TAVR: 100 and Counting at YRMC’s James Family Heart Center
On May 7, 2019, the 100th patient underwent transcatheter aortic valve replacement (TAVR) at the James Family Heart Center at Yavapai Regional Medical Center (YRMC) West in Prescott. Dr. Soundos Moualla “Our TAVR team does incredible work every day and for every patient,” said Soundos K. Moualla, MD, FACC, FSCAI, Structural Heart Interventional Cardiologist and Director, YRMC’s Structural Heart Program. “We are honored to have cared for the first 100 TAVR patients and look forward to serving the next 100 patients.” This milestone – reached less than two-and-a-half years after the Heart Center’s first TAVR in January 2017 – demonstrates the program’s growth and success. In addition to being important to the region, TAVR also has changed the lives of individuals whose health made traditional valve repair surgery too risky. “Our TAVR patients are so much more than numbers to the heart team,” said Pierre Tibi, MD, FACS, Cardiothoracic Surgeon and Medical Director, the James Family Heart Center at YRMC West. “These are amazing people who after their TAVR procedures have embraced life. They have welcomed grandchildren and great grandchildren, enjoyed travel, volunteered in the community, become dedicated to exercise, and lived healthy lives thanks to the availability of TAVR in our region.” Dr. Jose Torres How TAVR Works TAVR is a minimally invasive surgical procedure for people with aortic stenosis (blockage). During a TAVR procedure, the aortic valve is repaired without removing the old, damaged valve. The TAVR procedure steps are performed through an extremely small opening that leaves the chest bones in place. An artificial valve is deployed into the opening and takes over functioning for the damaged valve. YRMC’s Exceptional TAVR Team All TAVR programs are federally required to have both a surgeon and interventional cardiologist to perform TAVR. YRMC’s include: Jose Torres, MD, FACS – Cardiothoracic surgeon (primary implanter) Soundos Moualla, MD, FACC, FSCAI – Structural Heart Interventional Cardiologist (primary implanter) The TAVR team also includes: Saina Attaran, MD, MRCS, FRCS – Cardiothoracic Surgeon Pierre Tibi, MD, FACS – Cardiothoracic Surgeon Mansour Assar, MD – Interventional Cardiologist James D’Antonio, MD – Interventional Cardiologist Anil Kumar, MD, MRCP, FACC, RPVI, RPhS – Imaging Specialist, Cardiologist Gwen Rhodes, RN – Structural Heart Coordinator YRMC’s TAVR team works with George Gellert, MD, a globally recognized specialist in transesophageal echocardiogram imaging. The TAVR team also includes anesthesiologists and staff from YRMC’s Surgical Services and Cath Lab as well as the support of almost every discipline in the hospital. The Hybrid OR and TAVR TAVR procedures are performed in YRMC’s Hybrid Operating Room, considered to be among the finest in the nation. In the Hybrid OR, heart specialists diagnose patients using permanently integrated imaging equipment. After they diagnosis the patient’s condition, the heart team is able to immediately perform a non-invasive, therapeutic procedure. The Hybrid OR can also convert into a state-of-the-art operating suite, which allows a seamless transition without moving the patient. “The TAVR program’s success is due to the outstanding professionals who provide the highest level of care to our patients,” said Dr. Moualla. “I am proud to call them my colleagues.” For more information about TAVR, check out these videos: TAVR: The Transfemoral Approach TAVR: The Transapical Approach TAVR: The Transaortic Approach
The Family Resource Center at YRMC: Keeping our Families Strong for 30 Years
Thirty years ago, a group of concerned people from Yavapai Regional Medical Center (YRMC) and other organizations sat around a table to discuss the needs of Prescott’s most vulnerable population – its children. They explored ways they could offer support to parents so that they can give their children the best possible start in life. The grassroots effort took hold and the Family Resource Center (FRC) at Yavapai Regional Medical Center was born. Of course, the program has grown exponentially over the years, finding new ways to meet the changing needs of our families. This year, the FRC celebrates its 30th anniversary and continues to make a difference in the lives of young families through three successful programs. Each of the programs is free of charge to families in our community. First Steps “Families giving birth back in 1989 needed support and education. They couldn’t Google questions like we can today.” says David Barko, Director of the Family Resource Center. “Yavapai Regional Medical Center came forward with First Steps, which is still in existence today. Specially trained volunteers provide information to every family giving birth at YRMC. They discuss important topics like SIDS prevention and the signs of postpartum depression. We assess what each individual family might need and offer social and emotional support as well.” One-week and three-month follow up calls are also part of the family resources program. Healthy Families The early efforts of the Family Resource Center brought to light another critical need in Yavapai County – home visits for families to provide additional support and to learn more about early childhood and parenthood. Healthy Families, which is now a nationally recognized program operating in 38 states, was developed at YRMC. The focus of the program is strength and empowerment. “Healthy Families is one of the top evidence-based home visit programs in the nation. It works.” says Barko. “We use the most up to date early childhood development knowledge to support our parents. They, in turn, support their children and give them the best start in life as they can. We know from research and science that the first 3 to 5 years of life are the most critical. Every experience, interaction, feeling, and relationship a child has during these years literally affects the brain’s development. They set the stage for the rest of the child’s life – how they perceive everything, what kind of relationships they enter into, how they cope with stress, learn to trust, or not. The list goes on.” Healthy Families visits occur once a week for the first 6 to 12 months, then every other week. Home visits can continue for as long as five years. The program is customized to meet the need of each family. Medical health, safe sleep, developmental milestones, well checks, immunizations and childproofing the home are among the information shared with the families. A connection to community services is also part of the program. Just as importantly, parents gain a listening ear and a mentor who can help them through tough times they may be experiencing. Healthy Families staff are trained in communication strategies that help remove the stigma associated with postpartum depression, anxiety, substance and alcohol abuse, financial or relationship issues and other life stressors. The Healthy Families program also offers several holiday-themed social events each year where families can get together, make friends and celebrate what it means to be a family. Car Seat Safety Program Continuing to identify needs and find solutions, the Family Resource Center now offers car seat safety checks, conducted by nationally certified technicians. Partnering with other organizations, the safety checks are usually held at the Family Resource Center. They are also offered at community events and health expos throughout the year. As with the other programs through the FRC, the car seat safety checks are free of charge. Educating caregivers – or anyone who transports children – continues to be the priority. In 2018, approximately 90% of the seats and children that FRC saw arrived in an unsafe situation or configuration. In 2018… The FRC First Steps volunteers visited all of the families who gave birth at YRMC. The Healthy Families program served 76 families, which includes 167 children. The Car Seat Safety program distributed 216 car seats and conducted 265 safety checks. But the numbers only tell part of the story. Barko notes that even the briefest connection can often lead to unexpected opportunities to help a family. He recalls a car seat check with a grandmother who wanted to make sure she was transporting her grandchildren safely. “We ended up talking for an hour,” says Barko. “She opened up and shared with me that her daughter was pregnant and experiencing depression. I was able to reassure her and gave her some information so that she could connect with valuable community resources.” Barko also tells about a mother with two children under the age of six. They were in the YRMC emergency room after a car accident and couldn’t return home because the car seats were destroyed. In addition to new car seats, the Family Resource Center was able to offer emotional support and resources for counseling to help the family cope after such a traumatic event. At 30 years and counting, the Family Resource Center truly embodies YRMC’s mission. “In some organizations, the mission is just a poster on the wall,” says Barko, “but at YRMC, those values are lived day to day. If I were to describe our team, the words that come to mind are empathy, heart and spirit. Our goal is that with every visit, every connection, we keep another child safe and help with their start in life.” For more information on the Family Resource Center, contact David Barko at (928) 771-5651 or dbarko@yrmc.org.
