Remember when television migrated from analog to digital in 2009 and a few years later made the leap to high-definition television? With each generation, the images were crisper, the colors more vibrant, the monitors sleeker. The world of diagnostic ultrasound is having a similar moment, thanks to high-definition imaging technology like the Hologic SuperSonic™ MACH 30 Breast Ultrasound. This is good news for patients of the Breast Care Center at Dignity Health, Yavapai Regional Medical Center (YRMC) and Prescott Medical Imaging (PMI), where the technology was recently introduced. “It’s very stressful to be called back for additional testing after a screening mammography,” says Kathi Hoffer, Imaging Operations Manager at the Breast Care Center. “But the availability of this state-of-the-art diagnostic technology – and our excellent imaging team –  reassures our patients that we will get the most accurate results.” Some physicians are also recommending the Hologic breast ultrasound to screen patients who are at high risk for breast cancer. More Details, Less Time Ultrasound uses high-frequency sound waves to produce images of the body. How is the Hologic breast ultrasound different? First, it was designed specifically for breast tissue. It takes this a step further with an option to “customize” the exam according to the patient’s breast tissue. “If the woman has fatty breast tissue, dense breast tissue or cysts, for example, the Hologic breast ultrasound has specific modes for each of those,” explains Hoffer. “This allows the ultrasound technologist to gather images with exceptional clarity and detail for the radiologist to interpret.” The Hologic breast ultrasound images are also enhanced by a specially designed transducer, the handheld device used by the ultrasound technologist. Traditional ultrasound transducers pick up soundwaves from a single direction. The Hologic’s transducer records soundwaves from multiple angles. Ultrasound technologists and patients both benefit from the Hologic’s new touchpad. The device is user friendly and reduces the amount of time the exam takes. A Consistent Image Ensuring the availability of the Hologic breast ultrasound at both the Breast Care Center and PMI is part of YRMC’s commitment to imaging continuity. “It’s important that women undergo their annual breast screenings and any related breast studies at the same center,” Hoffer says. “If you’re using different equipment, it’s difficult to tell if changes in the breast tissue are related to the machine or the mass that’s being studied.” Brought to You by the YRMC Foundation The Hologic breast ultrasound technology was funded by a generous donation from the Yavapai Regional Medical Center Foundation. “The YRMC Foundation is honored to make this state-of-the-art diagnostic tool available to patients of the Breast Care Center and Prescott Medical Imaging,” says Dave Barrett, Chairman, YRMC Foundation Board of Trustees. “This gift demonstrates how important YRMC Foundation donors are to expanding and improving healthcare throughout our community.” For more information about Hologic breast ultrasound and other breast imaging services, speak to your physician. You may also contact the Breast Care Center or Prescott Medical Imaging at (928) 771-7577.

The Yavapai Regional Medical Center (YRMC) Foundation Board of Directors has announced its slate of elected officers for July 1, 2021 to June 30, 2022. The officers include Dave Barrett continuing his role as Chair; Pierre Tibi, MD, as newly elected Vice Chair; and Bill Sonsin adding the role of Treasurer to his existing role as Secretary. Mr. Barrett, owner of Barrett Propane, has served on the YRMC Foundation board since 2013, including the role of Vice Chair and serving as board Chair since 2018. He is a longtime benefactor of the Foundation including extensive support for the Breast Care Center at Dignity Health, Yavapai Regional Medical Center, and is also a leading sponsor of numerous community fundraising events. Dr. Tibi, a leading cardiovascular surgeon who was instrumental in the establishment of the James Family Heart Center at YRMC, is a longtime supporter of the Foundation and board member since 2020. He has also sponsored and organized the Crawfest events to benefit YRMC’s Partners for Healthy Students program. Mr. Sonsin, a retired financial advisor for American Express Financial Advisors (now Ameriprise), has served as a board member since 2017 and as board Secretary since 2018. He is a faithful supporter of YRMC’s Partners for Healthy Students program and many other initiatives including the YRMC COVID-19 Vaccination Center. The YRMC Foundation is committed to supporting the health care mission of Dignity Health, Yavapai Regional Medical Center – your local, not-for-profit community medical center – through fundraising and relationship building. The Foundation solicits philanthropic gifts, provides stewardship of these gifts, and grants funds to the hospital to advance the community’s access to health care. All charitable gifts received by the Foundation stay in our community and are utilized as directed by the donor. Donors may designate their gifts to any of the Foundation’s 18 special purpose funds. In 2020, community support to the YRMC Foundation topped $2.3 million. The expertise and talents of our YRMC Foundation board members span backgrounds in business, finance, law, communications, and more. These directors represent our community and business leaders, medical staff, and hospital leadership. In addition to Mr. Barrett, Dr. Tibi and Mr. Sonsin, the YRMC Board of Directors includes John Amos, Douglas Bristol, Mary Mallory, Robbie Nicol, Dr. Arabinda Pani and Harvey Skoog. To learn more about the YRMC Foundation, please contact (928) 771–5686 or foundation@yrmc.org, or visit www.yrmcfoundation.org.

