Yavapai Regional Medical Center to Expand Visitation Restrictions and Pause Some Elective Procedures
In response to rising COVID-19 infection rates throughout the community, Dignity Health, Yavapai Regional Medical Center (YRMC) has made the difficult decision to expand visitor restrictions beginning Tuesday, November 24. Hospital-based elective procedures that require an inpatient stay will pause beginning Thursday, November 26 through Friday, December 4. Procedures in YRMC’s Endoscopy Department will continue as scheduled but will continue to be evaluated. With patient and staff safety the top priority, visitation is being suspended at both YRMC West in Prescott and YRMC East in Prescott Valley until the situation improves. Special circumstances may exist, including: Laboring mothers may have one support person with them. For additional questions relating to YRMC’s Family Birthing Center, please call (928) 442-8800. Pediatric patients may have one guardian or support person with them. Patients with disabilities that depend on the assistance of a family member or caregiver to receive care will be allowed to designate a support person to accompany them. End of life visitations will be accommodated. All visitors are expected to follow YRMC’s strict mask-use policy while inside any YRMC facility. YRMC currently requires all visitors to wear a procedural mask to enter a YRMC facility. Visitors without a procedural mask will be given one during the screening process before they may enter. Family members of patients receiving care at Yavapai Regional Medical Center are encouraged to call (928) 445-2700 for more information before they visit. To minimize the impact on patients and their families, YRMC continues to encourage the use of teleconference tools to stay connected and can make a limited number of electronic tablets available for patients who don’t possess a smart phone or tablet. YRMC wants to emphasize that patients in need of emergent care should not avoid a visit to one of YRMC’s Emergency Departments. Precautions are in place to ensure your safety. As patient volumes remain higher than normal, YRMC will make every effort to provide care as quickly as possible. YRMC encourages patients in need of non-emergent care to seek advice from their medical provider. YRMC wants to thank the community for their support and understanding during this challenging time. Visitation restrictions will be evaluated and adjusted based on COVID-19 infection rates throughout the community. Please continue to wear a mask, wash your hands, and practice social distancing to ensure your safety and the safety of others.
YRMC Emergency Department Staff Assists Charities in Need
The images of frontline healthcare workers are now common. The stories are inspiring. Every day for months, medical personnel and support staff mask up, gear up and do what they can to keep our community healthy. During the COVID-19 pandemic, they are risking their own health to take care of ours. Physicians and staff from the Dignity Health, Yavapai Regional Medical Center (YRMC) Emergency Department are no exception. Earlier this year, this selflessness was taken to a new level when, amidst their changing and often overwhelming duties related to the pandemic, the staff organized an effort to help those in need in our community. This is a tradition that started in early 2019. In lieu of an annual physician recognition event by YRMC’s administration, emergency physicians and nurses and YRMC decided to join efforts to help other organizations in the community with significant need. The group jointly donated a total of $9,000 to Prescott Area Shelter Services, a local women’s shelter. This year, the Emergency Department staff at YRMC East and YRMC West raised a total of $11,000. Their charities of choice were the Chino Valley Education Foundation Hungry Kids Project and the Coalition for Compassion and Justice (CCJ). “There we were at the height of the pandemic, with everyone in the department wearing PPE, working under stressful conditions. We heard that there was a need to help children and the homeless population. We all wanted to help,” recalls Dr. Bill Resnick, a member of the YRMC Emergency Medicine Physicians group. “What is so impressive is the thought of these nurses and other staff with young families at home, wearing gowns, taking care of patients at the hospital, then going home and caring for their families. They’re still wanting to help other people.” Hungry Kids Project “Adequate nutrition is recognized as a common barrier that effects attendance, retention and academic achievement of students,” says Rich Spencer, Program Manager of the Chino Valley Hungry Kids Project. “Providing this basic need would remove that barrier. The Hungry Kids Project distributes 10,000 weekend meals each year to Humboldt Unified School District children, primarily in elementary school. With adequate nutrition, kids can return to school on Monday well-nourished and ready to learn.” With children staying at home during the pandemic, it quickly became apparent that many of the families served by the Hungry Kids Project were in need of healthy meals throughout the week as well. “Someone once said that whatever we possess becomes of double value when we share it with others. Looking at the difference the financial support the YRMC Emergency Department has made to our organization, I know that to be true,” Spencer says. “As a direct result of their donation, we were able to provide weekend food bags to 857 students which equates to 5,571 meals served. Additionally, we were able to provide groceries for 10 families that lost their jobs due to the COVID-19 pandemic.” Coalition for Compassion and Justice For some 20 years, the Coalition for Compassion and Justice has provided vital services, education, housing and advocacy to members of our community who live in poverty. The goal is self-sufficiency and an end to homelessness. With the pandemic and subsequent economic downturn, their services became more relevant than ever. “We could not have expected that front line workers in the emergency department would be thinking about our needs during a pandemic, in which they were experiencing some of the greatest impacts of this crisis,” says Jessi Hans, Executive Director of CCJ. “As we moved to stay open 24 hours a day to keep our clients safe and healthy, we needed the additional resources to respond to their needs.” “We are grateful and still in awe of the generous donation from the staff at YRMC,” reflects Hans. “It is humbling and beautiful to feel that kind of heartfelt giving.”
