Minimally Invasive Choices for Back Pain Relief
If you’re experiencing back pain, you’re certainly not alone. Ranging in severity from a muscle ache to a shooting pain radiating down the leg, back pain is one of the most common reasons that people visit their healthcare provider. A study conducted by the Georgetown University Health Policy Institute reports that “some 16 million adults – 8 percent of all adults – experience persistent or chronic back pain, and as a result are limited in certain everyday activities.” Over time, these limitations can restrict our capacity to interact physically, socially and emotionally, causing frustration and sometimes even depression. “Back pain need not be something you just have to live with,” says Dr. David Lloyd, neuroradiologist with Dignity Health, Yavapai Regional Medical Center and Vascular and Interventional Specialists of Prescott. “The vast majority of cases of back pain are treatable. Sometimes patience is required, but we have many tools at our disposal to help you feel healthier and more comfortable.” A neuroradiologist is a physician who is also a radiologist, specially trained in imaging such as MRI and CAT scan. This imaging is frequently necessary to properly diagnose the cause of your back pain and to plan how to treat it. Causes of back pain are extensive, but most commonly include degenerative disc disease, arthritis, compressed nerves, and even fractures. Lloyd stresses that depending on the diagnosis, there are many minimally invasive choices when it comes to relieving the pain. “Minimally invasive refers to procedures outside of what we typically think of as surgery,” he explains. “It does not require general anesthesia, avoids large incisions, and the recovery is much more tolerable. In almost all cases, the patient requires no inpatient stay at the hospital and is back to performing normal activities of daily living within a few hours of the procedure.” Steroid injections, epidural steroid injections and selective nerve blocks are among the most typical procedures. For compression fractures of the spine, which are most often found in osteoporosis patients, vertebroplasty is a highly effective procedure. A cement-like material is injected into the broken bone, stabilizing the fracture. Lloyd states that most patients experience pain relief and the renewed ability to go about their daily activities almost immediately. “The wonderful thing about the procedures I perform is how quickly and effectively most patients receive pain relief,” Lloyd says. “Obviously, magic pills don’t exist, and relief of back pain can remain elusive, but most patients receive a significantly improved quality of life shortly after receiving the needed procedure. It’s very satisfying to see a patient who was struggling with unrelenting pain be able to engage in a more fulfilling lifestyle and overcome the discouragement he or she was feeling.” Talk to your healthcare provider to see if a referral makes sense for you. Vascular and Interventional Specialists of Prescott can be reached at (928) 771-8477.
Kari Reily Joins the YRMC Foundation Board of Directors
Yavapai Regional Medical Center (YRMC) Foundation is pleased to announce that Kari Reily has joined the Foundation’s Board of Directors. “Kari is deeply committed to helping to improve the quality of life in our community,” said Dave Barrett, Chair of the Foundation. “Her energy and her enthusiasm are infectious and inspirational.” Ms. Reily’s professional career spans more than 30 years in the banking industry. She is currently Branch Manager of Foothills Bank in Prescott Valley. As an active member of both our economic and civic communities, she is a member of the Prescott Valley Economic Development Committee and Prescott Valley Chamber of Commerce. In addition, Ms. Reily is the incoming President of the Prescott Valley Early Birds Lions Club. The YRMC Foundation is committed to supporting the healthcare mission of Dignity Health, Yavapai Regional Medical Center, your local, not-for-profit community healthcare provider, through fundraising and relationship building. The Foundation solicits philanthropic gifts, provides stewardship of these gifts, and grants funds to the hospital to advance the community’s access to healthcare. All charitable gifts received by the Foundation stay in our community and are utilized as directed by the donor. Donors may designate their gifts to any of the Foundation’s 18 special purpose funds. In 2020, community support to the YRMC Foundation topped $2.3 million. Ms. Reily is one of nine volunteer members representing our community. The expertise and talents of the board members include backgrounds in business, finance, law, communications, and more. These directors represent our community and business leaders, medical staff and hospital leadership. In addition to Ms. Reily, board membership currently includes John Amos, Dave Barrett, Douglas Bristol, Mary Mallory, Robbie Nicol, Dr. Arabinda Pani, Harvey Skoog, William Sonsin and Dr. Pierre Tibi. To learn more about the YRMC Foundation, please contact (928) 771–5169 or foundation@yrmc.org or visit www.yrmcfoundation.org.
GoNoodle Keeps Kids Active During the COVID-19 Pandemic
Staying the course during the unpredictable events of 2020 was a challenge for non-profit organizations across the globe. Holding true to one’s mission and vision while focusing on new and effective ways to reach the community was a common theme. The experience at Dignity Health, Yavapai Regional Medical Center (YRMC) was no different. As the COVID-19 pandemic became a reality in early 2020, families in our community started to suffer tragic losses. Many of our neighbors faced unemployment. When schools closed, parents became full-time teachers in addition to keeping bills paid and food on the table. The list goes on. At YRMC, decisions were made to shift our community outreach priority to the families, children and young adults we serve. We felt it was one of the many ways we could stay consistent with our communities’ needs. In 2020, YRMC made charitable donations to the Humboldt Education Foundation’s Hungry Kids Project, Boys to Men Mentoring – North Central Arizona, Prescott Police Department’s Shop with a Cop, Prevent Child Abuse Arizona, Boys and Girls Clubs of Central Arizona and Yavapai Big Brothers, Big Sisters, among many others. In addition, YRMC’s continued sponsorship of GoNoodle for teachers, children and their families became more important than ever. Many of our local teachers have found that GoNoodle’s fun, enriching online content brings movement and mindfulness into the classroom, boosting students’ productivity, improving behavior and helping to build confidence and community in the classroom. However, during the months when schools were closed, more and more of our local parents started to rely on GoNoodle’s resources – including the videos, downloadables, and parent-focused blogs. GoNoodle became a refreshing and welcome addition to the school curriculum while parents were teaching their children at home. Just a few clicks can initiate a family dance party, offer the calming effect of a mindfulness video, or bring engaging information on how to stop the spread of germs. Screen time is turned into active time on laptops, phones and televisions. In fact, in 2020, there was a 187% increase in GoNoodle home usage in Yavapai County. Teachers continued to find creative ways to incorporate GoNoodle into their long-distance instruction as well. Even in 2020, teacher usage and the number of schools using GoNoodle grew. YRMC is pleased to have had the opportunity to help make our local parents’ and teachers’ days a bit easier – and perhaps our local kids’ days a bit more fun – during the COVID-19 pandemic through our continued sponsorship of GoNoodle. It’s one of the many ways we try, every day, to live out our commitment to the health of our communities.
