YRMC West
1003 Willow Creek Road
Prescott, Arizona 86301
(928) 445-2700
YRMC East
7700 East Florentine Road
Prescott Valley, Arizona 86314
(928) 445-2700
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Latest Articles

Let’s Celebrate YRMC’s Advanced Practice Providers!
If you’re like many Americans, your health care is provided by a combination of physicians and advanced practice providers (APPs). These professionals—nurse practitioners (NPs) and physician assistants (PAs)—are important members of the health care team at Dignity Health Yavapai Regional Medical Center (YRMC) and Dignity Health Yavapai Regional Medical Group (YRMG). Advanced practice providers Gaby Herrera, MSN, FNP-BC, YRMG Pediatrics; Karlene Olson, FNP-BC, YRMG Cardiology; and Jerry Baldwin, PA-C, YRMG Family and Internal Medicine. During National Advanced Practice Provider Week, September 25-29, YRMC is recognizing the APPs who care for patients throughout our organization’s health care network. We’re also looking at the essential role these professionals play in today’s health care delivery system. Three of those advanced practice providers—all who care for patients in YRMC’s community-based, provider clinics—are pictured here. “Nationally, there are not enough physicians,” says Herrera. “APPs bridge that gap, increase access to care, and decrease the amount of time people wait to see their providers. They work with physicians and other providers to make health care possible.” What role do APPs play in health care? APPs have been part of the health care delivery system since the 1960s. The physician shortage and an aging population more in need of health care services have increased demand for APPs in recent years. The Bureau of Labor Statistics predicts that trend will continue from 2022-32 with job growth for NPs and PAs soaring 38 percent and 27 percent, respectively. “There are differences in how APPs work,” Herrera explains. “Nurse practitioners have their own license and can care for patients independently while physician assistants work directly with a physician, often in surgery. What all APPs have in common is that we collaborate with physicians and other health care providers to ensure our patients receive the best health care possible.” PAs are licensed clinicians who practice in nearly every medical specialty. They work alongside physicians and, depending on the specialty, may provide primary care, assist surgeons in the operating room, and help care for patients following surgery. Like PAs, nurse practitioners provide a wide range of health care services, including: Obtaining patient histories and performing physical exams Diagnosing and managing acute and chronic conditions Ordering tests and interpreting results Developing and implementing treatment plans Prescribing medications Performing minor procedures APPs: Providers of Patient-Centered Care APPs are known for their patient-centered approach to care. They spend time with patients, listen to their concerns, answer questions, and provide education. This approach creates a strong patient-provider relationship and makes patients more likely to follow through on treatment plans. “What I enjoy most about being an APP is helping people regain their health,” says Herrera, who has cared for both adult and pediatric patients. “It’s very gratifying when a patient tells me, ‘I feel a lot better now that my blood pressure is controlled or my ear infection is gone.’” For more information about YRMC and its providers, visit DignityHealth.org/YRMC.

What you should know about your child’s eyes
Keeping a close watch on your children’s eye health is important to catching problems early. Especially when you consider that one of four school-age children has a vision disorder, according to the American Optometric Association. “This underscores the importance of monitoring your child’s eyes,” says Amy Negovan, RN, CPNP, Program Director, Partners for Healthy Students (PHS), Dignity Health Yavapai Regional Medical Center (YRMC). “Screening is an essential part of this because children may not realize when their vision isn’t normal.” August is Children’s Eye Health and Safety Month, a good time to focus on screenings and how to care for your child’s eyes at different stages. Newborn A physician or other trained health care professional will examine your newborn’s eyes to check their eye health. Babies can be born with cataracts, blocked tear ducts, and other problems that affect their health. Premature or low birthweight babies are considered high risk for vision loss. These children will need additional monitoring as they grow. Newborns with a family history of childhood eye disease should also be closely watched. Toddlers and young children “It’s important that all children undergo both vision screenings and eye exams as they’re growing and changing,” Negovan says. “A vision screening can provide early detection of nearsightedness or farsightedness. An eye exam is a detailed check of the child’s eyes and eye health.” PHS health care providers conduct vision screenings and eye exams for children of all ages. For vision screening, they use distant and near charts. Children who are too young – or unable to respond to the charts – are screened by special computerized equipment that measures their vision and other abnormalities, such as strabismus. A comprehensive eye exam is recommended for children between 12- and 36-months old. These exams include a “photo screening” to ensure eyes are developing correctly. Two of the most common childhood eye conditions are: Amblyopia – Also known as “lazy eye,” treatment for this may include an eye patch, eye drops, or eyeglasses. Strabismus – Often called “crossed eyes,” this condition may be treated with special eyewear or an eye patch. Severe cases of strabismus may require surgery. During eye exams, PHS pediatric nurse practitioners also examine the back of the eye – retina, optic disc, and blood vessels – using an ophthalmoscope. These exams can identify a variety of abnormalities that call for further examination by an ophthalmologist. 