’s Your Healthy Kitchen, where I post photos and videos of the meals I make in my own kitchen, plus links to my favorite food and gardening destinations on the web.
Focus on Fiber for Diabetes Management and Prevention
Increasing fiber in meals and snacks can improve blood sugar control for people with diabetes. High-fiber diets also lower your risk of developing cardiovascular disease, colon cancer, and other chronic illness. In our latest Dignity Health YRMC Your Healthy Kitchen video, we take a closer look at the benefits of fiber, where to find it, and how to increase your intake while making a delicious, high-fiber version of one of the world’s best comfort foods. Lemony Chicken Soup with White Beans and Leeks Fiber reduces blood sugar spikes after meals by slowing down the digestion and absorption of sugars and other carbohydrates. A high-fiber meal also helps you to fill up faster, reduce calories, and maintain a healthy weight. In addition, good research suggests that: Consuming whole, intact grains can reduce your risk of developing type 2 diabetes and cardiovascular disease. Whole grains may reduce blood pressure and help with weight loss. Fiber lowers blood cholesterol and insulin resistance. Increased fiber from all foods reduces the risk of cardiovascular disease, diabetes, pre-diabetes, metabolic syndrome, and colon cancer. Through the effect on gut microbial populations, fiber may also significantly reduce inflammation and improve immune function. The Academy of Nutrition and Dietetics recommends taking in 14 grams of fiber for every 1000 calories you eat, or over 25 grams of fiber daily for most adults. Try tracking your fiber intake to see where you land. If you need more, add a small portion of a new, high-fiber food to your meals each day until you reach your goal. Be sure to drink lots of water, too—64 ounces is usually a good goal. Remember to check out all our instructional videos and delicious, high-fiber recipes at yrmchealthconnect.org. You can also follow me on Facebook, where I post photos and videos of the meals I make in my kitchen, plus links to my favorite food and gardening destinations on the web.