New Interventional Pain Management Program at YRMC Offers Leading-Edge Chronic Pain Treatment
Pain is our body’s way of telling us that something is wrong. Whether it’s a bump or bruise, sprain or strain, we know immediately that we’re injured and we take the necessary precautions to protect ourselves and recover. But when the pain continues long after we’re healed, something very different is happening. This is known as chronic pain, and it can have a real impact on our day-to-day life and even our mental wellbeing. If you or someone you love suffers from chronic pain, you know how difficult it can be to live with. The good news is that there are now innovative and effective treatment alternatives close to home, thanks to the new Interventional Pain Management program at YRMC PhysicianCare in Prescott Valley. How is chronic pain different? When we injure ourselves, pain sensors are immediately activated at the site of the injury. Electrical signals are sent from the pain sensors, nerve to nerve, until they reach the brain. The brain then translates these signals to tell us that we are hurt. Once we’re healed, the signals typically discontinue. However, in the case of chronic pain, the pain sensors continue to send new signals to the brain for weeks, months, or even years after the injury. The brain continues to interpret these signals as pain. According to a report published in The Journal of Pain: Official Journal of the America Pain Society, chronic pain affects one in four adults over the age of 40 in the United States. The effects of living with chronic pain can be far-reaching. In addition to the pain itself, patients can experience stress, depression and other mental conditions. How is chronic pain treated? Craig Leicht MD, MHP is one of the practitioners with the Interventional Pain Management team at YRMC PhysicianCare. Dr. Leicht stresses that although Interventional Pain Management is a comparatively new specialty, it has already made a significant impact on chronic pain management. “In the past, much of pain management was handled by anesthesiologists and physical medicine and rehabilitation specialists. It may have been considered more of a sub-specialty,” says Dr. Leicht. “Now, Interventional Pain Management is a true specialty. My focus is the interventional aspect, which includes procedural and minimally invasive operative interventions. There is also a medication management specialist as well as a physical medicine and rehabilitation, or physiatry specialist. We also consult with the YRMC Physical Rehabilitation and Occupational Therapy Departments.” The Interventional Pain Management team works closely with the patient to determine the best approach for each individual. The goal is to relieve, reduce or manage pain so that patients can return to their daily activities quickly and without heavy reliance on medications. Dr. Leicht stresses that patient involvement is key. “My first visit with a patient will last up to one hour or more,” he says. “We discuss the spectrum of pain management approaches, beginning with weight loss and a walking program. I encourage my patients to get off of their cane or walker and get outside with walking poles if at all possible. Studies show that walking poles can ease 50 to 70% of the pressure in the lower back. Of course, walking is good for the brain and psyche too.” “Interventions such as Spinal Cord Stimulation (SCS) may ultimately be the best option, but it’s important to try lifestyle adjustments first,” he continues. “SCS is a tool to manage pain, along with lifestyle changes. SCS can be life changing, but the patient has to participate as much as they are able.” Download this Chronic Pain Assessment Checklist that you can review before you visit your healthcare provider. What is Spinal Cord Stimulation (SCS)? Spinal Cord Stimulation (SCS) is a minimally invasive procedure where two thin wires are placed in the back, near the spinal cord. The wires are connected to a small battery powered pulse generator, which is implanted under the skin. The pulse generator sends mild electrical pulses to the spinal cord. These pulses act to calm the nerves. This, in turn, minimizes the pain signals that are sent to the brain. A variety of conditions respond well to SCS, including failed back syndrome, which is fusion after previous lumbar surgery. SCS can also be effective for low back pain and/or sciatica that have not been treated effectively by epidurals or other methods. In addition, phantom limb pain experienced by amputees, as well as causalgia, which is similar to phantom limb pain, but without an amputation, can respond well to SCS. Can I try SCS before I commit to the procedure? Dr. Leicht requires that his patients undergo an SCS trial before making the decision to have the permanent procedure. In fact, SCS is one of the few surgical procedures that utilize a true trial prior to permanent implantation. For the trial, two temporary wires are inserted into the back, near the spinal cord. They are attached to a pulse generator, which is worn on your belt or taped to your side. You can use the temporary SCS for a week to see if it’s right for you. What additional new treatments and technology are available through YRMC’s Interventional Pain Management Program? Most recently, Dr. Leicht is the only physician in our area to offer two new, minimally invasive procedures that treat spinal canal stenosis with neurogenic claudication, which is a narrowing of the spinal canal causing pressure on the nerves. This condition causes leg pain and/or weakness after walking and is most often seen in our older population. These new, leading edge, minimally invasive procedures are called Minimally Invasive Lumbar Decompression (MILD) and Vertiflex Superion. Prior to these new advances in technology, the only option for relief was major open back surgery with fusion, which has a 1 to 2 year recovery period and is typically not recommended for older patients. The MILD and Vertiflex Superion procedures are both done on an outpatient basis using local anesthesia, making them better options for many older patients. Recovery is a week or less and both procedures have a 70 to 90% five-year effectiveness rate. “This brings a huge benefit to our patients,” says Dr. Leicht. “For those who can’t walk five feet without leaning on a shopping cart, these new procedures can often allow them to walk all day. We’re proud to be able to offer them here in the Quad-Cities for the first time.” How can I learn more? The Interventional Pain Management team is here to help get you back to the things you enjoy most in life. Best of all, you no longer have to leave our community to benefit from the latest pain management technology. For more information on the spectrum of pain management services available, or to schedule a consultation, you can contact the Interventional Pain Management team at (928) 777-1002. Their office is located at the Del E. Webb Outpatient Center, 3262 N. Windsong Drive, Suite A, Prescott Valley, Arizona.
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.
A New Home for YRMC Preventive Medicine and Outpatient Physical Rehabilitation
Yavapai Regional Medical Center’s (YRMC’s) Wellness Center – home to Preventive Medicine (Pendleton Center) and Outpatient Physical Rehabilitation in Prescott – has moved to a newly remodeled location at: 1112 Iron Springs Road Prescott, Arizona 86305 Pendleton Center in Prescott: (928) 771-5794 YRMC Physical Rehabilitation Services in Prescott: (928) 771-5131 Why We Moved These YRMC services were relocated to make way for a new health center and multi-level parking garage under construction at YRMC West in Prescott. “YRMC West is evolving into a state-of-the-art medical and wellness campus,” states Frank Almendarez, MHSA, Chief Administrative Officer at YRMC. “We’re excited that our community will have access to a new health center that supports health, prevention and wellness. We’re also building a multi-level parking structure that will add many new parking spaces to the YRMC West campus.” Some of the relocated services include: Adult Fitness Programs (e.g., personal training, fitness classes and more) Diabetes Education Outpatient Physical Rehabilitation Services (e.g., Occupational Therapy, Physical Therapy and Speech Therapy) Preventing the Parking Blues During the construction, YRMC encourages you to allow extra time for parking if you are going to the West Campus in Prescott. “Construction at our Prescott campus is accelerating,” said Almendarez. “This progress is good news, but it also means some changes for the people we serve.” YRMC encourages people going to the West Campus in Prescott to allow extra time for parking. “If it’s possible, I suggest that the person with the medical appointment be driven to the hospital entrance,” said Almendarez. “We also have volunteers available to shuttle people from the parking lot to the hospital entrance.” Getting Construction News YRMC is committed to keeping you up-to-date on our construction projects. New information will be provided to local media outlets when available. Updates will also be posted on YRMC HealthConnect and YRMC social media communities—Facebook and Twitter. We encourage you to subscribe to YRMC HealthConnect and follow us on social media to stay connected with developments. “We appreciate the patience and understanding of the people we serve during our expansion,” said Almendarez. “We also want to recognize our employees and volunteers for the positive attitudes they have shown during the construction. It’s an honor to work with such a great group of people.”