Five Signs it’s Time for a Total Knee Replacement
Is a total knee replacement on your radar? If it is, you’re not alone. More than 600,000 Americans opt for the procedure each year. That number makes total knee replacement the most frequently performed orthopedic surgery in the United States. It’s not always easy to know when it’s time for a total knee replacement. A recent article in the Journal of Bone & Joint Surgery found that about 90 percent of people wait longer than necessary to have the surgery. That statistic is no surprise to Francisco Jaume, DO, Lead Orthopedist at Dignity Health, Yavapai Regional Medical Group, Orthopedic Surgery. The accomplished orthopedic surgeon – who has himself undergone total knee replacement surgery – understands why people wrestle with this question. “People tend to wait longer than they should for a total knee replacement in the hopes they’ll be able to manage their pain,” says Dr. Jaume. “But if an x-ray reveals you have bone-on-bone opposition, the only way to fix this is surgery that resurfaces the knee joint. And that’s exactly what we do during a total knee replacement.” Dr. Jaume talks about all aspects of total knee replacement during this Healthy Conversations video. He also answers a wide-range of questions about total knee replacement from preparing your home for recovery (hint: roll up those rugs) to leading an active life after a total knee replacement (pickleball, anyone?). Five Signs it’s Time for a Total Knee Replacement Medications – even stronger anti-inflammatory drugs – don’t ease your pain. Dr. Jaume cautions that even over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) – like aspirin and ibuprofen – can be dangerous. These medications can damage your kidneys and liver as well as lead to high blood pressure. Cortisone injections, lubricating injections, physical therapy and other less-invasive treatment options aren’t effective in reducing your pain and inflammation. Dr. Jaume emphasizes that physical therapy is an essential part of a total knee replacement. He recommends physical therapy before surgery to build overall strength and after to ensure a successful recovery. Everyday tasks – dressing, bathing or getting out of a chair – are painful and challenging. Dr. Jaume asks patients if they’re having difficulty performing these and other activities of daily living. A ‘yes’ usually means it’s time for a total knee replacement. Your pain is severe and relentless. “If you experience pain even when you’re not using your knee, that’s a strong indication that it’s time for surgery,” Dr. Jaume says. “Total knee replacement can improve the quality of your life.” You need a walker or cane to get around. But don’t retire these assistive devices, too soon. You’ll need a walker for two-to-four weeks following total knee replacement surgery and a cane until you can walk without a limp. “Total knee replacement is life changing. I know from personal experience,” notes Dr. Jaume. “If you follow your post-surgery plan, you can live a pain-free and active life.” To schedule an appointment with Dr. Jaume, contact Yavapai Regional Medical Group, Orthopedic Surgery at (928) 708-4545 or talk to your primary care provider.
Our Healthcare Heroes Raise their Voices for the COVID-19 Vaccine
Sleeves Up for the COVID-19 Vaccine gives voice to healthcare heroes from Dignity Health, Yavapai Regional Medical Center. The video series features YRMC physicians, nurses, radiologic technologists, support staff and other members of the YRMC team, sharing their experiences of caring for the community during COVID-19. Sleeves Up for the COVID-19 Vaccine includes these dedicated YRMC team members and more: An Emergency Department registered nurse describing the heartbreak of watching long-time married couples say what could be their last goodbyes as one of them is hospitalized with COVID-19. Her words: “It touches a place in your soul that no one else can really understand.” A cardiac rehabilitation nurse recalling the emotion of watching one of her patient’s leave the hospital after battling COVID-19. A physician answering the question, “Can the COVID-19 vaccine give you the virus?“ Several YRMC team members talking about their personal experiences with the COVID-19 virus. “These are only a few of the candid comments from the YRMC family who participated in the Sleeves Up for the COVID-19 Vaccine video series,” says Ken Boush, Director of Marketing and Communications, Dignity Health, Yavapai Regional Medical Center. “Each of these individuals has sacrificed – and in many cases risked their personal health – to care for the community during the pandemic. To a person, they all express their willingness to do this as part of their commitment to their profession and the health of the community.” Follow Dignity Health, Yavapai Regional Medical Center on Facebook for the latest Sleeves Up for the COVID-19 Vaccine videos. You can also view the videos on YRMC’s YouTube page.
