Two Years Later, 100 Pounds Lighter – and Still Learning!
Russ Dowling’s life changed the day he was diagnosed with type 2 diabetes. As a man who works on his feet all day, he was anxious about complications like heart disease and peripheral neuropathy (damage to the nerves in his feet) and was at a loss about what to do to turn things around. That was two years ago. Today, after taking the Diabetes Self-Management Classes at Yavapai Regional Medical Center, working with his physician, and asking lots of questions, he’s 100 pounds lighter and his blood sugar levels are normal. His journey hasn’t been a straight shot (a budding pepperoni habit recently tripped him up a bit), and he’s still adding new, healthy habits into the lifestyle he enjoys. He’s learned that change is a process, not an event, and that change doesn’t happen overnight! Before the diagnosis of diabetes, Russ described himself as a man who was “living the dream”. He ate whatever he wanted and remarkably, all of his labs were normal. When results from labs drawn for a physical at work confirmed diabetes, he felt like he had been handed a ‘death sentence’. Russ states, “I really had no idea what to do. I needed help and information and I got all of that in the diabetes classes offered at the YRMC Del E. Webb Outpatient Center in Prescott Valley”. Click here to watch Two Years Later, 100 Pounds Lighter, and Still Learning on YouTube. Gathering information is an important first step anyone can take toward gaining a sense of empowerment and control in managing a disease like diabetes. However, information alone often fails to sustain healthy habits. Likewise, fear of complications from a disease might initially trigger a desire for change, but fear fades as time goes by, making room for old habits to return. Debbie Peterson knows all about the challenges surrounding lifestyle change. As a Professional Certified Life Coach (PCLC), DBA Coaching Clarity by Definition, she works with people who are looking for support in creating new habits. Debbie states, “The emotions and attitudes we have, as well as the value we place in changing lifestyle habits all predict our success”. She defines attitude as an emotional tie to beliefs about ourselves (and others) and emphasizes the big role that feelings and emotions play in making lifestyle changes that stick. Developing awareness of the feelings you have about making specific lifestyle changes can help clarify what motivates you to adopt new habits, as well as what holds you back! Practitioners of Motivational Interviewing (MI), a client/patient-centered counseling approach that helps people find their own motivation for change, view the conflicting feelings we often have about change as rich sources of useful information that can actually help people move forward. After all, while there are usually very good reasons to adopt a healthier diet, to drink more water, or begin a regular exercise routine, there are also good reasons to maintain the status quo! With any change in life, there are things to gain, but also things to lose, like comfortable routines and familiar ways of being with yourself and others. Simply writing down the pros and cons of adopting a new habit can help you honestly assess and come to terms with the up- and downside of change. Russ was fortunate to see mostly the upside of a new diet, weight loss and good blood sugar control. He wanted to keep working to support himself and his family, and he didn’t want anything to interfere with a big love in his life – travelling the country on his motorcycle. However, he did struggle with feelings about missing favorite foods and the comfortable habits he shared with others in his life. Making compromises and setting realistic goals has helped Russ maintain his (mostly) healthy diet. Debbie Peterson emphasizes the importance of being honest with yourself about change. “Having unreal expectations will foster feelings of disappointment that can sabotage your efforts and lend a hand to failure. Even though disappointment is nothing more than a feeling, we tend to experience that feeling when we buy into the anxiety of wrestling with our comfort zone”. She adds, “Keep your expectations real for each habit change. Most of the time we know what’s right, but choose what’s easy”. The power to make our own decisions and be the primary movers in our own lives lies at the heart of most successful lifestyle changes. By gathering information, honestly assessing the pros and cons of new habits, and being realistic about expectations (remember, nobody is perfect), we can dramatically increase our chances of creating healthy, lifelong habits!
YRMC’s Your Healthy Kitchen: On the Road to Better Health with Diabetes
Most people with diabetes agree – it takes time, education, and some experimentation to figure out what diet patterns, exercise routines, and medications work best for good blood sugar control. Fortunately, there are many excellent resources available locally, nationally, and online to turn to for help, whether you are new to diabetes or have had the disease for many years. Susan Gebhard is a person with diabetes who has found, with a lot of trial and error, a way to successfully manage and live with chronic disease. She joined us recently on the set of Your Healthy Kitchen, where she shared stories about her journey with diabetes and some of the resources she’s found especially helpful, including the YRMC Diabetes Self Management Training Program and Diabetes Food Hub, a new online site for recipes and meal planning developed by the American Diabetes Association (ADA). Using diet, regular exercise, and medications, Susan reduced her A1C, a measure of average blood sugar levels over 3 months, from a high of 12% to 5.9%, a value that indicates near-normal blood sugar. Check out the video to hear more from Susan about her journey and to check out some recipes from Diabetes Food Hub! Just as there are many different types of people with diabetes, there are many different diets that can improve blood sugar levels, weight, triglycerides, blood pressure and more. Some individuals get great results from a high-fiber, plant based vegan or vegetarian plan, while others, like Susan, do well with a lower carb approach that includes low fat animal proteins and big portions of vegetables! There are lots of diet patterns that fall in between these two extremes, so it helps to try different meals, snacks and foods to see what works best for you. Greek Salmon and Veggies in a Packet Susan attributes part of her success to the information and support she garnered from two local programs; the YRMC Diabetes Self-Management Training Program (DSMT) at the Pendleton Preventive Medicine and Wellness Centers, and the Arizona Living Well Program, a series of classes for people living with chronic disease, offered through Yavapai Community Health Services. The DSMT program at YRMC taught her how meals, medications, motion (physical activity), and stress affect blood sugar control. She also picked up important tips from both programs about managing diabetes successfully from day to day. Susan states, “I keep a journal of everything I do to manage diabetes. I use a Day Timer notebook and write down what I eat, the exercise I did, any blood sugar tests from that day, and general information about how I feel and what I think I can do better. This helps me see everything I want to do and how well I did! It motivates me to do the best I can every day”. Simply Delicious Lentil Salad Learning to make part or all of her meals ahead of time, one or two days a week, has also helped Susan improve her diet over time. During the summer, she preps leafy greens, vegetables, and some chicken or fish for big, satisfying salads during the week. When the days turn cold and damp, she cooks big pots of soup, which are easy to re-heat for quick nourishing meals. Living with diabetes certainly comes with its share of challenges. Figuring out what foods and medications work best, checking blood sugar levels daily, and just knowing that you have diabetes every day can be hard. Susan has some words of wisdom for anyone struggling with the disease. “At first everything seems overwhelming, but you get used to what you need to do. It can be frustrating to live with diabetes every day. Sometimes I just want to say the heck with it and eat what I want. This is one time I find journaling helpful, because it keeps me on track and positive. Sometimes I really do say the heck with it and have that bowl of ice cream! But I get back on track the next day. You can successfully manage your diabetes. It just takes time and effort to learn what works for you. There are many resources available to help. Most of all, don’t give up!” For more information on the YRMC Diabetes Self-Management Program in Prescott or Prescott Valley call the Pendleton Wellness Center at 928-771-5794. Information about Arizona Living Well is available at 928-442-5372. For additional ongoing education and peer support, you can also join the Living Well with Diabetes Support Group, which meets on the third Tuesday of most months, from 5:30-6:30 pm at the Pendleton Wellness Center in Prescott. To get regular updates on upcoming meetings, simply subscribe at YRMC HealthConnect. And don’t forget to check out all of the healthy cooking videos and recipes we’ve collected for you at Your Healthy Kitchen. Follow us on FaceBook too, at YRMC’s Your Healthy Kitchen, where you can see what I’m making at home in my kitchen, plus get insider tips, delicious recipes and links to helpful health and nutrition resources online and in the community!
