
Is it COVID-19, the flu, a cold, allergies or asthma?
Cold and flu season is here and COVID-19 continues to spread. With every cough or sniffle, you may wonder if it’s asthma or allergies, the flu, the common cold or even COVID-19. How can you tell the difference? They manifest similar symptoms, making it easy to mistake one for another. The surest way to an accurate diagnosis is to see your doctor and get tested. Short of that, familiarizing ourselves with various symptoms associated with each condition can help lessen anxiety and reduce the crush on healthcare resources during the coronavirus pandemic. This list may help. While it is not exhaustive or a substitute for medical advice, it can help identify basic differences between, say, seasonal allergies and the much more serious COVID-19. COVID-19 Symptoms According to the World Health Organization (WHO) COVID-19 can affect people differently. People with mild to moderate symptoms can often recover at home. On average it takes 5–6 days for symptoms to show following infection, however it can take up to 14 days. Common symptoms include: Fever Dry cough Tiredness Aches and pains Sore throat Diarrhea Headache Loss of taste or smell Skin rash or discoloration of fingers or toes Difficulty breathing or shortness of breath. Chest pain or pressure Loss of speech or movement Flu (Influenza) Symptoms COVID-19 and Influenza are caused by different viruses. Yet these viruses spread in similar ways and cause many of the same signs and symptoms. However, there are a few differences. With the flu, symptoms can start suddenly and cause mild to severe illness, sometimes resulting in death. Common symptoms of the flu include: Fever (often very high, 101 or above) Headache Extreme tiredness Chills Constant cough Sore throat Runny or stuffy nose Body aches in bones and/or muscles Diarrhea and vomiting (more common in children) Cold Symptoms The common cold is usually mild compared to the flu and COVID-19. But even a mild cold can trigger unpleasant symptoms, so if you catch a cold, it’s good to take it seriously. Common symptoms of a cold include: Mild cough Sneezing Runny or stuffy nose Sore throat A short fever Aches and pains Asthma Symptoms Asthma is a chronic disease that inflames the airways. The best way to manage it is to take asthma medication, avoid triggers and treat asthma symptoms as soon as they occur. Common symptoms of asthma include: Coughing Wheezing (a whistling, squeaky sound when you breathe) Shortness of breath Rapid breathing Chest tightness Allergy Symptoms The American College of Allergy, Asthma, and Immunology points out that allergies generally occur when the immune system overreacts to something often harmless for others. For seasonal allergy sufferers, that means their bodies don’t react well to allergens like pollen, grass, and/or ragweed. Allergies are not contagious, unlike colds, the flu and COVID. Symptoms that often accompany allergies include: Runny nose, stuffy nose, and/or sneezing Wheezing or shortness of breath Dry Cough Mucus Rashes Fatigue Headache This chart is a handy reference tool when trying to distinguish between symptoms.

Yavapai County’s First COVID-19 Patient: A Story of Friendship and Miracles
There are times when people touch our lives in unexpected and powerful ways. Amid extraordinary circumstances, strangers can share a common experience that unites them, instantly and enduringly. This is the story of such a bond, and of a remarkable recovery from a devastating illness. Richard Barrington had been ill for a week. He was fatigued and had a fever and persistent cough. On March 24, 2020 breathing became increasingly difficult. He called 911 and was transported to Dignity Health -Yavapai Regional Medical Center (YRMC) West in Prescott, Arizona. Little did Barrington know that for the next six weeks he would be fighting for his life as the first COVID-19 patient to be admitted to a hospital in Yavapai County. Barrington is 77 years old and a heart attack survivor. By any measure, this puts him in a high-risk category for COVID-19. “The doctor told my daughter that my chances of survival were less than ten percent,” says Barrington. “I’m a born-again Christian, so I’m prepared to die,” he pauses. “But considering the outcome, God must have something more for me to do.” Barrington doesn’t remember much about his hospital stay. He was put on a ventilator right away and remained on it for most of his stay, mainly in the ICU. He was unresponsive twice. Barrington’s daughter spoke with the staff several times a day, advocating for her father and developing a close bond with those who were keeping him alive and helping him heal. “My daughter tells me that at one point, the staff asked what they could do to keep me comfortable and comforted,” recalls Barrington. “She suggested putting my phone on Spotify and playing my favorite Christian music playlist. It turns out that the music comforted the staff too.” The staff’s affection for Barrington grew the longer he was there. His doctor nicknamed him his “miracle patient” because of Barrington’s strength in fighting the virus. “The care was extraordinary,” says Barrington. “They were really rooting for me. One of the first days that I can remember is the day they took me off the ventilator. The nurses were joyful. ‘You survived, you lived, thank God!’ they said.” Barrington continues to stay in touch with the staff at the Critical Care Unit. Nurse Manager Julie Briggs hears from him regularly. “Each time we communicate, he is always so grateful for the care he received,” says Briggs. “What a kind and wonderful man. It has been a pleasure to get to know him.” Barrington feels the same about the friends he made at YRMC. As far as his long-term recovery, Barrington is understandably taking it slow. After discharge, he stayed at a rehabilitation center for three weeks, followed by another three weeks at a nursing home, then a month in California where his daughter facilitated his care. He is now home and doing well. “I’m 75 to 85 percent better now, but my energy level isn’t what it used to be. I still have memory issues too. Quoting scripture is harder,” he admits. Barrington has been advised that it will take 6 months to a year to recover. In the meantime, he is reading aloud every day, on the advice of his doctor. Exercise, crossword puzzles and other interactive activities occupy much of his day. Barrington encourages everyone to get a vaccine when it becomes available. “If we can lower the death rate and hospital rates, then let’s get it done,” he says. The support and love between the staff and Barrington will live on in his heart forever. “I just don’t have enough praise to give those caregivers,” he says. “When I was discharged, the staff lined the halls to cheer me on. It was amazing that they would care that much to come out and help me celebrate my miraculous victory. I was feeling the love.”

Is Interventional Radiology Right for You?
Medical innovation moves forward at a rapid pace, with continuing technological advances and an ever-increasing understanding of health and the human body. Interventional Radiology may be one of the best examples of this phenomena. Thanks to this highly specialized medical field, procedures that once required surgery, a hospital stay, and extensive recovery time are now being performed on an outpatient basis using minimally invasive techniques. In fact, most of the procedures are performed without an incision. Interventional Radiology (IR) combines the use of advanced imaging such ultrasound, X-rays, CT scans and MRI to guide the treatment of a variety of conditions. Interventional Radiologists are board-certified physicians who are trained in both radiology and minimally invasive therapies. They treat conditions in virtually every organ system, including: Blood vessels Nervous system Reproductive system Gastrointestinal tract Liver Urinary tract Cardiovascular disease Cancer Dialysis access Back pain Leg pain and swelling Dr. Matthew Dicker is a Diagnostic and Interventional Radiologist with Yavapai Regional Medical Center. He emphasizes that a team approach delivers the best care for his patients. “Taking care of each patient starts with our office staff and administrative staff at the hospital. A great group of nurses and technologists help before, during and after each procedure,” Dicker says. “And of course, collaboration with the hospitalists and vascular surgeons as well as primary care providers creates the best possible 360-degree care for the patients in our community.” Dicker explains that Interventional Radiologists are consultants to virtually all of the specialties and subspecialties at YRMC, in addition to performing procedures specific to each. “Having the expertise to perform these procedures and having the facilities and support staff to perform them is a great benefit to the Quad Cities,” says Dicker. “The hassle of driving to Phoenix or elsewhere is no longer necessary.” As with the practice of medicine in general, Interventional Radiology continues to keep pace with ever-developing research and technology. “New and different ways to treat disease are happening almost daily,” Dicker notes. “We strive to perform the newest treatments safer than before. For instance, opening blockages in the leg arteries is being performed with access through the ankle as opposed to the groin where it had been typically performed, which significantly decrease the risk of bleeding while having the same excellent results.” “We are excited to introduce intravascular lithotripsy to break up plaque in the arteries that causes blockages,” he continues. “It uses the same technology that has been used for years to break up kidney stones.” Interventional Radiology allows for a quicker recovery time, less pain, reduced cost and a lower risk of complications. If you are a candidate for surgery, talk to your healthcare provider to see if an Interventional Radiology procedure makes sense for you as an alternative. “It is rewarding when a procedure is successful, a patient is happy with the results, and they are surprised that it was done without an incision with very little if any pain,” says Dicker. Click here to learn more about YRMC Imaging Services.

