Have you wondered how scientific research affects real lives? Look no further than the Human Genome Project for a shining example of how research leapt – relatively speaking – from research labs to patient clinics, like Yavapai Regional Medical Center’s (YRMC’s) Genetic Clinic in Prescott Valley. In 2003, scientists from 20 research institutions in six countries, including the United States, announced they had completed the monumental achievement of sequencing the entire human genome. How did this information make it into our everyday healthcare world? Jody Pelusi, PhD, FNP, AOCP, Oncology Nurse Practitioner, who oversees cancer genetic testing at YRMC’s Genetic Clinic recalls, for example, that breast cancer genetic testing used to involve only two genetic mutations: BRCA1 and BRCA2. “Now we know many genes exist,” said Dr. Pelusi. “Therefore, we do panel testing to look at anywhere from 30 to more than 100 genes.” What can genetic testing at YRMC’s Genetic Clinic accomplish? The answer to that question depends on the patient’s individual needs. Genetic testing is typically pursued to: Pinpoint actual risk for developing cancer from a hereditary mutation versus a perception of cancer risk. Learn cancer risk based on personal or family risk factors for people found not to be at high risk for cancer based on genetic testing. Determine the best treatment options, follow-up care and long-term monitoring for people diagnosed with cancer. Learning Your Genetic Risk for Cancer Before genetic testing happens – typically starting with a swab of salvia from the mouth – Dr. Pelusi meets with the individual to discuss his or her goals. Her approach is part scientist, part counselor and all supportive. “We talk about genetic testing, the information they will potentially learn and if knowing that will make a difference in how they approach their healthcare,” explained Dr. Pelusi. “Some people may come from families who didn’t discuss illness or they may be adopted and have no knowledge of their genetic history. There are many different circumstances.” During a first appointment, Dr. Pelusi introduces cancer genetic testing by: Reviewing the goals of cancer genetic testing. Discussing why the person is interested in genetic testing. Developing a profile based on the family’s history of cancer, including the type of cancer and at what age the family member was diagnosed with cancer. Outlining the pros and cons of genetic testing, including how test results can affect the people being tested as well as their family members. “About 10 percent of people will actually be found to have a genetic change that puts them at higher risk for potentially developing a cancer,” Dr. Pelusi said. “However, this 10 percent is significant as this can be life changing. Some individuals will come in and get the information and want to think about it before they determine if they want to undergo testing or not; this is absolutely fine.” Your Genetic Test Results For people whose genetic test results show they’re at higher risk for cancer, Dr. Pelusi works with their clinicians to provide valuable information on healthcare and lifestyle options. This may include increased health monitoring and screenings, lifestyle changes, risk-reducing surgeries and chemoprevention (using drugs, vitamins or other agents to reduce cancer risk, delay its development or help prevent recurrence). “These are emotional topics,” Dr. Pelusi said. “This is not a time to fear cancer. But we sure can fight it with our awareness, our knowledge and our actions. I make sure people have the information they need to make a decision they’re comfortable with. I listen and respect their approach. You can’t get that in a mail order test.” To schedule an appointment at the Genetic Clinic for a genetic evaluation and possible testing, call (928) 442-8747.