Palliative Medicine: A Big Picture Perspective
It’s rare for Palliative Medicine physician Larry Parsons, MD, to meet someone who understands his medical specialty or how it benefits patients with serious illnesses. Dr. Parsons directs inpatient Palliative Medicine at Dignity Health, Yavapai Regional Medical Center and is part of the Palliative Medicine team at Dignity Health, Yavapai Regional Medical Group. A dynamic communicator, Dr. Parsons helps patients and their families understand their medical choices and what they mean. “What I bring to hospitalized patients is a big-picture view of their health status,” says Dr. Parsons. “Heart doctors assess the patient’s cardiac health; kidney specialists focus on the patient’s kidney function; and palliative medicine physicians look at the entire patient. We take a holistic approach to healthcare.” What does the Palliative Medicine holistic approach include? This holistic approach means Palliative Medicine experts consider your physical, emotional, spiritual and family needs, which may include: Managing symptoms (pain, shortness of breath, weakness, fatigue and more) Addressing quality of life issues Alleviating emotional distress, anxiety or depression Assisting with advance directives Arranging for spiritual counseling Explaining and discussing a patient’s clinical status “This takes time,” Dr. Parsons says. “It means getting to know folks, learning what’s meaningful to them, and becoming familiar with their support systems. How is their illness affecting their life? Do they understand their clinical situation? Because I come with time, I can help people explore what’s important to them.” During this episode of Healthy Conversations, Dr. Parsons discusses YRMC’s Palliative Medicine program. He also shares a compelling story about his family’s experience with medical decision making. Palliative medicine is not hospice care A common assumption people make is that Palliative Medicine and Hospice are one in the same. In fact, they are two different services. For example, the Palliative Medicine team works with patients – and their physicians – as they are pursuing medical treatment. Additionally, Palliative Medicine can begin most any time during an illness. Hospice is an option for people who have a life expectancy of less than six months. A comprehensive Palliative Medicine program At YRMC, Palliative Medicine is available for inpatients – people hospitalized at YRMC East or YRMC West – or in the community through Dignity Health, Yavapai Regional Medical Group, Palliative Medicine. According to Dr. Parsons, it’s rare for a Palliative Medicine program to offer both inpatient and outpatient services. “Our community is very fortunate to have Palliative Medicine for hospitalized patients and as an outpatient service,” Dr. Parsons says. “It’s clear that YRMC understands the importance of this type of care for all patients.” If you’re hospitalized at YRMC East or YRMC West, you may request a Palliative Medicine consultation with Dr. Parsons through your attending physician – also called a hospitalist – or contact Dignity Health, Yavapai Regional Medical Group, Palliative Medicine at (928) 775-5567.
Exploring the Gut/Heart Connection with YRMC Cardiologist Phillip Tran, DO
If you have ever had a ‘gut feeling’ about something, you’ve sensed a connection that science is proving true: your gut communicates with the rest of your body. Specifically, research shows that the gut microbiome, or the collection of bacteria that live in the digestive tract, influences a host of bodily functions, including cholesterol metabolism, inflammation, blood pressure, and more. Recent studies suggest that an imbalance in the number and diversity of gut bacteria may even contribute to the development of cardiovascular disease (CVD), a group of conditions that includes atherosclerosis, heart attack, heart failure and stroke. As we learn more about the important role the gut microbiome plays in preserving health and triggering disease, a whole new box of tools for treating and preventing CVD may result. The Gut Microbiome Our bodies host trillions of bacteria that live on and within us, with the largest concentration of bacteria found in the lower digestive tract. These tiny organisms maintain the health of the lining of gut, produce important nutrients, regulate the immune system, and can trigger or reduce inflammation throughout the body. Research suggests that the number, diversity, and balance of different families of bacteria have a direct influence on cardiovascular health. Phillip Tran, DO, Cardiologist at Yavapai Regional Medical Group, is enthusiastic about these discoveries. “We know there are several known and common risk factors for CVD, including smoking, obesity, diabetes, and inactivity. Abnormal gut flora is now being considered another major risk factor. This may open up exciting new modalities for treating and preventing CVD.” Inflammation Inflammation results from a complex series of immune reactions in the body that can be triggered by a host of conditions. Dr. Tran states, “Chronic inflammation is a root cause of cardiovascular disease. An important factor in reducing inflammation in the body appears to be maintaining a healthy population of the bacteria that protect and feed the lining of the gut.” When bacterial populations are healthy and diverse, the lining of the gut, which prevents pro-inflammatory, disease-causing substances from entering the body, remains intact. However, when bacterial populations shift, either through dietary changes, stress, medications, or other causes, the gut lining itself can become damaged and inflamed, thus allowing disease-causing substances to enter the blood stream. This condition, often called leaky gut, may lead to an increased risk of cardiovascular disease. Cholesterol, Blood Pressure and TMAO Some of the most interesting medical research done in the last few years relates to the discovery of a potential link between gut bacteria, diet, increased CVD risk, and a chemical called trimethylamine N-oxide, or TMAO. Dr. Tran describes the connection. “TMA, or trimethylamine, is produced by certain gut bacteria when people regularly consume red meats. TMA is converted to TMAO in the liver, and research suggests that TMAO may increase inflammation in atherosclerotic plaque, decrease the elimination of cholesterol from the body, and indirectly promote increased cholesterol production. Foam cells, which are the cholesterol-filled cells found in plaque, may also increase in number and size under the influence of TMAO.” Several studies from the US and Europe have demonstrated that blood levels of TMAO are often linked to an increased risk of heart attack and stroke. Higher levels of TMAO have also been measured in people suffering from heart failure. Keeping in mind that these correlations do not prove that TMAO causes cardiovascular disease, researchers continue to study this intriguing connection. Prebiotics and Probiotics Several studies have shown that food and supplement-based pre and probiotics may reduce total cholesterol, LDL-cholesterol and inflammation. Prebiotics are plant fibers that feed the health-promoting bacteria living in the gut. These fibers may be one of the reasons why a high fiber, plant-based diet is strongly linked with better blood cholesterol levels, reduced inflammation, and reduced CVD risk. Probiotics include beneficial bacteria, yeasts and fungi, many of which are produced from the fermentation of a variety of foods. Probiotics can be taken as supplements or eaten as a natural part of fermented foods. Some common, probiotic-rich fermented foods include yogurt (dairy or plant based), sauerkraut, kimchi (a spicy Korean condiment), kefir, and kombucha (a type of fermented tea). Dr. Tran thinks we need more research to clarify and prove the benefits of taking probiotic supplements to prevent or treat CVD. He states, “Although many studies suggest that probiotics can favorably alter serum lipids, some human studies examining the benefits of probiotics on serum lipids have shown conflicting results.” Many researchers concur, stating that the science is new and will take time to determine what types and blends of probiotics might be therapeutic for certain conditions, and in what form probiotic supplements should be consumed for the best outcomes. Steps to Improve Gut and Cardiovascular Health Dr. Tran suggests the following steps to improve the health of your gut and possibly reduce your risk of CVD. Maintain healthy intestinal flora by eating a diet rich in high fiber, plant based foods, and by regularly consuming healthy fermented foods. Take antibiotics with caution and care as they kill all bacteria and can promote the growth of unhealthy bacteria in the gut. Supplement with prebiotics and probiotics whenever you take antibiotics. If you have cardiovascular disease, talk to your cardiologist about the potential benefits of pre and probiotics. While the science is not yet clear, boosting a healthy population of gut bacteria may reduce inflammatory processes that trigger cardiovascular conditions.
