Dr. Anil Kumar: Why Worrying About Your Varicose Veins is Not Vain
Varicose veins are more than a cosmetic issue, according to Anil Kumar, MD, ABVLM, RPVI, RPhS, FACC, FSVM, Medical Director of The Vein Center at YRMC in Prescott Valley. “Varicose veins are a potentially dangerous health issue that people often overlook,” Dr. Kumar said. “Without treatment, symptoms may progress and severely impact your quality of life. It’s our mission to educate and treat people about all aspects of vein health at YRMC’s Vein Center.” Dr. Kumar shares practical information on vein health during Varicose Veins – More Than a Cosmetic Issue. An accomplished vein specialist and vascular medicine physician, Dr. Kumar talks about: Strategies to prevent varicose veins and other vein disorders. Signs of vein disease that are often misunderstood, or worse, misdiagnosed. Factors that increase your risk for vein disease (some you can control and others you can’t). The latest treatments for vein disease, from compression stockings to advanced procedures. Dr. Kumar even shares this “tip sheet” for healthy legs and good circulation. Subscribe to YRMC HealthConnect to keep up-to-date on Healthy Conversation topics or check out our calendar. You can register for future presentations or watch past presentations here.
Budget-Friendly, Delicious Pantry Meals: Ready to Eat in 20 Minutes!
Canned tomatoes and garbanzo beans are two staples I always stock in my pantry. With these simple ingredients, plus a handful of fresh herbs and vegetables, I can create a delicious variety of meals that follow the seasons and fit into my budget. Check out this recent YRMC’s Your Healthy Kitchen video, where I put together two nourishing and comforting recipes using canned tomatoes and garbanzos, in about 20 minutes! Chickpeas and Bowties Recipe Creamy Tomato Carrot Soup Recipe Homemade meals are usually budget-friendly and nutritionally superior to prepared foods in many ways. For example, a typical can of tomato soup contains 8 grams of added sugar (which is equivalent to two added teaspoons of sugar per cup), and 480 mg of sodium. Low sodium varieties of tomato soup do score better, at 30 mg of sodium per 7.25 ounces, but the added sugar content is higher. If you buy a case of Campbell’s Low Sodium Tomato Soup, the bulk discount cost averages around $1.65 for a little less than one cup. Compare that to my homemade tomato soup and you’ll see that home-cooked is a bargain at $1.70 for a two cup serving! My homemade tomato soup is nutritionally superior as well, with no added sugar and comparable amounts of sodium, at approximately 7 mg per ounce vs. 5 mg per ounce for a can of low sodium Campbell’s Tomato Soup. A comforting cup of homemade tomato soup Of course, nothing beats the taste of homemade meals, where you control the quality of your ingredients as well as the type and amount of flavorings you add. For more ways to cook delicious, easy meals at home, remember to visit our collection of videos and recipes at YRMC’s Your Healthy Kitchen. All of our recipes include nutrient-packed, affordable, and local ingredients, plus easy to follow instructions. You can also follow me on Facebook at YRMC’s Your Healthy Kitchen, to see what I am making at home, get insider tips and link to some of my favorite food and nutrition destinations on the web.
Presenting GoNoodle: Good Energy at Home!
As the Quad-Cities’ GoNoodle Plus sponsor for schools and families, Yavapai Regional Medical Center is excited to announce the launch of GoNoodle: Good Energy at Home, a free online resource for our community. Whether it is the joy of a family dance party, the calming of a mindfulness video, or learning how to stop the spread of germs, we are engaging kids and their parents in fun ways to stay healthy and active while they spend more time at home. GoNoodle: Good Energy at Home offers a variety of activities, including movement videos, printable downloads, and offline activities – with new resources posted every week. You can sign up at https://www.GoNoodle.com/goodenergy for regular updates.
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.
For Good Health and Great Flavor, Spice Up Your Meals with this Award-Winning Salsa!
Jim Vorves is one of many multi-talented employees who walk the halls at YRMC. As a talented cook, musician and Desktop Support Manager for YRMC’s Information Systems Department, Jim qualifies as a true Renaissance man! He kindly joined me on the set of YRMC’s Your Healthy Kitchen to share one of his award-winning salsa recipes, and talk about the dedicated folks who keep everyone connected at YRMC. FYI: Don’t worry if you don’t like a lot of spice. Jim also shares his mild salsa recipe, for those of us who don’t do well with heat but still love the taste of salsa. Flaming Gringo Salsa Recipe Capsaicin (cap-SAY-sin) is the chemical that gives chilies their heat and fire. It is concentrated, but not limited to, the tissues around the seeds of chilies, where it likely protects the plant from pests and disease. In a neat twist of co-evolution, many of the chemicals (called phytochemicals) that plants produce to protect themselves from harm also protect and support the health of humans. This is certainly the case with capsaicin, as research shows that this spicy phytochemical: Improves insulin sensitivity and lowers blood glucose after meals Reduces inflammation throughout the body Lowers the risk of cardiovascular disease through anti-inflammatory and antioxidant activity Impairs the growth of H pylori, the bacteria that can cause stomach ulcers Capsaicin is found only in chilies that are spicy. The more spice, the more capsaicin, so the hotter you like your salsa the better! However, if you don’t like it hot, or for health reasons can’t tolerate chilies, there are many other beneficial nutrients in Jim’s hot and mild salsas. These include: Vitamin C Potassium Fiber Other important phytochemicals including: Lycopene, beta-carotene, and quercitin, all of which are antioxidants that protect against chronic illnesses such as cancer, cardiovascular disease, and diabetes. For more delicious ways to incorporate beneficial fresh herbs, spices and lots of flavor into your meals, remember to visit our collection of videos and recipes at YRMC’s Your Healthy Kitchen. All of our recipes include photochemical- and nutrient-packed, affordable, and local ingredients, plus easy to follow instructions. You’ll find nutrition information and cost per serving featured on every recipe as well. You can also follow me on Facebook at YRMC’s Your Healthy Kitchen, to see what I am making at home, get insider tips and link to some of my favorite food and nutrition destinations on the web. Until next time, eat well and spice up your meals for health!