Parents and Teachers Use GoNoodle to Fuel Learning
If you’re the parent of an elementary school-aged child in the Quad Cities, chances are you’ve heard them come home from school singing Go Bananas, Little Green Froggy or Happy Llama, Sad Llama, Totally Rad Llama. It might surprise you to know that these seemingly silly songs were created by child development experts from across the country. The songs and their accompanying videos are part of a powerful suite of online learning tools called GoNoodle. Available at school and at home, GoNoodle is designed to benefits kids’ physical wellness, academic success, and social-emotional health with a wide range of offerings that appeal to different ages, interests, skills and abilities. From jump rope rhymes and rap to yoga and deep breathing, GoNoodle is a hit with the elementary school crowd. Here in the Quad Cities, teachers and parents have access to the premium version of GoNoodle, called GoNoodle Plus, free of charge, thanks to a sponsorship from Yavapai Regional Medical Center. Teachers use short GoNoodle sessions throughout the day for students to get out of their seats and jump, dance, stretch and smile. Teachers know that these sessions increase focus and help students learn. In addition, they’re using the customized features offered in GoNoodle Plus to assist with math, spelling and social studies practice, tracking usage and more. Parents use GoNoodle at home to turn screen time into valuable exercise time, often including the whole family in the fun. If you have a K-5 student in Prescott Unified, Humboldt Unified or Chino Valley Unified School Districts, you may have seen them come home with Learning Extensions, printable worksheets and activities that are paired with more than one hundred GoNoodle videos. This is another added feature of GoNoodle Plus. Whether you’re a parent or educator, you can get started by creating an account at GoNoodle.com. You’ll be asked to provide your name, choice of username and password, and whether you are a parent or teacher. Please note that you’ll have access to the GoNoodle Plus features automatically if you live in the YRMC service area. “GoNoodle Plus aligns very well with our Vision of a Total Healing Environment which is based on caring for the body, mind and spirit,” says Kenneth Boush, Director, Marketing and Communications at YRMC. “YRMC is proud to sponsor programs like GoNoodle Plus, as well as Partners for Healthy Students and the YRMC Family Resource Center that enrich the lives of children and young families in our community.” For more information on YRMC’s sponsorship of GoNoodle Plus, contact the Community Outreach Department at CommunityOutreach@yrmc.org.
Why Doctors Love YRMC’s Structural Heart Program
Edwards Lifesciences needed an innovative structural heart team to inspire the thousands of interventional cardiologists gathering for its 2019 think tank at the Transcatheter Cardiovascular Therapeutics (TCT) in San Francisco. The TCT is the world’s largest and most important educational meeting for interventional cardiovascular medicine specialists— physicians who heal the heart’s valves, wall and chambers. During the think tank, Edwards planned to showcase a community based heart program that had successfully combined its leading-edge heart valve technology with strategies to significantly improve heart health in their respective community. What heart program did Edwards choose to use as an example? The James Family Heart Center at Yavapai Regional Medical (YRMC) in Prescott – represented by Structural Heart Program Director Soundos Moualla, MD, FACC, FSCAI – was their top choice. “Edwards is interested in the bread-and-butter work that leads to major leaps in the delivery of appropriate quality valve therapy for patients needing heart valve therapy,” said Dr. Moualla. “They recognized this success in our program.” Precise ECHO Exams YRMC’s Structural Heart Program excels in both identifying people with valve disease and in providing them state-of-the-art treatment that’s right for their condition. Nationwide, this is a major health challenge as only 60 percent of people who are diagnosed with severe aortic valve stenosis receive timely needed therapy. What happens in the Quad Cities – and other communities served by YRMC’s Heart Program – is similar to what you’ll find with other leading heart programs across the country. It begins with the exceptional quality of the information gathered by YRMC’s cardiac sonographers. These healthcare professionals perform echocardiograms (ECHO), the main test for diagnosing heart valve disease. “There are four major criteria for diagnosing aortic valve disease with an ECHO exam,” explained Gwen Rhodes, RN, Patient Navigator, the James Family Heart Center at YRMC. “YRMC’s sonographers capture all four of those criteria 92 percent of the time. Other programs may capture this necessary diagnostic data approximately 40 percent of the time.” This is critical because aortic valve disease – especially aortic stenosis – is often dangerously underestimated. Without appropriate treatment, approximately 50 percent of people with aortic stenosis experience heart failure and possibly death within two years. “People think, ‘it’s only a heart murmur’ or ‘my valve is just a little narrowed,’” said Dr. Moualla. “But when aortic stenosis becomes severe, the situation is very dangerous. It’s as serious as a cancer that has spread, but it involves your heart. That is the challenge we are facing in appreciating the serious implication of severe aortic stenosis.” ECHO Alert Gathering the highest quality information from the ECHO exam is step one in the Heart Center’s exceptional Structural Heart program. The next phase is putting the information to work for patients through YRMC’s “ECHO Alert” program. The result of every ECHO performed at YRMC – at a physician’s request, any clinical situation – is evaluated by the CardioCare program. The anonymous test results are scored using American College of Cardiology classification for heart disease. If a patient’s ECHO score is moderate to critical, their results are flagged when they’re returned to the YRMC Heart Center. “The system also alerts us if the patient’s cardiologist uses certain words, like ‘moderate’ in their report,” Rhodes said. “We capture critical information using numbers and language.” Armed with this, she delves into the next phase of the Structural Heart program’s process, which is to: Inform the patient’s physician of the ECHO results so the information can be shared with the patient. Collaborate with the physician and Structural Heart team to identify therapy options tailored to the patient’s unique health needs. Ensure the patient is in the care of a cardiologist. Involve the patient in every step of this process. The Right Therapy for Every Patient “Our turnaround time – from diagnosis to therapy – is among the fastest in the state because of our streamlined approach,” Dr. Moualla said. “Everyone on the team plays a role in ensuring patients receive the therapy that’s best for their individual situation.” Presenting during the Edwards Lifesciences TCT think tank was recognition of the Structural Heart program’s success, but it’s the individual patient experiences that inspire YRMC’s team. Heart Healing Stories Dr. Moualla recalls a patient whose health deteriorated rapidly, going from five-mile hikes and frequent tennis games to needing four liters of oxygen a day. His ECHO exam revealed a damaged heart valve that was caused by a tooth infection. The patient’s severely damaged heart valve was replaced with a prosthetic valve during a Transcatheter Aortic Valve Replacement (TAVR) at the James Family Heart Center. “A week after his TAVR, we were able to take him off of the oxygen,” Rhodes recalled. “When I see him now, he tells me about his latest golf game or tennis match or hike.” How does YRMC’s Structural Heart program team feel about the Edwards Lifesciences recognition? “We are pleased, humbled and delighted with the impact of the Structural Heart program,” Dr. Moualla said. “We all understand that everything we accomplish is due to our amazing team. And, of course, it’s inspired by our wonderful patients and their life stories.”