Advanced Wound Care: A Deep Dive into Healing
Take a deep dive … drill down … unpack the situation, they’re all about looking below the surface to understand complexities. That’s the kind of work that goes on every day at Advanced Wound Care at Dignity Health, Yavapai Regional Medical Center (YRMC) in Prescott Valley. “With non-healing wounds of the lower-extremities it’s critical to understand the underlying issues,” says Cheryl Sofonia, MPH, Program Manager, Advanced Wound Care at Dignity Health, YRMC. “A chronic wound cannot be healed until you know its underlying cause.” Here’s the Plan After a patient is referred to Advanced Wound Care by their primary care provider or other physician, the “deep dive” can begin. This includes a history and physical, lab work, imaging (an MRI or x-ray), and a thorough assessment of the non-healing wound. “This information is the foundation of every patient care plan at Advanced Wound Care,” explains Sofonia. What are the most common, non-healing wounds of the lower extremities? Arterial ulcers – These non-healing wounds form on the outer side of the ankles, feet, heels, or toes. The cause of these chronic wounds may be blocked arteries, diabetes, age and hypertension, to name a few. Venous ulcers – Typically found below the knee and on the inner ankle, these non-healing wounds can be triggered by poor circulation in the leg’s veins. Other risk factors include varicose veins, obesity, and smoking. Diabetic foot ulcers – For people with diabetes, a minor blister can develop quickly into a non-healing wound that requires intense therapy. Pressure ulcers – Long-term weight and friction on a specific area – often the feet – can lead to a non-healing wound. Other chronic wounds are caused by burns, radiation, and non-healing surgical wounds. In general, a wound that doesn’t heal after four weeks is considered chronic. Such wounds affect approximately 3% of people age 65 and older as well as more than 8 million U.S. residents. A Patient-Focused Approach Advanced Wound Care takes a team approach to diagnosing and treating chronic wounds. The patient – who is at the center of the team – receives treatment from exceptional wound care specialists and visiting physician specialists as well as experienced healthcare professionals. The Advanced Wound Care team includes: Two certified wound care physician specialists 11 registered nurses, including certified wound and ostomy nurses An occupational therapist who specializes in treating secondary lymphedema, a buildup of fluid in the tissues caused by another disease or condition An interventional cardiologist A podiatrist An infectious disease specialist Additionally, the experts at the Vein Center at Dignity Health, YRMC, are located adjacent to Advanced Wound Care. The Vein Center conducts ablation therapies to treat patients with issues related to the arteries and veins. “The collaborative nature of Advanced Wound Care benefits patients in many ways,” Sofonia says. “One of the most important aspects of our structure is that our patient care is centralized so people don’t have to travel to different clinics for care.” Talk to your healthcare provider for a referral to Advanced Wound Care. For more information, visit Advanced Wound Care at YRMC.org or call 928-771-4788.

Tips for Living with COPD
While it may be alarming to receive a diagnosis of Chronic Obstructive Pulmonary Disease (COPD), it’s important to educate yourself about the disease and what treatment choices are available to you. Making these decisions as soon as possible is key to improving one’s quality of life. What is COPD? COPD is a general term for a group of lung conditions, including chronic bronchitis and emphysema, where airflow from the lungs becomes increasingly blocked over time. Symptoms include shortness of breath, wheezing or a chronic cough. The American Lung Association estimates that 16.4 million people in the U.S. are living with COPD. 85 to 90% of those cases are caused by smoking. However, nonsmokers can get COPD as well. Long-term exposure to secondhand smoke, air pollution and fumes from certain chemicals can also play a role. Rocky Higgins, Respiratory Therapist at Dignity Health, Yavapai Regional Medical Center (YRMC) advises her patients to follow a handful of basic steps when diagnosed with any lung condition, including COPD. Listen to your Healthcare Provider First, Higgins recommends that you get on board right away with your physician and respiratory care team. COPD treatment may include medication, oxygen therapy or a pulmonary rehabilitation program. “We are all here to help you be successful and healthy,” she says. “Ask questions so that you understand your care plan, and don’t hesitate to ask your pharmacist if any questions arise about your medication.” Quit Smoking If you currently smoke or vape, quit. For someone with COPD, quitting smoking will make a huge difference. But Higgins recognizes that for many of us, it’s easier said than done. “Any habit change is difficult. You need to WANT to change the behavior and recognize that it will have its challenges,” she notes. “Try to be able to laugh at yourself rather than dog yourself when things roll in the wrong direction. Remember you are human. We sometimes learn through mistakes, but often it’s the best way to learn.” This excellent advice is especially relevant for those who attend YRMC’s smoking cessation classes. Higgins has been a program facilitator since 1986. Each session includes seven 90-minute classes and offers discounted or free Nicotine Replacement Therapy (NRT) to qualified clients. “There’s no pre-sign up. Clients can just show up to the introductory class and learn about the program. They can sign up at that time,” says Higgins. You can find out when the next session begins by contacting YRMC at (928) 771-5102. “Help is also available to all Arizona residents by calling the Arizona Smokers Hotline (ASHLine) at 1-800-556-6222,” Higgins adds. “ASHLine offers phone conversations with trained tobacco/nicotine coaches and NRT to clients who qualify.” Get Some Exercise “Quitting smoking and exercising go hand in hand,” states Higgins. “Replace those cigarettes with light hand weights, exercise bands or squeezy balls.” She explains that the idea is to replace a negative reaction (the urge to smoke) with a positive result (exercise). Incorporating some type of exercise will also help your body through the withdrawal symptoms and take your mind off of those negative feelings. “It is a known fact that exercise creates endorphins, those feel-good chemicals created in our brains,” says Higgins. For those who have COPD, regular exercise can also strengthen the lungs and improve circulation, which may increase the flow of oxygen throughout the body and reduce symptoms. Find Support Emotional support can be an integral part of staying on top of COPD. It’s important to know how to recognize and handle any feelings of anxiety, stress or depression that may arise. Talk to your healthcare team about counselors or support groups that may be available to you. Many people who attend the YRMC smoking cessation classes are appreciative of the support they receive from those who are taking the class. They note that it helps to share their experiences with someone who is going through a similar time in their lives. A healthy and happy life is possible with COPD. Experts recommend that you keep the dialog going with your care providers, stay active and seek out the support you need.