YRMC’s Lung Cancer Screening and Care Program: Early Detection is Saving Lives
Starr Herridge left her home one morning to go to the mall, a familiar trip where she regularly picked up her cigarettes. But on this particular morning in 2012, Starr decided to pull in to the neighborhood drug store instead, and found herself purchasing smoking cessation patches. Starr laughs, “I guess I was lazy – I didn’t want to go all the way to the mall!” “Once I retired, I started smoking so much more,” Starr admits. “When I was working, it wasn’t so bad because I wasn’t allowed to smoke at work. But I didn’t know what to do with myself at home and I ended up smoking all day long. I knew I had to do something.” Thankfully, the patches worked, and Starr has been a non-smoker ever since. Fast forward to 2018, when Starr’s primary care physician recommended a Medicare well-clinic health screening. Given Starr’s history of smoking, it was recommended that she get a low dose CT lung scan. Starr figured it couldn’t hurt. She went to Yavapai Regional Medical Center where she qualified for free annual lung screenings through the Lung Cancer Screening and Care Program. “YRMC’s Lung Cancer Screening and Care Program follows people generally between the ages of 55 and 77 who are at a higher risk for lung cancer due to a history of smoking,” explains Jennifer Harvey, RN, BSN, Patient Navigator at the YRMC Lung Cancer Screening and Care Program. “The screening uses a CT scan with a lower dose of radiation to take very detailed pictures of the lungs to detect cancer in its early stages, which allows for a greater chance for a cure.” “I first met Starr in July, 2018 when she came to the program,” says Harvey. “The first thing you notice is her sense of humor and her kind, humble heart!” The Lung Cancer Screening and Care Program is covered by private insurance and Medicare for people who meet certain criteria, including: Age 55-77 Current smoker or quit within 15 years 30 smoking pack years (1 pack a day for 30 years) Harvey notes that you need an order from your provider, so a good starting point is to talk to them first. In addition, a cash pay, discounted rate is available for those who do not qualify for insurance coverage. “My job is to provide information, answer questions and interpret what each individual patient needs,” says Harvey. “The whole idea from the very start is that everyone is in a different place. I followed Starr’s case and checked in occasionally to see how she was doing.” A year later, one of Starr’s regular screenings showed a very tiny nodule on one of her lungs. Although Starr showed no symptoms at all, her physician wanted to do a biopsy to be sure. However, the nodule was so small that it was impossible to biopsy. Starr and her doctor discussed Starr’s options. “I said let’s just go in there and get it out!” Starr recalls with her signature enthusiasm. “Within three weeks, I was in the hospital.” “I saw Starr after the surgery. She did great!” says Harvey. “The biopsy tested positive for cancer, but the good news was that the margins were clear, which means that everything around it was negative. This is exactly what you hope for, and it was made possible because we caught it so early.” Starr now goes in for follow-up CT scans every four months. She considers herself an advocate for screening and early detection. “I always tell people, why wait until you have a symptom? It takes thirty minutes out of your life, it doesn’t hurt, you don’t get undressed, and you just get up and go. Plus, It’s free, and I like free!” After a pause, Starr’s tone becomes more serious, “We got rid of the cancer before I became sick. I didn’t have to endure chemo or radiation because I went in early and they got all of it. It saved my life.” “Of course, quitting smoking is the most important thing you can do to reduce the risk of lung cancer,” says Harvey. “But that risk is still about three-fold in comparison to people who have never smoked, even 25 years after quitting. The value of regular screenings can’t be overstated.” So why don’t more people participate? “One of the biggest reasons people are reluctant is that they just don’t want to know,” explains Harvey. “We find this largely in people who are currently smoking. It’s hard to hold up a mirror to what smoking has done to their bodies. Another comment we hear is, ‘Well, I feel fine. I don’t need to do this.’ The truth is, the vast majority of lung cancer symptoms don’t appear until later stages.” “The great news is that the survival rate of lung cancer is on its way up. There are now more treatment options besides surgery, radiation and chemotherapy. What was considered a poor prognosis tens years ago may hold a lot more hope now, thanks to immunotherapies and targeted therapies,” says Harvey. The other important factor is that smokers and former smokers like Starr are becoming more aware of the life-saving benefits of early-detection programs like the Lung Cancer Screening and Care Program at YRMC. “My health is so important to me because I love life. I have two sisters, and I love being with them. I have a great group of friends – some are even from high school.” Starr continues. “Plus, I have a dog sitting business that I love. Dogs just love you unconditionally. I provide a great service to my clients, and just have a ball with the dogs!” For more information on the Lung Cancer Screening and Care Program at YRMC, call Jennifer Harvey, Patient Navigator at (928) 771-5454 or visit YRMC’s Website.
Tips for Transitioning to a Plant-Based Diet from YRMC Nutritionist Danyelle Schott
What’s the easiest way to ensure you’re getting the nutrients you need from a plant-based diet? “Enjoy the rainbow,” said Danyelle Schott, Certified Nutritionist and Certified Personal Trainer at Yavapai Regional Medical Center (YRMC). “The more colors – like red apples, orange peppers, green kale and purple grapes – the greater variety of important nutrients in your diet.” Danyelle calls this “nutrient density,” meaning food that’s high in nutrients but relatively low in calories. These kinds of foods contain vitamins, minerals, complex carbohydrates, lean protein and healthy fats. If you’re exploring a vegan diet – one without animal products, including meat, eggs and dairy – Danyelle says you can find needed protein in foods like oats, almonds and pumpkin seeds. Looking for an egg substitute for the muffins you’re making? You can substitute overripe bananas or pureed fruit for the eggs. There are more ideas on these flyers on plant-based eating. Watch Danyelle’s YRMC Healthy Conversations presentation, Plant Based Eating for Healthy Living, to learn how you can transition to a plant-based diet. (Meatless Mondays, anyone?) During the presentation, Danyelle even shares two of her favorite recipes for a veggie bake and a burrito. Subscribe to YRMC HealthConnect to keep up-to-date on our livestream topics or check out our calendar. You can register for future presentations or view past presentations at YRMC HealthConnect.
Learn from Your Laptop (or other device) with YRMC’s Healthy Conversations
There are lots of Healthy Conversations on the horizon thanks to Yavapai Regional Medical Center’s (YRMC’s) new virtual speakers bureau, which launches July 15 on YRMC HealthConnect. “This is a new era in how people will participate in and access YRMC’s high-quality health education presentations,” said Ken Boush, YRMC’s Director of Marketing and Communications. “We believe people will find that livestreaming on YRMC HealthConnect is an easy, fun and convenient way to enjoy YRMC’s exceptional speakers bureau presenters and topics.” Joining a Livestream Presentation Here’s how to join a YRMC livestream presentation: Visit YRMC HealthConnect. Go to the “Events” tab and then select “Calendar” for a menu of upcoming speakers and topics. Register for the presentations that interest you. Join the livestream presentation on its scheduled date and time by going to the “Events” tab on YRMC HealthConnect and selecting Healthy Conversations. “Anyone who is livestreaming a Healthy Conversations presentation will be able to submit questions to our presenter from the comfort of their home,” Boush said. “The presenter will respond to questions during the program. We’re anticipating robust and interesting interactions between our virtual audience and expert presenters.” Register for Upcoming Livestream Presentations One of YRMC’s most popular topics will kick off its livestream presentations. Register here for this upcoming presentation on plant-based eating. Wednesday, July 15, 1:00 – 1:30 pm – Plant Based Eating for Healthy Living, Danyelle Schott Dumas, Certified Nutritionist, Certified Personal Trainer and Health Coach Check back soon to register for these livestream presentations: Wednesday, July 29, 11:30 am – Noon – Varicose Veins: More Than a Cosmetic Issue, Anil Kumar, MD, Medical Director of the Vein Center at YRMC Thursday, August 13, 10:30 – 11 am – Self-Care Tips for Living with Chronic Pain, Cheryl Van Demark, PT, Physical Therapist Wednesday, August 26, 11:30 am – Noon – Swallowing Issues: Things to Consider, Courtney Brimm, MS, CCC-SLP, Speech-Language Pathologist Finding Past Presentations Can’t join the livestream presentation? Previous presentations will be available on YRMC HealthConnect. “YRMC is delighted to offer Healthy Conversations,” Boush said. “It’s a great way to provide the people of Yavapai County with convenient access to our knowledgeable team of healthcare providers.” To receive information about future livestream presentations, subscribe to YRMC HealthConnect.
What does Breast Cancer Feel Like?
Juliann Reiland, MD, FACS, a breast surgeon for the past two decades, has felt her fair share of breast cancers. To show women who ask what breast cancer feels like, Dr. Reiland, YRMC PhysicianCare Breast Surgery, carries a small, jagged, gravel rock in her pocket. Dr. Reiland carries this small rock with her to demonstrate for women what breast cancer feels like. While Dr. Reiland recommends annual screening mammograms and yearly clinical breast exams, she also advises patients to understand the usual look and feel of their own breasts, so they can report anything that feels abnormal. “The breast tissue under the skin is lumpy-bumpy stuff, similar to oatmeal or tapioca pudding,” Dr. Reiland explained. A lump that moves easily and feels smooth and round, like a pea, a grape, or even a Hot Tamale candy, is more likely to be a non-cancerous cyst or fibroadenoma. But a lump that feels like a hard rock, with jagged, irregular edges, and doesn’t move easily is more likely to be a cancer. “The stone I carry is one centimeter, smaller than the length of a dime. One centimeter is about the smallest cancer that can be felt with a breast exam.” Imitate a Mammogram Dr. Reiland advises that when women do a self-breast exam, they should try to imitate a mammogram as much as possible. Juliann Reiland MD, FACS, of YRMC PhysicianCare Breast Surgery. “A mammogram compresses or flattens out the breast tissue. Normal breast tissue, like oatmeal or tapioca, will flatten, but a cancer, like that rock, won’t flatten,” she said. Once a month, she recommends women lie flat on their back with their arm over their head, elbow close to their ear. “This allows the breast tissue to spread out and flatten. Then, keeping the fingers of the opposite hand close together to form a paddle, press down on the breast skin, trying to flatten the breast against the chest wall,” Dr. Reiland explained. “Your fingertips are more sensitive, and will feel all the normal lumps and bumps. It’s the action of trying to flatten out the breast tissue that helps abnormal lumps stand out.” The last part of your monthly self-breast exam, is to stand in front of a mirror to look at your breasts. Raise your arms over your head. (It’s normal to have one breast larger than the other). You are looking for dimples or puckering of the skin. Report any Changes Anything you believe is new or different should be reported to your healthcare provider. If you haven’t had a mammogram in a year, a diagnostic mammogram will be ordered. Often, ultrasound is used to look in the area of the lump you can feel. There are many tools used to identify breast cancer. Mammograms, the first tool, are excellent at seeing cancers too small to feel. This is why they are so important as a yearly screening. But even mammograms aren’t perfect, missing about eight to 15 percent of the breast cancer we can feel. So, even if your mammogram is normal and you feel a lump, you need to report it. There are other tests to look at breasts in different ways than mammograms. These are ultrasounds, MRI and contrast mammograms (CESM). “It’s important to use these tools when we are concerned a breast cancer is present,” Dr. Reiland said. “However, if a screening mammogram is normal, an exam in the clinic is normal, and a self-breast exam is normal, you most likely don’t have a breast cancer that has been missed.” For information about Dr. Reiland, please visit YRMC PhysicianCare Breast Surgery or contact us at (928) 442-8740. Screening mammography is available through the BreastCare Center at YRMC or Prescott Medical Imaging. Assistance is available for women unable to afford screening mammography through the Community BreastCare Fund.