Apples, Fry Bread and Dignity Health: Present Day Links to Prescott’s Distant Past
Signs of the past are everywhere in Prescott — in beautiful old buildings, apple orchards sprinkled among Ponderosa pines, savory-sweet fry bread served at summer festivals, and even state-of-the art healthcare at Dignity Health, Yavapai Regional Medical Center. We recently stepped back in time at YRMC’s Your Healthy Kitchen, to the late 19th and early 20th centuries, to celebrate the roots of Dignity Health and learn about the food ways of indigenous people and settlers back when Arizona was the American frontier. Mercy Hospital Chapel on Grove Ave The story of Dignity Health begins in Prescott, in 1898, when the Sisters of Mercy opened the doors of Mercy Hospital on Grove Avenue, where the Prescott College Campus exists today. After the hospital burned in 1940, the Sisters decided not to rebuild, but to continue their work at St. Joseph’s, the first hospital built in Phoenix. Last year, the Sisters returned to Prescott, as the sponsoring congregation behind Dignity Health, Yavapai Regional Medical Center. In Prescott’s early days, settlers planted apple trees, which provided fresh fruit and a variety preserved apple products throughout the year. Old recipes for Dutch oven baked apples, dried apple cake, and apple butter attest to the importance of those trees, as does the local tradition of fermenting apple cider, which continues to this day. Fresh apples, applesauce, apple butter, Stoic brand apple cider and apple cider vinegar The Yavapai People were forced to leave their traditional lands and ways of living, hunting, and gathering as Prescott became populated by settlers from the US, China, Mexico and elsewhere. They continued to rely on their creativity and ingenuity to survive on reservation land and grew gardens of corn, squash and beans, harvested native plants, hunted a little, and made the best they could of government commodity foods. Two wonderful guests join me virtually in this episode of YRMC’s Your Healthy Kitchen, so be sure to watch and learn more about indigenous food ways, old apple orchards, and how to make delicious, sugar free apple butter! Click on the link below the video to access the recipe. Apple Butter Recipe If you’d like to learn more about the Museum of Indigenous People, feel free to call them at 928-445-1230 or connect with them on the web at the museumofindigenouspeople.org. While there, you can learn more about the early inhabitants of our area and view a gallery of some of the beautiful items in their collection. To learn more about Stoic Cider and the incredible apple research they’ve been doing, visit their website at stoiccider.com. You can order their cider online and also buy directly from several local distributors in town. And of course, you can always learn more about what we’re up to in Your Healthy Kitchen by visiting yrmchealthconnect.org!
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.
Exploring the Gut/Heart Connection with YRMC Cardiologist Phillip Tran, DO
If you have ever had a ‘gut feeling’ about something, you’ve sensed a connection that science is proving true: your gut communicates with the rest of your body. Specifically, research shows that the gut microbiome, or the collection of bacteria that live in the digestive tract, influences a host of bodily functions, including cholesterol metabolism, inflammation, blood pressure, and more. Recent studies suggest that an imbalance in the number and diversity of gut bacteria may even contribute to the development of cardiovascular disease (CVD), a group of conditions that includes atherosclerosis, heart attack, heart failure and stroke. As we learn more about the important role the gut microbiome plays in preserving health and triggering disease, a whole new box of tools for treating and preventing CVD may result. The Gut Microbiome Our bodies host trillions of bacteria that live on and within us, with the largest concentration of bacteria found in the lower digestive tract. These tiny organisms maintain the health of the lining of gut, produce important nutrients, regulate the immune system, and can trigger or reduce inflammation throughout the body. Research suggests that the number, diversity, and balance of different families of bacteria have a direct influence on cardiovascular health. Phillip Tran, DO, Cardiologist at Yavapai Regional Medical Group, is enthusiastic about these discoveries. “We know there are several known and common risk factors for CVD, including smoking, obesity, diabetes, and inactivity. Abnormal gut flora is now being considered another major risk factor. This may open up exciting new modalities for treating and preventing CVD.” Inflammation Inflammation results from a complex series of immune reactions in the body that can be triggered by a host of conditions. Dr. Tran states, “Chronic inflammation is a root cause of cardiovascular disease. An important factor in reducing inflammation in the body appears to be maintaining a healthy population of the bacteria that protect and feed the lining of the gut.” When bacterial populations are healthy and diverse, the lining of the gut, which prevents pro-inflammatory, disease-causing substances from entering the body, remains intact. However, when bacterial populations shift, either through dietary changes, stress, medications, or other causes, the gut lining itself can become damaged and inflamed, thus allowing disease-causing substances to enter the blood stream. This condition, often called leaky gut, may lead to an increased risk of cardiovascular disease. Cholesterol, Blood Pressure and TMAO Some of the most interesting medical research done in the last few years relates to the discovery of a potential link between gut bacteria, diet, increased CVD risk, and a chemical called trimethylamine N-oxide, or TMAO. Dr. Tran describes the connection. “TMA, or trimethylamine, is produced by certain gut bacteria when people regularly consume red meats. TMA is converted to TMAO in the liver, and research suggests that TMAO may increase inflammation in atherosclerotic plaque, decrease the elimination of cholesterol from the body, and indirectly promote increased cholesterol production. Foam cells, which are the cholesterol-filled cells found in plaque, may also increase in number and size under the influence of TMAO.” Several studies from the US and Europe have demonstrated that blood levels of TMAO are often linked to an increased risk of heart attack and stroke. Higher levels of TMAO have also been measured in people suffering from heart failure. Keeping in mind that these correlations do not prove that TMAO causes cardiovascular disease, researchers continue to study this intriguing connection. Prebiotics and Probiotics Several studies have shown that food and supplement-based pre and probiotics may reduce total cholesterol, LDL-cholesterol and inflammation. Prebiotics are plant fibers that feed the health-promoting bacteria living in the gut. These fibers may be one of the reasons why a high fiber, plant-based diet is strongly linked with better blood cholesterol levels, reduced inflammation, and reduced CVD risk. Probiotics include