The Quad Cities Welcome Dignity Health, Yavapai Regional Medical Group
The recent affiliation of Yavapai Regional Medical Center (YRMC) and Dignity Health also includes YRMC PhysicianCare. The 26 multispecialty medical clinics – located in Chino Valley, Prescott and Prescott Valley – are now known as Dignity Health, Yavapai Regional Medical Group (YRMG). “From our patients’ perspective, the new name is the major change,” says Robert Thompson, MD, MBA, Executive Medical Director, Yavapai Regional Medical Group. “They will see the clinics re-branded with the YRMG name, and the Dignity Health logo on our signage as well as on any communication they receive from their providers.” YRMG’s provider team will not change and the clinics will continue to accept the same health insurance as they have previously. Patients can reach their physician using the same telephone number. They also will go to the same location for their appointments. According to Dr. Thompson, the YRMC-Dignity Health affiliation will build on YRMC’s current excellent programs and services to expand healthcare in our growing community. “The affiliation with Dignity Health will expand services and increase innovation throughout the entire YRMC health network, including Yavapai Regional Medical Group,” Dr. Thompson says. “One of the first steps will be the growth of our clinics to include more specialty physicians and primary care providers.” Yavapai Regional Medical Group currently includes nearly 100 providers in community-based clinics specializing in: Cardiology, Prescott and Prescott Valley Endocrinology and Psychiatry, Prescott Gastroenterology, Prescott Infectious Disease and Pulmonology, Prescott Neurology, Neurosurgery and Physiatry, Prescott Occupational Medicine, Prescott Orthopedic Surgery, Prescott Valley Pain Management, Prescott Valley Palliative Medicine, Prescott Pediatrics, Prescott Primary Medicine, Family Medicine and Internal Medicine, Chino Valley, Prescott and Prescott Valley Vascular Surgery For YRMG clinic locations, visit DignityHealth.org/YRMG. Keep up-to-date on the YRMC-Dignity Health affiliation and other YRMC news, by subscribing to YRMC HealthConnect.

Yavapai Regional Medical Group Welcomes Director of Geriatric and Palliative Medicine
Sam W. Downing, MD, is the new Director of Geriatric and Palliative Medicine for Dignity Health Yavapai Regional Medical Group (formerly YRMC PhysicianCare). The Clinic, which serves the entire Quad Cities, is located at: Dignity Health Yavapai Regional Medical Group, Palliative Medicine 802 Ainsworth, Suite C Prescott, Arizona 86301 (928) 775-5567 Sam W. Downing, MD Even though Yavapai Regional Medical Group, Palliative Medicine is located in Prescott, many Palliative Medicine appointments occur throughout the community. From Dr. Downing’s perspective, this “we-meet-you-where-you-are” approach to medical care is one of the strengths of Palliative Medicine. “Our team sees patients in the Palliative Medicine Clinic, care centers and private homes,” said Dr. Downing. “That’s an advantage to some people who may be homebound or who are concerned about going out into the community during a pandemic.” The team Dr. Downing oversees includes physicians, physician assistants, a nurse practitioner, a registered nurse, and a social worker. All of these caregivers are experts at managing the complexities of living with a serious illness. Dr. Downing describes Palliative Medicine as complementary to an individual’s primary care. The Palliative Medicine team cares for people with advanced illness, life-limiting illness, complex conditions, or chronic disease. Palliative Medicine: An Added Layer of Support “Palliative Medicine is an added layer of support,” Dr. Downing explained. “We’re not designed to replace the treatment and care someone is currently receiving. Much of what we do is help patients understand their choices and options. We also support them as they define their priorities for their medical care.” Dr. Downing is an expert at all of the above. He’s board certified by the American Academy of Hospice and Palliative Care as well as the American Academy of Family Physicians. He has had a 30-year relationship with YRMC, joining the community after completing a Family Practice residency at Phoenix Baptist Hospital. He earned his medical degree from the University of Colorado Health Sciences Center in Denver. Sharing his expertise with the community is a priority for Dr. Downing. He serves on the Board of Directors of Northland Cares, an outpatient services organization for people living with HIV/AIDS. Dr. Downing also speaks frequently to audiences about age-related issues. Geriatric Assessment Clinic to Open in 2021 Dr. Downing’s experience is in demand as Yavapai Regional Medical Group is in the process of developing a Geriatric Assessment Clinic. Due to open in 2021, the self-referral program will feature comprehensive assessments for people concerned about cognitive impairment and memory disorders. “This is exciting news for the people of our community who may be worried about their own, or a loved one’s, cognitive decline,” said Dr. Downing. “The Geriatric Assessment Clinic will include a four-hour, multi-disciplinary evaluation followed by specific recommendations on how to prevent further cognitive decline. Down the road, a complementary support program will address the needs of patients and their families who are dealing with cognitive challenges.” For more information about Yavapai Regional Medical Group, Palliative Medicine, talk to your primary care provider, visit YRMC.org, or call 928-775-5567.

Yavapai Regional Medical Center to Pause All Inpatient and Outpatient Elective Procedures at Both Hospital Locations
In response to rising COVID-19 hospitalization rates, Dignity Health, Yavapai Regional Medical Center will pause all inpatient and outpatient elective procedures at both hospital locations beginning Monday, December 21. Emergent and urgent procedures will continue at both locations. “This was a difficult decision but one that is necessary due to high COVID-19 admission rates at our hospitals,” states Keith Nichols, Chief Operating Officer, YRMC. “By pausing outpatient and inpatient hospital procedures, we manage bed capacity and staffing levels to care for the high patient volumes we are experiencing.” YRMC continues to see COVID-19 inpatient admissions at record levels. Additional units are being converted to COVID isolation units to care for the high-volume of patients. “Patient admissions for COVID-related conditions have spiked over the past several weeks to record levels,” states Nichols. “As of today, there are over 90 patients receiving care in our COVID units and we expect this trend to continue through the first of the year.” Other YRMC services will not be impacted by this move at this time. Medical imaging services and other non-hospital-based services will continue as scheduled. “We are taking extra precautions for the safety of our patients and staff at our off-campus facilities,” adds Nichols. “We are increasing the time between patient appointments to allow for deep cleaning and to minimize contact in our lobbies and registration areas.” YRMC also announced the temporarily closure of an outpatient laboratory draw center at 3120 Clearwater Drive in Prescott, effective Monday, December 21. Patients are being directed to other YRMC outpatient laboratory draw centers in Prescott and Prescott Valley for necessary lab work. The temporary closure will allow staff to be reassigned to support patient care in other areas. Visitor restrictions continue at both YRMC hospitals. Information regarding visitor restrictions can be found on YRMC’s website located at www.DignityHealth.org/YRMC. Visitors that refuse to follow YRMC’s strict mask use policy will not be allowed to enter. Hospital officials will continue to monitor and adjust patient care strategies to meet rapidly changing conditions. “Our caregivers and support teams at Yavapai Regional Medical Center and Yavapai Regional Medical Group continue to demonstrate great courage and dedication to serve our community,” states Nichols. “We can really use the community’s support during this challenging time. Please wear a mask, wash your hands, and practice social distancing.”

Taking On Breast Cancer
October is National Breast Cancer Awareness Month—a annual observance aimed at raising both awareness and funding. The funding is for research into the prevention, diagnosis, treatment and ultimately the cure for breast cancer. Awareness is generated in part through a pink ribbon, a symbol of solidarity among women and families touched by the disease. Such solidarity is found year around at The BreastCare Center at YRMC East in Prescott Valley. The center bands together to take on breast cancer and support women through all phases of the disease—prevention, detection, diagnosis, treatment and supportive care. At the BreastCare Center, women can receive one-on-one support from a clinical navigator, a registered nurse assigned just to them. This navigator serves as personal guide, advocate, educator and friend. And should the need arise, helps to perform a risk analysis. “If a patient’s family history shows they carry a higher risk for breast cancer, one of our navigators can perform a more comprehensive risk assessment called the Tyrer-Cuzick,” said Kathleen Hoffer, Imaging Operations Manager at the BreastCare Center. The tool is used to help inform a person’s decision about whether to get more genetic counselling and testing. Such genetic testing may be done through the center or a genetics expert may visit the home. Risk Factors Along with risk factors associated with family history and genetics, the National Breast Cancer Foundation has identified the following breast cancer risks: Gender: Women are 100 times more likely to get it than men Age: Two out of three women are diagnosed after age 55 Race: White women are more likely to get it Personal health history: If you get cancer in one breast, you risk getting it in the other breast Menstrual and reproductive history: Your risk increases if you started menstruating early (before age 12), started menopause after 55, had your first child when older or never gave birth Dense breast tissue: Increases your risk and make lumps harder to detect Early Detection “When patients are aware they carry a higher risk for breast cancer, they are usually more diligent about getting their regular screenings done,” Hoffer said. “Those at a really high risk might have an MRI along with their mammogram. If they find they have dense breast tissue, we may recommend tomography or ultrasound.” Early detection saves lives. When caught early enough, breast cancer is often stopped before it spreads. Regular screenings can detect breast cancer even before symptoms occur. These symptoms, once evident, include: Change in the look or feel, size or shape, of the breast Change in the look or feel of the nipple, including nipple discharge A lump or hard knot in the breast or underarm area Swelling, warmth, redness or darkening of the breast Dimpling or puckering of the skin Persistent pain in one area of the breast Prevention A healthy body is better equipped to fight off disease, including cancer of the breast. So basic healthy living is your main defense against breast cancer. These basics haven’t changed: exercise at least 30 minutes a day, five days a week; maintain a healthy weight; don’t smoke; and limit alcohol to one drink a day for women, two drinks a day for men.

