For Amazing Physical and Mental Health Benefits, Hit the Trail on a Bike!
There is an inescapable, childlike joy that comes from riding a bike over dramatic high desert landscapes, or through forests of towering pines, on one of Prescott’s many and varied trails. The good news is that you don’t have to be a pro to join the fun! In fact, whether you are seven or seventy, a novice or seasoned cyclist, there’s a ride for you in the 250 miles of trails that wind in and around Prescott. The physical benefits of trail riding have been extensively documented, and new research suggests that mountain biking can also keep you healthy in spirit and mind. Ximena Florez, Vice President of the Board of the Prescott Mountain Bike Alliance (PMBA), with responsibility for membership and social events, can’t contain her enthusiasm for mountain biking. “It’s fun, it can be social (or solo), and it keeps you smiling and feeling young! There are so many benefits, including physical fitness and mental health. I think trail riding is also a form of meditation, because when you ride, you need to keep your focus on the trail.” Ximena emphasizes that a great variety of people can, and do, enjoy mountain biking. “Almost anyone can ride, especially in Prescott, because our focus at PMBA is on advocating for diverse types of trails that appeal to people of all ages and abilities. Over a hundred miles of trails have been added in the Prescott area since PMBA’s inception, ten years ago. There is something for everyone. Examples include the trails at Pioneer Park for beginners, Thumb Butte and Spence Basin for intermediate riders, and the Dells for experienced cyclists. PMBA is continually raising funds for trail maintenance and expansion through its membership program.” A PMBA-led women’s ride at Spence Basin Physical Strength, Fitness and More The physical benefits of cycling in the great outdoors are well documented and include: Riding a bike over varied terrain builds strength and stamina throughout the body, including arm, back, and core muscles. Balance and coordination improve quickly on a mountain bike. Cycling puts less stress on joints than many other forms of weight-bearing exercise. Exposure to natural, bright light can improve sleep by stimulating the production and timely release of melatonin, a hormone that regulates wake and sleep cycles. Exposure to sun, even for just 5-10 minutes (without sunscreen) creates vitamin D, which is important not only for bones, but for the immune system as well. In fact, the World Health Organization estimates that a large number of diseases, including autoimmune conditions, some types of cancer, and osteoporosis may be linked with too little exposure to natural light and sun. Getting dirty (which is always part of the fun of mountain biking) might also have benefits! Significant research demonstrates that regular exposure to natural soil (i.e. dirt) supports a healthy microbiome: the collective bacteria living in and on us that support health in countless ways. A joyful ride under towering pines Improved Focus, Resiliency and Mood Research on the mental health benefits of mountain biking is relatively new and really exciting. For example, an ongoing study funded by Specialized Bikes demonstrates significant benefits for kids with Attention Deficit Hyperactivity Disorder, or ADHD. In 2012, Mike Sinyard, Founder and CEO of Specialized Bikes partnered with Stanford Medical School and RTSG Neuroscience Consultants to conduct research on riding and brain function. Along with improved outcomes in school, kids that participate in this ongoing study also report improved mood and a greater ability to focus on activities outside of school. While any kind of physical activity can help with grades and mood, the skills developed through mountain biking seem to build additional layers of confidence, focus, and resilience. A trailside view of Granite Basin Lake Additional research includes: Work done by NICA, the National Interscholastic Cycling Association, which uses mountain biking to teach essential life skills to youngsters. NICA research shows that kids who ride on a regular basis build resiliency and self-esteem. In a team sport where no one sits on the bench, kids also learn teamwork, camaraderie, consideration, and a host of other advanced social skills. A Scottish study, examining the benefits of mountain biking for people struggling with a variety of mental health issues. In this small pilot program, participants rode at regular intervals for six weeks in Glentress Forest, a site famous around the world for awe-inspiring trails. Preliminary data suggest that the cyclists experienced improvements in mood, self-worth, and social skills. The program is currently being considered as a treatment option for outpatient mental health clients throughout the United Kingdom. Programs sponsored by the Semper Fi Fund, an organization that exists to help veterans, with visible and invisible wounds, transition from active duty to civilian life. Mountain biking is just one of many sports veterans can join, with adaptive equipment and Olympic-level coaches provided and funded by the Semper Fi Fund. Overcoming complex or even simple challenges on the trail can bring a sense of mastery, accomplishment and joy to anyone. PMBA offers a variety of opportunities to ride, with scheduled skill building sessions and group rides listed on their website at https://prescottmtb.com. For up to date news and last minute announcements, follow PMBA-Prescott Mountain Biking Alliance on Facebook and Prescottmtb on Instagram, where you can also follow the development of Arizona’s first gravity-flow trail. PMBA recently received a grant to develop this one-way loop trail dedicated to all-level mountain biking. Trailside rest stop with a view of Granite Mountain Florez reminds riders that mountain biking “it is all about sharing the trails” and offers this simple guide to trail etiquette. ALWAYS give hikers and horses priority. Make it a habit to pull off the trail and let others pass safely by. Ride with a bell, so trail users know when you are coming up behind them. Give fellow bikers who are riding uphill a break. They are working hard and should take priority over those going down. If you haven’t been on a bike since you were a kid, consider giving trail riding a try! Start with easy trails to build confidence, strength and skill, and then advance – if you want to. It’s also ok to simply enjoy the warm sun, clean air and beautiful Prescott views on an easy, joy-filled ride. Don’t worry if it’s been a while. It’s like riding a bike – you don’t forget!
Taking On Breast Cancer
October is National Breast Cancer Awareness Month—a annual observance aimed at raising both awareness and funding. The funding is for research into the prevention, diagnosis, treatment and ultimately the cure for breast cancer. Awareness is generated in part through a pink ribbon, a symbol of solidarity among women and families touched by the disease. Such solidarity is found year around at The BreastCare Center at YRMC East in Prescott Valley. The center bands together to take on breast cancer and support women through all phases of the disease—prevention, detection, diagnosis, treatment and supportive care. At the BreastCare Center, women can receive one-on-one support from a clinical navigator, a registered nurse assigned just to them. This navigator serves as personal guide, advocate, educator and friend. And should the need arise, helps to perform a risk analysis. “If a patient’s family history shows they carry a higher risk for breast cancer, one of our navigators can perform a more comprehensive risk assessment called the Tyrer-Cuzick,” said Kathleen Hoffer, Imaging Operations Manager at the BreastCare Center. The tool is used to help inform a person’s decision about whether to get more genetic counselling and testing. Such genetic testing may be done through the center or a genetics expert may visit the home. Risk Factors Along with risk factors associated with family history and genetics, the National Breast Cancer Foundation has identified the following breast cancer risks: Gender: Women are 100 times more likely to get it than men Age: Two out of three women are diagnosed after age 55 Race: White women are more likely to get it Personal health history: If you get cancer in one breast, you risk getting it in the other breast Menstrual and reproductive history: Your risk increases if you started menstruating early (before age 12), started menopause after 55, had your first child when older or never gave birth Dense breast tissue: Increases your risk and make lumps harder to detect Early Detection “When patients are aware they carry a higher risk for breast cancer, they are usually more diligent about getting their regular screenings done,” Hoffer said. “Those at a really high risk might have an MRI along with their mammogram. If they find they have dense breast tissue, we may recommend tomography or ultrasound.” Early detection saves lives. When caught early enough, breast cancer is often stopped before it spreads. Regular screenings can detect breast cancer even before symptoms occur. These symptoms, once evident, include: Change in the look or feel, size or shape, of the breast Change in the look or feel of the nipple, including nipple discharge A lump or hard knot in the breast or underarm area Swelling, warmth, redness or darkening of the breast Dimpling or puckering of the skin Persistent pain in one area of the breast Prevention A healthy body is better equipped to fight off disease, including cancer of the breast. So basic healthy living is your main defense against breast cancer. These basics haven’t changed: exercise at least 30 minutes a day, five days a week; maintain a healthy weight; don’t smoke; and limit alcohol to one drink a day for women, two drinks a day for men.