YRMC Launches Clinical Research Program
In our connected world, the latest information about your recent medical diagnosis is as close as a Google search. Sprinkled throughout those search results you’ll typically find information about research studies involving leading-edge treatments, new medical devices and groundbreaking therapies. “Research studies are the foundation of medicine,” said Lynn Bessette, Clinical Research Consultant, Yavapai Regional Medical Center (YRMC). “Any advancements we’ve made in medicine are due to research.” This is one reason YRMC has joined other hospitals and providers nationwide as a research study site. In fact, YRMC is the first hospital in northern Arizona to take this important step. Because the medical research world is unfamiliar to most people, below are answers to some of the questions you may have about YRMC’s current research studies and more. How will YRMC’s involvement in research studies benefit our community? In addition to contributing to the overall advancement of medical science, YRMC had an even more important reason to get involved in research. “The decision was inspired by the people of our community,” Bessette said. “YRMC physicians and medical staff are dedicated to providing the best care available to our patients. By engaging in research studies, we are inviting the newest technology to our community so that our patients can receive leading-edge therapies while they remain within the comfort and care of their families.” What kinds of research studies will be available through YRMC? YRMC will participate in research studies across all therapeutic areas, starting out with several interventional cardiology studies related to new heart therapies. Before they become widely available, new medical devices, therapies and medications – as well as new ways of using existing treatments – are the focus of extensive clinical research studies. These research studies include hospitals, providers and patient volunteers from throughout the country. “Clinical research studies compare the current standard of care with the newly developed therapy,” said Bessette. “They also answer specific questions about the new approach, such as the optimal dosage for a new medication.” How are the research studies monitored? YRMC has formed a multidisciplinary Research Committee to oversee all research activity. The committee meets monthly to review the feasibility and appropriateness of each study, as proposed by individual physicians. This ensures the studies meet the needs of our patients in every way. What specific research studies are available through YRMC? Currently, YRMC is participating in two important studies under the direction of Interventional Cardiologists Mansour Assar, MD, FACC and Robert Candipan, PhD, MD, both of the James Family Heart Center. Here’s a summary of the research studies, both of which are now enrolling volunteers: A device study that involves a carotid artery stent – a small mesh tube – that’s designed to treat cerebrovascular disease by restoring blood flow to the head and neck. Cerebrovascular disease affects the blood vessels and arteries that supply the brain. Evaluation of Treatment Strategies for Severe Calcific Coronary Arteries: Orbital Atherectomy vs. Conventional Angioplasty Technique Prior to Implantation of Drug-Eluting Stents. What kinds of volunteers are needed for these two research studies? The studies are enrolling volunteers who meet specific age, health and other requirements. Whether referred by a cardiologist, or a current YRMC PhysicianCare Cardiology patient, all potential study volunteers are clinically evaluated to ensure they meet the study criteria before joining. Research participation is always voluntary. If you, or a family member, are interested in either of these research studies, the best place to start is with your primary care physician or cardiologist. Information about the studies is also available by contacting: Lynn Bessette YRMC Clinical Research Consultant lbessette@yrmc.org Bessette, who has been part of the medical research world for nearly 20 years, is looking forward to seeing the difference these and other research studies will make in the lives of people throughout our community. “Being involved in these amazing research studies gives us a look today at what is going to make tomorrow better for everyone,” she said.
YRMC Presents: Women and Heart Disease with Dr. Soundos Moualla
Heart disease might be considered a man’s disease, but according to the American Heart Association, more than one in three women is living with some form of cardiovascular disease. Symptoms can be different for women, which can sometimes cause confusion. It’s important to recognize the symptoms and learn about treatments and preventive measures you can take. Join Dr. Soundos Moualla, Medical Director of the Structural Heart Program at the James Family Heart Center at YRMC, for an enlightening presentation about specific issues related to women and heart disease. She’ll answer questions such as: What is heart disease and how is it diagnosed? How is it different for women? What symptoms should I be aware of? Are there risk factors for heart disease? What are the best treatments? What can I do to prevent heart disease? This presentation is free of charge and will take place at the Prescott Valley Public Library, Crystal Room, 7401 E. Skoog Blvd., Prescott Valley on Thursday, February 20th from 12 noon to 1 PM. Seating is limited, so please RSVP by using the “Events” tab at yrmchealthconnect.org. If you don’t have computer access, you can call (928) 708-4636 to register. Dr. Moualla practices at YRMC PhysicianCare Cardiology, located at 811 Ainsworth Drive, Suite 106 in Prescott.