Breast Screening Guidelines: What You Need to Know
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.”
Is Vitamin D Good for Your Heart?
When they say every body needs milk, they’re partly talking about Vitamin D. According to science, this fat-soluble vitamin helps the body absorb the calcium and phosphate it needs to build and preserve bone strength. But does science support a direct link between vitamin D and cardiovascular health? Can we take vitamin D to avoid heart disease or restore a diseased heart to health? Some people think so. But according to Phillip Tran, DO, FACOI, a cardiologist with YRMC PhysicanCare, science doesn’t fully bear it out yet. Vitamin D sustains heart muscle “Studies do show an inverse relationship between vitamin D and some chronic health conditions, such as high blood pressure or Type 2 Diabetes,” Dr. Tran said. “But taking more Vitamin D does not necessarily lower the risk of getting cardiovascular disease or help treat it. Preliminary evidence may suggest the fact, but more research is needed.” That isn’t to say vitamin D doesn’t impact heart health at all. Our bodies need the full family of vitamins to function properly. Not getting enough of any one vitamin can impact our health. Along with bones, Vitamin D also sustains muscle. Insufficient levels can cause both bone pain and muscle weakness. This includes the weakening of muscles found in the heart. “Vitamin D deficiencies may cause scar tissue to form on the heart wall,” Dr. Tran said. “This can lead to heart chamber dilation, impairing normal heart function.” When heart chambers are dilated, or enlarged, the heart muscle is weakened and can’t pump blood as well. Getting enough of the sunshine vitamin Known as the sunshine vitamin, vitamin D is produced naturally when skin is exposed to moderate sunlight. It also occurs naturally in foods—including some fish, fish liver oils and egg yolks—and in fortified dairy and grain products. Depending on the degree of sun exposure and diet, you may want to include an over-the-counter supplement. But what is the recommended daily allowance? “To maintain healthy levels, most adults need approximately 400-800 IU per day,” Dr. Tran said. However, 1,000 to 2,000 IU per day from a supplement is generally considered safe. More than 4,000 IU per day may lead to vitamin D toxicity. If you think you may be deficient in vitamin D see your doctor before taking too much of the vitamin. Remember, vitamin D deficiencies are more common in those who are elderly, have darker skin, or live farther away from the equator. Bottom line? Get your recommended daily allowance of vitamin D and your whole body with thank you. Including your heart.
Don’t Ignore these Symptoms of Heart Valve Disease
Increased shortness of breath, lack of energy and bouts of dizziness shouldn’t be written off to aging, according to experts at the James Family Heart Center at Yavapai Regional Medical Center (YRMC). In recognition of Heart Valve Disease Awareness Day on February 22, 2020, cardiac specialists from YRMC’s Heart Center are encouraging people of all ages to familiarize themselves with the subtle symptoms of heart valve disease. They also urge people to seek the advice of a physician if they are concerned about their heart health. An estimated 11 million Americans have heart valve disease, which involves damage to one or more of the heart’s valves. Many people with heart valve disease don’t experience noticeable symptoms until the blood flow is significantly restricted. Symptoms that could signal heart valve disease – and should be discussed with your physician – are: Breathlessness Chest pain, pressure or tightness Fainting Palpitations or a feeling of heavy, pounding, or noticeable heartbeats A decline in your activity level or reduced ability to do normal daily activities Heart valve disease can affect people in their 40s or 80s, but it’s most prominent in older adults. In fact, one in ten people age 75 and older struggle with moderate to severe heart valve disease. To understand why this happens, it helps to know the role healthy heart valves play in the body. The heart has four valves with tissue flaps – also called leaflets – that open and close with each heartbeat. The flaps ensure blood flows in the right direction through your heart’s four chambers and to the rest of your body. “Think of the leaflets as doors,” said Jose Torres, MD, Cardiothoracic Surgeon at YRMC’s James Family Heart Center. “Normally, the doors are very pliable. They open and close to allow blood to flow through the heart and then to the rest of the body. When the doors calcify, their pliability decreases and the heart has to work harder and harder to pump blood to the body.” Here’s a look at conditions that can cause or contribute to heart valve disease: Past medical history – A history of diabetes or rheumatic fever and cancer survivors treated with radiation therapy to the chest or sternum are at greater risk for heart valve disease. Congenital heart defect – People born with two leaflets, called bicuspid valve, are sometimes diagnosed with heart valve disease in their 40s or 50s. Heart murmur – Calcium buildup or a leaky aortic valve can cause a heart murmur, eventually leading to heart valve disease. The good news is that heart valve disease is treatable. Medications to lower high blood pressure or high cholesterol may be prescribed. Lifestyle changes – giving up smoking, eating a heart-healthy diet, getting regular physical exercise and aiming for your optimal weight – can slow the progress of heart valve disease. “Heart valve disease is a structural problem that requires surgery,” Dr. Torres said. “Once there’s a heart valve disease diagnosis, the solution is to remove that roadblock with heart valve surgery.” During surgical heart valve disease repair, patients are placed on a heart bypass machine to keep their hearts working. Cardiothoracic surgeons, like Dr. Torres, then replace the heart’s calcified valve with a new, artificial valve. People considered too high risk for heart valve replacement surgery may be eligible for Transcatheter Aortic Valve Replacement (TAVR). The minimally invasive TAVR procedure takes place in YRMC’s Hybrid Operating Suite—a combined state-of-the-art surgical suite and medical imaging facility. In YRMC’s Hybrid Suite – considered one of the nation’s best – a patient’s heart blockage can be diagnosed and then immediately repaired with a minimally invasive procedure, like TAVR. If the real-time imaging shows the patient requires surgery, YRMC’s heart team is ready to perform the procedure in the Hybrid Operating Suite. Learn more about heart valve disease and the advanced, comprehensive services available at YRMC’s James Family Heart Center.
