Yavapai Regional Medical Center’s (YRMC’s) Transcatheter Aortic Valve Replacement (TAVR) program has been up and running since November 2016, and is making a positive difference for local patients. Initially, the U.S. Food & Drug Administration (FDA) approved the program for high risk patients. “These were patients in their upper 80s with multiple medical comorbidities, like severe renal failure, previous open heart surgeries and at very high risk,” said Jose Torres, MD, Cardiothoracic Surgeon, The James Family Heart Center at YRMC. TAVR Open to More People The FDA has now approved TAVR for patients who are at moderate risk. “These are patients in their late 70s and early 80s,” said Dr. Torres. “They have some comorbidities—early kidney dysfunction, some heart failure, or some past open heart surgeries.” Although everyone wants to have a less invasive procedure these days, the minimally invasive TAVR procedure is not intended for younger patients. “The younger, lower risk patients usually need a mechanical valve, which may require a sternotomy and cardiopulmonary bypass,” Dr. Torres said. “At this time, the life expectancy of transcatheter valves is not comparable to mechanical valves in younger, healthier patients.” TAVR: Heal at Home TAVR is helping keep local residents home instead of going to Phoenix, which is a good thing for patients and their families. “Prior to starting up our valve clinic, we were sending out about 20 patients a year to Phoenix to get the transcatheter valves. So, it is definitely a good procedure to have in the community,” explained Dr. Torres. “We do have an older community. A lot of patients are a little bit sicker and their health isn’t as great as it used to be. Driving to Phoenix is just a big hassle for them.” Local Dewey resident and recent TAVR patient Linda Thompson likes that she can have her healthcare closer to home. “I would not have gone to Phoenix if they didn’t have TAVR up here; it’s just too hard on my family and once you have trust in your doctors up here, I wouldn’t want to go anywhere else,” she said. TAVR Changed Linda’s Life Linda had open heart surgery two years ago and developed valvular stenosis after it. She was on oxygen and could barely walk up a flight of stairs or participate in activities she enjoyed, such as playing Bunco with her friends and working in her garden. Because of her complications, Linda was not a good candidate for a repeat open heart surgery—it was too risky for her health. However, after TAVR, Linda said, “The doctors were very confident and very caring and told me there was hardly any risk with it. I had no pain from it at all. Right after it, I felt like a healthy person again.” Dr. Torres said, “The YRMC administration and cardiovascular physicians are very focused on developing a service line to help the community, whether it is from coronary artery disease, aortic valve disease, or mitral valve disease, so we are pushing ourselves and the institution to be on the forefront of structural heart disease.” 00Share with your friendsYour NameYour EmailRecipient EmailEnter a MessageI read this article and found it very interesting, thought it might be something for you. The article is called TAVR Turns Nine Months Old! and is located at https://yrmchealthconnect.org/tavr-turns-nine-months-old/.CaptchaSubmit

Riding a horse … hiking a mountain … climbing a flight of stairs, chronic pain can restrict people from their favorite activities as well as their day-to-day routines. Steven R. Galper, MD, Pain Medicine Physician, Psychiatrist and Neurologist at YRMC PhysicianCare, taps into this as he works with people experiencing chronic pain. Getting to know the patient and his or her journey is critical to addressing chronic pain, according to Dr. Galper. He draws on the advice of the founding father of modern medicine, Sir William Osler, who encouraged physicians to, “Just listen to your patient; he is telling you the diagnosis.” Listening to Learn About Your Pain During their first appointment, Dr. Galper listens as patients describe their pain, its cause and how it has been addressed in the past. “Pain management improves lives by giving structure to a treatment plan,” said Dr. Galper. “I ask new patients, ‘What is the pain stopping you from doing?’ The patient could respond, ‘I want to ride my horses, but I can’t tolerate it because sitting kills my back.’ Okay, let’s get to work on that.” Together, Dr. Galper and the patient identify an objective, functional goal that will assist in measuring progress. For example, returning to horseback riding three times a week, for one hour per ride, in six months. Dr. Galper also conducts a full neurologic physical exam. Many people who suffer from chronic pain have never undergone such an exam. Depending on what he learns from the neurologic exam, Dr. Galper may recommend blood work and magnetic resonance imaging (MRI) for the patient. With all of the information in hand, Dr. Galper collaborates with the patient – and his or her primary care provider – to create a comprehensive treatment plan. While they are individualized to each patient, all of Dr. Galper’s care plans include three important components: Mind-Body Work – Cognitive behavior therapy – a short-term, goal-oriented psychotherapy treatment – takes a hands-on, practical approach to problem solving. The goal of cognitive behavior therapy is to change patterns of thinking or behavior that are behind an individual’s difficulties. Movement – Building strength is important to managing pain. Depending on the patient’s resources and other factors, Dr. Galper recommends physical therapy or provides exercises for patients to pursue on their own. Medicine – To address a patient’s medical needs, Dr. Galper may prescribe a non-steroidal anti-inflammatory for inflammation; a neuropathic medication for nerve pain; and a muscle relaxant for spasm prevention. Dr. Galper does not prescribe opiates as a first-line medication for patients with non-cancer pain. “If you think about pain, it is biology, environment, nature and nurture,” said Dr. Galper. “You live at this intersection of what’s going on in people’s bodies and what’s going on in their minds. Some pain starts in your body and some pain is caused by what’s happening to you emotionally. It feels the same, but the thing is emotional pain should not be treated with opiates.” An Exceptional Medical Background While this is a challenging fork in the road, it suits Dr. Galper and his multidisciplinary background as a board certified pain medicine physician, psychiatrist and neurologist. It also suits the many patients he’s helped overcome chronic pain during his career. “You’ve got to meet people where they are and work with them,” he said. “Because, their pain is very real.” For an appointment with Dr. Galper, speak to your primary care provider or other physician. If you would like more information, contact Dr. Galper’s office at (928) 445-1232. 00Share with your friendsYour NameYour EmailRecipient EmailEnter a MessageI read this article and found it very interesting, thought it might be something for you. The article is called YRMC Physician Helps Patients Manage Pain and is located at https://yrmchealthconnect.org/yrmc-physician-helps-patients-manage-pain/.CaptchaSubmit

