If you are confused about the conflicting advice on breast screening (mammography) guidelines, you’re not alone. Women are asking: What’s the best age to begin breast screening? How often should I have breast screening? Is there a time that I’ll no longer need breast screening? “Most physicians, including myself, the radiologists at YRMC’s BreastCare Center and the American College of Radiology, recommend annual screening mammography starting at age 40,” said Michael G. Macon, MD, Breast Surgeon and Medical Director of the BreastCare Program at Yavapai Regional Medical Center (YRMC). At what age can annual breast screenings stop? That depends on the woman, according to the experts at YRMC’s BreastCare Program. “There are many women in their mid-70s who will live 15 to 20 more years,” Dr. Macon said. “If those women are going to act on the information from the mammogram, they should continue annual breast screenings. However, different organizations have different recommendations.” A Controversial Recommendation In January 2016, the U.S. Preventive Service Task Force (USPSTF) announced dramatic changes to its breast screening guidelines. The USPSTF – an independent group of preventive and evidence-based medicine experts – recommended that breast screening begin at age 50 and end when a woman reaches age 74. The group also recommended breast screening take place every two years, as opposed to annually. The USPSTF’s recommendations are based on statistics that show more women can be saved at lesser cost when breast screening begins later in life. As women age, they are more likely to be diagnosed with breast cancer. “The USPSTF is studying millions of women and making a recommendation based on data,” said Dr. Macon. “The difference is that physicians look at one woman at a time and ask: ‘What is best for this patient?’” Members of the medical community were alarmed by the USPSTF recommendations. They pointed out that breast screening mammography beginning at age 40 has been shown to reduce deaths due to breast cancer. Additionally, while breast cancer is more common as women get older, in younger women breast cancer tends to be more aggressive. Clinicians also argued that these more aggressive cancers need to be detected when the cancer is most treatable. Breast screening annually – rather than every two years as recommended by the USPSTF – would catch cancer earlier, when cure is most likely. Online Tools Assess Your Breast Cancer Risk  Breast screening recommendations are based on women at average risk for breast cancer. How can you learn your individual risk for breast cancer? You can start with an assessment tool. The Gail Model and Tyrer-Cuzick Model Breast Cancer Risk Evaluation Tool estimate the likelihood of a woman developing breast cancer within five or 10 years of her current age and during her lifetime. Take Action to Manage Your Health “It’s difficult for an organization in and of itself to make a nuanced recommendation on breast screening that works for all women,” said Dr. Macon. “Statistically, the USPSTF recommendations may make sense as a public health recommendation, but that doesn’t give a specific woman information on how she should act.”  

There’s lots of information online about COVID-19, but not all of it’s accurate. Yavapai Regional Medical Center (YRMC) recommends these state and national sources for reliable information during the COVID-19 pandemic: Centers for Disease Control and Prevention CDC Coronavirus Self-Checker CDC Key Facts Office of Arizona Governor Doug Ducey State of Arizona COVID-19 Hotline, 2-1-1, 8:00 am-8:00 pm, daily (211 online) Yavapai County Community Health Services Yavapai County Community Health Services COVID-19 Hotline, (928) 442-5103, 8:00 am-5:00 pm, Monday-Friday World Health Organization Yavapai Regional Medical Center Check back with us for other COVID-19 recommended sources from YRMC.

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.

After a long day, there’s nothing better than coming home to a dinner that is hot, delicious and ready to eat.   If you’re like me and don’t have someone at home making dinner for you, put your vintage Crock Pot (or sleek new slow cooker) to work! Crock Pots and other counter top slow cookers are simple, affordable tools that can make meal planning a breeze.  All you need are a handful of good recipes and generally less than an hour to prep ingredients.  I headed to YRMC’s Your Healthy Kitchen studio recently to prepare two of my favorite slow cooker recipes, and to share some useful tips for choosing and using any type of slow cooker.  Check it out! Braised Chicken with Artichokes and Olives Slow Cooked Vegetable Curry There are a few important things to consider if you are in the market for a new slow cooker.  First, choose the size that best suits your needs.  Slow cooker capacity is measured in quarts, and in general: 1-4 quarts – is best for singles and couples 6 quarts – is best for 3 or more people or to make enough leftovers for 2 8 quarts – is best for large families or gatherings (or to make a lot of leftovers!) Second, consider buying a slow cooker with an automatic timer.  The simplest cookers feature only high and low cook settings, which means they will keep cooking until you manually turn them off.  Slow cookers with timers will stop cooking automatically and hold food at a safe temperature for several hours.  This is a great feature if your cooker will be cooking while you are at work or are otherwise unable to keep an eye on the pot! Lastly, avoid cookers that have Teflon or aluminum inserts.  These materials can leach harmful chemicals into your food.  The best cookers feature simple stainless steel inserts or old-fashioned ceramic crocks. Slow Cooked Vegetable Curry Some basic cooking tips can be helpful if you are new to slow cooking.  First of all, practice a bit of patience and try not to peek into the pot before your food is done.  The lid on a slow cooker keeps all of the heat and moisture that is needed to cook your meal inside the pot.  When you lift the lid, heat and steam escape, resulting in prolonged cooking time.  Just set it and forget it! Second, if you plan to cook your meal while you are at work, simply prepare and assemble the ingredients in your slow cooker insert the night before and store it in the refrigerator.  In the morning, plug in your cooker, place the insert inside, set the timer and head out the door!  You may need to add 1-2 hours to the cooking time if the insert and ingredients are cold, but sometimes that works really well if you are gone for eight or more hours during the day. Third, with the exception of canned tomatoes, don’t use canned vegetables in your slow cooker.  Fresh vegetables (or frozen vegetables that have been thawed) will hold up to slow cooking better than canned (which generally just turn to mush).  Also, cut hard vegetables, like carrots and potatoes, into smaller sized pieces than softer vegetables like zucchini, so that everything cooks evenly. Lastly, if you want to speed up your slow cooker a bit, add hot or warm liquids to the pot instead of cold.  This will reduce the amount of time the cooker needs to heat everything up. So dust off that old Crock Pot or, better yet, get yourself a new one, and start to enjoy the pleasures of slow cooking! Remember to check out all of our videos and collection of healthy, delicious, and easy recipes at YRMC Health Connect. You can also follow me on Facebook at YRMC’s Your Healthy Kitchen, where  I regularly post photos and videos of the meals I make at home, plus news of food and farm related happenings in the community, gardening tips and links to some of my favorite health and food-related destinations on the web.