5 years and older Beginning at age 5, experts recommend annual vision screenings for children. That’s good timing since children often become farsighted or nearsighted between the ages of 6 and 12. While farsightedness often improves with age, being nearsighted typically worsens. Eyeglasses or contact lenses can correct blurry vision due to either condition. How can parents tell if their child has a vision problem? Headaches, tired or sore eyes, squinting to see clearly for nearsightedness, or trouble seeing things up close for farsightedness, may signal vision problems. Less obvious indications include quickly losing interest in activities that require eye use or easily losing their place when reading. At all ages: Eye health, screen time, and sports Lots of screen time may lead to nearsightedness and eye strain, according to recent studies. Even before remote classes, 83 percent of children spent nearly three hours a day on a digital device. To combat vision problems and eye strain, teach your child the 20-20-20 rule: look up from the screen every 20 minutes and focus at least 20 feet away for 20 seconds. Being an active kid can lead to eye injuries. Basketball, baseball, and softball are among the sports most often linked to eye injuries. Because of this, the American Academy of Pediatrics and the American Academy of Ophthalmology recommend protective eyewear for young people who participate in sports or other activities with a risk of eye injury. “Good vision is key to a child’s physical development, success in school, and overall wellbeing,” says Negovan. “Fortunately, screening and prevention strategies can identify issues early and give children the best outcomes possible.” Learn more PHS provides primary health care services to Quad Cities families at school-based clinics and a mobile health clinic. The program helps bridge the gap for uninsured or underinsured families, and those with AHCCCS or KidsCare. For more information, visit PHS or call (928) 771-5662 to schedule an appointment.

Do you know how to nourish your nervous system?
Like all body tissues, your nerves need the right nutrition to be healthy. Tune into this episode of Dignity Health Yavapai Regional Medical Center’s Your Healthy Kitchen to learn about the essential nutrients and foods that work together to keep your nervous system humming along for a lifetime. Reducing inflammation Research shows that chronic inflammation can damage nerves, leading to an increased risk of nervous system disorders, including Parkinson’s, ALS, Alzheimer’s disease, and stroke. But here’s the good news: you can significantly reduce the inflammation in your body every time you eat. In general, highly processed foods that contain added sugars, unhealthy fats, and little to no nutrients, tend to trigger the release of inflammatory chemicals throughout the body. On the other hand, whole foods – darkly colored vegetables and fruits, fresh herbs, nuts, spices, and some fish – contain powerful nutrients that fight inflammation. Here are some of the herbs, spices, and more with excellent anti-inflammatory qualities: Turmeric Ginger Garlic Rosemary Healthy omega-3 fats Flaxseed Walnuts Fatty fish Sea vegetables Berries Dark purple, red, orange, and green vegetables Green and black tea Essential nutrients In addition to eating meals packed with anti-inflammatory chemicals, it is important to consume essential nutrients for a healthy nervous system. For example, omega-3 fats, including those found in cold water fish, walnuts, and flax seeds support nerve cell communication and regeneration. B vitamins are essential to producing energy and manufacturing neurotransmitters—the chemicals that transmit information from one nerve cell to the next. Vitamin E helps to protect nerve cells from damage and studies suggest that vitamin D-3 may aid repair and growth. More research is needed better understand the role vitamins, minerals, and other nutrients play in our nerve health. However, it’s clear that meals containing a variety of colorful plants, healthy fats, and whole, less processed foods, will help keep you and your nervous system healthy.

Food that puts you in a mood (a good one)
In so many ways, food affects how we feel—from that sense of satisfaction after a good meal with friends to the positive vibes we get from eating nourishing food. This episode of Dignity Health YRMC’s Your Healthy Kitchen explores how food changes our mood. We also prepare a delicious meal that we hope will make you smile. The type and quality of fat in food significantly affects brain health and mood. Specifically, research shows that diets low in omega-3 fatty acids are associated with an increased risk of memory loss, anxiety, and even depression. Omega-3 fatty acids are some of the most important nutrients for nerve and brain health. These essential fats cannot be made in the body and must be taken in from food. They work to keep brain and nerve cells healthy, allowing neurotransmitters to easily pass through the nervous system. Neurotransmitters are the chemicals that relay information throughout your brain and nervous system and help determine mood and memory. Marine plants and fatty fish are the best sources of these healthy fats. These include: salmon mackerel sardines tuna anchovies herring trout seaweed If you are a vegetarian or avoid fish for other reasons, some land-based foods contain omega-3 fatty acids, though typically in lower amounts and in a form that can be less effective in the body. Some of these sources are: flaxseed chia walnuts cashews organic tofu and tempeh pumpkin seeds organic canola oil Brussel sprouts spinach broccoli basil The U.S. Food and Drug Administration advises consuming no more than 3 grams of EPA and DHA omega-3 fatty acids per day from foods and dietary supplements, unless prescribed by a health care provider. A word of caution: there is a risk of increased bleeding possible when people who take anti-platelet agents or anticoagulants also take high doses of omega-3 fatty acids. Be sure to tell your health care provider about these and any supplements you’re taking.

