Reduce Your Risk of Falling by Managing Your Medications
Anne is 65 years old and has been taking the same medications for years. But now, her physician has prescribed a new one. Anne is concerned about how the drugs may interact with each other, and whether she’ll experience any side effects. How can Anne safely take this new combination of medications, and where can she find guidance? Anne is right to be cautious. As we age, many of us need more types of medications. Drug interactions, combined with our changing metabolism, can cause new and unexpected side effects. Some of these possible side effects can put us at a greater risk for falling. Statistics show that 1 in 4 people aged 65 and older fall every year. In fact, falls are the number one cause of fatal and nonfatal injuries for older Americans. While the numbers are concerning, there are many things you can do to reduce your risk of falling, including being proactive about how and when you take your medications. Kimduy Nguyen, Pharm.D., Clinical Pharmacist at Yavapai Regional Medical Center, says that there are two main reasons why our senior population should keep track of their medications. First, as we age, the muscle mass, fat content and water content of our bodies change. In addition, our kidneys and liver may not work as well as they used to. “This can cause build up of the medication in the body, as we’re unable to metabolize or eliminate as we used to,” says Nguyen, “The distribution of the medication is different and the absorption as well. So this can increase the risk of falls, when the medications have more pronounced effects.” The second reason we should keep close track of our medications as we age has to do with polypharmacy, which is using more than 4 medications at a given time. This includes supplements as well. “When we have more medications, there’s more potential for drug-to-drug interaction, which is medications interacting among themselves, as well as drug-disease interaction,” Nguyen says. These interactions can cause pronounced side effects, which may include lightheadedness or dizziness. Dr. Nguyen offers a list of three important things to know when managing your medications: WHY you’re taking the medication, including the condition it is treating WHAT to expect when taking the medication, such as side effects HOW the medication works, so that you can take the medication at the time of day that’s the safest and most effective One easy ways to stay organized and aware of your medications is to write down what you are taking, why you are taking it, and what the dosage instructions are. Yavapai Regional Medical Center offers a free printable Medication Record at yrmc.org. Another way to manage your medications is to use a pill minder, which is a container with small, separate compartments. You can place individual dosages in each compartment, organized by the days of the week and time of day. Pill minders can be found at most pharmacies and other stores. Finally, perhaps the best advice for a person like Anne, who is concerned about the side effects of a new medication, is one of the easiest to do. “One of the best practices for safe medication management is actually talking to your doctor or pharmacist about all of your medications,” says Nguyen. “Not only prescription medications, but also herbal supplements and vitamins, inhalers and other things.” By talking to your doctor or pharmacist, you can get the information you need to personalize a system for managing your medications. This may include what time of day to take each medication, which medications you can take at the same time, and whether you should take them on a full or empty stomach. Yavapai Regional Medical Center has teamed up with the Arizona Falls Prevention Coalition – Northern Chapter to offer our community information and resources about how to minimize your risk of falling. Our goal is to allow our citizens to enjoy an independent, active lifestyle for years to come. For more information, tips and resources about preventing falls, visit the Arizona Falls Prevention Coalition website at www.azstopfalls.org.
YRMC – Your Destination for Cardiac Care and Blood Management: Watch Our Live Event from Home
Top cardiac specialists from Yavapai Regional Medical Center’s (YRMC’s) James Family Heart Center and leaders from its Patient Blood Management Program will join YRMC – Your Destination for Cardiac Care and Blood Management, a live-stream presentation and panel discussion. The event will feature prominent heart specialists – a cardiologist, a cardiothoracic surgeon, an electrophysiologist, an interventional cardiologist – and knowledgeable patient blood management experts. These professionals will highlight the leading-edge, less-invasive procedures used to repair hearts at YRMC as well as how patient blood management strategies are significantly improving patient outcomes. YRMC – Your Destination for Cardiac Care and Blood Management will broadcast live from the Yavapai College Performing Arts Center in Prescott for the public to watch: Date: Thursday, October 17, 2019 Time: 6:00 to 8:00 p.m., Mountain Standard Time Where: YRMCHealthConnect.org/pbm What is a Healthcare Destination Program? Healthcare destination programs are thriving, specialized medical programs – typically associated with hospitals – that patients seek out because of their: Highly skilled physicians Excellent outcomes State-of-the-art technology Innovative procedures Outstanding staff “YRMC’s Heart Program and its Patient Blood Management Program check all of those boxes,” said Pierre Tibi, MD, FACS, Medical Director of the James Family Heart Center at YRMC and YRMC’s Patient Blood Management Program. “It starts with our exceptional physicians, who were all trained at top heart programs. This team has worked together to expand our Heart Program and integrate patient blood management strategies that improve patient outcomes.” A Lively Live-Stream Event YRMC – Your Destination for Cardiac Care and Blood Management will include an energetic panel discussion with YRMC’s heart specialists and patient blood management experts. Those physicians and other YRMC leaders will also give interesting and informative talks on: YRMC, A Destination for Hearts and Blood Management John Amos, BS, MSM, President and Chief Executive Officer, Yavapai Regional Medical Center Launching YRMC Cardiology – A Journey to Better Outcomes for You George Rizk, MD, Invasive Cardiovascular Medicine, YRMC PhysicianCare The Beat Goes On Nisha Tung-Takher, MD, Cardiac Electrophysiologist, YRMC PhysicianCare Mending Hearts With Less Invasive Interventions Soundos Moualla, MD, FACC, FSCAI, Structural and Interventional Cardiologist, YRMC PhysicianCare Gwen Rhodes, RN, Patient Navigator, Yavapai Regional Medical Center PBM at YRMC – Together We Are Doing Great Things Elizabeth Black, Patient Blood Management Program Data Manager, Yavapai Regional Medical Center Patient Blood Management – YRMC and Beyond Pierre Tibi, MD, FACS, Medical Director, Patient Blood Management and the James Family Heart Center at Yavapai Regional Medical Center Ask the Experts – Panel Discussion Pierre Tibi, MD, FACS Elizabeth Black Dale Black, Patient Blood Management Program Coordinator, YRMC Soundos Moualla, MD, FACC, FSCAI Gwen Rhodes, RN George Rizk, MD Nisha Tung-Takher, MD To learn more about YRMC – Your Destination for Cardiac Care and Blood Management, visit YRMCHealthConnect.org/pbm.
Managing Chronic Pain in YRMC’s Your Healthy Kitchen
If you suffer from chronic pain, could diet changes provide any relief? The answer is … yes! Good research suggests that healthy meals and snacks, featuring colorful fruits and vegetables, whole grains, lean proteins and beneficial fats can often reduce pain, in a number of interesting and surprising ways. For example, high fiber fruits and whole grains support the growth of healthy, anti-inflammatory gut bacteria. Other healthy carbohydrates like legumes, sweet potatoes, and whole grain pastas, promote feelings of wellbeing and improved mood. In addition, colorful red, green, orange, purple and blue fruits and vegetables have powerful anti-inflammatory effects on joints, muscles and every other body tissue to reduce lower back pain, severe neck pain, fibromyalgia, and more. You can learn more in this new episode of YRMC’s Your Healthy Kitchen, where I recently explored some of the highlights of chronic pain and diet research, checked out a few handy pain-friendly kitchen tools, and made a delicious anti-inflammatory smoothie! Most researchers agree that filling your plate with lots of colorful vegetables and liberally flavoring meals with fresh herbs and spices are two of the best steps anyone can take to reduce chronic pain. The Mediterranean diet is likely the easiest and most recognized eating plan that fits with those recommendations. Mediterranean style meals and snacks are loaded with colorful vegetables — with whole grains, legumes, root vegetables, fruits, and lean proteins starring as healthy sides. Good fats, like those found in fish, avocados, nuts, and olive oil show up in small quantities throughout the day. Abundant resources exist online to help with planning Mediterranean style meals, including the Oldways Cultural Food Traditions site, which features a neat Mediterranean diet pyramid and many delicious recipes. Pain and Inflammation-Fighting Fresh Herbs, Colorful Fruits, Whole Grains and Olive Oil While the Mediterranean diet plan works well for most people, some folks find that eliminating foods they are allergic to or intolerant of can provide added pain relief. For example, grains containing gluten (wheat, barley and rye), dairy, soy, eggs, and peanuts are common triggers of discomfort, inflammation and sometimes outright allergic reactions. Experiment with avoiding one of these foods or food groups for a few weeks at a time to see if omitting them from your diet impacts your level of pain. In addition, experts agree that chronic pain sufferers should all eliminate or significantly restrict added sugars and artificial sweeteners, as well as certain types of fat, like those found in fried and processed foods. Cooking at home more can help you follow these pain-reducing diet guidelines, and here are some tricks that can help you prepare your own healthy meals: Try preparing your meals in stages, at the times of the day when you feel best. For example, you might chop some onions and other veggies in the morning and store them in the refrigerator to use in a dinner soup or stir-fry. In the afternoon, prepare some chicken or other simple protein to cook with your veggies later in the day. Prepare enough food so you have leftovers that you can freeze or refrigerate and use on the days when you’re just not up for fixing yourself a meal from scratch. Rely on healthy pre-chopped or frozen vegetables, or prepared, jarred sauces like pesto, marinara or olive tapenade to brighten up a simple meal of rotisserie chicken, pasta, or grilled meat or fish. Grocery delivery or the many meal delivery services available these days can lighten up meal prep time and responsibilities! Fortunately, the foods that reduce inflammation, support healthy gut bacteria, improve mood, and reduce pain also prevent lots of other chronic conditions, including diabetes, heart disease and cancer! Each of the recipes in Your Healthy Kitchen feature loads of vegetables, fresh fruit, whole grains, legumes, herbs, spices, and lots of color, so check them all out at yrmchealthconnect.org. You can also follow me on Face Book at YRMC’s Your Healthy Kitchen, where you can see what I make home, watch my mini-videos, and check out links to fun recipes, food blogs and food and garden-related events in the community.
