One of the most important healthcare decisions a woman will make is where to undergo breast screening. “Most women assume that all imaging facilities offer the same services and are pretty much interchangeable,” says Kathi Hoffer, Imaging Operations Manager, The Breast Care Center at Dignity Health, Yavapai Regional Medical Center (YRMC). “In reality, there are significant differences between imaging centers.” This October – National Breast Cancer Awareness Month – the Breast Care Center and Prescott Medical Imaging (PMI) are teaming up to give you the information you need to select an imaging center. We’ll also clear up some of the confusion about how frequently you should undergo screening mammography. Does your facility have advanced breast imaging technology? The  Breast Care Center and PMI have exceptional technology dedicated to detecting breast cancer. This includes state-of-the-art digital mammography, a dedicated breast MRI system, three-dimensional breast imaging, the Hologic Supersonic Mach 30 breast ultrasound and more. “Technology is constantly improving so it’s also important for imaging centers to continually invest in proven technology,” Hoffer explains. If I need a follow-up imaging procedure after a screening mammogram, is that available at your facility? The imaging center where you undergo your screening mammograms should be your breast health home. “I encourage women to think long term about their breast health,” explains Hoffer. “This means finding a center that can manage all breast imaging needs you may encounter at different times.” The Breast Care Center features a continuum of breast health services. The Center provides breast screening, diagnostic procedures and, if needed, treatment planning and the guidance of a clinical navigator. Do your radiologic technologists – the professionals who conduct mammograms – specialize in breast imaging? At the Breast Care Center and PMI, screening mammograms are performed by breast imaging technologists. These are radiologic technologists specially trained in breast imaging. “This really makes a difference in your mammogram,” says Hoffer. “Our breast imaging technologists are experienced at positioning for optimal views, recognizing possible pathology and taking extra views when needed.” Are your radiologists board certified? Radiologists are the physicians who interpret your mammogram and other imaging studies. At both the Breast Care Center and PMI, our radiologists are certified by leading radiology accreditation organizations. They also have been trained at some of the nation’s top radiology programs. “We have an amazing team of radiologists,” says Hoffer. “They are extremely skilled at interpreting breast screenings as well as performing breast-related diagnostic studies and procedures.” Are your breast imaging modalities accredited? The American College of Radiology (ACR) is the leading accreditation organization for imaging studies in the United States. ACR accreditation means an imaging center provides the highest level of image quality and safety requirements for equipment, medical personnel and quality assurance. Both the Breast Care Center and PMI have earned ACR accreditation in mammography. The Breast Care Center also has earned ACR accreditation in breast MRI and stereotactic biopsy. A Mammogram Screening Schedule Since 1990, screening mammography has helped reduce breast cancer mortality by nearly 40% in the United States. That’s an extremely positive track record. It’s why the Breast Care Center and PMI support the screening recommendations developed by the ACR. They include: A baseline mammogram between the ages of 35 and 40 Yearly mammograms after age 40 Continued annual screening for as long as you would pursue treatment if cancer was detected “Our community is full of very vibrant women in their 70s, 80s and even their 90s,” Hoffer says. “That’s a major reason we do not recommend ending annual mammograms at a certain age.” Schedule Your Mammogram Has it been more than a year since your last mammogram? Contact the Breast Care Center in Prescott Valley or PMI in Prescott at (928) 771-7577 to schedule your screening. It’s the best way to celebrate National Breast Cancer Awareness Month.