Flu Shots More Important Than Ever
As the flu season approaches, we stand the risk of contracting another respiratory illness on top of COVID-19. Along with the risk to ourselves, the flu virus could pressure healthcare resources, strain testing capacity, and increase the risk of people catching both diseases at once. That’s why getting a flu shot is more important than ever this year. For both the flu and COVID-19, the elderly and those with underlying conditions are more susceptible. But the flu also hits children and spreads readily in schools. The more we all get a flu shot the more protected everyone will be. The effectiveness of the flu vaccine can range from about 20 percent to 60 percent depending on how accurately scientists predict the circulating flu strains this year. Effectiveness also varies from person to person depending on age and health. Even if the vaccine doesn’t prevent the flu it may make the illness less serious. The Centers for Disease Control and Prevention recommends a flu shot for everyone over six months of age. While it is possible to be infected with the flu and COVID-19 at the same time, it’s too soon to tell how common such co-infections will be. Indeed, many questions remain unanswered. But what is clear is that the flu and COVID-19 both target the lungs. If one virus damages the lungs, the other virus stands the chance of creating greater damage. In the 2018-19 flu season, about 49 percent of Americans received a flu vaccine, averting an estimated 4.4 million illnesses, 58,000 hospitalizations, and 3,500 deaths, according to the CDC. Experts hope more Americans will choose to get a flu shot this year—for themselves and for others.
Dr. William Lockwood Recognized for Excellence
Dr. William Lockwood, Infectious Disease Specialist with YRMC PhysicianCare, is the recipient of the 2020 Excellence in Healthcare Award. The award, presented annually by the Prescott Chamber of Commerce, is given to an individual that has demonstrated excellence in the field of healthcare. Dr. Lockwood has been a source of truth, stability and confidence during the COVID-19 pandemic. He has guided YRMC’s leadership team, embraced his role as a trusted colleague and provided expert advice regarding the allocation of resources during a time when the healthcare landscape has changed by the day, and at times, by the hour. Please join us in congratulating Dr. Lockwood for this recognition.
Free Health Insurance Marketplace Enrollment Help from YRMC
Yavapai Regional Medical Center (YRMC) is offering free expert assistance to families and individuals who want health insurance coverage through the Health Insurance Marketplace. During open enrollment 2021 – November 1 through December 15, 2020 – YRMC’s Certified Application Counselors (CACs) will provide assistance by appointment. “For years, YRMC has provided no-cost, expert assistance to individuals and families who want health insurance coverage through the Health Insurance Marketplace,” said Ken Boush, Director of Marketing and Communications at YRMC. “Our team also helps people applying for AHCCCS, Arizona’s Medicaid.” This tradition will continue even during COVID-19 with a few changes: Scheduling – In order to ensure social distancing, YRMC will schedule appointments with CACs. Please call (928) 771-5151 to arrange an appointment for telephone or in-person enrollment assistance. Location – YRMC encourages people to schedule phone sessions for health insurance enrollment assistance. However, CACs are also available for in-person interviews at the Financial Counseling Offices at YRMC West in Prescott and YRMC East in Prescott Valley. (Both in-person and telephone appointments may be scheduled by calling 928-771-5151.) In-Person Appointments – YRMC asks that one family representative attend in-person appointments with the CAC. People who don’t bring masks, will be provided one. Prepare for Your Enrollment Meeting Whether you meet by phone or in-person, YRMC recommends you have the following items ready for your meeting: Social Security Numbers for everyone on the application Employer and income information for all working family members (for example, pay stubs, W-2 forms, or wage and tax statements) Marketplace (healthcare.gov) login information (username and password) or a valid email address Policy numbers for any current health insurance In 2021, some people may qualify for premium tax credits as well as lower monthly premiums, lower deductibles and co-payments from the Health Insurance Marketplace. “Our counselors help people determine their benefits based on their financial situation, number of dependents and more,” said Boush. Basic Benefits and More! All Health Insurance Marketplace Plans include the benefits listed below. Plans also may offer additional benefits. Ambulatory patient services (outpatient care) Emergency services Hospitalization Pregnancy, maternity and newborn care Mental health and substance use disorder services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices (services/devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills) Laboratory services Preventive and wellness services and chronic disease management Pediatric services, including oral and vision care (adult dental and vision coverage are not considered to be essential health benefits) Health insurance coverage begins January 1, 2021 for people who sign up during open enrollment. For more information about Health Insurance Marketplace enrollment or AHCCCS application assistance, please contact (928) 771-5151.
Protect Your Child With a Flu Shot
This is the year when kids need their flu shots more than ever. If your child contracts COVID-19 and hasn’t had their flu shot, they may wind up with both respiratory illnesses at once. And that could be dangerous. “We still don’t know what co-infection might look like,” said Matthew Hinton, MD, pediatrician at Ponderosa Pediatrics, a YRMC PhysicianCare clinic. “Influenza is a major illness that causes a lot of suffering among children. Why take the chance of compounding that with COVID? Especially when we have a vaccination for flu.” Plus if you protect your child with a flu shot, they’ll be healthier overall. Yet according to some studies at least a third of American parents say they don’t plan to have their kids vaccinated for influenza this year. “There’s a lot of misinformation out there,” states Dr Hinton. “Many parents worry the flu shot will make their children sick. But you cannot catch flu from the vaccine. If you feel a little under the weather after a flu shot it just means your immune system is doing its job. It’s helping your body develop an immune response to influenza. This is common and benign.” Debunking Myths To debunk a couple other myths: A flu shot does not increase the risk of getting COVID. Nor does a flu shot cause a positive COVID test result. What a flu shot does is prevent influenza. It saves lives. Still, many people don’t get them. “I often see parents who fully immunize their children, but don’t want to vaccinate against the flu,” Dr. Hinton said. “They say they don’t get a flu shot and they’ve never caught the flu. So why get a flu shot for their children. I try to encourage them that just because they’ve never gotten the flu doesn’t mean they won’t.” “Of all the things you can immunize against, the disease your child is most likely to get is influenza,” states Dr. Hinton. “It is by far the most common. Especially during the winter months when respiratory viruses are very active. There are hundreds of them. It can be hard to distinguish one from another when a child gets sick. By taking flu out of the equation we can better test and isolate other viruses.” Freeing Up Resources By preventing a major flu outbreak, we free up hospital capacity should we see a surge in coronavirus cases. “When hit by a flu epidemic the ER often fills up with people with influenza,” Dr. Hinton said. “If you add COVID on top of that it can overwhelm medical resources.” We need to do everything we can keep ourselves and our children healthy. That means getting a flu shot to minimize the risk of influenza. And wearing a mask and social distancing while we wait for a COVID-19 vaccine. The CDC addresses many questions around influenza and COVID here. Dr. Hinton recommends a flu shot for all children 6 months and older. “We’ve seen bad flu epidemics as early as October, although they’re more common between December and February.” The flu vaccine is currently available for Ponderosa Pediatrics patients. If you don’t currently take your children to Ponderosa Pediatrics, they are now accepting new patients. Just call (928) 778-4581.