Please Wear This
While COVID-19 continues to spread across Arizona, the issue of whether or not to wear a mask remains a point of debate. Some argue it does nothing to kill the virus. Some say a mask compromises their personal freedom. Others assert they are stronger than any virus bug. While others suggest they don’t know what to believe, that the recommendations keep changing. That’s the thing about this pandemic. It is called novel coronavirus (COVID-19) because it’s new to humans. Scientists are learning more about the virus every day. Which is why official guidelines aimed at keeping everyone safe continue to evolve. So what if we all agreed to wear a mask in attempt to protect each other, just in case? According to the most recent information from the CDC, that’s what a mask really does. By mitigating the spray—the aerosol that dispenses the virus outward from me to you, you to me—a mask helps to protect us both. How can that not be a good thing when people are dying? As the CDC puts it, “Cloth face coverings are a simple barrier to help prevent respiratory droplets from traveling into the air and onto other people when the person wearing the cloth face covering coughs, sneezes, talks or raises their voice. This is called source control.” As illustrated in this video: https://yrmchealthconnect.org/wp-content/uploads/2020/06/Cover_smart._Do_your_part._Slow_the_spread._Video_Download.mp4 The CDC now recommends wearing a cloth face mask in public settings, especially when it is difficult to maintain a social distance of at least six feet. Looking out for others Wearing a face covering sends a visual signal that you care about others in your community. It makes an important statement. Even if you don’t think you carry the virus, you may be a source and not know it. More people are turning up asymptomatic—with no symptoms at all. COVID-19 continues to demonstrate it’s not easy to anticipate or regulate. Consider this from the Arizona Department of Health Services: “As COVID-19 continues to spread in the United States and in Arizona, we advise all residents to wear a cloth face covering when in public regardless of whether you feel sick or not. Studies continue to be published showing how COVID-19 can be spread through speaking, coughing, sneezing—including by people who don’t even know they’re sick.” With the long holiday weekend before us and people visiting from outside the area, YRMC joins other healthcare organizations across the country in asking everyone to please don a mask whenever you leave home. As a reminder, on June 29 Arizona Governor Doug Ducey issued the following for a period of no less than 30 days in attempt to stymie COVID in our state: he suspended large gatherings; ceased the issuance of new special event licenses; paused the operations of bars, gyms, movie theaters, waterparks and tubing rentals; and delayed the restart of schools. Taking preventative measures The CDC recommends the following when using a face covering: Fit the mask snugly to your face. Secure the mask with ties or earloops. Use a mask with multiple layers when possible. Machine wash and dry your mask routinely. Do not touch your eyes, nose or mouth when removing your mask. Wash your hands immediately after removing the mask. Do not use cloth face coverings on children under 2 years old or people who have trouble breathing. Remember, along with wearing a mask, please continue to: Wash your hands often with soap and water for at least 20 seconds. If soap and water aren’t available, use a hand sanitizer containing at least 60 percent alcohol. Maintain a minimum of six feet between yourself and others when outside the home. Clean and disinfect frequently touched surfaces daily. Monitor your health and be alert for symptoms such as fever, cough and shortness of breath.
Quad-City COVID-19 Patient Tells His Story
Gary Ong was well prepared for physical distancing and the other restrictions that came with the COVID-19 pandemic. Since 1999, he has lived on 6 acres of land on the outskirts of Mayer, Arizona, surrounded by National Forest and ranch land. “Everyone has acreage in my neighborhood,” he says. For Ong, being isolated is a part of every day life. However, when Ong’s 94 year-old mother broke her wrist, he made the journey to Phoenix to help care for her. This is how Ong’s experience with COVID-19 began. “I was there when she was discharged from rehab, and I stayed to help her settle back into her apartment,” Ong recalls. “I took her to doctor’s appointments and helped line her up with physical therapy.” “I got a call four days after I got home. It was Mom’s caregiver saying that Mom was not breathing well and needed to go back to the hospital. They tested her for COVID, and it was positive.” Ong immediately advised some of his good friends, whom he saw after he returned home, to get tested right away. Their tests turned out negative. “For a while, I was fine, but eventually I started to feel sick, and went for testing. It came back negative. I kept getting sicker, but even the second test I got was negative,” he says. “I finally called 911 because I was feeling worse. I warned them that I might have COVID so they could be prepared. They took me to YRMC and that’s where I tested positive.” Ong spent two weeks in the ICU at Yavapai Regional Medical Center (YRMC) West in Prescott. “My oxygen levels just weren’t where they wanted them to be. I was on 15 liters of oxygen for four or five days.” Ong was told that if his oxygen levels didn’t improve, he would be put on a ventilator. He was placed in a prone position, on his stomach, to improve oxygen flow. “Thankfully my oxygen levels started to improve. I guess I was oblivious to the fact that, for a while there, I was in pretty bad shape.” Different for Everyone Five other members of Ong’s family also tested positive for the Coronavirus. They are as certain as they can be that all of the cases trace back to Ong’s mother. What is less clear is why each of the family members had such different symptoms. While Ong’s mother is in a high-risk age bracket and has an underlying heart condition, her symptoms were relatively mild and she fully recovered. Some family members had a cough, some had a fever, and one family member spent three days in the hospital with fever, diarrhea and difficulty breathing. One family member is still recovering. Ong is working on weaning himself off of supplemental oxygen. The Message Ong’s experience led him to contact Yavapai Regional Medical Center so that he could tell his story. He is hoping to help others as they navigate the often-contradictory information circulating in the news and on social media. “I want people to know that symptoms can be very different for different people, like they were for my family,” he explains. “I want them to know that a negative test result doesn’t necessarily mean you’re virus free. It took three tests before I got a positive result, even though I was already feeling sick.” “I wasn’t feeling bad, even when I was in the ICU,” Ong says. “What changed my mind? It was only one step from my bed to the bathroom. For two days in a row, I tried to walk back from the bathroom. By the time I got to the bed, just one step, it felt like someone was standing on my chest. I was told my oxygen level went to almost zero.” Reference Points “On Saturdays, I like to go to the swap meet in Prescott Valley with some friends. I’m still unable to go, but when my friends go, they wear masks now,” Ong says. “My friend told me that he’s been asked why they’re wearing masks. His answer is simple. ‘You must not know anyone who has had COVID.’” “People who don’t think it’s real have no reference point,” says Ong. “They aren’t able to put a face to the health risk.” Ong believes that once a person experiences the real-life scare of being sick, or having a loved one sick with COVID-19, their perspective may change. “Luckily, our family has come out of this well, but I hope this will give some people some insight. I hate to see it downplayed.” Ong pauses. “This virus has the potential to affect your life and the lives of the people you love.” “The numbers are there. We aren’t out of the woods yet,” says Ong. “When I’m clear to go out in public again, you can bet I’ll be wearing a mask too.”
Longest Running YRMC Volunteer Celebrates Her 40th Year
Forty years ago, volunteering at Yavapai Regional Medical Center (YRMC) would often mean joining the Medical Auxiliary. Dues were $5 a year. Auxiliary members would dedicate their time assisting at the Information Desk or Gift Shop. The dress code was strict. In fact, Auxiliary members purchased their own uniforms and wore regulation blouses. Dorothy Kalabus, YRMC’s longest-running volunteer, remembers those days with fondness and a good dose of her signature humor. “Imagine today if you had to pay to be a volunteer!” she jokes. Kalabus had just moved to Prescott from Pittsburgh. She had three school-aged children and her husband’s airline job often took him out of town. Not one to sit at home, she soon joined the Auxiliary and started a decades-long relationship with YRMC. It wasn’t long before Kalabus was asked to join the Auxiliary Board. In those days, the Auxiliary Board decided upon ‘wish list’ purchases for the hospital, funded by proceeds from the Gift Shop. When her grandson was born, Kalabus recalls that the stress monitor, just purchased by the Auxiliary, was used during his delivery. “I was so glad it was there for the staff to use,” says Kalabus. Dorothy Kalabus is the 10th of 12 children. Her father died when she was eleven. She and her siblings were raised to pitch in whenever and wherever possible. She graduated with honors and earned college scholarships. “There was never any idle time at our house,” she remembers. “I can’t even imagine sitting and doing nothing.” Now, at nearly 80 years old, Kalabus still has the energy of someone a fraction of her age. Forty years at the YRMC Information Desk isn’t the only impressive item on her volunteer resume. “Back in the 80’s I volunteered at Sacred Heart Church and at the Prescott Rodeo, where I became the chair of the Cattleman’s Club. I even earned my gold and silver rodeo belt buckle. I offered to stuff envelopes for Judge Ann Sterling’s campaign, and ended up becoming the campaign chair!” Nancy Thomes, Director of Volunteer Services at YRMC, emphasizes the important role Kalabus plays at the Information Desk. “Dorothy is such a joy to have at our Information Desk,” says Thomes. “This is a challenging position since the questions that are asked are often new. These volunteers often have to problem-solve while extending good customer service. Dorothy’s knowledge and willingness to serve is always evident, and the joy that she feels while doing this is always apparent.” When asked why she has stayed with her service to YRMC for forty years, Kalabus explains, “This is so important. You’re dealing directly with people in need. People come in with so many different needs. Most of them aren’t just asking for a patient’s room number, and often they’re in pain or feeling stress. You have to remember a lot of information about the hospital, and communicate it simply and clearly.” “And then there are the free lunches!” she laughs. “Every Friday, a dozen or so volunteers from all different departments get together for lunch, and new volunteers are always welcome. These people have all become my friends. We have such a good time!” Kalabus notes that she belongs to a special ‘foursome’ that makes her time at YRMC extra special. She works with Escorts Carol Shepherd and Shirley Reeves and fellow Information Desk volunteer Rob Petrocci each Friday. “We’re a great team,” she says. Kalabus was honored for her 40 years of service on July 2nd. Thomes and Chamine David, Volunteer Services Manager, visited Kalabus in her front yard for a ‘physically distanced’ celebration. Kalabus’ husband and daughter were there, as well as fellow volunteers Shepherd and Reeves. The neighbors across the street even held up a large handmade ‘Congratulations’ sign and took photos. “Dorothy enjoyed telling a few stories about her first days at YRMC,” says Thomes. “It was clear that her commitment to her role began 40 years ago when she first started volunteering.” “It was a fun visit,” Kalabus recalls. “There were balloons and flowers and we visited and reminisced. It’s fun telling the old stories and marveling at how far YRMC has come over the years. But I still can’t believe it’s been 40 years!” “I tell people that volunteering gives you life,” she explains. “It gives you something to look forward to and makes your life so much more interesting. Volunteering changes your whole world.” Kalabus continues. “When I started volunteering at YRMC 40 years ago, it was just to get to know a few people in my new hometown. But soon, I came to realize that this is a commitment. And as you can tell, when I start something, I finish it. Well, I’m not finished yet!” To learn more about becoming a volunteer at Yavapai Regional Medical Center visit yrmc.org, or call Volunteer Services in Prescott at (928) 771-5678, or in Prescott Valley at (928) 442-8678.
