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A Few Facts that May Surprise You About Palliative Medicine
Many of us have someone in our lives – a spouse, parent, grandparent or another loved one – who has been diagnosed with a serious illness or chronic disease. Or, maybe you have confronted a complex illness. Either way, the Palliative Medicine team at Yavapai Regional Medical Center (YRMC) PhysicianCare in Prescott Valley is a valuable healthcare partner for people facing life-limiting illnesses. During November, National Hospice and Palliative Care Month, YRMC’s Palliative Medicine team is helping build awareness of Palliative Medicine and its role in patient care. They’re also educating the public about some of the differences between palliative medicine and hospice care, both of which provide vital services to patients and their families. Let’s begin with some facts you may not know about palliative medicine. Fact: Palliative Medicine can become involved in a patient’s care immediately after a diagnosis. Palliative medicine can accompany a patient from the diagnosis of a serious illness – cancer, heart failure or kidney disease, for example – to as long as support is needed. Although it’s best to start soon after diagnosis, palliative medicine services can be of value at any time during a patient’s treatment. Fact: Palliative Medicine is not end-of-life care. “This highlights an important difference between palliative medicine and hospice care,” said Donna Frappier, Practice Manager, YRMC PhysicianCare, Palliative Medicine. “Palliative medicine works with patients undergoing treatment with the goal of curing them or extending life.” Hospice care begins when patients either can no longer benefit from aggressive treatments or when patients choose to forego aggressive measures in the interest of comfort. Hospice is traditionally an option for people who have a life expectancy of less than six months. Fact: Palliative Medicine is delivered by a team of healthcare professionals who have special training in the management of symptoms associated with serious illnesses. Both hospice and palliative medicine take a team approach to the care they provide. YRMC’s Palliative Medicine team includes physicians, physician assistants, a nurse practitioner, a registered nurse and social worker. All of these caregivers are experts at managing the complexities of living with a serious illness. “Our team takes a holistic approach to care,” Frappier explained. “We work with people who are facing life-limiting illnesses to address their physical, mental, social and spiritual needs.” When needed, YRMC’s Palliative Medicine team taps YRMC’s network of healthcare experts to assist patients with their needs, including: Dietitians for nutritional advice and information. Pharmacists to review prescriptions and simplify often complex medication routines. Occupational therapists and physical therapists for help in increasing strength and mobility, and to help patients maintain abilities for “activities of daily living.” YRMC’s Palliative Medicine team also identifies community resources for patients, such as transportation to physician appointments, paid in-home caregivers, volunteer services, chaplains, and meal delivery services. Fact: Palliative Medicine wraps the patient and family in an extra layer of care and comfort. As the patient’s primary care and specialty physicians pursue treatments aimed at a cure or extension of life, YRMC’s Palliative Medicine team concentrates on the patient’s comfort. That may include: Easing physical pain or discomfort. Addressing anxiety and other emotional issues. Alleviating symptoms, like breathing issues, nausea, constipation, agitation, and insomnia. Hospice also is dedicated to patient comfort, but they support the patient and family as they prepare for the end-of-life. Fact: Palliative Medicine supports the patient’s future plans. YRMC’s Palliative Medicine team works with patients and their families to develop care plans that are tailored to their priorities and goals. These plans may include information on advance directives – living wills, durable power of attorney, healthcare proxy, for example – and education about managing the side effects of treatment. “We’re very fortunate to have a social worker as part of our Palliative Medicine team,” Frappier said. “Our social worker visits patients in their homes so she understands their environment, family dynamics, communication styles and more. That information creates a complete picture that allows the team to identify resources that support the patient’s goals.” For Frappier and YRMC’s Palliative Medicine team, their work with people who have life-limiting illnesses can be summarized in three words: educate, support and advocate. “Palliative care is the purest form of humanity that we can possibly experience,” she said. “It’s about providing the best for the people you love. That focus on patient comfort and dignity is the ribbon that ties palliative care and hospice care.” For more information about YRMC’s Palliative Medicine Services and Palliative Care in Prescott Valley, Prescott, and surrounding areas, visit YRMC.org or call (928) 775-5567.
