2014-08-03 HealthCare Quarterly

DR. BRIAN LAWENDA HELPS LAUNCH INNOVATIVE WAY TO TREAT CANCER CHIROPRACTIC BIOPHYSICS WORKS TO CORRECT SOURCE OF PROBLEM

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5/2/14 11:14 9:31 AM 7/22/14 AM

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30 CONTENTS

30 A NOVEL APPROACH TO CANCER CARE

Treating the whole patient

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CHIROPRACTIC BIOPHYSICS A technique to end pain and disease

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NEW LEASE ON LIFE Local cardiologist helps young man live a full life after diagnosis of heart condition

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PATIENTS PICK NEVADA Out-of-state patients selecting Southern Nevada for medical care

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APPOINTMENT SHARING Shared medical appointments a new way to get face-to-face health care

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COLUMNS 16

EDUCATION Chris Mowan, CEO, MountainView Hospital Thomas L. Schwenk, M.D., Dean, University of Nevada School of Medicine

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TECHNOLOGY Fadi S. Braiteh, M.D., Comprehensive Cancer Centers of Nevada

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FINANCE Jimmy Lee, CFS, Wealth Consulting Group

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THE NOTES

58 62

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PATIENT SUCCESS PROFILE Katy Jeluso, MountainView Hospital

MAKING THE ROUNDS Southern Nevada health care events

News and notes from the health care community

CALENDAR Upcoming events and classes

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FITNESS Gracie Martinez, Pilates Studio Las Vegas

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48

LAW Stacy Rocheleau, Right Lawyers

26

COMMUNITY

REAL ESTATE Brian Riffel, Colliers International Las Vegas

24

DEPARTMENTS

THE LIST Residential Care Facilities

52

VOLUNTEER Q&A Peggy Miller, Southern Hills Hospital

70

HEALTH TIPS

72

BY THE NUMBERS Health care facts and figures

WELLNESS Nicole Dalessandro, D.P.M., Desert Institute of Specialty Care

Cover photo: Dr. Brian Lawenda by Sam Morris; Above photos: Sam Morris

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The latest health and nutrition news

LOOKING BACK Desert Springs Hospital

FALL 2014

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5/14/14 11:18 5:09 PM 7/22/14 AM

FROM THE EDITOR

W

ith the return of school less than three weeks away, parents are shifting into high gear with final preparations. When it comes to saying goodbye to summer – on the calendar, not on the thermometer – it’s more than just a new wardrobe, notebooks and pens.

Here some tips and things to keep in mind:

• Backpacks are handy for your child to carry materials, but they also can cause a

strain on back muscles and joints. Buy one with two wide, padded straps that go over the shoulders. And make sure it isn’t too heavy for them – and they aren’t hauling around video games, a laptop and extra shoes.

• Stress that an important breakfast will kick start the day for your kids. Try to work it into your

regular daily routine. It’ll make them more attentive and behaved in the classroom. When it comes to a packed lunch, encourage them to work in some protein and avoid the sugary drinks.

• According to the American Academy of Pediatrics, sleep recommendations are at least 10 hours for

children ages 5-10 and nine hours for kids ages 10 and older. Sleep deprivation causes the body to release a chemical that creates a craving of foods full of fat, sugar and sodium. Children who don’t get enough sleep are at greater risk for obesity, according to the Academy.

• With the return to school, your youngsters will be exposed to plenty of germs. Get them in the

routine of using a hand sanitizer or soap with warm water. Remind them not to share drinks or personal hygiene items such as hairbrushes with their friends.

• If your child has a fever or is contagious, keep them home.

• Make sure your children know what bullying is and what to do if it occurs to them. One study

revealed that almost 50 percent of kids said they were “bullied, teased or taunted in a way that seriously upset them.” One the flip side, make sure your child isn’t the one doing the bullying.

• If your little one rides the school bus, give them a refresher on the do’s and don’ts of walking to the

stop as well as crossing the roads. Make sure they’re aware of their surroundings and walk with a buddy if possible.

Seemingly every school year begins with promise and goals. Those can be set for the classroom as well as health-wise. If your child is an athlete – especially at the high school level – have them be aware of the importance of staying healthy and getting stronger. Make the most of the opportunities before them. Be sure to check out the story on page 57 by Dr. Jason Nielson, too.

For the parents with young ones, flip over to page 56 for a real informative piece by Dr. Blair Duddy about immunizations.

A special thank you goes out to our cover sponsor – Nevada State Bank – for its continued support of this publication. Best of luck, too, to all of the kids – and parents – for a successful and safe 2014-15 school year.

Until next time, Rob Langrell Editor of Custom Publications rob.langrell@gmgvegas.com

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FALL 2014

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3/26/13 11:21 12:28 AM PM 7/22/14

E D U C AT I O N

HOSPITAL-MEDICAL SCHOOL PARTNERSHIP BENEFIT ALL NEVADANS

By Chris Mowan and Thomas L. Schwenk, M.D.

T

he crisis in the Nevada physician supply can be solved only if we all work together. That’s what the recent agreement between the University of Nevada School of Medicine and MountainView Hospital is all about.

We have been discussing with our varied constituencies ways to increase the number of physicians who stay in Nevada after completing the first four years of their medical education. One key answer lies in the agreement that our two organizations completed in early June: greatly increase the number of residency (graduate medical education, or GME) positions in Nevada. This goal is the basis of the agreement to begin an expanded GME program based at MountainView.

While this is a School of Medicine-MountainView development, all of the GME positions are open to applicants from any accredited medical school. The program will represent a significant increase in existing GME positions in Southern Nevada, from the current 233 to 380 or more in several primary care and specialty disciplines. The residencies will help enhance the local supply of physicians serving Southern Nevada and will improve patient care access for the Las Vegas community.

“

ed medical and surgical subspecialties. The total program size of 150 additional resident positions will be advanced over a five-year window.

GME, or residency training, is the phase of training after medical school that is required for a physician to practice medicine. It is the final phase of a long educational process and is most influential in determining where a physician eventually practices. We believe that providing medical school graduates more opportunities to stay in Southern Nevada for residency training will have a significant impact on new physicians staying in Nevada to practice.

We have been gratified by the positive reception that our announcement has generated from our state’s leadership. Nevada Gov. Brian Sandoval said, “The announcement that MountainView Hospital and the University of Nevada School of Medicine have joined together to create an expanded GME program for Nevada is commendable. I look forward to MountainView accepting its first residents and for the larger impact this will have on Nevada health care.”

Las Vegas Mayor Carolyn Goodman said, “This is only going to help our state and is a giant step toward our long-

This is only going to help our state and is a giant step toward the long awaited goal of establishing an expanded, quality GME program in Nevada.

The expected start of the first residency program at MountainView Hospital could be as early as July 2016, depending on the speed with which a final affiliation agreement is reached. The agreement is expected to be completed before the end of this year.

Preliminary discussions have focused on GME programs in the critically needed primary care areas of internal medicine, family medicine and geriatrics, as well as specialties such as general surgery, urology and neurology, and select-

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— Carolyn Goodman, Mayor of Las Vegas awaited goal of establishing an expanded, quality GME program in Nevada.”

This is an innovative program for Las Vegas, MountainView Hospital and the School of Medicine. We are looking forward to working together to help grow the pipeline of new physicians. Offering medical students additional options for their residencies will keep more physicians in Nevada and assist as we continue to elevate patient care in our communities.