YRMC’s 2019 Volunteers of the Year Receive Virtual, Yet Heartfelt Recognition
Phyllis Sylvester, Yavapai Regional Medical Center’s (YRMC’s) West Campus Volunteer of the Year for 2019, was on hiatus from her usual duties as the chair of the YRMC Mail Department at the Prescott Campus. The COVID-19 pandemic had caused a temporary closure of Volunteer Services. One morning, Sylvester received a phone call from Nancy Thomes, Director of Volunteer Services at YRMC. Thomes said that she and Chamine David, Volunteer Services Manager, were going to swing by Sylvester’s home, just to say hello. “Well, they parked and got out of their car. Nancy did a little jig in the driveway and then announced my wonderful award,” says Sylvester. “What a surprise and honor.” “We borrowed an idea from the Publishers Clearing House and surprised each award winner at their home,” says Thomes. “This was accomplished prior to the ‘stay at home’ order and we maintained the appropriate social distancing.” The Jig The jig is a tradition at the annual Volunteer Recognition Event at YRMC. Each year, amid a joyous atmosphere, lunch, smiles and laughter, YRMC staff performs a ‘jig’ to show their appreciation for their volunteers. While the underlying intention is genuine, the staff doesn’t always perfectly master each dance step. This has become a source of much laughter and good-natured teasing at the event over the years. This year, in lieu of the in-person celebration, the staff gathered on what would have been the luncheon date to pose with their dance props. Thomes sent the photo, along with an explanation and word of thanks to the volunteers. “For those of you who have attended these events in the past, you will know what I mean when I say that all of our staff gathered to do a little ‘jig’ for you – it was our way of virtually performing the entertainment portion of the event. AND, you need to know that we didn’t make ANY mistakes (just trust us on this)!!!!” Passion and Commitment Physical distancing may have been in place, but the love and appreciation for YRMC volunteers was not diminished, perhaps this year more than ever. The volunteers’ absence during the pandemic restrictions was certainly noticed among YRMC staff. “I couldn’t believe the comments from our staff about how different YRMC looked without our volunteers,” Thomes notes, “We certainly missed them.” Mark Timm, Executive Director of Human Resources at YRMC, agrees. “While we always appreciate our volunteers’ contributions, we had a heightened awareness of all they do for us, especially when we didn’t have the luxury of more than 50 volunteers a day performing their many roles throughout YRMC.” In fact, it is often said that YRMC would not be able to continue its day-to-day operations if it wasn’t for their many volunteers. Last year, 712 volunteers logged 104,700 hours of volunteer time, which translates to $2,205,532. This is the equivalent of 46 full-time employees. “The passion and commitment our volunteers bring to YRMC is inspiring. And we all have the same goal – to provide a positive experience to everyone we meet here,” Thomes explains. “Our volunteers come from such diverse and interesting backgrounds and career paths. We all learn so much from them.” Three standout volunteers were honored this year. 2019 West Campus Volunteer of the Year – Phyllis Sylvester Sylvester started her volunteer service with YRMC over 18 years ago and has given more than 2,800 hours of service, including in the Emergency Department. She currently delivers the mail and is the chair of the Mail Department. A very hands-on leader, she will cover a shift if someone can’t come in, provides extensive training, and is diligent about keeping her group aware of personnel and departmental changes. Some of the accolades from her nominations include: Phyllis is always friendly, willing to take on new things when needed and consistently performs ‘over and above’. She has a great demeanor, is approachable and very fun. All of her partners have enjoyed working with her. Every which way you turn, Phyllis is greeting someone and offering to help. Sylvester has found volunteering to be a worthwhile way to support her community, particularly at YRMC. For her, giving back to the hospital and the sense of belonging it offers are the main reasons she dedicates her time and talent. “YRMC is a great place to volunteer. The staff and other volunteers are very friendly and make you feel like you belong. We work together as a team and we’re always ready to assist,” says Sylvester. “I feel very honored and special to be selected among all of the other volunteers.” 2019 East Campus Volunteer of the Year – Sandy Hanratty Hanratty has been an Escort for YRMC East since June 2014 and has contributed more than 1,200 hours. If she sees someone heading into the hospital that looks like they might need a wheelchair, she greets them with a chair before they even reach the door. Hanratty often helps out at the Registration Desk as well. It is said she always has a smile and kind words for everyone she comes across. Her nominations include the following praises: Sandy has a wonderful attitude and is very professional. She is very friendly and always ready to help the patients, visitors and her fellow volunteers. Sandy is the kindest, happiest person and it is a pleasure to work with her. “I can’t think of a finer thing to do with my time that volunteering. It gives me so much more joy than I give,” Hanratty says. “Volunteering gives my life worth. It’s a total pleasure.” Hanratty shares the credit. “I have to give credit to my Thursday afternoon group of volunteers. What a special group of people. There are five of us and we enjoy each other’s company and work so well together. You can’t do it alone.” 2019 Sandy Zinn-Martin Award – Diana Ashby The Sandy Zinn-Martin Award was created to honor the memory of a long-time YRMC volunteer and her spirit of generosity. It is given each year to a volunteer who embodies the ‘above and beyond’ attitude that Sandy exemplified. Ashby, this year’s honoree, gives her ‘all’ in service not only to YRMC, but to her fellow volunteers as well. An Escort at YRMC East since January 2017, she is always doing special things for her fellow volunteers, just like the award’s namesake, Sandy Zinn-Martin. Some of the comments from Ashby’s nominations include: Diana makes sure her fellow volunteers have rides to appointments. She purchases cards for fellow volunteers when they are ill and passes them around for other volunteers to sign. On birthdays, Diana passes a card around for the volunteers to sign and brings homemade goodies to share. In light of all she gives, Ashby reflects on what she receives in return. “What I get back is enjoyment, fulfillment and personal growth,” says Ashby. “I enjoy interacting with the visitors, patients, and employees that I come in contact with. It’s quite a feeling to know that you have the means to make a day brighter for someone who is unhappy, in pain, or simply angry, by giving them a smile or just listening to them. It’s pretty powerful.” A Positive Difference John Amos, YRMC President and CEO, reflects on the hours of service and dedication given by YRMC volunteers. “Thinking about time being an unrenewable resource… the time our volunteers gave in 2019 is significant and was often given for altruistic reasons,” Amos states. “It is our hope that our volunteers felt that significance and sensed how they made a positive difference.” Hanratty’s first day back after the COVID restrictions was punctuated by an enthusiastic encounter that may exemplify the positive difference that Amos describes. “I guess sometimes we just take things for granted,” she says. “The first day I went back, I walked past a nurse. She stopped, turned around, looked at my volunteer vest, then looked me straight in the eye and said, ‘We are SO glad to have you back!’” “I should be giving the award, not getting it,” she continues. “I’m so humbled, surprised and honored. I wish I could give them a hug, but I’ll have to save that for later.” And with any luck, the hug will be followed by an extra-joyful jig! Visit YRMC.org to learn more about becoming a volunteer at Yavapai Regional Medical Center. Or, you can call Volunteer Services in Prescott at (928) 771-5678, or in Prescott Valley at (928) 442-8678.
