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Precise Shoulder Surgery with ExactechGPS Available at YRMC

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Most of us tap the GPS on our mobile phone when we’re driving to an unfamiliar location. Advanced technology called ExactechGPS – introduced recently at Yavapai Regional Medical Center (YRMC) – uses the same principles to guide orthopedic surgeons performing reconstructive shoulder surgery.

“This is truly amazing technology,” said Bradley Williams, M.D., Ph.D., a YRMC orthopedic surgeon who specializes in sports medicine, arthroscopic surgery and reconstructive surgery of the knees and shoulders. “I spend lots of time researching technology that’s under development in the orthopedic world. Sometimes, I’ll decide to watch how a technology develops before pursuing it for my patients, but with ExactechGPS, I jumped on it right away.”

The first computer navigation system for shoulder surgery, ExactechGPS, is breakthrough technology in the field of orthopedics. Dr. Williams was confident it would benefit many people he treats. In fact, Williams was the first orthopedic surgeon in Northern Arizona to use ExactechGPS, which became part of YRMC’s Orthopedic Surgical program in the spring of 2019.

From Virtual to Reality

To understand ExactechGPS, it’s helpful to know that total shoulder replacement and reverse total shoulder replacement surgery – a common shoulder replacement at YRMC – are complex procedures that have improved immensely through the years.

“Orthopedic surgeons performing reverse shoulder replacement 20 years ago had to learn the optimal placement of the surgical screws in the shoulder,” Williams said. “Now, you gather information and put into the ExactechGPS, and you’re assured that the placement is precise.”

Achieving that precision takes planning that begins before Williams steps into an operating suite at YRMC. Each patient undergoes a CT scan that provides information on their anatomy and the condition of the shoulder. Using the ExactechGPS pre-operative planning function, Williams virtually performs the patient’s surgery on a computer. He determines if the patient needs to have bone removed during the surgery and selects the best base plate for the patient.

“The ExactechGPS actually allows you to trial different baseplates and see how they’ll work for that individual patient,” he explained. “You see where the baseplate should be implanted and how deep it should be placed. All that is accurately figured before surgery.”

From Virtual to Reality

In the operating suite, Williams consults the virtual surgery plan before beginning the actual procedure. He carefully checks the images of the patient’s shoulder displayed on the ExactechGPS screen. A tracker – placed on the patient’s bone – provides information on the patient’s individual anatomy and joint movement. This helps Williams to verify if bone needs to be removed and correctly place the implant.

“Before ExactechGPS, total shoulder replacement or reverse total shoulder replacement would be difficult for older people with fragile bones or people with extensive trauma,” Williams said. “This technology has changed that. You can walk out of the operating room and know the implant placement is exact.”

A Shoulder-to-Shoulder Comparison

Williams’s first ExactechGPS patient was in her late 80s. A few years earlier, she had undergone conventional surgery for relentless shoulder pain that didn’t respond to injections, physical therapy or other treatment. While the patient’s conventional surgery went well, both the operation and recovery were difficult.

“There was a big difference between the first surgery on her right shoulder and the ExactechGPS procedure on her left shoulder,” recalled Williams. “The ExactechGPS went faster and her recovery was immediate. When I saw her for a follow-up visit after, she told me there was no pain following the procedure.”

That first surgery, and others that have followed, reinforced with Williams the value of ExactechGPS.

“I continue to be impressed by the results,” he said. “It’s great that people don’t have to live with shoulder pain.” QCBN

By Bridget O’Gara

Visit YRMC.org for more information on YRMC Orthopedic Surgical Services.

Bridget O’Gara is a writer, communications strategist and project manager who specializes in health care. She works with mission-driven healthcare organizations, including hospitals, other healthcare providers and advocacy organizations.

YRMC Offering Cardiac Care Panel Discussion

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Top cardiac specialists from Yavapai Regional Medical Center’s (YRMC’s) James Family Heart Center and leaders from its Patient Blood Management Program will join YRMC – Your Destination for Cardiac Care and Blood Management, a live-stream presentation and panel discussion.

The event will feature prominent heart specialists – a cardiologist, a cardiothoracic surgeon, an electrophysiologist, an interventional cardiologist – and knowledgeable blood management experts. These professionals will highlight the leading-edge, less-invasive procedures used to repair hearts at YRMC as well as how blood management strategies are significantly improving patient outcomes.

YRMC – Your Destination for Cardiac Care and Blood Management will be broadcast live from the Yavapai College Performing Arts Center in Prescott for the public to watch 6-8 p.m., Thursday, Oct. 17, at YRMCHealthConnect.org/pbm.

What is a Healthcare Destination Program?