YRMC supports local health and wellness initiatives
Dignity Health Yavapai Regional Medical Center (YRMC) has awarded grants totaling nearly $320,000 to five Quad Cities organizations. The grants were announced June 15 during an event at YRMC’s Outpatient Services Building West in Prescott. “These grants will positively impact people throughout our community,” says Anthony Torres, MD, FACP, President and CEO, Dignity Health YRMC. “Seniors struggling with chronic illness, adults with disabilities, veterans who have served our country, working families with children, and many more will benefit thanks to YRMC’s Community Grant Program and these community organizations. This is the positive result of local organizations coming together with the shared goal of caring for the community.” The programs selected for the grants address behavioral health, chronic disease, and housing/homelessness—all important community health needs identified by YRMC. The grant recipients and their programs include: Care Management/Adult Day Health Services program, sponsored by The Susan J. Rheem Adult Day Center This YRMC-Susan J. Rheem Adult Day Center partnership ensures a successful transition from hospital to home for chronically ill individuals. The program will provide at-home medical monitoring and care-management services. Transportation and Support Services Project, sponsored by People Who Care Adults with vision loss, low vision, or physical disabilities will receive transportation services and home-safety inspections as part of this People Who Care project. Additionally, the project promotes independent living, encourages healthy living choices, and increases the health knowledge of participants. Economic Revitalization Project, sponsored by the Prescott Chamber of Commerce Foundation The Economic Revitalization Project is a multi-year initiative to improve Yavapai County’s economy and address important social needs. Led by the Prescott Chamber of Commerce Foundation, the effort begins with data collection and community input to better understand the county’s challenges and opportunities. This will be followed by the creation and implementation of a county-wide revitalization plan. Veterans Integrated Care, sponsored by U.S. VETS – Prescott Veterans 58 years and older will receive case management services, counseling, coordinated wellness activities, housing, career development assistance, and meals through Veterans Integrated Care. The program is located at the U.S. VETS Liberty Pointe campus in Prescott, which features a medical clinic with primary care services, palliative medicine, assisted living, and hospice care. Prescott Valley Afterschool Childcare, sponsored by The James Family Prescott YMCA Working families will have access to safe, affordable, and high-quality afterschool care for their children through Prescott Valley Afterschool Childcare. The program – sponsored by the Prescott YMCA – will be located in Prescott Valley and serve families with children in kindergarten through 6th grade. “YRMC is proud to partner with these organizations,” says Dr. Torres. “Like our organization, these community grant recipients are dedicated to improving the health and wellbeing of Yavapai County.” To learn more about YRMC, visit DignityHealth.org/YRMC.