What Are Your Tired Legs Telling You?
Do your tired legs keep you from doing what matters most to you? If your lower limbs feel fatigued even after minimal exercise, they may be sending an SOS. Tired legs may be caused by a vein disorder that can be easily diagnosed and treated. However, if it’s left untreated, that disorder can progress into a serious condition. “People often don’t associate tired legs with a health issue,” said Anil Kumar, MD, MRCP, FACC, RPVI, RPhS, Medical Director of the Vein Center at Yavapai Regional Medical Center (YRMC) in Prescott Valley. “In reality, tired legs may be a symptom of chronic venous insufficiency.” An estimated 40 percent of Americans may suffer from chronic venous insufficiency (CVI), according to the Society for Vascular Surgery. It’s most common in women – especially after multiple pregnancies – and in people who are middle-aged or older. CVI occurs when the venous walls and/or the valves in the leg’s veins have been damaged. This makes it difficult for blood to move from the legs to the heart and causes blood to pool above the ankles. Pull On Compression Stockings At the Vein Center, Dr. Kumar creates individual care plans to address CVI. Those plans include using compression stockings to promote better blood flow, reduce swelling and relieve discomfort. The team at the Vein Center can help you choose the right stockings to wear every day. Vein Ablation for Vein Health For some patients, Dr. Kumar recommends vein ablation, which closes the unhealthy vein and redirects the blood to a healthy vein. The Vein Center offers: VenaSeal Ablation Radiofrequency Ablation Liquid Sclerotherapy and Compression Dr. Kumar explains these procedures in this video, Minimally Invasive Solutions for Vein Disease. A strong family history of varicose veins and her own vein disease drove Dawn Neveau to undergo ablation at the Vein Center. “I experienced very little pain,” said Neveau. “It’s no more pain than when you have a cavity and you get a shot to numb your mouth. It’s just lickety-split and it’s done. I was able to do whatever I wanted after, with no limping or soreness.” For more information about the Vein Center at YRMC, contact us at (928) 759-5890.
Five Steps to Prevent Diabetes
One of the best health strategies is to prevent illness before it happens, especially when it comes to type 2 diabetes. While our genetics are hard wired, there are steps you can take to prevent diabetes and reduce your risk. In fact, before type 2 diabetes is diagnosed there’s a period called prediabetes, when blood sugar levels are elevated but not high enough to be considered diabetes. Without action, prediabetes often becomes type 2 diabetes within five years. In fact, up to 70 percent of people with prediabetes will go on to develop type 2 diabetes. Uncontrolled diabetes can cause blindness, kidney failure, heart disease and other serious conditions. But, progressing from prediabetes to diabetes isn’t inevitable. Yavapai Regional Medical Center (YRMC) recommends the following five steps to help you prevent diabetes. Let’s begin by learning your risk for type 2 diabetes by taking the American Diabetes Association’s (ADA’s) simple and fast ADA Type 2 Diabetes Risk Test. No matter your results, YRMC’s five steps are a great way to help prevent diabetes or delay its progression. Step 1: Eat a healthy diet with lots of vegetables Green vegetables – leafy greens, cruciferous vegetables (broccoli, cauliflower, Brussels sprouts), and others – are the most important foods to focus on for diabetes prevention. Non-starchy vegetables like mushrooms, onions, garlic, eggplant and peppers are also well-known diabetes fighters. What else should you include in your diabetes-prevention diet? Beans, lentils and other legumes Seeds and nuts Fresh fruits YRMC’s online cooking show, Your Healthy Kitchen, has excellent cooking videos and tasty recipes that help prevent diabetes. Step 2: Exercise regularly Get active to prevent diabetes. Exercise lowers your blood glucose, blood pressure and does a world of good for your health. So while you’re exercising to reduce your risk for prediabetes and type 2 diabetes, you’ll also lower your chance for heart disease and stroke. And, you’ll build stronger bones. Experts recommend: Continuous activity during the day—walk to lunch, take the stairs, keep moving Aerobic exercise, like brisk walking or swimming laps Strength training, such as lifting light weights Stretching and flexibility exercises Check out the fitness classes – SilverSneakers®, Silver&Fit® and Fitness Plus Silver Sneakers – available through YRMC’s Preventive Medicine and Wellness program. Step 3: Drink water Set aside soda, sugar-heavy coffee and fruit drinks for good old water. Sticking with water as your primary beverage helps you avoid soda, which is high in sugar, preservatives and other questionable ingredients. Water also won’t pack on the pounds, like soda and most anything that includes the word “latte” or “frappe.” Water is the most natural beverage you can drink. Step 4: Lose those extra pounds Nine in 10 people diagnosed with type 2 diabetes are overweight or are considered obese. Carrying extra weight – particularly in the abdominal area – increases your chances of developing diabetes and heart disease. The good news? Losing weight may significantly reduce your risk of diabetes. If you have prediabetes, or you are newly diagnosed with type 2 diabetes, decreasing your weight by about 10 percent can reverse your diabetes. For many people, that can mean dropping no more than 10 or 15 pounds. Step 5: Quit smoking You knew it was going to find its way on this list. Yes, people who smoke are 30 to 40 percent more likely to develop type 2 diabetes, according to the Centers for Disease Control and Prevention. And, people with diabetes who smoke are more likely to have difficulty controlling their disease. Ready to quit smoking? Learn about free programs offered by the Arizona Smokers’ Helpline online at the ASHLine or by calling 1-800-556-6222. There are other benefits linked to following these diabetes prevention steps. You’ll reduce your chances for developing heart disease and lung cancer, enhance your overall health, increase your energy and build your strength. That’s five steps with tons of health benefits.