Lifestyle Habits that Protect Against Breast Cancer
Today, one in eight women living in the U.S. will develop breast cancer in her lifetime, according to data cited by the American Cancer Society. That’s why it’s so important to do everything you can to reduce your risk. Experts agree that women (and men) can lessen their likelihood of getting breast cancer by moving more and sitting less everyday; working up a sweat a few times a week; building some muscle; and cutting back on alcohol. In fact, research shows that Americans could prevent one in three cases of breast cancer with healthy lifestyle habits. Move More and Sit Less Physical activity tops the list of lifestyle practices that provide protection to women and men at every age. According to a study released in 2017 by the American Institute for Cancer Research and the World Cancer Research Fund, 150 minutes per week of regular moderate activity, like walking at a pace that causes a slight increase in heart rate and deeper than normal breathing, reduces the risk of breast cancer in pre- and post-menopausal women by about 13% when compared to sedentary individuals. Vigorous exercise, or that which causes a faster heart rate and some sweating, boosts protection for pre-menopausal women to 17%. Other studies suggest even higher rates of protection when individuals increase exercise time to up to 300 minutes per week. Moving more and sitting less throughout the day and engaging in regular physical activity likely reduces the risk of breast cancer by lowering inflammation in the body (a risk factor for many types of cancer and other chronic diseases), reducing insulin resistance (which lowers blood glucose and insulin levels in the blood), improving immune function, and by reducing circulating levels of estrogen. In fact, some research suggests that a sedentary lifestyle, or one with little to no physical activity, is a major risk factor for breast and other types of cancer. A Lifetime of Enjoyable Exercise Decreases Breast Cancer Risk! Take away tips: Shoot for a minimum of 150 minutes of moderate, or 75 minutes of vigorous exercise 5 days a week. If you are new to physical activity, start with 5-10 minutes of activity at a time and gradually build your strength and stamina. Always check with your doctor before engaging in any new exercise plan. Get up every hour and do some walking, stretching, or other movement for 5 minutes if your lifestyle and job are sedentary. If you tend to be active only during certain seasons, plan to continue some type of regular, enjoyable movement year round. Since physical activity throughout life reduces the risk of breast and other types of cancer, encourage children to engage in regular physical activity that they enjoy and can continue into adulthood. Muscle Up After Menopause Multiple studies show that reducing body fat (especially abdominal fat) while increasing muscle mass can lower breast cancer risk in women after menopause. According to a study done by the University of North Carolina’s Lineberger Comprehensive Cancer Center, higher levels of body fat seem to be related to lower breast cancer risk in younger women, while weight and fat gain after menopause increases risk. While the reasons for this are not totally clear, researchers think that body fat protects breast tissue from excessive estrogen production in younger years, but increases exposure after menopause. Add Weights to Your Workouts! Take away tips: Maintain a healthy percentage of body fat throughout your lifetime. Keep physically active after menopause, and be sure to include strengthening exercises that build muscle and reduce body fat. Limit Alcoholic Beverages According to the American Cancer Society, even small amounts of alcohol may increase a women’s risk of breast cancer. Ethanal, the by-product of alcohol metabolism, can directly damage the DNA in cells, potentially leading to cancer growth and spread. Alcohol also raises estrogen levels in the blood, thus increasing risk of some breast cancer types. Take away tips: Consider limiting alcohol to three drinks per week or less. One drink is equal to 5 ounces of wine, 12 ounces of beer or 1.5 ounces of 80-proof liquor. Experiment with fun and flavorful mocktail recipes! Some physicians recommend that women at high risk of breast cancer avoid alcohol altogether. Enjoy Fun, Flavorful Mocktails! No one can predict exactly what combination of factors might lead to the growth and spread of breast cancer cells. However, good and extensive research shows that healthy lifestyle habits offer significant protection against this debilitating and potentially deadly disease. You can learn more about breast cancer, preventive testing, treatment, and local resources at YRMC’s Breast Care Center.

Is Vitamin D Good for Your Heart?
When they say every body needs milk, they’re partly talking about Vitamin D. According to science, this fat-soluble vitamin helps the body absorb the calcium and phosphate it needs to build and preserve bone strength. But does science support a direct link between vitamin D and cardiovascular health? Can we take vitamin D to avoid heart disease or restore a diseased heart to health? Some people think so. But according to Phillip Tran, DO, FACOI, a cardiologist with YRMC PhysicanCare, science doesn’t fully bear it out yet. Vitamin D sustains heart muscle “Studies do show an inverse relationship between vitamin D and some chronic health conditions, such as high blood pressure or Type 2 Diabetes,” Dr. Tran said. “But taking more Vitamin D does not necessarily lower the risk of getting cardiovascular disease or help treat it. Preliminary evidence may suggest the fact, but more research is needed.” That isn’t to say vitamin D doesn’t impact heart health at all. Our bodies need the full family of vitamins to function properly. Not getting enough of any one vitamin can impact our health. Along with bones, Vitamin D also sustains muscle. Insufficient levels can cause both bone pain and muscle weakness. This includes the weakening of muscles found in the heart. “Vitamin D deficiencies may cause scar tissue to form on the heart wall,” Dr. Tran said. “This can lead to heart chamber dilation, impairing normal heart function.” When heart chambers are dilated, or enlarged, the heart muscle is weakened and can’t pump blood as well. Getting enough of the sunshine vitamin Known as the sunshine vitamin, vitamin D is produced naturally when skin is exposed to moderate sunlight. It also occurs naturally in foods—including some fish, fish liver oils and egg yolks—and in fortified dairy and grain products. Depending on the degree of sun exposure and diet, you may want to include an over-the-counter supplement. But what is the recommended daily allowance? “To maintain healthy levels, most adults need approximately 400-800 IU per day,” Dr. Tran said. However, 1,000 to 2,000 IU per day from a supplement is generally considered safe. More than 4,000 IU per day may lead to vitamin D toxicity. If you think you may be deficient in vitamin D see your doctor before taking too much of the vitamin. Remember, vitamin D deficiencies are more common in those who are elderly, have darker skin, or live farther away from the equator. Bottom line? Get your recommended daily allowance of vitamin D and your whole body with thank you. Including your heart.