Healthcare destination programs are thriving, specialized medical programs – typically associated with hospitals – that patients seek out because of their:

Highly skilled physicians

Excellent outcomes

State-of-the-art technology

Innovative procedures

Outstanding staff

“YRMC’s Heart Program and its Patient Blood Management Program check all of those boxes,” said Pierre Tibi, M.D., FACS, medical director of the James Family Heart Center at YRMC and YRMC’s Patient Blood Management Program. “It starts with our exceptional physicians, who were all trained at top heart programs. This team has worked together to expand our Heart Program and integrate blood management strategies that improve patient outcomes.”

A Lively Live-Stream Event

YRMC – Your Destination for Cardiac Care and Blood Management will include an energetic panel discussion with YRMC’s heart specialists and patient blood management experts. Those physicians and other YRMC leaders will also give interesting and informative talks on:

YRMC, A Destination for Hearts and Blood Management
John Amos, BS, MSM, president and chief executive officer, Yavapai Regional Medical Center

Launching YRMC Cardiology – A Journey to Better Outcomes for You
George Rizk, M.D., Invasive Cardiovascular Medicine, YRMC PhysicianCare

The Beat Goes On
Nisha Tung-Takher, M.D., cardiac electrophysiologist, YRMC PhysicianCare

Mending Hearts With Less Invasive Interventions
Soundos Moualla, M.D., FACC, FSCAI, structural and interventional cardiologist, YRMC PhysicianCare
Gwen Rhodes, RN, patient navigator, Yavapai Regional Medical Center

PBM at YRMC – Together We Are Doing Great Things
Elizabeth Black, Patient Blood Management program data manager,
Yavapai Regional Medical Center

Patient Blood Management – YRMC and Beyond
Pierre Tibi, M.D., FACS, medical director, Patient Blood Management and the James Family Heart Center at Yavapai Regional Medical Center

Ask the Experts – Panel Discussion
Pierre Tibi, M.D., FACS
Elizabeth Black, Patient Blood Management data manager, YRMC
Dale Black, Patient Blood Management program coordinator, YRMC
Soundos Moualla, M.D., FACC, FSCAI
George Rizk, M.D.
Nisha Tung-Takher, M.D.

 

To learn more about YRMC – Your Destination for Cardiac Care and Blood Management, visit YRMCHealthConnect.org/pbm. QCBN

By Bridget O’Gara

 

Bridget O’Gara is a freelance writer, communications strategist and project manager who specializes in health care. She works with mission-driven healthcare organizations, including hospitals, other healthcare providers and advocacy organizations.

YRMC Offering Cardiac Care Panel Discussion

By Leave a Comment

Top cardiac specialists from Yavapai Regional Medical Center’s (YRMC’s) James Family Heart Center and leaders from its Patient Blood Management Program will join YRMC – Your Destination for Cardiac Care and Blood Management, a live-stream presentation and panel discussion.

The event will feature prominent heart specialists – a cardiologist, a cardiothoracic surgeon, an electrophysiologist, an interventional cardiologist – and knowledgeable blood management experts. These professionals will highlight the leading-edge, less-invasive procedures used to repair hearts at YRMC as well as how blood management strategies are significantly improving patient outcomes.

YRMC – Your Destination for Cardiac Care and Blood Management will be broadcast live from the Yavapai College Performing Arts Center in Prescott for the public to watch 6-8 p.m., Thursday, Oct. 17, at YRMCHealthConnect.org/pbm.

What is a Healthcare Destination Program?

Healthcare destination programs are thriving, specialized medical programs – typically associated with hospitals – that patients seek out because of their:

Highly skilled physicians

Excellent outcomes

State-of-the-art technology

Innovative procedures

Outstanding staff

“YRMC’s Heart Program and its Patient Blood Management Program check all of those boxes,” said Pierre Tibi, M.D., FACS, medical director of the James Family Heart Center at YRMC and YRMC’s Patient Blood Management Program. “It starts with our exceptional physicians, who were all trained at top heart programs. This team has worked together to expand our Heart Program and integrate blood management strategies that improve patient outcomes.”

A Lively Live-Stream Event

YRMC – Your Destination for Cardiac Care and Blood Management will include an energetic panel discussion with YRMC’s heart specialists and patient blood management experts. Those physicians and other YRMC leaders will also give interesting and informative talks on:

YRMC, A Destination for Hearts and Blood Management
John Amos, BS, MSM, president and chief executive officer, Yavapai Regional Medical Center

Launching YRMC Cardiology – A Journey to Better Outcomes for You
George Rizk, M.D., Invasive Cardiovascular Medicine, YRMC PhysicianCare

The Beat Goes On
Nisha Tung-Takher, M.D., cardiac electrophysiologist, YRMC PhysicianCare