Chronic Pain: How to Treat it, Not Just Manage it
Aching, throbbing, excruciating and relentless—chronic pain can be all of those and still difficult to describe for people experiencing it. “I compare chronic pain to a snowball that grows bigger as it rolls downhill,” said Cheryl Van Demark, PT, C-IAYT, Physical Rehabilitation Services, Dignity Health, Yavapai Regional Medical Center (YRMC). “The good news is that snowballs can be melted.” Guiding people as they learn how to melt that metaphorical snowball is something Van Demark does very well as the facilitator of YRMC’s Chronic Pain Self-Care Program. An important part of her role is helping program participants understand how the nervous system adapts to chronic pain. “Our protective reaction to pain is imbedded in our nervous system,” explained Van Demark, a YRMC Physical Therapist and Yoga Therapist. “How we respond versus how we react comes from how we have learned to approach adversity throughout a lifetime.” And it gets more complicated with chronic pain, which is defined as pain that lasts three to six months or longer and is present at least 50% of our days. Chronic pain can be the result of an injury, illness, surgery or nerve damage. However, it does not always involve tissue damage, as in the case of a phantom limb pain, for example. The Snowball Effect To understand the scope of chronic pain, let’s return to Van Demark’s snowball analogy. As the snowball rolls downhill, making rotation after rotation, other factors come into play: stress, exhaustion, lack of physical activity, rising blood pressure, weight gain (or loss), anger and fear, to name a few. “Now it’s no longer just the initial event that led to the chronic pain. All of these other factors are involved,” Van Demark said. YRMC’s Chronic Pain Self-Care Program focuses on treating the factors in the chronic pain cascade. In fact, Van Demark uses the words “pain treatment” or “pain care” as opposed to “pain management.” “Pain is not just something you learn to live with,” she said. “People absolutely have the capacity to change their experience.” A Pain Program Participant’s Story In recent years, the complicated nature of chronic pain has gained national attention. A staggering 20% of the general population and two-thirds of older adults live with chronic pain every day. Prescott resident Cassandra Culver is among that 20%. An injury she sustained in 2013 triggered a spiral of autoimmune diseases and persistent pain. By 2017, Culver needed a walker to get around. That’s when she began physical therapy through YRMC’s Physical Rehabilitation Services and soon after joined the Chronic Pain Self-Care Program. Today, Culver walks without an assistive device the majority of the time. YRMC’s Chronic Pain Self-Care Program – developed by members of the Physical Rehabilitation Services team and other YRMC healthcare professionals – features: Ten hours of instruction, delivered during two-hour sessions over five weeks. Knowledgeable speakers from YRMC’s Nutrition Counseling and Pharmacy as well as an interventional pain management expert. Support materials with specific self-care practices to pursue each week. Ongoing contact (every six weeks) with program participants to share tangible information and keep them connected to their self-care practice. How do YRMC’s Chronic Pain Self-Care participants benefit from the program? Most participants say they have less perceived stress, reduced fear of movement and a greater understanding of their pain. “The program helped me believe that I can have quality of life,” Culver said. Pain Program Empowers After their five weeks of learning, program participants meet every six weeks as part of the “Empowerment Group.” Its goal is to support people as they apply what they learned during the instructional sessions. During COVID-19, the Empowerment Group has continued via thought-provoking email messages and links to helpful video resources that Van Demark shares. “Through the program, participants learn to reframe their pain stories and embrace the story not yet written,” she said. “It’s about living life on their terms.” That’s exactly what Culver continues to do. She recently took up sewing, something she would have shied away from previously for fear it could increase her pain. “Part of what Cheryl brought to light with the Chronic Pain Self-Care Program is empowerment and enrichment,” Culver said. “You can find ways to bring activities back into your life that you enjoy and to learn new things.” Get Involved The Chronic Pain Self-Care Program approach is considered a best practice in pain care. It also supports YRMC’s mission and vision for a Total Healing Environment. To participate in YRMC’s Chronic Pain Self-Care Program, talk to your healthcare provider or contact Cheryl Van Demark by phone (928-771-4747) or email.
World Diabetes Day: A Day of Diabetes Prevention
By Justin Khoa Ma, Pharm.D., Pharmacy, Yavapai Regional Medical Center Did you know that one in two adults with diabetes remain undiagnosed? Multiple factors, such as family history, age, and obesity, increases the risk of diabetes. In 2019, approximately 463 million adults were living with diabetes globally; this is expected to rise to 578 million by 2030. To combat this global epidemic, the International Diabetes Federation (IDF) and the World Health Organization (WHO) created World Diabetes Day, which is annually recognized on November 14 as it’s also the birthday of Sir Frederick Banting, one of the scientists who discovered insulin. In light of World Diabetes Day, take a moment to review some online resources on diabetes for you and your loved ones. Online Diabetes Risk Assessment An important component of World Diabetes Day is to raise diabetes awareness and promote preventative actions. Left untreated, diabetes could result in serious complications, including permanent damage to your eyes, kidney, and nerves. The first step to prevention is early detection. Complete this 60-second, online risk assessment test for type 2 diabetes provided by the American Diabetes Association (ADA) for yourself or for your loved ones. Understanding your specific risks for diabetes will allow for an important conversation between you and your healthcare providers and plan for your next steps. American Diabetes Association (ADA) If you are already diagnosed with diabetes, review the online resources provided by the American Diabetes Association here. From healthy and delicious recipes to tips on incorporating exercise into your daily life, this valuable resource is a definite must to check out. YRMC and the CDC: Diabetes Info and Resources The Centers for Disease Control and Prevention (CDC) also provides a thorough explanation of different components of diabetes, including risk factors, symptoms, and the nuances between prediabetes, gestational diabetes, type 1, and type 2 diabetes. If you are newly diagnosed, check out Yavapai Regional Medical Center’s (YRMC’s) Outpatient Diabetes Self-Management Education Program. Our program includes classes, sessions with a diabetes nurse educator and other diabetes-related information, all designed to help you live better with diabetes. Healthy Conversations by YRMC Finally, YRMC provides some excellent resources on caring for your health on our online blog, YRMC HealthConnect. From carb-counting to cooking a healthy, hearty risotto, YRMC strives to provide resources to create a total healing environment that meets our communities’ needs. Subscribe to YRMC HealthConnect and stay tuned for more health-related topics to help you care for yourself and your family!
Lung Cancer Screening: A YRMC Healthy Conversations Presentation
If you’ve ever smoked or you’re a current smoker, the possibility of lung cancer is probably in the back of your mind. What you may not know is that 80 percent of lung cancers are curable, if they’re found early. Enter Lung Cancer Screening and Care at Dignity Health, Yavapai Regional Medical Center. This program uses low-dose computed tomography (LDCT) to detect lung cancer early in people considered high-risk for lung cancer. During a recent YRMC Healthy Conversations, Jennifer Harvey, RN, Nurse Navigator, Lung Cancer Screening and Care, highlighted how the program saves lives with early detection. You’re may qualify for Lung Cancer Screening and Care if you are: 55 to 80 years old (depending on your insurance provider) A current smoker or a former smoker who quit in the last 15 years A smoker with a history of at least 30 “pack years”—one pack a day for 30 years Participants must also have no symptoms of lung cancer and be healthy enough – as well as willing – to undergo curative treatment. Harvey also discussed Arizona’s latest lung cancer statistics (there’s some good news), provided smoking cessation resources, and responded to questions during the livestream presentation. For more information about Lung Cancer Screening and Care, contact Jennifer Harvey, RN, at 928-771-5454 or jlharvey@yrmc.org. Subscribe to YRMC HealthConnect to keep up-to-date on Healthy Conversations topics or check out our calendar. You can register for future presentations or watch past presentations at YRMC HealthConnect.