The world’s only inflatable, walk-through exhibits of the human body, heart and colon are coming to Yavapai Regional Medical Center’s (YRMC) Celebrate Life Health Expo 2019. MEGA Body™, MEGA Heart™ and Boston Scientific’s Colossal Colon combine learning and fun in a larger-than-life way. “This will be a new experience for our community,” said Ken Boush, YRMC’s Director of Marketing and Communications. “The sheer size of these exhibits will give people the opportunity to explore how the human body works. The experience is interactive and designed for people of all ages. YRMC is delighted to make MEGA Body, MEGA Heart and Colossal Colon part of this year’s Celebrate Life Health Expo.” The Expo will also feature more than 100 exhibits that focus on health, wellness and active lifestyles. Join the fun on: Friday, September 6 and Saturday, September 7, 2019 9:00 am – 3:00 pm Findlay Toyota Center 3201 North Main Street Prescott Valley, Arizona The Expo is a free community service sponsored by YRMC Meet the MEGAs and More! Tours of MEGA Body, MEGA Heart and the Colossal Colon, delve into how the body operates, potential health challenges and how our lifestyle choices – diet, exercise and not smoking – can help us stay healthy. Members of Prescott hospital and administration team will be there as you check out the inner workings of the body, heart and colon. MEGA Body includes a teeth-to-torso exploration of the human body. As you travel through MEGA Body – approximately 50 feet long by 15 feet wide by 12 feet tall – you’ll learn about our body’s bones, muscles, skin and even our ears. Your journey will take you to these organs: Brain Esophagus Stomach Intestines Kidneys Heart Lungs Explore what makes your heart tick in MEGA Heart. A MEGA Heart and a Movie Premiere! Visitors to MEGA Heart are in for a highly interactive, educational experience. During your MEGA heart adventure, you’ll see how a healthy heart functions, observe examples of various types of heart disease and check out displays featuring some of the latest medical treatments for heart problems. You’ll also learn about heart attacks, irregular heart rhythms and blood clots as well as the most advanced ways to treat those conditions. The James Family Heart Center at YRMC will premiere Places in the Heart, an informative video featuring Pierre Tibi, MD, FACS, Medical Director of YRMC’s James Family Heart Center. During a dissection of a pig heart, the highly regarded cardiothoracic surgeon explains how the human heart functions. Places in the Heart will show every 30 minutes throughout the Expo. (Pig hearts – provided by a scientific supply company – are used in educational settings to teach heart anatomy because they are nearly identical to the human heart.) “Representatives from YRMC’s James Family Heart Center will join the Expo to highlight the Center’s state-of-the-art medical services and impressive facilities,” said Boush. Colossal Colon Tours of Colossal Colon highlight the importance of our digestive system to overall health. You also will: Learn about conditions like Crohn’s disease and ulcerative colitis Get the latest facts on colon cancer, which will affect 140,000 Americans in 2019 Discover steps you can take to keep your colon healthy Giveaways, Prize Drawings and Games! In 2019, more than 100 organizations committed to health, wellness and community good will participate in YRMC’s Expo. Exhibits will include fun activities, lots of giveaways and even chances to get into drawings for great prizes. “If you like hiking, biking, cooking, exercising and other healthy lifestyle pursuits, you’ll really enjoy this year’s Expo,” Boush said. “There’s going to be lots of opportunities for people to connect with organizations dedicated to all of these activities and more.” Here are a few examples of the experiences and opportunities available at the Expo: Healthy Living Biking group Hiking club Healthy nutrition tips and demonstrations (with samples) A “smoothie bike”—create a nutritious smoothie as you pedal for fitness Health Screenings and More Blood pressure checks Carbon monoxide breathalyzer Compression sock fittings Lung function tests Myovision screenings for your back Pre-diabetes self-assessments For Kids of All Ages GoNoodle kids’ fitness routines Information about tennis for kids Photos with your favorite mascot, including YRMC’s Wellby the Yavabear Professional face painters Fitness, Fun and Safety CPR basics Chair yoga demonstrations First aid tips from emergency experts Self-defense demonstrations Prize Drawings Annual parking pass for Prescott Parks A Fitbit® Gift basket with kids’ dental health items GoNoodle Prize Packs March of Dimes blanket Staycation gift basket Target gift card valued at $25 Lots more! Plan Your Day and Help Your Neighbors! Visit our event page on YRMC HealthConnect for videos of MEGA Body and MEGA Heart as well as these useful pre-event tools: A map of the event to print and plan your own Expo experience A shopping list with non-perishable food items and toiletries. Bring your donations to the Expo to support the good work of Prescott Area Shelter Services and area food banks Keep up on prize drawings, giveaways and activities Expo exhibitors are planning on our Facebook event page.

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.