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One of the most exciting aspects of this partnership is that we can build upon the number of physicians now working with the School to provide primary and specialty care GME in the programs that already are established at University Medical Center and the VA. MountainView Hospital’s 340-bed size and wide scope of primary and specialty care offer a broad foundation of clinical expertise upon which to support the ambitious number of residencies we envision for Southern Nevada. The Cardiovascular and Thoracic Surgery Associates group is helping to redefine patient care and outcomes, while the Las Vegas Institute of Robotic Surgery is leading the region with its depth and scope of robotic-assisted surgeries. These innovative programs are examples of how we can work in partnership, thinking ahead to com-

munity needs in the future. The well-laid foundation that is already in place will only help to grow additional programs and enhance patient care in our community.

This agreement is particularly notable because private hospitals have not traditionally affiliated with medical schools for large residency training programs. The urgency of the physician shortage and opportunity presented by this particular time and place have propelled our actions and will continue to focus our attention to opening our collective doors to new residencies as soon as possible. The impact will be tremendous, leading to 50 to 60 residency and fellowship graduates each year who have a high likelihood of staying in Southern Nevada and enhancing its health and health care.

Chris Mowan is chief executive officer at MountainView Hospital and Thomas L. Schwenk, M.D., is dean of the University of Nevada School of Medicine.

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TECHNOLOGY

IMMUNO-ONCOLOGY: UTILIZING YOUR IMMUNE SYSTEM TO FIGHT ALL TYPES OF CANCER

By Fadi S. Braiteh, M.D.

I

n the past three years, there has been nothing short of a remarkable revolution in the way we understand and ultimately treat cancers. There are thousands of different types of cancers and no two cases are the same.

In the last decade, the field of oncology has evolved from grouping cancer cases based on the organ where they originated from and treating all patients collectively with chemotherapy, to individually recognizing the molecular makeup of each case and personalizing a treatment plan specific to that person and its cancer biology.

Researchers have accelerated the development in the field of immuno-oncology, where newer drugs aim to re-establish the body’s immune system capabilities to recognize the cancer cells and selectively destroy them through natural means.

This promising new therapeutic approach is not just providing meaningful hope, but is already delivering unprecedented results with many cases resulting in a cure of advanced widespread cancer, which until today would be deemed terminal.

Before diving into the details of immuno-oncology, it’s important to understand the history of cancer treatment and how we’ve arrived at immuno-oncology as a prime option for patients.

From surgery to immuno-oncology The first surgery to remove cancer dates back to ancient Egypt, more than 4,000 years ago and for long was the only available procedure to treat cancerous growth. At the turn of the last century, discovery of radium by Marie Curie quickly led to its application for cancer treatment both in Europe and the United States. Cancer has the tendency to spread throughout the body, therefore the need for a medicine which could stop it from spreading everywhere in the body was crucial.

The usage of systemic chemical agents gave birth to chemotherapy and the field of medical oncology. The development of specific chemical agents, calculation of the right dose and testing of the right combination has been

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the foundation of chemotherapy, and originated back in the post World War II era. In fact, the Federal Drug Administration approved its first anti-cancer drug back in 1949.

When cancer cells metastasize, or spread from the site of origin to a distant organ, the disease becomes often noncurable, and most harmful. The hallmark of a cancer cell is its ability to resist death, divide rapidly non-stop without respect to physical boundaries. Since the 1940s, chemotherapy agents have been designed to stop the cancer cell rapid division, duplication and growth. However, chemotherapy is a double-edged sword, with collateral damage to the normal bystander cells. While most of the damage is afflicted to the cancer cells, healthy cells can succumb to the chemotherapy, which is why patients often lose hair and their blood cell counts drop, increasing symptoms and other adverse events such as heart, nerve, and liver damages.

In the last two decades, the discoveries in molecular and cell biology, as well as the accelerated advances in genetics, led to a new era in understanding the biology of a cell. As a result, two new classes of non-chemical biologic agents, often referred to as “small molecules” and “monoclonal antibodies,” were engineered to directly target the affected component of a specific cancerous cell. Some of these agents have been lifesavers such as, Imatinib, and other newer molecules, in the treatment of chronic myelogenous leukemia, the anti-HER2 antibodies and small molecules in the treatment of breast and stomach cancers. Other new biologics to treat variants of lung cancers, leukemia, prostate cancers and melanoma revolutionized the approach on how we treat cancer.

Immuno-oncology is the most recent “superstar” offering meaningful advances in the field of cancer treatment. The concept of empowering the immune system to fight back cancer cells is not new, and even pre-dates the birth of chemotherapy; but unlike Leonardo da Vinci plans for flying machines, it took a few decades before it became a reality and could deliver unprecedented results.

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“

The hallmark of a cancer cell is its ability to resist death, divide rapidly non-stop without respect to physical boundaries.

Equipping the body’s ‘police force’

In theory, each individual could develop a cancer cell in his or her system at some point. But the immune system, an extremely complex cluster of highly specialized cells and molecules, is the body’s “police” and will recognize the cancerous cells to eliminate them. This system is not perfect and can be overwhelmed at times, or shut down by the cancer itself. The cancer can develop a “camouflage” process to shield itself from the immune system. The cancer can then survive, grow, spread and ultimately take over the normal body functions, rendering it incapable of eliminating the malignant cells.

For years, researchers tried to put the immune system to work to attack the cancer cells, but only to get modest results. Bacillus CalmetteGuerin was given through a urinary catheter to treat early bladder cancer. Natural immune systems products, administered to patients at high dose, such as Interleukin-2 and Interferon successfully helped treat some melanoma and kidney cancers. However, the long-term success was rare, often limited and unpredictable, not to mention it was delivered with a high rate of serious and severe toxicities and side effects.

The recent discoveries of how the body limits the power of the immune system, which is often held back by the cancer itself, offered a unique opportunity to reverse this process: re-exposing cancer cells to the immune system and unleashing it back to attack and selectively eliminate the cancerous cells. An immuno-oncology product can come into play by breaking down the camouflage, exposing the malignant cells and eliminating them. Although the success story of immuno-oncology is still unfolding, the preliminary results offer profound anti-cancer responses, and some terminal cancer patients are now cancer free, with a hope of a definitive cure being a reachable reality.

Research and results Comprehensive Cancer Centers of Nevada, along with a few other University Cancer Centers, has pioneered partnerships with numerous pharmaceutical and biotechnology companies to develop many of these immune-oncology compounds, often referred to as checkpoint inhibitors such as anti-CTLA4 combinations, anti-PD-L1, anti-PD-1, anti-OX40 and IDO inhibitors. The clinical researchers at the Translational Oncology

— Dr. Fadi Braiteh

Research Program at CCCN are able to partner with other prestigious centers to develop clinical trials with novel combination of these products. This allows patients from Southern Nevada easy access to promising drugs that are normally available at distant centers located in places such as Texas, Connecticut, Massachusetts or Europe.

Our research with national affiliations is leading to remarkable results.

The anti-PD-L1 compound MPDL3280A (manufactured by Roche Genentech) has proven to be effective in eradicating a number of different types of cancer including melanoma, kidney, bladder, head and neck and breast cancers, in addition to few cases of ovarian, and stomach cancers.

We helped take the compound to Phase II study in lung cancers, and now in Phase III trial. The unprecedented success in bladder and kidney cancers led to its development in Phase II and III trials at CCCN. The bladder cancer results were unique and based on data co-presented by CCCN at the American Society of Clinical Oncology 2014 annual meeting has been awarded “breakthrough therapy” designation by the FDA. Many patients in Las Vegas with widespread bladder cancer are disease free after treatment with MPDL3280A. Three patients with a metastatic breast cancer, the aggressive triple-negative variant, are cancer free in response to such agents. Similar impressive results are also seen in patients with head and neck cancers. Although this specific trial continues to only enroll patients with bladder and breast cancers, other studies are available at CCCN designed for patients with melanoma, lung, bladder and kidney cancers. Newer studies are also planning to open at CCCN and will start enrolling patients with various other types of cancer.