Don’t Ignore these Symptoms of Heart Valve Disease
Increased shortness of breath, lack of energy and bouts of dizziness shouldn’t be written off to aging, according to experts at the James Family Heart Center at Yavapai Regional Medical Center (YRMC). In recognition of Heart Valve Disease Awareness Day on February 22, 2020, cardiac specialists from YRMC’s Heart Center are encouraging people of all ages to familiarize themselves with the subtle symptoms of heart valve disease. They also urge people to seek the advice of a physician if they are concerned about their heart health. An estimated 11 million Americans have heart valve disease, which involves damage to one or more of the heart’s valves. Many people with heart valve disease don’t experience noticeable symptoms until the blood flow is significantly restricted. Symptoms that could signal heart valve disease – and should be discussed with your physician – are: Breathlessness Chest pain, pressure or tightness Fainting Palpitations or a feeling of heavy, pounding, or noticeable heartbeats A decline in your activity level or reduced ability to do normal daily activities Heart valve disease can affect people in their 40s or 80s, but it’s most prominent in older adults. In fact, one in ten people age 75 and older struggle with moderate to severe heart valve disease. To understand why this happens, it helps to know the role healthy heart valves play in the body. The heart has four valves with tissue flaps – also called leaflets – that open and close with each heartbeat. The flaps ensure blood flows in the right direction through your heart’s four chambers and to the rest of your body. “Think of the leaflets as doors,” said Jose Torres, MD, Cardiothoracic Surgeon at YRMC’s James Family Heart Center. “Normally, the doors are very pliable. They open and close to allow blood to flow through the heart and then to the rest of the body. When the doors calcify, their pliability decreases and the heart has to work harder and harder to pump blood to the body.” Here’s a look at conditions that can cause or contribute to heart valve disease: Past medical history – A history of diabetes or rheumatic fever and cancer survivors treated with radiation therapy to the chest or sternum are at greater risk for heart valve disease. Congenital heart defect – People born with two leaflets, called bicuspid valve, are sometimes diagnosed with heart valve disease in their 40s or 50s. Heart murmur – Calcium buildup or a leaky aortic valve can cause a heart murmur, eventually leading to heart valve disease. The good news is that heart valve disease is treatable. Medications to lower high blood pressure or high cholesterol may be prescribed. Lifestyle changes – giving up smoking, eating a heart-healthy diet, getting regular physical exercise and aiming for your optimal weight – can slow the progress of heart valve disease. “Heart valve disease is a structural problem that requires surgery,” Dr. Torres said. “Once there’s a heart valve disease diagnosis, the solution is to remove that roadblock with heart valve surgery.” During surgical heart valve disease repair, patients are placed on a heart bypass machine to keep their hearts working. Cardiothoracic surgeons, like Dr. Torres, then replace the heart’s calcified valve with a new, artificial valve. People considered too high risk for heart valve replacement surgery may be eligible for Transcatheter Aortic Valve Replacement (TAVR). The minimally invasive TAVR procedure takes place in YRMC’s Hybrid Operating Suite—a combined state-of-the-art surgical suite and medical imaging facility. In YRMC’s Hybrid Suite – considered one of the nation’s best – a patient’s heart blockage can be diagnosed and then immediately repaired with a minimally invasive procedure, like TAVR. If the real-time imaging shows the patient requires surgery, YRMC’s heart team is ready to perform the procedure in the Hybrid Operating Suite. Learn more about heart valve disease and the advanced, comprehensive services available at YRMC’s James Family Heart Center.

Is it COVID-19, the flu, a cold, allergies or asthma?
Cold and flu season is here and COVID-19 continues to spread. With every cough or sniffle, you may wonder if it’s asthma or allergies, the flu, the common cold or even COVID-19. How can you tell the difference? They manifest similar symptoms, making it easy to mistake one for another. The surest way to an accurate diagnosis is to see your doctor and get tested. Short of that, familiarizing ourselves with various symptoms associated with each condition can help lessen anxiety and reduce the crush on healthcare resources during the coronavirus pandemic. This list may help. While it is not exhaustive or a substitute for medical advice, it can help identify basic differences between, say, seasonal allergies and the much more serious COVID-19. COVID-19 Symptoms According to the World Health Organization (WHO) COVID-19 can affect people differently. People with mild to moderate symptoms can often recover at home. On average it takes 5–6 days for symptoms to show following infection, however it can take up to 14 days. Common symptoms include: Fever Dry cough Tiredness Aches and pains Sore throat Diarrhea Headache Loss of taste or smell Skin rash or discoloration of fingers or toes Difficulty breathing or shortness of breath. Chest pain or pressure Loss of speech or movement Flu (Influenza) Symptoms COVID-19 and Influenza are caused by different viruses. Yet these viruses spread in similar ways and cause many of the same signs and symptoms. However, there are a few differences. With the flu, symptoms can start suddenly and cause mild to severe illness, sometimes resulting in death. Common symptoms of the flu include: Fever (often very high, 101 or above) Headache Extreme tiredness Chills Constant cough Sore throat Runny or stuffy nose Body aches in bones and/or muscles Diarrhea and vomiting (more common in children) Cold Symptoms The common cold is usually mild compared to the flu and COVID-19. But even a mild cold can trigger unpleasant symptoms, so if you catch a cold, it’s good to take it seriously. Common symptoms of a cold include: Mild cough Sneezing Runny or stuffy nose Sore throat A short fever Aches and pains Asthma Symptoms Asthma is a chronic disease that inflames the airways. The best way to manage it is to take asthma medication, avoid triggers and treat asthma symptoms as soon as they occur. Common symptoms of asthma include: Coughing Wheezing (a whistling, squeaky sound when you breathe) Shortness of breath Rapid breathing Chest tightness Allergy Symptoms The American College of Allergy, Asthma, and Immunology points out that allergies generally occur when the immune system overreacts to something often harmless for others. For seasonal allergy sufferers, that means their bodies don’t react well to allergens like pollen, grass, and/or ragweed. Allergies are not contagious, unlike colds, the flu and COVID. Symptoms that often accompany allergies include: Runny nose, stuffy nose, and/or sneezing Wheezing or shortness of breath Dry Cough Mucus Rashes Fatigue Headache This chart is a handy reference tool when trying to distinguish between symptoms.

Circle for Excellence: With Gratitude From Our Homes to Yours
Gratitude is the thread that weaves the Yavapai Regional Medical Center (YRMC) Foundation together with our donors. In 2020, that message of thanks culminated in a unique and heartwarming Circle for Excellence Reception. “This annual event is one of our opportunities to recognize our many loyal donors,” says Robbie Nicol, Executive Director of the YRMC Foundation. “In 2020 especially, we wanted to express our gratitude but we wanted to do it safely during this challenging time.” This was the inspiration for the YRMC Foundation’s first virtual Circle for Excellence Reception. On November 12, 2020 at 5:00 pm, Circle for Excellence members – donors who give $100 or more annually – joined the online event from the comfort and safety of their homes. Speaking from the Heart Dave Barrett, Chair of the YRMC Foundation, welcomed Circle for Excellence donors to the reception from his living room. He introduced the following people (in order of appearance), who also spoke from their homes: Robbie Nicol, Executive Director of the YRMC Foundation Pierre Tibi, MD, FACS, Medical Director of the James Family Heart Center at YRMC Marnie Uhl, President and CEO of the Prescott Valley Chamber of Commerce Jennifer Harvey, RN, Nurse Navigator of Lung Cancer Screening and Care at Dignity Health, Yavapai Regional Medical Center John Amos, President and CEO of Dignity Health, Yavapai Regional Medical Center How Donors Make a Difference There was much to share about the remarkable impact donors had on healthcare at YRMC in 2020. The thank-you list featured the following and more: The renovation of Cath Lab and 14-bed Intensive Care Unit to state-of-the-art facilities, both of which serve patients of the James Family Heart Center at YRMC. The expansion of YRMC’s Partners for Healthy Students program to support families during COVID-19. The essential screening and support services provided to community members through the BreastCare Center at YRMC. The inspiring gestures of support for the YRMC family during COVID-19 including donations to purchase masks, gowns, gloves and more. “The 2020 virtual Circle for Excellence Reception was reminder of the generosity of our community and all they do to care for each other by supporting the YRMC Foundation and YRMC,” says John Goodenow, Director of Philanthropy for the YRMC Foundation. Do you want to learn how to become part of YRMC Foundation’s Circle for Excellence? Contact the YRMC Foundation at (928) 771-5686 or foundation@yrmc.org.