Prostate Cancer: Five Ways to Help Prevent a Common Cancer
Guys, here’s your healthcare quiz for the day: What is the most common form of cancer in men? The answer is prostate cancer. This is a slow-growing cancer of the prostate gland—a walnut-sized organ in the male reproductive system. Unfortunately, prostate cancer is also the second leading cause of cancer death among men. Prostate Cancer Awareness Week – September 15-21, 2019 – is a good time to encourage men to get proactive with prostate cancer prevention. That’s why Yavapai Regional Medical Center (YRMC) is arming men with this list of the risk factors, prevention strategies and prostate cancer symptoms. Know your family history and other risk factors. Family history, age and ethnic background play a role in your likelihood of being diagnosed with prostate cancer. Let’s begin with family history, the strongest risk factor for prostate cancer. A man who has one close relative with prostate cancer – a father or a brother, for example – is twice as likely to develop prostate cancer as a male with no family history of the disease. Age is also a factor in prostate cancer. The disease is rare for men under 40 and most common in men 65 years and older. Ethnicity can affect your likelihood of being diagnosed with prostate cancer. African American men are more likely to be diagnosed with the disease; Asian American males are the least likely. Get screened. Timely screenings are crucial to detecting prostate cancer, which will affect one in seven men. The American Cancer Society (ACS) recommends discussing prostate exams with your healthcare provider around age 45, if you have a family history of prostate cancer or you are an African American male. Men at lower risk should also discuss screening with their physicians since prostate cancer can occur in men considered lower risk for the disease, too. Eat your fruits and vegetables. There is no specific diet for prostate cancer prevention, however, eating a mostly plant-based diet benefits your overall health. What types of foods should be on your plate and what should you avoid? A healthy diet consists of whole grains, plenty of fruits and vegetables, and good fats (avocado and nuts). Limiting your consumption of meat and dairy products is also recommended. For healthy, tasty and affordable menu ideas, visit YRMC’s Your Healthy Kitchen on YRMC HealthConnect or Facebook. Watch your weight. Being obese or overweight can increase your risk for prostate cancer. You are considered obese when your Body Mass Index (BMI) is 30 or higher. Use this BMI calculator to learn where you are on the scale. If you’re overweight or obese, it’s time to embrace a regular exercise routine and a healthier diet. Your healthcare provider can advise you on both. Signs of prostate cancer in men Contact your healthcare provider if you are experiencing any of the following symptoms: difficulty urinating, frequent urge to urinate, pain in the lower back and hips, or blood in your urine. Take control of your health now by talking to your healthcare provider about prostate cancer.
Now Showing: Places in the Heart
Knowledge is power. This old saying rings true when you’re faced with medical decisions for yourself or someone you love. When it comes to heart care, these decisions can be life altering. Pierre Tibi, MD, FACS, Medical Director of the James Family Heart Center at Yavapai Regional Medical Center (YRMC), regularly performs heart dissections for YRMC staff and nursing students to enhance their knowledge and to augment their training and education. However, for the first time, YRMC has recorded Dr. Tibi performing a heart dissection so that community members, including medical students, patients, teachers and families, can learn first-hand what a heart looks like and how it functions. Bringing this knowledge to our community is in direct alignment with YRMC’s Mission. As a not-for-profit community healthcare provider, YRMC makes community education a priority. The video demonstrating methods of heart dissection was one of the many educational opportunities on display at the 2019 Celebrate Life Health Expo, sponsored by YRMC, and held on September 6th and 7th at the Findlay Toyota Center in Prescott Valley. “I’m very proud that the James Family Heart Center has become a destination program for patients,” states Dr. Tibi, one of most respected cardiothoracic surgeons in the country. “Since 2007, we have carefully developed one of the top heart programs in Arizona by being selective in targeting the professionals to define and grow the program. This, in turn, attracts more top-quality physicians to the Prescott area.” The top-notch, multidisciplinary cardiac program at the James Family Heart Center, combined with an informed patient, makes a complete healthcare team, which in turn, allows for the best outcomes. With his signature personality and humor, Dr. Tibi begins the video with a schematic drawing of the heart, demonstrating the journey of a single red blood cell as it enters and exits the heart, giving the viewer a better understanding of what they will see during the dissection. He then begins the heart dissection, displaying the various parts of the heart and describing the function that each part serves. The dissection is performed on the heart from a pig. In the medical community, pig heart dissection for demonstration is used since it is anatomically similar to a human heart. As he facilitates the journey through the heart, Tibi discusses various conditions such as blood clots, heart attack, coronary artery disease, stenosis, endocarditis, congenital conditions and the purpose of anticoagulants. These are some of the more common issues that may arise if you are a heart patient. To learn more about about the James Family Heart Center at YRMC, visit yrmc.org.
Falls Prevention: Improving Your Balance at Any Age
It’s clear that you are enjoying your retirement when you are freely pursuing the activities you love; playing with the grandkids, golf, gardening or hiking, to name a few. When a fear of falling creeps into your day-to-day life, when you begin restricting your activities to avoid the risk of falling, or if you have experienced a fall in the past, it may be time to seek help from a medical professional. According to the Arizona Falls Prevention Coalition, in 2014, unintentional falls were the leading cause of injury-related mortality among Arizona residents aged 65 years and older. Statistics show the rate of fall-related injury and death is even higher in Northern Arizona, where we deal with a greater number of specific risk factors such as freezing weather accompanied by icy streets and sidewalks, hills, unpaved streets and trails, and older homes with wood floors and staircases. Even the actual activities we want to enjoy in retirement can increase one’s risk for a fall. While the numbers indicate that there is a reason to be concerned, there are many simple things you can do to decrease your risk of an unexpected fall. Having your balance tested by a specialist and then working with them on an individually designed exercise plan is a good way to begin. Rich Tenney, Senior Physical Therapist and a member of YRMC’s Physical Rehabilitation Team, emphasizes the importance of personalized care. “When someone comes in for an assessment at YRMC, the first thing we do is visit with them and get a history of how they feel about their balance,” states Tenney. “That’s really important for the specialist to know so we can tailor their treatment.” A specialist will conduct assessments of the three important systems that affect balance: Vision Vestibular balance – ear balance Sensation balance – joints and muscles The results of the testing will indicate if there are any particular deficits or weaknesses in one or more of these areas. This information, combined with your personal goals, will help you and your specialist create a customized treatment plan. Objective measures are put in place to track progress and improvement. Tenney states that one of the most important goals is increased confidence. When the patient’s risk of falling is in a normal range, they will feel secure enough to continue pursuing the activities they enjoy. “Our bodies are absolutely amazing, no matter what the age is. And when it comes to balance, you can change that. You can improve that,” says Tenney. “You just need the right direction and the right knowledge. That’s what a specialist can offer, so that you can overcome those fears of falling and be able to live that life you want, at any age.” To learn more about the balance assessment services available through YRMC’s Physical Rehabilitation Department, please call (928) 771-5131 or visit yrmc.org. For more information, tips and resources about preventing falls, visit the Arizona Falls Prevention Coalition website at www.azstopfalls.org.