YRMC: Your Destination for Heart Care and Patient Blood Management
What does the phrase “destination healthcare” bring to mind? For a growing number of people in Arizona and the southwest it means heart care, patient blood management or both of these specialized programs, provided by Yavapai Regional Medical Center (YRMC). Cardiac specialists from the James Family Heart Center and leaders from YRMC’s Patient Blood Management program (PBM) joined a live-stream event on October 17, 2019 at Yavapai College Performing Arts Center to speak about both of these innovative programs. Over 600 participated in “YRMC – Your Destination for Cardiac Care and Blood Management” at Yavapai College and the live-stream the event online. YRMC – Your Destination for Cardiac Care and Blood Management featured exceptional cardiac specialists: a Cardiologist, Cardiac Electrophysiologist, Cardiothoracic Surgeon, and a Structural and Interventional Cardiologist. Patient Blood Management experts also took part in the event. Together, these professionals highlighted the services, technology and teamwork that are the hallmark of YRMC’s Heart Program and Patient Blood Management Program. “Neither of these programs existed 12 years ago,” said Pierre Tibi, MD, FACS, Medical Director of YRMC’s James Family Heart Center and Patient Blood Management Program. “Today, there is no other community hospital in Arizona or the southwest that offers what YRMC does. We are now a destination program for Cardiac Care and PBM.” Defining PBM Until recently, prestigious organizations like the Society for the Advancement of Blood Management (SABM), the World Health Organization (WHO) and the American Association of Blood Banks (AABB), all mentioned blood transfusions in their PBM definitions. “They focused on thresholds for blood transfusion,” said Dr. Tibi, SABM’s Immediate Past President. “Today, the SABM definition states that PBM is a patient-centered approach that aims to improve patient outcomes.” At YRMC, this is accomplished by: Involving the patient in decision making Identifying anemia and other conditions early Managing conditions that can affect blood count Minimizing blood loss during hospitalization Embracing PBM tactics throughout the organization “We focus on taking care of the entire patient and keeping the patient as safe as possible before, during and after a procedure,” said Dale Black, Coordinator, Patient Blood Management, YRMC. “And one way to keep patients safe is to not subject them to possibly unnecessary blood transfusions.” YRMC: What Your Heart Needs John Amos, President and CEO, YRMC, recalled the beginning of YRMC’s heart services, which launched in 2004 with a single Cardiac Catheterization Lab at YRMC West in Prescott. “Even then, we envisioned a heart program that would bring together the latest services, exceptional specialists, unparalleled technology and compassionate caregivers,” said Amos. YRMC took a major step toward that goal in 2007 when Dr. Tibi – a highly regarded Cardiothoracic Surgeon from Phoenix – joined YRMC. Dr. Tibi brought open heart surgery to the community, launched YRMC’s Heart Program and introduced PBM. Under Dr. Tibi’s leadership, YRMC’s thriving, comprehensive Heart Program has grown to feature these services and exceptional cardiac specialists: Structural Heart Disease Services – Soundos Moualla, MD, FACC, FSCAI, Structural and Interventional Cardiologist, YRMC PhysicianCare, Prescott Mitral Valve Repair with MitraClip Paravalvular Leak Closure (PVL) Transcatheter Aortic Valve Replacement (TAVR) Transcatheter Mitral Valve Replacement (TMVR) WATCHMAN™/Left Atrial Appendage Closure (LAAC) Electrophysiology Services – Nisha Tung-Takher, MD, Cardiac Electrophysiologist, YRMC PhysicianCare, Prescott Curative Management and Ablation Procedures for Cardiac Arrhythmias (atrial fibrillation, atrial flutter, supraventricular tachycardia, atrial tachycardia, premature ventricular contractions and ventricular tachycardia) Device Implantations (pacemakers and defibrillators) Remote Monitoring (pacemakers, defibrillators and cardiac resynchronization therapy, CRT) Heart Failure Management Care with Compassion YRMC’s Heart Program and PBM Program combine science and service, according to George Rizk, MD, Invasive Cardiovascular Medicine, YRMC PhysicianCare in Prescott. “YRMC is doing what’s best for patients,” said Dr. Rizk, who presented during the live-stream event. “If you deliver the most scientifically advanced services without putting the patient’s interest first, you don’t get too far. YRMC’s team has a passion for helping patients.” One way that YRMC does what’s best for patients was described by Elizabeth Black, YRMC’s Patient Blood Management, Data Manager. In the tradition of healthcare and acronyms, she called it “KTBITP” or “keeping the blood in the patient.” Less than a decade ago, Black noted, blood transfusion was the most common procedure performed in U.S. hospitals. While some blood transfusions are deemed medically necessary, she said, they all come with risks. Those risks include increased infection rates, medical complications (kidney, lung and heart), and higher death rates. PBM strategies combine evidence-based medicine with good clinical practice to maximize the patient’s blood health and reduce exposure to risks associated with transfusion. A Field of Dreams Dr. Rizk remembers the opening of YRMC’s first Cath Lab as a “field of dreams” moment. “We thought: If we build it, they will come,” he said. “And, if you build it well, they will never leave.” These statements are even more relevant today as YRMC’s Heart and PBM Programs emerge as destination programs. To learn more about YRMC – Your Destination for Cardiac Care and Blood Management check out YRMC HealthConnect. For information about YRMC’s Heart Program and PBM Program, visit our website.