Mending Hearts With Less Invasive Interventions
Soundos Moualla, M.D., FACC, FSCAI, structural and interventional cardiologist, YRMC PhysicianCare
Gwen Rhodes, RN, patient navigator, Yavapai Regional Medical Center

PBM at YRMC – Together We Are Doing Great Things
Elizabeth Black, Patient Blood Management program data manager,
Yavapai Regional Medical Center

Patient Blood Management – YRMC and Beyond
Pierre Tibi, M.D., FACS, medical director, Patient Blood Management and the James Family Heart Center at Yavapai Regional Medical Center

Ask the Experts – Panel Discussion
Pierre Tibi, M.D., FACS
Elizabeth Black, Patient Blood Management data manager, YRMC
Dale Black, Patient Blood Management program coordinator, YRMC
Soundos Moualla, M.D., FACC, FSCAI
George Rizk, M.D.
Nisha Tung-Takher, M.D.

 

To learn more about YRMC – Your Destination for Cardiac Care and Blood Management, visit YRMCHealthConnect.org/pbm. QCBN

By Bridget O’Gara

Bridget O’Gara is a freelance writer, communications strategist and project manager who specializes in health care. She works with mission-driven healthcare organizations, including hospitals, other healthcare providers and advocacy organizations.

Why Does Breast Density Matter?

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You’re dedicated to your monthly self-exams and you follow your healthcare provider’s recommendations for breast cancer screenings, given your age and family risk factors. But are you aware that it’s also important to know your breast density? It’s an important and timely question for October, National Breast Cancer Awareness Month.

Breast density is a way to describe the composition of a woman’s breasts. It compares the area of breast and connective tissue – as seen on a mammogram – to the area of fat. Breast and connective tissue are denser than fat, so high breast density means there is more breast and connective tissue as compared to fat. On a mammogram, connective tissue appears as solid white, making it difficult to see through. And therein lies the challenge.

“Breast cancer also is white on a mammogram,” said Yavapai Regional Medical Center (YRMC) Breast Care Program Medical Director and Breast Surgeon Michael Macon, M.D., FACS. “The whiter the background, the more difficult it is to identify breast cancer in the white background of a dense breast.”

Who is at Risk for Breast Density?

Generally, women who are younger and thinner have denser breast tissue, according to Dr. Macon. As a woman ages, she may gain weight, decreasing the density. Genetics also plays a role. If your mother had dense breasts, you are more likely to as well.

Additionally, breast density is more common among women taking hormone therapy to relieve the symptoms of menopause. Women with dense breasts have a higher risk – up to six times, by some estimates – of developing breast cancer. The reason is unknown.

Learn Your Breast Density

How can you learn your breast density? The radiologist administering your mammogram will determine the ratio of your dense to non-dense tissue. Four categories are used in the Breast Imaging Reporting and Database Systems:

Fatty Replaced Breast (Category A, 0-25 percent dense tissue) – This mammogram likely would show any abnormalities.

Scattered Fibroglandular Density (Category B, 25-50 percent dense tissue) – This breast density has quite a bit of fat, but also a few areas of fibrous and glandular tissue. This is the most common category.

Heterogeneously Dense (Category C, 50-75 percent dense breast tissue) – When areas of fibrous and glandular tissue are greater than fatty breast tissue, it can be difficult to see small masses on mammograms.

Extremely Dense (Category D, 75-100 percent dense tissue) – This increases the difficulty of detecting cancerous tissue because it can blend in with other white background tissue.

What Should You Do About Breast Density?

“If the radiologist determines you have heterogeneous density or extreme density, it is important to have a 3-D mammogram,” said Dr. Macon. “A 3-D mammogram uses new technology to create a three-dimensional picture.”

To assess your risk for breast cancer, Macon recommends the Tyrer-Cuzick Model – also known as the Ibis Risk Model – which may be taken online. This risk assessment tool generates a 10-year risk and lifetime risk of breast cancer based on your answers to a series of questions, including one about breast density. Women with Category C or Category D breast density have an increased risk for breast cancer.“

For women with a lifetime risk of breast cancer greater than 20 percent,” explained Macon, “more aggressive breast surveillance consisting of alternating 3-D mammograms and breast Magnetic Resonance Imaging (MRI) is the standard.” QCBN

 

For screening mammography, including 3-D mammography, contact The BreastCare Center at YRMC at 928-442-8900.

 

Prescott Medical Imaging at 928-771-7577.

To schedule an appointment at YRMC’s Genetic Clinic for a genetic evaluation and possible testing, call 928-442-8747.