Enjoying Retirement, Preventing Falls
You’ve worked hard to get to this point in your life. Retirement is here! Now you can enjoy doing all those things you’ve been planning for – travel, hiking, fishing, gardening, golf – the list is only limited by your imagination, unless you experience an unexpected setback, like an accidental fall. According to the Arizona Falls Prevention Coalition, in 2014, unintentional falls were the leading cause of injury-related mortality among Arizona residents aged 65 years and older. Statistics show that the rate of fall-related injury and death is even higher in Northern Arizona, where we deal with a greater number of specific risk factors such as freezing weather accompanied by icy streets and sidewalks, hills, unpaved streets and trails, and historic homes with wood floors and staircases. Even the new activities you are enjoying can increase your risk for a fall. Numerous studies indicate that as we get older, falls can have a more serious impact on one’s health. Chris Thompson, RN, BSN, Trauma Service Program Coordinator at Yavapai Regional Medical Center, says that this is reflected in YRMC admission rates. “At 59 years and below, the admission rate for falls is about 17%,” Thompson says, “And for 60 and above, admission rate is up towards 50%.” While the numbers are alarming, there are many things you can do to decrease your risk of an unexpected fall. A new chapter of the statewide coalition, called Arizona Falls Prevention Coalition, Northern Chapter, is addressing our specific needs in Northern Arizona. “The coalition is very active,” says Virginia Rodriguez, Health Education Coordinator, Yavapai County Community Health Services, “At each meeting we have different organizations present a variety of different topics related to things like fall risks, assessment, recovery and education.” Rodriguez adds that raising awareness of risk factors for falling and how to prevent them is one of the chapter’s main goals, “There are a number of resources and organizations that are great assets to the community. We want to get the word out.” Connecting with available resources is a great way to keep your risk for falls at a minimum. But what can you do right now? Larry Parsons MD, Director of Inpatient Palliative Medicine, Yavapai Regional Medical Center PhysicianCare, has a brief checklist that can make a big difference: Medication management: Review all of your medications with your healthcare provider. Find out if there are any that you no longer need to take. Ask whether there are any adverse drug interactions you should be aware of. Home safety assessment: Check your home for loose rugs or electrical cords, clutter, unstable furniture, poor lighting and other fall hazards. Hydration: Drink plenty of water throughout the day. This helps keep your mind clear and helps prevent dizziness. Stand up slowly: Sit at the bed or chair for a few moments and pump your hands and legs, then slowly stand up. Exercise: Even if it is walking a little each day or doing chair exercises, do what you can to keep your muscles active. Be on the lookout for further information from Arizona Falls Prevention Coalition, Northern Chapter. Their goal is to keep you informed so that you can make the most of your retirement years, filled with physical activity and fun here in Northern Arizona.
Teachers and Parents Enjoy the Premium Features of GoNoodle Plus
Chances are, if you have an elementary school aged child, you’ve heard of GoNoodle, a web-based suite of hundreds of learning games. The GoNoodle games and videos are designed to get kids dancing, running, jumping, stretching, deep breathing, and more. Kids become familiar with the fun, engaging characters and look forward to exercising with them again and again. Teachers across the Quad-City school districts have incorporated GoNoodle’s interactive learning games into their classrooms to assist with practicing math, spelling and social studies skills. They’re logging into GoNoodle throughout the day for exercise and stretch sessions to keep students active and engaged. What many teachers don’t know, however, is that they have access to the premium version of GoNoodle for free, called GoNoodle Plus, thanks to a sponsorship from Yavapai Regional Medical Center. Parents in the YRMC service area have access to GoNoodle Plus as well. GoNoodle Plus has all the features of GoNoodle, plus several substantial additions. With GoNoodle Plus, teachers can input their own content so that the games and activities are customized to their specific curriculum, classroom, or individual students’ needs. Teachers also have the option of choosing from hundreds of expertly curated math, spelling, ELA, science and social studies question sets. Parents who have internet access at home can use any of the custom question sets that their child’s teacher has created. For example, teachers can send home their customized weekly spelling lists, mental math facts or science content. From there, parents and children can turn study time into fun, energetic exercise time with GoNoodle songs and GoNoodle dance. This may be one of the rare times kids actually enjoy doing homework! Parents can also download the GoNoodle app for free for GoNoodle on the go. If you have a K-5 student in any of the major school districts in the area such as Prescott Unified, Humboldt Unified or Chino Valley Unified, or in many of the private schools or home school groups, you may have seen them come home with Learning Extensions, which are printable worksheets and activities paired with more than one hundred GoNoodle videos. This is another added feature of GoNoodle Plus. Usage reports are sent each month to GoNoodle Plus teachers. These reports provide easy tracking of teacher and student usage minutes. Support and training opportunities are also available for Plus users. Teachers and parents can get started by visiting GoNoodle.com and creating an account. You’ll be asked for your name, your choice of username and password, and whether you are a parent or teacher. Please note that if you already have a GoNoodle account, you don’t need to establish a new account. You have access to the GoNoodle Plus features automatically if you live in the YRMC service area. Once you have an account, you can begin exploring the many features of GoNoodle Plus, thanks to YRMC’s generous sponsorship. Take some time to try out the games, activities, songs and exercise programs designed to keep your child, or your class, active, engaged and ready to learn. “GoNoodle Plus aligns very well with our Vision of a Total Healing Environment which is based on caring for the body, mind and spirit,” says Robbie Nicol, Executive Director, Community Outreach and Philanthropy at YRMC. “YRMC is proud to sponsor programs like GoNoodle Plus, as well as Partners for Healthy Students and the YRMC Family Resource Center, that enrich the lives of children and young families in our community.” For more information about YRMC’s sponsorship of GoNoodle Plus, contact the Community Outreach Department at CommunityOutreach@yrmc.org.
Celebrate Life Health Expo 2019
A MEGA Experience and Learning Opportunity
That means you, your family and your friends can explore the world’s only larger-than-life, walk-through exhibits of the human body: MEGA Body™ and MEGA Heart™.
Find Out More
From Research Lab to Real Life: YRMC’s Genetic Clinic
Have you wondered how scientific research affects real lives? Look no further than the Human Genome Project for a shining example of how research leapt – relatively speaking – from research labs to patient clinics, like Yavapai Regional Medical Center’s (YRMC’s) Genetic Clinic in Prescott Valley. In 2003, scientists from 20 research institutions in six countries, including the United States, announced they had completed the monumental achievement of sequencing the entire human genome. How did this information make it into our everyday healthcare world? Jody Pelusi, PhD, FNP, AOCP, Oncology Nurse Practitioner, who oversees cancer genetic testing at YRMC’s Genetic Clinic recalls, for example, that breast cancer genetic testing used to involve only two genetic mutations: BRCA1 and BRCA2. “Now we know many genes exist,” said Dr. Pelusi. “Therefore, we do panel testing to look at anywhere from 30 to more than 100 genes.” What can genetic testing at YRMC’s Genetic Clinic accomplish? The answer to that question depends on the patient’s individual needs. Genetic testing is typically pursued to: Pinpoint actual risk for developing cancer from a hereditary mutation versus a perception of cancer risk. Learn cancer risk based on personal or family risk factors for people found not to be at high risk for cancer based on genetic testing. Determine the best treatment options, follow-up care and long-term monitoring for people diagnosed with cancer. Learning Your Genetic Risk for Cancer Before genetic testing happens – typically starting with a swab of salvia from the mouth – Dr. Pelusi meets with the individual to discuss his or her goals. Her approach is part scientist, part counselor and all supportive. “We talk about genetic testing, the information they will potentially learn and if knowing that will make a difference in how they approach their healthcare,” explained Dr. Pelusi. “Some people may come from families who didn’t discuss illness or they may be adopted and have no knowledge of their genetic history. There are many different circumstances.” During a first appointment, Dr. Pelusi introduces cancer genetic testing by: Reviewing the goals of cancer genetic testing. Discussing why the person is interested in genetic testing. Developing a profile based on the family’s history of cancer, including the type of cancer and at what age the family member was diagnosed with cancer. Outlining the pros and cons of genetic testing, including how test results can affect the people being tested as well as their family members. “About 10 percent of people will actually be found to have a genetic change that puts them at higher risk for potentially developing a cancer,” Dr. Pelusi said. “However, this 10 percent is significant as this can be life changing. Some individuals will come in and get the information and want to think about it before they determine if they want to undergo testing or not; this is absolutely fine.” Your Genetic Test Results For people whose genetic test results show they’re at higher risk for cancer, Dr. Pelusi works with their clinicians to provide valuable information on healthcare and lifestyle options. This may include increased health monitoring and screenings, lifestyle changes, risk-reducing surgeries and chemoprevention (using drugs, vitamins or other agents to reduce cancer risk, delay its development or help prevent recurrence). “These are emotional topics,” Dr. Pelusi said. “This is not a time to fear cancer. But we sure can fight it with our awareness, our knowledge and our actions. I make sure people have the information they need to make a decision they’re comfortable with. I listen and respect their approach. You can’t get that in a mail order test.” To schedule an appointment at the Genetic Clinic for a genetic evaluation and possible testing, call (928) 442-8747.