Local Physicians and YRMC Team Up to Benefit Prescott Area Shelter Services
Every year on National Doctors’ Day, we take a moment to recognize the men and women who choose to dedicate their lives to the delivery of healthcare. This year, members of our local medical community and YRMC chose to celebrate National Doctors’ Day by giving back to the community through a donation to Prescott Area Shelter Services (PASS). “We are very fortunate to have so many talented healthcare providers in our community,” states Anthony Torres, MD, Chief Medical Officer, Yavapai Regional Medical Center. “In addition to the work they do every day to provide the important medical care we count on, they are proud to make this community their home, to raise their families here, and to lend a hand to help others.” PASS was selected as this year’s recipient of the Doctors’ Day donation in the amount of $9,125. The donation, comprised of contributions from YRMC physicians and YRMC, will help pay for a project to provide housing for women with teenage sons. From left: Dr. William Resnick, PASS Executive Director Carmen Frederic, Dr. Anthony Torres “Providing safe housing for mothers with teenage sons is an area of need in our community,” states project organizer Bill Resnick, DO, Emergency Medicine, Yavapai Regional Medical Center. “Dr. Michael D’Angelo and I led the project committee and were aware of PASS and their work in the community. After receiving many suggestions from other YRMC physicians, we selected PASS to be the recipient of our first Doctors’ Day donation based on their commitment to provide housing for women in need.” To date, over 25 physicians and healthcare organizations have contributed to the donation. “We at PASS thank our local physicians and YRMC so very much for choosing us as the recipient for their financial support,” states Carmen Frederic, Executive Director, Prescott Area Shelter Services. “It really means so much to us that they care deeply about helping some of the most vulnerable people in our community. Their donation will make it possible for us to launch our new Shelter Expansion Project. This project will add much needed space in our shelter to serve a part of our community that isn’t currently being served, mothers with boys 12 and older.”
My Vision for YRMC’s Future: John Amos, President and CEO, Yavapai Regional Medical Center
By John Amos, President and Chief Executive Officer, Yavapai Regional Medical Center Friends recently showed me photos of a garden their children had planted as a summer project. In the first photo, small bunches of broccoli sprouted strong and healthy. This was planted in spring, my friend explained. He swiped to the next photo for a view of the entire garden. Next, he zoomed in to show me rows of tomatoes, peppers, eggplant, and watermelon. Garden markers staked in the dirt showed where seeds were planted. The tomatoes and peppers already looked like a promising crop. The photos of that garden came to mind as I began writing this article about Yavapai Regional Medical Center’s (YRMC’s) vision for the future. They reminded me of two important points: First, a garden is bigger than any single plant and second, a garden grows in stages, not in unison. A Bold Vision and a Strong Leadership Team The same is true for an organization’s vision for the future. The best visions are bold, inspiring, clear, and bound by time. They set a direction for planning that is rolled out over five to seven years. My vision for YRMC is a community in which all people achieve their full potential for health and wellness. The strategies that will make this vision a reality depend on: Understanding, listening to, and addressing our community’s health needs. Continuing to provide leading edge, technologically advanced and comprehensive healthcare programs and services. Focusing on programs and services that promote healthy living and wellness. Fortifying our strong relationships with our community partners, patients, medical staff, employees, and volunteers. Continuing to act as good financial stewards and effective planners for YRMC’s future. Collaborating as a leadership team to make YRMC’s future vision a reality. While all of these are important to achieving our vision for YRMC, I am grateful for the support of an extraordinary leadership team: YRMC’s Administrative Council (AdCo) and our Board of Directors. A State-of-the-Art Medical and Wellness Campus In the coming months, you’ll hear from several AdCo members who will focus on aspects of the plan to achieve our vision. Our first topic will feature the construction that is beginning at YRMC West in Prescott. Our goal is to evolve YRMC West into a state-of-the-art medical and wellness campus. The campus will feature YRMC West and will include a new health center to support prevention and wellness. The new health center on the campus of YRMC West will be an ideal home for primary care and specialty medical practices that need to be close to the services of YRMC West. Our new state-of-the-art health center in many ways will be the hub of YRMC’s evolving focus on health and wellness. It will also be home to YRMC’s Preventive Medicine and Wellness program (Pendleton Center), our Physical Rehabilitation Services and other services that help people manage their health and prevent illness. The Evolution of Growth Our evolution to a medical and wellness campus, like a garden, will happen in stages. Over the coming years we will also add inpatient hospital beds and explore valuable specialty services. As you would expect, our modern medical and wellness campus will also feature amenities that increase convenience for the people we serve. For example, the health center’s new multi-level parking structure – a welcome and necessary addition – will provide people easy access to the services they need. Ready for the Future As we move forward, I am confident that YRMC is well positioned to fulfill our vision. As a non-profit, community-based healthcare system, YRMC has never relied on property tax dollars for operating expenses or expansion projects. In fact, YRMC’s excellent financial health has earned us an A level bond rating. This upgrade was accomplished thanks to the entire YRMC family – our medical staff, employees and volunteers. Even more impressive, it happened as other community-based hospitals are facing uncertain financial times. As President and CEO, I am constantly scanning the horizon to ensure I’m steering YRMC to the best possible future. With the guidance of an outstanding leadership team and your continued involvement and support, I look forward to our vision blossoming into reality.
Preventing Osteoporosis in Your Healthy Kitchen!