Preparing for recovery before surgery: A new approach to healing
If you’ve had surgery, you know how important rehabilitation is to recovery. Working with a physical therapist, occupational therapist, and other rehabilitation specialists helps you regain your strength and returns you to your normal activities faster. Traditionally, rehabilitation begins after surgery. The team at Dignity Health Yavapai Regional Medical Center (YRMC) is part of a movement by leading health care organizations to introduce what could be named “prehabilitation.” Enhanced Recovery After Surgery (ERAS®), as it’s actually called, is designed to get you ready for your post-surgery recovery program before you even see the inside of a surgical suite. “ERAS is a way to help people prepare physically and mentally for their postoperative course,” says Pierre Tibi, MD, FACS, Director, the James Family Heart Center at Dignity Health YRMC and a cardiothoracic surgeon. “It’s a partnership that involves patients and every YRMC team member who comes in contact with them as part of their surgery.” That multi-disciplinary team – physicians, nurses, dietitians, pharmacists, rehabilitation specialists, and more – puts into action ERAS protocols that are scientifically proven to curb complications, reduce hospital stays, and accelerate recovery. Education and communication are threads that connect ERAS protocols at every phase. “Patients are at the center of ERAS,” Dr. Tibi says. “They are provided complete information about what to expect during their surgical journey. This empowers people to take an active role in their recovery.” Why is YRMC implementing ERAS? The answer is related to metrics and mission. Data from numerous large studies show ERAS programs: Reduce complications by 50 percent Shorten hospital stays by 30 to 50 percent Improve patient satisfaction “Beyond the data, ERAS demonstrates YRMC’s commitment to ensuring patients have the best experience we can give them during a stressful time,” says Kenneth O’Beirne, MD, a YRMC-affiliated anesthesiologist. “We’re applying the top medical science available and evidence-based practices to improve their care. To me, that shows we take our role as health care providers very seriously.” The ERAS journey ERAS begins as patients are contemplating surgery and continues through recovery. The protocols – developed by the non-profit ERAS Society – focus on improving the delivery of health care for surgical patients throughout the care cycle. This includes a surgery-specific roadmap that covers many phases, all of which involve patients in their recovery. Operation get ready for surgery Before surgery, YRMC clinicians help patients prepare using ERAS strategies that improve nutrition and physical fitness. They also share information on what patients can expect at every phase of their specific operation. “The more patients understand about their surgery, the more they can participate in their healing,” says Olivia Marsh, RN, Nurse Manager, Pre-Admission Testing, Pre-Op, and Post-Anesthesia Care Unit. “During the pre-operative phase of ERAS, we speak to patients about their expectations after surgery. We also discuss pain, which is part of the healing process.” For example, YRMC nurses coach patients undergoing knee replacement surgery to prepare by walking five times a day, even if it’s making loops around their living room. Studies confirm that being active prior to surgery reduces pain following the operation. In addition to engaging in exercise, patients receive information and tools to, for example: Eat a healthy balanced diet Stop smoking or consuming alcohol/drugs Manage blood sugar levels What happens during surgery helps with recovery The surgeon and anesthesiologist collaborate during surgery to reduce the physical stress of the operation on the patient. Fluid management is a good example of ERAS protocols at work in the operating room. Typically, patients receive fluids during surgery to manage their blood pressure. The problem is too much fluid can lead to excessive water weight, which can delay recovery. ERAS protocols call for careful fluid management. During surgery, anesthesiologists combine different types of medications as part of the ERAS protocol. Anesthetic drugs, nerve blocks, and anesthesia that targets specific parts of the body may replace conventional anesthesia. Let the healing continue After surgery, patients are encouraged to both eat and walk sooner. Research shows that the quicker food is re-introduced, the less need there is for intravenous medications and fluids. Additionally, walking reduces muscle loss, improves the respiratory function, and lowers the risk for pneumonia. “Patients also get a psychological boost when they’re up and moving following surgery,” Dr. O’Beirne says. “They think, ‘I can do this.’” Opioids are not part of the ERAS pain management protocol. Instead, combinations of acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), injections of local anesthetics at the incision, and peripheral nerve blocks help ease pain. A patient-provider partnership How has the patient-provider dynamic evolved thanks to ERAS? “Safe and successful surgeries have always been the goal of our team,” Marsh says. “What’s changed is that ERAS challenges us to look at every aspect of the surgical journey from our patients’ perspective. That’s driving us to adopt strategies that involve patients as our partners in new ways that benefit all of us.”

Oh, my aging feet: Five common foot problems and how to manage them