Breast Screening Guidelines: What You Need to Know
If you are confused about the conflicting advice on breast screening (mammography) guidelines, you’re not alone. Women are asking: What’s the best age to begin breast screening? How often should I have breast screening? Is there a time that I’ll no longer need breast screening? “Most physicians, including myself, the radiologists at YRMC’s BreastCare Center and the American College of Radiology, recommend annual screening mammography starting at age 40,” said Michael G. Macon, MD, Breast Surgeon and Medical Director of the BreastCare Program at Yavapai Regional Medical Center (YRMC). At what age can annual breast screenings stop? That depends on the woman, according to the experts at YRMC’s BreastCare Program. “There are many women in their mid-70s who will live 15 to 20 more years,” Dr. Macon said. “If those women are going to act on the information from the mammogram, they should continue annual breast screenings. However, different organizations have different recommendations.” A Controversial Recommendation In January 2016, the U.S. Preventive Service Task Force (USPSTF) announced dramatic changes to its breast screening guidelines. The USPSTF – an independent group of preventive and evidence-based medicine experts – recommended that breast screening begin at age 50 and end when a woman reaches age 74. The group also recommended breast screening take place every two years, as opposed to annually. The USPSTF’s recommendations are based on statistics that show more women can be saved at lesser cost when breast screening begins later in life. As women age, they are more likely to be diagnosed with breast cancer. “The USPSTF is studying millions of women and making a recommendation based on data,” said Dr. Macon. “The difference is that physicians look at one woman at a time and ask: ‘What is best for this patient?’” Members of the medical community were alarmed by the USPSTF recommendations. They pointed out that breast screening mammography beginning at age 40 has been shown to reduce deaths due to breast cancer. Additionally, while breast cancer is more common as women get older, in younger women breast cancer tends to be more aggressive. Clinicians also argued that these more aggressive cancers need to be detected when the cancer is most treatable. Breast screening annually – rather than every two years as recommended by the USPSTF – would catch cancer earlier, when cure is most likely. Online Tools Assess Your Breast Cancer Risk Breast screening recommendations are based on women at average risk for breast cancer. How can you learn your individual risk for breast cancer? You can start with an assessment tool. The Gail Model and Tyrer-Cuzick Model Breast Cancer Risk Evaluation Tool estimate the likelihood of a woman developing breast cancer within five or 10 years of her current age and during her lifetime. Take Action to Manage Your Health “It’s difficult for an organization in and of itself to make a nuanced recommendation on breast screening that works for all women,” said Dr. Macon. “Statistically, the USPSTF recommendations may make sense as a public health recommendation, but that doesn’t give a specific woman information on how she should act.”
Why Does Breast Density Matter?
You’re dedicated to your monthly self-exams and you follow your healthcare provider’s recommendations for breast cancer screenings, given your age and family risk factors. But when it come to breast density, are you aware of dense breast tissue? An important part of breast cancer prevention is knowing your breast density and taking this into account during screening. Breast density is a way to describe the composition of a woman’s breasts. It compares the area of breast and connective tissue – as seen on a mammogram – to the area of fat. Breast and connective tissue are denser than fat, so high breast density means there is more breast and connective tissue as compared to fat. On a mammogram, connective tissue appears as solid white, making it difficult to see through. And therein lies the challenge. “Breast cancer also is white on a mammogram,” said Michael Macon, MD, FACS, Breast Surgeon and Medical Director of the BreastCare Program at Yavapai Regional Medical Center (YRMC). “The whiter the background, the more difficult it is to identify breast cancer in the white background of a dense breast.” What Causes Dense Breast Tissue? Generally, women who are younger and thinner have denser breast tissue, according to Dr. Macon. As a woman ages, she may gain weight, decreasing the density. Genetics also plays a role. If your mother had dense breasts, you are more likely to as well. Additionally, breast density is more common among women taking hormone therapy to relieve the symptoms of menopause. Women with dense breasts have a higher risk – up to six times, by some estimates – of developing breast cancer. The reason is unknown. Learn Your Breast Density How can you learn your breast density? The YRMC radiologist administering your mammogram will determine the ratio of your dense to non-dense tissue. Four categories are used in the Breast Imaging Reporting and Database Systems: Fatty Replaced Breast (Category A, 0-25% dense tissue): This mammogram likely would show any abnormalities. Scattered Fibroglandular Density (Category B, 25-50% dense tissue): This breast density has quite a bit of fat, but also a few areas of fibrous and glandular tissue. This is the most common category. Heterogeneously Dense (Category C, 50-75% dense breast tissue): When areas of fibrous and glandular tissue are greater than fatty breast tissue, it can be difficult to see small masses on mammograms. Extremely Dense (Category D, 75-100% dense tissue): This increases the difficulty of detecting cancerous tissue because it can blend in with other white background tissue. What Should I Do About Breast Density? Should I Worry About Dense Breast Tissue? “If the radiologist determines you have heterogeneous density or extreme density, it is important to have a 3-D mammogram,” said Dr. Macon. “A 3-D mammogram uses new technology to create a three-dimensional picture.” To assess your risk for breast cancer, Dr. Macon recommends the Tyrer-Cuzick Model – also known as the Ibis Risk Model – which is available here. This risk assessment tool generates a 10-year risk and lifetime risk of breast cancer based on your answers to a series of questions, including one about breast density. Women with Category C or Category D breast density have an increased risk for breast cancer. “For women with a lifetime risk of breast cancer greater than 20 percent,” explained Dr. Macon, “more aggressive breast surveillance consisting of alternating 3-D mammograms and breast Magnetic Resonance Imaging (MRI) is the standard.” For screening mammography, including 3-D mammography, contact: The BreastCare Center at YRMC at (928) 442-8900 Prescott Medical Imaging at (928) 771-7577
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.
Parents and Teachers Use GoNoodle to Fuel Learning
If you’re the parent of an elementary school-aged child in the Quad Cities, chances are you’ve heard them come home from school singing Go Bananas, Little Green Froggy or Happy Llama, Sad Llama, Totally Rad Llama. It might surprise you to know that these seemingly silly songs were created by child development experts from across the country. The songs and their accompanying videos are part of a powerful suite of online learning tools called GoNoodle. Available at school and at home, GoNoodle is designed to benefits kids’ physical wellness, academic success, and social-emotional health with a wide range of offerings that appeal to different ages, interests, skills and abilities. From jump rope rhymes and rap to yoga and deep breathing, GoNoodle is a hit with the elementary school crowd. Here in the Quad Cities, teachers and parents have access to the premium version of GoNoodle, called GoNoodle Plus, free of charge, thanks to a sponsorship from Yavapai Regional Medical Center. Teachers use short GoNoodle sessions throughout the day for students to get out of their seats and jump, dance, stretch and smile. Teachers know that these sessions increase focus and help students learn. In addition, they’re using the customized features offered in GoNoodle Plus to assist with math, spelling and social studies practice, tracking usage and more. Parents use GoNoodle at home to turn screen time into valuable exercise time, often including the whole family in the fun. If you have a K-5 student in Prescott Unified, Humboldt Unified or Chino Valley Unified School Districts, you may have seen them come home with Learning Extensions, printable worksheets and activities that are paired with more than one hundred GoNoodle videos. This is another added feature of GoNoodle Plus. Whether you’re a parent or educator, you can get started by creating an account at GoNoodle.com. You’ll be asked to provide your name, choice of username and password, and whether you are a parent or teacher. Please note that you’ll have access to the GoNoodle Plus features automatically if you live in the YRMC service area. “GoNoodle Plus aligns very well with our Vision of a Total Healing Environment which is based on caring for the body, mind and spirit,” says Kenneth Boush, Director, Marketing and Communications at YRMC. “YRMC is proud to sponsor programs like GoNoodle Plus, as well as Partners for Healthy Students and the YRMC Family Resource Center that enrich the lives of children and young families in our community.” For more information on YRMC’s sponsorship of GoNoodle Plus, contact the Community Outreach Department at CommunityOutreach@yrmc.org.