Your Blood, Your Call
Patient Blood Management (PBM) is a multi-disciplinary approach to maximizing your own blood health and supply. Often this is most crucial during surgery. When large amounts of blood are lost in surgery, it is often possible to get the blood you need by electing to use your own blood. Not blood from a donor, not blood limited by type. And not blood straining the nation’s precious blood supply. (This is especially important during COVID-19 when national blood banks have experienced a drop in donations, which in turn reduces blood supply and drives up blood costs.) The decision is yours—the YRMC PBM program hinges on informed consent. Meaning you have the right to be informed of your choices. Then you have the right to choose to optimize and/or use your own blood (captured and reinfused during surgery), receive someone else’s blood, or receive a combination of both when necessary. It’s your blood, your call. Based on your decision, a team of medical professionals will assess your blood management needs and develop a clinically sound, evidence-based plan of care during your hospital stay. This plan marshals pharmaceuticals, technology and medical techniques to decrease blood loss and enhance blood cell production—which reduces or eliminates the need for a blood transfusion. Progressive Leadership Yavapai Regional Medical Center (YRMC) has the only officially recognized PBM program in Arizona and one of the relatively few in the nation. When it comes to PBM, your local hospital is doing some of the highest caliber work in the country and even the world. That’s why YRMC hosts an annual PBM Symposium in Prescott, an event viewed internationally and presented by some of the world’s leading PBM experts. How did this happen? “We owe our PBM program to progressive leaders and top-notch medical professionals at our hospital,” said PBM Program Coordinator Dale Black. The program started in 2012 after Black and Pierre Tibi, MD broached the subject with hospital administrators. “It never would have happened without leadership’s forward-thinking mindset and ongoing commitment over the past eight years,” Black said. “In less than a decade we’ve become part of a worldwide initiative that uses evidence-based science to achieve better patient outcomes using blood management principles.” Today Dr. Tibi is a leading authority on PBM and serves as the Medical Director of the YRMC PBM Program and The James Family Heart Center. Better Outcomes While blood transfusions remain a vital life-saving procedure, growing evidence shows that patients who maximize their own blood supply benefit from: lower infection rates. less anemia. fewer kidney, lung and heart complications. less exposure to viruses and other blood-borne disease. shorter hospital stays. all-around better surgical outcomes. A Continuum of Care YRMC’s PBM program provides you with care and support before, during and after surgery. Presurgical measures center on optimizing red blood cell mass to prevent anemia. This may involve iron therapy, a vitamin regime, nutritional support and medication management. Erythropoietin-stimulating agents (ESAs) may be administered via a shot to stimulate the production of additional red blood cells. Surgical techniques may include removing a calculated amount of blood, adding non-blood expanders, and reinfusing red cells back to the patient. Or they may include cell-salvage, collecting blood lost during surgery—then washing, filtering and reinfusing red blood cells back to the patient. Hemostatic agents may be used to promote rapid blood coagulation. Postsurgical procedures include detecting and mitigating bleeding, minimizing the frequency and volume of blood draws, nutritional support, and continued iron therapy, possibly in conjunction with ESA administration if appropriate. The next time you are scheduled for surgery at YRMC, be sure to ask about Patient Blood Management, or PBM. For more information you can also contact Dale Black directly at dblack2@yrmc.org or (928) 771-5109. You can also visit the Society for the Advancement of Blood Management and download their Patient Guide.
Top Orthopedic Surgeon to Lead New Yavapai Regional Medical Group
Yavapai Regional Medical Center (YRMC) has expanded its network of multispecialty medical practices to include Yavapai Regional Medical Group, Orthopedic Surgical Services. Francisco Jaume, DO, an accomplished orthopedic surgeon with 28 years of experience, will serve as Lead Orthopedist for Yavapai Regional Medical Group, Orthopedic Surgical Services (formerly Yavapai Regional Medical Center PhysicianCare). The new Clinic has opened at the following temporary location: YRMC Outpatient Services Building 7700 East Florentine Road, Building B, Suite 203 Prescott Valley, Arizona 86314 (928) 708-4545 An Experienced Orthopedic Surgeon In his new role, Dr. Jaume will lead the development of Yavapai Regional Medical Group, Orthopedic Surgical Services, which will serve the orthopedic needs of people throughout Yavapai County. “I’m looking forward to building an orthopedic group from the ground up,” Dr. Jaume said. “Our goal is to provide the highest quality care to patients. We’ll achieve this through a talented team of orthopedic surgeons, registered nurses and other healthcare professionals who will join me in delivering the latest in orthopedic surgical services.” Leveraging Collaborative Care Yavapai Regional Medical Group, Orthopedic Surgical Services takes a collaborative approach to healthcare thanks to the multispecialty medical practices that comprise Yavapai Regional Medical Group. The collaborative, integrated network includes 25 primary and specialty clinics located throughout the community. Dr. Jaume – who is board certified by the American Osteopathic Board of Orthopedic Medicine – is an expert in the following orthopedic surgical procedures and care: Knee arthroscopy Knee replacement Hip replacement Carpal tunnel release Press-fit total knee replacement Fracture care (upper and lower extremities) Joint injections Rotator cuff repair Achilles tendon repair Flexor and extensor tendon repair of the hand A Career of Service Dr. Jaume has served patients in the Quad Cities area since 2004. In 2015, he was recognized as YRMC’s Physician of the Year for his outstanding leadership and commitment to exceptional patient care. Dr. Jaume received his Doctor of Osteopathic Medicine from the University of Medicine and Dentistry of New Jersey in Stratford, New Jersey. After that, he pursued a rotating internship at Union Hospital in Union, New Jersey. This was followed by an orthopedic surgical residency at the College of Osteopathic Medicine in Philadelphia, Pennsylvania. Dr. Jaume’s career also includes an impressive record of military service. He served in the United States Marine Corps for six years, achieving the rank of Sergeant. He also served for eight years in the United States Air Force Medical Service Corps, where he earned the rank of Major. For more information about Yavapai Regional Medical Group, Orthopedic Surgical Services, talk to your primary care provider, visit YRMC.org, or call (928) 708-4545.
YRMC’s Your Healthy Kitchen: Making a Delicious Meal in a Bowl While Raising Awareness for Lung Cancer Screening
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/.