Lifestyle Habits that Protect Against Breast Cancer
Today, one in eight women living in the U.S. will develop breast cancer in her lifetime, according to data cited by the American Cancer Society. That’s why it’s so important to do everything you can to reduce your risk. Experts agree that women (and men) can lessen their likelihood of getting breast cancer by moving more and sitting less everyday; working up a sweat a few times a week; building some muscle; and cutting back on alcohol. In fact, research shows that Americans could prevent one in three cases of breast cancer with healthy lifestyle habits. Move More and Sit Less Physical activity tops the list of lifestyle practices that provide protection to women and men at every age. According to a study released in 2017 by the American Institute for Cancer Research and the World Cancer Research Fund, 150 minutes per week of regular moderate activity, like walking at a pace that causes a slight increase in heart rate and deeper than normal breathing, reduces the risk of breast cancer in pre- and post-menopausal women by about 13% when compared to sedentary individuals. Vigorous exercise, or that which causes a faster heart rate and some sweating, boosts protection for pre-menopausal women to 17%. Other studies suggest even higher rates of protection when individuals increase exercise time to up to 300 minutes per week. Moving more and sitting less throughout the day and engaging in regular physical activity likely reduces the risk of breast cancer by lowering inflammation in the body (a risk factor for many types of cancer and other chronic diseases), reducing insulin resistance (which lowers blood glucose and insulin levels in the blood), improving immune function, and by reducing circulating levels of estrogen. In fact, some research suggests that a sedentary lifestyle, or one with little to no physical activity, is a major risk factor for breast and other types of cancer. A Lifetime of Enjoyable Exercise Decreases Breast Cancer Risk! Take away tips: Shoot for a minimum of 150 minutes of moderate, or 75 minutes of vigorous exercise 5 days a week. If you are new to physical activity, start with 5-10 minutes of activity at a time and gradually build your strength and stamina. Always check with your doctor before engaging in any new exercise plan. Get up every hour and do some walking, stretching, or other movement for 5 minutes if your lifestyle and job are sedentary. If you tend to be active only during certain seasons, plan to continue some type of regular, enjoyable movement year round. Since physical activity throughout life reduces the risk of breast and other types of cancer, encourage children to engage in regular physical activity that they enjoy and can continue into adulthood. Muscle Up After Menopause Multiple studies show that reducing body fat (especially abdominal fat) while increasing muscle mass can lower breast cancer risk in women after menopause. According to a study done by the University of North Carolina’s Lineberger Comprehensive Cancer Center, higher levels of body fat seem to be related to lower breast cancer risk in younger women, while weight and fat gain after menopause increases risk. While the reasons for this are not totally clear, researchers think that body fat protects breast tissue from excessive estrogen production in younger years, but increases exposure after menopause. Add Weights to Your Workouts! Take away tips: Maintain a healthy percentage of body fat throughout your lifetime. Keep physically active after menopause, and be sure to include strengthening exercises that build muscle and reduce body fat. Limit Alcoholic Beverages According to the American Cancer Society, even small amounts of alcohol may increase a women’s risk of breast cancer. Ethanal, the by-product of alcohol metabolism, can directly damage the DNA in cells, potentially leading to cancer growth and spread. Alcohol also raises estrogen levels in the blood, thus increasing risk of some breast cancer types. Take away tips: Consider limiting alcohol to three drinks per week or less. One drink is equal to 5 ounces of wine, 12 ounces of beer or 1.5 ounces of 80-proof liquor. Experiment with fun and flavorful mocktail recipes! Some physicians recommend that women at high risk of breast cancer avoid alcohol altogether. Enjoy Fun, Flavorful Mocktails! No one can predict exactly what combination of factors might lead to the growth and spread of breast cancer cells. However, good and extensive research shows that healthy lifestyle habits offer significant protection against this debilitating and potentially deadly disease. You can learn more about breast cancer, preventive testing, treatment, and local resources at YRMC’s Breast Care Center.
YRMC’s Digital Journey: Introducing Online Appointment Preregistration
Over the course of recent years YRMC has joined other forward-thinking healthcare organizations by adopting digital solutions to streamline care and improve the overall patient experience. The primary reason for this is simple. Multidisciplinary healthcare systems like YRMC can serve their patients better through the use of sophisticated Electronic Medical Record (EMR) systems and other innovative digital solutions. The advantages include: Accurate, up-to-date information at the point of care; More coordinated, efficient care; Better communication among healthcare providers; More reliable prescribing; Complete documentation and streamlined coding and billing; Privacy and security of patient data. Such conversions are never easy—it is a journey—but YRMC has come a long way in a relatively short amount of time. Digital technology at YRMC now makes patient data available to providers across the system with a click of a mouse. Data retrieval is now streamlined, imaging studies can be shared as digital files, and physicians can collaborate on the development of care plans at a higher level. YRMC’s digital transformation is also extending care directly into the patient’s home through telemedicine and remote monitoring programs that improve the patient’s experience. The Journey Continues with Online Appointment Pre-registration Skipping forward, as of this day YRMC is piloting the use of its digital network to expedite the process you need to follow to preregister for an appointment. To ensure a quality experience and to minimize frustration, this new service is being introduced on a gradual basis. “We are incredibly excited to offer this convenience to patients, but we want to make sure their experience is positive from the very start,” says Adraine Newell-Bauer, YRMC’s Director of Patient Access. “That’s why we are making it available on a limited basis initially, specifically in support of clinics at our Outpatient Services Center in Prescott Valley.” Beginning on October 13, patients will have the option to pre-register for appointments online for appointments scheduled at the following clinics located inside of YRMC’s Outpatient Services Center in Prescott Valley (7700 East Florentine Road, Building B, Suite 201): Prescott Valley Cardiac Diagnostic Imaging Prescott Valley Medical Imaging YRMC PhysicianCare – Primary Care YRMC PhysicianCare – Cardiology “We understand that when a patient arrives for an appointment, the registration process can be time consuming,” says Newell-Bauer. “With our new pre-registration process, patients will be able to register from home, before arriving for their appointment, by using a computer, tablet or smartphone.” Designed with the Patient in Mind The pre-registration process is being developed with patient convenience in mind. After the patient calls to schedule an appointment, an appointment confirmation will be sent to the patient via email with instructions on how to subscribe to the reregistration portal. The patient will then follow the provided instructions to complete the pre-registration process. “Patients will use the portal to answer the questions they traditionally have had to answer in person before their appointment,” states Newell-Bauer. “These include questions about insurance, medication, advance directives, patient rights and much more.” Once the patient completes the pre-registration process, they will be sent a barcode via email. When the patient arrives for their appointment, they will simply scan the barcode via a registration kiosk or tablet. “Our plan is to introduce this exciting new program to support clinics in our Prescott Valley Outpatient Services Center,” states Newell-Bauer. “We intend to make this time-saving program available system-wide in the very near future.” The pre-registration portal is another advancement made possible by the YRMC’s commitment to patient satisfaction and is coming soon to a YRMC clinic near you.
Taking On Breast Cancer
October is National Breast Cancer Awareness Month—a annual observance aimed at raising both awareness and funding. The funding is for research into the prevention, diagnosis, treatment and ultimately the cure for breast cancer. Awareness is generated in part through a pink ribbon, a symbol of solidarity among women and families touched by the disease. Such solidarity is found year around at The BreastCare Center at YRMC East in Prescott Valley. The center bands together to take on breast cancer and support women through all phases of the disease—prevention, detection, diagnosis, treatment and supportive care. At the BreastCare Center, women can receive one-on-one support from a clinical navigator, a registered nurse assigned just to them. This navigator serves as personal guide, advocate, educator and friend. And should the need arise, helps to perform a risk analysis. “If a patient’s family history shows they carry a higher risk for breast cancer, one of our navigators can perform a more comprehensive risk assessment called the Tyrer-Cuzick,” said Kathleen Hoffer, Imaging Operations Manager at the BreastCare Center. The tool is used to help inform a person’s decision about whether to get more genetic counselling and testing. Such genetic testing may be done through the center or a genetics expert may visit the home. Risk Factors Along with risk factors associated with family history and genetics, the National Breast Cancer Foundation has identified the following breast cancer risks: Gender: Women are 100 times more likely to get it than men Age: Two out of three women are diagnosed after age 55 Race: White women are more likely to get it Personal health history: If you get cancer in one breast, you risk getting it in the other breast Menstrual and reproductive history: Your risk increases if you started menstruating early (before age 12), started menopause after 55, had your first child when older or never gave birth Dense breast tissue: Increases your risk and make lumps harder to detect Early Detection “When patients are aware they carry a higher risk for breast cancer, they are usually more diligent about getting their regular screenings done,” Hoffer said. “Those at a really high risk might have an MRI along with their mammogram. If they find they have dense breast tissue, we may recommend tomography or ultrasound.” Early detection saves lives. When caught early enough, breast cancer is often stopped before it spreads. Regular screenings can detect breast cancer even before symptoms occur. These symptoms, once evident, include: Change in the look or feel, size or shape, of the breast Change in the look or feel of the nipple, including nipple discharge A lump or hard knot in the breast or underarm area Swelling, warmth, redness or darkening of the breast Dimpling or puckering of the skin Persistent pain in one area of the breast Prevention A healthy body is better equipped to fight off disease, including cancer of the breast. So basic healthy living is your main defense against breast cancer. These basics haven’t changed: exercise at least 30 minutes a day, five days a week; maintain a healthy weight; don’t smoke; and limit alcohol to one drink a day for women, two drinks a day for men.