YRMC’s New Cardiac Cath Lab: A First for the Western United States
A third Cardiac Catheterization Laboratory – featuring technology available in only a few hospitals nationwide – has opened at the James Family Heart Center at Yavapai Regional Medical Center (YRMC) West in Prescott. “Our comprehensive Heart Program offers – in addition to a robust surgical program – a wide range of highly advanced catheter-based therapies in the cardiovascular arena,” said Soundos Moualla, MD, FACC, FSCAI, Medical Director, Structural Heart Program, James Family Heart Center at YRMC. “The innovative technology and clinical expertise allow us to deliver highly advanced structural, coronary, peripheral and electrophysiological procedures to our community. The new Cardiac Cath Lab enhances our standing in these areas of excellence.” In fact, the new Cardiac Cath Lab incorporates technology so advanced that it is the first of its kind in the western United States. It joins two other advanced YRMC Cardiac Cath Labs, and the Hybrid Operating Suite all of which are equipped with sophisticated diagnostic imaging equipment. In the Heart Center’s Cardiac Cath Labs, interventional cardiologists – specialists who perform non-surgical heart procedures – tap technology to visualize the heart’s arteries, vessels and chambers. After diagnosing a heart disorder, YRMC’s interventional cardiologists repair patients’ hearts using the advanced imaging technology. “The heart services provided at YRMC are typically only available in much larger markets across the country,” said George Rizk, MD, Medical Director, Cardiac Catheterization Laboratory, James Family Heart Center at YRMC. “We are very fortunate to have this technology and talent available in the Quad Cities area.” The following features are part of the world-first technology in YRMC’s new Cardiac Cath Lab: Azurion Angiography Operating System – The Heart Center’s Azurion operating system takes both x-ray and ultrasound images. As the patient lies on the table, a rotating arm gathers the images into a single, three-dimensional view of the heart. Approximately 100 of these Philips operating systems are currently available in the United States. The EchoNavigator – This technology gathers the Azurion’s three-dimensional images into a clear and detailed “road map” of the patient’s heart. It allows physicians to see real-time, three-dimensional images of the heart. At the same time, the technology gives interventional cardiologists a sharp view of the catheter or heart implant they are guiding during a procedure. “YRMC’s Heart Center has invested in both the technology and the talent,” said Lauren Weedon, RN, MSN, Director of Cardiovascular Services at YRMC. “This allows our physicians, nurses and radiologic technologists to learn new, innovative procedures. Our team is constantly learning and striving to do their very best for our patients.” Skilled teams of interventional cardiologists, nurses and radiologic technologists perform the following leading-edge procedures and more in YRMC’s Cardiac Cath Labs: 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) Patent Foramen Ovale (PFO) Closure Check out other heart innovations and heart healthy tips on YRMC HealthConnect.
YRMC PhysicianCare Welcomes Pete Banchuin, MD, Family Medicine
Yavapai Regional Medical Center PhysicianCare is pleased to announce that Pete Banchuin, MD, Family Medicine, has joined our Primary Care Team at our outpatient clinic located at 7700 East Florentine Road, Building B, Suite 101, Prescott Valley, AZ 86314. Dr. Banchuin is a graduate of the Virginia Polytechnic Institute and State University in Blacksburg, Virginia and completed a Doctor of Medicine at the Virginia Commonwealth University, College of Medicine, Richmond, Virginia. Additionally Dr. Banchuin has completed a Family Medicine Residency at the Northern Colorado Family Medicine Residency Program in Sterling, Colorado. Dr. Banchuin is currently accepting new patients. Please call (928) 442-8710 to schedule an appointment or visit our website for more information. YRMC PhysicianCare is pleased to accept most insurance plans including Medicare.