Pink ribbons are synonymous with October, National Breast Cancer Awareness Month. In the Quad Cities, businesses, organizations and individuals get involved in the recognition month by supporting the Breast Care Center at Dignity Health, Yavapai Regional Medical Center East in Prescott Valley. The Breast Care Center has served the community since 2011. “We are incredibly grateful for the generosity our community shows the Breast Care Center in October and throughout the year,” says Robbie Nicol, Executive Director of Community Outreach and Philanthropy at the Yavapai Regional Medical Center Foundation, a Dignity Health member. “We see the positive impact these gifts have on patients receiving care at the Breast Care Center.” Share the Care Nearly a decade ago, YRMC launched Share the Care as part of a community-wide program to increase access to breast screening, encourage friends and family to get mammograms, and support patients undergoing breast cancer treatment. Since then, the community has embraced Share the Care by hosting events, sponsoring programs and raising funds to support the Breast Care Center. How do gifts to the Breast Care Center help people throughout our community? They provide diagnostic and treatment services and essential health support for patients who do not qualify for other programs and community services. Funds also help promote breast health awareness and education, purchase new technology, and provide staff education and training. “The tradition of giving to the Breast Care Center has continued and grown during 2021,” Nicol says. “There are so many creative ways that our community finds to ‘share the care’ in October and beyond.” Visit the following organizations’ web communities or Facebook pages to learn how you can support their Share the Care activities or join their events. Activities Barrett Propane Pink Truck (Website and Facebook) The Daily Courier “Pink Pages” (Website and Facebook) Fork in the Road Restaurants, “Boot Out Cancer” – Gurley Street Grill, Murphy’s and The Office Cantina Hassayampa Inn Wishing Fountain (Website and Facebook) Homes & Land Magazine “Pink Edition” (Website) Pink Patch Project – Camp Verde Marshal’s Office, Prescott Police Department and Yavapai County Sheriff’s Department Prescott Frontier Days® (Facebook) Wrangler’s® Tough Enough to Wear Pink™ Texas Roadhouse, “Stompin’ Out Breast Cancer” (Facebook) Events Saturday, October 2, 8:00 am – 5:00 pm Summit 4X4 Company, “Trails 4 Tatas” 154 South Montezuma in Prescott, Arizona Breakfast and poker run followed by a lunch event at the Grand Highland Hotel and Holiday Courtyard. Ticket information Thursday, October 7 Capital Canyon Club Golf Tournament, “Swing Fore the Cure” Members’ event Saturday, October 16, 4:00 – 10:00 pm Los Pinos Mexican Restaurant, “Remembering Toni” 1245 White Spar Road in Prescott, Arizona Dinner, music and more are part of this event at Los Pinos Mexican Restaurant. Ticket information: (928) 541-1245 Monday, October 18, 5:30 – 6:30 pm The Movement Studio, “Dance for a Cause” 6425 East 2nd Street, Suite B, in Prescott Valley, Arizona Make a donation and join a cardio dance workout that will get your heart pumping. More information: (928) 515-2919 (Website and Facebook) How You Can Give a Gift Individuals may give at any time by visiting the YRMC Foundation giving page and selecting the “Breast Care Center Fund” under “Donation Designation.” “We are so appreciative of the generous support of individual donors throughout our community,” notes Nicol. “These are people who care deeply about preventing breast cancer and supporting people diagnosed with breast cancer.” Visit YRMC to learn more about participating in Share the Care.

If you are a woman with diabetes, your risk of developing (and dying from) heart disease may be greater than you think. Diabetes seems to erase, or even reverse the protective effect of female gender against cardiovascular disease and heart attack, making women with diabetes significantly more susceptible than men with diabetes. While the reasons for this are not entirely clear, researchers and healthcare providers agree that women with diabetes need more careful prevention, treatment and tracking to protect their cardiovascular health. Women are Frequently Diagnosed with Diabetes at a More Advanced Stage Both type 1 and type 2 diabetes increase the risk of a number of health concerns in men and women, including cardiovascular disease, kidney disease, and neuropathy (nerve damage).  The longer someone has diabetes, especially with poor glucose control, the greater the risk of complications. Similarly, the longer someone has prediabetes, when glucose levels are above normal, but not yet in diabetes range, the greater the risk of cardiovascular disease. Research suggests that more than 90% of people with prediabetes don’t know they have it and that women tend to have undiagnosed prediabetes for a longer period of time than men. Additional research suggests that men and women can have elevated blood sugar or insulin levels (a sign of impaired glucose tolerance) for up to 20 years before they are actually diagnosed with diabetes, and that women are often diagnosed with diabetes at a later stage than men. Women Have Different Responses to Disease and Medical Treatment Diabetes may be more damaging to the vascular system in females than in males, at any age.  A study following a group of children and adolescents with well-controlled type 1 diabetes discovered that girls were more likely to have heart abnormalities and other indicators of early cardiovascular disease than boys. Indeed, research indicates that women and girls are more susceptible to the cellular and vascular damage caused by elevated blood glucose and low-grade inflammation, a chronic side effect of diabetes. Women may also not respond as well to medical treatment for cardiovascular disease. For example, data suggests that some medications, including those used to reduce blood clotting, may not be as effective in preventing heart attacks in women compared with men. Sub-optimal treatment may be a consequence of women historically being under represented in the clinical trials used to determine the effectiveness and proper dosage of drugs. There may even be disparities in healthcare for women when compared to men. Data indicate that women may be less likely to have their cardiac risk factors assessed by physicians, and are typically not treated as aggressively as men. Most critically, women with diabetes are more likely to die as the result of a heart attack than men. This could be partially due to the fact that women are typically diagnosed with heart disease at a later and more debilitated age, but other factors may also come into play. For example, research from a Scottish study suggests that the blood levels of troponin, a heart muscle protein, that when detected in the blood signals a heart attack, are often lower in women having a heart attack than men. Consequently, a woman having a heart attack may not receive appropriate emergency treatment. In addition, women may not experience classic heart attack symptoms, including pain in the chest, arms, back and jaw, heartburn and shortness of breath. The most common symptom of heart attack women may experience is unusual fatigue. In fact, in one study, women reported deep fatigue and disturbed sleep as much as a month or two before a heart attack. During a heart attack, only about one in eight women report chest pain, and tend to describe it as pressure, aching, or tightness rather than pain. Know Your Risks of Prediabetes, Diabetes and Cardiovascular Disease Considering all of the risks of cardiovascular disease for women with diabetes, researchers encourage women and their healthcare providers to take extra care and precautions; catching prediabetes, diabetes and signs of cardiovascular disease at their earliest possible stages. Women at risk for prediabetes, diabetes and cardiovascular disease include those who: Currently have or have had gestational diabetes Smoke Are inactive Carry extra abdominal fat Have polycystic ovarian syndrome (PCOS) Experience chronic stress Eat a poor diet Have periodontal disease Have a family history of diabetes and cardiovascular disease Some symptoms of diabetes or prediabetes are: Fatigue Depression and mood changes Increased cravings for sweets Sudden weight gain or weight loss Chronic vaginal yeast infections Chronic urinary tract infections Increased hunger, thirst and urination Sexual dysfunction If you have prediabetes or diabetes, check out the services and resources offered at the YRMC Pendleton Center.  The Pendleton Center offers excellent classes and individualized counseling for people with prediabetes and diabetes and also has an adult fitness program, featuring a complete gym and large variety of exercise classes designed for people at all levels of fitness, flexibility and strength. Our education and fitness programs are designed to help anyone achieve good blood sugar control and improved fitness, which reduces the risk of cardiovascular disease. For more information, call 928-771-5794.