The next chapter Only a solid collaboration between scientists, physicians, pharmaceutical companies, government agencies, and national affiliations along with the determination of cancer patients can lead to ethical and meaningful scientific research studies to advance the field and improve the outcome of cancer treatment.

The field of medical oncology is at the forefront of making a giant leap forward, and significant progress is projected for the next 10 to 15 years.

Yesterday’s science fiction is now today’s reality.

Dr. Fadi S. Braiteh is a medical oncologist and director of the Translational Oncology Program (TOP)-Phase I for Comprehensive Cancer Centers of Nevada. He is board certified in medical oncology and palliative medicine and specializes in the area of gastro-intestinal and thoracic oncology.

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FINANCE

PHYSICIANS NEED A PERSONAL FINANCE MANAGER

By Jimmy Lee, CFS

W

ithin my practice, I have formed a specialized program for physicians, helping them properly prepare for retirement, instill a succession plan, protect themselves and their assets and take on other related points of fiscal responsibility.

Doctors face a variety of difficulties. One may have a financial advisor, an insurance agent, a CPA and an attorney, all playing a specific role in asset protection and retirement saving. This can pose a difficulty when it comes to coordinating all of the moving parts. Physicians have a lot to potentially lose, and not much time outside of work to plan.

As such, I have authored a few takeaways that all doctors should consider when it comes to asset protection, succession planning, comfortable retirement and estate planning.

• Start early. Just because this rule applies to all professions, does not mean that it is any less important to physicians. I’ve seen too many doctors hit the age of 50, go to their financial planner and get shocked when they can’t retire as comfortably as they want to. It is paramount to remember that the ability to make a lot of money is often mutually exclusive with the ability to save a lot of money.

• Your practice is a business, treat it like one. This seems obvious, but is often ignored. Take advantage of small business savings plans, properly plan to minimize assets lost to taxes, and remember, stopping work means selling your practice or passing it onto somebody, rather than just retiring. It is a very unpleasant surprise when somebody is ready to retire and is blindsided with a longerthan-expected legal and financial process.

• When putting forth a financial plan, be flexible. This flexibility is not just a mindset. If you are working with a financial advisor, be sure to incorporate a contingency plan so that if you suddenly want a big change, it can be done with little hassle and financial stress. There will be many opportunities to move, expand, contract, join a conglomerate, etc. You need to be ready so you can decide purely on what is absolutely best for you, rather than what is doable.

• Protect yourself. Liability insurance is a great start, but it is just that – a start. I advise my clients to incorporate their practices. This ensures that personal assets are protected in case of lawsuits from employees or business creditors, and generally lessens the potential for a lawsuit, because a smaller payoff is less likely to be worth one’s time. Of course, having proper amounts of malpractice and personal liability insurance are critical.

• When you expand your practice, do so correctly. One of my clients, a physical therapist, has discussed that in growing, it’s time to think more like a business owner and less like a physical therapist. One can be a tremendous practitioner, but in gaining this expertise, not fully hone the skills needed to be a successful practitioner and business owner. Hiring somebody with a businesscentric skillset can help you expand your practice significantly while you focus more on your patients – ensuring that you are not just a more successful doctor, but also more importantly, a better doctor. Note that growth, in a way, compounds on itself. An owner of a small practice might find a buyer who is willing to pay three- to five-times earnings, whereas the owner of a large practice might be able to get five- to 10-times earnings.

• Prepare for the future. It astounds me that doctors can be so up-to-date on every new technical piece of progress in medicine, but not at all medical business-savvy.

For example, telemedicine (the ability to provide care using technology on a mobile basis) is definitely going to be a part of the field moving forward, and those who are prepared will progress much more quickly than those who are not.

Overall, the important point to keep in mind is that a little effort now can save an absurd amount of hassle later.

Working in Las Vegas, we are prepared for almost anything.

Let’s not forget to prepare for the future.

Jimmy Lee, CFS, is a managing partner at the Wealth Consulting Group, a Las Vegas-based wealth management firm with about $1.5 billion in assets under advisement.

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City National is The way up® for me and my business.

Walter Schroeder, M.D. Ear, Nose and Throat Specialist Hear Dr. Schroeder’s complete story at cnb.com/HelpYouGrow.

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R E A L E S TAT E

MEDICAL MARIJUANA TO IMPACT COMMERCIAL REAL ESTATE MARKET

By Brian Riffel

T

he legalization of marijuana is creating a new buzz for Nevada. The recent developments usher in thoughts of positive economic development in the Valley. Each municipality in Southern Nevada is at a different stage of this new medical venture, and the final outcome is still yet to be determined.

The commercial real estate market has been experiencing modest improvement over the past 18 months regardless of the new medical marijuana movement. The market has gone through several recovery stages, and the vast majority of bank-owned properties are no longer available, as the tenants and buyers have exhausted most of the “Flight for Quality� opportunities. Build to suits have also expanded, and now speculative developments are beginning to take shape.

The medical marijuana opportunities have been on a fast-paced, learn-as-you-go process, as the municipalities are working quickly to establish regulations and guidelines for these types of operations, and how they revolve around commercial real estate.

Not limited to dispensaries The majority of the media is focused on the dispensaries, which are the retail end of the business. There are, however, also the cultivation and testing aspects to consider. Since marijuana is still a controlled substance on the federal level, transportation of marijuana across state lines is problematic.

This necessitates cultivation of the plants in the same area they are to be consumed. Property owners must consider if they will lease or buy their commercial real estate space.

Since retail space is primarily lease only, operators must first seek out landlords who will allow this type of use in their space.

Surrounding area impact In terms of leasing, many landlords must face the moral dilemma for this type of use, as well as consider how it will impact neighboring tenants.

Will nearby tenants be opposed to these types of operations? Will prospective tenants look elsewhere if an operating medical marijuana facility is already in operation? Will tenants be put off by these potential neighbors?

The landlords have a lot to consider and must focus on all of their current tenants, as well as potential future business.

Location requirements and restrictions made by the municipalities are making it difficult to find and lease suitable properties. Add that to the headache of trying to find an agreeable landlord, and the operator has quite the task at hand.

Market influence The commercial real estate market will most likely see an upswing in higher lease rates, as the landlords drive rates upward in the market.

Due to the high risk involved with these operations, increased rent rates as well as nonrefundable deposits may be required. In terms of saleable properties, the seller can also seek and demand a higher price since the availability of locations that meet the requirements and restrictions will be limited within the Las Vegas Valley.

This price increase will eventually be seen as a bubble, and may skew comparable property values and future listings within the market.

Currently, many Las Vegas locals who are getting involved with the medical marijuana business are partnering with out-of-state operators. The out-of-state operations are up and running, and they could bring the know-how to our market with their experience and expertise in the field.

It is safe to say that good real estate products will continue to be absorbed by both medical marijuana operators and the traditional users.

In terms of the impact on commercial real estate, the cultivation part of marijuana for medical use will have the largest impact on absorption in commercial real estate, especially the industrial product type. Due to the fact that marijuana continues to be a controlled substance on the federal level, institutional owners of real estate avoid doing deals with growers and dispensers.

For this reason, leases with companies in the marijuana industry tend to go toward older, smaller properties with local ownership. In a market with elevated vacancy rates, especially in older product, this could prove to be quite a boom.

The industrial market may see an influx of rate increases as more and more spaces are being leased to these operators. With no new industrial real estate development currently taking place, this will push rates higher as vacancy rates will continue to drop.