beneficial bacteria, yeasts and fungi, many of which are produced from the fermentation of a variety of foods. Probiotics can be taken as supplements or eaten as a natural part of fermented foods. Some common, probiotic-rich fermented foods include yogurt (dairy or plant based), sauerkraut, kimchi (a spicy Korean condiment), kefir, and kombucha (a type of fermented tea). Dr. Tran thinks we need more research to clarify and prove the benefits of taking probiotic supplements to prevent or treat CVD. He states, “Although many studies suggest that probiotics can favorably alter serum lipids, some human studies examining the benefits of probiotics on serum lipids have shown conflicting results.” Many researchers concur, stating that the science is new and will take time to determine what types and blends of probiotics might be therapeutic for certain conditions, and in what form probiotic supplements should be consumed for the best outcomes. Steps to Improve Gut and Cardiovascular Health Dr. Tran suggests the following steps to improve the health of your gut and possibly reduce your risk of CVD. Maintain healthy intestinal flora by eating a diet rich in high fiber, plant based foods, and by regularly consuming healthy fermented foods. Take antibiotics with caution and care as they kill all bacteria and can promote the growth of unhealthy bacteria in the gut. Supplement with prebiotics and probiotics whenever you take antibiotics. If you have cardiovascular disease, talk to your cardiologist about the potential benefits of pre and probiotics. While the science is not yet clear, boosting a healthy population of gut bacteria may reduce inflammatory processes that trigger cardiovascular conditions.
Women with Diabetes Have a Greater Risk of Heart Disease than Men
If you are a woman with diabetes, your risk of developing (and dying from) heart disease may be greater than you think. Diabetes seems to erase, or even reverse the protective effect of female gender against cardiovascular disease and heart attack, making women with diabetes significantly more susceptible than men with diabetes. While the reasons for this are not entirely clear, researchers and healthcare providers agree that women with diabetes need more careful prevention, treatment and tracking to protect their cardiovascular health. Women are Frequently Diagnosed with Diabetes at a More Advanced Stage Both type 1 and type 2 diabetes increase the risk of a number of health concerns in men and women, including cardiovascular disease, kidney disease, and neuropathy (nerve damage). The longer someone has diabetes, especially with poor glucose control, the greater the risk of complications. Similarly, the longer someone has prediabetes, when glucose levels are above normal, but not yet in diabetes range, the greater the risk of cardiovascular disease. Research suggests that more than 90% of people with prediabetes don’t know they have it and that women tend to have undiagnosed prediabetes for a longer period of time than men. Additional research suggests that men and women can have elevated blood sugar or insulin levels (a sign of impaired glucose tolerance) for up to 20 years before they are actually diagnosed with diabetes, and that women are often diagnosed with diabetes at a later stage than men. Women Have Different Responses to Disease and Medical Treatment Diabetes may be more damaging to the vascular system in females than in males, at any age. A study following a group of children and adolescents with well-controlled type 1 diabetes discovered that girls were more likely to have heart abnormalities and other indicators of early cardiovascular disease than boys. Indeed, research indicates that women and girls are more susceptible to the cellular and vascular damage caused by elevated blood glucose and low-grade inflammation, a chronic side effect of diabetes. Women may also not respond as well to medical treatment for cardiovascular disease. For example, data suggests that some medications, including those used to reduce blood clotting, may not be as effective in preventing heart attacks in women compared with men. Sub-optimal treatment may be a consequence of women historically being under represented in the clinical trials used to determine the effectiveness and proper dosage of drugs. There may even be disparities in healthcare for women when compared to men. Data indicate that women may be less likely to have their cardiac risk factors assessed by physicians, and are typically not treated as aggressively as men. Most critically, women with diabetes are more likely to die as the result of a heart attack than men. This could be partially due to the fact that women are typically diagnosed with heart disease at a later and more debilitated age, but other factors may also come into play. For example, research from a Scottish study suggests that the blood levels of troponin, a heart muscle protein, that when detected in the blood signals a heart attack, are often lower in women having a heart attack than men. Consequently, a woman having a heart attack may not receive appropriate emergency treatment. In addition, women may not experience classic heart attack symptoms, including pain in the chest, arms, back and jaw, heartburn and shortness of breath. The most common symptom of heart attack women may experience is unusual fatigue. In fact, in one study, women reported deep fatigue and disturbed sleep as much as a month or two before a heart attack. During a heart attack, only about one in eight women report chest pain, and tend to describe it as pressure, aching, or tightness rather than pain. Know Your Risks of Prediabetes, Diabetes and Cardiovascular Disease Considering all of the risks of cardiovascular disease for women with diabetes, researchers encourage women and their healthcare providers to take extra care and precautions; catching prediabetes, diabetes and signs of cardiovascular disease at their earliest possible stages. Women at risk for prediabetes, diabetes and cardiovascular disease include those who: Currently have or have had gestational diabetes Smoke Are inactive Carry extra abdominal fat Have polycystic ovarian syndrome (PCOS) Experience chronic stress Eat a poor diet Have periodontal disease Have a family history of diabetes and cardiovascular disease Some symptoms of diabetes or prediabetes are: Fatigue Depression and mood changes Increased cravings for sweets Sudden weight gain or weight loss Chronic vaginal yeast infections Chronic urinary tract infections Increased hunger, thirst and urination Sexual dysfunction If you have prediabetes or diabetes, check out the services and resources offered at the YRMC Pendleton Center. The Pendleton Center offers excellent classes and individualized counseling for people with prediabetes and diabetes and also has an adult fitness program, featuring a complete gym and large variety of exercise classes designed for people at all levels of fitness, flexibility and strength. Our education and fitness programs are designed to help anyone achieve good blood sugar control and improved fitness, which reduces the risk of cardiovascular disease. For more information, call 928-771-5794.