Five Healthy Habits to Change Your Life in 2020
There’s nothing like starting the New Year with healthy habits that are reachable and will make a big difference in your life. Yavapai Regional Medical Center (YRMC) has selected five healthy habits to inspire you in 2020 and beyond. Healthy Habit #1: Get regular preventive screenings. Preventive screening tests can detect illness early, when it’s most treatable. The screenings you need will depend on your health history and age. Here are some recommendations to jump start a conversation with your healthcare provider: Ages 18-39 – Most of the recommended preventive screenings in this age group can be completed during an annual physical. Depending on your health history, your provider may screen for high blood pressure, elevated cholesterol levels and diabetes. For women, routine pelvic exams and pap smears screen for cervical cancer and other conditions. Don’t have a healthcare provider? Contact YRMC’s Physician Listing Service at (928) 771-5106. Ages 40-65 – Additional screenings are important for women and men 40 years and older. Mammograms, which screen for breast cancer, are recommended annually for women starting at age 40. Most men age 50 or older should have a prostate blood test and an exam. Male or female, when you reach 50, your physician will recommend a colonoscopy to screen for colorectal cancer. Age 65 and older – Bone density screenings – which measure bone strength to prevent fractures – typically begin at age 65. If you’re a postmenopausal woman, age 50 or older and have recently suffered a broken a bone, talk to your healthcare provider. Another screening schedule may be recommended for you. And men, ask your physician if you should be screened for osteoporosis, too. You could be at risk for osteoporosis if you used steroids for an extended time, are considered low body weight, smoke, use alcohol frequently, or had a fracture after age 50. Women, talk to your healthcare provider about the breast screening and bone density screening plan that fits your health history. The latest screening mammography and bone density screening technologies are available at: The BreastCare Center at YRMC at (928) 442-8900 Prescott Medical Imaging and Prescott Valley Medical Imaging at (928) 771-7577 YRMC Imaging Services at (928) 771-7577 Round out your preventive health habits in 2020 with regular dental and eye exams, as well as updated immunizations and annual flu shots. Healthy Habit #2: Eat right. Whether your goal is weight loss or weight management, moderation – not deprivation – is the key to success. Eat smaller portion sizes and fill up on vegetables, fruits, whole grains, healthy fats and lean protein. Be mindful of what you eat and stay hydrated to maintain the energy you need throughout the day as well as to manage cravings. YRMC’s Your Healthy Kitchen offers nutritious, delicious and affordable plant-based meal options if you’re looking for some inspiration. Healthy Habit #3: Commit to regular exercise. Physical activity is crucial to long-term health. Work, family obligations and lack of energy can interfere with those needed workouts. If hours at the gym are not an option, or even an interest, get creative. Try walking during your lunch break, stretching while watching TV or riding your bike to run that errand. Hold yourself accountable by exercising with a friend or tracking your progress with a smartphone app. Has it been a while since you’ve exercised? Ease into a routine. You may also want to talk to your healthcare provider. Healthy Habit #4: Manage stress and pay attention to your mental health. As life gets busier, that to-do list and social calendar can start to feel overwhelming. Taking care of your mental health is another piece of the overall health puzzle. Calming practices like meditation and deep breathing are equally as important as taking some time for yourself and talking with a friend. Identify your stressors and look for ways to reduce them. Remember, a good laugh, a brisk walk or a hot bath can go a long way to easing a difficult day. Healthy Habit #5: Catch your ZZZs. Getting enough quality sleep not only keeps you sharp for the day but it is also critical for mental, emotional and physical health. When you sleep, your brain and body have a chance to repair and rebuild. A good sleep helps you learn better, get along with others and even builds muscle. So, turn off those screens, unwind to some calming music and get some rest. You deserve it. To keep you motivated during 2020, visit and subscribe to YRMC HealthConnect. We’ll inspire you with healthy living tips, local learning opportunities and answers to your healthcare questions.
Brains, Heart, Courage: YRMC Volunteers of the Year for 2019
The quest for brains, heart and courage was a central theme in the beloved novel and film The Wizard of Oz. Had the Scarecrow, Tin Man and Cowardly Lion made Yavapai Regional Medical Center (YRMC) their first stop, their quest would have been fulfilled. Any day of the week, the YRMC volunteers display these traits and more, according to Nancy Thomes, Director of Volunteer Services at YRMC. The staff at YRMC recently honored its volunteers at the annual Volunteer Appreciation Luncheon. With nearly 400 people attending, this year’s theme was The Wizard of Oz. The festivities took place at the Prescott Resort, with YRMC staff appearing as various characters from the classic story. Thomes says the luncheon conveys only a fraction of the gratitude that YRMC and the community at large has for the volunteers at YRMC. “In 2018, our volunteers contributed 112,132 hours of service, which is a record,” says Thomes. “Every one of those moments means that someone, in some way, is served because of our volunteers. How fortunate we are.” Three volunteers in particular were honored for the ways in which they embody the mission and vision of YRMC each day they come to work. YRMC West Campus Volunteer of the Year: Joe Clyne Joe Clyne started volunteering at YRMC 13 years ago and has given more than 2,300 hours in 11 different capacities. He currently volunteers as an Escort as well as offering administrative assistance in the Payroll Department and delivering mail. Clyne saw a need for regular clean up and maintenance in the Healing Garden and took it upon himself to fill that need as well. “Volunteering at YRMC is very satisfying and gives me a real sense of purpose,” says Clyne. “Being the Volunteer of the Year is a recognition that is beyond words. There are so many deserving volunteers working at this facility.” Clyne’s knowledge and experience, positivity and willingness to jump in wherever he’s needed makes him the YRMC West Campus Volunteer of the Year for 2019. YRMC East Campus Volunteer of the Year: Andrea Bell Andrea Bell joined the YRMC Volunteer community in July of 2011, when the BreastCare Center at YRMC East opened its doors. Since then, she has donated more than 1600 hours of her time to the program. Bell served as the Department Chair for a period of time and has even helped train new volunteers when the Chair position was vacant. Members of the staff consider Bell’s compassionate support for both patients and staff one of the reasons why the BreastCare Center volunteer program is such a success. However, Bell’s unassuming nature deflects the high praise. “I used to say ‘I’m just a volunteer’ and boy would they put me in my place! I don’t say that anymore!” says Bell. On a more serious note, Bell expresses her gratitude for the opportunity. “I always feel so thankful that I’m able to give my time to volunteering at YRMC,” Bell says. “Volunteering is an uplifting and positive part of my life. It’s a gift to me!” Bell was recognized at the luncheon as the YRMC East Campus Volunteer of the Year for 2019. YRMC Sandy Zinn Martin Award: Rick Smith Sandy Zinn Martin was a long-time YRMC volunteer who was known as the ‘little lady with the big personality.’ Her dedication and giving nature was known throughout the hospital. The Sandy Zinn-Martin Award was created in her memory to honor her spirit of generosity. It is given each year to a volunteer who embodies the ‘above and beyond’ attitude that Sandy exemplified. Rick Smith is an East Campus Escort on Thursday afternoons and works as a substitute Courtesy Cart driver or Shredder when needed. He has volunteered at YRMC for more than two years and has clocked more than 550 volunteer hours. But Smith’s dedication to YRMC and its volunteers extends far beyond this job description. Smith is considered a friend to all. In his off-duty hours, has been known to visit fellow volunteers in the hospital, rehabilitation facilities and even in their homes. His optimism and sense of humor makes everyone smile, even when sick or convalescing. Smith takes the accolades in stride. “I am surprised and humbled. It is very nice to be acknowledged,” he says. “I consider these hard working and dedicated people to be my friends and I’m lucky to get to spend time with them.“ “I have been very lucky in my own life,” Smith reflects. “It so nice to do a little bit for folks who are maybe not having the best of luck. You definitely get back more than you put in.” Smith’s generosity of spirit has earned him the YRMC Sandy Zinn-Martin Award for 2019. In The Wizard of Oz, the Tin Man wisely said, “You people with hearts have something to guide you.” Thomes says that the Tin Man must have known something about volunteerism. “Without generous hearts, there would be no volunteering,” she says. “I work with what I consider the best of the best. These are individuals who want to give of their time, the most valuable resource that anyone can give.” Thomes continues, “I feel a little skewed about humanity because I work with the kind of people who say yes to whatever we ask of them. I think volunteering is the best thing a person can do.”