YRMC’s Kim Haugen Named PV Chamber of Commerce 2020 Volunteer of the Year
Photo: Kim Haugen, Prescott Valley Chamber of Commerce 2020 Volunteer of the Year (center) with Frank Almendarez, YRMC East Chief Administrative Officer (left) and Chris Graff, Chair of the PV Chamber of Commerce (right). After working in corporate management in Illinois, Kim Haugen moved to Prescott and became a Medical Transcriptionist. She enjoyed working from home and appreciated the flexibility the job offered. However, Haugen sometimes felt like she was missing out on regular interaction with others. Eleven years ago, after some thoughtful consideration, she decided to volunteer once a week with the PAWS (Pets are Warm Support) pet visitation program at Yavapai Regional Medical Center (YRMC) with her then two-year-old Bouvier dog, Dirk. “Joining PAWS at YRMC was one of most worthwhile things I have ever done,” says Haugen. “There’s nothing like that connection between a dog and a person. He has touched so many lives. People have even recognized him on the street!” Dirk is now 13 years old and no longer joins Haugen at YRMC. “When Dirk could no longer walk, I requested a different job on Thursdays,” Haugen continues. “It was important to me to keep seeing the other YRMC volunteers, management and staff who had become my friends.” She started delivering the mail each Thursday, and over the years has tackled positions as varied as stocking supplies in the Family Birthing Center and Nutrition Department, helping with the ‘Pet Partners’ certification process, working as an Escort and serving at the Information Desk. She has become a well-respected volunteer throughout the hospital, known for her dedication and hard work. Victoria Spears, YRMC East Volunteer Services Manager, wanted to give Haugen special recognition for all she has done for YRMC. She submitted a nomination to the Prescott Valley Chamber of Commerce for their Volunteer of the Year Award. “Kim constantly goes above and beyond the call of duty,” states Spears. “When she sees a need, Kim is the first one to offer to fill it. She displays all the qualities of a valuable volunteer, exemplifying the spirit of cooperation. She is respected not only by the other volunteers but by staff as well.” The Chamber chooses one recipient each year for their Norm Pariseau Volunteer of the Year Award. Pariseau was a longtime member of the Prescott Valley Early Bird Lions and was Board Chairman of the Prescott Valley Chamber. Each year, the winner exemplifies Pariseau’s commitment to the community and generosity of spirit. Haugen won the award. “Kim not only works hard and does an excellent job, but she truly loves to serve YRMC and our community and this is very apparent when you see her in action,” says Spears. Haugen was not expecting the honor. “This certainly surprised the heck out of me!” admits Haugen. “It’s very humbling. There are so many wonderful, deserving volunteers. And I was chosen not only from YRMC, but from all over Prescott Valley. It’s so exciting.” Haugen continues, “I like to think of this as an honor not only for me, but for YRMC – for the way they have cared for the community, not only during the pandemic, but over the years. I felt that the award was as much for the hospital as for me, and this was the Chamber’s way of thanking the hospital through me.” “Volunteering makes you feel like you are helping the community. It’s so nice to give back, to feel like you’re making a difference in someone’s life,” says Haugen. “And even behind the scenes – helping make the staff’s job easier. That’s a good feeling. You’re giving the workers a chance for more quality time with their patients.” Haugen’s beloved dog Dirk was, in many ways, responsible for bringing her to YRMC and launching her years-long commitment to the hospital. It’s nice to know that while Dirk has ‘retired’ from volunteering, he has a little brother named Sebastian. Haugen is happy to report that Sebastian may begin visiting YRMC patients through the PAWS Program in the not too distant future! To learn more about becoming a volunteer at Yavapai Regional Medical Center, visit yrmc.org. Or, you can call Volunteer Services in Prescott at (928) 771-5678, or in Prescott Valley at (928) 442-8678.

Longest Running YRMC Volunteer Celebrates Her 40th Year
Forty years ago, volunteering at Yavapai Regional Medical Center (YRMC) would often mean joining the Medical Auxiliary. Dues were $5 a year. Auxiliary members would dedicate their time assisting at the Information Desk or Gift Shop. The dress code was strict. In fact, Auxiliary members purchased their own uniforms and wore regulation blouses. Dorothy Kalabus, YRMC’s longest-running volunteer, remembers those days with fondness and a good dose of her signature humor. “Imagine today if you had to pay to be a volunteer!” she jokes. Kalabus had just moved to Prescott from Pittsburgh. She had three school-aged children and her husband’s airline job often took him out of town. Not one to sit at home, she soon joined the Auxiliary and started a decades-long relationship with YRMC. It wasn’t long before Kalabus was asked to join the Auxiliary Board. In those days, the Auxiliary Board decided upon ‘wish list’ purchases for the hospital, funded by proceeds from the Gift Shop. When her grandson was born, Kalabus recalls that the stress monitor, just purchased by the Auxiliary, was used during his delivery. “I was so glad it was there for the staff to use,” says Kalabus. Dorothy Kalabus is the 10th of 12 children. Her father died when she was eleven. She and her siblings were raised to pitch in whenever and wherever possible. She graduated with honors and earned college scholarships. “There was never any idle time at our house,” she remembers. “I can’t even imagine sitting and doing nothing.” Now, at nearly 80 years old, Kalabus still has the energy of someone a fraction of her age. Forty years at the YRMC Information Desk isn’t the only impressive item on her volunteer resume. “Back in the 80’s I volunteered at Sacred Heart Church and at the Prescott Rodeo, where I became the chair of the Cattleman’s Club. I even earned my gold and silver rodeo belt buckle. I offered to stuff envelopes for Judge Ann Sterling’s campaign, and ended up becoming the campaign chair!” Nancy Thomes, Director of Volunteer Services at YRMC, emphasizes the important role Kalabus plays at the Information Desk. “Dorothy is such a joy to have at our Information Desk,” says Thomes. “This is a challenging position since the questions that are asked are often new. These volunteers often have to problem-solve while extending good customer service. Dorothy’s knowledge and willingness to serve is always evident, and the joy that she feels while doing this is always apparent.” When asked why she has stayed with her service to YRMC for forty years, Kalabus explains, “This is so important. You’re dealing directly with people in need. People come in with so many different needs. Most of them aren’t just asking for a patient’s room number, and often they’re in pain or feeling stress. You have to remember a lot of information about the hospital, and communicate it simply and clearly.” “And then there are the free lunches!” she laughs. “Every Friday, a dozen or so volunteers from all different departments get together for lunch, and new volunteers are always welcome. These people have all become my friends. We have such a good time!” Kalabus notes that she belongs to a special ‘foursome’ that makes her time at YRMC extra special. She works with Escorts Carol Shepherd and Shirley Reeves and fellow Information Desk volunteer Rob Petrocci each Friday. “We’re a great team,” she says. Kalabus was honored for her 40 years of service on July 2nd. Thomes and Chamine David, Volunteer Services Manager, visited Kalabus in her front yard for a ‘physically distanced’ celebration. Kalabus’ husband and daughter were there, as well as fellow volunteers Shepherd and Reeves. The neighbors across the street even held up a large handmade ‘Congratulations’ sign and took photos. “Dorothy enjoyed telling a few stories about her first days at YRMC,” says Thomes. “It was clear that her commitment to her role began 40 years ago when she first started volunteering.” “It was a fun visit,” Kalabus recalls. “There were balloons and flowers and we visited and reminisced. It’s fun telling the old stories and marveling at how far YRMC has come over the years. But I still can’t believe it’s been 40 years!” “I tell people that volunteering gives you life,” she explains. “It gives you something to look forward to and makes your life so much more interesting. Volunteering changes your whole world.” Kalabus continues. “When I started volunteering at YRMC 40 years ago, it was just to get to know a few people in my new hometown. But soon, I came to realize that this is a commitment. And as you can tell, when I start something, I finish it. Well, I’m not finished yet!” To learn more about becoming a volunteer at Yavapai Regional Medical Center visit yrmc.org, or call Volunteer Services in Prescott at (928) 771-5678, or in Prescott Valley at (928) 442-8678.