Our Healthcare Heroes Raise their Voices for the COVID-19 Vaccine
Sleeves Up for the COVID-19 Vaccine gives voice to healthcare heroes from Dignity Health, Yavapai Regional Medical Center. The video series features YRMC physicians, nurses, radiologic technologists, support staff and other members of the YRMC team, sharing their experiences of caring for the community during COVID-19. Sleeves Up for the COVID-19 Vaccine includes these dedicated YRMC team members and more: An Emergency Department registered nurse describing the heartbreak of watching long-time married couples say what could be their last goodbyes as one of them is hospitalized with COVID-19. Her words: “It touches a place in your soul that no one else can really understand.” A cardiac rehabilitation nurse recalling the emotion of watching one of her patient’s leave the hospital after battling COVID-19. A physician answering the question, “Can the COVID-19 vaccine give you the virus?“ Several YRMC team members talking about their personal experiences with the COVID-19 virus. “These are only a few of the candid comments from the YRMC family who participated in the Sleeves Up for the COVID-19 Vaccine video series,” says Ken Boush, Director of Marketing and Communications, Dignity Health, Yavapai Regional Medical Center. “Each of these individuals has sacrificed – and in many cases risked their personal health – to care for the community during the pandemic. To a person, they all express their willingness to do this as part of their commitment to their profession and the health of the community.” Follow Dignity Health, Yavapai Regional Medical Center on Facebook for the latest Sleeves Up for the COVID-19 Vaccine videos. You can also view the videos on YRMC’s YouTube page.
Ventilating the Home During COVID
Home is where we tend to feel the most safe during COVID. Yet when a family member returns from an errand, or someone decides to pay us a visit, virus particles can enter the home and accumulate in the air. That’s why we need good home ventilation to help keep the air clean during the pandemic. To improve ventilation within our homes the CDC and Environmental Protection Agency (EPA) recommend the following measures. Increase ventilation To increase ventilation, bring in as much fresh air as possible: Open windows and screened doors unless doing so poses a safety or health risk to children or other family members (extreme cold, risk of falling, triggering asthma symptoms, etc.). While it’s best to open doors and windows wide, even a slight crack can help. Use a window air conditioner that has an outdoor air intake or vent, with the vent open. Turn on the bathroom fan when the bathroom is in use or run it continuously if possible. Improve the flow Even with an open window or door, natural ventilation is limited when outdoor air is still or when indoor and outdoor temperatures are about the same. To improve natural ventilation: Increase cross-ventilation by opening windows or doors at opposite sides of the home and keeping internal doors open. Open the highest and lowest windows at the same time (especially on different floors). For double-hung windows, open the top sash of one window and the bottom sash of another. Even when using a single window, partially opening both the top and bottom sash improves ventilation. Use indoor fans in combination with open doors or windows to further increase ventilation. Place box fans or tower fans in front of windows. Use multiple fans to push air out one window and in from another. (Face a fan toward the window to blow suspect air out, away from the window to bring fresh air in.) Make sure fans don’t blow air directly from one person to another to reduce the risk of airborne transmission. Put your HVAC to work Since HVAC systems filter the air they circulate, they can help reduce airborne contaminants, including viruses. If you have an HVAC system: Run the system fan for a long as possible or even continuously. HVAC systems only filter the air when the fan is running. Most fans can run without the heating or cooling function. Make sure the filter is correctly in place and consider upgrading to the highest-rated filter your system can manage. If your HVAC system has one, use the energy-efficient air-to-air heat exchanger, heat recovery ventilator (HRV) or energy-recovery ventilator (ERV). These help increase ventilation. Consider a portable air cleaner While HVAC systems filter air throughout the home, portable air cleaners—also known as air purifiers or air sanitizers—filter air in a single room or area. When combined with other best practices recommended by the CDC, they help can protect your home. The Environmental Protection Agency (EPA) provides extensive information on air cleaners and air filters for the home.
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.