Lifestyle Habits that Protect Against Breast Cancer
Today, one in eight women living in the U.S. will develop breast cancer in her lifetime, according to data cited by the American Cancer Society. That’s why it’s so important to do everything you can to reduce your risk. Experts agree that women (and men) can lessen their likelihood of getting breast cancer by moving more and sitting less everyday; working up a sweat a few times a week; building some muscle; and cutting back on alcohol. In fact, research shows that Americans could prevent one in three cases of breast cancer with healthy lifestyle habits. Move More and Sit Less Physical activity tops the list of lifestyle practices that provide protection to women and men at every age. According to a study released in 2017 by the American Institute for Cancer Research and the World Cancer Research Fund, 150 minutes per week of regular moderate activity, like walking at a pace that causes a slight increase in heart rate and deeper than normal breathing, reduces the risk of breast cancer in pre- and post-menopausal women by about 13% when compared to sedentary individuals. Vigorous exercise, or that which causes a faster heart rate and some sweating, boosts protection for pre-menopausal women to 17%. Other studies suggest even higher rates of protection when individuals increase exercise time to up to 300 minutes per week. Moving more and sitting less throughout the day and engaging in regular physical activity likely reduces the risk of breast cancer by lowering inflammation in the body (a risk factor for many types of cancer and other chronic diseases), reducing insulin resistance (which lowers blood glucose and insulin levels in the blood), improving immune function, and by reducing circulating levels of estrogen. In fact, some research suggests that a sedentary lifestyle, or one with little to no physical activity, is a major risk factor for breast and other types of cancer. A Lifetime of Enjoyable Exercise Decreases Breast Cancer Risk! Take away tips: Shoot for a minimum of 150 minutes of moderate, or 75 minutes of vigorous exercise 5 days a week. If you are new to physical activity, start with 5-10 minutes of activity at a time and gradually build your strength and stamina. Always check with your doctor before engaging in any new exercise plan. Get up every hour and do some walking, stretching, or other movement for 5 minutes if your lifestyle and job are sedentary. If you tend to be active only during certain seasons, plan to continue some type of regular, enjoyable movement year round. Since physical activity throughout life reduces the risk of breast and other types of cancer, encourage children to engage in regular physical activity that they enjoy and can continue into adulthood. Muscle Up After Menopause Multiple studies show that reducing body fat (especially abdominal fat) while increasing muscle mass can lower breast cancer risk in women after menopause. According to a study done by the University of North Carolina’s Lineberger Comprehensive Cancer Center, higher levels of body fat seem to be related to lower breast cancer risk in younger women, while weight and fat gain after menopause increases risk. While the reasons for this are not totally clear, researchers think that body fat protects breast tissue from excessive estrogen production in younger years, but increases exposure after menopause. Add Weights to Your Workouts! Take away tips: Maintain a healthy percentage of body fat throughout your lifetime. Keep physically active after menopause, and be sure to include strengthening exercises that build muscle and reduce body fat. Limit Alcoholic Beverages According to the American Cancer Society, even small amounts of alcohol may increase a women’s risk of breast cancer. Ethanal, the by-product of alcohol metabolism, can directly damage the DNA in cells, potentially leading to cancer growth and spread. Alcohol also raises estrogen levels in the blood, thus increasing risk of some breast cancer types. Take away tips: Consider limiting alcohol to three drinks per week or less. One drink is equal to 5 ounces of wine, 12 ounces of beer or 1.5 ounces of 80-proof liquor. Experiment with fun and flavorful mocktail recipes! Some physicians recommend that women at high risk of breast cancer avoid alcohol altogether. Enjoy Fun, Flavorful Mocktails! No one can predict exactly what combination of factors might lead to the growth and spread of breast cancer cells. However, good and extensive research shows that healthy lifestyle habits offer significant protection against this debilitating and potentially deadly disease. You can learn more about breast cancer, preventive testing, treatment, and local resources at YRMC’s Breast Care Center.
Is Vitamin D Good for Your Heart?
When they say every body needs milk, they’re partly talking about Vitamin D. According to science, this fat-soluble vitamin helps the body absorb the calcium and phosphate it needs to build and preserve bone strength. But does science support a direct link between vitamin D and cardiovascular health? Can we take vitamin D to avoid heart disease or restore a diseased heart to health? Some people think so. But according to Phillip Tran, DO, FACOI, a cardiologist with YRMC PhysicanCare, science doesn’t fully bear it out yet. Vitamin D sustains heart muscle “Studies do show an inverse relationship between vitamin D and some chronic health conditions, such as high blood pressure or Type 2 Diabetes,” Dr. Tran said. “But taking more Vitamin D does not necessarily lower the risk of getting cardiovascular disease or help treat it. Preliminary evidence may suggest the fact, but more research is needed.” That isn’t to say vitamin D doesn’t impact heart health at all. Our bodies need the full family of vitamins to function properly. Not getting enough of any one vitamin can impact our health. Along with bones, Vitamin D also sustains muscle. Insufficient levels can cause both bone pain and muscle weakness. This includes the weakening of muscles found in the heart. “Vitamin D deficiencies may cause scar tissue to form on the heart wall,” Dr. Tran said. “This can lead to heart chamber dilation, impairing normal heart function.” When heart chambers are dilated, or enlarged, the heart muscle is weakened and can’t pump blood as well. Getting enough of the sunshine vitamin Known as the sunshine vitamin, vitamin D is produced naturally when skin is exposed to moderate sunlight. It also occurs naturally in foods—including some fish, fish liver oils and egg yolks—and in fortified dairy and grain products. Depending on the degree of sun exposure and diet, you may want to include an over-the-counter supplement. But what is the recommended daily allowance? “To maintain healthy levels, most adults need approximately 400-800 IU per day,” Dr. Tran said. However, 1,000 to 2,000 IU per day from a supplement is generally considered safe. More than 4,000 IU per day may lead to vitamin D toxicity. If you think you may be deficient in vitamin D see your doctor before taking too much of the vitamin. Remember, vitamin D deficiencies are more common in those who are elderly, have darker skin, or live farther away from the equator. Bottom line? Get your recommended daily allowance of vitamin D and your whole body with thank you. Including your heart.
Don’t Ignore these Symptoms of Heart Valve Disease
Increased shortness of breath, lack of energy and bouts of dizziness shouldn’t be written off to aging, according to experts at the James Family Heart Center at Yavapai Regional Medical Center (YRMC). In recognition of Heart Valve Disease Awareness Day on February 22, 2020, cardiac specialists from YRMC’s Heart Center are encouraging people of all ages to familiarize themselves with the subtle symptoms of heart valve disease. They also urge people to seek the advice of a physician if they are concerned about their heart health. An estimated 11 million Americans have heart valve disease, which involves damage to one or more of the heart’s valves. Many people with heart valve disease don’t experience noticeable symptoms until the blood flow is significantly restricted. Symptoms that could signal heart valve disease – and should be discussed with your physician – are: Breathlessness Chest pain, pressure or tightness Fainting Palpitations or a feeling of heavy, pounding, or noticeable heartbeats A decline in your activity level or reduced ability to do normal daily activities Heart valve disease can affect people in their 40s or 80s, but it’s most prominent in older adults. In fact, one in ten people age 75 and older struggle with moderate to severe heart valve disease. To understand why this happens, it helps to know the role healthy heart valves play in the body. The heart has four valves with tissue flaps – also called leaflets – that open and close with each heartbeat. The flaps ensure blood flows in the right direction through your heart’s four chambers and to the rest of your body. “Think of the leaflets as doors,” said Jose Torres, MD, Cardiothoracic Surgeon at YRMC’s James Family Heart Center. “Normally, the doors are very pliable. They open and close to allow blood to flow through the heart and then to the rest of the body. When the doors calcify, their pliability decreases and the heart has to work harder and harder to pump blood to the body.” Here’s a look at conditions that can cause or contribute to heart valve disease: Past medical history – A history of diabetes or rheumatic fever and cancer survivors treated with radiation therapy to the chest or sternum are at greater risk for heart valve disease. Congenital heart defect – People born with two leaflets, called bicuspid valve, are sometimes diagnosed with heart valve disease in their 40s or 50s. Heart murmur – Calcium buildup or a leaky aortic valve can cause a heart murmur, eventually leading to heart valve disease. The good news is that heart valve disease is treatable. Medications to lower high blood pressure or high cholesterol may be prescribed. Lifestyle changes – giving up smoking, eating a heart-healthy diet, getting regular physical exercise and aiming for your optimal weight – can slow the progress of heart valve disease. “Heart valve disease is a structural problem that requires surgery,” Dr. Torres said. “Once there’s a heart valve disease diagnosis, the solution is to remove that roadblock with heart valve surgery.” During surgical heart valve disease repair, patients are placed on a heart bypass machine to keep their hearts working. Cardiothoracic surgeons, like Dr. Torres, then replace the heart’s calcified valve with a new, artificial valve. People considered too high risk for heart valve replacement surgery may be eligible for Transcatheter Aortic Valve Replacement (TAVR). The minimally invasive TAVR procedure takes place in YRMC’s Hybrid Operating Suite—a combined state-of-the-art surgical suite and medical imaging facility. In YRMC’s Hybrid Suite – considered one of the nation’s best – a patient’s heart blockage can be diagnosed and then immediately repaired with a minimally invasive procedure, like TAVR. If the real-time imaging shows the patient requires surgery, YRMC’s heart team is ready to perform the procedure in the Hybrid Operating Suite. Learn more about heart valve disease and the advanced, comprehensive services available at YRMC’s James Family Heart Center.