There are few things better in my healthy kitchen than the flavorful produce, freshly baked bread, meaty mushrooms, vibrant herbs, pungent sauces and other delicious delights I find each week at the Prescott Farmers Market! In addition to being a wonderful place to purchase a big variety of fresh, seasonal produce and prepared foods, it’s also a family friendly venue that builds ties within our community while supporting local family farms. Kathleen Yetman, Executive Director of the Prescott Farmers Market recently joined me on the set of YRMC’s Your Healthy Kitchen to share some exciting market news, tell a few stories, and make her family’s favorite easy and delicious market meal! The Prescott Farmers Market, a non-profit 501(c)3 organization, has come a long way since 1997, when a few local farmers, cooks, and craftspeople gathered together in downtown Prescott on summer weekends to sell their wares. Today, the market is open for business year-round on Saturday mornings in Prescott and on summer Thursday afternoons in Chino Valley, with over 50 farms and small businesses selling products in the summer and over 40 hardy vendors in the winter! In addition, regular pop-up venues bring fresh food and produce to people throughout our community, especially those who live far from the regular market sites. On a recent walk through the summer market, I saw vendors selling beautiful fresh-cut flowers, vibrant seasonal produce, freshly baked breads, fresh mushrooms, gourmet heirloom garlic, lavender products, hand-knitted clothing, soaps, wooden cutting boards and utensils, baked goods, tamales, wood-fired pizza, quiche, samosas, fresh frozen fruit pops and even kombucha! There’s always hot coffee, tea and ice-cold lemonade available at the market to quench your thirst, and music to relax with or dance to. Local ranchers offer grass-fed beef, chicken, pork and farm fresh eggs, and there are a large variety of beautiful hand-made gifts to buy.  All of the products for sale at the Prescott Farmers Market are locally grown or produced. Farmers submit crop plans at the beginning of each season that must match the products they sell. Farm inspections ensure that everything a farmer sells was grown on his or her farm. Food products, like tamales, sandwiches, and samosas, must contain some local ingredients and be made by the people selling them. Yetman comments, “I don’t know of any other farmers market in our state that inspects farms like the Prescott Farmers Market does”. Farm fresh eggs The economic contribution to the community is substantial. In 2018, vendors at the summer and winter markets did over one million dollars in sales, and much of this much of this money stayed right here, supporting other local businesses. Yetman explains, “For every ten dollars we spend on local products, more than four of those dollars stay in our community, supporting other small family businesses. When we shop at large chain or corporate stores, only a little over one dollar recirculates into our community”. Yetman continues, “Another economic benefit is that vendors at the market sell their products directly to customers, eliminating middlemen, which improves their ability to make a sustainable, living wage”. Fresh, vibrant produce Other benefits of the Prescott Farmers Market can’t be measured in dollars and cents. For example, the value of knowing who grows your produce, raises the chickens that lay the eggs you love, or bakes your bread is immeasurable. Fresh produce, picked at peak ripeness, bursts with more flavor and nutrients than fruits and vegetables grown to withstand the time and travel needed to bring food from distant farms to regional stores. Local produce also stays fresh and vibrant much longer than anything you can buy at a big box store, saving money in the long run because food does not spoil quickly and go to waste! In addition, and possibly most important, the ties that are formed between vendors and their customers, or among strangers and friends who gather to shop and socialize, strengthen our community in many ways as we get to know our close and distant neighbors. The summer Prescott Farmers Market is open from 7:30-12:00 on Saturdays in Prescott at Yavapai College, parking lot D, and in Chino Valley on Thursdays, from 3:00-6:00 pm, at Olsen’s Grain, 344 Highway 89. The market accepts SNAP (Supplemental Nutrition Assistance Program) and is a proud provider of Double Up Food Bucks Arizona, where SNAP recipients receive a dollar for dollar match in tokens for SNAP dollars, up to $20 per market visit to buy fresh Arizona-grown fruits and vegetables. A number of vendors also accept Farmers Market Nutrition Program checks that are available to eligible low-income WIC (Women, Infants, and Children) and SFMNP (Senior Farmers Market Nutrition Program) recipients through Yavapai County Community Health Services.  In addition, the Prescott Farmers Market website, at https://www.prescottfarmersmarket.org/ is packed with information about market locations and hours, scheduled pop-ups, events, and every vendor. While there, be sure to sign up for their informative newsletter, where you can read more about featured vendors in each issue. You can also sign up for text message alerts about market times and pop-ups! I hope to see you there soon!