How to Safely Dispose of Your Old Medications
Do you have expired or partially used prescription medications in your medicine chest, in the back of your kitchen cabinet or stashed in a drawer? Many people keep old pills for years with the best intentions. We want to get rid of them, but often don’t know how to dispose of them properly. We’re concerned about accidentally allowing the medications to get in the wrong hands or taint the environment and simply let them stack up for years. “It’s important to quit taking expired medications and get rid of them safely as soon as you can,” says Josh Goldman, Opioid and Substance Abuse Health Educator, Yavapai County Community Health Services. “Expired meds tend to lose their potency, so in essence, you’ll no longer have the benefits of the medication you were prescribed in the first place. Some medications are even susceptible to bacterial growth.” Medications that tend to lose their potency quickly include liquid antibiotics and compounded medications, which are medications made from a personalized formulation, ordered specifically for you by your doctor. There is also the real risk of the unused drugs getting in the wrong hands. According to the Centers for Disease Control, approximately 60,000 children under the age of 5 are seen in emergency rooms each year for accidental medication overdose. And it is never advisable to give unused prescription medications to a friend or family member. Saving a trip to the doctor or saving money is not worth the health risk. So, what is the best way to get rid of old medications? Goldman says there are several easy and safe options: Deterra Deactivation Pouches Deterra Pouches are a relatively new option for safe drug disposal at home. These sealable pouches contain activated carbon, which renders the drug inert. Simply place your pills, patches or liquid medication in the pouch, fill with warm tap water and waits 30 seconds. Seal and gently shake the pouch and place it in the trash. Deterra Pouches are available for purchase at outlets such as Walmart and Amazon. DisposeRx Some pharmacies are now offering DisposeRx packets with every prescription free of charge, to facilitate at-home drug disposal. To use, pour the contents of the DisposeRx packet directly into the pill bottle, add warm water, seal and shake the bottle for 30 seconds. Remove the label from your pill bottle or black out the information with a marker. The bottle can now be safely discarded in the trash. DisposeRx is also available at the Yavapai County Community Health Services office at 1090 Commerce Drive in Prescott. Another Option for Safe Disposal at Home If you have no other option for home disposal, the Food and Drug Administration (FDA) and Environmental Protection Agency (EPA) recommend putting expired medications in the trash after following these steps: Remove the pills or liquid from the original container and mix them with dirt, used coffee grounds, kitty litter or sawdust. Put the mixture in a Ziploc bag or similar, seal it tightly and put it in the regular trash. Remove or black out the label on the original container with a marker and dispose of the container separately. Remember that this method makes the drug undesirable, but will not render the drug inactive. Drop Boxes Local law enforcement agencies and some Yavapai College campuses offer free drug drop box locations throughout Yavapai County that will accept medications for safe disposal. Be aware that each location has different parameters regarding what types of medication they will accept. For instance, some drop boxes may not accept sharps, needles, aerosol cans or inhalers. Click here for a complete list of Yavapai County drop box locations, contact information, requirements, and what medications are accepted at each. In addition, pharmacies such as Walgreens Pharmacy at 2880 N. Centre Court in Prescott Valley offer drug disposal kiosks, similar to dropping mail into a mailbox. Medicine Take-Back Events Drug take-back events are held twice a year in Yavapai County, according to MatForce Executive Director Merilee Fowler. The effort continues to grow. “The Dump the Drugs National Take Back Day takes place the last weekend of April and October,” says Fowler. “We partner with local law enforcement agencies and the Drug Enforcement Agency to provide easy, accessible drop off locations to the general public. Since 2008, we have collected more than 32,400 pounds of drugs for safe disposal.” Is Flushing Safe? According to the Arizona Department of Environmental Quality (ADEQ), prescription and nonprescription drugs can be found at trace levels in treated wastewater discharged from sewage treatment plants. We now know that some of these substances can be harmful to our environment. ADEQ recommends alternative means of disposal whenever possible. Click here for more information. However, the FDA regularly updates a list of prescription medications that have been approved for flushing down the toilet if no other option exists. The known risk of harm, including death, from these substances from accidental exposure outweighs potential risks from flushing them. The list includes medications such as fentanyl, oxycodone and morphine. Click here for the full list. What About Medical Sharps? “The best practice for sharps such as needles, syringes and lancets is to place them in a sturdy, puncture-proof container with a tight lid and tape it shut, “ says Goldman, “You can purchase a specially designed container from a pharmacy, or you can use a heavy plastic or metal container that has a secure lid, such as a liquid laundry detergent bottle.” According to ADEQ, do not use glass containers, and make sure the container is not overstuffed. Mark the container “Do Not Recycle” so that it goes to the landfill rather than a recycle center. While your container is in the process of being filled for disposal, make sure you keep it sealed and out of the way of children and pets. Getting rid of your old, unused medications can be safe and easy. Following these recommendations now can make your home safer in the long run by reducing the risk of accidental drug exposure. And you’ll be assured that you’re following the right precautions to keep our environment safe. For more information on safe medication disposal, or to find out about the next Dump the Drugs National Take Back Day, contact MatForce at (928) 708-0100. Yavapai County Community Health Services can be reached at (928) 771-3122.
YRMC Employees Benefit from Student Loan Debt Relief Program
Brian Frank works in the Accounting office at Yavapai Regional Medical Center (YRMC). His job is to collect data to help the nonprofit hospital make sound decisions regarding business expenditures. This is a new career path for Frank. His dream of a career change came relatively late in life. He was a heavy equipment operator in a small, remote Arizona town for 27 years. While in his 40’s and still working full-time, he started taking online classes. After six years, he earned his MBA. Kelli Catterlin was recently promoted to Patient Access Training Specialist at YRMC. She is responsible for developing educational materials and training the Admitting Department staff on processes, procedures and patient registration systems. Catterlin’s undergraduate degree is in International Business and Japanese. But, as Catterlin says, life ‘took a turn’. Her husband, Michael was an Infantry Marine for 5 years. They traveled extensively. Upon returning home, Catterlin reevaluated her career path and decided to go back to school for a Masters Degree in Healthcare Administration. Frank is 52 years old and looking forward to retirement. Catterlin is 28 and hopes to pursue a career as a hospital administrator. While in very different stages of their lives, Frank and Catterlin are both being helped by Fiducius, a YRMC benefits provider who helps employees take control of their student loan debt. “I was paying back my student loans at $630 a month,” says Frank. “This is what I was ready to do for the next 20 years. I’ve always had a ‘pay your debt’ attitude. I figured that I made too much money to qualify for any assistance. That was mistake number one.” The Human Resources Department at YRMC introduced Frank to Fiducius, who uses their Student Loan Financial Planning approach to educate employees about their student loan options. Frank worked with a Fiducius advisor to research and implement the best loan forgiveness solution for his particular circumstances. “One of our goals in the HR Department at YRMC is to give our employees the tools they need to live the best life they can, both at work and at home,” says Brian DeVries, PHR, HR Manager, Benefits, Employee Health and Wellness at YRMC. “Much like Virgin Pulse MyHealth, which is the wellness platform we recently rolled out for their physical health, Fiducius can help our employees improve their financial well being.” “My monthly payment was adjusted according to what I earn,” says Frank. “This cut my payment in half.” In addition, if Frank continues to work at a nonprofit organization, the government will forgive 100% of the outstanding loan balance, including interest, after 10 years. Catterlin is now on a similar program. “I was absolutely blown away to the point of tears,” says Catterlin. “People my age are told that you have to go to school to live the American dream. But for so many of us, there’s astronomical debt and when we enter the job market, we’re not even using what we studied. It can be disheartening.” Catterlin’s $600 monthly student loan payment has been drastically reduced. She has been guaranteed that her monthly payment will never be more that half of what she would be paying without the program. If she continues to work for a nonprofit, the remainder of her debt will be forgiven in 10 years. Catterlin is the first member of her family to earn a degree in higher education. “I am so blessed to have the opportunity to go back to school and not be concerned about mounting debt,” she says. “My Masters program has truly expanded my horizons. It has made me a better employee and a better asset to YRMC.” And as for Frank, retirement is closer than ever. “I wouldn’t have known about Fiducius if it wasn’t for YRMC,” he says. “Continuing to pay $630 a month might have been the deciding factor for me to delay retirement. But now, looking forward to retirement with no student debt is huge for me.” As the largest not-for-profit healthcare system serving the region, Yavapai Regional Medical Center is pleased to provide rewarding career opportunities and innovative benefit programs. To learn more about career opportunities available across the YRMC network, please visit https://careers.yrmc.org.
YRMC PhysicianCare Cardiology Welcomes Dr. Mansour Assar
Yavapai Regional Medical Center PhysicianCare is pleased to welcome Mansour Assar, MD, FACC, Interventional Cardiology, to the cardiology team on Ainsworth Drive in Prescott. Dr. Assar completed an Interventional Cardiology Fellowship and a Cardiology Fellowship at Maimonides Medical Center, State University of New York in Brooklyn, New York. He is Board Certified in Interventional Cardiology, Cardiovascular Medicine, Internal Medicine, Pediatrics and Nuclear Cardiology. Dr. Assar is currently accepting new patients. Please speak to your family doctor or call (928) 771-5256 to schedule your appointment. YRMC PhysicianCare is pleased to accept most insurance plans including Medicare and is located at 811 Ainsworth Drive, Suite 106 in Prescott. For more information, visit www.yrmcpc.org.
