Continuous glucose monitoring (CGM) is a game changer for people with type I and type II diabetes. That’s how Bonita Wilson, RN, CDCES, Diabetes Educator at Dignity Health Yavapai Regional Medical Center (YRMC), describes the impact of CGM technology on the lives of people with diabetes. “CGM is the latest and greatest way to monitor blood sugar levels,” she says. “And, it’s done without finger sticks.” This is good news for the one in 10 Americans who live with diabetes, some who may need up to seven finger sticks a day to monitor their glucose (blood sugar) levels. CGM gives people greater control of their blood sugars and their long-term health. Through YRMC’s Diabetes Education program, people with diabetes also receive the support they need to thrive with their CGM. “With CGM, patients can see the results of their dietary choices as they’re experiencing them,” explains Wilson. “If you eat a high-carb food, your CGM registers how that’s affecting your glucose levels as it’s happening. It’s immediate and it’s meaningful.” CGM’s smart technology also provides trending data that a healthcare provider can download and review for patterns. This creates a complete picture of how blood sugar levels change over time. It also helps people with diabetes – and their providers – understand how food, activity, stress and illness affect their blood sugar levels. “Understanding the reason for a patient’s fluctuating glucose levels leads to targeted care plans,” Wilson says. ““This is important to diabetes management.” Which CGM works for you? In this episode of YRMC’s Healthy Conversations, Wilson demonstrates how to put on a CGM. She also shares model-specific information including the: Number of finger sticks required High-and-low glucose alerts Smartphone compatibility Frequency of sensor changes Unique attributes of each model (e.g., nighttime alerts) “CGM doesn’t eliminate the patient’s role in decision making about their health,” Wilson explains. “It’s a tool that can validate their choices.” How do CGM systems work? CGMs include the following three components that work together to gather and share information about blood sugar levels. Glucose sensor – This is painlessly inserted under the skin of the upper arm or abdomen either by the individual or, if the model requires, a healthcare provider. How frequently your sensor needs to be changed depends on the CGM model. It can vary from approximately six days to six months. Transmitter – This small piece – which fits on the sensor – gathers information on the individual’s glucose levels and wirelessly sends the data to the receiver. Receiver – A smartphone app or a small monitor captures the information from the transmitter and immediately displays current glucose levels. Some CGMs also send glucose information directly to an insulin pump. The data gathered from a CGM is shared with whomever the patient designates—their healthcare provider, spouse or a neighbor. “There’s lots of fear about high and low blood sugar levels,” says Wilson. “This CGM feature keeps people close to you informed of your glucose levels so they can check in if there’s a dip or a spike. It’s a great safety feature.” Lean into learning about CGM and more YRMC’s Diabetes Education program is for anyone with diabetes, from the newly diagnosed to people who have lived with diabetes for decades. Recognized by the American Diabetes Association (ADA) for Quality Self-Management Education, YRMC’s menu of learning opportunities include: A free, one-time pre-diabetes session – This hour-long session will be presented by Wilson six times in 2023—three in Prescott and three in Prescott Valley. Individual consults – During one-on-one meetings, Wilson advises people on all matters related to their diabetes, including CGM. Diabetes self-management – Wilson leads this five-week series which covers an important “M” topic each week—meals, motion, medications, monitoring and mindfulness. “Participants learn from each other and they learn that they are not alone,” says Wilson of the Diabetes Self-Management series. Wilson calls the series an underutilized Medicare benefit as only seven percent of people who are eligible for it actually take advantage. Check out YRMC’s Diabetes Education program for more information or call (928) 771-5794 in Prescott or (928) 759-5920 in Prescott Valley.