YRMC Volunteer Spotlight: John Peters and Richard McBride
If you’ve spent any time at Yavapai Regional Medical Center, you’ve probably heard the sound of a hand bell throughout the halls twice a day. The bell heralds the arrival of the snack cart, and the ringer is a member of the snack cart volunteer team, serving hot coffee, juices, fruit, yogurt and other goodies to visitors and staff at the hospital. Watch Volunteer Spotlight: John Peters and Richard McBride on YouTube On any given morning, you might be served by YRMC volunteers John Peters and Richard McBride. The duo often resembles a comedy team more than hospital volunteers. Employees and visitors who purchase snacks from the cart can’t help but join in the banter and good-natured teasing. But don’t let the lightheartedness fool you. They take their job very seriously. “A big philosophy we have is that we go the extra mile,” says Peters, “Let’s say that you have a nurse caring for a patient in one of the rooms in ICU. I know one nurse in particular who always wants a bag of cheddar popcorn and a string cheese. I’ll get her badge from her, ring it up and take it back there to her station.” Peters and McBride are particularly proud of their dedication. “Our record for uninterrupted service is 79 weeks without missing a day,” says Peters. A snowstorm prevented the volunteers from coming in on the 80th day. When asked why this dedication is so important, Peters responds, ”I really can’t explain it. I’m sure it’s this way for all the other volunteers. It’s just a sense of good feeling that you’re providing a service.” Peters describes the camaraderie and friendship as an added bonus to volunteering at YRMC, including getting to know the staff and fellow volunteers, learning about their families, grandchildren and travels. As McBride picks up the hand bell and starts down the hall to ring their arrival, Peters sums it up this way, “Volunteering is a wonderful experience. Period. It’s the only way to explain it.” The YRMC Volunteer Services Department welcomes inquiries about volunteering for the snack cart as well as a wide variety of other volunteer opportunities. For more information, call: Volunteer Services, YRMC West, Prescott: (928) 771-5678 Volunteer Services, YRMC East, Prescott Valley: (928) 442-8678
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.
10 Facts We Learned at YRMC’s Patient Blood Management Symposium
Science and history intersected during Patient Blood Management: Yesterday, Today and Tomorrow, Yavapai Regional Medical Center’s (YRMC’s) 6th Annual Patient Blood Management (PBM) Symposium. Approximately 350 people – PBM advocates from across the southwest, physicians, nurses, college students and more – gathered for the 2018 PBM Symposium at Yavapai College Performing Arts Center in Prescott. Throughout the world, even more streamed the Symposium live on laptops, smart phones and other devices. “It was the best of both worlds,” said Dale Black, Patient Blood Management Program Coordinator at YRMC. “Our guests enjoyed a pre-Symposium reception that included an array of appetizers, lots of friendly conversation and information from our industry partners who support YRMC’s vision for Patient Blood Management.” Industry leaders who joined YRMC at the PBM Symposium include: Instrumentation Laboratory Daiichi Sankyo, Inc. Haemonetics Baxter “During the Symposium,” said Black, “we welcomed guests from throughout the globe who live-streamed the event. All Symposium participants took away new information about the value of PBM and the leadership role YRMC plays in PBM.” If you missed the Symposium, we’ve collected some highlights to get you up to speed on PBM’s science, history and future. #1 Patient Blood Management wasn’t built in a day. The 6th Annual PBM Symposium coincided with YRMC’s 75th anniversary, a perfect opportunity to highlight the history of PBM, courtesy of Pierre Tibi, MD, FACS, Cardiothoracic Surgeon and Medical Director of the James Family Heart Center at YRMC West. Dr. Tibi said the idea of transfusing blood goes back to 1556, but the first actual human-to-human “blood transfer” happened in 1818. Fast forward to the early 1900s for another milestone: the identification of human blood types—A, B, AB and O. Soon after, a test that allowed physicians to ensure blood compatibility before transfusing patients was introduced. Another big breakthrough coincided with World War II as researchers discovered how to break down blood into components and products. Plasma – a blood product – saved the lives of many wounded soldiers during the war. #2 Blood is one tough tissue. Daniel Beck, MD, Anesthesiologist at Prescott Anesthesia, emphasized that blood – a connective tissue – actually functions like a complex, multifaceted organ. Comprised of water, electrolytes, small molecules, proteins and cells, blood performs many significant roles in the body. For example, Dr. Beck highlighted the important job performed by one of our two types of white blood cells. “These white blood cells repair all types of tissue damage,” said Dr. Beck. “The repairs range from paper cuts to broken bones and all of the way to heart attacks.” #3 When it comes to the safety of our blood supply the expression, “we don’t know, what we don’t know,” applies. Medical experts in the United States agree that our blood supply is the safest it has ever been when it comes to disease transmission. “The concern is always about unknown infectious diseases,” said Elizabeth Black, Data Manager and Administrative Assistant, YRMC’s PBM Program. “Current blood testing measures are only going to test for infectious diseases we know about. You can’t test for something if you don’t know it exists.” #4 Storing your own blood for surgery comes with some potential complications. Storing your blood for use during and after surgery sounds like an ideal way to prevent the transfusion of a virus. However, autologous blood donation – as it’s called – may lead to anemia, which can slow recovery. “Even your own blood is stored blood,” said Elizabeth Black. “It is not the same quality as the fresh blood moving through our bodies or the blood that’s taken immediately before surgery.” #5 Physicians and PBM experts know: If you don’t use it, you won’t lose it. YRMC’s thriving Structural Heart Program demonstrates how medicine is integrating PBM into its less invasive procedures. Soundos Moualla, MD, FACC, FSCAI, Interventional Cardiologist at the James Family Heart Center at YRMC West, uses less-invasive procedures and advanced technologies to help people previously considered too high-risk for surgery. These procedures require small skin punctures, rather than major incisions. “These new technologies allow us to safely perform minimally invasive procedures,” said Dr. Moualla. “The procedures do not require blood use and typically there is no blood loss.” #6 New procedures at YRMC’s Heart Center support PBM principles. In the 1980s, cardiology took its first steps in this direction with the introduction of cardiac stenting, which allowed some patients to forego open heart surgery. Today, many heart procedures are minimally invasive, including these which are available at the James