Brian Riffel is senior vice president, industrial division at Colliers International Las Vegas.

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All of these therapies, as well as comprehensive digital imaging and lab services, are provided under one roor, while maximizing efficiency and

coordination of care and minimizing stress on patients. CTCA® is also the nation’s first all digital cancer hospital.

We also believe in providing the Mother Standard® of care in the delivery of that treatment. Choosing the right treatment facility is one of the most important decisions a patient and their caregivers will make in their journey with cancer. Each day, cancer patients from across the nation come to CTCA to receive care from a team of highly-skilled clinicians and physicians with expertise in treating all forms of cancer, including advanced stage disease. The hospital’s travel program assists qualifying patients with expenses incurred while traveling for care. Upon arriving at

CTCA, patients receive an individualized, comprehensive treatment plan developed by cancer experts across multiple disciplines who work together as a team.

Advocating for patient empowerment through health literacy, CTCA publishes quality of life data and survival outcomes for the most common cancer types on their website. To learn more about the unique, integrative treatment options available at CTCA, or to speak with an Oncology Information Specialist for more information, visit cancercenter.com or call 888-214-9488.

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3:03 PM 7/23/14 3:09

H E A LT H C A R E L A W

KNOW YOUR LEGAL OPTIONS FOR HEALTH CARE COVERAGE AFTER DIVORCE

By Stacy Rocheleau

T

here are a wide variety of issues that arise during divorce settlements, but one of the most common is the question of how to address health care coverage. Negotiating health insurance coverage and health care costs is incredibly routine in a divorce.

The issue continues to be a hot topic among separating couples because most families are covered by one spouse’s health insurance plan. Typically, that is the individual who has served as the family provider or the spouse who simply has more comprehensive coverage through his or her employer.

As a result of this trend, divorce often leaves one spouse without health insurance after losing coverage through his or her former partner. A study published in the Journal of Health and Social Behavior found that approximately 115,000 women each year lose private health insurance after a divorce. In the divorce cases that I handle, I see men losing their health insurance coverage as much as women.

Individuals can face a significant financial burden if they are suddenly left without health care coverage following a divorce, and people often already have other issues to tackle, such as finding a new residence or dividing household bills. It is imperative that people are aware of their legal options during a divorce to obtain financial assistance for health care costs.

There are several avenues that separating couples can consider for addressing their health insurance coverage.

It has definitely become easier for divorced individuals to find new health insurance coverage after the implementation of the Affordable Care Act. Those with pre-existing conditions no longer have to worry about being rejected or charged higher premiums when they are searching for a new provider.

Some people might not need to find a private provider following a divorce. It is useful when couples are divorcing to consider the age and income of the spouse losing coverage, as they might qualify for Medicare or Medicaid.

Divorced individuals also have the option to apply for continued health insurance coverage under their former spouses’ plans under a federal law called the Consolidated Omnibus Budget Reconciliation Act, or COBRA. I don’t recommend this option, however. Those who use COBRA can face costly premiums as high as 102 percent of the group rate cost.

Health costs can be challenging in many divorce cases.

Unfortunately, I find that many who choose to use their own

employer’s insurance or private insurance after a divorce may not be able to afford health insurance payments.

If a couple knows that is the case, it is important to discuss financial compensation for the individual losing coverage through his or her spouse during the divorce negotiations. While these conversations can be difficult, it is wise to address the issue before the divorce is final.

Divorcing couples often agree that the spouse losing health insurance will receive additional spousal support. This support can help supplement the individual’s income to afford monthly insurance payments he or she didn’t face before.

Spousal support can also cover any out-of-pocket payments a spouse was providing for important health care.

There are also more unusual tactics some divorcing couples pursue to address health coverage concerns. Some individuals simply try to keep their former spouses on their health insurance plans after they divorce.

I do not recommend this, as it is insurance fraud. I have witnessed a couple attempt this, only to be discovered by the insurance company during an audit. All of the expenses that had been covered were charged directly to the uninsured spouse.

There is still another option that I see couples use more often than many might expect. Some splitting couples face the combined issues that one spouse will lose coverage in the divorce, while the other is unable to afford compensating for the loss with spousal support payments.

In these instances, it is possible for couples to opt for a legal separation instead of divorcing. I explain legal separation as a “half marriage.” The couple is technically still married, but not all legal aspects of marriage still apply. For instance, one spouse can incur debt without that applying to his or her legally separated spouse. However, an individual can still retain coverage under his or her spouse’s health insurance plan if they are legally separated, which many couples choose to do.

While legal separation has proven successful for some of my clients, I recommend considering this option carefully.

While both individuals can continue using the same health insurance plan while they are living apart, they don’t have the same legal status as a divorced couple.

Although it can be daunting to consider health insurance coverage in divorce settlements, there are many options available for couples.

Stacy Rocheleau is an attorney with Right Lawyers law firm.

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FITNESS

PILATES CAN ‘MEGAFORM’ YOUR BODY, INCREASE FLEXIBILITY AND STRENGTH

By Gracie Martinez

I

began teaching Pilates in 1998 after an 18-year career as a professional dancer and choreographer.

I had the privilege to choreograph halftime routines for the Los Angeles Clipper Girls and the San Diego Charger Girls, to teach dance alongside Tina Landon and Paula Abdul, study with Joe Tremaine and perform for four years in Bally’s Jubilee – the show that brought me to Las Vegas from Los Angeles.

Since then, I have completed certification training with BASI Pilates, Physical Mind Institute, Aline Conditioning, ACE Personal Training, Gyrotonic and the Megaformer. I continually work to expand my knowledge and expertise, and I am currently working on my Pilates master training with my mentor, BASI Pilates founder Rael Isacowitz.

In 2007, I opened the Pilates Studio Las Vegas at 3655 S. Durango Drive, Las Vegas. Owning my own studio gives me the freedom to present innovative health and fitness opportunities to my friends and community here in Las Vegas. Last month, one of my clients told me “sweat is just the fat crying.”

At the Pilates Studio Las Vegas, we do our best to make fat cry like it’s watching Beaches alone in its sweatpants.

That said, “thin” is not our goal. Physical fitness is more than the number on your scale or the tag on your jeans. Fitness is a component of health, and at the Pilates Studio Las Vegas, we help our clients achieve cardiorespiratory endurance, muscular strength, muscular endurance, flexibility, and yes, improved body composition.

For this, we use the Megaformer. The Megaformer was born when French bodybuilder Sebastien Lagree deconstructed the old “horse and buggy” Pilates Reformer and used the parts – plus a few more – to build his “Cadillac.”

The Megaformer workout, or as some call it, “Pilates on Steroids,” uses resistance and counter-resistance, springs and pulleys, to target muscles while reducing impact on joints and connective tissue.

A Megaformer class takes a simple exercise and unleashes its full potential. Take the lunge, for example. During class, I may ask my clients to do slow lunge repetitions on the Megaformer for one minute, then hold the lunge for 30 seconds, repetitions for another minute and then short pulses for another 30 seconds. The counter-resistance built into the Megaformer relieves pressure on the knees and tar-

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gets the hamstrings, glutes and quadriceps, building muscle strength. The series of repetitions, holds and pulses trains the muscles to the point of fatigue, building muscular endurance. Shaking muscles are good!

The support of the Megaformer also allows my clients to gently stretch deeper into the motion of the lunge, increasing flexibility around joints and lengthening muscles. My classes string together exercises like the lunge into series, creating cardiovascular workouts that safely elevate the heart rate to burn calories, boost metabolism and build endurance. It is a full-body workout, and we commonly combine exercises, working out shoulders and triceps during squats or lunges, or simultaneously working arms and obliques.