Chances are, unless you’ve broken one, you don’t spend a lot of time thinking about the health of your bones! However, since half of all women and one in five men will suffer at least one fracture from osteoporosis in their lifetimes, now is a great time to find out more about your risk of this life-altering and sometimes deadly disease. In recognition of National Osteoporosis Month, we invited Kathi Hoffer, Imaging Services Operations Manager at The Breast Care Center at YRMC, to the set of Your Healthy Kitchen to talk about the nutrients, foods, and lifestyle habits that protect women and men against bone loss. Kathi also shared some important news about DXA Scan, an effective, non-invasive testing tool that can detect osteoporosis in its earliest stages. YRMC offers DXA Scan services at two convenient locations: in Prescott at Prescott Medical Imaging and at the Breast Care Center in Prescott Valley. Tomato-Vegetable Juice Osteoporosis and its precursor, osteopenia, are silent diseases marked by the gradual loss of structure and strength in bones. Unfortunately, most people have no idea that their bones are in trouble until one breaks. While many fractures do heal, the process can be painfully slow and many people lose their ability to live independently as a result. The statistics for hip fractures are particularly frightening: 28% of women and 37% of men die from complications within a year of breaking a hip. The good news: osteopenia and osteoporosis are preventable, treatable, and sometimes reversible conditions, so it’s important to speak with your healthcare providers about your risk. While osteoporosis can occur at any age, post-menopausal women and men over age 65 are at greatest risk. Other factors that can lead to weakened bones include a family history of osteoporosis, low body weight, poor diet (without adequate fruits, vegetables, calcium and vitamin D and high in sodium), history of one or more broken bones (especially in the wrist, hip or spine), a sedentary (not physically active) lifestyle, certain medications, and smoking (currently or in the past). Kathi Hoffer states, “If you are at risk, your physician can order a DXA Scan to assess the strength of your bones. DXA is a simple, painless exam using a low level of radiation that calculates the mineral density of bone. Women often schedule their mammograms at the same time, completing two important, and potentially life saving exams in one appointment.” While some risk factors, like gender, age and genetics can’t be changed, diet and lifestyle choices can! If you lead a sedentary lifestyle and are able to start moving more – do! Weight-bearing exercise like walking or hiking, dancing, strength training, or anything else that gets you on your feet more often will help you build stronger bones. Bones are smart! When you make physical demands on them, they respond and become denser and more resistant to fracture. However, it’s important to speak with your healthcare providers about the best exercise for you, especially if you have osteopenia or osteoporosis, as certain movements could increase your risk of fracture. Calcium and vitamin D are both critically important nutrients for bone health, but so are vitamins C and K, magnesium, potassium and more. There is even a class of phytochemicals called carotenes that also appear to play a role in bone health. These include lycopene, which is concentrated in red and pink fruits and veggies; lutein, found predominantly in leafy greens; and zeaxanthin, found in orange peppers, mangoes, egg yolks, and oranges. Filling at least half of your plate at lunch and dinner with a variety of vegetables and fruits (think the colors of the rainbow) will help you get many of the nutrients your bones need. Magnesium-packed whole grains, nuts, seeds and beans are also important components of a bone-healthy diet, as are good sources of calcium, including greens, low fat dairy and calcium-fortified plant-based milks and juices. In honor of National Osteoporosis Month, the National Osteoporosis Foundation (NOF) has created a helpful interactive tool, 35 Ways to Stay Bone Strong. Each box links to a fact, resource or action you can take to protect your bones and to live a healthy, active life. The NOF also has a new podcast and blog, Bone Talk, which highlights a variety of issues related to osteoporosis and includes conversations with patients, healthcare providers, researchers, advocates, and more. For more information about YRMC DXA Scan services, call 928-771-7577.
Asthma: It’s Not Just For Kids
Asthma is so associated with children that when an adult is diagnosed with the condition, it’s called “adult onset asthma.” It’s somewhat surprising that an equal percentage of adults and children in the United States – 8.3 percent – suffer from asthma, according to the Centers for Disease Control and Prevention. May is National Asthma and Allergy Awareness Month, a time to highlight the causes, symptoms and treatments of asthma and allergies. Yavapai Regional Medical Center (YRMC) is doing its part by featuring adult onset asthma, starting with how it’s different from childhood asthma. Asthma is the same disease whether you’re five or 50. What’s different is how children and adults experience asthma. Kids often have intermittent asthma symptoms stemming from allergy triggers or respiratory infections. Adults typically experience persistent asthma symptoms: wheezing, coughing, shortness of breath, and chest tightness. It’s not uncommon for adults to think they have heart disease or lung disease until their healthcare provider diagnoses adult onset asthma. Asthma Triggers Asthma causes swelling and inflammation in the airways of the lungs. This makes your lungs sensitive to asthma “triggers” and can lead to asthma attacks. Common asthma triggers include: Respiratory infections or colds Cold temperatures Dry air Emotional stress or excitement Exercise Smoke Mold and mildew Air pollution Feather bedding Dust mites Animal dander or saliva Colds, Cats and More! Allergies can make you more likely to develop adult onset asthma. In fact, approximately 30 percent of adult asthma cases begin when people are exposed to allergens and triggers. Other factors that increase your chances of developing adult onset asthma include: Health History – If you had asthma as a child, you’re at risk for relapse in your 30s or 40s. Weight – Obesity appears to increase the chances of developing asthma as an adult. Gender –The hormonal changes women experience during pregnancy and menopause may lead to adult onset asthma. What Can You Do About Asthma? The first step is to get a definitive diagnosis from your healthcare provider. Your treatment plan may include regular medication and a “rescue” inhaler to help during an asthma attack in order to provide relief of asthma symptoms. Your provider will also advise you about what to do if your asthma symptoms get worse. Talk to your provider about what you can do to manage asthma symptoms, such as allergy-proofing your home and workplace, and what asthmatic treatment options are available. Make sure you get your annual flu shot and older adults should also ask their healthcare provider about the pneumonia vaccination. Join YRMC’s Better Breathers Club YRMC works with the American Lung Association to sponsor the Better Breathers Club in our community. This program connects people living with lung disease to education, support and each other. Participants learn ways to cope with lung conditions such as asthma and chronic obstructive pulmonary disorder (COPD) while getting the support of others in similar situations. The Better Breathers Club is a fun and interesting combination of guest speakers and problem-solving discussions. Led by a YRMC Registered Respiratory Therapist, this adult support group meets the second Monday of the month from September through May. Want to receive information about future Better Breathers Club meetings? Go to YRMC HealthConnect “Subscribe” and select “Better Breathers Club Support Group” from our menu of support groups and special interests. Now that you understand adult onset asthma and know how it’s treated, YRMC hopes you’ll breathe easier.