If you have ever had a ‘gut feeling’ about something, you’ve sensed a connection that science is proving true: your gut communicates with the rest of your body.  Specifically, research shows that the gut microbiome, or the collection of bacteria that live in the digestive tract, influences a host of bodily functions, including cholesterol metabolism, inflammation, blood pressure, and more. Recent studies suggest that an imbalance in the number and diversity of gut bacteria may even contribute to the development of cardiovascular disease (CVD), a group of conditions that includes atherosclerosis, heart attack, heart failure and stroke.  As we learn more about the important role the gut microbiome plays in preserving health and triggering disease, a whole new box of tools for treating and preventing CVD may result. The Gut Microbiome Our bodies host trillions of bacteria that live on and within us, with the largest concentration of bacteria found in the lower digestive tract.  These tiny organisms maintain the health of the lining of gut, produce important nutrients, regulate the immune system, and can trigger or reduce inflammation throughout the body.  Research suggests that the number, diversity, and balance of different families of bacteria have a direct influence on cardiovascular health.  Phillip Tran, DO, Cardiologist at Yavapai Regional Medical Group, is enthusiastic about these discoveries.  “We know there are several known and common risk factors for CVD, including smoking, obesity, diabetes, and inactivity.  Abnormal gut flora is now being considered another major risk factor.  This may open up exciting new modalities for treating and preventing CVD.” Inflammation Inflammation results from a complex series of immune reactions in the body that can be triggered by a host of conditions.  Dr. Tran states, “Chronic inflammation is a root cause of cardiovascular disease.  An important factor in reducing inflammation in the body appears to be maintaining a healthy population of the bacteria that protect and feed the lining of the gut.” When bacterial populations are healthy and diverse, the lining of the gut, which prevents pro-inflammatory, disease-causing substances from entering the body, remains intact.  However, when bacterial populations shift, either through dietary changes, stress, medications, or other causes, the gut lining itself can become damaged and inflamed, thus allowing disease-causing substances to enter the blood stream.  This condition, often called leaky gut, may lead to an increased risk of cardiovascular disease. Cholesterol, Blood Pressure and TMAO Some of the most interesting medical research done in the last few years relates to the discovery of a potential link between gut bacteria, diet, increased CVD risk, and a chemical called trimethylamine N-oxide, or TMAO.  Dr. Tran describes the connection.  “TMA, or trimethylamine, is produced by certain gut bacteria when people regularly consume red meats.  TMA is converted to TMAO in the liver, and research suggests that TMAO may increase inflammation in atherosclerotic plaque, decrease the elimination of cholesterol from the body, and indirectly promote increased cholesterol production.  Foam cells, which are the cholesterol-filled cells found in plaque, may also increase in number and size under the influence of TMAO.” Several studies from the US and Europe have demonstrated that blood levels of TMAO are often linked to an increased risk of heart attack and stroke.  Higher levels of TMAO have also been measured in people suffering from heart failure.  Keeping in mind that these correlations do not prove that TMAO causes cardiovascular disease, researchers continue to study this intriguing connection. Prebiotics and Probiotics Several studies have shown that food and supplement-based pre and probiotics may reduce total cholesterol, LDL-cholesterol and inflammation. Prebiotics are plant fibers that feed the health-promoting bacteria living in the gut.  These fibers may be one of the reasons why a high fiber, plant-based diet is strongly linked with better blood cholesterol levels, reduced inflammation, and reduced CVD risk. Probiotics include beneficial bacteria, yeasts and fungi, many of which are produced from the fermentation of a variety of foods.  Probiotics can be taken as supplements or eaten as a natural part of fermented foods.  Some common, probiotic-rich fermented foods include yogurt (dairy or plant based), sauerkraut, kimchi (a spicy Korean condiment), kefir, and kombucha (a type of fermented tea). Dr. Tran thinks we need more research to clarify and prove the benefits of taking probiotic supplements to prevent or treat CVD.  He states, “Although many studies suggest that probiotics can favorably alter serum lipids, some human studies examining the benefits of probiotics on serum lipids have shown conflicting results.” Many researchers concur, stating that the science is new and will take time to determine what types and blends of probiotics might be therapeutic for certain conditions, and in what form probiotic supplements should be consumed for the best outcomes. Steps to Improve Gut and Cardiovascular Health Dr. Tran suggests the following steps to improve the health of your gut and possibly reduce your risk of CVD. Maintain healthy intestinal flora by eating a diet rich in high fiber, plant based foods, and by regularly consuming healthy fermented foods. Take antibiotics with caution and care as they kill all bacteria and can promote the growth of unhealthy bacteria in the gut.  Supplement with prebiotics and probiotics whenever you take antibiotics. If you have cardiovascular disease, talk to your cardiologist about the potential benefits of pre and probiotics.  While the science is not yet clear, boosting a healthy population of gut bacteria may reduce inflammatory processes that trigger cardiovascular conditions.        