YRMC’s Your Healthy Kitchen: Making a Delicious Meal in a Bowl While Raising Awareness for Lung Cancer Screening
Did you know that early detection of lung cancer saves lives and that lung cancer screening services are available at YRMC? To raise awareness of the vital role regular imaging plays in lung cancer survival, we invited Jennifer Harvey, Nurse Navigator, Lung Cancer Screening and Care at YRMC, onto the set at YRMC’s Your Healthy Kitchen! Jennifer supports and guides individuals at risk for lung cancer through the screening process and offers support to those who are trying to quit smoking. In the kitchen together, we talked about who might benefit from regular lung cancer screening, as well as strategies to help with the food and weight challenges people often face when they quit smoking. Of course, we also made a delicious, nourishing meal, filled with flavorful ingredients that just happen to help our bodies heal and detoxify from nicotine! Lung cancer is the second leading cause of cancer-related deaths for men and women, according to the American Cancer Society. In fact, more people die annually of lung cancer than cancer of the colon, breast and prostate combined. While both smokers and non-smokers can develop lung cancer, the risks are much greater for past and present smokers. Lung cancer screening is designed to catch cancer at its earliest stages, when survival is most likely, in those who are most at risk. Join us as Jennifer explains the criteria that define high-risk individuals, talks about her role as a Nurse Navigator, and shares what inspires her at work, everyday. Recipe: Whole Grain Spanish Rice Statistics show that many people (but not all) do gain weight after smoking cessation. However, the health risks of smoking far outweigh the downsides of weight gain — so don’t let the scale stop you from quitting! Also, developing a healthy relationship with food, the stressors in your life, and your body can be some of the greatest gifts of smoking cessation. Simple tips that can reduce the amount of weight you might gain after saying goodbye to cigarettes include: When you eat, just eat. Taking time out for meals and snacks and eating them without distraction (i.e. no TV, work, computers, phones, etc.) will increase your sense of satisfaction and ‘fullness’ after eating, improve calorie burning, and reduce your cravings for sweets and snacks throughout the day and night. Instead of snacking on sweets or processed foods like chips or pretzels, consider creating snacks that resemble little meals. A small meal that includes fruit or vegetables, some protein (chicken, fish, meat, eggs, beans or nuts), carbohydrate (whole grain products, fruit, or beans) and healthy fat (avocado, nuts, seeds, or olive oil) will satisfy your taste buds as well as your belly and your brain. Check out this episode of YRMC’s Your Healthy Kitchen for great snack ideas! Experiment and discover how physical activity helps you move through and reduce stress, fatigue, boredom and food cravings! It’s important to find a way to move your body that is enjoyable, not stressful. Do you like walking in nature or around your neighborhood? How about dancing, alone or with others? Working in the yard or garden, going to a gym, taking gentle or vigorous exercise classes, doing yoga or Tai Chi, or even standing, stretching, and walking in place at regular intervals during the day qualifies as healthy movement that can reduce stress-related eating. Eat a larger meal in the middle of the day and a smaller meal at night. Most people burn more calories between noon and 2 pm, so it makes sense to eat more food at lunch! For other great tips on successfully navigating the challenges of smoking cessation, check out all of the resources available from the American Cancer Society and consider joining thousands of other Americans who have decided to quit on November 21st for The Great American Smokeout! Remember to also check out all of our informative videos and easy, delicious recipes at YRMC’s Your Healthy Kitchen! Our site now includes an easy link to Your Healthy Kitchen’s YouTube Channel, where you can easily view and access our entire library! You can access these at https://www.yrmchealthconnect.org/your-healthy-kitchen/.
YRMC’s Outpatient Laboratory Draw Centers Offer Ease and Convenience
At Yavapai Regional Medical Center, we’re proud of our position as the premier Healthcare provider for our community. Because we value and respect your trust, we strive to make our services as convenient and streamlined as possible. The next time your physician orders a blood draw for you, remember that most draws can be performed at any of the YRMC Outpatient Draw Centers, rather than at our hospital locations. The advantages include: Onsite registration – no need to register at the hospital, which can be time consuming. Faster service as blood draws are performed on a first come, first served basis. Blood draws at our outpatient draw centers can also be less expensive – services are delivered in an outpatient environment and not an inpatient hospital environment. No appointment is needed at the YRMC Outpatient Draw Centers. Here are some tips to get you ready for your visit: Select an outpatient draw center location that is convenient for you. Follow any fasting or other instructions from your physician. Bring your physician’s written request for the test. We have three convenient locations ready to serve you: YRMC Outpatient Draw Center 1050 Gail Gardner Way, Suite 200 Prescott, AZ 86305 (928) 717-5234 Open Monday through Thursday, 7:30 am to 4:30 pm and on Friday from 7:30 am to 4:00 pm YRMC Outpatient Draw Center YRMC PhysicianCare, Internal Medicine 3120 Clearwater Drive Prescott, AZ 86305 (928) 771-3704, ext. 115 Open Monday through Friday, 7:45 am to 12:00 pm and from 1:00 pm to 4:30 pm YRMC Outpatient Draw Center YRMC Outpatient Services Building 7700 E. Florentine Road, Building B, Suite 201 Prescott Valley, AZ 86314 (928) 759-5800 Open Monday through Friday, 6:30 am to 4:30 pm Talk to your physician about the best blood draw option for you. Remember to follow fasting or other instructions you’ve been given and bring your physician’s written request for the test. The YRMC Outpatient Draw Center team prides itself on timely, accurate and excellent service.
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.”