10 Facts We Learned at YRMC’s Patient Blood Management Symposium
Science and history intersected during Patient Blood Management: Yesterday, Today and Tomorrow, Yavapai Regional Medical Center’s (YRMC’s) 6th Annual Patient Blood Management (PBM) Symposium. Approximately 350 people – PBM advocates from across the southwest, physicians, nurses, college students and more – gathered for the 2018 PBM Symposium at Yavapai College Performing Arts Center in Prescott. Throughout the world, even more streamed the Symposium live on laptops, smart phones and other devices. “It was the best of both worlds,” said Dale Black, Patient Blood Management Program Coordinator at YRMC. “Our guests enjoyed a pre-Symposium reception that included an array of appetizers, lots of friendly conversation and information from our industry partners who support YRMC’s vision for Patient Blood Management.” Industry leaders who joined YRMC at the PBM Symposium include: Instrumentation Laboratory Daiichi Sankyo, Inc. Haemonetics Baxter “During the Symposium,” said Black, “we welcomed guests from throughout the globe who live-streamed the event. All Symposium participants took away new information about the value of PBM and the leadership role YRMC plays in PBM.” If you missed the Symposium, we’ve collected some highlights to get you up to speed on PBM’s science, history and future. #1 Patient Blood Management wasn’t built in a day. The 6th Annual PBM Symposium coincided with YRMC’s 75th anniversary, a perfect opportunity to highlight the history of PBM, courtesy of Pierre Tibi, MD, FACS, Cardiothoracic Surgeon and Medical Director of the James Family Heart Center at YRMC West. Dr. Tibi said the idea of transfusing blood goes back to 1556, but the first actual human-to-human “blood transfer” happened in 1818. Fast forward to the early 1900s for another milestone: the identification of human blood types—A, B, AB and O. Soon after, a test that allowed physicians to ensure blood compatibility before transfusing patients was introduced. Another big breakthrough coincided with World War II as researchers discovered how to break down blood into components and products. Plasma – a blood product – saved the lives of many wounded soldiers during the war. #2 Blood is one tough tissue. Daniel Beck, MD, Anesthesiologist at Prescott Anesthesia, emphasized that blood – a connective tissue – actually functions like a complex, multifaceted organ. Comprised of water, electrolytes, small molecules, proteins and cells, blood performs many significant roles in the body. For example, Dr. Beck highlighted the important job performed by one of our two types of white blood cells. “These white blood cells repair all types of tissue damage,” said Dr. Beck. “The repairs range from paper cuts to broken bones and all of the way to heart attacks.” #3 When it comes to the safety of our blood supply the expression, “we don’t know, what we don’t know,” applies. Medical experts in the United States agree that our blood supply is the safest it has ever been when it comes to disease transmission. “The concern is always about unknown infectious diseases,” said Elizabeth Black, Data Manager and Administrative Assistant, YRMC’s PBM Program. “Current blood testing measures are only going to test for infectious diseases we know about. You can’t test for something if you don’t know it exists.” #4 Storing your own blood for surgery comes with some potential complications. Storing your blood for use during and after surgery sounds like an ideal way to prevent the transfusion of a virus. However, autologous blood donation – as it’s called – may lead to anemia, which can slow recovery. “Even your own blood is stored blood,” said Elizabeth Black. “It is not the same quality as the fresh blood moving through our bodies or the blood that’s taken immediately before surgery.” #5 Physicians and PBM experts know: If you don’t use it, you won’t lose it. YRMC’s thriving Structural Heart Program demonstrates how medicine is integrating PBM into its less invasive procedures. Soundos Moualla, MD, FACC, FSCAI, Interventional Cardiologist at the James Family Heart Center at YRMC West, uses less-invasive procedures and advanced technologies to help people previously considered too high-risk for surgery. These procedures require small skin punctures, rather than major incisions. “These new technologies allow us to safely perform minimally invasive procedures,” said Dr. Moualla. “The procedures do not require blood use and typically there is no blood loss.” #6 New procedures at YRMC’s Heart Center support PBM principles. In the 1980s, cardiology took its first steps in this direction with the introduction of cardiac stenting, which allowed some patients to forego open heart surgery. Today, many heart procedures are minimally invasive, including these which are available at the James Family Heart Center at YRMC West. Left Atrial Appendage Closure (WATCHMAN) Mitral Valve Repair with MitraClip Paravalvular Leak Closure (PVL) Transcatheter Aortic Valve Replacement (TAVR) #7 Your YRMC providers are your PBM partners. PBM is at its best when there is strong communication between nurses, patients, family members and other patient advocates. This is standard operating procedure at YRMC. “We’ll literally report at your bedside to involve you and your family,” said YRMC’s Selina Bliss, MS, PhD, RN. “This allows us to clearly communicate a care plan for your anemia.” YRMC’s multi-disciplinary team – advanced clinical practitioners, dietitians, medical laboratory professionals, nurses, pharmacists, physical therapists, physicians and more – also share their best practices for preventing patient anemia during “Lunch and Learn” programs. Recently, YRMC’s Emergency Department team outlined how early admission of a medication to treat excessive blood loss has helped patients experiencing traumatic bleeding. The ICU staff shared a successful strategy to monitor hemoglobin counts – a low count may indicate anemia – as a way of reducing the frequency of patient blood draws, which can lead to anemia. #8 Researchers are applying leading-edge science to the study of blood. Creating a blood substitute…developing a universal blood type…transforming human stem cells into units of blood…all of these and more are under research today. “Scientists are looking for the optimal artificial human blood that can carry oxygen to our tissues without any of the biological baggage associated with a unit of blood,” explained Jared Head, AGACNP-BC, Hospitalist, NAZ Hospitalist. #9 PBM’s future is now. During the PBM Symposium, Dale Black, PBM Program Coordinator, spoke with Tucson resident Anthony Caballero about the extensive heart procedures he underwent at YRMC’s Heart Center, all using PBM principles. Even as researchers race toward an array of alternatives to blood transfusions, most medical experts point to PBM as the most effective way to safely care for patients. “What we are doing now may well be the future,” stated Head. “Keeping blood inside of the body and minimizing the number of blood draws to harness anemia—these and other PBM strategies may be the future of transfusion medicine.” #10 PBM is making a difference at YRMC today. YRMC has experienced an impressive reduction in the use of blood products, thanks to its hospital-wide PBM Program. “YRMC launched its PBM Program in 2012,” said Diane Drexler, RN, BSN, MBA, FACHE, Chief Nursing Officer at YRMC. “Since then, our use of red blood cells and fresh frozen plasma has declined by 32 percent and 61 percent, respectively.” Why is this decline good news for YRMC’s patients? It means YRMC’s surgeons and other physicians are minimizing patients’ blood loss and reducing unnecessary transfusions. And, as studies have shown, both of these PBM strategies can improve patient outcomes and speed recovery. For more information about YRMC’s Patient Blood Management Program, visit us here.
YRMC’s Lung Cancer Screening and Care Program: Early Detection is Saving Lives
Starr Herridge left her home one morning to go to the mall, a familiar trip where she regularly picked up her cigarettes. But on this particular morning in 2012, Starr decided to pull in to the neighborhood drug store instead, and found herself purchasing smoking cessation patches. Starr laughs, “I guess I was lazy – I didn’t want to go all the way to the mall!” “Once I retired, I started smoking so much more,” Starr admits. “When I was working, it wasn’t so bad because I wasn’t allowed to smoke at work. But I didn’t know what to do with myself at home and I ended up smoking all day long. I knew I had to do something.” Thankfully, the patches worked, and Starr has been a non-smoker ever since. Fast forward to 2018, when Starr’s primary care physician recommended a Medicare well-clinic health screening. Given Starr’s history of smoking, it was recommended that she get a low dose CT lung scan. Starr figured it couldn’t hurt. She went to Yavapai Regional Medical Center where she qualified for free annual lung screenings through the Lung Cancer Screening and Care Program. “YRMC’s Lung Cancer Screening and Care Program follows people generally between the ages of 55 and 77 who are at a higher risk for lung cancer due to a history of smoking,” explains Jennifer Harvey, RN, BSN, Patient Navigator at the YRMC Lung Cancer Screening and Care Program. “The screening uses a CT scan with a lower dose of radiation to take very detailed pictures of the lungs to detect cancer in its early stages, which allows for a greater chance for a cure.” “I first met Starr in July, 2018 when she came to the program,” says Harvey. “The first thing you notice is her sense of humor and her kind, humble heart!” The Lung Cancer Screening and Care Program is covered by private insurance and Medicare for people who meet certain criteria, including: Age 55-77 Current smoker or quit within 15 years 30 smoking pack years (1 pack a day for 30 years) Harvey notes that you need an order from your provider, so a good starting point is to talk to them first. In addition, a cash pay, discounted rate is available for those who do not qualify for insurance coverage. “My job is to provide information, answer questions and interpret what each individual patient needs,” says Harvey. “The whole idea from the very start is that everyone is in a different place. I followed Starr’s case and checked in occasionally to see how she was doing.” A year later, one of Starr’s regular screenings showed a very tiny nodule on one of her lungs. Although Starr showed no symptoms at all, her physician wanted to do a biopsy to be sure. However, the nodule was so small that it was impossible to biopsy. Starr and her doctor discussed Starr’s options. “I said let’s just go in there and get it out!” Starr recalls with her signature enthusiasm. “Within three weeks, I was in the hospital.” “I saw Starr after the surgery. She did great!” says Harvey. “The biopsy tested positive for cancer, but the good news was that the margins were clear, which means that everything around it was negative. This is exactly what you hope for, and it was made possible because we caught it so early.” Starr now goes in for follow-up CT scans every four months. She considers herself an advocate for screening and early detection. “I always tell people, why wait until you have a symptom? It takes thirty minutes out of your life, it doesn’t hurt, you don’t get undressed, and you just get up and go. Plus, It’s free, and I like free!” After a pause, Starr’s tone becomes more serious, “We got rid of the cancer before I became sick. I didn’t have to endure chemo or radiation because I went in early and they got all of it. It saved my life.” “Of course, quitting smoking is the most important thing you can do to reduce the risk of lung cancer,” says Harvey. “But that risk is still about three-fold in comparison to people who have never smoked, even 25 years after quitting. The value of regular screenings can’t be overstated.” So why don’t more people participate? “One of the biggest reasons people are reluctant is that they just don’t want to know,” explains Harvey. “We find this largely in people who are currently smoking. It’s hard to hold up a mirror to what smoking has done to their bodies. Another comment we hear is, ‘Well, I feel fine. I don’t need to do this.’ The truth is, the vast majority of lung cancer symptoms don’t appear until later stages.” “The great news is that the survival rate of lung cancer is on its way up. There are now more treatment options besides surgery, radiation and chemotherapy. What was considered a poor prognosis tens years ago may hold a lot more hope now, thanks to immunotherapies and targeted therapies,” says Harvey. The other important factor is that smokers and former smokers like Starr are becoming more aware of the life-saving benefits of early-detection programs like the Lung Cancer Screening and Care Program at YRMC. “My health is so important to me because I love life. I have two sisters, and I love being with them. I have a great group of friends – some are even from high school.” Starr continues. “Plus, I have a dog sitting business that I love. Dogs just love you unconditionally. I provide a great service to my clients, and just have a ball with the dogs!” For more information on the Lung Cancer Screening and Care Program at YRMC, call Jennifer Harvey, Patient Navigator at (928) 771-5454 or visit YRMC’s Website.