Taking On Breast Cancer
October is National Breast Cancer Awareness Month—a annual observance aimed at raising both awareness and funding. The funding is for research into the prevention, diagnosis, treatment and ultimately the cure for breast cancer. Awareness is generated in part through a pink ribbon, a symbol of solidarity among women and families touched by the disease. Such solidarity is found year around at The BreastCare Center at YRMC East in Prescott Valley. The center bands together to take on breast cancer and support women through all phases of the disease—prevention, detection, diagnosis, treatment and supportive care. At the BreastCare Center, women can receive one-on-one support from a clinical navigator, a registered nurse assigned just to them. This navigator serves as personal guide, advocate, educator and friend. And should the need arise, helps to perform a risk analysis. “If a patient’s family history shows they carry a higher risk for breast cancer, one of our navigators can perform a more comprehensive risk assessment called the Tyrer-Cuzick,” said Kathleen Hoffer, Imaging Operations Manager at the BreastCare Center. The tool is used to help inform a person’s decision about whether to get more genetic counselling and testing. Such genetic testing may be done through the center or a genetics expert may visit the home. Risk Factors Along with risk factors associated with family history and genetics, the National Breast Cancer Foundation has identified the following breast cancer risks: Gender: Women are 100 times more likely to get it than men Age: Two out of three women are diagnosed after age 55 Race: White women are more likely to get it Personal health history: If you get cancer in one breast, you risk getting it in the other breast Menstrual and reproductive history: Your risk increases if you started menstruating early (before age 12), started menopause after 55, had your first child when older or never gave birth Dense breast tissue: Increases your risk and make lumps harder to detect Early Detection “When patients are aware they carry a higher risk for breast cancer, they are usually more diligent about getting their regular screenings done,” Hoffer said. “Those at a really high risk might have an MRI along with their mammogram. If they find they have dense breast tissue, we may recommend tomography or ultrasound.” Early detection saves lives. When caught early enough, breast cancer is often stopped before it spreads. Regular screenings can detect breast cancer even before symptoms occur. These symptoms, once evident, include: Change in the look or feel, size or shape, of the breast Change in the look or feel of the nipple, including nipple discharge A lump or hard knot in the breast or underarm area Swelling, warmth, redness or darkening of the breast Dimpling or puckering of the skin Persistent pain in one area of the breast Prevention A healthy body is better equipped to fight off disease, including cancer of the breast. So basic healthy living is your main defense against breast cancer. These basics haven’t changed: exercise at least 30 minutes a day, five days a week; maintain a healthy weight; don’t smoke; and limit alcohol to one drink a day for women, two drinks a day for men.
Lifestyle Habits that Protect Against Breast Cancer
Today, one in eight women living in the U.S. will develop breast cancer in her lifetime, according to data cited by the American Cancer Society. That’s why it’s so important to do everything you can to reduce your risk. Experts agree that women (and men) can lessen their likelihood of getting breast cancer by moving more and sitting less everyday; working up a sweat a few times a week; building some muscle; and cutting back on alcohol. In fact, research shows that Americans could prevent one in three cases of breast cancer with healthy lifestyle habits. Move More and Sit Less Physical activity tops the list of lifestyle practices that provide protection to women and men at every age. According to a study released in 2017 by the American Institute for Cancer Research and the World Cancer Research Fund, 150 minutes per week of regular moderate activity, like walking at a pace that causes a slight increase in heart rate and deeper than normal breathing, reduces the risk of breast cancer in pre- and post-menopausal women by about 13% when compared to sedentary individuals. Vigorous exercise, or that which causes a faster heart rate and some sweating, boosts protection for pre-menopausal women to 17%. Other studies suggest even higher rates of protection when individuals increase exercise time to up to 300 minutes per week. Moving more and sitting less throughout the day and engaging in regular physical activity likely reduces the risk of breast cancer by lowering inflammation in the body (a risk factor for many types of cancer and other chronic diseases), reducing insulin resistance (which lowers blood glucose and insulin levels in the blood), improving immune function, and by reducing circulating levels of estrogen. In fact, some research suggests that a sedentary lifestyle, or one with little to no physical activity, is a major risk factor for breast and other types of cancer. A Lifetime of Enjoyable Exercise Decreases Breast Cancer Risk! Take away tips: Shoot for a minimum of 150 minutes of moderate, or 75 minutes of vigorous exercise 5 days a week. If you are new to physical activity, start with 5-10 minutes of activity at a time and gradually build your strength and stamina. Always check with your doctor before engaging in any new exercise plan. Get up every hour and do some walking, stretching, or other movement for 5 minutes if your lifestyle and job are sedentary. If you tend to be active only during certain seasons, plan to continue some type of regular, enjoyable movement year round. Since physical activity throughout life reduces the risk of breast and other types of cancer, encourage children to engage in regular physical activity that they enjoy and can continue into adulthood. Muscle Up After Menopause Multiple studies show that reducing body fat (especially abdominal fat) while increasing muscle mass can lower breast cancer risk in women after menopause. According to a study done by the University of North Carolina’s Lineberger Comprehensive Cancer Center, higher levels of body fat seem to be related to lower breast cancer risk in younger women, while weight and fat gain after menopause increases risk. While the reasons for this are not totally clear, researchers think that body fat protects breast tissue from excessive estrogen production in younger years, but increases exposure after menopause. Add Weights to Your Workouts! Take away tips: Maintain a healthy percentage of body fat throughout your lifetime. Keep physically active after menopause, and be sure to include strengthening exercises that build muscle and reduce body fat. Limit Alcoholic Beverages According to the American Cancer Society, even small amounts of alcohol may increase a women’s risk of breast cancer. Ethanal, the by-product of alcohol metabolism, can directly damage the DNA in cells, potentially leading to cancer growth and spread. Alcohol also raises estrogen levels in the blood, thus increasing risk of some breast cancer types. Take away tips: Consider limiting alcohol to three drinks per week or less. One drink is equal to 5 ounces of wine, 12 ounces of beer or 1.5 ounces of 80-proof liquor. Experiment with fun and flavorful mocktail recipes! Some physicians recommend that women at high risk of breast cancer avoid alcohol altogether. Enjoy Fun, Flavorful Mocktails! No one can predict exactly what combination of factors might lead to the growth and spread of breast cancer cells. However, good and extensive research shows that healthy lifestyle habits offer significant protection against this debilitating and potentially deadly disease. You can learn more about breast cancer, preventive testing, treatment, and local resources at YRMC’s Breast Care Center.
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.