At the Whiskey Row Half Marathon, Small Steps Toward Wellness Reap Big Rewards
When Melody Gimlin crossed the finish line at the 2019 Whiskey Row Half Marathon in Prescott, she had fulfilled a very specific personal goal. It had to do with her plan to incorporate wellness into her everyday life. Gimlin had a baby in August and was experiencing the demands of parenthood and a full-time job. “I was stressed all the time. It was overwhelming.” She decided to discuss the issue with her doctor. “He recommended taking time every day for myself – just to read a book, have coffee outside, have my husband watch the baby for a while – to work on my wellbeing. What I’ve learned is that everyone needs their own time to find their own little happiness. For me, it was running.” Voted as one of the best half marathons in Arizona, the Whiskey Row Marathon sought out by residents and tourists alike who are looking for outdoor things to do in Prescott, AZ. Gimlin works as a Medical Assistant at the Yavapai Regional Medical Center (YRMC) PhysicianCare Internal Medicine office. She arrived at the decision to run the half marathon by chance. “I entered a raffle through the Human Resources Department at YRMC and won. The prize was free registration for the Whiskey Row Half Marathon. This was a sign that I needed to actually commit to it. So I started training right away.” This first step launched Gimlin’s wellness journey. The terms ‘wellness’ and ‘wellbeing’ seem to be everywhere these days, from hotels to juice advertisements to yoga apps. But what is wellness? Why is it important? And most importantly, should we strive, like Gimlin, to be more conscious of wellness in our own lives? Experts agree that wellness includes much more than physical fitness. In his presentation entitled The Wellbeing Imperative, Global Industry Analyst Josh Bersin lists six elements of a total wellbeing program. They are safety, physical health, mental fitness, financial fitness, community building and purpose/meaning. It might seem daunting to decide how to begin, but studies show that simple steps reap big benefits. A June, 2019 study published in Scientific Reports shows that spending two hours in nature a week can improve health and well-being. The results were equal whether the subjects spent a continuous two hours or broke up the time over the course of the week. Better still, the results were consistent across groups of older adults and people who have long-term health issues. Dana Blome, Cath Lab nurse at YRMC West, joined a group of coworkers and friends this year to walk the Whiskey Row 10K. “It was a social event for me, a nice break from the norm, some fun physical activity and a chance to contribute to my community, all rolled into one event,” she says. “It made me feel more connected to my hometown and was very fulfilling.” “Working in cardiology, I see a lot of people who are sick,” says Landon Stribe, Physician Assistant at YRMC PhysicianCare Cardiology, “but it’s important to do what we can to prevent those conditions in the first place. A lot of my job is preventive medicine – teaching good habits, trying to lead by example. If my patients can see me being healthy, it has a much better foothold.” Stribe’s go-to stress reliever is mountain biking. He completed the Whiskey Off-Road Mountain Bike 30K in May, 2019. “It felt great to cross that finish line,” says Stribe. “It’s a tough race and I was very tired. You could tell by the look on everyone’s face that we all felt like we accomplished something big. And it was fun seeing YRMC staff coming together at the bike race to support this big community event. It really shows the strength of YRMC’s driving force in bettering our community.” In keeping with national trends, YRMC is on the leading edge of promoting wellness in the Quad Cities. Today’s focus in healthcare is shifting toward keeping people healthy through prevention and education. This enables people to take charge of managing their own health as much as possible, and ultimately avoiding emergency care. Wellness initiatives are offered to YRMC staff and employees as well. Financial fitness, community building and volunteer opportunities are always available. In addition, a wellness app helps employees track their activities, join contests and earn rewards for their efforts. “The YRMC MyHealth app from Virgin Pulse is a great way to bond with our coworkers, be active and relieve a bit of stress in the workplace,” says Brian DeVries, HR Manager, Employee Benefits and Wellness at YRMC. “Many of our staff and employees use it both at work and at home. So many folks report that the app enhances their work experience and helps them feel happier and healthier.” “Through the YRMC My Health app you can participate in challenges, share tips and recipes and get encouragement from your colleagues,” says Gimlin. “It’s definitely made me more aware of my health habits, and if you’re not in it alone, you’re more apt to stick with it.” Gimlin’s reflects on where her wellness journey may take her. “I try to think about the future – what I want to be like, what my level of health will be. I want to teach my kids and grandkids how to take care of themselves so that we can enjoy each other with the time we have.” This may seem like a lofty goal, but Gimlin is living proof that it starts with small steps, like completing the Whiskey Row Half Marathon. “I felt so proud of myself,” she says. “Even if I ended up in last place, I didn’t care. I just wanted to say that I did it.”