Your Blood, Your Call
Patient Blood Management (PBM) is a multi-disciplinary approach to maximizing your own blood health and supply. Often this is most crucial during surgery. When large amounts of blood are lost in surgery, it is often possible to get the blood you need by electing to use your own blood. Not blood from a donor, not blood limited by type. And not blood straining the nation’s precious blood supply. (This is especially important during COVID-19 when national blood banks have experienced a drop in donations, which in turn reduces blood supply and drives up blood costs.) The decision is yours—the YRMC PBM program hinges on informed consent. Meaning you have the right to be informed of your choices. Then you have the right to choose to optimize and/or use your own blood (captured and reinfused during surgery), receive someone else’s blood, or receive a combination of both when necessary. It’s your blood, your call. Based on your decision, a team of medical professionals will assess your blood management needs and develop a clinically sound, evidence-based plan of care during your hospital stay. This plan marshals pharmaceuticals, technology and medical techniques to decrease blood loss and enhance blood cell production—which reduces or eliminates the need for a blood transfusion. Progressive Leadership Yavapai Regional Medical Center (YRMC) has the only officially recognized PBM program in Arizona and one of the relatively few in the nation. When it comes to PBM, your local hospital is doing some of the highest caliber work in the country and even the world. That’s why YRMC hosts an annual PBM Symposium in Prescott, an event viewed internationally and presented by some of the world’s leading PBM experts. How did this happen? “We owe our PBM program to progressive leaders and top-notch medical professionals at our hospital,” said PBM Program Coordinator Dale Black. The program started in 2012 after Black and Pierre Tibi, MD broached the subject with hospital administrators. “It never would have happened without leadership’s forward-thinking mindset and ongoing commitment over the past eight years,” Black said. “In less than a decade we’ve become part of a worldwide initiative that uses evidence-based science to achieve better patient outcomes using blood management principles.” Today Dr. Tibi is a leading authority on PBM and serves as the Medical Director of the YRMC PBM Program and The James Family Heart Center. Better Outcomes While blood transfusions remain a vital life-saving procedure, growing evidence shows that patients who maximize their own blood supply benefit from: lower infection rates. less anemia. fewer kidney, lung and heart complications. less exposure to viruses and other blood-borne disease. shorter hospital stays. all-around better surgical outcomes. A Continuum of Care YRMC’s PBM program provides you with care and support before, during and after surgery. Presurgical measures center on optimizing red blood cell mass to prevent anemia. This may involve iron therapy, a vitamin regime, nutritional support and medication management. Erythropoietin-stimulating agents (ESAs) may be administered via a shot to stimulate the production of additional red blood cells. Surgical techniques may include removing a calculated amount of blood, adding non-blood expanders, and reinfusing red cells back to the patient. Or they may include cell-salvage, collecting blood lost during surgery—then washing, filtering and reinfusing red blood cells back to the patient. Hemostatic agents may be used to promote rapid blood coagulation. Postsurgical procedures include detecting and mitigating bleeding, minimizing the frequency and volume of blood draws, nutritional support, and continued iron therapy, possibly in conjunction with ESA administration if appropriate. The next time you are scheduled for surgery at YRMC, be sure to ask about Patient Blood Management, or PBM. For more information you can also contact Dale Black directly at dblack2@yrmc.org or (928) 771-5109. You can also visit the Society for the Advancement of Blood Management and download their Patient Guide.
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.
Is Interventional Radiology Right for You?
Medical innovation moves forward at a rapid pace, with continuing technological advances and an ever-increasing understanding of health and the human body. Interventional Radiology may be one of the best examples of this phenomena. Thanks to this highly specialized medical field, procedures that once required surgery, a hospital stay, and extensive recovery time are now being performed on an outpatient basis using minimally invasive techniques. In fact, most of the procedures are performed without an incision. Interventional Radiology (IR) combines the use of advanced imaging such ultrasound, X-rays, CT scans and MRI to guide the treatment of a variety of conditions. Interventional Radiologists are board-certified physicians who are trained in both radiology and minimally invasive therapies. They treat conditions in virtually every organ system, including: Blood vessels Nervous system Reproductive system Gastrointestinal tract Liver Urinary tract Cardiovascular disease Cancer Dialysis access Back pain Leg pain and swelling Dr. Matthew Dicker is a Diagnostic and Interventional Radiologist with Yavapai Regional Medical Center. He emphasizes that a team approach delivers the best care for his patients. “Taking care of each patient starts with our office staff and administrative staff at the hospital. A great group of nurses and technologists help before, during and after each procedure,” Dicker says. “And of course, collaboration with the hospitalists and vascular surgeons as well as primary care providers creates the best possible 360-degree care for the patients in our community.” Dicker explains that Interventional Radiologists are consultants to virtually all of the specialties and subspecialties at YRMC, in addition to performing procedures specific to each. “Having the expertise to perform these procedures and having the facilities and support staff to perform them is a great benefit to the Quad Cities,” says Dicker. “The hassle of driving to Phoenix or elsewhere is no longer necessary.” As with the practice of medicine in general, Interventional Radiology continues to keep pace with ever-developing research and technology. “New and different ways to treat disease are happening almost daily,” Dicker notes. “We strive to perform the newest treatments safer than before. For instance, opening blockages in the leg arteries is being performed with access through the ankle as opposed to the groin where it had been typically performed, which significantly decrease the risk of bleeding while having the same excellent results.” “We are excited to introduce intravascular lithotripsy to break up plaque in the arteries that causes blockages,” he continues. “It uses the same technology that has been used for years to break up kidney stones.” Interventional Radiology allows for a quicker recovery time, less pain, reduced cost and a lower risk of complications. If you are a candidate for surgery, talk to your healthcare provider to see if an Interventional Radiology procedure makes sense for you as an alternative. “It is rewarding when a procedure is successful, a patient is happy with the results, and they are surprised that it was done without an incision with very little if any pain,” says Dicker. Click here to learn more about YRMC Imaging Services.