Breaking Free from Information Overload
The world has seen pandemics before, but COVID-19 has introduced a new set of challenges unique to the digital age–-information overload. Information overload is a real phenomenon where people have unlimited, instant access to related, but unauthenticated information. Overload often occurs when too much relevant information arrives too quickly, making it difficult to determine which information is reliable and helpful. It can make people feel overwhelmed and powerless, causing fatigue, anxiety and anger. This can lead to a type of paralysis where people don’t know what to do, so do nothing, which can be dangerous during a pandemic. So how do we break free from information overload–-so information can give us strength rather than deplete us? These tips may help. Limiting Information Pick Your Sources. Select your sources carefully. Give top consideration to people and organizations with access to authenticated information. Set Select Times. The sudden and near-constant stream of news reports can be agitating, so gather information at regular intervals once or twice a day, seeking to distinguish facts from rumors. Focus on Facts. Cut down on how often you engage with venues where fear feeds on itself rather than reality. For example, limit social media or conversations with people who do more speculating and catastrophizing than sharing sound information. These types generally assume the worst and tend to exaggerate difficulties. Take a Break. Continual watching, reading or listening to the news can be upsetting. Constant scrolling through social media for the latest updates on the pandemic can also be stressful. Take a break. Make time to unwind and do activities you enjoy. Cutting Back on Screen Time The fact people have nearly constant access to digital screens doesn’t help. iPhone recently reported that user screen times have more than doubled during the pandemic. Here are some ways to cut back. Put your phone in another room. This simple act forces you to think twice when you would normally grab your phone without even realizing it. Ban the phone from the bedside. Keeping the phone by the bed may tempt you to check for messages or the time if you wake during the night. Looking at your phone’s screen just before bed has been shown to disrupt sleep patterns for some people. Keep meals phone free. Meals are a tempting time to catch up on news and social media. By banning screens from the table you’ll not only give your eyes a rest, you’ll probably enjoy your food more. Set the timer. Set time limits on Facebook, Instagram, Twitter, etc. Start by timing how long you actually spend there, then gradually reduce those times to a more realistic level. Move or remove apps. Figure out which apps tend to hook you in. Then either delete them or move them to a different page or folder. This slight inconvenience may be enough to stop you from unconscious scrolling. Disable notifications. Notifications are distracting. They can tempt you to get on your phone and before you know it minutes have turned into hours. Managing the flow of information will not only free us from information overload but also lead to clearer decisions while we navigate uncharted territory.
Dignity Health, Yavapai Regional Medical Center Complete Affiliation
Yavapai Regional Medical Center (YRMC) and Dignity Health have completed an affiliation, uniting two strong healthcare systems that are committed to creating healthier communities by providing accessible, affordable and innovative health services. The affiliation will scale best-in-class clinical services, recruit and retain primary care providers and top medical specialists, and align clinical operations to improve delivery of care. It will also bring to Yavapai County innovative medical technologies and treatments, as well as collaborative initiatives with existing community resources, which will expand YRMC’s ability to effectively serve and advocate for all people. Shared Values, Vision and History “This partnership is a reflection of our shared vision and values with YRMC, and we look forward to helping enhance healthcare services for the residents of Yavapai County,” says Linda Hunt, president and CEO of Dignity Health’s Arizona Division. “Yavapai County residents will continue to receive exceptional medical care, and now they will also have access to world-class specialty services.” In addition to providing leading acute-care services and expanding access to healthcare, the affiliation is focused on reinvesting in the community through grants and the creation of additional clinical programs to better serve the residents of Yavapai County. “This is an important milestone in our 77-year journey of serving Yavapai County,” says John Amos, president and CEO of YRMC. “This affiliation will expand our current healthcare services and resources to benefit the people and communities we serve.” Dignity Health and the Prescott community share a special historical significance that dates back to 1890 when the Sisters of Mercy, who founded Dignity Health St. Joseph’s Hospital and Medical Center in Phoenix, opened Prescott’s first hospital. “We have a long-standing shared legacy with Yavapai County and we are excited to come home to provide a strong future of healthcare services within the Quad Cities,” says Hunt. A Consistent, Thoughtful Alignment Leadership from both organizations are working closely to ensure consistent, thoughtful alignment. No assets were exchanged under the affiliation, and any transitions will be phased in over the next year. YRMC will be part of Dignity Health’s Arizona Division and will remain a not-for-profit, community hospital. The affiliation is not anticipated to cause any disruption in service or access to healthcare, but rather increase access and availability to health services. The organizations’ leaders will continue to communicate developments with staff and community stakeholders as they occur. Dignity Health’s Arizona division includes six acute-care hospitals in the Phoenix-area including Chandler Regional Medical Center, Mercy Gilbert Medical Center, St. Joseph’s Hospital and Medical Center, which includes Barrow Neurological Institute, Norton Thoracic Institute, and Dignity Health Cancer Institute; St. Joseph’s Westgate Medical Center, Arizona General Hospital Laveen and Arizona General Hospital Mesa. From this foundation, Dignity Health in Arizona has expanded into a comprehensive healthcare system, which includes clinics, specialty hospitals, urgent cares, insurance providers, and an accountable care organization.
YRMC’s Kim Haugen Named PV Chamber of Commerce 2020 Volunteer of the Year
Photo: Kim Haugen, Prescott Valley Chamber of Commerce 2020 Volunteer of the Year (center) with Frank Almendarez, YRMC East Chief Administrative Officer (left) and Chris Graff, Chair of the PV Chamber of Commerce (right). After working in corporate management in Illinois, Kim Haugen moved to Prescott and became a Medical Transcriptionist. She enjoyed working from home and appreciated the flexibility the job offered. However, Haugen sometimes felt like she was missing out on regular interaction with others. Eleven years ago, after some thoughtful consideration, she decided to volunteer once a week with the PAWS (Pets are Warm Support) pet visitation program at Yavapai Regional Medical Center (YRMC) with her then two-year-old Bouvier dog, Dirk. “Joining PAWS at YRMC was one of most worthwhile things I have ever done,” says Haugen. “There’s nothing like that connection between a dog and a person. He has touched so many lives. People have even recognized him on the street!” Dirk is now 13 years old and no longer joins Haugen at YRMC. “When Dirk could no longer walk, I requested a different job on Thursdays,” Haugen continues. “It was important to me to keep seeing the other YRMC volunteers, management and staff who had become my friends.” She started delivering the mail each Thursday, and over the years has tackled positions as varied as stocking supplies in the Family Birthing Center and Nutrition Department, helping with the ‘Pet Partners’ certification process, working as an Escort and serving at the Information Desk. She has become a well-respected volunteer throughout the hospital, known for her dedication and hard work. Victoria Spears, YRMC East Volunteer Services Manager, wanted to give Haugen special recognition for all she has done for YRMC. She submitted a nomination to the Prescott Valley Chamber of Commerce for their Volunteer of the Year Award. “Kim constantly goes above and beyond the call of duty,” states Spears. “When she sees a need, Kim is the first one to offer to fill it. She displays all the qualities of a valuable volunteer, exemplifying the spirit of cooperation. She is respected not only by the other volunteers but by staff as well.” The Chamber chooses one recipient each year for their Norm Pariseau Volunteer of the Year Award. Pariseau was a longtime member of the Prescott Valley Early Bird Lions and was Board Chairman of the Prescott Valley Chamber. Each year, the winner exemplifies Pariseau’s commitment to the community and generosity of spirit. Haugen won the award. “Kim not only works hard and does an excellent job, but she truly loves to serve YRMC and our community and this is very apparent when you see her in action,” says Spears. Haugen was not expecting the honor. “This certainly surprised the heck out of me!” admits Haugen. “It’s very humbling. There are so many wonderful, deserving volunteers. And I was chosen not only from YRMC, but from all over Prescott Valley. It’s so exciting.” Haugen continues, “I like to think of this as an honor not only for me, but for YRMC – for the way they have cared for the community, not only during the pandemic, but over the years. I felt that the award was as much for the hospital as for me, and this was the Chamber’s way of thanking the hospital through me.” “Volunteering makes you feel like you are helping the community. It’s so nice to give back, to feel like you’re making a difference in someone’s life,” says Haugen. “And even behind the scenes – helping make the staff’s job easier. That’s a good feeling. You’re giving the workers a chance for more quality time with their patients.” Haugen’s beloved dog Dirk was, in many ways, responsible for bringing her to YRMC and launching her years-long commitment to the hospital. It’s nice to know that while Dirk has ‘retired’ from volunteering, he has a little brother named Sebastian. Haugen is happy to report that Sebastian may begin visiting YRMC patients through the PAWS Program in the not too distant future! To learn more about becoming a volunteer at Yavapai Regional Medical Center, visit yrmc.org. Or, you can call Volunteer Services in Prescott at (928) 771-5678, or in Prescott Valley at (928) 442-8678.