Clients often experience soreness after working out on the Megaformer, which is initially a surprise to very fit people. The unique resistance and counter-resistance system of the Megaformer effectively targets under-used muscle groups. My clients are surprised to wake up the next morn-

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ing, feeling muscles they didn’t remember that they had. This also allows us to target “problem areas,” providing unexpected solutions and toning long-standing wobbly bits.

We try to leave classes with smiles on our faces, and on our butts!

The average Megaformer workout burns between 400 and 800 calories during the 45-minute class, but my clients also burn extra calories over the course of the day. I wore a calorie counter on the day of my first class, and found that I burned 1,500 calories in one afternoon! I continued burning calories after class at more than twice my regular rate.

One of my clients recently decided to get serious about fitness. In addition to a healthy nutrition program, she began taking Megaformer classes three times per week, and a Barre class on Saturday mornings. She lost 20 pounds in three months! I had another client discover she had lost three inches around her waist after a 30-day holiday fitness challenge.

While the Megaformer is a hot trend in celebrity fitness – devotees include Jennifer Aniston, Sofia Vergara, Alessandra Ambrosio and Kim Kardashian – most of my clients are regular Las Vegans, enjoying the benefits

of elite fitness training without any velvet ropes. Still, the Megaformer is available in Nevada exclusively at the Pilates Studio Las Vegas, and our small studio ensures that each of my clients receives the personalized attention necessary to optimize his or her progress.

The Pilates Studio Las Vegas is unique among Megaformer studios because we also offer traditional Pilates as well as Barre Plus fitness classes.

While most of my clients jump right into a Megaformer workout, some prefer to start with Pilates, building up their strength and endurance at a slower pace until they feel comfortable moving on. The first few classes are the hardest, and I offer slight modifications to help my clients build the strength and endurance for the full workout.

Perhaps most importantly, my clients leave a Megaformer session exhausted, but quickly begin feeling healthier and more energetic. I help people look and feel their best, and that is the most rewarding part of my career.

Gracie Martinez is owner of the Pilates Studio Las Vegas.

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WELLNESS

PUT YOUR BEST FOOT — AND SHOE — FORWARD IN WARM WEATHER

By Nicole Dalessandro, D.P.M.

S

ummer is a traditional time to kick off your shoes and relax, but it’s not always the best time of year for foot health. The heat and humidity – paired with the desire to go barefoot or wear unsupportive shoes – can lead to numerous problems for your feet.

Conditions including plantar fasciitis, bunions, neuroma, metatarsalgia and complications related to diabetes can all be an unfortunate result of your summer shoewear selection.

Feet are the foundation of the body. If the feet are mechanically unsound, the alignment of the ankles, knees, hips and spine can be altered. Follow the below tips to select summer shoe options that flaunt both style and support.

When wearing wedges it is important to ensure that the shoe extends from the back of the heel to the forefront.

Additional tips include: • Look for shoes that have cork or raffia soles, as they offer better shock absorption.

• Avoid wood soles. Wood is very rigid and can cause your foot to overcompensate. This can lead to instability and extra pressure on the knees and hips.

• Consider purchasing sole inserts for added support.

Inserts are sold over the counter and can also be custom ordered.

When wearing casual sandals you must ensure that the heel of the shoe doesn’t lie lower than the forefront. Many “earth shoes” are built this way and increase the chances of damaging the Achilles tendon. Additional tips include: • Avoid sandals without arch support and cardboardthin soles that don’t offer any shock absorption.

• Steer clear of straps that have the potential to rub and cause blisters. This can lead to more severe conditions in the summertime, such as fungal infections or eczema.

When wearing platforms or heels, try to limit your time standing in the shoes and always have a back up pair of supportive shoes to change into if needed. Wearing heels frequently, for long periods of time can increase your risk for metatarsalgia, which causes pain and inflammation in the upper foot region. Additional tips include: • The thicker the heel, the more support you receive.

• Purchase a padded insole or arch cushion for extra support.

• When wearing closed-toed shoes, ensure your feet are dry and use an antiperspirant.

One of the most popular shoe choices is widely considered a summer fashion staple – flip-flops. Despite the popularity of the footwear option, it is arguably a shoe style that can potentially cause the most harm to your feet and overall alignment. Flip-flops do not provide any arch support and can actually begin to flatten out your arch over time.

Most flip-flops have thin, unsupportive soles and aren’t made to walk on uneven terrain, in turn increasing risk of spraining your ankle, along with other potential injuries.

Due to these risks, keep flip-flop wearing to lounging poolside, around the house or gardening in the backyard. Avoid this option when you will be covering uneven terrain or long distances.

With any shoe style, it’s imperative to ensure your shoes fit correctly. Shoes that are too narrow for your foot can lead to nerve damage and neuroma, which causes pain, odd sensations and numbness over the ball of the foot. Ways to know your shoes fit correctly include: • Ensure the ball of your foot fits comfortably into the widest part of the shoe.

• Avoid buying shoes that feel too tight and expect them to stretch to fit.

• Shoes should not ride up and down on your heel when you walk. Your heel should fit comfortably in the shoe with a minimum amount of slipping.

• Don’t select shoes by the size marked on the shoe, but rather by how the shoe fits your foot.

• When fitting your shoe, make sure there is enough space (three-eighth inches to a half-inch) for your longest toe at the end of each shoe when you are standing up.

Another general tip that applies to all types of footwear, especially during the summer months, is ensuring the shoes are clean. Humidity, heat and pool water can all make your shoes a breeding ground for fungus and bacteria.

Fungal spores can reside in shoes for years. Purchasing and using a topical or aerosol foot antiperspirant can eliminate this problem. Additionally, after wearing your shoes make sure to thoroughly wash and dry your footwear to maintain your foot health.

Dr. Nicole Dalessandro is a podiatrist at the Desert Institute of Specialty Care. She specializes in general foot and ankle care, forefoot and rearfoot surgery, sports medicine, wound care and biomechanics.

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A Red Rock Fertility Success Story

features

Photographer: Meghan Poort

Elanor’s Story Ever since their wedding in 2010, Mom and Dad had longed to be parents. Despite continuous attempts, they had not found success. Mom was of advanced maternal age (over 40) and had been diagnosed by Hysterosalpingogram as having a bicornuate shaped uterus. In 2012 they turned to Red Rock Fertility for help. Dr. Littman was immediately able to determine that the abnormality was not a bicornuate shaped uterus but was actually a large uterine septum which was preventing Mom from staying pregnant. Through a hysteroscopy, Dr. Littman was able to correct the problem. After a brief recovery period Mom and Dad began their first IVF cycle and had success with their very first implantation! They became pregnant with Baby Elanor and Mom was able to carry her to a healthy delivery. Congratulations to Mom, Dad and Elanor.

To learn more about Red Rock Fertility, visit us online at www.redrockfertility.com Red Rock Fertility Center is Nevada’s 1st and only boutique-style center specializing in personalized physician care and expertise in an intimate, cozy setting. Giving the gift of life all year long.

Eva Littman,

Mark Severino,

Shannon L. McGrath,

Practice Director, Trained at Duke & Stanford Universities

Medical Director, Board Certified in Obstetrics & Gynecology and Reproductive Endocrinology & Infertility

Women’s Health Nurse Practitioner, Received Master’s Degree in Nursing from Vanderbilt University with the Highest Honors

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6410 Medical Center Street, Suite A • Las Vegas, NV 89148 870 Seven Hills Drive, Suite 103 • Henderson, NV 89052

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M.D., F.A.C.O.G.

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Schedule An Appointment Today 702-979-7475

M.S.N., W.H.N.P.-C.