For Amazing Physical and Mental Health Benefits, Hit the Trail on a Bike!
There is an inescapable, childlike joy that comes from riding a bike over dramatic high desert landscapes, or through forests of towering pines, on one of Prescott’s many and varied trails. The good news is that you don’t have to be a pro to join the fun! In fact, whether you are seven or seventy, a novice or seasoned cyclist, there’s a ride for you in the 250 miles of trails that wind in and around Prescott. The physical benefits of trail riding have been extensively documented, and new research suggests that mountain biking can also keep you healthy in spirit and mind. Ximena Florez, Vice President of the Board of the Prescott Mountain Bike Alliance (PMBA), with responsibility for membership and social events, can’t contain her enthusiasm for mountain biking. “It’s fun, it can be social (or solo), and it keeps you smiling and feeling young! There are so many benefits, including physical fitness and mental health. I think trail riding is also a form of meditation, because when you ride, you need to keep your focus on the trail.” Ximena emphasizes that a great variety of people can, and do, enjoy mountain biking. “Almost anyone can ride, especially in Prescott, because our focus at PMBA is on advocating for diverse types of trails that appeal to people of all ages and abilities. Over a hundred miles of trails have been added in the Prescott area since PMBA’s inception, ten years ago. There is something for everyone. Examples include the trails at Pioneer Park for beginners, Thumb Butte and Spence Basin for intermediate riders, and the Dells for experienced cyclists. PMBA is continually raising funds for trail maintenance and expansion through its membership program.” A PMBA-led women’s ride at Spence Basin Physical Strength, Fitness and More The physical benefits of cycling in the great outdoors are well documented and include: Riding a bike over varied terrain builds strength and stamina throughout the body, including arm, back, and core muscles. Balance and coordination improve quickly on a mountain bike. Cycling puts less stress on joints than many other forms of weight-bearing exercise. Exposure to natural, bright light can improve sleep by stimulating the production and timely release of melatonin, a hormone that regulates wake and sleep cycles. Exposure to sun, even for just 5-10 minutes (without sunscreen) creates vitamin D, which is important not only for bones, but for the immune system as well. In fact, the World Health Organization estimates that a large number of diseases, including autoimmune conditions, some types of cancer, and osteoporosis may be linked with too little exposure to natural light and sun. Getting dirty (which is always part of the fun of mountain biking) might also have benefits! Significant research demonstrates that regular exposure to natural soil (i.e. dirt) supports a healthy microbiome: the collective bacteria living in and on us that support health in countless ways. A joyful ride under towering pines Improved Focus, Resiliency and Mood Research on the mental health benefits of mountain biking is relatively new and really exciting. For example, an ongoing study funded by Specialized Bikes demonstrates significant benefits for kids with Attention Deficit Hyperactivity Disorder, or ADHD. In 2012, Mike Sinyard, Founder and CEO of Specialized Bikes partnered with Stanford Medical School and RTSG Neuroscience Consultants to conduct research on riding and brain function. Along with improved outcomes in school, kids that participate in this ongoing study also report improved mood and a greater ability to focus on activities outside of school. While any kind of physical activity can help with grades and mood, the skills developed through mountain biking seem to build additional layers of confidence, focus, and resilience. A trailside view of Granite Basin Lake Additional research includes: Work done by NICA, the National Interscholastic Cycling Association, which uses mountain biking to teach essential life skills to youngsters. NICA research shows that kids who ride on a regular basis build resiliency and self-esteem. In a team sport where no one sits on the bench, kids also learn teamwork, camaraderie, consideration, and a host of other advanced social skills. A Scottish study, examining the benefits of mountain biking for people struggling with a variety of mental health issues. In this small pilot program, participants rode at regular intervals for six weeks in Glentress Forest, a site famous around the world for awe-inspiring trails. Preliminary data suggest that the cyclists experienced improvements in mood, self-worth, and social skills. The program is currently being considered as a treatment option for outpatient mental health clients throughout the United Kingdom. Programs sponsored by the Semper Fi Fund, an organization that exists to help veterans, with visible and invisible wounds, transition from active duty to civilian life. Mountain biking is just one of many sports veterans can join, with adaptive equipment and Olympic-level coaches provided and funded by the Semper Fi Fund. Overcoming complex or even simple challenges on the trail can bring a sense of mastery, accomplishment and joy to anyone. PMBA offers a variety of opportunities to ride, with scheduled skill building sessions and group rides listed on their website at https://prescottmtb.com. For up to date news and last minute announcements, follow PMBA-Prescott Mountain Biking Alliance on Facebook and Prescottmtb on Instagram, where you can also follow the development of Arizona’s first gravity-flow trail. PMBA recently received a grant to develop this one-way loop trail dedicated to all-level mountain biking. Trailside rest stop with a view of Granite Mountain Florez reminds riders that mountain biking “it is all about sharing the trails” and offers this simple guide to trail etiquette. ALWAYS give hikers and horses priority. Make it a habit to pull off the trail and let others pass safely by. Ride with a bell, so trail users know when you are coming up behind them. Give fellow bikers who are riding uphill a break. They are working hard and should take priority over those going down. If you haven’t been on a bike since you were a kid, consider giving trail riding a try! Start with easy trails to build confidence, strength and skill, and then advance – if you want to. It’s also ok to simply enjoy the warm sun, clean air and beautiful Prescott views on an easy, joy-filled ride. Don’t worry if it’s been a while. It’s like riding a bike – you don’t forget!
Flu Shots More Important Than Ever
As the flu season approaches, we stand the risk of contracting another respiratory illness on top of COVID-19. Along with the risk to ourselves, the flu virus could pressure healthcare resources, strain testing capacity, and increase the risk of people catching both diseases at once. That’s why getting a flu shot is more important than ever this year. For both the flu and COVID-19, the elderly and those with underlying conditions are more susceptible. But the flu also hits children and spreads readily in schools. The more we all get a flu shot the more protected everyone will be. The effectiveness of the flu vaccine can range from about 20 percent to 60 percent depending on how accurately scientists predict the circulating flu strains this year. Effectiveness also varies from person to person depending on age and health. Even if the vaccine doesn’t prevent the flu it may make the illness less serious. The Centers for Disease Control and Prevention recommends a flu shot for everyone over six months of age. While it is possible to be infected with the flu and COVID-19 at the same time, it’s too soon to tell how common such co-infections will be. Indeed, many questions remain unanswered. But what is clear is that the flu and COVID-19 both target the lungs. If one virus damages the lungs, the other virus stands the chance of creating greater damage. In the 2018-19 flu season, about 49 percent of Americans received a flu vaccine, averting an estimated 4.4 million illnesses, 58,000 hospitalizations, and 3,500 deaths, according to the CDC. Experts hope more Americans will choose to get a flu shot this year—for themselves and for others.