Longest Running YRMC Volunteer Celebrates Her 40th Year
Forty years ago, volunteering at Yavapai Regional Medical Center (YRMC) would often mean joining the Medical Auxiliary. Dues were $5 a year. Auxiliary members would dedicate their time assisting at the Information Desk or Gift Shop. The dress code was strict. In fact, Auxiliary members purchased their own uniforms and wore regulation blouses. Dorothy Kalabus, YRMC’s longest-running volunteer, remembers those days with fondness and a good dose of her signature humor. “Imagine today if you had to pay to be a volunteer!” she jokes. Kalabus had just moved to Prescott from Pittsburgh. She had three school-aged children and her husband’s airline job often took him out of town. Not one to sit at home, she soon joined the Auxiliary and started a decades-long relationship with YRMC. It wasn’t long before Kalabus was asked to join the Auxiliary Board. In those days, the Auxiliary Board decided upon ‘wish list’ purchases for the hospital, funded by proceeds from the Gift Shop. When her grandson was born, Kalabus recalls that the stress monitor, just purchased by the Auxiliary, was used during his delivery. “I was so glad it was there for the staff to use,” says Kalabus. Dorothy Kalabus is the 10th of 12 children. Her father died when she was eleven. She and her siblings were raised to pitch in whenever and wherever possible. She graduated with honors and earned college scholarships. “There was never any idle time at our house,” she remembers. “I can’t even imagine sitting and doing nothing.” Now, at nearly 80 years old, Kalabus still has the energy of someone a fraction of her age. Forty years at the YRMC Information Desk isn’t the only impressive item on her volunteer resume. “Back in the 80’s I volunteered at Sacred Heart Church and at the Prescott Rodeo, where I became the chair of the Cattleman’s Club. I even earned my gold and silver rodeo belt buckle. I offered to stuff envelopes for Judge Ann Sterling’s campaign, and ended up becoming the campaign chair!” Nancy Thomes, Director of Volunteer Services at YRMC, emphasizes the important role Kalabus plays at the Information Desk. “Dorothy is such a joy to have at our Information Desk,” says Thomes. “This is a challenging position since the questions that are asked are often new. These volunteers often have to problem-solve while extending good customer service. Dorothy’s knowledge and willingness to serve is always evident, and the joy that she feels while doing this is always apparent.” When asked why she has stayed with her service to YRMC for forty years, Kalabus explains, “This is so important. You’re dealing directly with people in need. People come in with so many different needs. Most of them aren’t just asking for a patient’s room number, and often they’re in pain or feeling stress. You have to remember a lot of information about the hospital, and communicate it simply and clearly.” “And then there are the free lunches!” she laughs. “Every Friday, a dozen or so volunteers from all different departments get together for lunch, and new volunteers are always welcome. These people have all become my friends. We have such a good time!” Kalabus notes that she belongs to a special ‘foursome’ that makes her time at YRMC extra special. She works with Escorts Carol Shepherd and Shirley Reeves and fellow Information Desk volunteer Rob Petrocci each Friday. “We’re a great team,” she says. Kalabus was honored for her 40 years of service on July 2nd. Thomes and Chamine David, Volunteer Services Manager, visited Kalabus in her front yard for a ‘physically distanced’ celebration. Kalabus’ husband and daughter were there, as well as fellow volunteers Shepherd and Reeves. The neighbors across the street even held up a large handmade ‘Congratulations’ sign and took photos. “Dorothy enjoyed telling a few stories about her first days at YRMC,” says Thomes. “It was clear that her commitment to her role began 40 years ago when she first started volunteering.” “It was a fun visit,” Kalabus recalls. “There were balloons and flowers and we visited and reminisced. It’s fun telling the old stories and marveling at how far YRMC has come over the years. But I still can’t believe it’s been 40 years!” “I tell people that volunteering gives you life,” she explains. “It gives you something to look forward to and makes your life so much more interesting. Volunteering changes your whole world.” Kalabus continues. “When I started volunteering at YRMC 40 years ago, it was just to get to know a few people in my new hometown. But soon, I came to realize that this is a commitment. And as you can tell, when I start something, I finish it. Well, I’m not finished yet!” To learn more about becoming a volunteer at Yavapai Regional Medical Center visit yrmc.org, or call Volunteer Services in Prescott at (928) 771-5678, or in Prescott Valley at (928) 442-8678.