Gabriela Herrera, MSN, FNP-BC, has joined Dignity Health Yavapai Regional Medical Group (YRMG) Pediatrics in Prescott. An accomplished advanced practice registered nurse, Herrera has cared for patients in a variety of specialties, including pediatrics. Herrera graduated summa cum laude with a Master of Science in Nursing, Family Nurse Practitioner degree from Northern Arizona University in Flagstaff. Before that, she was awarded a Bachelor of Science in Nursing from the University of Louisiana in Lafayette, Louisiana. Herrera received an Associate of Applied Science in Nursing from Yavapai College in Prescott. Herrera is board certified as a family nurse practitioner by the American Nurses Credentialing Center and is involved in numerous professional organizations, including the National Association of Pediatric Nurse Practitioners. Schedule an Appointment Herrera is currently taking new patients. To schedule an appointment, please contact: YRMG Pediatrics 2120 Centerpointe West Drive Prescott, Arizona 86301 (928) 778-4581    

Patient-shared decision making is an important aspect of healthcare today. However, advocating for yourself – or someone you love – requires information, especially with a relatively new concept like patient blood management (PBM). This is one reason the Society for the Advancement of Patient Blood Management (SABM) is sponsoring Patient Blood Management Awareness Week®, November 7-11, 2022. This worldwide awareness week is dedicated to informing patients about the importance of blood health. Prescott City Council member, Steve Sischka – who also serves on the Dignity Health, YRMC Board of Trustees – presents Beth Black with a mayoral proclamation declaring Patient Blood Management Awareness Week. In our community, Dignity Health, Yavapai Regional Medical Center (YRMC) is home to Arizona’s only PBM program that’s recognized by SABM. Local leaders also understand the importance of PBM. Prescott Mayor Phil Goode, for example, has signed a proclamation declaring November 7-11, 2022, “Patient Blood Management Awareness Week” in Prescott. “Dignity Health, YRMC has been forward-thinking in its implementation of PBM,” says Dale Black, Program Coordinator, Patient Blood Management at Dignity Health, YRMC. “The people of Yavapai County are fortunate that YRMC has embraced blood conservation. This means residents have access to local providers for information about PBM.” The Pillars of PBM What is PBM and why is it important to you? “PBM is about keeping your blood in you and keeping it working well,” explains Beth Black, Administrative Assistant and Program Data Manager, Patient Blood Management at Dignity Health, YRMC. YRMC’s PBM program uses a team approach to: Manage anemia Ensure that bleeding is under control and blood is clotting appropriately (not too much, not too little) Utilize blood-conserving measures during surgery Involve patients in decision making about their blood Blood tests – particularly during hospitalization – give your provider important information about your health. However, drawing too much blood can lead to anemia in hospitalized patients. That’s why “phlebotomy stewardship” is becoming more and more important. This means taking only the needed amount of blood for testing in order to avoid hospital-acquired anemia. A Few Words About Anemia When you have anemia, your body lacks the healthy red blood cells needed to carry oxygen to your body’s tissues. Symptoms of anemia include, for example: Fatigue Weakness Cold hands and feet Dizziness Irregular heart rhythm Shortness of breath Headache Pale or yellowish skin “Once a year, ask your physician to order a complete work up of your blood,” Dale Black says. “If you are anemic, work with your doctor to learn the underlying cause of your anemia.” Prepping for Surgery with PBM If a surgery is in your future, ask your physician to order blood work two to four weeks before the procedure. If your blood counts are low, your doctor may recommend dietary changes. You may also need iron, vitamin B-12 or folic acid to fuel red blood cell production before surgery. “You’ll also want to discuss any herbals you take, along with other over-the-counter medications, such as ibuprofen,” says Beth Black. “These can all affect your body’s ability to clot.” Before your operation, talk to your surgeon about strategies that reduce blood loss. If you’re undergoing heart or orthopedic surgery – which are known to cause blood loss – discuss collecting blood lost during surgery for immediate post-operative reinfusion, if needed. Medications and blood products that promote clotting and reduce bleeding are also available. PBM is About You, the Patient Want to ensure blood conservation is part of your healthcare? Talk to your providers about PBM, especially prior to hospitalization. “Let your team know that you want to be treated in a manner that conserves your blood,” says Dale Black. “You can even mention your desire for minimal blood draws – just what is necessary for testing – during your hospitalization. With PBM, you are in charge of that precious resource, your blood.” Interested in learning more about YRMC’s PBM program? Get answers to your questions here or call (928) 771-5109.