On the Set of YRMC’s Your Healthy Kitchen with Dr. Michael Macon, Medical Director of The Breast Care Center at YRMC
Breast cancer is the most commonly diagnosed cancer among women in Arizona, and Yavapai County has the third highest rate of breast cancer among all counties in the state. While we have no control over some of the risks for breast cancer, including family history and genetics, maintaining a healthy weight, enjoying a plant-based diet, being physically active, and scheduling regular mammograms are all steps that women can take to both prevent and detect breast cancer in its earliest stages. Dr. Michael Macon, Medical Director of the Breast Care Center at YRMC joined us recently on the set of YRMC’s Your Healthy Kitchen to share news about the excellent diagnostic tools, cutting edge treatment plans, caring staff and patient support available at the Breast Care Center. He also helped us prepare a delicious roasted cauliflower soup filled with cancer-fighting nutrients and lots of warm, satisfying flavor! Nourishing Ingredients Ready for Making Curried Roasted Cauliflower Soup The Breast Care Center at YRMC offers a number of excellent screening and diagnostic tools that can detect breast cancer in its earliest stages and help determine which treatment might be best if cancer is found. Dr. Macon describes the Breast Care Center as “a basecamp for cancer diagnosis and treatment, where first and foremost, women can get mammograms with expert mammographers using the latest equipment. Also, if someone is diagnosed with breast cancer, it is a place that provides excellent treatment, plus ongoing care that includes a support group for women who have cancer”. Check out the video to learn more about the great care provided at the Breast Care Center, and see how easy it is to make our delicious soup! Good research suggests that a plant-based diet (one filled with lots of vegetables, whole grains, beans, fruit, nuts and seeds, and smaller portions of animal-based foods) helps to prevent the onset and recurrence of breast cancer. In fact, a recent study led by researchers an the Harvard T.H. Chan School of Public Health found that women who ate 5 ½ servings of fruits and vegetables or more each day (one serving equals 1 cup of raw leafy greens or ½ cup cooked or raw non-leafy vegetables and fruits) had an 11% reduction in their risk of breast cancer compared to women who ate approximately half that amount or less each day. Cruciferous vegetables, including cauliflower, broccoli and Brussels sprouts, and yellow and orange vegetables may confer the most protection, especially against the most aggressive types of tumors. Warm and Satisfying Curried Roasted Cauliflower Soup The cancer-preventing effects of a diet filled with plants may be due to multiple factors, including high levels of fiber, which can reduce harmful estrogen levels in the body, and phytochemicals, which may act to stimulate the immune system, reduce inflammation, and even directly fight cancer growth. Eating meals that are filled with nourishing plants (especially vegetables) can also help women maintain a healthy weight. After all, if you replace some of the higher calorie foods on your plate, like meats and starches, with low calorie vegetables, you’ll be eating fewer calories, but will likely still feel comfortably full because of the fiber and volume that vegetables add to meals. Adequate physical activity, of at least 150 minutes of moderate or 75 minutes of vigorous exercise a week, may also reduce breast cancer risk by helping women to maintain a healthy weight. Other benefits of exercise likely include a reduction of harmful estrogen levels and improved immune function. Moving more throughout the day also means you are sitting less, which offers benefits that extend to increased longevity and reduced risk of a number of chronic diseases. There’s no doubt that lifestyle changes help reduce the risk of breast cancer, but remember, getting regular mammograms is equally important, whether you are at increased risk of breast cancer because of family or personal history or not. Call now, 928-442-8900, to schedule your mammogram, and remind your friends and loved ones to do the same. The Breast Care Center is located at Yavapai Regional Medical Center East, 7700 Florentine Road, in Prescott Valley. Curry Cauliflower Soup Apricot Pear Chutney
Celebrate Life Health Expo 2019
A MEGA Experience and Learning Opportunity
That means you, your family and your friends can explore the world’s only larger-than-life, walk-through exhibits of the human body: MEGA Body™ and MEGA Heart™.
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On the Set of YRMC’s Your Healthy Kitchen with Dr. Michael Macon, Medical Director of The Breast Care Center at YRMC
Breast cancer is the most commonly diagnosed cancer among women in Arizona, and Yavapai County has the third highest rate of breast cancer among all counties in the state. While we have no control over some of the risks for breast cancer, including family history and genetics, maintaining a healthy weight, enjoying a plant-based diet, being physically active, and scheduling regular mammograms are all steps that women can take to both prevent and detect breast cancer in its earliest stages. Dr. Michael Macon, Medical Director of the Breast Care Center at YRMC joined us recently on the set of YRMC’s Your Healthy Kitchen to share news about the excellent diagnostic tools, cutting edge treatment plans, caring staff and patient support available at the Breast Care Center. He also helped us prepare a delicious roasted cauliflower soup filled with cancer-fighting nutrients and lots of warm, satisfying flavor! Nourishing Ingredients Ready for Making Curried Roasted Cauliflower Soup The Breast Care Center at YRMC offers a number of excellent screening and diagnostic tools that can detect breast cancer in its earliest stages and help determine which treatment might be best if cancer is found. Dr. Macon describes the Breast Care Center as “a basecamp for cancer diagnosis and treatment, where first and foremost, women can get mammograms with expert mammographers using the latest equipment. Also, if someone is diagnosed with breast cancer, it is a place that provides excellent treatment, plus ongoing care that includes a support group for women who have cancer”. Check out the video to learn more about the great care provided at the Breast Care Center, and see how easy it is to make our delicious soup! Good research suggests that a plant-based diet (one filled with lots of vegetables, whole grains, beans, fruit, nuts and seeds, and smaller portions of animal-based foods) helps to prevent the onset and recurrence of breast cancer. In fact, a recent study led by researchers an the Harvard T.H. Chan School of Public Health found that women who ate 5 ½ servings of fruits and vegetables or more each day (one serving equals 1 cup of raw leafy greens or ½ cup cooked or raw non-leafy vegetables and fruits) had an 11% reduction in their risk of breast cancer compared to women who ate approximately half that amount or less each day. Cruciferous vegetables, including cauliflower, broccoli and Brussels sprouts, and yellow and orange vegetables may confer the most protection, especially against the most aggressive types of tumors. Warm and Satisfying Curried Roasted Cauliflower Soup The cancer-preventing effects of a diet filled with plants may be due to multiple factors, including high levels of fiber, which can reduce harmful estrogen levels in the body, and phytochemicals, which may act to stimulate the immune system, reduce inflammation, and even directly fight cancer growth. Eating meals that are filled with nourishing plants (especially vegetables) can also help women maintain a healthy weight. After all, if you replace some of the higher calorie foods on your plate, like meats and starches, with low calorie vegetables, you’ll be eating fewer calories, but will likely still feel comfortably full because of the fiber and volume that vegetables add to meals. Adequate physical activity, of at least 150 minutes of moderate or 75 minutes of vigorous exercise a week, may also reduce breast cancer risk by helping women to maintain a healthy weight. Other benefits of exercise likely include a reduction of harmful estrogen levels and improved immune function. Moving more throughout the day also means you are sitting less, which offers benefits that extend to increased longevity and reduced risk of a number of chronic diseases. There’s no doubt that lifestyle changes help reduce the risk of breast cancer, but remember, getting regular mammograms is equally important, whether you are at increased risk of breast cancer because of family or personal history or not. Call now, 928-442-8900, to schedule your mammogram, and remind your friends and loved ones to do the same. The Breast Care Center is located at Yavapai Regional Medical Center East, 7700 Florentine Road, in Prescott Valley. Curry Cauliflower Soup Apricot Pear Chutney
Fork in the Road Breast Cancer Fundraiser for YRMC Reaches New Heights
Thanks to widespread community support, the Fork in the Road Restaurants’ annual “Boot Out Cancer” fundraising program to benefit YRMC’s BreastCare Center raised a grand total of $30,670.00. This remarkable achievement marks an 18-year partnership to help the underserved in our community receive breast wellness services. Throughout the month of October – National Breast Cancer Awareness Month – area Taco Bell and Pizza Hut restaurants, together with Gurley Street Grill, Murphy’s, and The Office, invited their patrons to lend their support to the battle against breast cancer. The hundreds who did signed their names to pink “Boot Out Cancer” boots that adorned the walls in these restaurants throughout our community. “We are so grateful for the partnership we have enjoyed with the Fork in the Road organization these past 18 years. We are equally grateful for our community’s outpouring of support for our BreastCare Center,” said Dave Barrett, Chair of the Yavapai Regional Medical Center Foundation. “Community members value the fact that 100 percent of their donations stay in our community to help battle this disease and recognize we are fortunate to have such a high quality program.” Funds donated to YRMC’s BreastCare Center are used to provide screening mammograms for those who do not have the ability to pay, to help ensure the Center has the latest medical technology, and pay for professional education and training and community outreach. To learn more about the BreastCare Center’s programs and services, visit YRMC or contact the YRMC Foundation at (928) 771–5686.