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

YRMC: Your Destination for Heart Care and Patient Blood Management
What does the phrase “destination healthcare” bring to mind? For a growing number of people in Arizona and the southwest it means heart care, patient blood management or both of these specialized programs, provided by Yavapai Regional Medical Center (YRMC). Cardiac specialists from the James Family Heart Center and leaders from YRMC’s Patient Blood Management program (PBM) joined a live-stream event on October 17, 2019 at Yavapai College Performing Arts Center to speak about both of these innovative programs. Over 600 participated in “YRMC – Your Destination for Cardiac Care and Blood Management” at Yavapai College and the live-stream the event online. YRMC – Your Destination for Cardiac Care and Blood Management featured exceptional cardiac specialists: a Cardiologist, Cardiac Electrophysiologist, Cardiothoracic Surgeon, and a Structural and Interventional Cardiologist. Patient Blood Management experts also took part in the event. Together, these professionals highlighted the services, technology and teamwork that are the hallmark of YRMC’s Heart Program and Patient Blood Management Program. “Neither of these programs existed 12 years ago,” said Pierre Tibi, MD, FACS, Medical Director of YRMC’s James Family Heart Center and Patient Blood Management Program. “Today, there is no other community hospital in Arizona or the southwest that offers what YRMC does. We are now a destination program for Cardiac Care and PBM.” Defining PBM Until recently, prestigious organizations like the Society for the Advancement of Blood Management (SABM), the World Health Organization (WHO) and the American Association of Blood Banks (AABB), all mentioned blood transfusions in their PBM definitions. “They focused on thresholds for blood transfusion,” said Dr. Tibi, SABM’s Immediate Past President. “Today, the SABM definition states that PBM is a patient-centered approach that aims to improve patient outcomes.” At YRMC, this is accomplished by: Involving the patient in decision making Identifying anemia and other conditions early Managing conditions that can affect blood count Minimizing blood loss during hospitalization Embracing PBM tactics throughout the organization “We focus on taking care of the entire patient and keeping the patient as safe as possible before, during and after a procedure,” said Dale Black, Coordinator, Patient Blood Management, YRMC. “And one way to keep patients safe is to not subject them to possibly unnecessary blood transfusions.” YRMC: What Your Heart Needs John Amos, President and CEO, YRMC, recalled the beginning of YRMC’s heart services, which launched in 2004 with a single Cardiac Catheterization Lab at YRMC West in Prescott. “Even then, we envisioned a heart program that would bring together the latest services, exceptional specialists, unparalleled technology and compassionate caregivers,” said Amos. YRMC took a major step toward that goal in 2007 when Dr. Tibi – a highly regarded Cardiothoracic Surgeon from Phoenix – joined YRMC. Dr. Tibi brought open heart surgery to the community, launched YRMC’s Heart Program and introduced PBM. Under Dr. Tibi’s leadership, YRMC’s thriving, comprehensive Heart Program has grown to feature these services and exceptional cardiac specialists: Structural Heart Disease Services – Soundos Moualla, MD, FACC, FSCAI, Structural and Interventional Cardiologist, YRMC PhysicianCare, Prescott Mitral Valve Repair with MitraClip Paravalvular Leak Closure (PVL) Transcatheter Aortic Valve Replacement (TAVR) Transcatheter Mitral Valve Replacement (TMVR) WATCHMAN™/Left Atrial Appendage Closure (LAAC) Electrophysiology Services – Nisha Tung-Takher, MD, Cardiac Electrophysiologist, YRMC PhysicianCare, Prescott Curative Management and Ablation Procedures for Cardiac Arrhythmias (atrial fibrillation, atrial flutter, supraventricular tachycardia, atrial tachycardia, premature ventricular contractions and ventricular tachycardia) Device Implantations (pacemakers and defibrillators) Remote Monitoring (pacemakers, defibrillators and cardiac resynchronization therapy, CRT) Heart Failure Management Care with Compassion YRMC’s Heart Program and PBM Program combine science and service, according to George Rizk, MD, Invasive Cardiovascular Medicine, YRMC PhysicianCare in Prescott. “YRMC is doing what’s best for patients,” said Dr. Rizk, who presented during the live-stream event. “If you deliver the most scientifically advanced services without putting the patient’s interest first, you don’t get too far. YRMC’s team has a passion for helping patients.” One way that YRMC does what’s best for patients was described by Elizabeth Black, YRMC’s Patient Blood Management, Data Manager. In the tradition of healthcare and acronyms, she called it “KTBITP” or “keeping the blood in the patient.” Less than a decade ago, Black noted, blood transfusion was the most common procedure performed in U.S. hospitals. While some blood transfusions are deemed medically necessary, she said, they all come with risks. Those risks include increased infection rates, medical complications (kidney, lung and heart), and higher death rates. PBM strategies combine evidence-based medicine with good clinical practice to maximize the patient’s blood health and reduce exposure to risks associated with transfusion. A Field of Dreams Dr. Rizk remembers the opening of YRMC’s first Cath Lab as a “field of dreams” moment. “We thought: If we build it, they will come,” he said. “And, if you build it well, they will never leave.” These statements are even more relevant today as YRMC’s Heart and PBM Programs emerge as destination programs. To learn more about YRMC – Your Destination for Cardiac Care and Blood Management check out YRMC HealthConnect. For information about YRMC’s Heart Program and PBM Program, visit our website.

Is Interventional Radiology Right for You?
Medical innovation moves forward at a rapid pace, with continuing technological advances and an ever-increasing understanding of health and the human body. Interventional Radiology may be one of the best examples of this phenomena. Thanks to this highly specialized medical field, procedures that once required surgery, a hospital stay, and extensive recovery time are now being performed on an outpatient basis using minimally invasive techniques. In fact, most of the procedures are performed without an incision. Interventional Radiology (IR) combines the use of advanced imaging such ultrasound, X-rays, CT scans and MRI to guide the treatment of a variety of conditions. Interventional Radiologists are board-certified physicians who are trained in both radiology and minimally invasive therapies. They treat conditions in virtually every organ system, including: Blood vessels Nervous system Reproductive system Gastrointestinal tract Liver Urinary tract Cardiovascular disease Cancer Dialysis access Back pain Leg pain and swelling Dr. Matthew Dicker is a Diagnostic and Interventional Radiologist with Yavapai Regional Medical Center. He emphasizes that a team approach delivers the best care for his patients. “Taking care of each patient starts with our office staff and administrative staff at the hospital. A great group of nurses and technologists help before, during and after each procedure,” Dicker says. “And of course, collaboration with the hospitalists and vascular surgeons as well as primary care providers creates the best possible 360-degree care for the patients in our community.” Dicker explains that Interventional Radiologists are consultants to virtually all of the specialties and subspecialties at YRMC, in addition to performing procedures specific to each. “Having the expertise to perform these procedures and having the facilities and support staff to perform them is a great benefit to the Quad Cities,” says Dicker. “The hassle of driving to Phoenix or elsewhere is no longer necessary.” As with the practice of medicine in general, Interventional Radiology continues to keep pace with ever-developing research and technology. “New and different ways to treat disease are happening almost daily,” Dicker notes. “We strive to perform the newest treatments safer than before. For instance, opening blockages in the leg arteries is being performed with access through the ankle as opposed to the groin where it had been typically performed, which significantly decrease the risk of bleeding while having the same excellent results.” “We are excited to introduce intravascular lithotripsy to break up plaque in the arteries that causes blockages,” he continues. “It uses the same technology that has been used for years to break up kidney stones.” Interventional Radiology allows for a quicker recovery time, less pain, reduced cost and a lower risk of complications. If you are a candidate for surgery, talk to your healthcare provider to see if an Interventional Radiology procedure makes sense for you as an alternative. “It is rewarding when a procedure is successful, a patient is happy with the results, and they are surprised that it was done without an incision with very little if any pain,” says Dicker. Click here to learn more about YRMC Imaging Services.

