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.

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.

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.”  

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.