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7/21/14 12:08 2:43 PM 7/22/14

A NOVEL APPROACH TO

CANCER CARE TREATING THE WHOLE PATIENT

By Sara Costanza

2

1 st Century Oncology of Las Vegas launched the Integrative Oncology and Cancer Survivorship Program for cancer patients and survivors this spring.

The program offers comprehensive, evidence-informed rec-

ommendations to promote an anti-cancer lifestyle – combining three essential components to cancer care: conventional treatments (i.e., radiation therapy, chemotherapy and surgery), complementary treatments (i.e., acupuncture, massage) and lifestyle changes (i.e. anti-cancer nutrition, exercise and stress reduction).

Harvard-trained, board-certified radiation oncologist and Stanford/UCLA-trained medical acupuncturist, Dr. Brian Lawenda is the national director of the Integrative Oncology and Cancer Survivorship Program for 21st Century Oncology. With a steady Continued on page 32

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Dr. Brian Lawenda, the national director of the Integrative Oncology and Cancer Survivorship Program for 21st Century Oncology.

Photo by Sam Morris

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“

…combining conventional and complementary treatments with lifestyle changes, we empower

patients to manage side effects and symptoms

and make lasting changes that make the body less conducive to cancer.

— Dr. Brian Lawenda

Continued from page 31

source of credible medical research supporting the benefits of this approach, patients are becoming more aware of the potential to maximize their cancer care and personal health. The methods are being piloted in Las Vegas with the goal of rolling out similar programs in other 21st Century Oncology centers across the U.S. “This program is designed to help guide patients through their treatment and survivorship using a whole systems approach,” says Lawenda. “By educating our patients and coaching them about the importance of combining conventional and complementary treatments with lifestyle changes, we empower them to manage side effects and symptoms and make lasting changes that make the body less conducive to cancer.”

As part of their cancer care, patients who enroll in the program learn about helpful diet changes, stress reduction tips, and the safe and effective use of supplements and complementary therapies (i.e., acupuncture, massage, yoga, etc). Patients also receive customized survivorship care planning to help maintain the anticancer lifestyle after treatment.

The introduction of this in-office Integrative Oncology and Cancer Survivorship Program represents a significant leap forward in offering a more holistic, personalized approach to Integrative Oncology and survivorship care planning for local cancer patients.

Dr. Constantine Mantz, chief medical officer for 21st Century Oncology, the nation’s largest integrated cancer care provider, recognizes the importance of this Integrative Medicine approach.

“The Integrative Oncology and Cancer Survivorship Program offers patients practical and scientifically-informed information

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about how to best maximize their care,” says Dr. Mantz. “Integrated Cancer Care has been our operating model for over 30 years, and providing these resources directly to patients will prove invaluable to their care.”

We sat down with Lawenda to find out more.

Q. What does Integrative Oncology mean?

Integrative Oncology is a comprehensive approach to cancer care based on combining anti-cancer lifestyle changes, evidenceinformed complementary and alternative therapies, and the latest,

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state-of-the-art cancer treatments. The goal is to improve the lives of people affected by cancer and to help them increase their sense of hope and control. This is for patients who want to know what else they can do (besides optimize cancer outcomes and minimize side effects.

Many patients come to me looking for relief from the various side effects and complications that can occur during and after cancer treatment, such as anxiety, stress, pain, nausea and sleeping problems. Our program is personalized to each patient and teaches him or her how to identify, reduce or prevent these problems. Integrative Oncology encourages living a healthy, anticancer lifestyle to help the body in its natural abilities to fight and prevent cancer. This can be accomplished by learning strategies to reduce stress, increasing physical activity and eating healthfully. Patients and cancer survivors who adopt these lifestyle goals will help change their internal physiology in ways that have been shown to strengthen the immune system, decrease systemic inflammation, reduce (free radical) oxidative damage to cells, and decrease hormonal stimulation of cancer cells.

Q. How can patients in Las Vegas access an Integrative Oncology program?

In 2009, I created Integrative Oncology-Essentials and the Anti-Cancerize Me Program to teach patients and anyone else interested in health and cancer about Integrative Oncology online, from the convenience of their home. With the launch of our Las Vegas Integrative Oncology program, I have been able to enroll all interested patients from our practice, as well as patients from other groups, into a structured, face-to-face Integrative Oncology program. We are the only oncology practice in Las Vegas with a robust integrative oncology program and a dedicated Integrative Oncologist who sees patients specifically for Integrative Oncology consultations and follow-up visits. Any patient seen at our office for this program must be a cancer patient or cancer survivor.

Q. If someone is diagnosed with cancer, what conventional treatments are available?

The earlier cancer is detected the more options a patient has in treatment and the more effective it is. Our expert team of physicians provides those facing a cancer diagnosis with state-of-theart radiation therapy and the most sophisticated, compassionate care available.

Radiation Oncology often works in tandem with surgery, pharmaceuticals and chemotherapy. It is relatively quick, painfree and requires no sedation. Advanced radiation technologies deliver more precise targeting and treatment than ever before, reducing the risk of side effects.

Q. And what are some of the Integrative Oncology treatments available?

A complementary therapy is often described as any therapy that is used in addition to conventional treatment (surgery, chemotherapy, radiation therapy, pharmaceuticals, etc.). Integrative Oncologists often recommend complementary therapies to patients, as long as there is high-quality evidence of safety and effectiveness. Complementary therapies may include massage, acupuncture, meditation, and botanical supplements. This is in addition to lifestyle counseling: making changes for the better in anti-cancer nutrition, exercise programs, stress reducPatients are able to take tion and reducing exposures home this test kit to to toxins. measure salivary cortisol, Nutrition is one of the a chronic stress marker. most important elements in Integrative Oncology. Patients will learn about anticancer nutrition, as well as foods and recipes that can help through and after cancer treatment. Physical activity and exercise are important before, during and after a diagnosis of cancer.

They have been proven to reduce the risk of cancer development, recurrence and progression and to help minimize side effects of cancer treatment.

Pain and discomfort can be a huge issue for many cancer patients. Although pain medications still may be needed, there are numerous non-pharmacologic, complementary therapies that can be used along with or instead of these medications. I often recommend acupuncture, guided-imagery, meditation, massage, aromatherapy or referrals to other specialists when needed (i.e. pain management, physical therapy, etc.) It is important to recognize that Integrative Oncology is based on the collaboration with our patients’ entire healthcare team to get them through their treatments with the best possible outcomes.

Spiritual support along with involving loved ones can improve outlook and help cope throughout treatment. We also recommend individual and family counseling, and support groups when they are available.

To learn more about the Integrative Oncology and Cancer Survivorship Program, visit www.integrativeoncology-essentials.com.

Sara Costanza is physician liaison at 21st Century Oncology.

Photos by Sam Morris

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CHIROPRAC T

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C TIC BIOPHYSICS: A TECHNIQUE TO END PAIN AND DISEASE

By Renee Roberts

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orking for long hours at the computer definitely isn’t healthy, but unfortunately for most of us, it’s reality. It’s no surprise that each year, millions of Americans turn to chiropractors, medical doctors, massage therapists and acupuncturists to help alleviate nagging neck and back pain.

Unfortunately those seeking medical intervention, massage therapy or acupuncture as the means to eliminate their pain will only receive temporary relief, leaving the root cause of the problem unaddressed.

Unlike regular chiropractic that mainly focuses on immediate pain relief, Chiropractic BioPhysics, or CBP, goes one step further to also correct the source of the problem. That’s why most patients under the care of a CBP chiropractor not only report relief from pain and discomfort, but as their posture begins to align, they notice other conditions such as acid reflux, ADHD, asthma, ear infections, high blood pressure, headaches, and leg, arm, neck and back pain clearing up as well.