From our first steps as a child, we depend on our feet to carry us through life. For the average lifetime, that’s an estimated 115,000 miles of walking—the equivalent of circling the globe four times on foot. “Our feet are extremely complex structures,” says Richard Amundsen, DPM, a podiatrist affiliated with Dignity Health Yavapai Regional Medical Center (YRMC). “There’s a tremendous amount of mechanical demand on the feet. And after a lifetime of use, things can wear out.” Want to make sure your feet are healthy for the long haul? Here are five common foot problems people experience as they age and suggestions on how to manage them. 1. Osteoarthritis Often referred to as “wear and tear” arthritis, this is a degenerative joint disease that gradually leads to the breakdown of cartilage and other tissue. Symptoms: Decreased range of motion, swelling, bones that seem bigger, and an achiness that intensifies over time. Treatment options: Focus on reducing symptoms, managing pain, and decreasing inflammation through low-impact exercises, like biking and swimming. Your health care provider may also recommend physical therapy, steroid injections, oral steroids, or anti-inflammatory medications. In extreme cases, surgery may be necessary to either replace or fuse joints. 2. Peripheral Arterial Disease (PAD) This is a serious vascular disease that causes blockages or narrowing in the veins and arteries. It also restricts blood flow from the heart to the toes. Symptoms: Fatigue, pain, discomfort, or a heaviness in the legs. Treatment options: Lifestyle changes – a healthy diet and regular exercise – are typically recommended for PAD patients. Some people may also need medication or surgery. Early detection is important as PAD can be dangerous if left untreated. Contact your provider immediately if you experience symptoms. You may be referred to a cardiologist, interventional cardiologist, or a vascular surgeon for treatment. 3. Neuropathy (also known as peripheral neuropathy) This condition occurs when the nerves are no longer able to communicate properly between the feet and the brain. Neuropathy can be caused by diabetes, chemotherapy, immunotherapy, traumatic injuries, infections, metabolic problems, inherited causes, exposure to toxins (such as overuse of alcohol), and more. Symptoms: Numbness, tingling, lack of sensation in the lower extremities, and odd or painful sensations. Treatment options: Embracing preventative measures and addressing the root cause of neuropathy is important. If you have diabetes, work with your health care provider to effectively manage your blood sugar levels. Some people may need to quit consuming alcohol. Once the cause of neuropathy is diagnosed, your provider may prescribe medication or recommend supplements, such as vitamin B complex and alpha lipoic acid. No matter the cause of the condition, everyone with neuropathy should make sure their shoes fit properly. “Something as simple as a tight shoe can cause a blister and lead to a non-healing wound,” Dr. Amundsen says. “It’s important for anyone who has neuropathy to have the right foot gear – shoes and socks – and to check their feet frequently.” 4. Plantar Fasciitis This painful condition flares up when the thick band of soft tissue (fascia) that connects the heel with the rest of the foot becomes irritated and inflamed. Symptoms: Stabbing pain on the bottom of the foot near the heel that may improve with movement and worsen after prolonged periods of standing. Treatment options: Ice, rest, steroid injections, physical therapy, oral steroids, and proper footwear with orthotics to balance the heel are all used to treat plantar fasciitis. 5. Achilles Tendinitis Weekend athletes – especially tennis and basketball players as well as joggers who suddenly intensify their runs – are particularly susceptible to Achilles tendinitis. Symptoms: Achilles tendinitis begins as a mild ache in the back of the leg, or above the heel, and gets worse with prolonged activity. People with the condition also experience painful stiffness in the same area in the morning. Treatment options: Ice, physical therapy, heel lifts, and nonsteroidal anti-inflammatory medications are recommended for Achilles tendinitis. Keeping your feet on a healthy path “I talk to my patients about staying as active as they can,” says Dr. Amundsen. “I also emphasize that foot health is connected to our overall health.” Dr. Amundsen suggests swimming and bicycling to keep your feet – and the rest of your body – healthy and flexible. He also recommends investing in a good pair of supportive running or trail shoes for foot health and comfort.

A delicious way to prevent prostate cancer
Prostate cancer is the second most commonly diagnosed cancer worldwide. However, there is good news: extensive research suggests that lifestyle and diet play an important role in prostate cancer prevention and treatment. In our latest Dignity Health Yavapai Regional Medical Center (YRMC) Your Healthy Kitchen video, I make a delicious recipe that is packed with important phytochemicals shown to reduce your risk, plus I explore other protective diet and lifestyle habits. Roasted Tomatoes with Ginger and Garlic Many of the diet and lifestyle recommendations for the prevention of prostate cancer are similar to recommendations for the prevention of cardiovascular disease, diabetes, and other types of cancers. The top five for prostate cancer prevention are: Quit smoking Get regular, if not daily physical activity Maintain a healthy weight Reduce your intake of processed foods and added sugars Eat a big variety of colorful fruits and vegetables There are also several nutrients and foods that have been linked specifically to a reduced risk of prostate cancer, including lycopene and ECGC, or epigallocatechin-3-gallate, a potent phytochemical found in green tea. Lycopene is one of several plant-based chemicals linked to reduced prostate cancer risk. It’s one of about 600 different colorful carotenoids made by plants and is found in red, orange and green vegetables, herbs, and fruits. All carotenoids act as antioxidants – protecting the cells, blood vessels, nerves, and organs in your body from damage – but lycopene seems to be the most powerful one. Good sources of lycopene include: Tomatoes Watermelon Papaya Dried apricots Pink grapefruit Carrots Asparagus Parsley For prevention of prostate cancer and many other chronic diseases, be sure to get a good source of daily lycopene, green tea, and lots of colorful fruits and vegetables, along with regular exercise, and embrace a smoke-free lifestyle. And be sure to check out all of our instructional videos and delicious, health-promoting recipes at yrmchealthconnect.org. You can follow me on Facebook too, at YRMC’s Your Healthy Kitchen, where I post photos and videos of the meals I make in my own kitchen, plus links to my favorite food and gardening destinations on the web.