YRMC Resource Center Keeping Families Strong for 30 Years

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Thirty years ago, a group of concerned people from Yavapai Regional Medical Center (YRMC) and other organizations sat around a table to discuss the needs of Prescott’s most vulnerable population – its children. They explored ways they could offer support to parents so that they can give their children the best possible start in life. The grassroots effort took hold and the Family Resource Center (FRC) at Yavapai Regional Medical Center was born. The program has grown exponentially over the years, finding new ways to meet the changing needs of our families.
This year, the FRC celebrates its 30th anniversary and continues to make a difference in the lives of young families through three successful programs. Each of the programs is free of charge to families in our community.
First Steps
“Families giving birth back in 1989 needed support and education. They couldn’t Google questions like we can today,” said Family Resource Center Director David Barko. “Yavapai Regional Medical Center came forward with First Steps, which is still in existence today. Specially trained volunteers provide information to every family giving birth at YRMC. They discuss important topics like SIDS prevention and the signs of postpartum depression. We assess what each individual family might need and offer social and emotional support as well.”
One-week and three-month follow-up calls are also part of the family resources program.
Healthy Families
The early efforts of the Family Resource Center brought to light another critical need in Yavapai County – home visits for families to provide additional support and to learn more about early childhood and parenthood. Healthy Families, which is now a nationally recognized program operating in 38 states, was developed at YRMC. The focus of the program is strength and empowerment.
“Healthy Families is one of the top evidence-based home visit programs in the nation. It works,” said Barko. “We use the most up-to-date early childhood development knowledge to support our parents. They, in turn, support their children and give them the best start in life as they can. We know from research and science that the first three to five years of life are the most critical. Every experience, interaction, feeling and relationship a child has during these years literally affects the brain’s development. They set the stage for the rest of the child’s life – how they perceive everything, what kind of relationships they enter into, how they cope with stress, learn to trust, or not. The list goes on.”
Healthy Families visits occur once a week for the first six to 12 months, then every other week. Home visits can continue for as long as five years. The program is customized to meet the needs of each family. Medical health, safe sleep, developmental milestones, well checks, immunizations and childproofing the home are among the information shared with the families. A connection to community services is also part of the program.
Just as important, parents gain a listening ear and a mentor who can help them through tough times they may be experiencing. Healthy Families staff are trained in communication strategies that help remove the stigma associated with postpartum depression, anxiety, substance and alcohol abuse, financial or relationship issues and other life stressors.
The Healthy Families program also offers several holiday-themed social events each year where families can get together, make friends and celebrate what it means to be a family.
Car Seat Safety Program
Continuing to identify needs and find solutions, the Family Resource Center now offers car seat safety checks, conducted by nationally certified technicians. Partnering with other organizations, the safety checks are usually held at the Family Resource Center. They are also offered at community events and health expos throughout the year. As with the other programs through the FRC, the car seat safety checks are free of charge. Educating caregivers – or anyone who transports children – continues to be the priority. In 2018, approximately 90 percent of the seats and children that FRC saw arrived in an unsafe situation or configuration.
In 2018…
– The FRC First Steps volunteers visited all of the families who gave birth at YRMC.
– The Healthy Families program served 76 families, which includes 167 children.
– The Car Seat Safety program distributed 216 car seats and conducted 265 safety checks.
But the numbers only tell part of the story.
Barko notes that even the briefest connection can often lead to unexpected opportunities to help a family. He recalls a car seat check with a grandmother who wanted to make sure she was transporting her grandchildren safely.
“We ended up talking for an hour,” said Barko. “She opened up and shared with me that her daughter was pregnant and experiencing depression. I was able to reassure her and gave her some information so that she could connect with valuable community resources.”
Barko also tells about a mother with two children under the age of six. They were in the YRMC emergency room after a car accident and couldn’t return home because the car seats were destroyed. In addition to new car seats, the Family Resource Center was able to offer emotional support and resources for counseling to help the family cope after such a traumatic event.
At 30 years and counting, the Family Resource Center truly embodies YRMC’s mission.
“In some organizations, the mission is just a poster on the wall,” said Barko, “but at YRMC, those values are lived day to day. If I were to describe our team, the words that come to mind are empathy, heart and spirit. Our goal is that with every visit, every connection, we keep another child safe and help with their start in life.”
For more information on the Family Resource Center, contact David Barko at 928-771-5651 or dbarko@yrmc.org. QCBN

By Joanne Mack Robertson

Joanne Mack Robertson is freelance writer and video producer. She and her husband, Jeff, are the creative energy behind Big Picture Video Production in Prescott and Tucson.

How to Prevent a Brain Attack

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Many in the medical community now use the phrase “brain attack” in place of “stroke.” That’s because strokes have a lot in common with heart attacks.

A heart attack happens when an artery that delivers blood to the heart becomes blocked. Deprived of oxygen and nutrient-rich blood, heart tissue begins to die. Immediate treatment is needed to prevent extensive damage to the heart.