CBP is a highly advanced, scientific and proven chiropractic technique that corrects and restores your spine back to alignment. This technique is even being advocated for small children.

With more than 140 peer-reviewed scientific publications (where the majority are in the Index Medicus / pubmed journals), the CBP Technique is one the most published methods in the chiropractic profession. Thus, CBP is one of the most scientifically validated techniques in the industry. There are only approximately 1,000 chiropractors around the world appropriately trained in CBP and only 19 instructors for CBP Technique.

Dr. Jason Jaeger, the administrative director of Aliante Integrating Physical Medicine, one of Nevada’s leading integrated physical medical practices, is a local CBP chiropractic physician and one of the 19 CBP Certified instructors worldwide.

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Jason Jaeger, DC, FCBP and Administrative Director for Aliante Integrated Physical Medicine reviews an x-ray image of a patient.

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Dr. Jason Jaeger, left, visits with a patient receiving therapy on a Universal Tractioning System (UTS). Jaeger helped develop and conceptualize the specialized equipment, which has been distributed and used around the world.

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“CBP combines biology, physiology, engineering and physics, geometry, and anatomy to identify the causes of your pain, discomfort, loss of mobility and altered health,” Jaeger said. “That means your diagnosis – and treatment – will be based on sound scientific and chiropractic principles.”

The late Dr. Donald Harrison, DC, PhD, MSE, is the primary origin of Chiropractic BioPhysics Technique in 1980, with its Mirror Image methods. His brother, Dr. Glenn Harrison, was a founding member and developer of CBP Technique as well.

During his time, Donald Harrison became one of the most published chiropractic researchers in the history of the profession, with more than 80 peer-reviewed publications and multiple textbooks to his name. These publications appeared in the top physical medicine, orthopedic, biomechanics and spine research journals around the world. He voted in as member of the prestigious International Society for the Study of the Lumbar Spine, an orthopedic research society.

“A CBP chiropractor starts with a scientifically-based examination of your posture, spinal alignment, and function – often involving X-rays as a way to pinpoint the root cause of your spinal misalignment,” Jaeger said. “Once the source is identified, your doctor will create a carefully planned series of adjustments, exer-

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cises and a spinal remodeling program to put you on a pain-free road to better health.”

“Our 5-year-old daughter was diagnosed with scoliosis, and had eight weeks to complete CBP treatment before our family was to move out-of-town,” said Melodie Cromeans. “Her final X-rays were astonishing! I watched a close family friend diagnosed at age 3 grow up in back braces and surgery. The CBP treatment at Aliante Integrated Physical Medicine has been an answer from God to us, because now our daughter will grow up living a normal life.”

According to Jaeger, what sets his practice apart from other chiropractic businesses is that they work in a multi-disciplinary setting. AIPM has teamed up with a medical doctor, a nurse practitioner and physical therapists to work with its chiropractors.

AIPM is an integrated physical medicine practice, which provides the finest care through the use of modern physiology and chiropractic equipment and technology.

AIPM’s services include the spectrum of medical evaluation, chiropractic, corrective care (CBP), physical therapy, physiotherapy, exercise and fitness as well as nutrition and weight loss. The practice follows chiropractic philosophies that produce proactive, health-oriented results. AIPM does not prescribe drugs; it is focused on purely physical medicine.

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of those patients who will benefit from surgical intervention. This Jaeger has been in practice for more than 14 years. He attended collaboration allows for select patients to have outpatient surgical the University of Nevada, Las Vegas during his undergraduate procedures as well as rapid return to normal life.” program and graduate school at Southern California University of “The patient with persistent or progressive pain, abnormal Health Sciences. He is a native Las Vegan whose family has called spine movement, muscle weakness or numbness who is not recovthe Valley home since the 1940s. ering as expected may benefit from an interdisciplinary approach As class representative and the Student American Chiropractic with the combined expertise of chiropractic physicians and Association vice president of the SCUHS chapter, Jaeger successneurosurgeons,” Jaeger said. “The potential patient benefits of fully lobbied in Washington for such issues as Medicare and HMO cooperative care include early diagnosis and intervention, a broad reform. He participated in a rotation through Cal State Northrange of therapeutic options, continuity of care and improved ridge’s prestigious physical therapy program where he successpotential for patient recovery.” fully integrated neuro-musculoskelatal therapies on paralysis and Jaeger and Smith believe, working together, they are more stroke victims. confident and skilled at appropriately referring their patients. For Jaeger is the developer of the Universal Tractioning System. example, if a patient consults a neurosurgeon, but is not a good He served as the Southern Nevada Representative to the Nevada candidate for surgery, the patient would be referred to a nonChiropractic Association from 2008-’09 where he successfully surgical specialist. Or, if a patient has not responded to conservalobbied for Nevada’s acceptance of the Practicing Chiropractive therapy or chiropractic care, he or she should be referred to tors Committee on Radiology Protocols. a surgeon. For the patients, appropriate Jaeger has served as the Nevada referrals between spine specialists State Delegate to the International should mean they no longer have to Chiropractic Association and Alternate worry if they are seeing the right kind of Nevada Delegate since 2010. He was Unlike regular chiropractic that health care professional. published in peer-reviewed literature Jaeger decided to become a chiropracon conservative rehabilitation methods mainly focuses on immediate tor while he was in his first semester of this year. He was a reviewer for the ICA pain relief, Chiropractic college at UNLV. Best Practices Guidelines, a document While on his way to work as a sword accepted in the National ClearingBioPhysics, or CBP, goes one fighting stuntman in King Arthur’s house of Guidelines. Dr. Jaeger spoke Tournament on Thanksgiving evening at the 2011 European Chiropractic step further to also correct the in 1989, he was involved in a car accident Union Annual Conference in Zurich on, that resulted in substantial damage “Cooperative Methods between Neurosource of the problem. to his vehicle and himself. The police Surgeons and Chiropractors”. He is escorted him to work that night. He licensed to practice Chiropractic in did two shows and then went home.

Nevada, Arizona and California.

He woke up in the morning injured so Jaeger says he is honored to work badly, he had to be physically carried into a doctor’s office due to with Dr. William Smith, director of performance improvement for extreme pain. the Western Regional Center for Brain and Spine Surgery and the Jaeger ended up at a chiropractor’s office. He underwent a care chief of neurology for University Medical Center. They collaboplan of approximately three months. At the end of that time, he rate on conservative and surgical methods of preserving or restorfelt better than new. ing spinal integrity while prioritizing their patients’ well being.

“After chiropractic treatment, I felt like a million bucks, howevWhen dealing with spinal and other postural distortions, chiroer, the actual cause of my problem had not been corrected,” Jaeger practic physicians are known to have the highest patient satisfacsaid. “This prompted me to pick my major in college, become a tion ratings for conservative care. chiropractic physician and learn CBP Technique.”

Neurosurgeons are known for their thoughtful and minimally Simply put, the nervous system is responsible for every funcinvasive approach to spine problems and are known to perform tion of the human body. From movement, blinking and heartbeat, operative procedures with the least risk for the greatest chance of to regulation of hormones, breathing and vision, it’s incredible gain. Both neurosurgeons and chiropractors have a neuroscience just how huge of a role our play in keeping us alive and healthy. background, and as such are beneficial to see these two disciplines Unfortunately, poor posture, accidents and injuries put excescome together in cooperative spine care. sive pressure on the delicate nerves in the neck and back, lead“No single discipline can be the sole provider to improve the ing to diminished nerve flow to the limbs and vital organs. If left quality of life for those suffering from unrelenting back pain,” untreated, diminished nerve function will lead to pain, organ Smith said. “The complex nature of identifying and treating pain dysfunction and eventually disease. generation in the modern day health care system demands joint For more information about CBP, visit www.idealspine.com. collaboration. Chiropractic BioPhysics’ techniques and minimally invasive spinal surgery in combination allow individualization of Renee Roberts is a principal at Paragon Communications. care, both in avoiding surgery as well as improving the outcomes

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“

On the list of people most crucial to my life, Dr. Navratil is at the top.