Family Heart Center at YRMC West. Left Atrial Appendage Closure (WATCHMAN) Mitral Valve Repair with MitraClip Paravalvular Leak Closure (PVL) Transcatheter Aortic Valve Replacement (TAVR) #7 Your YRMC providers are your PBM partners. PBM is at its best when there is strong communication between nurses, patients, family members and other patient advocates. This is standard operating procedure at YRMC. “We’ll literally report at your bedside to involve you and your family,” said YRMC’s Selina Bliss, MS, PhD, RN. “This allows us to clearly communicate a care plan for your anemia.” YRMC’s multi-disciplinary team – advanced clinical practitioners, dietitians, medical laboratory professionals, nurses, pharmacists, physical therapists, physicians and more – also share their best practices for preventing patient anemia during “Lunch and Learn” programs. Recently, YRMC’s Emergency Department team outlined how early admission of a medication to treat excessive blood loss has helped patients experiencing traumatic bleeding. The ICU staff shared a successful strategy to monitor hemoglobin counts – a low count may indicate anemia – as a way of reducing the frequency of patient blood draws, which can lead to anemia. #8 Researchers are applying leading-edge science to the study of blood. Creating a blood substitute…developing a universal blood type…transforming human stem cells into units of blood…all of these and more are under research today. “Scientists are looking for the optimal artificial human blood that can carry oxygen to our tissues without any of the biological baggage associated with a unit of blood,” explained Jared Head, AGACNP-BC, Hospitalist, NAZ Hospitalist. #9 PBM’s future is now. During the PBM Symposium, Dale Black, PBM Program Coordinator, spoke with Tucson resident Anthony Caballero about the extensive heart procedures he underwent at YRMC’s Heart Center, all using PBM principles. Even as researchers race toward an array of alternatives to blood transfusions, most medical experts point to PBM as the most effective way to safely care for patients. “What we are doing now may well be the future,” stated Head. “Keeping blood inside of the body and minimizing the number of blood draws to harness anemia—these and other PBM strategies may be the future of transfusion medicine.” #10 PBM is making a difference at YRMC today. YRMC has experienced an impressive reduction in the use of blood products, thanks to its hospital-wide PBM Program. “YRMC launched its PBM Program in 2012,” said Diane Drexler, RN, BSN, MBA, FACHE, Chief Nursing Officer at YRMC. “Since then, our use of red blood cells and fresh frozen plasma has declined by 32 percent and 61 percent, respectively.” Why is this decline good news for YRMC’s patients? It means YRMC’s surgeons and other physicians are minimizing patients’ blood loss and reducing unnecessary transfusions. And, as studies have shown, both of these PBM strategies can improve patient outcomes and speed recovery. For more information about YRMC’s Patient Blood Management Program, visit us here.
Women and Lung Cancer: Should You Get Screened?
It’s probably no coincidence that National Women’s Lung Health Week (May 12-18, 2019) kicks off on Mother’s Day. According to the American Lung Association, over the past 41 years the rate of women being diagnosed with the disease has increased by 87 percent. Women or men who smoke are at most risk for developing lung cancer, but people who have never smoked also can be diagnosed with lung cancer. The risk of lung cancer increases with the length of time and number of cigarettes smoked. If you quit smoking – even after many years of smoking – you can significantly reduce your chances of developing lung cancer. During National Women’s Lung Health Week, Yavapai Regional Medical Center (YRMC) is highlighting low-dose computed tomography (LDCT). Heavy, long-term smokers, current smokers, or people with a family history of lung cancer have lung cancer screening with low-dose computed tomography (LDCT) available at: Prescott Medical Imaging (PMI) Prescott Valley Medical Imaging (PVMI) YRMC East in Prescott Valley Why Lung Cancer Screening is Important Lung cancer often has no symptoms. Because of this, it can spread outside of the lungs before it is detected. By then, the cancer may be advanced which can affect treatment outcomes for the patient. “It’s very important to get screened even if you don’t have symptoms,” said Mary Sterling, Director of Imaging Services for YRMC. “The benefit of early detection is finding a cancer before it has a chance to spread. The earlier cancer is detected, the more likely it is treatable.” Should You be Screened for Lung Cancer? LDCT is part of YRMC’s Lung Cancer Screening and Care Program. To be eligible for the Medicare-sponsored screening you must be: Between the ages of 55-77 Free of cancer symptoms Either currently smoking or a past smoker who quit 15 years ago or less A heavy smoker averaging one pack per day for 30 years or two packs per day for 15 years People are encouraged to talk with their primary care providers to determine if they are eligible for the screening program. “The patient and healthcare provider will have a discussion about the patient’s smoking history and find out if they have any symptoms,” Sterling said. “They’ll also talk about smoking cessation if the patient is still smoking.” A Team Approach YRMC’s Lung Cancer Screening and Care Program uses a team approach that draws on the skills of primary care providers, pulmonologists, procedural pulmonologists, radiologists and a cardiothoracic surgeon. The program also includes a patient navigator whose job is to serve as a patient contact. This professional answers questions about program eligibility and directs patients to the appropriate provider if specific care is required. The patient navigator also can help people determine if their current insurance plan covers the screening or assist people who would like to undergo the exam using the self-pay option YRMC offers. A Prevention Plan “The program is not a one-time screening test,” said Sterling. “Annual follow-up screening is recommended for patients whose initial screenings do not show signs of lung cancer.” If a patient’s LDCT findings show signs of lung cancer, a follow-up scan will be scheduled. A biopsy may also be recommended, in which case the patient would be referred to a procedural pulmonologist or a radiologist, depending on the location of the lung nodule. Should the patient need surgery, the Lung Cancer Screening and Care Program team also includes a cardiothoracic surgeon. Jennifer Harvey, RN, BSN, YRMC’s Lung Cancer Screening and Care Program Patient Navigator encourages people to support lung health year-round and during National Women’s Lung Health Week. Learn More About LDCT For more information about LDCT, please contact your primary care provider or the Lung Cancer Screening and Care Program Patient Navigator at (928) 771-5454. Need help giving up smoking? Contact the ASHLine, Arizona Smokers’ Helpline (1-800-556-6222), for free assistance. Help spread the word about lung cancer screening by sharing this YRMC HealthConnect article with your social media friends.