Jack took up smoking in high school, quickly accelerating to a pack-a-day habit. It was his own high school-age children who finally convinced him to quit for good. A smoke-free decade later, Jack feels healthy but he worries about the possibility of lung cancer due to his 34 years of smoking. “This isn’t uncommon,” said Mary Sterling, Director of Imaging Services at Yavapai Regional Medical Center (YRMC). “People who have a history of smoking and current smokers worry about a lung cancer diagnosis.” People like Jack were the motivation for YRMC’s recently launched Lung Cancer Screening and Care program.  The comprehensive program includes lung cancer screening with low-dose computed tomography (LDCT). The screenings produce detailed images of the lungs and may reveal extremely small nodules—an indication of lung cancer in its early stages. LDCT is available at the Imaging Services Department at YRMC East in Prescott Valley, Prescott Valley Medical Imaging and Prescott Medical Imaging. “It’s estimated that more than 80 percent of lung cancers could be cured if they were discovered at this early stage,” Sterling said. “LDCT is for people before they begin to experience symptoms.” Who should consider LDCT? YRMC recommends speaking to your healthcare provider about LDCT if you have concerns about your smoking history and if you are: 55 to 77 years old A current smoker A former smoker who quit in the last 15 years Someone who has a smoking history of at least one pack of cigarettes a day for 30 years If the results of your screening are normal, you’ll undergo another LDCT in 12 months. If the screening detects potential cancerous nodules, YRMC’s Lung Cancer Screening and Care Program includes top medical professionals. These radiologists and pulmonologists as well as a procedural pulmonologist and cardiothoracic surgeon collaborate to diagnose and treat lung cancer. YRMC’s Lung Cancer Screening and Care Program also includes a clinical navigator who is available to assist and support people at all phases of the program. To find out if LDCT is right for you, speak to your physician. Visit our website for information on Lung Cancer Screening and Care at YRMC or call our clinical navigator at (928) 771-5454. Also, check out the free Respiratory Wellness Classes YRMC offers for people throughout our communities. 00Share with your friendsYour NameYour EmailRecipient EmailEnter a MessageI read this article and found it very interesting, thought it might be something for you. The article is called Is Lung Cancer Screening Right for You? and is located at https://yrmchealthconnect.org/is-lung-cancer-screening-right-for-you/.CaptchaSubmit

Is fruit juice a staple in your little one’s diet? If your child is 12 months or younger, the American Academy of Pediatrics (AAP) suggests a diet that’s free of fruit juice. The new recommendation – the first change on this subject since 2001 – is linked to rising childhood obesity rates and concerns about dental health. “Fruit juice contains lots of sugar,” said Jennifer Tidroski, DO, Pediatrician at Ponderosa Pediatrics in Prescott. “It’s better to introduce children to delicious whole fruit, which has fiber and is an important part of a healthy diet.” When can children have fruit juice? Here’s a guide to fruit juice consumption for children after their first birthday and as they grow: One to three years old – Limit fruit juice to four ounces a day. Four to six years old – Four to six ounces of fruit juice a day is the recommended limit for children in this age group. Seven years and older – Fruit juice intake shouldn’t exceed eight ounces a day. For youngsters, fruit juice should not be served in a way that allows the child to sip the juice throughout the day. Fruit juice contains carbohydrates and long-term exposure can lead to tooth decay. Another good reason to limit young children’s fruit juice consumption? “They may be less likely to crave soda and other sugary drinks when they reach their teen years,” Dr. Tidroski said. If your child does not have a doctor, contact Ponderosa Pediatrics in Prescott at (928) 778-4581. New patients are currently being accepted. For more about Ponderosa Pediatrics, visit our website and follow us on Facebook. 00Share with your friendsYour NameYour EmailRecipient EmailEnter a MessageI read this article and found it very interesting, thought it might be something for you. The article is called The Truth About Babies and Juice and is located at https://yrmchealthconnect.org/the-truth-about-babies-and-juice/.CaptchaSubmit