Re-read that paragraph and exchange the word “heart” for “brain.” You are now describing a stroke, or brain attack. Like your heart, your brain is fueled by oxygen and nutrients delivered by the blood. The most common form of stroke occurs when a blood vessel in the brain becomes clogged.

As a healthcare provider, Yavapai Regional Medical Center (YRMC) is sharing information on stroke prevention and how high blood pressure affects brain health. Uncontrolled high blood pressure can double or even quadruple your risk for brain attack.

A severe stroke can permanently destroy massive numbers of brain cells. When brain cells die, abilities controlled by that area of the brain – language, memory, muscle control – are affected. Some people recover completely from brain attack, but more than two-thirds of survivors have some type of disability.

How to Manage Your Risk for Brain Attack

While you can’t roll back the years or change your family history – both of which impact your risk for stroke – the single best way to reduce your risk for brain attack is to maintain a healthy blood pressure.

What is normal blood pressure? Less than 120 over 80 (120/80) is considered normal, according to the American Stroke Association.

If your blood pressure is above the normal range, talk to your healthcare provider immediately. Here are some strategies to get your numbers under control:

Reduce your salt intake to no more than a half teaspoon a day. 

Avoid high-cholesterol foods like hamburgers, cheese and ice cream.

Get to a healthy weight if you’re overweight. Losing even 10 pounds can have a positive impact on your stroke risk.

Eat a diet that includes four to five cups of fruits and vegetables every day, one serving of fish two to three times a week and several daily servings of whole grains and low-fat dairy.

Exercise at least 30 minutes a day, and more, if possible.

Give up tobacco, if you smoke.

Drink alcohol only in moderation. Studies show that more than two alcoholic drinks per day sharply increases your risk for brain attack.

Want to monitor your blood pressure between appointments with your healthcare provider? You may want to invest in a home blood pressure monitor kit. Some pharmacies also have complimentary blood pressure monitors to use. QCBN

Visit YRMC HealthConnect (YRMCHealthconnect.org) for more information on stroke prevention and controlling your blood pressure.

YRMC’s Celebrate Life Health Expo Offering Fun, Learning

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Get ready for an event that’s big, mega and even colossal.

Yavapai Regional Medical Center’s (YRMC) Celebrate Life Health Expo 2019 will feature MEGA Body and MEGA Heart – the world’s only portable, inflatable, walk-through exhibits of the human body and the human heart. The Expo will also include a colossal colon, courtesy of Boston Scientific.

“Touring MEGA Body, MEGA Heart and the colossal colon is a fun and informative adventure for people of all ages,” said YRMC Director of Marketing and Communications Ken Boush. “This is truly an extraordinary and rare opportunity that we’re thrilled to make available to our community during Celebrate Life Health Expo.”

Interactive tours of the larger-than-life inflatables and nearly 100 health and wellness exhibits are part of this year’s Expo. A free community service of YRMC, the Expo takes place 9 a.m. to 3 p.m., Friday, Sept. 6 and Saturday, Sept. 7, at Findlay Toyota Center, 3201 North Main Street in Prescott Valley.

Meet the MEGAs

Tours of MEGA Body, MEGA Heart and the colossal colon delve into how the body operates, potential health challenges and how our lifestyle choices – diet, exercise and not smoking – can help us stay healthy.

“Boston Scientific’s colossal colon is a good example of this,” Boush said. “It’s designed to share lifesaving information to prevent diseases of the large intestine and digestive system.”

MEGA Body includes a teeth-to-torso exploration of the body that begins in the mouth, where visitors learn about cavities and oral hygiene. As you travel through MEGA Body – approximately 50 feet long by 15 feet wide by 12 feet tall – you’ll learn about our body’s bones, muscles, skin and even our ears. You’ll also journey to many organs, including the:

Brain

Esophagus

Stomach

Intestines

Kidneys

Heart

Lungs

Get Pumped About MEGA Heart

At 26 feet long by 15 feet wide by 13 feet tall, MEGA Heart has earned its name. Visitors to this big heart are in for a highly interactive educational experience designed to increase awareness of heart disease and share information on how to keep your heart healthy.

During your MEGA heart adventure, you’ll see how a healthy heart functions, observe examples of various types of heart disease and check out displays featuring some of the latest medical treatments for heart problems.

Here’s what you’ll see inside MEGA Heart:

Heart valves – The heart’s four valves control blood flow in and out of the heart.

Endocarditis – An infection of the inner lining of your heart chambers and heart valves.

Ventricular septal defect – A hole in the heart, which is a common heart defect that’s present at birth.

You’ll also learn about heart attacks, irregular heart rhythms and blood clots as well as current ways to treat those conditions.

“Representatives from YRMC’s James Family Heart Center will join the Expo to highlight the Center’s state-of-the-art medical services and impressive facilities,” said Boush.