YRMC Construction and Parking Alert!
Yavapai Regional Medical Center (YRMC) will soon begin an exciting and significant expansion project on its West Campus in Prescott. “This multi-year project will evolve YRMC West into a state-of-the-art medical and wellness campus,” said Frank Almendarez, MHSA, Chief Administrative Officer at YRMC. “The campus will include a new health center to support our focus on prevention and wellness.” Construction Begins – Parking is Limited Phase one of this project has already started with the expansion of the Energy Center at YRMC West. An essential aspect of the infrastructure needed to support the entire campus, the Energy Center reduced the number of parking spaces and limited access to YRMC West parking lots.There will be additional challenges as other phases of this project roll out. The next phase – construction of a multi-level parking structure – is scheduled to begin soon. “The parking structure will ultimately add several hundred new parking spaces to the YRMC West campus,” Almendarez said. Plan Your Visit to YRMC If you have a procedure or another appointment scheduled at the hospital, YRMC encourages you to allow extra time for parking. You also may want to look for YRMC volunteers driving carts in the parking lot to shuttle you to the hospital entrance. “I have suggested to friends that the person with the medical appointment be driven to the hospital entrance,” said Almendarez. “We also will have plenty of volunteers available to shuttle people from the parking lot to the hospital.” Keep Up-to-Date We are committed to keeping you up-to-date on our construction projects. New information will be provided to local media outlets when available. Updates also will be posted on YRMC HealthConnect and YRMC social media communities—Facebook and Twitter. We encourage you to subscribe to YRMC HealthConnect and follow us on social media to stay connected with developments. We appreciate your patience and understanding during our expansion. We are confident the long-term benefits of the expansion will outweigh the temporary inconveniences. We will keep you informed of other steps to improve access to YRMC West during the expansion.
Do You Understand Your Blood Pressure Numbers?
Our health is measured by many numbers: cholesterol, blood sugar and body mass index are just a few. For most of us, the actual numbers aren’t as important as knowing our blood pressure numbers are within a healthy range. May is National High Blood Pressure Education Month so the James Family Heart Center at Yavapai Regional Medical Center West wants to arm you with information to manage and monitor your blood pressure. Why the focus on managing blood pressure? High blood pressure affects one in three American adults and only 54 percent of them have it under control. High blood pressure has earned the scary name of “silent killer” because early-on there are no obvious symptoms or signs associated with it. Even scarier, untreated high blood pressure can lead to heart disease, stroke and kidney failure. Warning Signs If you have high blood pressure that’s untreated for a period of time, there can be warning signs and blood pressure symptoms. Contact your healthcare provider immediately if you’re experiencing the following symptoms: Dizziness Weight loss/hair loss Blurred vision Chest pain Shortness of breath Intense headaches What Do Your Blood Pressure Numbers Mean? If your blood pressure is elevated, it’s important that you are monitored by a healthcare provider. This chart – created by the American Stroke Association and American Heart Association – outlines the categories of high blood pressure. Once you know your blood pressure, what steps should you take to monitor your health? Here are some recommendations to discuss with your healthcare provider: Normal blood pressure (less than 120/80) – Have your blood pressure checked at least every two years or as frequently as your healthcare provider recommends. Borderline high pressure or prehypertension (between 120/80 and 139/89) – Check your blood pressure at least every year, or more often, if your healthcare provider recommends it. If you have other medical issues, even a borderline reading may be considered too high. 140/90 or higher – You have high blood pressure and need to see your healthcare provider to develop a treatment plan. Tips for Taking Your Blood Pressure Want to monitor your blood pressure between appointments with your healthcare provider? This can be a good way to ensure your blood pressure is at healthy levels. Many pharmacies have blood pressure monitors or you may want to invest in a home blood pressure monitor kit. Either way, use the same monitor each time you take your blood pressure. Here are some hints for taking your blood pressure: Always use the same arm and place the cuff on bare skin. Take up to three readings each time to ensure accuracy. Measure before eating and exercising but not right after you wake up. No caffeine, food, alcohol or tobacco 30 minutes before taking your blood pressure. Look at Your Lifestyle If you smoke, giving up tobacco is a good way to lower your blood pressure and improve your overall health. If you consume alcohol, consume in moderation. Eating a healthy diet and getting regular aerobic exercise are also good lifestyle habits that can help reduce your blood pressure. Follow YRMC, and YRMC’s Your Healthy Kitchen, on Facebook and Twitter for healthy living tips and nutritious and delicious recipes.
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™.
Find Out More
From Research Lab to Real Life: YRMC’s Genetic Clinic
Have you wondered how scientific research affects real lives? Look no further than the Human Genome Project for a shining example of how research leapt – relatively speaking – from research labs to patient clinics, like Yavapai Regional Medical Center’s (YRMC’s) Genetic Clinic in Prescott Valley. In 2003, scientists from 20 research institutions in six countries, including the United States, announced they had completed the monumental achievement of sequencing the entire human genome. How did this information make it into our everyday healthcare world? Jody Pelusi, PhD, FNP, AOCP, Oncology Nurse Practitioner, who oversees cancer genetic testing at YRMC’s Genetic Clinic recalls, for example, that breast cancer genetic testing used to involve only two genetic mutations: BRCA1 and BRCA2. “Now we know many genes exist,” said Dr. Pelusi. “Therefore, we do panel testing to look at anywhere from 30 to more than 100 genes.” What can genetic testing at YRMC’s Genetic Clinic accomplish? The answer to that question depends on the patient’s individual needs. Genetic testing is typically pursued to: Pinpoint actual risk for developing cancer from a hereditary mutation versus a perception of cancer risk. Learn cancer risk based on personal or family risk factors for people found not to be at high risk for cancer based on genetic testing. Determine the best treatment options, follow-up care and long-term monitoring for people diagnosed with cancer. Learning Your Genetic Risk for Cancer Before genetic testing happens – typically starting with a swab of salvia from the mouth – Dr. Pelusi meets with the individual to discuss his or her goals. Her approach is part scientist, part counselor and all supportive. “We talk about genetic testing, the information they will potentially learn and if knowing that will make a difference in how they approach their healthcare,” explained Dr. Pelusi. “Some people may come from families who didn’t discuss illness or they may be adopted and have no knowledge of their genetic history. There are many different circumstances.” During a first appointment, Dr. Pelusi introduces cancer genetic testing by: Reviewing the goals of cancer genetic testing. Discussing why the person is interested in genetic testing. Developing a profile based on the family’s history of cancer, including the type of cancer and at what age the family member was diagnosed with cancer. Outlining the pros and cons of genetic testing, including how test results can affect the people being tested as well as their family members. “About 10 percent of people will actually be found to have a genetic change that puts them at higher risk for potentially developing a cancer,” Dr. Pelusi said. “However, this 10 percent is significant as this can be life changing. Some individuals will come in and get the information and want to think about it before they determine if they want to undergo testing or not; this is absolutely fine.” Your Genetic Test Results For people whose genetic test results show they’re at higher risk for cancer, Dr. Pelusi works with their clinicians to provide valuable information on healthcare and lifestyle options. This may include increased health monitoring and screenings, lifestyle changes, risk-reducing surgeries and chemoprevention (using drugs, vitamins or other agents to reduce cancer risk, delay its development or help prevent recurrence). “These are emotional topics,” Dr. Pelusi said. “This is not a time to fear cancer. But we sure can fight it with our awareness, our knowledge and our actions. I make sure people have the information they need to make a decision they’re comfortable with. I listen and respect their approach. You can’t get that in a mail order test.” To schedule an appointment at the Genetic Clinic for a genetic evaluation and possible testing, call (928) 442-8747.