On the Set of YRMC’s Your Healthy Kitchen with Dr. Michael Macon, Medical Director of The Breast Care Center at YRMC
Breast cancer is the most commonly diagnosed cancer among women in Arizona, and Yavapai County has the third highest rate of breast cancer among all counties in the state. While we have no control over some of the risks for breast cancer, including family history and genetics, maintaining a healthy weight, enjoying a plant-based diet, being physically active, and scheduling regular mammograms are all steps that women can take to both prevent and detect breast cancer in its earliest stages. Dr. Michael Macon, Medical Director of the Breast Care Center at YRMC joined us recently on the set of YRMC’s Your Healthy Kitchen to share news about the excellent diagnostic tools, cutting edge treatment plans, caring staff and patient support available at the Breast Care Center. He also helped us prepare a delicious roasted cauliflower soup filled with cancer-fighting nutrients and lots of warm, satisfying flavor! Nourishing Ingredients Ready for Making Curried Roasted Cauliflower Soup The Breast Care Center at YRMC offers a number of excellent screening and diagnostic tools that can detect breast cancer in its earliest stages and help determine which treatment might be best if cancer is found. Dr. Macon describes the Breast Care Center as “a basecamp for cancer diagnosis and treatment, where first and foremost, women can get mammograms with expert mammographers using the latest equipment. Also, if someone is diagnosed with breast cancer, it is a place that provides excellent treatment, plus ongoing care that includes a support group for women who have cancer”. Check out the video to learn more about the great care provided at the Breast Care Center, and see how easy it is to make our delicious soup! Good research suggests that a plant-based diet (one filled with lots of vegetables, whole grains, beans, fruit, nuts and seeds, and smaller portions of animal-based foods) helps to prevent the onset and recurrence of breast cancer. In fact, a recent study led by researchers an the Harvard T.H. Chan School of Public Health found that women who ate 5 ½ servings of fruits and vegetables or more each day (one serving equals 1 cup of raw leafy greens or ½ cup cooked or raw non-leafy vegetables and fruits) had an 11% reduction in their risk of breast cancer compared to women who ate approximately half that amount or less each day. Cruciferous vegetables, including cauliflower, broccoli and Brussels sprouts, and yellow and orange vegetables may confer the most protection, especially against the most aggressive types of tumors. Warm and Satisfying Curried Roasted Cauliflower Soup The cancer-preventing effects of a diet filled with plants may be due to multiple factors, including high levels of fiber, which can reduce harmful estrogen levels in the body, and phytochemicals, which may act to stimulate the immune system, reduce inflammation, and even directly fight cancer growth. Eating meals that are filled with nourishing plants (especially vegetables) can also help women maintain a healthy weight. After all, if you replace some of the higher calorie foods on your plate, like meats and starches, with low calorie vegetables, you’ll be eating fewer calories, but will likely still feel comfortably full because of the fiber and volume that vegetables add to meals. Adequate physical activity, of at least 150 minutes of moderate or 75 minutes of vigorous exercise a week, may also reduce breast cancer risk by helping women to maintain a healthy weight. Other benefits of exercise likely include a reduction of harmful estrogen levels and improved immune function. Moving more throughout the day also means you are sitting less, which offers benefits that extend to increased longevity and reduced risk of a number of chronic diseases. There’s no doubt that lifestyle changes help reduce the risk of breast cancer, but remember, getting regular mammograms is equally important, whether you are at increased risk of breast cancer because of family or personal history or not. Call now, 928-442-8900, to schedule your mammogram, and remind your friends and loved ones to do the same. The Breast Care Center is located at Yavapai Regional Medical Center East, 7700 Florentine Road, in Prescott Valley. Curry Cauliflower Soup Apricot Pear Chutney
YRMC – Your Destination for Cardiac Care and Blood Management: Watch Our Live Event from Home
Top cardiac specialists from Yavapai Regional Medical Center’s (YRMC’s) James Family Heart Center and leaders from its Patient Blood Management Program will join YRMC – Your Destination for Cardiac Care and Blood Management, a live-stream presentation and panel discussion. The event will feature prominent heart specialists – a cardiologist, a cardiothoracic surgeon, an electrophysiologist, an interventional cardiologist – and knowledgeable patient blood management experts. These professionals will highlight the leading-edge, less-invasive procedures used to repair hearts at YRMC as well as how patient blood management strategies are significantly improving patient outcomes. YRMC – Your Destination for Cardiac Care and Blood Management will broadcast live from the Yavapai College Performing Arts Center in Prescott for the public to watch: Date: Thursday, October 17, 2019 Time: 6:00 to 8:00 p.m., Mountain Standard Time Where: YRMCHealthConnect.org/pbm What is a Healthcare Destination Program? Healthcare destination programs are thriving, specialized medical programs – typically associated with hospitals – that patients seek out because of their: Highly skilled physicians Excellent outcomes State-of-the-art technology Innovative procedures Outstanding staff “YRMC’s Heart Program and its Patient Blood Management Program check all of those boxes,” said Pierre Tibi, MD, FACS, Medical Director of the James Family Heart Center at YRMC and YRMC’s Patient Blood Management Program. “It starts with our exceptional physicians, who were all trained at top heart programs. This team has worked together to expand our Heart Program and integrate patient blood management strategies that improve patient outcomes.” A Lively Live-Stream Event YRMC – Your Destination for Cardiac Care and Blood Management will include an energetic panel discussion with YRMC’s heart specialists and patient blood management experts. Those physicians and other YRMC leaders will also give interesting and informative talks on: YRMC, A Destination for Hearts and Blood Management John Amos, BS, MSM, President and Chief Executive Officer, Yavapai Regional Medical Center Launching YRMC Cardiology – A Journey to Better Outcomes for You George Rizk, MD, Invasive Cardiovascular Medicine, YRMC PhysicianCare The Beat Goes On Nisha Tung-Takher, MD, Cardiac Electrophysiologist, YRMC PhysicianCare Mending Hearts With Less Invasive Interventions Soundos Moualla, MD, FACC, FSCAI, Structural and Interventional Cardiologist, YRMC PhysicianCare Gwen Rhodes, RN, Patient Navigator, Yavapai Regional Medical Center PBM at YRMC – Together We Are Doing Great Things Elizabeth Black, Patient Blood Management Program Data Manager, Yavapai Regional Medical Center Patient Blood Management – YRMC and Beyond Pierre Tibi, MD, FACS, Medical Director, Patient Blood Management and the James Family Heart Center at Yavapai Regional Medical Center Ask the Experts – Panel Discussion Pierre Tibi, MD, FACS Elizabeth Black Dale Black, Patient Blood Management Program Coordinator, YRMC Soundos Moualla, MD, FACC, FSCAI Gwen Rhodes, RN George Rizk, MD Nisha Tung-Takher, MD To learn more about YRMC – Your Destination for Cardiac Care and Blood Management, visit YRMCHealthConnect.org/pbm.
Now Showing: Places in the Heart
Knowledge is power. This old saying rings true when you’re faced with medical decisions for yourself or someone you love. When it comes to heart care, these decisions can be life altering. Pierre Tibi, MD, FACS, Medical Director of the James Family Heart Center at Yavapai Regional Medical Center (YRMC), regularly performs heart dissections for YRMC staff and nursing students to enhance their knowledge and to augment their training and education. However, for the first time, YRMC has recorded Dr. Tibi performing a heart dissection so that community members, including medical students, patients, teachers and families, can learn first-hand what a heart looks like and how it functions. Bringing this knowledge to our community is in direct alignment with YRMC’s Mission. As a not-for-profit community healthcare provider, YRMC makes community education a priority. The video demonstrating methods of heart dissection was one of the many educational opportunities on display at the 2019 Celebrate Life Health Expo, sponsored by YRMC, and held on September 6th and 7th at the Findlay Toyota Center in Prescott Valley. “I’m very proud that the James Family Heart Center has become a destination program for patients,” states Dr. Tibi, one of most respected cardiothoracic surgeons in the country. “Since 2007, we have carefully developed one of the top heart programs in Arizona by being selective in targeting the professionals to define and grow the program. This, in turn, attracts more top-quality physicians to the Prescott area.” The top-notch, multidisciplinary cardiac program at the James Family Heart Center, combined with an informed patient, makes a complete healthcare team, which in turn, allows for the best outcomes. With his signature personality and humor, Dr. Tibi begins the video with a schematic drawing of the heart, demonstrating the journey of a single red blood cell as it enters and exits the heart, giving the viewer a better understanding of what they will see during the dissection. He then begins the heart dissection, displaying the various parts of the heart and describing the function that each part serves. The dissection is performed on the heart from a pig. In the medical community, pig heart dissection for demonstration is used since it is anatomically similar to a human heart. As he facilitates the journey through the heart, Tibi discusses various conditions such as blood clots, heart attack, coronary artery disease, stenosis, endocarditis, congenital conditions and the purpose of anticoagulants. These are some of the more common issues that may arise if you are a heart patient. To learn more about about the James Family Heart Center at YRMC, visit yrmc.org.