To continue the focus on heart awareness, the James Family Heart Center will premiere a video of a pig heart dissection that will run hourly throughout the Expo. Pig hearts – provided by a scientific supply company – are used to teach heart anatomy because they are nearly identical to the human heart. 

Best Exhibits Ever

In 2019, nearly 100 organizations committed to health, wellness and community well-being will participate in YRMC’s Expo.

“The Expo is a great opportunity for people to connect with like-minded organizations and individuals,” Boush explained. “If you enjoy hiking, biking, cooking, exercising, learning and more, you’ll thoroughly enjoy the Expo.”

Here are just a few examples of the experiences and opportunities available to Expo attendees:

People and organizations dedicated to biking, hiking and other healthy lifestyles.

A “smoothie bike” – create a nutritious smoothie as you pedal for fitness.

Healthy nutrition tips and demonstrations (with samples).

CPR basics and first aid tips from emergency experts.

Self-defense and chair yoga demonstrations.

Kids’ fitness routines and information about tennis for kids.

Professional face painters and photos with your favorite mascot, YRMC’s Wellby the Yavabear.

Pre-diabetes self-assessments, lung function tests, blood pressure checks and compression sock fittings.

Chances to get into prize drawings for a Fitbit, Target gift card, a gift basket with kids’ dental health items and more.

Learn more about Celebrate Life Health Expo, see photos and view videos of MEGA Heart and MEGA Body and watch for Expo updates at YRMCHealthConnect.org/Celebrate-Life-Health-Expo. QCBN

By Bridget O’Gara

Bridget O’Gara is a writer, communications strategist and project manager who specializes in healthcare. She works with mission-driven healthcare organizations, including hospitals, other healthcare providers and advocacy organizations.

YRMC’s Genetic Clinic: Information and Tools to Fight Cancer

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Have you wondered how scientific research affects real lives? Look no further than the Human Genome Project for an example of how research moved from research labs to patient clinics, like Yavapai Regional Medical Center’s (YRMC’s) Genetic Clinic in Prescott Valley.

How did this information make it into our everyday healthcare world?

Oncology Nurse Practitioner Jody Pelusi, PhD, FNP, AOCP, who oversees cancer genetic testing at YRMC’s Genetic Clinic recalls, for example, that breast cancer genetic testing used to involve only two genetic mutations: BRCA1 and BRCA2. 

“Now we know many genes exist,” said Dr. Pelusi. “Therefore, we do panel testing to look at anywhere from 30 to more than 100 genes.”

What can genetic testing at YRMC’s Genetic Clinic accomplish? The answer to that question depends on the patient’s individual needs. Genetic testing is typically pursued to:

Pinpoint actual risk for developing cancer from a hereditary mutation versus a perception of cancer risk.

Learn cancer risk based on personal or family risk factors for people found not to be at high risk for cancer based on genetic testing.

Determine the best cancer treatment options, follow-up care and long-term monitoring for people diagnosed with cancer.

Learning Your Genetic Risk for Cancer

Before genetic testing happens – typically starting with a swab of saliva from the mouth – Dr. Pelusi meets with people to discuss their goals. Her approach is part scientist, part counselor and all supportive.

“We talk about genetic testing, the information they will potentially learn and if knowing that will make a difference in how they approach their healthcare,” explained Dr. Pelusi. “Some people may come from families who didn’t discuss illness or they may be adopted and have no knowledge of their genetic history. There are many different circumstances.”

During a first appointment, Dr. Pelusi introduces cancer genetic testing by:

Reviewing the goals of cancer genetic testing.

Discussing why the person is interested in cancer genetic testing.

Developing a profile based on the family’s history of cancer, including the type of cancer and at what age the family member was diagnosed with cancer.

Outlining the pros and cons of genetic testing, including how test results can affect the people being tested as well as their family members.

“About 10 percent of people will actually be found to have a genetic change that puts them at higher risk for potentially developing a cancer,” Dr. Pelusi said. “However, this 10 percent is significant, as this can be life changing. Some individuals will come in and get the information and want to think about it before they determine if they want to undergo testing or not; this is absolutely fine.”

Your Genetic Test Results

For people whose genetic test results show they’re at higher risk for cancer, Dr. Pelusi works with their clinicians to provide valuable information on health care and lifestyle options. This may include increased health monitoring and screenings, lifestyle changes, risk-reducing surgeries and chemoprevention (using drugs, vitamins or other agents to reduce cancer risk, delay its development or help prevent recurrence).

“These are emotional topics,” Dr. Pelusi said. “This is not a time to fear cancer. But we sure can fight it with our awareness, our knowledge and our actions. I make sure people have the information they need to make a decision they’re comfortable with. I listen and respect their approach. You can’t get that in a mail order test.”