Experts agree that proper hydration is key to a healthy lifestyle. Drinking enough water helps keep our organs functioning as they should, lubricates our joints, helps to deliver nutrients to our bodies and helps prevent infection. It can also help with cognitive functioning and the quality of our sleep. In general, we should aim for about six to eight 8-ounce glasses of water per day. Plain water can be flavored with fruit or vegetables, such as lemons, berries, or orange or cucumber slices. Coffee or tea can also be a substitute for some of the water. The key is to stay away from sugary beverages. Click here for refreshing infused water suggestions from Rita Carey Rubin, the host of YRMC’s Your Healthy Kitchen. In a CNN Health article, Douglas Casa, CEO of the University of Connecticut’s Korey Stringer Institute, says that one of the best ways to tell whether you’re lacking fluids is by the color of your urine. “The morning is the best time to get a global sense of your hydration status,” Casa advised. “If your urine looks more like apple juice instead of lemonade, then you’re dehydrated. On the flip side, the need to urinate throughout the day is a sign that you’re well-hydrated.” However, the increased physical demands of a marathon runner may present a few additional questions about proper hydration. What’s the right way to hydrate before, during and after a race? The Cleveland Clinic offers some general guidelines. In the weeks before the race, make sure you’re drinking lots of non-sugary fluids to ensure you’re well hydrated. This, along with a healthy diet, will help put you in top physical shape when race day arrives. A chat with your healthcare provider and trainer can be a helpful first step to creating your own hydration and nutrition plan. On the big day, some experts suggest drinking about 16 ounces of water or other fluid an hour before the race begins. Avoid caffeine, which is a diuretic and could increase the urge to urinate. At this point, you may want to stop fluid intake until after the race begins, giving you an opportunity to use the restroom a final time. During your race, drinking small amounts frequently rather than large gulps less frequently helps your body absorb the liquid better. A common rule of thumb is hydrating every 15 to 20 minutes. Most marathons, such as the annual Whiskey Row Marathon in Prescott, have water stops along the course. Some runners like to carry their own water bottle, edible water pods or water packs. Experiment with your options well before the day of the race to determine which works best for you. When the race is over, remember to rehydrate regularly with water, a sports drink containing electrolytes, or other fluids. The effects of dehydration can be felt hours after a race, often as a result of forgetting to hydrate properly after the race is finished. Symptoms include fatigue, headache, muscle cramping and dizziness. It’s also a good idea to check your urine after the race. If it is dark, it may be a sign that you need to drink more fluids. Most runners develop their nutrition and hydration plans while training in the weeks, months and years before a race. They rely on the advice of their healthcare provider, trainer, suggestions from fellow athletes, and their own judgment to make the choices that are right for them. Just like running shoes, there’s no one size fits all, but these guidelines may help you get you started.