Mediterranean Diet Meals Rank #1 for Best Overall Diet Plan!
Looking for the best eating plan for long-term health? According to a recent US News and World Report, the Mediterranean Diet beat out the competition for ‘Best Overall Diet’, as well as the best and easiest plan to follow for the prevention and treatment of diabetes and heart disease. The benefits of enjoying a Mediterranean Diet menu filled with an abundance of colorful vegetables and fruits, savory whole grains and beans, rich and flavorful olive oil, a variety of lean proteins, and even a bit of red wine, have been studied for decades, and continue to be hot topics of research as nutrition scientists learn more about the important links between the foods we eat and lifelong health. As a long time advocate of the Mediterranean Diet, Mellissa Ellis, RD, YRMC Clinical Dietician Supervisor, encourages many of her patients to adopt this easy and satisfying eating plan. Melissa recently took time to share some insights on why this particular diet has the potential to benefit so many individuals. Heart Healthy Breakfast of Whole Grains, Nuts, Berries and Fresh Figs Taking a bird’s eye view, Melissa describes the diet as one that features “many foods historically enjoyed in the region of the world bordering the Mediterranean Sea, including those from Greece, Southern Italy, and Crete. This plant-based diet promotes a high intake of vegetables, fruits, legumes (beans), and unprocessed, whole grains. Limits are put on dairy products, red and processed meats and sweets, but red wine can be consumed in moderation with meals. Healthy fats, like those in avocados, walnuts, and olive oil are prominent in the plan, as are lean sources of protein like fish, poultry and legumes.” In addition, most meals indigenous to the Mediterranean region are also flavored with an abundance of bright, fresh herbs and a variety of savory, sweet and sometimes pungent spices. Research shows that the potential health benefits of the Mediterranean Diet are many and varied, and Ellis stresses that these benefits “are greatest when the featured foods are eaten frequently, at most meals throughout the week.” Many of the health benefits of the diet are likely due to the rich blend of essential vitamins, minerals, fats, fibers, and phytochemicals that are packed into every meal. For example, the abundance of vegetables, fruits, spices, and herbs provide important disease-preventing antioxidant and anti-inflammatory nutrients like vitamin C and certain phytochemicals, including lutein in green vegetables and lycopene in tomatoes. The fiber in fruits, vegetables, whole grains and beans keep blood sugar and cholesterol levels in check, while also supporting healthy bacteria in, and regular elimination from, the gut! Added sugars, which tend to raise triglyceride and blood sugar levels, are limited, and healthy fats, which improve blood cholesterol and reduce inflammation, take center stage! Whole Grain Pasta with Fresh Tomato Sauce, Garlic, and Herbs Ellis states that, “This diet would benefit most anyone. In addition to proven protection from cardiovascular disease and diabetes, promising research also has linked this way of eating to reduced risk of cancer, Parkinson’s and Alzheimer’s disease. Because it is not a ‘quick fix’ diet that overly restricts calories or a specific nutrient, it can be a plan that one can follow for life. Anyone that wants to maintain a healthy weight, take good care of their heart and support overall health should consider trying it”. In general, the guidelines for planning healthy Mediterranean Diet meal plan include the following: Fill at least half of your plate at lunch and dinner with a variety of colorful vegetables. Flavor your meals with fragrant fresh herbs and spices. Enjoy a variety of fish or seafood once or twice a week. Build meals around rich and filling lentils or beans several times a week. Savor the sweetness of fresh fruit for snacks and desserts. Explore and sample wonderfully satisfying whole grains, including traditional varieties from the Mediterranean like bulgur (cracked wheat), barley, or farro (an ancient variety of wheat). Choose the healthiest fats, including those found in avocados and avocado oil, olives and olive oil, and a variety of whole nuts and seeds. A number of useful and free online tools are available to help with meal planning and other details of the diet. The Oldways Mediterranean Diet Pyramid and Planning Kit, developed in partnership with the Harvard School of Public Health and the World Health Organization, is filled with helpful tips and background information about the supporting science behind the diet. The American Diabetes Association offers a number of simple, delicious Mediterranean-style recipes at their user-friendly recipe and menu-planning site, Diabetes Food Hub. In addition, almost every one of our YRMC Your Healthy Kitchen video cooking tutorials feature meals that fit into a healthy, flavorful Mediterranean Diet plan, including a simple dish of pasta with fresh tomato sauce and herbs and a big variety of herb and flavor-packed pesto possibilities!