If you have a history of smoking, adding annual lung cancer screening to your preventive health plan could save your life. Lung cancer screening uses low-dose computed tomography (LDCT) to produce detailed images of the chest and lungs and detect lung cancer early, when it’s most curable. “Early-stage lung cancer has about an 80 percent chance of cure, or survival, over five years,” says Jennifer Harvey, RN, Nurse Navigator, Lung Cancer Screening and Care at Dignity Health, Yavapai Regional Medical Center (YRMC). “That is huge.” November is Lung Cancer Awareness Month, a good time to explore the benefits of this lifesaving program. Here are just a few: There’s even more data demonstrating that lung cancer screening works. Thanks to its success, lung cancer screening now begins at a younger age and includes people who have smoked less. The latest Medicare screening guidelines include people who are: Ages 50 – 77 Heavy smokers (one pack a day for 20 years or the equivalent) Current smokers or smokers who have quit in the last 15 years Free of any lung cancer symptoms “Lowering both the qualifying age for screening to 50-years-old from 55, and the pack-per-day eligibility allows for more individualized risk assessment,” Harvey says. “For example, someone who has a strong family history of lung cancer, or other risk factors, is now eligible for screening at a younger age.” Top physician organizations recommend lung cancer screening. The American Academy of Family Physicians (AAFP) – one of the largest physician organizations in the United States – is the latest to endorse lung cancer screening. The organization’s leaders point to mounting evidence that lung cancer screening works. The AAFP also supports the expanded criteria, which makes lung cancer screening available to more minority populations who may have fewer “pack years” but are at higher risk for lung cancer. Lung Cancer Screening and Care at YRMC is a dedicated healthcare partner. That partnership begins by ensuring you qualify for lung cancer screening. Additionally, our nurse navigator is available to answer questions about LDCT and lung health. Harvey reaches out to every Lung Cancer Screening and Care participant to remind them of their annual lung cancer screening. That year-to-year continuity is an important aspect of Lung Cancer Screening and Care. “Lung cancer screening is not a one and done,” says Harvey. “If you don’t have any signs of lung cancer after your first screening, you will be screened annually. I suggest that people think of their LDCT as they would a mammogram or colonoscopy. It’s a screening that you need even – and especially – if you have no symptoms.” If a patient’s lung cancer screening findings are suspicious, a follow-up scan may be scheduled. The Lung Cancer Screening and Care team may also recommend a biopsy, in which case the patient would be referred to a procedural pulmonologist or a radiologist. If surgery is needed, the Lung Cancer Screening and Care team also includes a cardiothoracic surgeon. LDCT not only detects lung cancer early, but it can discover other potentially life-threatening illnesses before you’re experiencing symptoms. LDCT scans include a large part of the body. This means in addition to lung cancer, LDCT can also detect chronic pulmonary obstructive disorder (COPD) and heart disease, for example. If you’re a longtime smoker who wants to quit, you’ll receive support from Lung Cancer Screening and Care. The health benefits of giving up smoking are substantial: One year after quitting smoking, a person’s risk for coronary heart disease decreases 50 percent. After 10 years, a person’s chances of developing lung cancer and dying from it are cut in half compared to someone who continues smoking. “It’s exciting how the body heals itself after giving up smoking,” Harvey says. “After someone quits, it’s recommended that they continue annual lung screening for at least 15 years. After that, their chance of developing lung cancer drops significantly.” How do you get help quitting? The Arizona ASHLine sponsors a customized program called Quit Coaching. This free program includes individual “quit plans” to support and encourage people as they give up tobacco. Want to learn more about Lung Cancer Screening and Care? Speak to your healthcare provider or contact us at (928) 771-5454.