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
TAVR: 100 and Counting at YRMC’s James Family Heart Center
On May 7, 2019, the 100th patient underwent transcatheter aortic valve replacement (TAVR) at the James Family Heart Center at Yavapai Regional Medical Center (YRMC) West in Prescott. Dr. Soundos Moualla “Our TAVR team does incredible work every day and for every patient,” said Soundos K. Moualla, MD, FACC, FSCAI, Structural Heart Interventional Cardiologist and Director, YRMC’s Structural Heart Program. “We are honored to have cared for the first 100 TAVR patients and look forward to serving the next 100 patients.” This milestone – reached less than two-and-a-half years after the Heart Center’s first TAVR in January 2017 – demonstrates the program’s growth and success. In addition to being important to the region, TAVR also has changed the lives of individuals whose health made traditional valve repair surgery too risky. “Our TAVR patients are so much more than numbers to the heart team,” said Pierre Tibi, MD, FACS, Cardiothoracic Surgeon and Medical Director, the James Family Heart Center at YRMC West. “These are amazing people who after their TAVR procedures have embraced life. They have welcomed grandchildren and great grandchildren, enjoyed travel, volunteered in the community, become dedicated to exercise, and lived healthy lives thanks to the availability of TAVR in our region.” Dr. Jose Torres How TAVR Works TAVR is a minimally invasive surgical procedure for people with aortic stenosis (blockage). During a TAVR procedure, the aortic valve is repaired without removing the old, damaged valve. The TAVR procedure steps are performed through an extremely small opening that leaves the chest bones in place. An artificial valve is deployed into the opening and takes over functioning for the damaged valve. YRMC’s Exceptional TAVR Team All TAVR programs are federally required to have both a surgeon and interventional cardiologist to perform TAVR. YRMC’s include: Jose Torres, MD, FACS – Cardiothoracic surgeon (primary implanter) Soundos Moualla, MD, FACC, FSCAI – Structural Heart Interventional Cardiologist (primary implanter) The TAVR team also includes: Saina Attaran, MD, MRCS, FRCS – Cardiothoracic Surgeon Pierre Tibi, MD, FACS – Cardiothoracic Surgeon Mansour Assar, MD – Interventional Cardiologist James D’Antonio, MD – Interventional Cardiologist Anil Kumar, MD, MRCP, FACC, RPVI, RPhS – Imaging Specialist, Cardiologist Gwen Rhodes, RN – Structural Heart Coordinator YRMC’s TAVR team works with George Gellert, MD, a globally recognized specialist in transesophageal echocardiogram imaging. The TAVR team also includes anesthesiologists and staff from YRMC’s Surgical Services and Cath Lab as well as the support of almost every discipline in the hospital. The Hybrid OR and TAVR TAVR procedures are performed in YRMC’s Hybrid Operating Room, considered to be among the finest in the nation. In the Hybrid OR, heart specialists diagnose patients using permanently integrated imaging equipment. After they diagnosis the patient’s condition, the heart team is able to immediately perform a non-invasive, therapeutic procedure. The Hybrid OR can also convert into a state-of-the-art operating suite, which allows a seamless transition without moving the patient. “The TAVR program’s success is due to the outstanding professionals who provide the highest level of care to our patients,” said Dr. Moualla. “I am proud to call them my colleagues.” For more information about TAVR, check out these videos: TAVR: The Transfemoral Approach TAVR: The Transapical Approach TAVR: The Transaortic Approach
Do You Understand Your Blood Pressure Numbers?
Our health is measured by many numbers: cholesterol, blood sugar and body mass index are just a few. For most of us, the actual numbers aren’t as important as knowing our blood pressure numbers are within a healthy range. May is National High Blood Pressure Education Month so the James Family Heart Center at Yavapai Regional Medical Center West wants to arm you with information to manage and monitor your blood pressure. Why the focus on managing blood pressure? High blood pressure affects one in three American adults and only 54 percent of them have it under control. High blood pressure has earned the scary name of “silent killer” because early-on there are no obvious symptoms or signs associated with it. Even scarier, untreated high blood pressure can lead to heart disease, stroke and kidney failure. Warning Signs If you have high blood pressure that’s untreated for a period of time, there can be warning signs and blood pressure symptoms. Contact your healthcare provider immediately if you’re experiencing the following symptoms: Dizziness Weight loss/hair loss Blurred vision Chest pain Shortness of breath Intense headaches What Do Your Blood Pressure Numbers Mean? If your blood pressure is elevated, it’s important that you are monitored by a healthcare provider. This chart – created by the American Stroke Association and American Heart Association – outlines the categories of high blood pressure. Once you know your blood pressure, what steps should you take to monitor your health? Here are some recommendations to discuss with your healthcare provider: Normal blood pressure (less than 120/80) – Have your blood pressure checked at least every two years or as frequently as your healthcare provider recommends. Borderline high pressure or prehypertension (between 120/80 and 139/89) – Check your blood pressure at least every year, or more often, if your healthcare provider recommends it. If you have other medical issues, even a borderline reading may be considered too high. 140/90 or higher – You have high blood pressure and need to see your healthcare provider to develop a treatment plan. Tips for Taking Your Blood Pressure Want to monitor your blood pressure between appointments with your healthcare provider? This can be a good way to ensure your blood pressure is at healthy levels. Many pharmacies have blood pressure monitors or you may want to invest in a home blood pressure monitor kit. Either way, use the same monitor each time you take your blood pressure. Here are some hints for taking your blood pressure: Always use the same arm and place the cuff on bare skin. Take up to three readings each time to ensure accuracy. Measure before eating and exercising but not right after you wake up. No caffeine, food, alcohol or tobacco 30 minutes before taking your blood pressure. Look at Your Lifestyle If you smoke, giving up tobacco is a good way to lower your blood pressure and improve your overall health. If you consume alcohol, consume in moderation. Eating a healthy diet and getting regular aerobic exercise are also good lifestyle habits that can help reduce your blood pressure. Follow YRMC, and YRMC’s Your Healthy Kitchen, on Facebook and Twitter for healthy living tips and nutritious and delicious recipes.