Four Reasons to Choose Prostate MRI
June is Men’s Health Month, the ideal time to highlight prostate Magnetic Resonance Imaging (MRI). This is an important advancement to how physicians diagnose conditions of the prostate—the walnut-sized gland below the bladder in men. And that’s good news for men throughout Yavapai County. YRMC’s Dr. Cox has interpreted approximately 1,000 prostate MRIs. “Prostate MRI can prevent some biopsies and give urologists the information they need to perform targeted biopsies,” said Deven Cox, DO, a Yavapai Regional Medical Center (YRMC) Diagnostic Radiologist who is fellowship trained in Body Imaging. That’s reason enough to celebrate the introduction of prostate MRI at YRMC, but we’ve highlighted a few more below. Prostate MRI is a relatively new way to diagnose prostate cancer and other prostate-related conditions. Diagnosing prostate cancer requires a physical exam of the gland’s surface and a prostate-specific antigen (PSA) blood test. These may be followed by the transrectal ultrasound (TRUS) biopsy. “The TRUS biopsy is not a true targeted and guided biopsy,” said John Saali, MRI Supervisor, YRMC West in Prescott. “TRUS takes a systematic, but rather blind approach to diagnosing prostate cancer.” TRUS biopsies require a total of 12 needle punctures: six on one side of the prostate gland and six on the other side. Following a TRUS biopsy, some men experience pain or tenderness, infection, hemorrhaging, and lower urinary tract difficulties. Prostate MRI is non-invasive, painless and has no side effects. To patients, the prostate MRI experience closely mimics an MRI. The patient lies comfortably in the MRI scanner at YRMC West in Prescott. An imaging contrast agent is delivered through an IV, which allows the YRMC Imaging Services team to gather images of the patient’s prostate. After the approximately 30-minute procedure, the patient is ready to go about his day. Prostate MRI is more than a scan of the prostate gland. Prostate MRI technology allows diagnostic radiologists to answer three essential questions about prostate cancer: Where is the tumor located in the prostate gland? How aggressive is the tumor? Has the cancer spread outside of the prostate gland? “There are three specific imaging features that make up the prostate MRI,” Saali explained. “They form a construct that provides functional information about a prostate tumor. This information makes treatment much more effective.” Many prostate conditions can be diagnosed with prostate MRI. Prostate cancer is a major health issue for men, with one in nine experiencing it during their lives. However, there are many other prostate-related conditions that can be diagnosed by prostate MRI, including: Benign Prostatic Hyperplasia (BPH) – An enlarged prostate, which is most common in older males. Prostatitis – This is inflammation or an infection of the prostate. Prostate abscesses and urethral diverticula are less common prostate conditions that are also diagnosed by prostate MRI. Dr. Cox – who has interpreted approximately 1,000 prostate MRIs during his career – is pleased the medical service is now available at YRMC West. “It’s an important diagnostic tool to offer the people of our community,” he said. Prostate MRI is covered by Medicare and most commercial health plans. Talk to your healthcare provider for more information. For specific prostate MRI questions, contact John Saali at (928) 771-5116.
Budget-Friendly, Delicious Pantry Meals: Ready to Eat in 20 Minutes!
Canned tomatoes and garbanzo beans are two staples I always stock in my pantry. With these simple ingredients, plus a handful of fresh herbs and vegetables, I can create a delicious variety of meals that follow the seasons and fit into my budget. Check out this recent YRMC’s Your Healthy Kitchen video, where I put together two nourishing and comforting recipes using canned tomatoes and garbanzos, in about 20 minutes! Chickpeas and Bowties Recipe Creamy Tomato Carrot Soup Recipe Homemade meals are usually budget-friendly and nutritionally superior to prepared foods in many ways. For example, a typical can of tomato soup contains 8 grams of added sugar (which is equivalent to two added teaspoons of sugar per cup), and 480 mg of sodium. Low sodium varieties of tomato soup do score better, at 30 mg of sodium per 7.25 ounces, but the added sugar content is higher. If you buy a case of Campbell’s Low Sodium Tomato Soup, the bulk discount cost averages around $1.65 for a little less than one cup. Compare that to my homemade tomato soup and you’ll see that home-cooked is a bargain at $1.70 for a two cup serving! My homemade tomato soup is nutritionally superior as well, with no added sugar and comparable amounts of sodium, at approximately 7 mg per ounce vs. 5 mg per ounce for a can of low sodium Campbell’s Tomato Soup. A comforting cup of homemade tomato soup Of course, nothing beats the taste of homemade meals, where you control the quality of your ingredients as well as the type and amount of flavorings you add. For more ways to cook delicious, easy meals at home, remember to visit our collection of videos and recipes at YRMC’s Your Healthy Kitchen. All of our recipes include nutrient-packed, affordable, and local ingredients, plus easy to follow instructions. You can also follow me on Facebook at YRMC’s Your Healthy Kitchen, to see what I am making at home, get insider tips and link to some of my favorite food and nutrition destinations on the web.
For Good Health and Great Flavor, Spice Up Your Meals with this Award-Winning Salsa!
Jim Vorves is one of many multi-talented employees who walk the halls at YRMC. As a talented cook, musician and Desktop Support Manager for YRMC’s Information Systems Department, Jim qualifies as a true Renaissance man! He kindly joined me on the set of YRMC’s Your Healthy Kitchen to share one of his award-winning salsa recipes, and talk about the dedicated folks who keep everyone connected at YRMC. FYI: Don’t worry if you don’t like a lot of spice. Jim also shares his mild salsa recipe, for those of us who don’t do well with heat but still love the taste of salsa. Flaming Gringo Salsa Recipe Capsaicin (cap-SAY-sin) is the chemical that gives chilies their heat and fire. It is concentrated, but not limited to, the tissues around the seeds of chilies, where it likely protects the plant from pests and disease. In a neat twist of co-evolution, many of the chemicals (called phytochemicals) that plants produce to protect themselves from harm also protect and support the health of humans. This is certainly the case with capsaicin, as research shows that this spicy phytochemical: Improves insulin sensitivity and lowers blood glucose after meals Reduces inflammation throughout the body Lowers the risk of cardiovascular disease through anti-inflammatory and antioxidant activity Impairs the growth of H pylori, the bacteria that can cause stomach ulcers Capsaicin is found only in chilies that are spicy. The more spice, the more capsaicin, so the hotter you like your salsa the better! However, if you don’t like it hot, or for health reasons can’t tolerate chilies, there are many other beneficial nutrients in Jim’s hot and mild salsas. These include: Vitamin C Potassium Fiber Other important phytochemicals including: Lycopene, beta-carotene, and quercitin, all of which are antioxidants that protect against chronic illnesses such as cancer, cardiovascular disease, and diabetes. For more delicious ways to incorporate beneficial fresh herbs, spices and lots of flavor into your meals, remember to visit our collection of videos and recipes at YRMC’s Your Healthy Kitchen. All of our recipes include photochemical- and nutrient-packed, affordable, and local ingredients, plus easy to follow instructions. You’ll find nutrition information and cost per serving featured on every recipe as well. You can also follow me on Facebook at YRMC’s Your Healthy Kitchen, to see what I am making at home, get insider tips and link to some of my favorite food and nutrition destinations on the web. Until next time, eat well and spice up your meals for health!