Your Blood, Your Call
Patient Blood Management (PBM) is a multi-disciplinary approach to maximizing your own blood health and supply. Often this is most crucial during surgery. When large amounts of blood are lost in surgery, it is often possible to get the blood you need by electing to use your own blood. Not blood from a donor, not blood limited by type. And not blood straining the nation’s precious blood supply. (This is especially important during COVID-19 when national blood banks have experienced a drop in donations, which in turn reduces blood supply and drives up blood costs.) The decision is yours—the YRMC PBM program hinges on informed consent. Meaning you have the right to be informed of your choices. Then you have the right to choose to optimize and/or use your own blood (captured and reinfused during surgery), receive someone else’s blood, or receive a combination of both when necessary. It’s your blood, your call. Based on your decision, a team of medical professionals will assess your blood management needs and develop a clinically sound, evidence-based plan of care during your hospital stay. This plan marshals pharmaceuticals, technology and medical techniques to decrease blood loss and enhance blood cell production—which reduces or eliminates the need for a blood transfusion. Progressive Leadership Yavapai Regional Medical Center (YRMC) has the only officially recognized PBM program in Arizona and one of the relatively few in the nation. When it comes to PBM, your local hospital is doing some of the highest caliber work in the country and even the world. That’s why YRMC hosts an annual PBM Symposium in Prescott, an event viewed internationally and presented by some of the world’s leading PBM experts. How did this happen? “We owe our PBM program to progressive leaders and top-notch medical professionals at our hospital,” said PBM Program Coordinator Dale Black. The program started in 2012 after Black and Pierre Tibi, MD broached the subject with hospital administrators. “It never would have happened without leadership’s forward-thinking mindset and ongoing commitment over the past eight years,” Black said. “In less than a decade we’ve become part of a worldwide initiative that uses evidence-based science to achieve better patient outcomes using blood management principles.” Today Dr. Tibi is a leading authority on PBM and serves as the Medical Director of the YRMC PBM Program and The James Family Heart Center. Better Outcomes While blood transfusions remain a vital life-saving procedure, growing evidence shows that patients who maximize their own blood supply benefit from: lower infection rates. less anemia. fewer kidney, lung and heart complications. less exposure to viruses and other blood-borne disease. shorter hospital stays. all-around better surgical outcomes. A Continuum of Care YRMC’s PBM program provides you with care and support before, during and after surgery. Presurgical measures center on optimizing red blood cell mass to prevent anemia. This may involve iron therapy, a vitamin regime, nutritional support and medication management. Erythropoietin-stimulating agents (ESAs) may be administered via a shot to stimulate the production of additional red blood cells. Surgical techniques may include removing a calculated amount of blood, adding non-blood expanders, and reinfusing red cells back to the patient. Or they may include cell-salvage, collecting blood lost during surgery—then washing, filtering and reinfusing red blood cells back to the patient. Hemostatic agents may be used to promote rapid blood coagulation. Postsurgical procedures include detecting and mitigating bleeding, minimizing the frequency and volume of blood draws, nutritional support, and continued iron therapy, possibly in conjunction with ESA administration if appropriate. The next time you are scheduled for surgery at YRMC, be sure to ask about Patient Blood Management, or PBM. For more information you can also contact Dale Black directly at dblack2@yrmc.org or (928) 771-5109. You can also visit the Society for the Advancement of Blood Management and download their Patient Guide.
YRMC: Your Destination for Heart Care and Patient Blood Management
What does the phrase “destination healthcare” bring to mind? For a growing number of people in Arizona and the southwest it means heart care, patient blood management or both of these specialized programs, provided by Yavapai Regional Medical Center (YRMC). Cardiac specialists from the James Family Heart Center and leaders from YRMC’s Patient Blood Management program (PBM) joined a live-stream event on October 17, 2019 at Yavapai College Performing Arts Center to speak about both of these innovative programs. Over 600 participated in “YRMC – Your Destination for Cardiac Care and Blood Management” at Yavapai College and the live-stream the event online. YRMC – Your Destination for Cardiac Care and Blood Management featured exceptional cardiac specialists: a Cardiologist, Cardiac Electrophysiologist, Cardiothoracic Surgeon, and a Structural and Interventional Cardiologist. Patient Blood Management experts also took part in the event. Together, these professionals highlighted the services, technology and teamwork that are the hallmark of YRMC’s Heart Program and Patient Blood Management Program. “Neither of these programs existed 12 years ago,” said Pierre Tibi, MD, FACS, Medical Director of YRMC’s James Family Heart Center and Patient Blood Management Program. “Today, there is no other community hospital in Arizona or the southwest that offers what YRMC does. We are now a destination program for Cardiac Care and PBM.” Defining PBM Until recently, prestigious organizations like the Society for the Advancement of Blood Management (SABM), the World Health Organization (WHO) and the American Association of Blood Banks (AABB), all mentioned blood transfusions in their PBM definitions. “They focused on thresholds for blood transfusion,” said Dr. Tibi, SABM’s Immediate Past President. “Today, the SABM definition states that PBM is a patient-centered approach that aims to improve patient outcomes.” At YRMC, this is accomplished by: Involving the patient in decision making Identifying anemia and other conditions early Managing conditions that can affect blood count Minimizing blood loss during hospitalization Embracing PBM tactics throughout the organization “We focus on taking care of the entire patient and keeping the patient as safe as possible before, during and after a procedure,” said Dale Black, Coordinator, Patient Blood Management, YRMC. “And one way to keep patients safe is to not subject them to possibly unnecessary blood transfusions.” YRMC: What Your Heart Needs John Amos, President and CEO, YRMC, recalled the beginning of YRMC’s heart services, which launched in 2004 with a single Cardiac Catheterization Lab at YRMC West in Prescott. “Even then, we envisioned a heart program that would bring together the latest services, exceptional specialists, unparalleled technology and compassionate caregivers,” said Amos. YRMC took a major step toward that goal in 2007 when Dr. Tibi – a highly regarded Cardiothoracic Surgeon from Phoenix – joined YRMC. Dr. Tibi brought open heart surgery to the community, launched YRMC’s Heart Program and introduced PBM. Under Dr. Tibi’s leadership, YRMC’s thriving, comprehensive Heart Program has grown to feature these services and exceptional cardiac specialists: Structural Heart Disease Services – Soundos Moualla, MD, FACC, FSCAI, Structural and Interventional Cardiologist, YRMC PhysicianCare, Prescott Mitral Valve Repair with MitraClip Paravalvular Leak Closure (PVL) Transcatheter Aortic Valve Replacement (TAVR) Transcatheter Mitral Valve Replacement (TMVR) WATCHMAN™/Left Atrial Appendage Closure (LAAC) Electrophysiology Services – Nisha Tung-Takher, MD, Cardiac Electrophysiologist, YRMC PhysicianCare, Prescott Curative Management and Ablation Procedures for Cardiac Arrhythmias (atrial fibrillation, atrial flutter, supraventricular tachycardia, atrial tachycardia, premature ventricular contractions and ventricular tachycardia) Device Implantations (pacemakers and defibrillators) Remote Monitoring (pacemakers, defibrillators and cardiac resynchronization therapy, CRT) Heart Failure Management Care with Compassion YRMC’s Heart Program and PBM Program combine science and service, according to George Rizk, MD, Invasive Cardiovascular Medicine, YRMC PhysicianCare in Prescott. “YRMC is doing what’s best for patients,” said Dr. Rizk, who presented during the live-stream event. “If you deliver the most scientifically advanced services without putting the patient’s interest first, you don’t get too far. YRMC’s team has a passion for helping patients.” One way that YRMC does what’s best for patients was described by Elizabeth Black, YRMC’s Patient Blood Management, Data Manager. In the tradition of healthcare and acronyms, she called it “KTBITP” or “keeping the blood in the patient.” Less than a decade ago, Black noted, blood transfusion was the most common procedure performed in U.S. hospitals. While some blood transfusions are deemed medically necessary, she said, they all come with risks. Those risks include increased infection rates, medical complications (kidney, lung and heart), and higher death rates. PBM strategies combine evidence-based medicine with good clinical practice to maximize the patient’s blood health and reduce exposure to risks associated with transfusion. A Field of Dreams Dr. Rizk remembers the opening of YRMC’s first Cath Lab as a “field of dreams” moment. “We thought: If we build it, they will come,” he said. “And, if you build it well, they will never leave.” These statements are even more relevant today as YRMC’s Heart and PBM Programs emerge as destination programs. To learn more about YRMC – Your Destination for Cardiac Care and Blood Management check out YRMC HealthConnect. For information about YRMC’s Heart Program and PBM Program, visit our website.