Enjoying Retirement, Preventing Falls
You’ve worked hard to get to this point in your life. Retirement is here! Now you can enjoy doing all those things you’ve been planning for – travel, hiking, fishing, gardening, golf – the list is only limited by your imagination, unless you experience an unexpected setback, like an accidental fall. According to the Arizona Falls Prevention Coalition, in 2014, unintentional falls were the leading cause of injury-related mortality among Arizona residents aged 65 years and older. Statistics show that the rate of fall-related injury and death is even higher in Northern Arizona, where we deal with a greater number of specific risk factors such as freezing weather accompanied by icy streets and sidewalks, hills, unpaved streets and trails, and historic homes with wood floors and staircases. Even the new activities you are enjoying can increase your risk for a fall. Numerous studies indicate that as we get older, falls can have a more serious impact on one’s health. Chris Thompson, RN, BSN, Trauma Service Program Coordinator at Yavapai Regional Medical Center, says that this is reflected in YRMC admission rates. “At 59 years and below, the admission rate for falls is about 17%,” Thompson says, “And for 60 and above, admission rate is up towards 50%.” While the numbers are alarming, there are many things you can do to decrease your risk of an unexpected fall. A new chapter of the statewide coalition, called Arizona Falls Prevention Coalition, Northern Chapter, is addressing our specific needs in Northern Arizona. “The coalition is very active,” says Virginia Rodriguez, Health Education Coordinator, Yavapai County Community Health Services, “At each meeting we have different organizations present a variety of different topics related to things like fall risks, assessment, recovery and education.” Rodriguez adds that raising awareness of risk factors for falling and how to prevent them is one of the chapter’s main goals, “There are a number of resources and organizations that are great assets to the community. We want to get the word out.” Connecting with available resources is a great way to keep your risk for falls at a minimum. But what can you do right now? Larry Parsons MD, Director of Inpatient Palliative Medicine, Yavapai Regional Medical Center PhysicianCare, has a brief checklist that can make a big difference: Medication management: Review all of your medications with your healthcare provider. Find out if there are any that you no longer need to take. Ask whether there are any adverse drug interactions you should be aware of. Home safety assessment: Check your home for loose rugs or electrical cords, clutter, unstable furniture, poor lighting and other fall hazards. Hydration: Drink plenty of water throughout the day. This helps keep your mind clear and helps prevent dizziness. Stand up slowly: Sit at the bed or chair for a few moments and pump your hands and legs, then slowly stand up. Exercise: Even if it is walking a little each day or doing chair exercises, do what you can to keep your muscles active. Be on the lookout for further information from Arizona Falls Prevention Coalition, Northern Chapter. Their goal is to keep you informed so that you can make the most of your retirement years, filled with physical activity and fun here in Northern Arizona.
YRMC Kids’ Fun Ride: Pedaling for Fun and Fitness
When do colorful streamers tied to handlebars become wings that can make a bike fly? When a child’s imagination and energy are in high-gear as they were at the 2019 Yavapai Regional Medical Center Kids’ Fun Ride. Kids ranging in age from toddler to tween joined the YRMC Kids’ Ride, which took place Sunday, April 28 in downtown Prescott as part of the Whiskey Off-Road weekend. For the second consecutive year, YRMC sponsored the Kids’ Fun Ride, covering every child’s $10 registration fee, and donating the fees to Prevent Child Abuse Arizona. “The weekend was an all-around success,” said Ken Boush, YRMC’s Director of Marketing and Communications. “It was great to see so many kids and their parents participating in this positive, health-focused event. To top it off, YRMC was pleased to again support the important work of Prevent Child Abuse Arizona.” Riders Set a Record! YRMC partnered with Epic Rides, sponsor of the Whiskey Off-Road, on the YRMC Kids’ Fun Ride. “Both of our organizations believe in creating healthier communities,” said Todd Sadow, President and CEO of Epic Rides, sponsor of the Whiskey Off-Road. “YRMC’s commitment helped increase participation in the Kids’ Fun Ride to a new high of 292 kids riding bikes. This allowed YRMC to donate $2,920 to Prevent Child Abuse Arizona.” Kids Get Their Wheels Ready to Roll! On Saturday, April 27, kids, parents and grandparents joined the YRMC Kids’ Fun Ride Bike Decorating Party at the Holiday Courtyard, right in the heart of the Whiskey Off-Road festivities. Children who registered for the YRMC Kids’ Fun Ride were invited to the free bike decorating party, sponsored by YRMC. Under the Courtyard’s big tent, children let their imaginations go as they customized their bikes with colorful streamers, wheel beads, neon-colored tire valve caps, and fuzzy twists. Some of the super hero and unicorn stickers found their way on to kids’ bike helmets. Face painters took requests from party goers who asked for favorite animated characters, butterflies, cats, and more. Chili Bean the clown joined the YRMC Kids’ Bike Decorating Party, with her cool purple Schwinn Stingray. The Kids’ Fun Ride Begins! “The decorating party built the momentum for the Kids’ Fun Ride,” said Brian DeVries, PHR, YRMC’s Manager – Benefits and Employee Health/Wellness. “Our goal is to inspire fitness as a lifestyle among children and their families. From what we saw during the fun ride, the younger generation is very inspired.” The YRMC Kids’ Fun Ride began on Montezuma Street near Prescott Courthouse Plaza. YRMC’s Wellby the Yavabear was there to start the ride. It wasn’t long before young cyclists were crossing the finish line. They were greeted by enthusiastic applause and medals from the YRMC team.
Brains, Heart, Courage: YRMC Volunteers of the Year for 2019
The quest for brains, heart and courage was a central theme in the beloved novel and film The Wizard of Oz. Had the Scarecrow, Tin Man and Cowardly Lion made Yavapai Regional Medical Center (YRMC) their first stop, their quest would have been fulfilled. Any day of the week, the YRMC volunteers display these traits and more, according to Nancy Thomes, Director of Volunteer Services at YRMC. The staff at YRMC recently honored its volunteers at the annual Volunteer Appreciation Luncheon. With nearly 400 people attending, this year’s theme was The Wizard of Oz. The festivities took place at the Prescott Resort, with YRMC staff appearing as various characters from the classic story. Thomes says the luncheon conveys only a fraction of the gratitude that YRMC and the community at large has for the volunteers at YRMC. “In 2018, our volunteers contributed 112,132 hours of service, which is a record,” says Thomes. “Every one of those moments means that someone, in some way, is served because of our volunteers. How fortunate we are.” Three volunteers in particular were honored for the ways in which they embody the mission and vision of YRMC each day they come to work. YRMC West Campus Volunteer of the Year: Joe Clyne Joe Clyne started volunteering at YRMC 13 years ago and has given more than 2,300 hours in 11 different capacities. He currently volunteers as an Escort as well as offering administrative assistance in the Payroll Department and delivering mail. Clyne saw a need for regular clean up and maintenance in the Healing Garden and took it upon himself to fill that need as well. “Volunteering at YRMC is very satisfying and gives me a real sense of purpose,” says Clyne. “Being the Volunteer of the Year is a recognition that is beyond words. There are so many deserving volunteers working at this facility.” Clyne’s knowledge and experience, positivity and willingness to jump in wherever he’s needed makes him the YRMC West Campus Volunteer of the Year for 2019. YRMC East Campus Volunteer of the Year: Andrea Bell Andrea Bell joined the YRMC Volunteer community in July of 2011, when the BreastCare Center at YRMC East opened its doors. Since then, she has donated more than 1600 hours of her time to the program. Bell served as the Department Chair for a period of time and has even helped train new volunteers when the Chair position was vacant. Members of the staff consider Bell’s compassionate support for both patients and staff one of the reasons why the BreastCare Center volunteer program is such a success. However, Bell’s unassuming nature deflects the high praise. “I used to say ‘I’m just a volunteer’ and boy would they put me in my place! I don’t say that anymore!” says Bell. On a more serious note, Bell expresses her gratitude for the opportunity. “I always feel so thankful that I’m able to give my time to volunteering at YRMC,” Bell says. “Volunteering is an uplifting and positive part of my life. It’s a gift to me!” Bell was recognized at the luncheon as the YRMC East Campus Volunteer of the Year for 2019. YRMC Sandy Zinn Martin Award: Rick Smith Sandy Zinn Martin was a long-time YRMC volunteer who was known as the ‘little lady with the big personality.’ Her dedication and giving nature was known throughout the hospital. The Sandy Zinn-Martin Award was created in her memory to honor her spirit of generosity. It is given each year to a volunteer who embodies the ‘above and beyond’ attitude that Sandy exemplified. Rick Smith is an East Campus Escort on Thursday afternoons and works as a substitute Courtesy Cart driver or Shredder when needed. He has volunteered at YRMC for more than two years and has clocked more than 550 volunteer hours. But Smith’s dedication to YRMC and its volunteers extends far beyond this job description. Smith is considered a friend to all. In his off-duty hours, has been known to visit fellow volunteers in the hospital, rehabilitation facilities and even in their homes. His optimism and sense of humor makes everyone smile, even when sick or convalescing. Smith takes the accolades in stride. “I am surprised and humbled. It is very nice to be acknowledged,” he says. “I consider these hard working and dedicated people to be my friends and I’m lucky to get to spend time with them.“ “I have been very lucky in my own life,” Smith reflects. “It so nice to do a little bit for folks who are maybe not having the best of luck. You definitely get back more than you put in.” Smith’s generosity of spirit has earned him the YRMC Sandy Zinn-Martin Award for 2019. In The Wizard of Oz, the Tin Man wisely said, “You people with hearts have something to guide you.” Thomes says that the Tin Man must have known something about volunteerism. “Without generous hearts, there would be no volunteering,” she says. “I work with what I consider the best of the best. These are individuals who want to give of their time, the most valuable resource that anyone can give.” Thomes continues, “I feel a little skewed about humanity because I work with the kind of people who say yes to whatever we ask of them. I think volunteering is the best thing a person can do.”