Heart Valve Disease: 5 Symptoms You Shouldn’t Ignore
In years past, your grandfather may have written off his shortness of breath to old age. Even people diagnosed early in life with heart conditions often didn’t link their decreased energy or their dizziness decades later to their heart conditions. Today, primary care physicians and cardiologists are tuned into subtle changes that may signal heart valve disease—a condition that can affect people in their 40s or 80s. “People are taking better care of themselves and living longer,” said Jose Torres, MD, Cardiothoracic Surgeon at the James Family Heart Center at Yavapai Regional Medical Center West (YRMC). “That means more people will be diagnosed with heart valve disease and more will be referred to heart surgeons for treatment.” In fact, one in ten people age 75 and older struggle with moderate to severe heart valve disease, which happens when one or more of your heart valves don’t work well. 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 Dr. Torres. “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.” Click here to watch Dr. Jose Torres: The Healthy Heart on YouTube. 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 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. Currently, no medicines can cure heart valve disease. However, 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 Room (OR)—a combined state-of-the-art surgical suite and medical imaging facility. In YRMC’s Hybrid OR – 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 OR. Learn more about heart valve disease and the advanced, comprehensive services available at YRMC’s James Family Heart Center. Related: Valvular Heart Disease: A Quiet and Dangerous Disorder
The Story of TAVR Patient Number 12
Replacing damaged heart valves with transcatheter aortic valve replacement (TAVR) – a minimally invasive procedure – improves the quality of life for the critically ill people who undergo it, recent research reviews show. This is no surprise to Prescott Valley resident Nicholas “Red” Demino and his daughter, Lily Bergin, of Skull Valley. “My heart disease was so severe that I wasn’t a candidate for open heart surgery,” Demino said. Demino suffers from aortic stenosis – a narrowing of the aortic valve – a condition that tends to develop with age. The condition can lead to chest pain, fatigue, shortness of breath and heart failure. People with severe aortic stenosis at an advanced age, like Demino, are not eligible for traditional valve replacement surgery. Getting Ready for TAVR After speaking to Gwen Rhodes, RN, Patient Navigator for the James Family Heart Center at YRMC, and learning more about TAVR, Demino began preparing for TAVR. Rhodes arranged for Demino – a highly decorated Army and Air Force veteran – to undergo the series of tests required before TAVR. Dedicated to patient education, Rhodes also talked to Demino about how his heart works; provided a step-by-step overview of what happens before, during and after a TAVR procedure; and, most important to patients, discussed the pain and discomfort involved in the procedure (it’s minimal). Demino underwent TAVR in YRMC’s state-of-the-art Hybrid Operating Suite in April 2017. He was the Heart Center’s 12th TAVR patient, a number that now has grown to more than 70. “Everything went superbly,” said Bergin of her father’s experience. “They took great care of my Dad.” From Wheelchair to Weightlifting Following his TAVR, Demino joined Cardiac Rehabilitation at YRMC’s Pendleton Center West in Prescott. The 90-year-old’s exercise routine was supervised by one of the Center’s therapists. During sessions, he rode a stationary bicycle, worked out on an elliptical trainer, lifted weights from a chair, participated in resistance training and walked along a rail to build balance. “He went into Cardiac Rehabilitation in a wheelchair,” remembered Bergin. “Each day, we saw improvement. On the last day of Cardiac Rehabilitation, he stopped by to say thank you to Gwen and then walked out the door with his cane.” Today, Demino exercises on his own at home with a treadmill he purchased after he completed YRMC’s Cardiac Rehabilitation program. Lucky Number 12 Demino is proud he was among the Heart Center’s first group of patients. In fact, when he calls Rhodes to catch up or with a question, he enjoys teasing her by identifying himself as “number 12.” And research also shows that laughter improves your quality of life. For more information about TAVR and the James Family Heart Center at YRMC West, visit www.yrmc.org.
How to Safely Dispose of Your Old Medications
Do you have expired or partially used prescription medications in your medicine chest, in the back of your kitchen cabinet or stashed in a drawer? Many people keep old pills for years with the best intentions. We want to get rid of them, but often don’t know how to dispose of them properly. We’re concerned about accidentally allowing the medications to get in the wrong hands or taint the environment and simply let them stack up for years. “It’s important to quit taking expired medications and get rid of them safely as soon as you can,” says Josh Goldman, Opioid and Substance Abuse Health Educator, Yavapai County Community Health Services. “Expired meds tend to lose their potency, so in essence, you’ll no longer have the benefits of the medication you were prescribed in the first place. Some medications are even susceptible to bacterial growth.” Medications that tend to lose their potency quickly include liquid antibiotics and compounded medications, which are medications made from a personalized formulation, ordered specifically for you by your doctor. There is also the real risk of the unused drugs getting in the wrong hands. According to the Centers for Disease Control, approximately 60,000 children under the age of 5 are seen in emergency rooms each year for accidental medication overdose. And it is never advisable to give unused prescription medications to a friend or family member. Saving a trip to the doctor or saving money is not worth the health risk. So, what is the best way to get rid of old medications? Goldman says there are several easy and safe options: Deterra Deactivation Pouches Deterra Pouches are a relatively new option for safe drug disposal at home. These sealable pouches contain activated carbon, which renders the drug inert. Simply place your pills, patches or liquid medication in the pouch, fill with warm tap water and waits 30 seconds. Seal and gently shake the pouch and place it in the trash. Deterra Pouches are available for purchase at outlets such as Walmart and Amazon. DisposeRx Some pharmacies are now offering DisposeRx packets with every prescription free of charge, to facilitate at-home drug disposal. To use, pour the contents of the DisposeRx packet directly into the pill bottle, add warm water, seal and shake the bottle for 30 seconds. Remove the label from your pill bottle or black out the information with a marker. The bottle can now be safely discarded in the trash. DisposeRx is also available at the Yavapai County Community Health Services office at 1090 Commerce Drive in Prescott. Another Option for Safe Disposal at Home If you have no other option for home disposal, the Food and Drug Administration (FDA) and Environmental Protection Agency (EPA) recommend putting expired medications in the trash after following these steps: Remove the pills or liquid from the original container and mix them with dirt, used coffee grounds, kitty litter or sawdust. Put the mixture in a Ziploc bag or similar, seal it tightly and put it in the regular trash. Remove or black out the label on the original container with a marker and dispose of the container separately. Remember that this method makes the drug undesirable, but will not render the drug inactive. Drop Boxes Local law enforcement agencies and some Yavapai College campuses offer free drug drop box locations throughout Yavapai County that will accept medications for safe disposal. Be aware that each location has different parameters regarding what types of medication they will accept. For instance, some drop boxes may not accept sharps, needles, aerosol cans or inhalers. Click here for a complete list of Yavapai County drop box locations, contact information, requirements, and what medications are accepted at each. In addition, pharmacies such as Walgreens Pharmacy at 2880 N. Centre Court in Prescott Valley offer drug disposal kiosks, similar to dropping mail into a mailbox. Medicine Take-Back Events Drug take-back events are held twice a year in Yavapai County, according to MatForce Executive Director Merilee Fowler. The effort continues to grow. “The Dump the Drugs National Take Back Day takes