Prescott Medical Imaging: New Technology to Detect Bone Loss Disease
Dual-energy x-ray absorptiometry (DXA) – gold standard technology for measuring bone mass and diagnosing osteoporosis – is now available at Prescott Medical Imaging (PMI) in Prescott. With the introduction of DXA to PMI, the service is now accessible to people throughout the community. DXA is also available at the BreastCare Center at YRMC East. How does DXA work? During a DXA exam, the patient lies flat on a comfortable, padded table. An x-ray generator is located below the patient and an imaging device, or detector, is positioned above. The detector passes over the patient, generating images on a computer monitor. “DXA is quick, painless and uses very little radiation,” said Michael J. Locke, BBA, BBM, CRA, Outpatient Imaging Operations Manager at PMI and Prescott Valley Medical Imaging (PVMI). “The exam lasts approximately 10 minutes. After the exam, one of our experienced PMI radiologists interprets the DXA and shares the results with the patient’s physician.” Osteoporosis – which causes bones to weaken and easily break – is a “silent disease.” Some people don’t realize they have experienced dangerous bone loss until they suffer a fracture. “DXA is an extremely important preventive and diagnostic tool,” said Mary Sterling, Director of Imaging Services at Yavapai Regional Medical Center (YRMC). “The information DXA provides helps patients and their physicians develop a plan that can prevent fractures due to osteoporosis.” Who should undergo DXA? Talk to your physician about your risk for osteoporosis and the possibility of undergoing DXA. In general, risk factors for osteoporosis include: Being over age 50 and female (men typically begin to experience bone loss after age 70) Menopause, particularly early-onset menopause A family history of osteoporosis Being small and thin Broken bones or height loss For more information about DXA and other imaging services, contact: Prescott Medical Imaging 810 Whipple Street Prescott, Arizona (928) 771-7577 The BreastCare Center at YRMC East 7700 East Florentine Road Prescott Valley, Arizona (928) 442-8900
Super Bowl Sunday’s Heart-Healthier Loaded Nachos
February is all about things related to the heart… and football! In fact, February was named National Heart Month in 1963, and it’s been Super Bowl Sunday month since 2004. This creates a puzzling question: For those of us who are trying to eat heart-healthier, what should we serve on game day? Rita has the answer! In this segment, our host, Registered Dietician and Certified Diabetes Educator Rita Carey Rubin, prepares for Super Bowl LIV by tackling (pun intended!) her Heart Healthier Loaded Nachos with Zesty Cilantro Sauce recipe. She demonstrates layer-by-layer what goes into this fresh, delicious, crowd-pleasing snack. It’s all about choosing (or making!) the best chips, piling on fresh veggies and beans, and adding a little high-quality cheese. Top it off with Rita’s special blend of phytochemical-packed sauces and you’re ready for kickoff. Rita even makes shopping suggestions for the tastiest chips and cheeses, including vegan options! This is one of the few things that 49ers and Chiefs fans can agree on: These nachos are easy to make, and delicious! So download the recipe, make a big platter of these hearty nachos, sit back, and enjoy the game! Click here to download Rita’s Heart Healthier Loaded Nachos with Zesty Cilantro Sauce recipe. Your Healthy Kitchen is one of the many ways that Yavapai Regional Medical Center brings health and wellness education to our community. For more videos, downloadable recipes and insider tips, visit our blog at yrmchealthconnect.org. You can also see what’s happening in Rita’s kitchen by following her on Facebook at YRMC’s Your Healthy Kitchen.
Eat Well in 2020 with YRMC’s Your Healthy Kitchen!
Are you ready to shake up your diet, savor simple, flavorful meals, meet some neighbors, and learn a whole lot about healthy eating along the way? You can start right here at YRMC HealthConnect, where we’ve been stocking the library at YRMC’s Your Healthy Kitchen with dozens of stories packed with easy, delicious recipes, cooking tutorials, reliable nutrition information, interviews with local chefs, farmers, kids, teachers, doctors, gardeners, and more! As the host of YRMC’s Your Healthy Kitchen, I rely on my experience as a Registered Dietician, Certified Diabetes Educator, and Personal Chef, as well as my lifelong love of good food to create flavorful meals, snacks, beverages and even desserts that nourish and satisfy. With a focus on incorporating fresh, affordable ingredients, I take you step by step through each recipe, sharing helpful cooking and nutrition tips along the way, including this easy way to dice an onion! In the Your Healthy Kitchen catalog, you’ll find recipes suitable for anyone looking for healthy meal ideas, plus extra tips for eating well with diabetes, cardiovascular disease, and cancer. Want to learn how to prepare and enjoy more vegetables, whole grains, fresh herbs and greens? We’ve got you covered with videos featuring vibrant flavors, fresh, colorful produce, and nourishing grains, including barley, oats, quinoa, and more. Printable recipes with nutrition information and an estimated cost per serving, like this one for our popular Mediterranean Grilled Vegetable and Barley Salad, are posted at YRMC HealthConnect with every video. Check out the video that shows how to make this flavorful, nutrient-packed crowd pleaser and learn about the benefits of barley as well! Guests from YRMC and the community join us frequently on the set and in the field, bringing delicious local flavors and bright, talented people into the kitchen. Want to learn more about the Breast Care Center at YRMC, Preventive Medicine and Wellness at the Pendleton Centers, or the James Family Heart Center? Check out our videos featuring the fabulous folks who work with and lead these programs! We also have great footage featuring local farmers, gardeners, and chefs, including this fun episode with Sharla Mortimer and me preparing a delicious meal at Mortimer Farms. To view more of our videos, interviews, articles and recipes, simply go to YRMC HealthConnect, scroll down the page and click on the Your Healthy Kitchen blog. You can also access additional videos, including short interviews with farmer friends, all of our episodes on AZTV’s local morning variety show, and even footage of the amazing human-powered smoothie machine on the Yavapai Regional Medical Center You Tube Channel. You can also follow me on Facebook, at YRMC’s Your Healthy Kitchen, where I share what I am making in my kitchen at home, plus links to other helpful recipe sites and videos, gardening tips, food and nutrition related events in the community and more. Whether you are just learning to cook and changing your diet or are already comfortable in the kitchen, there’s something here for everyone. Hope to see you soon! Taco Time at Mortimer Farms