YRMC Volunteer Spotlight: John Peters and Richard McBride
If you’ve spent any time at Yavapai Regional Medical Center, you’ve probably heard the sound of a hand bell throughout the halls twice a day. The bell heralds the arrival of the snack cart, and the ringer is a member of the snack cart volunteer team, serving hot coffee, juices, fruit, yogurt and other goodies to visitors and staff at the hospital. Watch Volunteer Spotlight: John Peters and Richard McBride on YouTube On any given morning, you might be served by YRMC volunteers John Peters and Richard McBride. The duo often resembles a comedy team more than hospital volunteers. Employees and visitors who purchase snacks from the cart can’t help but join in the banter and good-natured teasing. But don’t let the lightheartedness fool you. They take their job very seriously. “A big philosophy we have is that we go the extra mile,” says Peters, “Let’s say that you have a nurse caring for a patient in one of the rooms in ICU. I know one nurse in particular who always wants a bag of cheddar popcorn and a string cheese. I’ll get her badge from her, ring it up and take it back there to her station.” Peters and McBride are particularly proud of their dedication. “Our record for uninterrupted service is 79 weeks without missing a day,” says Peters. A snowstorm prevented the volunteers from coming in on the 80th day. When asked why this dedication is so important, Peters responds, ”I really can’t explain it. I’m sure it’s this way for all the other volunteers. It’s just a sense of good feeling that you’re providing a service.” Peters describes the camaraderie and friendship as an added bonus to volunteering at YRMC, including getting to know the staff and fellow volunteers, learning about their families, grandchildren and travels. As McBride picks up the hand bell and starts down the hall to ring their arrival, Peters sums it up this way, “Volunteering is a wonderful experience. Period. It’s the only way to explain it.” The YRMC Volunteer Services Department welcomes inquiries about volunteering for the snack cart as well as a wide variety of other volunteer opportunities. For more information, call: Volunteer Services, YRMC West, Prescott: (928) 771-5678 Volunteer Services, YRMC East, Prescott Valley: (928) 442-8678
YRMC – Your Destination for Cardiac Care and Blood Management: Watch Our Live Event from Home
Top cardiac specialists from Yavapai Regional Medical Center’s (YRMC’s) James Family Heart Center and leaders from its Patient Blood Management Program will join YRMC – Your Destination for Cardiac Care and Blood Management, a live-stream presentation and panel discussion. The event will feature prominent heart specialists – a cardiologist, a cardiothoracic surgeon, an electrophysiologist, an interventional cardiologist – and knowledgeable patient blood management experts. These professionals will highlight the leading-edge, less-invasive procedures used to repair hearts at YRMC as well as how patient blood management strategies are significantly improving patient outcomes. YRMC – Your Destination for Cardiac Care and Blood Management will broadcast live from the Yavapai College Performing Arts Center in Prescott for the public to watch: Date: Thursday, October 17, 2019 Time: 6:00 to 8:00 p.m., Mountain Standard Time Where: YRMCHealthConnect.org/pbm What is a Healthcare Destination Program? Healthcare destination programs are thriving, specialized medical programs – typically associated with hospitals – that patients seek out because of their: Highly skilled physicians Excellent outcomes State-of-the-art technology Innovative procedures Outstanding staff “YRMC’s Heart Program and its Patient Blood Management Program check all of those boxes,” said Pierre Tibi, MD, FACS, Medical Director of the James Family Heart Center at YRMC and YRMC’s Patient Blood Management Program. “It starts with our exceptional physicians, who were all trained at top heart programs. This team has worked together to expand our Heart Program and integrate patient blood management strategies that improve patient outcomes.” A Lively Live-Stream Event YRMC – Your Destination for Cardiac Care and Blood Management will include an energetic panel discussion with YRMC’s heart specialists and patient blood management experts. Those physicians and other YRMC leaders will also give interesting and informative talks on: YRMC, A Destination for Hearts and Blood Management John Amos, BS, MSM, President and Chief Executive Officer, Yavapai Regional Medical Center Launching YRMC Cardiology – A Journey to Better Outcomes for You George Rizk, MD, Invasive Cardiovascular Medicine, YRMC PhysicianCare The Beat Goes On Nisha Tung-Takher, MD, Cardiac Electrophysiologist, YRMC PhysicianCare Mending Hearts With Less Invasive Interventions Soundos Moualla, MD, FACC, FSCAI, Structural and Interventional Cardiologist, YRMC PhysicianCare Gwen Rhodes, RN, Patient Navigator, Yavapai Regional Medical Center PBM at YRMC – Together We Are Doing Great Things Elizabeth Black, Patient Blood Management Program Data Manager, Yavapai Regional Medical Center Patient Blood Management – YRMC and Beyond Pierre Tibi, MD, FACS, Medical Director, Patient Blood Management and the James Family Heart Center at Yavapai Regional Medical Center Ask the Experts – Panel Discussion Pierre Tibi, MD, FACS Elizabeth Black Dale Black, Patient Blood Management Program Coordinator, YRMC Soundos Moualla, MD, FACC, FSCAI Gwen Rhodes, RN George Rizk, MD Nisha Tung-Takher, MD To learn more about YRMC – Your Destination for Cardiac Care and Blood Management, visit YRMCHealthConnect.org/pbm.
10 Facts We Learned at YRMC’s Patient Blood Management Symposium
Science and history intersected during Patient Blood Management: Yesterday, Today and Tomorrow, Yavapai Regional Medical Center’s (YRMC’s) 6th Annual Patient Blood Management (PBM) Symposium. Approximately 350 people – PBM advocates from across the southwest, physicians, nurses, college students and more – gathered for the 2018 PBM Symposium at Yavapai College Performing Arts Center in Prescott. Throughout the world, even more streamed the Symposium live on laptops, smart phones and other devices. “It was the best of both worlds,” said Dale Black, Patient Blood Management Program Coordinator at YRMC. “Our guests enjoyed a pre-Symposium reception that included an array of appetizers, lots of friendly conversation and information from our industry partners who support YRMC’s vision for Patient Blood Management.” Industry leaders who joined YRMC at the PBM Symposium include: Instrumentation Laboratory Daiichi Sankyo, Inc. Haemonetics Baxter “During the Symposium,” said Black, “we welcomed guests from throughout the globe who live-streamed the event. All Symposium participants took away new information about the value of PBM and the leadership role YRMC plays in PBM.” If you missed the Symposium, we’ve collected some highlights to get you up to speed on PBM’s science, history and future. #1 Patient Blood Management wasn’t built in a day. The 6th Annual PBM Symposium coincided with YRMC’s 75th anniversary, a perfect opportunity to highlight the history of PBM, courtesy of Pierre Tibi, MD, FACS, Cardiothoracic Surgeon and Medical Director of the James Family Heart Center at YRMC West. Dr. Tibi said the idea of transfusing blood goes back to 1556, but the first actual human-to-human “blood transfer” happened in 1818. Fast forward to the early 1900s for another milestone: the identification of human blood types—A, B, AB and O. Soon after, a test that allowed physicians to ensure blood compatibility before transfusing patients was introduced. Another big breakthrough coincided with World War II as researchers discovered how to break down blood into components and products. Plasma – a blood product – saved the lives of many wounded soldiers during the war. #2 Blood is one tough tissue. Daniel Beck, MD, Anesthesiologist at Prescott Anesthesia, emphasized that blood – a connective tissue – actually functions like a complex, multifaceted organ. Comprised of water, electrolytes, small molecules, proteins and cells, blood performs many significant roles in the body. For example, Dr. Beck highlighted the important job performed by one of our two types of white blood cells. “These white blood cells repair all types of tissue damage,” said Dr. Beck. “The repairs range from paper cuts to broken bones and all of the way to heart attacks.” #3 When it comes to the safety of our blood supply the expression, “we don’t know, what we don’t know,” applies. Medical experts in the United States agree that our blood supply is the safest it has ever been when it comes to disease transmission. “The concern is always about unknown infectious diseases,” said Elizabeth Black, Data Manager and Administrative Assistant, YRMC’s PBM Program. “Current