Local Physicians and YRMC Team Up to Benefit Prescott Area Shelter Services
Every year on National Doctors’ Day, we take a moment to recognize the men and women who choose to dedicate their lives to the delivery of healthcare. This year, members of our local medical community and YRMC chose to celebrate National Doctors’ Day by giving back to the community through a donation to Prescott Area Shelter Services (PASS). “We are very fortunate to have so many talented healthcare providers in our community,” states Anthony Torres, MD, Chief Medical Officer, Yavapai Regional Medical Center. “In addition to the work they do every day to provide the important medical care we count on, they are proud to make this community their home, to raise their families here, and to lend a hand to help others.” PASS was selected as this year’s recipient of the Doctors’ Day donation in the amount of $9,125. The donation, comprised of contributions from YRMC physicians and YRMC, will help pay for a project to provide housing for women with teenage sons. From left: Dr. William Resnick, PASS Executive Director Carmen Frederic, Dr. Anthony Torres “Providing safe housing for mothers with teenage sons is an area of need in our community,” states project organizer Bill Resnick, DO, Emergency Medicine, Yavapai Regional Medical Center. “Dr. Michael D’Angelo and I led the project committee and were aware of PASS and their work in the community. After receiving many suggestions from other YRMC physicians, we selected PASS to be the recipient of our first Doctors’ Day donation based on their commitment to provide housing for women in need.” To date, over 25 physicians and healthcare organizations have contributed to the donation. “We at PASS thank our local physicians and YRMC so very much for choosing us as the recipient for their financial support,” states Carmen Frederic, Executive Director, Prescott Area Shelter Services. “It really means so much to us that they care deeply about helping some of the most vulnerable people in our community. Their donation will make it possible for us to launch our new Shelter Expansion Project. This project will add much needed space in our shelter to serve a part of our community that isn’t currently being served, mothers with boys 12 and older.”
At the Whiskey Row Marathon, Dave DeVeau Goes the Distance
Distance running is a solitary sport for many people, but for Dave DeVeau it’s a team builder. The Finance Manager of Yavapai Regional Medical Center (YRMC) peppers conversations about his running experience at the Whiskey Row Marathon with words like coach, comradery and team. Team Training It was Dave’s co-workers in YRMC’s Finance Department – led by Chief Financial Officer, Lee Livin – who got him interested in running. “There was strong comradery among us right from the gate,” said Dave. “Lee got us started with running and soon we were talking about our training schedules and running together when we could.” Lee recommended a structured approach to running that appealed to Dave. He suggested websites and articles on the science of running. In 2016, Dave ran the Whiskey Row Marathon 10K with his wife Stacy. They crossed the finish line together with hands clasped in the air and smiles on their faces. Dave DeVeau (center) celebrates at the end of a recent marathon with wife Stacy and Jason Metcalf, YRMC’s Director, Revenue Cycle. Dave was inspired. He continued training with his YRMC colleagues, trimming eight minutes off his time between the 2017 and 2018 Whiskey Row Half Marathon. He’s currently training for the 41st Annual Whiskey Row Marathon (half marathon) on Saturday, May 4, 2019. It’s especially motivating since YRMC is the event’s Signature Sponsor. Set Your Goals Dave’s training schedule typically includes five-mile runs throughout the week and long runs on the weekend. He likes the Peavine and Iron King Trails. “I get into my own world during long runs,” Dave said. “It’s a great stress reducer. Sometimes, I’ll run 15, 18 miles and then realize I have only two miles to go.” Avoiding the Dreaded “Wall” The long runs also help Dave prepare for hitting the dreaded “wall” during a race. Runners reach this point when their stored muscle energy (glycogen) is depleted. To avoid this, Dave recommends eating breakfast – he likes an egg sandwich – and packing high-energy snacks for along the race course. “The last thing I want to do after intense training is walk the final three miles of a race,” he said. The Energy of the Crowd The crowd’s energy and enthusiasm help Dave power through to the end of the Whiskey Row Marathon. “When you get to the Courthouse Square, people are clapping and cheering,” Dave said. “So, when I come around that last block, I kind of turn it on and get as close to a sprint as I can.” Look for Dave – and lots of YRMC employees, medical staff and volunteers – at the 2019 Whiskey Row Marathon. To register, volunteer or for more information about the Whiskey Row Marathon: Visit the official Whiskey Row Marathon website. Find the Whiskey Row Marathon on Facebook and Instagram. Contact Rachele Skvarek, Whiskey Row Marathon Race Director at (928) 445-7221, ext. 217.
