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.”  

Brighten the holidays with these 12 healthy holiday tips from Yavapai Regional Medical Center and the Centers for Disease Control (CDC). These little nuggets of conventional wisdom may remind us of small things our mothers used to say, things we too often forget. But put into practice these tips really can improve both our health and happiness during the weeks surrounding the holidays. Be good to yourself. If you feel stressed out or overwhelmed by the holidays it is important to carve out a little time just for you. Because without enough sleep, human support and community interaction stress can indeed jeopardize your health. Remember the children. With all the activity going on it’s important to identify toys, food, drinks or other household items that may prove dangerous to kids. Also important are extra measures taken to protect them from accidents like drowning, burns and falls. Wash those hands. You can help combat germs by using lots of soap and rinsing hands under warm water for at least 20 seconds. This takes a serious bite out of those pesky, contagious bugs. Practice food safety. Remember to keep hands and surfaces clean, avoid cross-contamination, refrigerate foods promptly, and cook foods to proper temperature. Try to maintain a healthy weight. You can enjoy those holiday treats with less guilt by increasing your physical activity. It’s a matter of calories consumed vs. calories burned—and keeping consumed calories as nutritious as possible. So think more good calories, less bad calories like those found in fat, salt and sugar. Bundle up. When venturing out in the cold wear light, warm layers, gloves, hats, scarves and waterproof boots. It will help you stay warm and dry, while also helping keep winter illnesses at bay. Buckle up for safety. Put on the seat belt, no matter how short the drive is, and ask the same of passengers. Also follow height, weight and age guidelines to properly secure children in car seats, booster seats and seat belts. Choose not to drink and drive and help others do the same. Because to do otherwise puts everyone on the road in danger. Keep up with vaccines. Make sure everyone in the family is current on vaccinations, especially the annual flu vaccine, by paying a visit to your healthcare provider. Stay on top of exams and screenings. So along with vaccines, ask your healthcare provider about all the screenings and exams recommended for you and your family and whether they are up to date. Avoid smoking and secondhand smoke as much as possible. Because cigarette smoke heightens health risks for everyone exposed. Practice fire safety. Most residential fires occur during the winter months, so keep an eye on stoves, fireplaces, space heaters and candles. Also have an emergency plan in place and make sure everyone is prepared to use it. Please follow these tips and have a happy, healthy Holiday Season 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.

Did you know that early detection of lung cancer saves lives and that lung cancer screening services are available at YRMC?  To raise awareness of the vital role regular imaging plays in lung cancer survival, we invited Jennifer Harvey, Nurse Navigator, Lung Cancer Screening and Care at YRMC, onto the set at YRMC’s Your Healthy Kitchen!  Jennifer supports and guides individuals at risk for lung cancer through the screening process and offers support to those who are trying to quit smoking.  In the kitchen together, we talked about who might benefit from regular lung cancer screening, as well as strategies to help with the food and weight challenges people often face when they quit smoking.  Of course, we also made a delicious, nourishing meal, filled with flavorful ingredients that just happen to help our bodies heal and detoxify from nicotine! Lung cancer is the second leading cause of cancer-related deaths for men and women, according to the American Cancer Society.  In fact, more people die annually of lung cancer than cancer of the colon, breast and prostate combined.  While both smokers and non-smokers can develop lung cancer, the risks are much greater for past and present smokers.  Lung cancer screening is designed to catch cancer at its earliest stages, when survival is most likely, in those who are most at risk.  Join us as Jennifer explains the criteria that define high-risk individuals, talks about her role as a Nurse Navigator, and shares what inspires her at work, everyday. Recipe: Whole Grain Spanish Rice Statistics show that many people (but not all) do gain weight after smoking cessation.  However, the health risks of smoking far outweigh the downsides of weight gain — so don’t let the scale stop you from quitting!  Also, developing a healthy relationship with food, the stressors in your life, and your body can be some of the greatest gifts of smoking cessation. Simple tips that can reduce the amount of weight you might gain after saying goodbye to cigarettes include: When you eat, just eat. Taking time out for meals and snacks and eating them without distraction (i.e. no TV, work, computers, phones, etc.) will increase your sense of satisfaction and ‘fullness’ after eating, improve calorie burning, and reduce your cravings for sweets and snacks throughout the day and night. Instead of snacking on sweets or processed foods like chips or pretzels, consider creating snacks that resemble little meals. A small meal that includes fruit or vegetables, some protein (chicken, fish, meat, eggs, beans or nuts), carbohydrate (whole grain products, fruit, or beans) and healthy fat (avocado, nuts, seeds, or olive oil) will satisfy your taste buds as well as your belly and your brain.  Check out this episode of YRMC’s Your Healthy Kitchen for great snack ideas! Experiment and discover how physical activity helps you move through and reduce stress, fatigue, boredom and food cravings! It’s important to find a way to move your body that is enjoyable, not stressful.  Do you like walking in nature or around your neighborhood?  How about dancing, alone or with others?  Working in the yard or garden, going to a gym, taking gentle or vigorous exercise classes, doing yoga or Tai Chi, or even standing, stretching, and walking in place at regular intervals during the day qualifies as healthy movement that can reduce stress-related eating. Eat a larger meal in the middle of the day and a smaller meal at night. Most people burn more calories between noon and 2 pm, so it makes sense to eat more food at lunch! For other great tips on successfully navigating the challenges of smoking cessation, check out all of the resources available from the American Cancer Society and consider joining thousands of other Americans who have decided to quit on November 21st for The Great American Smokeout! Remember to also check out all of our informative videos and easy, delicious recipes at YRMC’s Your Healthy Kitchen!  Our site now includes an easy link to Your Healthy Kitchen’s YouTube Channel, where you can easily view and access our entire library!  You can access these at https://www.yrmchealthconnect.org/your-healthy-kitchen/.