blood testing measures are only going to test for infectious diseases we know about. You can’t test for something if you don’t know it exists.” #4 Storing your own blood for surgery comes with some potential complications. Storing your blood for use during and after surgery sounds like an ideal way to prevent the transfusion of a virus. However, autologous blood donation – as it’s called – may lead to anemia, which can slow recovery. “Even your own blood is stored blood,” said Elizabeth Black. “It is not the same quality as the fresh blood moving through our bodies or the blood that’s taken immediately before surgery.” #5 Physicians and PBM experts know: If you don’t use it, you won’t lose it. YRMC’s thriving Structural Heart Program demonstrates how medicine is integrating PBM into its less invasive procedures. Soundos Moualla, MD, FACC, FSCAI, Interventional Cardiologist at the James Family Heart Center at YRMC West, uses less-invasive procedures and advanced technologies to help people previously considered too high-risk for surgery. These procedures require small skin punctures, rather than major incisions. “These new technologies allow us to safely perform minimally invasive procedures,” said Dr. Moualla. “The procedures do not require blood use and typically there is no blood loss.” #6 New procedures at YRMC’s Heart Center support PBM principles. In the 1980s, cardiology took its first steps in this direction with the introduction of cardiac stenting, which allowed some patients to forego open heart surgery. Today, many heart procedures are minimally invasive, including these which are available at the James Family Heart Center at YRMC West. Left Atrial Appendage Closure (WATCHMAN) Mitral Valve Repair with MitraClip Paravalvular Leak Closure (PVL) Transcatheter Aortic Valve Replacement (TAVR) #7 Your YRMC providers are your PBM partners. PBM is at its best when there is strong communication between nurses, patients, family members and other patient advocates. This is standard operating procedure at YRMC. “We’ll literally report at your bedside to involve you and your family,” said YRMC’s Selina Bliss, MS, PhD, RN. “This allows us to clearly communicate a care plan for your anemia.” YRMC’s multi-disciplinary team – advanced clinical practitioners, dietitians, medical laboratory professionals, nurses, pharmacists, physical therapists, physicians and more – also share their best practices for preventing patient anemia during “Lunch and Learn” programs. Recently, YRMC’s Emergency Department team outlined how early admission of a medication to treat excessive blood loss has helped patients experiencing traumatic bleeding. The ICU staff shared a successful strategy to monitor hemoglobin counts – a low count may indicate anemia – as a way of reducing the frequency of patient blood draws, which can lead to anemia. #8 Researchers are applying leading-edge science to the study of blood. Creating a blood substitute…developing a universal blood type…transforming human stem cells into units of blood…all of these and more are under research today. “Scientists are looking for the optimal artificial human blood that can carry oxygen to our tissues without any of the biological baggage associated with a unit of blood,” explained Jared Head, AGACNP-BC, Hospitalist, NAZ Hospitalist. #9 PBM’s future is now. During the PBM Symposium, Dale Black, PBM Program Coordinator, spoke with Tucson resident Anthony Caballero about the extensive heart procedures he underwent at YRMC’s Heart Center, all using PBM principles. Even as researchers race toward an array of alternatives to blood transfusions, most medical experts point to PBM as the most effective way to safely care for patients. “What we are doing now may well be the future,” stated Head. “Keeping blood inside of the body and minimizing the number of blood draws to harness anemia—these and other PBM strategies may be the future of transfusion medicine.” #10 PBM is making a difference at YRMC today. YRMC has experienced an impressive reduction in the use of blood products, thanks to its hospital-wide PBM Program. “YRMC launched its PBM Program in 2012,” said Diane Drexler, RN, BSN, MBA, FACHE, Chief Nursing Officer at YRMC. “Since then, our use of red blood cells and fresh frozen plasma has declined by 32 percent and 61 percent, respectively.” Why is this decline good news for YRMC’s patients? It means YRMC’s surgeons and other physicians are minimizing patients’ blood loss and reducing unnecessary transfusions. And, as studies have shown, both of these PBM strategies can improve patient outcomes and speed recovery. For more information about YRMC’s Patient Blood Management Program, visit us here.
Women and Lung Cancer: Should You Get Screened?
It’s probably no coincidence that National Women’s Lung Health Week (May 12-18, 2019) kicks off on Mother’s Day. According to the American Lung Association, over the past 41 years the rate of women being diagnosed with the disease has increased by 87 percent. Women or men who smoke are at most risk for developing lung cancer, but people who have never smoked also can be diagnosed with lung cancer. The risk of lung cancer increases with the length of time and number of cigarettes smoked. If you quit smoking – even after many years of smoking – you can significantly reduce your chances of developing lung cancer. During National Women’s Lung Health Week, Yavapai Regional Medical Center (YRMC) is highlighting low-dose computed tomography (LDCT). Heavy, long-term smokers, current smokers, or people with a family history of lung cancer have lung cancer screening with low-dose computed tomography (LDCT) available at: Prescott Medical Imaging (PMI) Prescott Valley Medical Imaging (PVMI) YRMC East in Prescott Valley Why Lung Cancer Screening is Important Lung cancer often has no symptoms. Because of this, it can spread outside of the lungs before it is detected. By then, the cancer may be advanced which can affect treatment outcomes for the patient. “It’s very important to get screened even if you don’t have symptoms,” said Mary Sterling, Director of Imaging Services for YRMC. “The benefit of early detection is finding a cancer before it has a chance to spread. The earlier cancer is detected, the more likely it is treatable.” Should You be Screened for Lung Cancer? LDCT is part of YRMC’s Lung Cancer Screening and Care Program. To be eligible for the Medicare-sponsored screening you must be: Between the ages of 55-77 Free of cancer symptoms Either currently smoking or a past smoker who quit 15 years ago or less A heavy smoker averaging one pack per day for 30 years or two packs per day for 15 years People are encouraged to talk with their primary care providers to determine if they are eligible for the screening program. “The patient and healthcare provider will have a discussion about the patient’s smoking history and find out if they have any symptoms,” Sterling said. “They’ll also talk about smoking cessation if the patient is still smoking.” A Team Approach YRMC’s Lung Cancer Screening and Care Program uses a team approach that draws on the skills of primary care providers, pulmonologists, procedural pulmonologists, radiologists and a cardiothoracic surgeon. The program also includes a patient navigator whose job is to serve as a patient contact. This professional answers questions about program eligibility and directs patients to the appropriate provider if specific care is required. The patient navigator also can help people determine if their current insurance plan covers the screening or assist people who would like to undergo the exam using the self-pay option YRMC offers. A Prevention Plan “The program is not a one-time screening test,” said Sterling. “Annual follow-up screening is recommended for patients whose initial screenings do not show signs of lung cancer.” If a patient’s LDCT findings show signs of lung cancer, a follow-up scan will be scheduled. A biopsy may also be recommended, in which case the patient would be referred to a procedural pulmonologist or a radiologist, depending on the location of the lung nodule. Should the patient need surgery, the Lung Cancer Screening and Care Program team also includes a cardiothoracic surgeon. Jennifer Harvey, RN, BSN, YRMC’s Lung Cancer Screening and Care Program Patient Navigator encourages people to support lung health year-round and during National Women’s Lung Health Week. Learn More About LDCT For more information about LDCT, please contact your primary care provider or the Lung Cancer Screening and Care Program Patient Navigator at (928) 771-5454. Need help giving up smoking? Contact the ASHLine, Arizona Smokers’ Helpline (1-800-556-6222), for free assistance. Help spread the word about lung cancer screening by sharing this YRMC HealthConnect article with your social media friends.