Musculoskeletal Radiologist Dr. Warren Spencer Joins the YRMC Team
Dignity Health, Yavapai Regional Medical Center (YRMC) is pleased to introduce Musculoskeletal Radiologist Warren Spencer M.D. to the Quad City area. Dr. Spencer has joined the team at YRMC, specializing in medical imaging of the extremities, specifically the joints, bones and muscles. “When a patient comes in for an x-ray, ultrasound, CT, or MRI of a bone or joint, it will be interpreted by a board-certified radiologist. I serve as a reference for other radiologists when unique or challenging musculoskeletal cases present themselves,” explains Dr. Spencer. “The majority of musculoskeletal studies that I interpret are related to arthritis or trauma that occur in the spine and joints,” he continues. “For example, many people in our community suffer from painful joint disease as a result of trauma or age-related wear and tear. Proper diagnosis and care will extend the quality of life for many of our aging population.” Working closely with YRMC orthopedic surgeons, pathologists, general practitioners and emergency department physicians, Dr. Spencer specializes in all varieties of disease of the musculoskeletal system, including trauma, sports medicine, arthritis, and bone and soft tissue tumors. “Each day at YRMC, I interpret imaging for patients in inpatient and outpatient settings, as well as in the emergency department,” says Dr. Spencer. “I also perform image-guided procedures, which include biopsies, injections and fluid drainages. I particularly enjoy interpreting musculoskeletal MRI.” Dr. Spencer earned his medical degree from the Medical School of Wisconsin and completed his Internship at Wheaton Franciscan Healthcare St. Joseph’s Hospital in Milwaukee, Wisconsin. Both his residency training in Diagnostic Radiology and Fellowship in Musculoskeletal Radiology were completed at the University of Iowa Hospitals and Clinics in Iowa City. Dr. Spencer is certified by the American Board of Radiology and he practiced as a Radiology Specialist in Iowa for six years. He is also a member of the American College of Radiology and the Radiological Society of North America. Originally from Utah, Dr. Spencer chose to move to Prescott because of the collegial and collaborative environment among the physicians at his practice. In addition, he and his family were drawn to the quality of life in the Prescott area. “Prescott reminds me of my hometown in Utah, with beautiful scenery and temperate weather. Moving from the Midwest, we have enjoyed being in closer proximity to extended family.”

Delicious Recipes for Happy, Healthy Holidays!
Holiday meals can be delicious, satisfying, memorable and healthy too! After all, the holiday season is also a time when late fall and winter produce is at its peak. Sweet winter squashes, bright greens, savory herbs, crunchy apples, and earthy root vegetables can all be transformed into countless nourishing, celebratory meals. Join me here in our latest episode of YRMC’s Your Healthy Kitchen as I share some of my healthy holiday favorites! Gingery Homemade Cranberry Sauce Recipe Anadama Dinner Rolls Recipe Wild Mushroom Farro Risotto Recipe A few of my favorite holiday recipes have been featured in YRMC’s Your Healthy Kitchen before, like winter green salad sweetened with seasonal fruit and toasted pecans, luscious baked apples, and a simple carrot soup warmed with ginger, cinnamon and coriander. Each of these recipes can be switched up a bit and serve as templates for your creativity. Try apples or mandarin oranges and toasted walnuts or pumpkin seeds in the salad instead of pears and pecans. Substitute butternut squash for the carrots in the soup. Change up the baked apple stuffing to include a variety of dried fruits and nuts and create your own flavorful sauce using different cooking liquids, spices and/or herbs. Winter salads can feature a variety of greens, toasted nuts and fruits Winter Salad with Seasonal Greens, Nuts and Fruit Recipe Ingredients for Fruit and Nut-Stuffed Baked Apples Baked Apples Recipe Creamy carrot or butternut squash soup with warm winter spices Carrot Soup with Warm Spices Recipe I wish everyone happy, healthy holidays and look forward to seeing you again in the new year! Until then, remember to to visit our collection of videos and healthy, delicious recipes at YRMC’s Your Healthy Kitchen. All of our recipes include nutrient-packed plants; affordable, local ingredients; and easy to follow instructions. You can also follow me on Facebook at YRMC’s Your Healthy Kitchen, to see what I am making at home, get insider tips and link to some of my favorite food and nutrition destinations on the web.

YRMC’s Your Healthy Kitchen: Making a Delicious Meal in a Bowl While Raising Awareness for Lung Cancer Screening
Did you know that early detection of lung cancer saves lives and that lung cancer screening services are available at YRMC? To raise awareness of the vital role regular imaging plays in lung cancer survival, we invited Jennifer Harvey, Nurse Navigator, Lung Cancer Screening and Care at YRMC, onto the set at YRMC’s Your Healthy Kitchen! Jennifer supports and guides individuals at risk for lung cancer through the screening process and offers support to those who are trying to quit smoking. In the kitchen together, we talked about who might benefit from regular lung cancer screening, as well as strategies to help with the food and weight challenges people often face when they quit smoking. Of course, we also made a delicious, nourishing meal, filled with flavorful ingredients that just happen to help our bodies heal and detoxify from nicotine! Lung cancer is the second leading cause of cancer-related deaths for men and women, according to the American Cancer Society. In fact, more people die annually of lung cancer than cancer of the colon, breast and prostate combined. While both smokers and non-smokers can develop lung cancer, the risks are much greater for past and present smokers. Lung cancer screening is designed to catch cancer at its earliest stages, when survival is most likely, in those who are most at risk. Join us as Jennifer explains the criteria that define high-risk individuals, talks about her role as a Nurse Navigator, and shares what inspires her at work, everyday. Recipe: Whole Grain Spanish Rice Statistics show that many people (but not all) do gain weight after smoking cessation. However, the health risks of smoking far outweigh the downsides of weight gain — so don’t let the scale stop you from quitting! Also, developing a healthy relationship with food, the stressors in your life, and your body can be some of the greatest gifts of smoking cessation. Simple tips that can reduce the amount of weight you might gain after saying goodbye to cigarettes include: When you eat, just eat. Taking time out for meals and snacks and eating them without distraction (i.e. no TV, work, computers, phones, etc.) will increase your sense of satisfaction and ‘fullness’ after eating, improve calorie burning, and reduce your cravings for sweets and snacks throughout the day and night. Instead of snacking on sweets or processed foods like chips or pretzels, consider creating snacks that resemble little meals. A small meal that includes fruit or vegetables, some protein (chicken, fish, meat, eggs, beans or nuts), carbohydrate (whole grain products, fruit, or beans) and healthy fat (avocado, nuts, seeds, or olive oil) will satisfy your taste buds as well as your belly and your brain. Check out this episode of YRMC’s Your Healthy Kitchen for great snack ideas! Experiment and discover how physical activity helps you move through and reduce stress, fatigue, boredom and food cravings! It’s important to find a way to move your body that is enjoyable, not stressful. Do you like walking in nature or around your neighborhood? How about dancing, alone or with others? Working in the yard or garden, going to a gym, taking gentle or vigorous exercise classes, doing yoga or Tai Chi, or even standing, stretching, and walking in place at regular intervals during the day qualifies as healthy movement that can reduce stress-related eating. Eat a larger meal in the middle of the day and a smaller meal at night. Most people burn more calories between noon and 2 pm, so it makes sense to eat more food at lunch! For other great tips on successfully navigating the challenges of smoking cessation, check out all of the resources available from the American Cancer Society and consider joining thousands of other Americans who have decided to quit on November 21st for The Great American Smokeout! Remember to also check out all of our informative videos and easy, delicious recipes at YRMC’s Your Healthy Kitchen! Our site now includes an easy link to Your Healthy Kitchen’s YouTube Channel, where you can easily view and access our entire library! You can access these at https://www.yrmchealthconnect.org/your-healthy-kitchen/.