YRMC’s Kim Haugen Named PV Chamber of Commerce 2020 Volunteer of the Year
Photo: Kim Haugen, Prescott Valley Chamber of Commerce 2020 Volunteer of the Year (center) with Frank Almendarez, YRMC East Chief Administrative Officer (left) and Chris Graff, Chair of the PV Chamber of Commerce (right). After working in corporate management in Illinois, Kim Haugen moved to Prescott and became a Medical Transcriptionist. She enjoyed working from home and appreciated the flexibility the job offered. However, Haugen sometimes felt like she was missing out on regular interaction with others. Eleven years ago, after some thoughtful consideration, she decided to volunteer once a week with the PAWS (Pets are Warm Support) pet visitation program at Yavapai Regional Medical Center (YRMC) with her then two-year-old Bouvier dog, Dirk. “Joining PAWS at YRMC was one of most worthwhile things I have ever done,” says Haugen. “There’s nothing like that connection between a dog and a person. He has touched so many lives. People have even recognized him on the street!” Dirk is now 13 years old and no longer joins Haugen at YRMC. “When Dirk could no longer walk, I requested a different job on Thursdays,” Haugen continues. “It was important to me to keep seeing the other YRMC volunteers, management and staff who had become my friends.” She started delivering the mail each Thursday, and over the years has tackled positions as varied as stocking supplies in the Family Birthing Center and Nutrition Department, helping with the ‘Pet Partners’ certification process, working as an Escort and serving at the Information Desk. She has become a well-respected volunteer throughout the hospital, known for her dedication and hard work. Victoria Spears, YRMC East Volunteer Services Manager, wanted to give Haugen special recognition for all she has done for YRMC. She submitted a nomination to the Prescott Valley Chamber of Commerce for their Volunteer of the Year Award. “Kim constantly goes above and beyond the call of duty,” states Spears. “When she sees a need, Kim is the first one to offer to fill it. She displays all the qualities of a valuable volunteer, exemplifying the spirit of cooperation. She is respected not only by the other volunteers but by staff as well.” The Chamber chooses one recipient each year for their Norm Pariseau Volunteer of the Year Award. Pariseau was a longtime member of the Prescott Valley Early Bird Lions and was Board Chairman of the Prescott Valley Chamber. Each year, the winner exemplifies Pariseau’s commitment to the community and generosity of spirit. Haugen won the award. “Kim not only works hard and does an excellent job, but she truly loves to serve YRMC and our community and this is very apparent when you see her in action,” says Spears. Haugen was not expecting the honor. “This certainly surprised the heck out of me!” admits Haugen. “It’s very humbling. There are so many wonderful, deserving volunteers. And I was chosen not only from YRMC, but from all over Prescott Valley. It’s so exciting.” Haugen continues, “I like to think of this as an honor not only for me, but for YRMC – for the way they have cared for the community, not only during the pandemic, but over the years. I felt that the award was as much for the hospital as for me, and this was the Chamber’s way of thanking the hospital through me.” “Volunteering makes you feel like you are helping the community. It’s so nice to give back, to feel like you’re making a difference in someone’s life,” says Haugen. “And even behind the scenes – helping make the staff’s job easier. That’s a good feeling. You’re giving the workers a chance for more quality time with their patients.” Haugen’s beloved dog Dirk was, in many ways, responsible for bringing her to YRMC and launching her years-long commitment to the hospital. It’s nice to know that while Dirk has ‘retired’ from volunteering, he has a little brother named Sebastian. Haugen is happy to report that Sebastian may begin visiting YRMC patients through the PAWS Program in the not too distant future! To learn more about becoming a volunteer at Yavapai Regional Medical Center, visit yrmc.org. Or, you can call Volunteer Services in Prescott at (928) 771-5678, or in Prescott Valley at (928) 442-8678.
Longest Running YRMC Volunteer Celebrates Her 40th Year
Forty years ago, volunteering at Yavapai Regional Medical Center (YRMC) would often mean joining the Medical Auxiliary. Dues were $5 a year. Auxiliary members would dedicate their time assisting at the Information Desk or Gift Shop. The dress code was strict. In fact, Auxiliary members purchased their own uniforms and wore regulation blouses. Dorothy Kalabus, YRMC’s longest-running volunteer, remembers those days with fondness and a good dose of her signature humor. “Imagine today if you had to pay to be a volunteer!” she jokes. Kalabus had just moved to Prescott from Pittsburgh. She had three school-aged children and her husband’s airline job often took him out of town. Not one to sit at home, she soon joined the Auxiliary and started a decades-long relationship with YRMC. It wasn’t long before Kalabus was asked to join the Auxiliary Board. In those days, the Auxiliary Board decided upon ‘wish list’ purchases for the hospital, funded by proceeds from the Gift Shop. When her grandson was born, Kalabus recalls that the stress monitor, just purchased by the Auxiliary, was used during his delivery. “I was so glad it was there for the staff to use,” says Kalabus. Dorothy Kalabus is the 10th of 12 children. Her father died when she was eleven. She and her siblings were raised to pitch in whenever and wherever possible. She graduated with honors and earned college scholarships. “There was never any idle time at our house,” she remembers. “I can’t even imagine sitting and doing nothing.” Now, at nearly 80 years old, Kalabus still has the energy of someone a fraction of her age. Forty years at the YRMC Information Desk isn’t the only impressive item on her volunteer resume. “Back in the 80’s I volunteered at Sacred Heart Church and at the Prescott Rodeo, where I became the chair of the Cattleman’s Club. I even earned my gold and silver rodeo belt buckle. I offered to stuff envelopes for Judge Ann Sterling’s campaign, and ended up becoming the campaign chair!” Nancy Thomes, Director of Volunteer Services at YRMC, emphasizes the important role Kalabus plays at the Information Desk. “Dorothy is such a joy to have at our Information Desk,” says Thomes. “This is a challenging position since the questions that are asked are often new. These volunteers often have to problem-solve while extending good customer service. Dorothy’s knowledge and willingness to serve is always evident, and the joy that she feels while doing this is always apparent.” When asked why she has stayed with her service to YRMC for forty years, Kalabus explains, “This is so important. You’re dealing directly with people in need. People come in with so many different needs. Most of them aren’t just asking for a patient’s room number, and often they’re in pain or feeling stress. You have to remember a lot of information about the hospital, and communicate it simply and clearly.” “And then there are the free lunches!” she laughs. “Every Friday, a dozen or so volunteers from all different departments get together for lunch, and new volunteers are always welcome. These people have all become my friends. We have such a good time!” Kalabus notes that she belongs to a special ‘foursome’ that makes her time at YRMC extra special. She works with Escorts Carol Shepherd and Shirley Reeves and fellow Information Desk volunteer Rob Petrocci each Friday. “We’re a great team,” she says. Kalabus was honored for her 40 years of service on July 2nd. Thomes and Chamine David, Volunteer Services Manager, visited Kalabus in her front yard for a ‘physically distanced’ celebration. Kalabus’ husband and daughter were there, as well as fellow volunteers Shepherd and Reeves. The neighbors across the street even held up a large handmade ‘Congratulations’ sign and took photos. “Dorothy enjoyed telling a few stories about her first days at YRMC,” says Thomes. “It was clear that her commitment to her role began 40 years ago when she first started volunteering.” “It was a fun visit,” Kalabus recalls. “There were balloons and flowers and we visited and reminisced. It’s fun telling the old stories and marveling at how far YRMC has come over the years. But I still can’t believe it’s been 40 years!” “I tell people that volunteering gives you life,” she explains. “It gives you something to look forward to and makes your life so much more interesting. Volunteering changes your whole world.” Kalabus continues. “When I started volunteering at YRMC 40 years ago, it was just to get to know a few people in my new hometown. But soon, I came to realize that this is a commitment. And as you can tell, when I start something, I finish it. Well, I’m not finished yet!” To learn more about becoming a volunteer at Yavapai Regional Medical Center visit yrmc.org, or call Volunteer Services in Prescott at (928) 771-5678, or in Prescott Valley at (928) 442-8678.