Prescott Medical Imaging: New Technology to Detect Bone Loss Disease
Dual-energy x-ray absorptiometry (DXA) – gold standard technology for measuring bone mass and diagnosing osteoporosis – is now available at Prescott Medical Imaging (PMI) in Prescott. With the introduction of DXA to PMI, the service is now accessible to people throughout the community. DXA is also available at the BreastCare Center at YRMC East. How does DXA work? During a DXA exam, the patient lies flat on a comfortable, padded table. An x-ray generator is located below the patient and an imaging device, or detector, is positioned above. The detector passes over the patient, generating images on a computer monitor. “DXA is quick, painless and uses very little radiation,” said Michael J. Locke, BBA, BBM, CRA, Outpatient Imaging Operations Manager at PMI and Prescott Valley Medical Imaging (PVMI). “The exam lasts approximately 10 minutes. After the exam, one of our experienced PMI radiologists interprets the DXA and shares the results with the patient’s physician.” Osteoporosis – which causes bones to weaken and easily break – is a “silent disease.” Some people don’t realize they have experienced dangerous bone loss until they suffer a fracture. “DXA is an extremely important preventive and diagnostic tool,” said Mary Sterling, Director of Imaging Services at Yavapai Regional Medical Center (YRMC). “The information DXA provides helps patients and their physicians develop a plan that can prevent fractures due to osteoporosis.” Who should undergo DXA? Talk to your physician about your risk for osteoporosis and the possibility of undergoing DXA. In general, risk factors for osteoporosis include: Being over age 50 and female (men typically begin to experience bone loss after age 70) Menopause, particularly early-onset menopause A family history of osteoporosis Being small and thin Broken bones or height loss For more information about DXA and other imaging services, contact: Prescott Medical Imaging 810 Whipple Street Prescott, Arizona (928) 771-7577 The BreastCare Center at YRMC East 7700 East Florentine Road Prescott Valley, Arizona (928) 442-8900
Managing Chronic Pain in YRMC’s Your Healthy Kitchen
If you suffer from chronic pain, could diet changes provide any relief? The answer is … yes! Good research suggests that healthy meals and snacks, featuring colorful fruits and vegetables, whole grains, lean proteins and beneficial fats can often reduce pain, in a number of interesting and surprising ways. For example, high fiber fruits and whole grains support the growth of healthy, anti-inflammatory gut bacteria. Other healthy carbohydrates like legumes, sweet potatoes, and whole grain pastas, promote feelings of wellbeing and improved mood. In addition, colorful red, green, orange, purple and blue fruits and vegetables have powerful anti-inflammatory effects on joints, muscles and every other body tissue to reduce lower back pain, severe neck pain, fibromyalgia, and more. You can learn more in this new episode of YRMC’s Your Healthy Kitchen, where I recently explored some of the highlights of chronic pain and diet research, checked out a few handy pain-friendly kitchen tools, and made a delicious anti-inflammatory smoothie! Most researchers agree that filling your plate with lots of colorful vegetables and liberally flavoring meals with fresh herbs and spices are two of the best steps anyone can take to reduce chronic pain. The Mediterranean diet is likely the easiest and most recognized eating plan that fits with those recommendations. Mediterranean style meals and snacks are loaded with colorful vegetables — with whole grains, legumes, root vegetables, fruits, and lean proteins starring as healthy sides. Good fats, like those found in fish, avocados, nuts, and olive oil show up in small quantities throughout the day. Abundant resources exist online to help with planning Mediterranean style meals, including the Oldways Cultural Food Traditions site, which features a neat Mediterranean diet pyramid and many delicious recipes. Pain and Inflammation-Fighting Fresh Herbs, Colorful Fruits, Whole Grains and Olive Oil While the Mediterranean diet plan works well for most people, some folks find that eliminating foods they are allergic to or intolerant of can provide added pain relief. For example, grains containing gluten (wheat, barley and rye), dairy, soy, eggs, and peanuts are common triggers of discomfort, inflammation and sometimes outright allergic reactions. Experiment with avoiding one of these foods or food groups for a few weeks at a time to see if omitting them from your diet impacts your level of pain. In addition, experts agree that chronic pain sufferers should all eliminate or significantly restrict added sugars and artificial sweeteners, as well as certain types of fat, like those found in fried and processed foods. Cooking at home more can help you follow these pain-reducing diet guidelines, and here are some tricks that can help you prepare your own healthy meals: Try preparing your meals in stages, at the times of the day when you feel best. For example, you might chop some onions and other veggies in the morning and store them in the refrigerator to use in a dinner soup or stir-fry. In the afternoon, prepare some chicken or other simple protein to cook with your veggies later in the day. Prepare enough food so you have leftovers that you can freeze or refrigerate and use on the days when you’re just not up for fixing yourself a meal from scratch. Rely on healthy pre-chopped or frozen vegetables, or prepared, jarred sauces like pesto, marinara or olive tapenade to brighten up a simple meal of rotisserie chicken, pasta, or grilled meat or fish. Grocery delivery or the many meal delivery services available these days can lighten up meal prep time and responsibilities! Fortunately, the foods that reduce inflammation, support healthy gut bacteria, improve mood, and reduce pain also prevent lots of other chronic conditions, including diabetes, heart disease and cancer! Each of the recipes in Your Healthy Kitchen feature loads of vegetables, fresh fruit, whole grains, legumes, herbs, spices, and lots of color, so check them all out at yrmchealthconnect.org. You can also follow me on Face Book at YRMC’s Your Healthy Kitchen, where you can see what I make home, watch my mini-videos, and check out links to fun recipes, food blogs and food and garden-related events in the community.
Farm Fresh Burritos with Prescott Farmer’s Market
There are few things better in my healthy kitchen than the flavorful produce, freshly baked bread, meaty mushrooms, vibrant herbs, pungent sauces and other delicious delights I find each week at the Prescott Farmers Market! In addition to being a wonderful place to purchase a big variety of fresh, seasonal produce and prepared foods, it’s also a family friendly venue that builds ties within our community while supporting local family farms. Kathleen Yetman, Executive Director of the Prescott Farmers Market recently joined me on the set of YRMC’s Your Healthy Kitchen to share some exciting market news, tell a few stories, and make her family’s favorite easy and delicious market meal! The Prescott Farmers Market, a non-profit 501(c)3 organization, has come a long way since 1997, when a few local farmers, cooks, and craftspeople gathered together in downtown Prescott on summer weekends to sell their wares. Today, the market is open for business year-round on Saturday mornings in Prescott and on summer Thursday afternoons in Chino Valley, with over 50 farms and small businesses selling products in the summer and over 40 hardy vendors in the winter! In addition, regular pop-up venues bring fresh food and produce to people throughout our community, especially those who live far from the regular market sites. On a recent walk through the summer market, I saw vendors selling beautiful fresh-cut flowers, vibrant seasonal produce, freshly baked breads, fresh mushrooms, gourmet heirloom garlic, lavender products, hand-knitted clothing, soaps, wooden cutting boards and utensils, baked goods, tamales, wood-fired pizza, quiche, samosas, fresh frozen fruit pops and even kombucha! There’s always hot coffee, tea and ice-cold lemonade available at the market to quench your thirst, and music to relax with or dance to. Local ranchers offer grass-fed beef, chicken, pork and farm fresh eggs, and there are a large variety of beautiful hand-made gifts to buy. All of the products for sale at the Prescott Farmers Market are locally grown or produced. Farmers submit crop plans at the beginning of each season that must match the products they sell. Farm inspections ensure that everything a farmer sells was grown on his or her farm. Food products, like tamales, sandwiches, and samosas, must contain some local ingredients and be made by the people selling them. Yetman comments, “I don’t know of any other farmers market in our state that inspects farms like the Prescott Farmers Market does”. Farm fresh eggs The economic contribution to the community is substantial. In 2018, vendors at the summer and winter markets did over one million dollars in sales, and much of this much of this money stayed right here, supporting other local businesses. Yetman explains, “For every ten dollars we spend on local products, more than four of those dollars stay in our community, supporting other small family businesses. When we shop at large chain or corporate stores, only a little over one dollar recirculates into our community”. Yetman continues, “Another economic benefit is that vendors at the market sell their products directly to customers, eliminating middlemen, which improves their ability to make a sustainable, living wage”. Fresh, vibrant produce Other benefits of the Prescott Farmers Market can’t be measured in dollars and cents. For example, the value of knowing who grows your produce, raises the chickens that lay the eggs you love, or bakes your bread is immeasurable. Fresh produce, picked at peak ripeness, bursts with more flavor and nutrients than fruits and vegetables grown to withstand the time and travel needed to bring food from distant farms to regional stores. Local produce also stays fresh and vibrant much longer than anything you can buy at a big box store, saving money in the long run because food does not spoil quickly and go to waste! In addition, and possibly most important, the ties that are formed between vendors and their customers, or among strangers and friends who gather to shop and socialize, strengthen our community in many ways as we get to know our close and distant neighbors. The summer Prescott, AZ Farmers Market is open from 7:30-12:00 on Saturdays in Prescott at Yavapai College, parking lot D, and in Chino Valley on Thursdays, from 3:00-6:00 pm, at Olsen’s Grain, 344 Highway 89. The market accepts SNAP (Supplemental Nutrition Assistance Program) and is a proud provider of Double Up Food Bucks Arizona, where SNAP recipients receive a dollar for dollar match in tokens for SNAP dollars, up to $20 per market visit to buy fresh Arizona-grown fruits and vegetables. A number of vendors also accept Farmers Market Nutrition Program checks that are available to eligible low-income WIC (Women, Infants, and Children) and SFMNP (Senior Farmers Market Nutrition Program) recipients through Yavapai County Community Health Services. In addition, the Prescott Farmers Market website, at https://www.prescottfarmersmarket.org/ is packed with information about market locations and hours, scheduled pop-ups, events, and every vendor. While there, be sure to sign up for their informative newsletter, where you can read more about featured vendors in each issue. You can also sign up for text message alerts about market times and pop-ups! I hope to see you there soon!