Patient Blood Management (PBM) is a multi-disciplinary approach to maximizing your own blood health and supply. Often this is most crucial during surgery. When large amounts of blood are lost in surgery, it is often possible to get the blood you need by electing to use your own blood. Not blood from a donor, not blood limited by type. And not blood straining the nation’s precious blood supply. (This is especially important during COVID-19 when national blood banks have experienced a drop in donations, which in turn reduces blood supply and drives up blood costs.) The decision is yours—the YRMC PBM program hinges on informed consent. Meaning you have the right to be informed of your choices. Then you have the right to choose to optimize and/or use your own blood (captured and reinfused during surgery), receive someone else’s blood, or receive a combination of both when necessary. It’s your blood, your call. Based on your decision, a team of medical professionals will assess your blood management needs and develop a clinically sound, evidence-based plan of care during your hospital stay. This plan marshals pharmaceuticals, technology and medical techniques to decrease blood loss and enhance blood cell production—which reduces or eliminates the need for a blood transfusion. Progressive Leadership Yavapai Regional Medical Center (YRMC) has the only officially recognized PBM program in Arizona and one of the relatively few in the nation. When it comes to PBM, your local hospital is doing some of the highest caliber work in the country and even the world. That’s why YRMC hosts an annual PBM Symposium in Prescott, an event viewed internationally and presented by some of the world’s leading PBM experts. How did this happen? “We owe our PBM program to progressive leaders and top-notch medical professionals at our hospital,” said PBM Program Coordinator Dale Black. The program started in 2012 after Black and Pierre Tibi, MD broached the subject with hospital administrators. “It never would have happened without leadership’s forward-thinking mindset and ongoing commitment over the past eight years,” Black said. “In less than a decade we’ve become part of a worldwide initiative that uses evidence-based science to achieve better patient outcomes using blood management principles.” Today Dr. Tibi is a leading authority on PBM and serves as the Medical Director of the YRMC PBM Program and The James Family Heart Center. Better Outcomes While blood transfusions remain a vital life-saving procedure, growing evidence shows that patients who maximize their own blood supply benefit from: lower infection rates. less anemia. fewer kidney, lung and heart complications. less exposure to viruses and other blood-borne disease. shorter hospital stays. all-around better surgical outcomes. A Continuum of Care YRMC’s PBM program provides you with care and support before, during and after surgery. Presurgical measures center on optimizing red blood cell mass to prevent anemia. This may involve iron therapy, a vitamin regime, nutritional support and medication management. Erythropoietin-stimulating agents (ESAs) may be administered via a shot to stimulate the production of additional red blood cells. Surgical techniques may include removing a calculated amount of blood, adding non-blood expanders, and reinfusing red cells back to the patient. Or they may include cell-salvage, collecting blood lost during surgery—then washing, filtering and reinfusing red blood cells back to the patient. Hemostatic agents may be used to promote rapid blood coagulation. Postsurgical procedures include detecting and mitigating bleeding, minimizing the frequency and volume of blood draws, nutritional support, and continued iron therapy, possibly in conjunction with ESA administration if appropriate. The next time you are scheduled for surgery at YRMC, be sure to ask about Patient Blood Management, or PBM. For more information you can also contact Dale Black directly at dblack2@yrmc.org or (928) 771-5109. You can also visit the Society for the Advancement of Blood Management and download their Patient Guide.            

Do you dream of having your own backyard vegetable garden but need expert help?  If so, check out the Grow Food in Your Backyard Project!  Developed in collaboration with Slow Food Prescott, Yavapai County Cooperative Extension, and the Roaring Fork Food Alliance, this project matches new gardeners with local, experienced mentors who offer guidance at every step along the way. Gardening and growing your own food offers a multitude of physical and mental health benefits.  Studies show that gardening can improve physical fitness, lift mood, reduce depression, lower blood pressure, and increase fruit and vegetable intake — all of which help prevent obesity, diabetes, heart disease and other chronic illness. Join Dignity Health, YRMC’s Your Healthy Kitchen in our latest episode as we check out the preliminary results of the Grow Food in Your Backyard Project.  You’ll hear from Jeff Schalau at Yavapai County Cooperative Extension, Gwen Garcelon from the Roaring Fork Food Alliance, Molly Beverly with Slow Food Prescott and Melissa, who gives a tour of her new backyard garden while sharing stories with her mentor and enthusiastic family. In addition to personal and family benefits, gardens can also positively impact communities.  After all, produce from backyard and community gardens can be shared, improving the health of everyone nearby.  Social bonds form from growing and sharing food, offering a multitude of emotional benefits.  In addition, local gardens bolster local food resilience, an important factor in managing a changing climate and potential disruptions in fresh food supplies. To learn more and get connected with the grow Food in Your Backyard Project, contact Molly Beverly at PrescottAZ@slowfoodusa.org.  Remember also to check out all of our educational videos and easy, delicious recipes (that you can make with your garden produce!) at yrmchealthconnect.org.  Follow me on Facebook too, at YRMC’s Your Healthy Kitchen, where I regularly post what I make in my own kitchen, plus share my favorite food and gardening links on the web.