As a surgeon-in-training in Baltimore, Maryland in the 1980s, Michael G. Macon, MD, FACS, participated in a research study comparing two potential breast cancer screening methods: mammography and thermography. “The hope was that thermography would measure heat throughout the breast and that this would be an indication of abnormalities in the breast, allowing breast surveillance without the need for radiation,” said Dr. Macon. “However, it was clear early on that thermography only measured the heat on the skin’s surface, which does not provide information on possible cancers within the breast. That’s why thermography was abandoned as a breast screening method.” FDA Alert: Thermography and Safety Fast forward several decades and Dr. Macon – an accomplished breast surgeon who serves as Medical Director of the Breast Care Program at Yavapai Regional Medical Center (YRMC) – was surprised and concerned when he learned from patients that thermography was being marketed at some centers as an alternative or addition to mammography screening. Dr. Macon isn’t alone in his concern. In February 2019, the U.S. Food & Drug Administration (FDA), which regulates medical devices used for breast cancer screening, issued a “safety communication” about the use of thermography – also called thermal imaging and infrared breast imaging – in place of mammography. A month later, the FDA released a reminder after receiving reports from healthcare providers and patients that some centers were providing misleading information about thermography. “Centers that offer both are offering one test that is scientifically proven – mammography – and one test that isn’t, thermography,” said Dr. Macon. The FDA recommends that women: Be aware thermography is not a substitute for mammography. Have regular mammograms according to screening guidelines or as discussed with their healthcare provider. Talk to their healthcare provider about other ways to detect breast cancer, including clinical breast exams as well as other imaging studies (3-D mammography, breast ultrasound or breast MRI, for example). Mammography and Radiation Thermography is often promoted as a painless, safe alternative because it doesn’t involve radiation, as mammography does. According to the American Cancer Society and other healthcare organizations, the benefits of mammography outweigh the small amounts of radiation exposure. “You get approximately the same amount of radiation while on an airplane flight from Denver to Washington, D.C.,” Dr. Macon said. “Most radiation comes from the sun and is all around us.” Detecting Breast Cancer Early About one in eight women will be diagnosed with breast cancer during their lifetimes, the National Cancer Institute reports. A decline in deaths from breast cancer has been reported in recent years, mostly due to earlier detection through mammography. “There is absolutely no question that yearly mammograms done at high quality facilities are the best way to detect breast cancer at a small, curable size,” said Dr. Macon. “The YRMC BreastCare Center recommends annual screening mammography begin at age 40.” Talk to your healthcare provider about the breast screening plan that fits your health history. The latest screening mammography and other breast imaging technologies are available at The BreastCare Center at YRMC at (928) 442-8900 and Prescott Medical Imaging at (928) 771-7577.

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.

The phrase “early adopter” usually brings to mind tech-industry leaders. When it comes to patient blood management (PBM), however, it’s a perfect description of how the James Family Heart Center at Yavapai Regional Medical Center (YRMC) has embraced PBM. “Years ago, it was considered bold to question treatment standards for blood transfusions,” said Pierre Tibi, MD, FACS, Medical Director of the James Family Heart Center at YRMC and YRMC’s Patient Blood Management program. “Now, blood conservation and patient blood management are discussed in medical journals. Even Medicare is taking serious interest in PBM. It’s only a matter of time before it becomes the standard of care.” That topic no doubt will be part of the narrative during YRMC – Your Destination for Cardiac Care and Blood Management, a live-stream event sponsored by YRMC. You may join the event: Date: Thursday, October 17, 2019 Time: 6:00 to 8:00 p.m., Mountain Standard Time Where: YRMCHealthConnect.org/pbm With YRMC – Your Destination for Cardiac Care and Blood Management fast approaching, now is the perfect time to highlight why YRMC stepped into the world of PBM as an early adopter. Here are five reasons PBM was embraced by YRMC and why the program continues to thrive: Reason #1: Forward-thinking leaders. Questioning the status quo – even when science supports it – requires someone who is not afraid of change and who understands the long-term benefit of that change. For YRMC, that person is Dr. Tibi, a renowned cardiothoracic surgeon and PBM pioneer. He also currently serves as President of the Society for the Advancement of Blood Management (SABM), an international organization dedicated to promoting effective PBM strategies. “It’s surprising to some people that YRMC – a regional healthcare system in Arizona – is regarded as a worldwide leader on PBM,” said Dr. Tibi. “We have earned that reputation because of our forward-thinking leadership and excellent medical team.” Reason #2: PBM’s positive impact on hospitalized patients. The case for PBM at YRMC was bolstered by YRMC’s dedication to patient safety. Studies show PBM reduces illness and death among critically ill patients. It also leads to shorter hospital stays. Reason #3: Concern about the risks associated with blood transfusions. “Most people don’t understand that a blood transfusion is a liquid transplant,” explained Dr. Tibi. “As with any transplant, it’s important to understand the risks and benefits of a blood transfusion.” While some transfusions are medically necessary, they all come with risks, including: Increased infection rates Kidney, lung and heart complications Higher death rates Reason #4: Worry about the frequency of blood transfusions. Blood transfusions are historically one of the most common hospital procedures in the United States. However, a study published in a 2018 issue of JAMA found that after a 15-year increase, blood transfusions for red blood cells and plasma declined from 2011 to 2014. At the same time, platelet transfusions remained stable. “Those of us in the forefront of PBM are hoping this is an indication of a paradigm shift in views about blood transfusions,” said Dr. Tibi. “The study’s authors attributed the reduction of transfusions to the successful collective efforts of patient blood management initiatives nationwide.” Reason #5: An understanding throughout YRMC that blood is a precious resource. With the PBM program at YRMC approaching its eighth year, medical professionals from the operating suite to the patient bedside are dedicated to implementing PBM strategies to reduce blood transfusions. Before surgery those strategies include: Treating anemia in patients so their blood is healthy heading into surgery Correcting patients’ bleeding tendencies Talking to patients about the risks and benefits of transfusions (known in the medical world as “informed consent” or “informed choice”) Once patients are in the operating suite, PBM strategies include: Following meticulous surgical techniques that reduce bleeding Salvaging blood lost during and after surgery to wash, filter and re-infuse it with red blood cells before returning it to the respective patient Utilizing special machines and medications to reduce the need for blood transfusion Throughout a patient’s stay at YRMC, the healthcare team works together to minimize the frequency as well as the volume of blood draws. “At YRMC, Patient Blood Management now extends beyond the Heart Center to include other medical services,” Dr. Tibi said. “I’m proud YRMC was an early adopter of PBM. Now, providers from throughout the world are turning to us for our expertise and experience.” To learn more about PBM, join YRMC – Your Destination for Cardiac Care and Blood Management at YRMCHealthConnect.org/pbm.

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.