Brains, Heart, Courage: YRMC Volunteers of the Year for 2019
The quest for brains, heart and courage was a central theme in the beloved novel and film The Wizard of Oz. Had the Scarecrow, Tin Man and Cowardly Lion made Yavapai Regional Medical Center (YRMC) their first stop, their quest would have been fulfilled. Any day of the week, the YRMC volunteers display these traits and more, according to Nancy Thomes, Director of Volunteer Services at YRMC. The staff at YRMC recently honored its volunteers at the annual Volunteer Appreciation Luncheon. With nearly 400 people attending, this year’s theme was The Wizard of Oz. The festivities took place at the Prescott Resort, with YRMC staff appearing as various characters from the classic story. Thomes says the luncheon conveys only a fraction of the gratitude that YRMC and the community at large has for the volunteers at YRMC. “In 2018, our volunteers contributed 112,132 hours of service, which is a record,” says Thomes. “Every one of those moments means that someone, in some way, is served because of our volunteers. How fortunate we are.” Three volunteers in particular were honored for the ways in which they embody the mission and vision of YRMC each day they come to work. YRMC West Campus Volunteer of the Year: Joe Clyne Joe Clyne started volunteering at YRMC 13 years ago and has given more than 2,300 hours in 11 different capacities. He currently volunteers as an Escort as well as offering administrative assistance in the Payroll Department and delivering mail. Clyne saw a need for regular clean up and maintenance in the Healing Garden and took it upon himself to fill that need as well. “Volunteering at YRMC is very satisfying and gives me a real sense of purpose,” says Clyne. “Being the Volunteer of the Year is a recognition that is beyond words. There are so many deserving volunteers working at this facility.” Clyne’s knowledge and experience, positivity and willingness to jump in wherever he’s needed makes him the YRMC West Campus Volunteer of the Year for 2019. YRMC East Campus Volunteer of the Year: Andrea Bell Andrea Bell joined the YRMC Volunteer community in July of 2011, when the BreastCare Center at YRMC East opened its doors. Since then, she has donated more than 1600 hours of her time to the program. Bell served as the Department Chair for a period of time and has even helped train new volunteers when the Chair position was vacant. Members of the staff consider Bell’s compassionate support for both patients and staff one of the reasons why the BreastCare Center volunteer program is such a success. However, Bell’s unassuming nature deflects the high praise. “I used to say ‘I’m just a volunteer’ and boy would they put me in my place! I don’t say that anymore!” says Bell. On a more serious note, Bell expresses her gratitude for the opportunity. “I always feel so thankful that I’m able to give my time to volunteering at YRMC,” Bell says. “Volunteering is an uplifting and positive part of my life. It’s a gift to me!” Bell was recognized at the luncheon as the YRMC East Campus Volunteer of the Year for 2019. YRMC Sandy Zinn Martin Award: Rick Smith Sandy Zinn Martin was a long-time YRMC volunteer who was known as the ‘little lady with the big personality.’ Her dedication and giving nature was known throughout the hospital. The Sandy Zinn-Martin Award was created in her memory to honor her spirit of generosity. It is given each year to a volunteer who embodies the ‘above and beyond’ attitude that Sandy exemplified. Rick Smith is an East Campus Escort on Thursday afternoons and works as a substitute Courtesy Cart driver or Shredder when needed. He has volunteered at YRMC for more than two years and has clocked more than 550 volunteer hours. But Smith’s dedication to YRMC and its volunteers extends far beyond this job description. Smith is considered a friend to all. In his off-duty hours, has been known to visit fellow volunteers in the hospital, rehabilitation facilities and even in their homes. His optimism and sense of humor makes everyone smile, even when sick or convalescing. Smith takes the accolades in stride. “I am surprised and humbled. It is very nice to be acknowledged,” he says. “I consider these hard working and dedicated people to be my friends and I’m lucky to get to spend time with them.“ “I have been very lucky in my own life,” Smith reflects. “It so nice to do a little bit for folks who are maybe not having the best of luck. You definitely get back more than you put in.” Smith’s generosity of spirit has earned him the YRMC Sandy Zinn-Martin Award for 2019. In The Wizard of Oz, the Tin Man wisely said, “You people with hearts have something to guide you.” Thomes says that the Tin Man must have known something about volunteerism. “Without generous hearts, there would be no volunteering,” she says. “I work with what I consider the best of the best. These are individuals who want to give of their time, the most valuable resource that anyone can give.” Thomes continues, “I feel a little skewed about humanity because I work with the kind of people who say yes to whatever we ask of them. I think volunteering is the best thing a person can do.”
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
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.
Women and Lung Cancer: Should You Get Screened?
It’s probably no coincidence that National Women’s Lung Health Week (May 12-18, 2019) kicks off on Mother’s Day. According to the American Lung Association, over the past 41 years the rate of women being diagnosed with the disease has increased by 87 percent. Women or men who smoke are at most risk for developing lung cancer, but people who have never smoked also can be diagnosed with lung cancer. The risk of lung cancer increases with the length of time and number of cigarettes smoked. If you quit smoking – even after many years of smoking – you can significantly reduce your chances of developing lung cancer. During National Women’s Lung Health Week, Yavapai Regional Medical Center (YRMC) is highlighting low-dose computed tomography (LDCT). Heavy, long-term smokers, current smokers, or people with a family history of lung cancer have lung cancer screening with low-dose computed tomography (LDCT) available at: Prescott Medical Imaging (PMI) Prescott Valley Medical Imaging (PVMI) YRMC East in Prescott Valley Why Lung Cancer Screening is Important Lung cancer often has no symptoms. Because of this, it can spread outside of the lungs before it is detected. By then, the cancer may be advanced which can affect treatment outcomes for the patient. “It’s very important to get screened even if you don’t have symptoms,” said Mary Sterling, Director of Imaging Services for YRMC. “The benefit of early detection is finding a cancer before it has a chance to spread. The earlier cancer is detected, the more likely it is treatable.” Should You be Screened for Lung Cancer? LDCT is part of YRMC’s Lung Cancer Screening and Care Program. To be eligible for the Medicare-sponsored screening you must be: Between the ages of 55-77 Free of cancer symptoms Either currently smoking or a past smoker who quit 15 years ago or less A heavy smoker averaging one pack per day for 30 years or two packs per day for 15 years People are encouraged to talk with their primary care providers to determine if they are eligible for the screening program. “The patient and healthcare provider will have a discussion about the patient’s smoking history and find out if they have any symptoms,” Sterling said. “They’ll also talk about smoking cessation if the patient is still smoking.” A Team Approach YRMC’s Lung Cancer Screening and Care Program uses a team approach that draws on the skills of primary care providers, pulmonologists, procedural pulmonologists, radiologists and a cardiothoracic surgeon. The program also includes a patient navigator whose job is to serve as a patient contact. This professional answers questions about program eligibility and directs patients to the appropriate provider if specific care is required. The patient navigator also can help people determine if their current insurance plan covers the screening or assist people who would like to undergo the exam using the self-pay option YRMC offers. A Prevention Plan “The program is not a one-time screening test,” said Sterling. “Annual follow-up screening is recommended for patients whose initial screenings do not show signs of lung cancer.” If a patient’s LDCT findings show signs of lung cancer, a follow-up scan will be scheduled. A biopsy may also be recommended, in which case the patient would be referred to a procedural pulmonologist or a radiologist, depending on the location of the lung nodule. Should the patient need surgery, the Lung Cancer Screening and Care Program team also includes a cardiothoracic surgeon. Jennifer Harvey, RN, BSN, YRMC’s Lung Cancer Screening and Care Program Patient Navigator encourages people to support lung health year-round and during National Women’s Lung Health Week. Learn More About LDCT For more information about LDCT, please contact your primary care provider or the Lung Cancer Screening and Care Program Patient Navigator at (928) 771-5454. Need help giving up smoking? Contact the ASHLine, Arizona Smokers’ Helpline (1-800-556-6222), for free assistance. Help spread the word about lung cancer screening by sharing this YRMC HealthConnect article with your social media friends.