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 ten 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.
Detect Prostate Cancer Early
During National Prostate Cancer Awareness Month remember—when you detect prostate cancer early your chances of successful treatment go up exponentially. The importance of early detection ranks right up there with knowing your risks and practicing prevention, prostate topics covered in an earlier story on YRMC HealthConnect. One of the best ways to detect prostate cancer early is through regular screening. When should you start? That’s a conversation for you and your doctor. Your doctor can recommend a screening routine after taking your risk factors into account. These primarily include family history, race and age. Screenings typically begin between 40 and 50. Screening Routine screening includes a digital rectal exam (DRE) where your doctor examines the size and shape of your prostate with a gloved finger. Typically, your doctor also checks the level of your prostate-specific antigen (PSA). This test measures the amount of PSA in your blood. It is often ordered as part of routine blood work done at your regular checkup. PSA is a protein produced by cells in the prostate. Since cancerous cells tend to produce more PSA, a spike in your PSA level, or a steady increase over time, may signify a problem. But it may not. That’s why more tests are often needed. Diagnosing When a DRE or PSA test reveal something abnormal in your prostate, you may need further testing to rule out prostate cancer. This often entails a biopsy where sample tissues are examined under a microscope. However, this method can cause incontinence and erectile disfunction over time. It also carries the risk of infection. A safer way to detect intermediate to high risk cancers is through a prostate MRI (Magnetic Resonance Imaging). This method lowers the risk of incontinence and impotence associated with excessive biopsies. Yavapai Regional Medical Center now offers prostate MRIs. An MRI is a good option for those who have an elevated PSA and want to avoid frequent biopsies. Or for those who want to get a prostate MRI to confirm biopsy results. Please discuss these options with your doctor. A prostate MRI is covered by most insurance plans, including Medicare. If you receive a confirmed diagnosis of prostate cancer, the next step is to determine the extent, or the stage, of the disease. After assessing your stage, your doctor will help you determine next steps—whether it’s best to repeat the tests after a period of time or to begin treatment for prostate cancer. To learn more about treatment options for prostate cancer please watch for the next HealthConnect posting on prostate cancer. This information is provided by YRMC as part of National Prostate Cancer Awareness Month.
YRMC’s Your Healthy Kitchen: Making a Delicious Meal in a Bowl While Raising Awareness for Lung Cancer Screening
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/.
Reducing the Risk of Breast Cancer with a Plant-Centered Diet
According to estimates by the American Cancer Society, in 2019, over 350,000 women and nearly 3,000 men were diagnosed with breast cancer. In the same year, approximately 41,000 women and 500 men died of the disease. That’s certainly a scary number of new breast cancer cases and deaths. Fortunately, research shows that there is a lot you can do to reduce your risk of getting breast cancer and, in case you are diagnosed, improve your ability to recover and survive. For example, experts recommend building your front line defenses with plant-based meals that are packed with cancer-fighting and immune-boosting phytochemicals, while reducing your intake of animal products, sugar and alcohol. In this episode of YRMC’s Your Healthy Kitchen, we take a look at their recommendations while making a delicious, cancer-fighting meal. Recipe: Walnut-Orange Quinoa with Warm Spices Follow These General Diet Recommendations The American Cancer Society, American Institute for Cancer Research (AICR) and the World Health Organization agree that a healthy diet can reduce the risk of breast cancer for women and men. They recommend: Enjoying a plant-based diet that includes smaller portions of meat, poultry, and other animal products. Shooting for 5-7 servings of vegetables and 1-2 servings of fruit per day. Eating moderate amounts of high fiber whole grains and beans, or a portion that fills one-quarter of your plate at meals. Limiting alcohol to less than one drink per day or avoiding alcohol altogether. Reducing added sugars and other refined carbohydrates, including white flour products, refined grains and cereals, fast foods and highly processed snacks. Enjoy an Abundance of Phytochemical-Rich Plants Vegetables, fruits, whole grains, nuts, and beans contain nutrients called phytochemicals that have been shown to strengthen the immune system, reduce inflammation (which scientists link to increased cancer risk), and even trigger cancer cell death. Remember, when you fill your plate with smaller portions of animal products, there’s a lot more room for cancer-fighting plants! Fill Up with Cancer-Fighting Fiber Plant-based foods contain fiber, which may reduce breast cancer risk by binding to, and eliminating harmful forms of estrogen from the body. High fiber whole grains, vegetables, lentils, and beans also promote healthy blood sugar levels. Research suggests that individuals with higher than normal average blood sugars are at greater risk for breast and other types of cancers. Reduce or Eliminate Alcohol Alcohol is directly linked with breast cancer risk, as well as an increased chance of developing colorectal, esophageal, stomach and liver cancers. According to the AICR, when you drink alcohol, it turns to a chemical called acetaldehyde (ethanal). This chemical can damage cellular DNA and interfere with DNA repair, potentially triggering the growth and spread of cancer cells. Since alcohol also increases levels of harmful estrogens, some practitioners advise women who are at high risk of breast cancer to avoid alcohol altogether. Think of Sweets as Occasional Treats Sugar does not directly cause any type of cancer, and it’s okay to enjoy sweets now and then. However, diets that are high in sugar and other refined carbohydrates can trigger higher than normal levels of sugar in the blood, which might increase risk. Limiting your intake of these foods may also reduce body fat, which lowers your chance of being diagnosed with breast cancer after menopause. Overall, research on breast cancer prevention and survival strongly supports a diet pattern that contains a healthy variety of fiber-, phytochemical-, and nutrient-packed plant foods, with limited alcohol, sugar, and refined carbohydrates. By simply filling one-half of your plate with brightly colored vegetables at meals, adding fruit or vegetables to your snacks, and choosing whole grains, lentils and beans as satisfying starches, you’ll meet many of the diet recommendations put forth by the world’s most prominent cancer research organizations. You can read more about preventing breast cancer at aicr.org, cancer.org, or who.int. And don’t forget to check out all of our cancer-fighting recipes, including delicious Broccoli with Basil, plus lots of educational nutrition and cooking tutorials on YRMC’s Your Healthy Kitchen Blog at yrmchealthconnect.org.