YRMC: Your Destination for Heart Care and Patient Blood Management
What does the phrase “destination healthcare” bring to mind? For a growing number of people in Arizona and the southwest it means heart care, patient blood management or both of these specialized programs, provided by Yavapai Regional Medical Center (YRMC). Cardiac specialists from the James Family Heart Center and leaders from YRMC’s Patient Blood Management program (PBM) joined a live-stream event on October 17, 2019 at Yavapai College Performing Arts Center to speak about both of these innovative programs. Over 600 participated in “YRMC – Your Destination for Cardiac Care and Blood Management” at Yavapai College and the live-stream the event online. YRMC – Your Destination for Cardiac Care and Blood Management featured exceptional cardiac specialists: a Cardiologist, Cardiac Electrophysiologist, Cardiothoracic Surgeon, and a Structural and Interventional Cardiologist. Patient Blood Management experts also took part in the event. Together, these professionals highlighted the services, technology and teamwork that are the hallmark of YRMC’s Heart Program and Patient Blood Management Program. “Neither of these programs existed 12 years ago,” said Pierre Tibi, MD, FACS, Medical Director of YRMC’s James Family Heart Center and Patient Blood Management Program. “Today, there is no other community hospital in Arizona or the southwest that offers what YRMC does. We are now a destination program for Cardiac Care and PBM.” Defining PBM Until recently, prestigious organizations like the Society for the Advancement of Blood Management (SABM), the World Health Organization (WHO) and the American Association of Blood Banks (AABB), all mentioned blood transfusions in their PBM definitions. “They focused on thresholds for blood transfusion,” said Dr. Tibi, SABM’s Immediate Past President. “Today, the SABM definition states that PBM is a patient-centered approach that aims to improve patient outcomes.” At YRMC, this is accomplished by: Involving the patient in decision making Identifying anemia and other conditions early Managing conditions that can affect blood count Minimizing blood loss during hospitalization Embracing PBM tactics throughout the organization “We focus on taking care of the entire patient and keeping the patient as safe as possible before, during and after a procedure,” said Dale Black, Coordinator, Patient Blood Management, YRMC. “And one way to keep patients safe is to not subject them to possibly unnecessary blood transfusions.” YRMC: What Your Heart Needs John Amos, President and CEO, YRMC, recalled the beginning of YRMC’s heart services, which launched in 2004 with a single Cardiac Catheterization Lab at YRMC West in Prescott. “Even then, we envisioned a heart program that would bring together the latest services, exceptional specialists, unparalleled technology and compassionate caregivers,” said Amos. YRMC took a major step toward that goal in 2007 when Dr. Tibi – a highly regarded Cardiothoracic Surgeon from Phoenix – joined YRMC. Dr. Tibi brought open heart surgery to the community, launched YRMC’s Heart Program and introduced PBM. Under Dr. Tibi’s leadership, YRMC’s thriving, comprehensive Heart Program has grown to feature these services and exceptional cardiac specialists: Structural Heart Disease Services – Soundos Moualla, MD, FACC, FSCAI, Structural and Interventional Cardiologist, YRMC PhysicianCare, Prescott Mitral Valve Repair with MitraClip Paravalvular Leak Closure (PVL) Transcatheter Aortic Valve Replacement (TAVR) Transcatheter Mitral Valve Replacement (TMVR) WATCHMAN™/Left Atrial Appendage Closure (LAAC) Electrophysiology Services – Nisha Tung-Takher, MD, Cardiac Electrophysiologist, YRMC PhysicianCare, Prescott Curative Management and Ablation Procedures for Cardiac Arrhythmias (atrial fibrillation, atrial flutter, supraventricular tachycardia, atrial tachycardia, premature ventricular contractions and ventricular tachycardia) Device Implantations (pacemakers and defibrillators) Remote Monitoring (pacemakers, defibrillators and cardiac resynchronization therapy, CRT) Heart Failure Management Care with Compassion YRMC’s Heart Program and PBM Program combine science and service, according to George Rizk, MD, Invasive Cardiovascular Medicine, YRMC PhysicianCare in Prescott. “YRMC is doing what’s best for patients,” said Dr. Rizk, who presented during the live-stream event. “If you deliver the most scientifically advanced services without putting the patient’s interest first, you don’t get too far. YRMC’s team has a passion for helping patients.” One way that YRMC does what’s best for patients was described by Elizabeth Black, YRMC’s Patient Blood Management, Data Manager. In the tradition of healthcare and acronyms, she called it “KTBITP” or “keeping the blood in the patient.” Less than a decade ago, Black noted, blood transfusion was the most common procedure performed in U.S. hospitals. While some blood transfusions are deemed medically necessary, she said, they all come with risks. Those risks include increased infection rates, medical complications (kidney, lung and heart), and higher death rates. PBM strategies combine evidence-based medicine with good clinical practice to maximize the patient’s blood health and reduce exposure to risks associated with transfusion. A Field of Dreams Dr. Rizk remembers the opening of YRMC’s first Cath Lab as a “field of dreams” moment. “We thought: If we build it, they will come,” he said. “And, if you build it well, they will never leave.” These statements are even more relevant today as YRMC’s Heart and PBM Programs emerge as destination programs. To learn more about YRMC – Your Destination for Cardiac Care and Blood Management check out YRMC HealthConnect. For information about YRMC’s Heart Program and PBM Program, visit our website.
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.
Detect Prostate Cancer Early
During National Prostate Cancer Awareness Month remember—when you detect prostate cancer early your chances of successful treatment go up exponentially. The importance of early detection ranks right up there with knowing your risks and practicing prevention, prostate topics covered in an earlier story on YRMC HealthConnect. One of the best ways to detect prostate cancer early is through regular screening. When should you start? That’s a conversation for you and your doctor. Your doctor can recommend a screening routine after taking your risk factors into account. These primarily include family history, race and age. Screenings typically begin between 40 and 50. Screening Routine screening includes a digital rectal exam (DRE) where your doctor examines the size and shape of your prostate with a gloved finger. Typically, your doctor also checks the level of your prostate-specific antigen (PSA). This test measures the amount of PSA in your blood. It is often ordered as part of routine blood work done at your regular checkup. PSA is a protein produced by cells in the prostate. Since cancerous cells tend to produce more PSA, a spike in your PSA level, or a steady increase over time, may signify a problem. But it may not. That’s why more tests are often needed. Diagnosing When a DRE or PSA test reveal something abnormal in your prostate, you may need further testing to rule out prostate cancer. This often entails a biopsy where sample tissues are examined under a microscope. However, this method can cause incontinence and erectile disfunction over time. It also carries the risk of infection. A safer way to detect intermediate to high risk cancers is through a prostate MRI (Magnetic Resonance Imaging). This method lowers the risk of incontinence and impotence associated with excessive biopsies. Yavapai Regional Medical Center now offers prostate MRIs. An MRI is a good option for those who have an elevated PSA and want to avoid frequent biopsies. Or for those who want to get a prostate MRI to confirm biopsy results. Please discuss these options with your doctor. A prostate MRI is covered by most insurance plans, including Medicare. If you receive a confirmed diagnosis of prostate cancer, the next step is to determine the extent, or the stage, of the disease. After assessing your stage, your doctor will help you determine next steps—whether it’s best to repeat the tests after a period of time or to begin treatment for prostate cancer. To learn more about treatment options for prostate cancer please watch for the next HealthConnect posting on prostate cancer. This information is provided by YRMC as part of National Prostate Cancer Awareness Month.