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
Preventing Osteoporosis in Your Healthy Kitchen!
Chances are, unless you’ve broken one, you don’t spend a lot of time thinking about the health of your bones! However, since half of all women and one in five men will suffer at least one fracture from osteoporosis in their lifetimes, now is a great time to find out more about your risk of this life-altering and sometimes deadly disease. In recognition of National Osteoporosis Month, we invited Kathi Hoffer, Imaging Services Operations Manager at The Breast Care Center at YRMC, to the set of Your Healthy Kitchen to talk about the nutrients, foods, and lifestyle habits that protect women and men against bone loss. Kathi also shared some important news about DXA Scan, an effective, non-invasive testing tool that can detect osteoporosis in its earliest stages. YRMC offers DXA Scan services at two convenient locations: in Prescott at Prescott Medical Imaging and at the Breast Care Center in Prescott Valley. Tomato-Vegetable Juice Osteoporosis and its precursor, osteopenia, are silent diseases marked by the gradual loss of structure and strength in bones. Unfortunately, most people have no idea that their bones are in trouble until one breaks. While many fractures do heal, the process can be painfully slow and many people lose their ability to live independently as a result. The statistics for hip fractures are particularly frightening: 28% of women and 37% of men die from complications within a year of breaking a hip. The good news: osteopenia and osteoporosis are preventable, treatable, and sometimes reversible conditions, so it’s important to speak with your healthcare providers about your risk. While osteoporosis can occur at any age, post-menopausal women and men over age 65 are at greatest risk. Other factors that can lead to weakened bones include a family history of osteoporosis, low body weight, poor diet (without adequate fruits, vegetables, calcium and vitamin D and high in sodium), history of one or more broken bones (especially in the wrist, hip or spine), a sedentary (not physically active) lifestyle, certain medications, and smoking (currently or in the past). Kathi Hoffer states, “If you are at risk, your physician can order a DXA Scan to assess the strength of your bones. DXA is a simple, painless exam using a low level of radiation that calculates the mineral density of bone. Women often schedule their mammograms at the same time, completing two important, and potentially life saving exams in one appointment.” While some risk factors, like gender, age and genetics can’t be changed, diet and lifestyle choices can! If you lead a sedentary lifestyle and are able to start moving more – do! Weight-bearing exercise like walking or hiking, dancing, strength training, or anything else that gets you on your feet more often will help you build stronger bones. Bones are smart! When you make physical demands on them, they respond and become denser and more resistant to fracture. However, it’s important to speak with your healthcare providers about the best exercise for you, especially if you have osteopenia or osteoporosis, as certain movements could increase your risk of fracture. Calcium and vitamin D are both critically important nutrients for bone health, but so are vitamins C and K, magnesium, potassium and more. There is even a class of phytochemicals called carotenes that also appear to play a role in bone health. These include lycopene, which is concentrated in red and pink fruits and veggies; lutein, found predominantly in leafy greens; and zeaxanthin, found in orange peppers, mangoes, egg yolks, and oranges. Filling at least half of your plate at lunch and dinner with a variety of vegetables and fruits (think the colors of the rainbow) will help you get many of the nutrients your bones need. Magnesium-packed whole grains, nuts, seeds and beans are also important components of a bone-healthy diet, as are good sources of calcium, including greens, low fat dairy and calcium-fortified plant-based milks and juices. In honor of National Osteoporosis Month, the National Osteoporosis Foundation (NOF) has created a helpful interactive tool, 35 Ways to Stay Bone Strong. Each box links to a fact, resource or action you can take to protect your bones and to live a healthy, active life. The NOF also has a new podcast and blog, Bone Talk, which highlights a variety of issues related to osteoporosis and includes conversations with patients, healthcare providers, researchers, advocates, and more. For more information about YRMC DXA Scan services, call 928-771-7577.
Making a Healthy, Hearty, Whole Grain Risotto in YRMC’s Your Healthy Kitchen!
Risotto is a hearty, belly-warming dish that’s traditionally made with just a few simple ingredients: short grain Arborio rice, flavorful stock, pungent onions, wine, creamy butter and Parmesan cheese. While traditional risotto is delicious, it’s not terribly nutritious; after all, it’s essentially a dish made with a lot of white rice and butter! Fortunately, you can turn a basic risotto recipe into something comforting, delicious, warming AND good for you by replacing the white rice with whole grains, reducing the butter a bit (or using olive oil), and adding an extra helping of vegetables to the pot to make a delicious whole grain risotto. Once you learn how to make a basic risotto, there are an endless number of options for creating your own healthy comfort food at home! A variety of whole grains can be used to make risotto, including farro (an ancient variety of wheat), brown rice, buckwheat, quinoa, and even whole or steel cut oats. However, for a whole grain dish that most closely resembles the creamy texture of traditional risotto, barley can’t be beat! The chewy texture of barley is similar to Arborio rice and, as barley cooks, it releases starch into the pan, which helps create a creamy sauce like that found in traditional risotto. Check out how easy it is to make a hearty batch of mushroom-barley risotto in this recent video from YRMC’s Your Healthy Kitchen! Recipe for Creamy Mushroom Barley Risotto Barley is an economical, nutrient-packed whole grain. Each tender seed contains a good amount of magnesium and B vitamins, plus more fiber than any other grain. Barley is a great choice for people with diabetes, as it may improve blood sugar control throughout the day. In fact, research shows that people who eat barley with dinner tend to have better blood sugar readings in the morning, even after eating breakfast! The fiber in barley also lowers cholesterol and is included in the FDA’s list of foods that can reduce the risk of cardiovascular disease. The fiber in barley is similar to the fiber in oats, and when included in a diet that is low in saturated fat and cholesterol, barley has been shown to reduce total and LDL cholesterol by up to 13%. There are many other ways to enjoy barley. Throw a handful into a pot of homemade soup, or try this easy Your Healthy Kitchen Mediterranean Barley Salad! Barley is delicious in a cold dish because, unlike other grains, it maintains a chewy, moist texture when chilled. You can also substitute rolled barley flakes for rolled oats in the morning – it’s a great way to start your day and, if you have diabetes, you’ll likely have better blood sugar readings after breakfast and, possibly, throughout the day! For more healthy meal ideas, recipes and lots of videos, please visit us at yrmchealthconnect.org. You can also follow me on Facebook at YRMC’s Your healthy Kitchen, where I share what I am making in my own kitchen, plus information on community food- and garden-related events, and other fun and fascinating links to food and healthy living.