place the last weekend of April and October,” says Fowler. “We partner with local law enforcement agencies and the Drug Enforcement Agency to provide easy, accessible drop off locations to the general public. Since 2008, we have collected more than 32,400 pounds of drugs for safe disposal.” Is Flushing Safe? According to the Arizona Department of Environmental Quality (ADEQ), prescription and nonprescription drugs can be found at trace levels in treated wastewater discharged from sewage treatment plants. We now know that some of these substances can be harmful to our environment. ADEQ recommends alternative means of disposal whenever possible. Click here for more information. However, the FDA regularly updates a list of prescription medications that have been approved for flushing down the toilet if no other option exists. The known risk of harm, including death, from these substances from accidental exposure outweighs potential risks from flushing them. The list includes medications such as fentanyl, oxycodone and morphine. Click here for the full list. What About Medical Sharps? “The best practice for sharps such as needles, syringes and lancets is to place them in a sturdy, puncture-proof container with a tight lid and tape it shut, “ says Goldman, “You can purchase a specially designed container from a pharmacy, or you can use a heavy plastic or metal container that has a secure lid, such as a liquid laundry detergent bottle.” According to ADEQ, do not use glass containers, and make sure the container is not overstuffed. Mark the container “Do Not Recycle” so that it goes to the landfill rather than a recycle center. While your container is in the process of being filled for disposal, make sure you keep it sealed and out of the way of children and pets. Getting rid of your old, unused medications can be safe and easy. Following these recommendations now can make your home safer in the long run by reducing the risk of accidental drug exposure. And you’ll be assured that you’re following the right precautions to keep our environment safe. For more information on safe medication disposal, or to find out about the next Dump the Drugs National Take Back Day, contact MatForce at (928) 708-0100. Yavapai County Community Health Services can be reached at (928) 771-3122.
Win a School Visit from a Harlem Globetrotter with GoNoodle!
In partnership with the world famous Harlem Globetrotters, GoNoodle has launched a brand new exercise video called Sweet Georgia Brown. It’s guaranteed to get you and your family dancing! GoNoodle is a robust suite of online games and activities designed by experts to engage children and enhance learning, both at school and at home. From January 12th to March 31st, play Sweet Georgia Brown at home and be entered to win the Take a Harlem Globetrotter to School Sweepstakes. One winner will receive an exclusive prize pack and a school visit from a Harlem Globetrotter. To be eligible for the sweepstakes, you must be playing while logged in to your verified GoNoodle family account. (Limit one entry per person, per email address. Only one individual per household is eligible to win the Grand Prize. Click here for a complete list of rules.) Thanks to a generous sponsorship from Yavapai Regional Medical Center, the premium version of GoNoodle, called GoNoodle Plus, is available free of charge to parents and educators in the Quad Cities area. It’s one of the many ways that YRMC promotes health and wellness for people of all ages in our community. Create your free family account at http://www.gonoodle.com. In addition, you can download the free GoNoodle app at app.gonoodle.com. If you already have an account, you can verify it by entering a valid email address in the Settings section of the GoNoodle.com app or on app.gonoodle.com. Join the more than 2 million families who play GoNoodle at home, turning screen time into active time. Who knows, you may even win a visit from a Harlem Globetrotter! For more information on YRMC’s sponsorship of GoNoodle Plus, contact YRMC’s Community Outreach Department at CommunityOutreach@yrmc.org.
YRMC Volunteer Spotlight: John Peters and Richard McBride
If you’ve spent any time at Yavapai Regional Medical Center, you’ve probably heard the sound of a hand bell throughout the halls twice a day. The bell heralds the arrival of the snack cart, and the ringer is a member of the snack cart volunteer team, serving hot coffee, juices, fruit, yogurt and other goodies to visitors and staff at the hospital. Watch Volunteer Spotlight: John Peters and Richard McBride on YouTube On any given morning, you might be served by YRMC volunteers John Peters and Richard McBride. The duo often resembles a comedy team more than hospital volunteers. Employees and visitors who purchase snacks from the cart can’t help but join in the banter and good-natured teasing. But don’t let the lightheartedness fool you. They take their job very seriously. “A big philosophy we have is that we go the extra mile,” says Peters, “Let’s say that you have a nurse caring for a patient in one of the rooms in ICU. I know one nurse in particular who always wants a bag of cheddar popcorn and a string cheese. I’ll get her badge from her, ring it up and take it back there to her station.” Peters and McBride are particularly proud of their dedication. “Our record for uninterrupted service is 79 weeks without missing a day,” says Peters. A snowstorm prevented the volunteers from coming in on the 80th day. When asked why this dedication is so important, Peters responds, ”I really can’t explain it. I’m sure it’s this way for all the other volunteers. It’s just a sense of good feeling that you’re providing a service.” Peters describes the camaraderie and friendship as an added bonus to volunteering at YRMC, including getting to know the staff and fellow volunteers, learning about their families, grandchildren and travels. As McBride picks up the hand bell and starts down the hall to ring their arrival, Peters sums it up this way, “Volunteering is a wonderful experience. Period. It’s the only way to explain it.” The YRMC Volunteer Services Department welcomes inquiries about volunteering for the snack cart as well as a wide variety of other volunteer opportunities. For more information, call: Volunteer Services, YRMC West, Prescott: (928) 771-5678 Volunteer Services, YRMC East, Prescott Valley: (928) 442-8678
Volunteer Spotlight: Don Packard, PAWS Pet Therapy Program
Anyone who owns a dog or other pet knows the calming effect they can have. When we pet our animal friends, stress and worry often seem to melt away. Scientific studies have now proven this to be true. Pets can lower blood pressure and reduce anxiety. In addition, petting an animal can release endorphins that have a calming effect and can enhance healing. Watch YRMC Volunteer Spotlight: Don Packard on YouTube In keeping with our Vision of treating the whole patient — body, mind and spirit — Yavapai Regional Medical Center offers visits from specially trained therapy animals through the Pets Are Warm Support (PAWS) program. YRMC accepts dogs who are certified through Pet Partners, a national organization that evaluates and tests all animals to ensure that their health, skills and aptitude meet rigorous standards. Visits from PAWS pets can reduce boredom, increase socialization and communication, and provide comfort, especially for those patients who are missing their own pets at home. PAWS program volunteer Don Packard brings Sailor, his beautiful Australian Shepherd, to YRMC every Tuesday. “Of course I’m giving back, but there’s more to it than that,” says Packard, “It gives me satisfaction seeing these folks who don’t get to see dogs. It does their heart good, and it does mine too.” Patients aren’t the only people who enjoy the therapy pets at YRMC. The staff looks forward to their regularly scheduled visits as well. “He’s a therapy dog for everybody,” says Packard, “The staff really likes him too. He’s well known. ‘It’s Tuesday and Sailor’s here!’ That’s what they say.” You can take a preliminary quiz to see if your dog may have the right temperament to be a therapy dog at petpartners.org. If you’re a patient at YRMC and would like to arrange a PAWS visit, check with your caregiver first, then call Volunteer Services. In Prescott, the phone number is (928) 771-5678. In Prescott Valley, call (928) 442-8678. YRMC Volunteer Services welcomes inquiries about volunteering for the PAWS program as well as a wide variety of other volunteer opportunities. For more information call: Volunteer Services, YRMC West, Prescott: (928) 771-5678 Volunteer Services, YRMC East, Prescott Valley: (928) 442-8678
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.