Jennifer Goddard, MD, recently joined the team at Dignity Health, Yavapai Regional Medical Group, Primary Care, in Prescott Valley. Dr. Goddard earned her medical degree from Temple University, College of Medicine in Philadelphia, Pennsylvania. Following that, she pursued a residency in Family Medicine from Trident/Medical University of South Carolina in Charleston. “Yavapai Regional Medical Group is committed to expanding its primary care program with exceptional physicians like Dr. Goddard,” says Ken Boush, Director of Marketing and Communications, Yavapai Regional Medical Center (YRMC). “We’re very pleased to welcome Dr. Goddard to our community.” Dr. Goddard is board certified by the American Board of Family Medicine. She is also well regarded by her patients. In 2015, she received both a “Patient Choice Award” and “Compassionate Doctor Recognition.” To schedule an appointment with Dr. Goddard, please contact: Dignity Health, Yavapai Regional Medical Group, Primary Care 7700 East Florentine Road Building B, Suite 101 Prescott Valley, Arizona 86314 (928) 442-8710

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.

Chances are, you know or care for someone with Alzheimer’s dementia.  One in nine Americans over age 65 have the disease, and according to the Alzheimer’s Association, that number is growing fast.  Along with memories, Alzheimer’s dementia takes away vibrancy of life and places a large burden on caregivers — many of whom provide unpaid, at-home support. In our latest episode of YRMC’s Your Healthy Kitchen, Dr. Sam Downing, Director of Geriatrics and Palliative Medicine at Dignity Health, Yavapai Regional Medical Center, talks about the role the Alzheimer’s and Dementia Care Program plays in supporting patients and caregivers in our community.  He also shares diet and lifestyle advice for prevention while helping to prepare a delicious, brain-boosting meal. Recipe for Agrodolce Blueberries Focus on Prevention Lifestyle, diet, education, health care, and environment all play a role in preventing Alzheimer’s and other forms of dementia.  In fact, the 2020 recommendations of the Lancet Commission on Dementia Prevention, Intervention, and Care suggest that these twelve actions could prevent or delay up to 40% of dementia cases worldwide: Prevent or effectively manage diabetes Prevent or effectively manage high blood pressure Prevent head injury Stop smoking Prevent midlife obesity Maintain lifelong, frequent physical activity Avoid excessive alcohol Reduce air pollution Effectively address and treat depression Effectively address and treat hearing loss Maintain healthy social interaction Encourage higher education and lifelong mental stimulation The Diet Connection Research shows that diet supports brain health indirectly by preventing diabetes, hypertension, midlife obesity, and cardiovascular disease.  In addition, data from MRI studies suggest that Mediterranean-eating styles, which feature flavorful, plant-forward meals, may directly protect the parts of the brain that are most often damaged in dementia. In other research, scientists involved with the MIND Study (Mediterranean-DASH Intervention for Neurodegenerative Delay) examined the effects of combining aspects of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets; highlighting foods linked to reduced risk of Alzheimer’s and other forms of dementia.  The results, which are promising, suggest that frequent consumption of the following foods may offer protection: Berries                                     2 or more servings per week Green leafy vegetables            6 or more servings per week Other vegetables                     1 or more servings per day Whole grains                           3 or more servings per day Olive oil                                   Primary oil in diet Beans                                      3 or more servings per week Nuts                                        5 or more servings per week Fish                                         1 or more servings per week Poultry                                     2 or more servings per week Wine                                        1 or less serving per day For more brain-boosting meal ideas, remember to check out all of our informative videos and delicious, plant-forward recipes at yrmchealthconnect.org.  There is something there for everyone and each recipe has been curated or created with ease or preparation, affordability and long-term health in mind.  All of our recipes fit into the Mediterranean eating style that is linked with prevention of dementia and other chronic diseases.  You can also follow me on Facebook at YRMC’s Your Healthy Kitchen, where I post photos, videos and recipes for the meals I make at home, plus links to my favorite food, cooking and gardening sites on the web.