To schedule an appointment at the Genetic Clinic for a genetic evaluation and possible testing, call 928-442-8747. QCBN

By Bridget O’Gara

Bridget O’Gara is a freelance writer, communications strategist and project manager who specializes in healthcare. She works with mission-driven healthcare organizations, including hospitals, other healthcare providers and advocacy organizations.

How to Safely Dispose of Your Old Medication

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Do you have expired or partially used prescription medications in your medicine chest, in the back of your kitchen cabinet or stashed in a drawer? Many people keep old pills for years with the best intentions. We want to get rid of them, but often don’t know how to dispose of them properly. We’re concerned about accidentally allowing the medications to get in the wrong hands or taint the environment and simply let them stack up for years.

“It’s important to quit taking expired medications and get rid of them safely as soon as you can,” said Yavapai County Community Health Services Opioid and Substance Abuse Health Educator Josh Goldman. “Expired meds tend to lose their potency, so in essence, you’ll no longer have the benefits of the medication you were prescribed in the first place. Some medications are even susceptible to bacterial growth.”

Medications that tend to lose their potency quickly include liquid antibiotics and compounded medications, which are medications made from a personalized formulation, ordered specifically for you by your doctor.

There is also the real risk of the unused drugs getting in the wrong hands. According to the Centers for Disease Control, approximately 60,000 children under the age of five are seen in emergency rooms each year for accidental medication overdose.

And it is never advisable to give unused prescription medications to a friend or family member. Saving a trip to the doctor or saving money is not worth the health risk.

So, what is the best way to get rid of old medications? Goldman says there are several easy and safe options:

Deterra Deactivation Pouches

Deterra Pouches are a relatively new option for safe drug disposal at home. These sealable pouches contain activated carbon, which renders the drug inert. Simply place your pills, patches or liquid medication in the pouch, fill with warm tap water and wait 30 seconds. Seal and gently shake the pouch and place it in the trash. Deterra Pouches are available for purchase at outlets such as Walmart and Amazon.

DisposeRx

Some pharmacies are now offering DisposeRx packets with every prescription free of charge, to facilitate at-home drug disposal. To use, pour the contents of the DisposeRx packet directly into the pill bottle, add warm water, seal and shake the bottle for 30 seconds. Remove the label from your pill bottle or black out the information with a marker. The bottle can now be safely discarded in the trash. DisposeRx is also available at the Yavapai County Community Health Services office at 1090 Commerce Drive in Prescott.

Another Option for Safe Disposal at Home

If you have no other option for home disposal, the Food and Drug Administration (FDA) and Environmental Protection Agency (EPA) recommend putting expired medications in the trash after following these steps:

Remove the pills or liquid from the original container and mix them with dirt, used coffee grounds, kitty litter or sawdust.

Put the mixture in a Ziploc bag or similar, seal it tightly and put it in the regular trash.

Remove or black out the label on the original container with a marker and dispose of the container separately.

Remember that this method makes the drug undesirable, but will not render the drug inactive.

Drop Boxes

Local law enforcement agencies and some Yavapai College campuses offer free drug drop box locations throughout Yavapai County that will accept medications for safe disposal. Be aware that each location has different parameters regarding what types of medication they will accept. For instance, some drop boxes may not accept sharps, needles, aerosol cans or inhalers.

YRMC’s website has a complete list of Yavapai County drop box locations, contact information, requirements and what medications are accepted at each. To find “Yavapai County Medication Drop Off Locations,” go to YRMC.org, open the green “Support and Community” tab located on the menu at the top of the webpage and then go to “Medication Disposal.” The document will open for you to download and print.

In addition, pharmacies such as Walgreens Pharmacy at 2880 N. Centre Court in Prescott Valley offer drug disposal kiosks, similar to dropping mail into a mailbox.

Medicine Take-Back Events

Drug take-back events are held twice a year in Yavapai County, according to MatForce Executive Director Merilee Fowler. The effort continues to grow.

“The Dump the Drugs National Take Back Day takes place the last weekend of April and October,” said Fowler. “We partner with local law enforcement agencies and the Drug Enforcement Agency to provide easy, accessible drop off locations to the general public. Since 2008, we have collected more than 32,400 pounds of drugs for safe disposal.”

Is Flushing Safe?

According to the Arizona Department of Environmental Quality (ADEQ), prescription and non-prescription drugs can be found at trace levels in treated wastewater discharged from sewage treatment plants. We now know that some of these substances can be harmful to our environment. ADEQ recommends alternative means of disposal whenever possible.

However, the FDA regularly updates a list of prescription medications that have been approved for flushing down the toilet if no other option exists. The known risk of harm, including death, from these substances from accidental exposure outweighs potential risks from flushing them. The list includes medications such as fentanyl, oxycodone and morphine.