Curious About Patient Blood Management? Watch YRMC’s Live Broadcast on October 25
Yavapai Regional Medical Center (YRMC) is recognized worldwide as a pioneer in Patient Blood Management (PBM). The public has the opportunity to learn from these PBM pioneers by watching Patient Blood Management: Yesterday, Today and Tomorrow, YRMC’s sixth PBM Symposium. The Symposium will be broadcast live via the Internet for the public to watch from the comfort of their homes. Log-in to learn about the science and history behind PBM on: Date: Thursday, October 25, 2018 Time: 6:00 to 8:00 p.m., Mountain Standard Time Log-In Options: YRMCHealthConnect.org/pbm or Facebook.com/YavapaiRegionalMedicalCenter What is PBM? What does PBM mean to you as a patient? It minimizes blood loss, reduces unnecessary transfusions and improves patient outcomes when medical teams embrace evidence-based medical and surgical concepts guided by the principles of PBM. Watch YRMC Patient Blood Management Services on YouTube. YRMC’s PBM Symposium will include an expert panel and short videos that highlight significant PBM experiences among Symposium participants. PBM Symposium Experts: Informative & Interesting Additionally, these Prescott, Arizona PBM experts will give thought-provoking, informative talks on: The Wonder of Blood Daniel Beck, MD, Anesthesiologist, Prescott Anesthesia The History of Transfusion Medicine Pierre Tibi, MD, FACS, Medical Director, Patient Blood Management and the James Family Heart Center at YRMC West Transfusion Medicine, Where We are Today Elizabeth Black, Data Manager/Assistant Coordinator, Patient Blood Management Program, YRMC Transfusion Medicine, What the Future Holds Jared Head, AGACNP-BC, Hospitalist, NAZ Hospitalists Heart Surgery Without “Surgery” Soundos Moualla, MD, Cardiologist, YRMC PhysicianCare Nurses: Creating an Environment in Which Patients Thrive Selina Bliss, MS, PhD, RN, YRMC Out-of-Town, But Not Out-of-Time Dale Black, Patient Blood Management Program Coordinator, YRMC For more information about Patient Blood Management: Yesterday, Today and Tomorrow, visit YRMCHealthConnect.org/pbm.
Prescott Medical Imaging: New Technology to Detect Bone Loss Disease
Dual-energy x-ray absorptiometry (DXA) – gold standard technology for measuring bone mass and diagnosing osteoporosis – is now available at Prescott Medical Imaging (PMI) in Prescott. With the introduction of DXA to PMI, the service is now accessible to people throughout the community. DXA is also available at the BreastCare Center at YRMC East. How does DXA work? During a DXA exam, the patient lies flat on a comfortable, padded table. An x-ray generator is located below the patient and an imaging device, or detector, is positioned above. The detector passes over the patient, generating images on a computer monitor. “DXA is quick, painless and uses very little radiation,” said Michael J. Locke, BBA, BBM, CRA, Outpatient Imaging Operations Manager at PMI and Prescott Valley Medical Imaging (PVMI). “The exam lasts approximately 10 minutes. After the exam, one of our experienced PMI radiologists interprets the DXA and shares the results with the patient’s physician.” Osteoporosis – which causes bones to weaken and easily break – is a “silent disease.” Some people don’t realize they have experienced dangerous bone loss until they suffer a fracture. “DXA is an extremely important preventive and diagnostic tool,” said Mary Sterling, Director of Imaging Services at Yavapai Regional Medical Center (YRMC). “The information DXA provides helps patients and their physicians develop a plan that can prevent fractures due to osteoporosis.” Who should undergo DXA? Talk to your physician about your risk for osteoporosis and the possibility of undergoing DXA. In general, risk factors for osteoporosis include: Being over age 50 and female (men typically begin to experience bone loss after age 70) Menopause, particularly early-onset menopause A family history of osteoporosis Being small and thin Broken bones or height loss For more information about DXA and other imaging services, contact: Prescott Medical Imaging 810 Whipple Street Prescott, Arizona (928) 771-7577 The BreastCare Center at YRMC East 7700 East Florentine Road Prescott Valley, Arizona (928) 442-8900
This Hometown Girl Has Many Talents: How Jennifer Harvey is Making a Difference
If you have ever had the privilege of hearing Jennifer Harvey sing with her Femme-Folk Pop-Rock band, The Gurley Girls, you will know instantly that this busy lady’s got skills. She is a wife, mom, daughter, sister, aunt, cousin, niece, friend and cake pop baker in addition to her role as the Patient Navigator for the Lung Cancer Screening and Care program at Yavapai Regional Medical Center (YRMC). Her title is a mouthful and so is her job! YRMC started the Lung Cancer Screening and Care program in response to a national push to provide annual low dose CT scanning as a screening method for detecting lung cancer early. This program started as a result of a large-scale study known as the National Lung Screening Trial, which was sponsored by the National Cancer Institute (NCI) and conducted by the American College of Radiology (ACR). This study showed that “for the first time, we have a modality that’s proven by research to catch lung cancer early and it is effective and can save lives,” explained Jennifer. Early detection of lung cancer can increase the five-year survival rate. Jennifer added, “YRMC started this program to support our community because we have a high volume of smokers and we know that when people wait until they have symptoms of lung cancer, they are not likely to survive their diagnosis.” Jennifer’s role in the process is to help identify high risk groups and to inform practitioners as well as people in the community that this service is available; to act as a liaison between providers and specialists such as pulmonologists, radiologists, oncologists and surgeons; to connect patients to the screening program and treatments they may need after the screening; and to create educational materials and classes to help patients become healthier. “So, I act as a hub in this busy wheel,” said Jennifer. The day before a patient arrives for the first appointment, Jennifer calls them and explains how “the program is not a one and done type of thing. You come back annually for screening.” When they initially arrive at the clinic, Jennifer goes through a patient information folder she creates and develops a personal relationship with the patients. She wants them “to feel fully supported, to put a face with a name, and to really help them through the process.” There are some additional benefits of entering the program such as “smokers who enter the program often decide to quit smoking after realizing what smoking does to them,” Jennifer states. Another benefit of this program is that incidental findings may also be detected because of the screening. If someone has coronary artery disease, the calcifications can be spotted through CT screening and the patient can be referred to a cardiologist so that a heart attack may be prevented. A thyroid nodule may be discovered or another type of medical concern might also be noticed. “They might get help for something they didn’t even know they had,” explains Jennifer. If you think that lung cancer screening is something you should consider, please speak to your primary care physician or contact Jennifer at (928) 771-5454.