YRMC’s Lung Cancer Screening and Care Program: Early Detection is Saving Lives
Starr Herridge left her home one morning to go to the mall, a familiar trip where she regularly picked up her cigarettes. But on this particular morning in 2012, Starr decided to pull in to the neighborhood drug store instead, and found herself purchasing smoking cessation patches. Starr laughs, “I guess I was lazy – I didn’t want to go all the way to the mall!” “Once I retired, I started smoking so much more,” Starr admits. “When I was working, it wasn’t so bad because I wasn’t allowed to smoke at work. But I didn’t know what to do with myself at home and I ended up smoking all day long. I knew I had to do something.” Thankfully, the patches worked, and Starr has been a non-smoker ever since. Fast forward to 2018, when Starr’s primary care physician recommended a Medicare well-clinic health screening. Given Starr’s history of smoking, it was recommended that she get a low dose CT lung scan. Starr figured it couldn’t hurt. She went to Yavapai Regional Medical Center where she qualified for free annual lung screenings through the Lung Cancer Screening and Care Program. “YRMC’s Lung Cancer Screening and Care Program follows people generally between the ages of 55 and 77 who are at a higher risk for lung cancer due to a history of smoking,” explains Jennifer Harvey, RN, BSN, Patient Navigator at the YRMC Lung Cancer Screening and Care Program. “The screening uses a CT scan with a lower dose of radiation to take very detailed pictures of the lungs to detect cancer in its early stages, which allows for a greater chance for a cure.” “I first met Starr in July, 2018 when she came to the program,” says Harvey. “The first thing you notice is her sense of humor and her kind, humble heart!” The Lung Cancer Screening and Care Program is covered by private insurance and Medicare for people who meet certain criteria, including: Age 55-77 Current smoker or quit within 15 years 30 smoking pack years (1 pack a day for 30 years) Harvey notes that you need an order from your provider, so a good starting point is to talk to them first. In addition, a cash pay, discounted rate is available for those who do not qualify for insurance coverage. “My job is to provide information, answer questions and interpret what each individual patient needs,” says Harvey. “The whole idea from the very start is that everyone is in a different place. I followed Starr’s case and checked in occasionally to see how she was doing.” A year later, one of Starr’s regular screenings showed a very tiny nodule on one of her lungs. Although Starr showed no symptoms at all, her physician wanted to do a biopsy to be sure. However, the nodule was so small that it was impossible to biopsy. Starr and her doctor discussed Starr’s options. “I said let’s just go in there and get it out!” Starr recalls with her signature enthusiasm. “Within three weeks, I was in the hospital.” “I saw Starr after the surgery. She did great!” says Harvey. “The biopsy tested positive for cancer, but the good news was that the margins were clear, which means that everything around it was negative. This is exactly what you hope for, and it was made possible because we caught it so early.” Starr now goes in for follow-up CT scans every four months. She considers herself an advocate for screening and early detection. “I always tell people, why wait until you have a symptom? It takes thirty minutes out of your life, it doesn’t hurt, you don’t get undressed, and you just get up and go. Plus, It’s free, and I like free!” After a pause, Starr’s tone becomes more serious, “We got rid of the cancer before I became sick. I didn’t have to endure chemo or radiation because I went in early and they got all of it. It saved my life.” “Of course, quitting smoking is the most important thing you can do to reduce the risk of lung cancer,” says Harvey. “But that risk is still about three-fold in comparison to people who have never smoked, even 25 years after quitting. The value of regular screenings can’t be overstated.” So why don’t more people participate? “One of the biggest reasons people are reluctant is that they just don’t want to know,” explains Harvey. “We find this largely in people who are currently smoking. It’s hard to hold up a mirror to what smoking has done to their bodies. Another comment we hear is, ‘Well, I feel fine. I don’t need to do this.’ The truth is, the vast majority of lung cancer symptoms don’t appear until later stages.” “The great news is that the survival rate of lung cancer is on its way up. There are now more treatment options besides surgery, radiation and chemotherapy. What was considered a poor prognosis ten years ago may hold a lot more hope now, thanks to immunotherapies and targeted therapies,” says Harvey. The other important factor is that smokers and former smokers like Starr are becoming more aware of the life-saving benefits of early-detection programs like the Lung Cancer Screening and Care Program at YRMC. “My health is so important to me because I love life. I have two sisters, and I love being with them. I have a great group of friends – some are even from high school.” Starr continues. “Plus, I have a dog sitting business that I love. Dogs just love you unconditionally. I provide a great service to my clients, and just have a ball with the dogs!” For more information on the Lung Cancer Screening and Care Program at YRMC, call Jennifer Harvey, Patient Navigator at (928) 771-5454 or visit YRMC’s Website.
Reducing the Risk of Breast Cancer with a Plant-Centered Diet
According to estimates by the American Cancer Society, in 2019, over 350,000 women and nearly 3,000 men were diagnosed with breast cancer. In the same year, approximately 41,000 women and 500 men died of the disease. That’s certainly a scary number of new breast cancer cases and deaths. Fortunately, research shows that there is a lot you can do to reduce your risk of getting breast cancer and, in case you are diagnosed, improve your ability to recover and survive. For example, experts recommend building your front line defenses with plant-based meals that are packed with cancer-fighting and immune-boosting phytochemicals, while reducing your intake of animal products, sugar and alcohol. In this episode of YRMC’s Your Healthy Kitchen, we take a look at their recommendations while making a delicious, cancer-fighting meal. Recipe: Walnut-Orange Quinoa with Warm Spices Follow These General Diet Recommendations The American Cancer Society, American Institute for Cancer Research (AICR) and the World Health Organization agree that a healthy diet can reduce the risk of breast cancer for women and men. They recommend: Enjoying a plant-based diet that includes smaller portions of meat, poultry, and other animal products. Shooting for 5-7 servings of vegetables and 1-2 servings of fruit per day. Eating moderate amounts of high fiber whole grains and beans, or a portion that fills one-quarter of your plate at meals. Limiting alcohol to less than one drink per day or avoiding alcohol altogether. Reducing added sugars and other refined carbohydrates, including white flour products, refined grains and cereals, fast foods and highly processed snacks. Enjoy an Abundance of Phytochemical-Rich Plants Vegetables, fruits, whole grains, nuts, and beans contain nutrients called phytochemicals that have been shown to strengthen the immune system, reduce inflammation (which scientists link to increased cancer risk), and even trigger cancer cell death. Remember, when you fill your plate with smaller portions of animal products, there’s a lot more room for cancer-fighting plants! Fill Up with Cancer-Fighting Fiber Plant-based foods contain fiber, which may reduce breast cancer risk by binding to, and eliminating harmful forms of estrogen from the body. High fiber whole grains, vegetables, lentils, and beans also promote healthy blood sugar levels. Research suggests that individuals with higher than normal average blood sugars are at greater risk for breast and other types of cancers. Reduce or Eliminate Alcohol Alcohol is directly linked with breast cancer risk, as well as an increased chance of developing colorectal, esophageal, stomach and liver cancers. According to the AICR, when you drink alcohol, it turns to a chemical called acetaldehyde (ethanal). This chemical can damage cellular DNA and interfere with DNA repair, potentially triggering the growth and spread of cancer cells. Since alcohol also increases levels of harmful estrogens, some practitioners advise women who are at high risk of breast cancer to avoid alcohol altogether. Think of Sweets as Occasional Treats Sugar does not directly cause any type of cancer, and it’s okay to enjoy sweets now and then. However, diets that are high in sugar and other refined carbohydrates can trigger higher than normal levels of sugar in the blood, which might increase risk. Limiting your intake of these foods may also reduce body fat, which lowers your chance of being diagnosed with breast cancer after menopause. Overall, research on breast cancer prevention and survival strongly supports a diet pattern that contains a healthy variety of fiber-, phytochemical-, and nutrient-packed plant foods, with limited alcohol, sugar, and refined carbohydrates. By simply filling one-half of your plate with brightly colored vegetables at meals, adding fruit or vegetables to your snacks, and choosing whole grains, lentils and beans as satisfying starches, you’ll meet many of the diet recommendations put forth by the world’s most prominent cancer research organizations. You can read more about preventing breast cancer at aicr.org, cancer.org, or who.int. And don’t forget to check out all of our cancer-fighting recipes, including delicious Broccoli with Basil, plus lots of educational nutrition and cooking tutorials on YRMC’s Your Healthy Kitchen Blog at yrmchealthconnect.org.
From Garden to Plate: Molly Beverly Teaches How to Grow, Preserve, Store and Cook Healthy Food
Molly Beverly’s passion for gardening began with the simple desire to grow some food in an urban backyard. She explains, “My husband Gary and I grew up in suburbia, and had never grown anything before. We really wanted to get back in touch with the land, and the best way to do that was to grow our own food”. Years later, they are largely living ‘garden to plate’, and feeding themselves year round with the food they grow on their three-acre organic Chino Valley farm. Molly is a chef, teacher, food activist and Chair of Slow Food Prescott, where she advocates for local growers, heritage foods, and creative food and culinary education. She readily shares her garden and cooking wisdom, and graciously invited YRMC’s Your Healthy Kitchen to walk through her gorgeous gardens, learn some tricks for growing and preserving food, and make her fabulous garden-fresh minestrone soup. Molly Beverly’s Summer Minestrone Recipe I brought home a basket of produce, including savory Italian badda beans, crispy black eyed peas, tender red okra, juicy plum tomatoes, and fragrant basil, to make Molly’s minestrone in my own kitchen. You can watch the process here! a Molly’s recipe was originally published in Edible Phoenix, and is available online at ediblecommunities.com. Edible Communities publishes over ninety independently owned magazines throughout the U.S. and Canada. Each uniquely highlights the local growers, bakers, chefs, brewers, vintners, and others who feed the folks living in their respective communities. You can learn more about Slow Food, an international organization that works to prevent the disappearance of traditional foods and food cultures at slowfood.com. Slow food teaches millions of people about where their food comes from; explores indigenous tastes and flavors; and shows how our everyday food choices can affect people locally and around the world. Don’t forget to follow Molly on her Facebook page at facebook.com/mollyscookingclasses/, where she explores home-style cuisine with international flair, using ingredients from her garden and local farms. And remember, as always, to check out all of our delicious and nutritious recipes, plus lots of fun, educational videos at YRMC’s HealthConnect. You can also stop by my kitchen by following me on Facebook at YRMC’s Your Healthy Kitchen, where I post photos and videos about the meals I make for myself and my family, plus interesting links to my favorite food, cooking and gardening destinations on the web.