What About Medical Sharps?

“The best practice for sharps such as needles, syringes and lancets is to place them in a sturdy, puncture-proof container with a tight lid and tape it shut,” said Goldman. “You can purchase a specially designed container from a pharmacy, or you can use a heavy plastic or metal container that has a secure lid, such as a liquid laundry detergent bottle.”

According to ADEQ, do not use glass containers, and make sure the container is not overstuffed. Mark the container “Do Not Recycle” so that it goes to the landfill rather than a recycle center.

While your container is in the process of being filled for disposal, make sure you keep it sealed and out of the way of children and pets.

Getting rid of your old, unused medications can be safe and easy. Following these recommendations now can make your home safer in the long run by reducing the risk of accidental drug exposure. And you’ll be assured that you’re following the right precautions to keep our environment safe.

For more information on safe medication disposal, or to find out about the next Dump the Drugs National Take Back Day, contact MatForce at 928-708-0100. Yavapai County Community Health Services can be reached at 928-771-3122. QCBN

By Joanne Mack Robertson

Joanne Mack Robertson is freelance writer and video producer who writes for Yavapai Regional Medical Center. For more information about YRMC, visit yrmc.org.

Heart Valve Disease: Five Symptoms You Shouldn’t Ignore

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In years past, your grandfather may have written off his shortness of breath to old age. Even people diagnosed early in life with heart conditions often didn’t link their decreased energy or their dizziness decades later to their heart conditions.

Today, primary care physicians and cardiologists are tuned into subtle changes that may signal heart valve disease – a condition that can affect people in their 40s or 80s.

“People are taking better care of themselves and living longer,” said Cardiothoracic Surgeon Jose Torres, M.D., at The James Family Heart Center at Yavapai Regional Medical Center West (YRMC). “That means more people will be diagnosed with heart valve disease and more will be referred to heart surgeons for treatment.”

In fact, one in 10 people age 75 and older struggle with moderate to severe heart valve disease, which happens when one or more of your heart valves don’t work well. To understand why this happens, it helps to know the role healthy heart valves play in the body. The heart has four valves with tissue flaps – also called leaflets – that open and close with each heartbeat. The flaps ensure blood flows in the right direction through your heart’s four chambers and to the rest of your body.

“Think of the leaflets as doors,” said Dr. Torres. “Normally, the doors are very pliable. They open and close to allow blood to flow through the heart and then to the rest of the body. When the doors calcify, their pliability decreases and the heart has to work harder and harder to pump blood to the body.”

Many people with heart valve disease don’t experience noticeable symptoms until the blood flow is significantly restricted. Symptoms that could signal heart valve disease – and should be discussed with your physician – are:

Breathlessness

Chest pain, pressure or tightness

Fainting

Palpitations or a feeling of heavy, pounding, or noticeable heartbeats

A decline in your activity level or reduced ability to do normal daily activities

Here’s a look at conditions that can cause or contribute to heart valve disease:

Past medical history – A history of diabetes or rheumatic fever and cancer survivors treated with radiation therapy to the chest or sternum are at greater risk for heart valve disease.

Congenital heart defect – People born with two leaflets, called bicuspid valve, are sometimes diagnosed with heart valve disease in their 40s or 50s.

Heart murmur – Calcium buildup or a leaky aortic valve can cause a heart murmur, eventually leading to heart valve disease.

Currently, no medicines can cure heart valve disease. However, medications to lower high blood pressure or high cholesterol may be prescribed. Lifestyle changes – giving up smoking, eating a heart-healthy diet, getting regular physical exercise and aiming for your optimal weight – can slow the progress of heart valve disease.

“Heart valve disease is a structural problem that requires surgery,” Torres said. “Once there’s a heart valve disease diagnosis, the solution is to remove that roadblock with heart valve surgery.”

During surgical heart valve disease repair, patients are placed on a heart bypass machine to keep their hearts working. Cardiothoracic surgeons, like Dr. Torres, then replace the heart’s calcified valve with a new artificial valve.

People considered too high risk for heart valve replacement surgery may be eligible for Transcatheter Aortic Valve Replacement (TAVR). The minimally invasive TAVR procedure takes place in YRMC’s Hybrid Operating Room (OR) – a combined state-of-the-art surgical suite and medical imaging facility.

In YRMC’s Hybrid OR – considered one of the nation’s best – a patient’s heart blockage can be diagnosed and then immediately repaired with a minimally invasive procedure, like TAVR. If the real-time imaging shows the patient requires surgery, YRMC’s heart team is ready to perform the procedure in the Hybrid OR. QCBN

 

Visit YRMC.org to learn more about the advanced, comprehensive services available at YRMC’s James Family Heart Center.