YRMC’s Your Healthy Kitchen: On the Road to Better Health with Diabetes
Most people with diabetes agree – it takes time, education, and some experimentation to figure out what diet patterns, exercise routines, and medications work best for good blood sugar control. Fortunately, there are many excellent resources available locally, nationally, and online to turn to for help, whether you are new to diabetes or have had the disease for many years. Susan Gebhard is a person with diabetes who has found, with a lot of trial and error, a way to successfully manage and live with chronic disease. She joined us recently on the set of Your Healthy Kitchen, where she shared stories about her journey with diabetes and some of the resources she’s found especially helpful, including the YRMC Diabetes Self Management Training Program and Diabetes Food Hub, a new online site for recipes and meal planning developed by the American Diabetes Association (ADA). Using diet, regular exercise, and medications, Susan reduced her A1C, a measure of average blood sugar levels over 3 months, from a high of 12% to 5.9%, a value that indicates near-normal blood sugar. Check out the video to hear more from Susan about her journey and to check out some recipes from Diabetes Food Hub! Just as there are many different types of people with diabetes, there are many different diets that can improve blood sugar levels, weight, triglycerides, blood pressure and more. Some individuals get great results from a high-fiber, plant based vegan or vegetarian plan, while others, like Susan, do well with a lower carb approach that includes low fat animal proteins and big portions of vegetables! There are lots of diet patterns that fall in between these two extremes, so it helps to try different meals, snacks and foods to see what works best for you. Greek Salmon and Veggies in a Packet Susan attributes part of her success to the information and support she garnered from two local programs; the YRMC Diabetes Self-Management Training Program (DSMT) at the Pendleton Preventive Medicine and Wellness Centers, and the Arizona Living Well Program, a series of classes for people living with chronic disease, offered through Yavapai Community Health Services. The DSMT program at YRMC taught her how meals, medications, motion (physical activity), and stress affect blood sugar control. She also picked up important tips from both programs about managing diabetes successfully from day to day. Susan states, “I keep a journal of everything I do to manage diabetes. I use a Day Timer notebook and write down what I eat, the exercise I did, any blood sugar tests from that day, and general information about how I feel and what I think I can do better. This helps me see everything I want to do and how well I did! It motivates me to do the best I can every day”. Simply Delicious Lentil Salad Learning to make part or all of her meals ahead of time, one or two days a week, has also helped Susan improve her diet over time. During the summer, she preps leafy greens, vegetables, and some chicken or fish for big, satisfying salads during the week. When the days turn cold and damp, she cooks big pots of soup, which are easy to re-heat for quick nourishing meals. Living with diabetes certainly comes with its share of challenges. Figuring out what foods and medications work best, checking blood sugar levels daily, and just knowing that you have diabetes every day can be hard. Susan has some words of wisdom for anyone struggling with the disease. “At first everything seems overwhelming, but you get used to what you need to do. It can be frustrating to live with diabetes every day. Sometimes I just want to say the heck with it and eat what I want. This is one time I find journaling helpful, because it keeps me on track and positive. Sometimes I really do say the heck with it and have that bowl of ice cream! But I get back on track the next day. You can successfully manage your diabetes. It just takes time and effort to learn what works for you. There are many resources available to help. Most of all, don’t give up!” For more information on the YRMC Diabetes Self-Management Program in Prescott or Prescott Valley call the Pendleton Wellness Center at 928-771-5794. Information about Arizona Living Well is available at 928-442-5372. For additional ongoing education and peer support, you can also join the Living Well with Diabetes Support Group, which meets on the third Tuesday of most months, from 5:30-6:30 pm at the Pendleton Wellness Center in Prescott. To get regular updates on upcoming meetings, simply subscribe at YRMC HealthConnect. And don’t forget to check out all of the healthy cooking videos and recipes we’ve collected for you at Your Healthy Kitchen. Follow us on FaceBook too, at YRMC’s Your Healthy Kitchen, where you can see what I’m making at home in my kitchen, plus get insider tips, delicious recipes and links to helpful health and nutrition resources online and in the community!
On the Set of YRMC’s Your Healthy Kitchen with Dr. Michael Macon, Medical Director of The Breast Care Center at YRMC
Breast cancer is the most commonly diagnosed cancer among women in Arizona, and Yavapai County has the third highest rate of breast cancer among all counties in the state. While we have no control over some of the risks for breast cancer, including family history and genetics, maintaining a healthy weight, enjoying a plant-based diet, being physically active, and scheduling regular mammograms are all steps that women can take to both prevent and detect breast cancer in its earliest stages. Dr. Michael Macon, Medical Director of the Breast Care Center at YRMC joined us recently on the set of YRMC’s Your Healthy Kitchen to share news about the excellent diagnostic tools, cutting edge treatment plans, caring staff and patient support available at the Breast Care Center. He also helped us prepare a delicious roasted cauliflower soup filled with cancer-fighting nutrients and lots of warm, satisfying flavor! Nourishing Ingredients Ready for Making Curried Roasted Cauliflower Soup The Breast Care Center at YRMC offers a number of excellent screening and diagnostic tools that can detect breast cancer in its earliest stages and help determine which treatment might be best if cancer is found. Dr. Macon describes the Breast Care Center as “a basecamp for cancer diagnosis and treatment, where first and foremost, women can get mammograms with expert mammographers using the latest equipment. Also, if someone is diagnosed with breast cancer, it is a place that provides excellent treatment, plus ongoing care that includes a support group for women who have cancer”. Check out the video to learn more about the great care provided at the Breast Care Center, and see how easy it is to make our delicious soup! Good research suggests that a plant-based diet (one filled with lots of vegetables, whole grains, beans, fruit, nuts and seeds, and smaller portions of animal-based foods) helps to prevent the onset and recurrence of breast cancer. In fact, a recent study led by researchers an the Harvard T.H. Chan School of Public Health found that women who ate 5 ½ servings of fruits and vegetables or more each day (one serving equals 1 cup of raw leafy greens or ½ cup cooked or raw non-leafy vegetables and fruits) had an 11% reduction in their risk of breast cancer compared to women who ate approximately half that amount or less each day. Cruciferous vegetables, including cauliflower, broccoli and Brussels sprouts, and yellow and orange vegetables may confer the most protection, especially against the most aggressive types of tumors. Warm and Satisfying Curried Roasted Cauliflower Soup The cancer-preventing effects of a diet filled with plants may be due to multiple factors, including high levels of fiber, which can reduce harmful estrogen levels in the body, and phytochemicals, which may act to stimulate the immune system, reduce inflammation, and even directly fight cancer growth. Eating meals that are filled with nourishing plants (especially vegetables) can also help women maintain a healthy weight. After all, if you replace some of the higher calorie foods on your plate, like meats and starches, with low calorie vegetables, you’ll be eating fewer calories, but will likely still feel comfortably full because of the fiber and volume that vegetables add to meals. Adequate physical activity, of at least 150 minutes of moderate or 75 minutes of vigorous exercise a week, may also reduce breast cancer risk by helping women to maintain a healthy weight. Other benefits of exercise likely include a reduction of harmful estrogen levels and improved immune function. Moving more throughout the day also means you are sitting less, which offers benefits that extend to increased longevity and reduced risk of a number of chronic diseases. There’s no doubt that lifestyle changes help reduce the risk of breast cancer, but remember, getting regular mammograms is equally important, whether you are at increased risk of breast cancer because of family or personal history or not. Call now, 928-442-8900, to schedule your mammogram, and remind your friends and loved ones to do the same. The Breast Care Center is located at Yavapai Regional Medical Center East, 7700 Florentine Road, in Prescott Valley. Curry Cauliflower Soup Apricot Pear Chutney