Musculoskeletal Radiologist Dr. Warren Spencer Joins the YRMC Team
Dignity Health, Yavapai Regional Medical Center (YRMC) is pleased to introduce Musculoskeletal Radiologist Warren Spencer M.D. to the Quad City area. Dr. Spencer has joined the team at YRMC, specializing in medical imaging of the extremities, specifically the joints, bones and muscles. “When a patient comes in for an x-ray, ultrasound, CT, or MRI of a bone or joint, it will be interpreted by a board-certified radiologist. I serve as a reference for other radiologists when unique or challenging musculoskeletal cases present themselves,” explains Dr. Spencer. “The majority of musculoskeletal studies that I interpret are related to arthritis or trauma that occur in the spine and joints,” he continues. “For example, many people in our community suffer from painful joint disease as a result of trauma or age-related wear and tear. Proper diagnosis and care will extend the quality of life for many of our aging population.” Working closely with YRMC orthopedic surgeons, pathologists, general practitioners and emergency department physicians, Dr. Spencer specializes in all varieties of disease of the musculoskeletal system, including trauma, sports medicine, arthritis, and bone and soft tissue tumors. “Each day at YRMC, I interpret imaging for patients in inpatient and outpatient settings, as well as in the emergency department,” says Dr. Spencer. “I also perform image-guided procedures, which include biopsies, injections and fluid drainages. I particularly enjoy interpreting musculoskeletal MRI.” Dr. Spencer earned his medical degree from the Medical School of Wisconsin and completed his Internship at Wheaton Franciscan Healthcare St. Joseph’s Hospital in Milwaukee, Wisconsin. Both his residency training in Diagnostic Radiology and Fellowship in Musculoskeletal Radiology were completed at the University of Iowa Hospitals and Clinics in Iowa City. Dr. Spencer is certified by the American Board of Radiology and he practiced as a Radiology Specialist in Iowa for six years. He is also a member of the American College of Radiology and the Radiological Society of North America. Originally from Utah, Dr. Spencer chose to move to Prescott because of the collegial and collaborative environment among the physicians at his practice. In addition, he and his family were drawn to the quality of life in the Prescott area. “Prescott reminds me of my hometown in Utah, with beautiful scenery and temperate weather. Moving from the Midwest, we have enjoyed being in closer proximity to extended family.”
Apples, Fry Bread and Dignity Health: Present Day Links to Prescott’s Distant Past
Signs of the past are everywhere in Prescott — in beautiful old buildings, apple orchards sprinkled among Ponderosa pines, savory-sweet fry bread served at summer festivals, and even state-of-the art healthcare at Dignity Health, Yavapai Regional Medical Center. We recently stepped back in time at YRMC’s Your Healthy Kitchen, to the late 19th and early 20th centuries, to celebrate the roots of Dignity Health and learn about the food ways of indigenous people and settlers back when Arizona was the American frontier. Mercy Hospital Chapel on Grove Ave The story of Dignity Health begins in Prescott, in 1898, when the Sisters of Mercy opened the doors of Mercy Hospital on Grove Avenue, where the Prescott College Campus exists today. After the hospital burned in 1940, the Sisters decided not to rebuild, but to continue their work at St. Joseph’s, the first hospital built in Phoenix. Last year, the Sisters returned to Prescott, as the sponsoring congregation behind Dignity Health, Yavapai Regional Medical Center. In Prescott’s early days, settlers planted apple trees, which provided fresh fruit and a variety preserved apple products throughout the year. Old recipes for Dutch oven baked apples, dried apple cake, and apple butter attest to the importance of those trees, as does the local tradition of fermenting apple cider, which continues to this day. Fresh apples, applesauce, apple butter, Stoic brand apple cider and apple cider vinegar The Yavapai People were forced to leave their traditional lands and ways of living, hunting, and gathering as Prescott became populated by settlers from the US, China, Mexico and elsewhere. They continued to rely on their creativity and ingenuity to survive on reservation land and grew gardens of corn, squash and beans, harvested native plants, hunted a little, and made the best they could of government commodity foods. Two wonderful guests join me virtually in this episode of YRMC’s Your Healthy Kitchen, so be sure to watch and learn more about indigenous food ways, old apple orchards, and how to make delicious, sugar free apple butter! Click on the link below the video to access the recipe. Apple Butter Recipe If you’d like to learn more about the Museum of Indigenous People, feel free to call them at 928-445-1230 or connect with them on the web at the museumofindigenouspeople.org. While there, you can learn more about the early inhabitants of our area and view a gallery of some of the beautiful items in their collection. To learn more about Stoic Cider and the incredible apple research they’ve been doing, visit their website at stoiccider.com. You can order their cider online and also buy directly from several local distributors in town. And of course, you can always learn more about what we’re up to in Your Healthy Kitchen by visiting yrmchealthconnect.org!
Bonita Wilson, RN, Empowers People with Diabetes to Live Longer, Healthier Lives
Healthcare organizations around the world are celebrating the important role nurses play in helping people with diabetes to live longer, healthier lives. After all, multiple studies show that when nurses and diabetes educators work alongside physicians as part of a healthcare team, people with diabetes are more likely to reach their blood sugar goals, have fewer complications, feel more in control, and experience much less diabetes-related stress. To honor and recognize the nurses, educators, and people with diabetes in our community, we invited Bonita Wilson, Registered Nurse and YRMC Diabetes Educator to the set of YRMC’s Your Healthy Kitchen via Zoom, to talk about her work and prepare an easy, delicious, diabetes-friendly meal! Grilled Fish with Salsa Fresca Recipe Prior to our video chat, Bonita shared what she enjoys about her job. “I love making a difference and am continually inspired by the people who live long, healthy lives with diabetes. Life can be challenging for all of us sometimes, so imagine having diabetes on top of the everyday ups and downs we all face. I am impressed by the strong, resilient people living with diabetes in our community. They inspire me each day to be a great nurse and diabetes educator”. Diabetes educators are healthcare professionals who apply their in-depth knowledge to help patients manage the daily and future challenges of diabetes. As part of a healthcare team, diabetes educators provide individualized counseling and classroom-based education related to every aspect of diabetes management, including diet, physical activity, medications, monitoring and stress management. Studies show that the more informed people with diabetes are about the disease, the more likely they are to maintain their health and avoid long term complications, including cardiovascular disease, kidney failure and neuropathy. Remember, one in every three Americans currently has, or is at risk for developing diabetes, so talk to your healthcare provider about your risks of developing the disease. If you have diabetes or pre-diabetes, get more information and connect with YRMC’s Diabetes Education Program at 928-771-5794 in Prescott and 928-759-5920 in Prescott Valley.