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— Nick Giorgione

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NEW LEASE ON LIFE

By Stephen Portz, M.D.

LOCAL CARDIOLOGIST HELPS YOUNG MAN LIVE A FULL LIFE AFTER DIAGNOSIS OF HEART CONDITION MORE THAN A DECADE AGO

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sk Nick Giorgione what he’s learned about his heart condition during the past 13 years, and the 26-year-old can get very specific.

The Henderson resident knows walking up stairs will leave him winded. Running up them could result in blacking out. He has experienced firsthand that sprinting on a treadmill will trigger a device in his chest to administer internal electric shocks, correcting abnormalities with his heart rate.

Nick is also certain of something else: he has a comprehensive understanding of his hypertrophic cardiomyopathy, a wide-ranging cardiac disease, and he has lived a well-rounded life in spite of it thanks to cardiologist Dr. David Navratil with HealthCare Partners Cardiology.

Ask Nick Giorgione what he’s learned about his heart condition during the past 13 years, and the 26-year-old can get very specific.

The Henderson resident knows walking up stairs will leave him winded. Running up them could result in blacking out. He has experienced firsthand that

sprinting on a treadmill will trigger a device in his chest to administer internal electric shocks, correcting abnormalities with his heart rate.

Nick is also certain of something else: he has a comprehensive understanding of his hypertrophic cardiomyopathy, a wide-ranging cardiac disease, and he has lived a well-rounded life in spite of it thanks to cardiologist Dr. David Navratil with HealthCare Partners Cardiology.

Navratil has served as Nick’s cardiologist for 13 consecutive years, making himself immediately available to review tests, perform vital surgeries and provide emergency consultations. He has developed an intimate knowledge of the young man’s condition, demonstrating the personalized care that serves as the crux of HealthCare Partners’ Total Care Model.

Navratil has also helped Nick with perhaps the most important realization of his life: that he can experience quality of life with his condition.

“On the list of people most crucial to my life, Dr. Navratil is at the top,” Nick says.

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Cardiac issues at a young age

For much of Nick’s childhood, there were no indications he had a significant cardiac issue. Although he had been born with a heart murmur, later testing showed nothing to raise any alarms.

A pediatric cardiologist signed the approval for him to play in a youth football league.

At an evening football practice in 2001, however, Nick noticed he felt strange. Transitioning from running laps to stretching, the 13-year-old saw everything suddenly grow fuzzy.

He woke up still on the field to paramedics leaning over him with defibrillator paddles. With his heart rate at more than 400 beats per minute, it was the first cardiac arrest of his life.

“I was just confused,” he recalls. “I wasn’t fully aware, and I knew I was at football practice and I wasn’t supposed to be on the ground.”

When he was transported to Desert Springs Hospital, Nick’s father, Steven Giorgione, sought the expert opinion of an old family friend and cardiologist who happened to be in the building.

Navratil, who is board-certified in internal medicine, cardiovascular diseases and cardiac electrophysiology, was happy to help.

“There were no pediatric electrophysiologists available in Las Vegas in 2001, and I was occasionally asked for guidance with younger cardiac patients,” Navratil says. “This was one case where I personally knew the family, and it just so happened to fit under my area of expertise.”

Navratil conducted an echocardiogram and diagnosed Nick with hypertrophic cardiomyopathy.

The condition, which Navratil says can’t be prevented among those who are genetically predisposed, involves the heart muscle becoming abnormally thick, making it difficult for the organ to pump blood. Symptoms can range from mild to severe, with some patients at high risk for sudden death.

“I have fewer than a dozen of these cases in my practice, and none of them are as aggressive as Nick’s condition,” Navratil says.

Navratil knew what was key for keeping Nick alive. Within a week, the cardiologist surgically implanted an automatic implantable cardioverter defibrillator, or AICD, into the teenager’s chest. The device, which would save Nick’s life several times in the following years, monitors his heart rate and administers shocks to the heart in response to any issues that arise.

Nick’s condition is typically diagnosed among teenagers, Navratil says. That’s why it is imperative for families to be aware of symptoms that might indicate cardiac issues, he says, including passing out after strenuous activity.

“It is a common misconception that heart issues only affect middle-aged or senior individuals,” Navratil says. “As people of many age groups continue to be diagnosed with cardiac issues, it remains important to manage these conditions carefully. A key part of this is finding a cardiologist and medical team you can trust to deliver the best quality of care.”

Total care model

As a result of the aggressive nature of Nick’s condition, it was important for him to have regular access to a dedicated cardiologist.

Navratil was the clear choice after Nick’s diagnosis, initiating a doctor-patient relationship that has lasted more than a decade.

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“He has contributed to treating my condition since day one. I trust him because he’s seen everything I’ve gone through, including the progression of my disease and the battles I’ve gone through with managing it,” Nick says. “He has knowledge of my personal case that no other cardiologist has.”

This ongoing continuum of care is an important component of the Total Care Model practiced by HealthCare Partners Nevada, a medical network serving more than 300,000 patients a year. The organization offers 290 primary care providers and more than 1,700 specialists across Southern Nevada.

HealthCare Partners has experienced many successful patient stories like Nick’s through the Total Care Model, a unique approach to health care focusing on comprehensive, patient-focused care. Under this approach, primary care providers, specialists and professional staff work as a coordinated team to manage all aspects of patients’ care and overall health.

The health care delivery model also emphasizes highly personalized care, which Nick says he continues to experience with Navratil.

“I have trust in him because he’s a doctor who knows what he’s doing and who does it confidently,” Nick says. “He has been there to help whenever I have needed him.”

Battling for control Nick admits he initially struggled to accept his diagnosis.

His case of hypertrophic cardiomyopathy involves high risk of cardiac arrest during physical activity. This was crushing news for Nick to hear at 13 years old, when, at already more than 6-feet tall, competitive sports were his passion.

Refusing to accept the potential repercussions, he rejected the idea of giving up competitive basketball. He also initially refused the AICD implant when he learned it would make football an impossibility, on account of the heavy contact sport raising the risk of damaging the device.

“I couldn’t comprehend the full breadth of what had happened and what it meant going forward. I rebelled against it,” Nick remembers.

Additional research didn’t help his outlook. A broad range of experts informed the teenager point blank that his heart couldn’t handle any heavy physical activity.

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Right: An automatic implantable cardioverter defibrillator, or AICD, was implanted into Nick’s chest. Below: Dr. Navratil and technician Michael Graham review test results.

Nick even remembers a specialist from the Mayo Clinic telling him at 13 years old, “You have the worst thing you can possibly have.

You’ll be lucky if you ever swing a golf club in the rest of your life.”

But Navratil offered a more broad-minded prognosis, allowing Nick to follow his passion for sports while carefully monitoring his symptoms.

The cardiologist still takes the same approach with Nick today, one of the many reasons Nick continues to rely on Navratil as his doctor.

“Navratil gave me the confidence that this condition wasn’t going to kill me,” Nick says.

Many professionals in Navratil’s field now support his opinion that individuals with hypertrophic cardiomyopathy can be active, Navratil says. Basing this opinion on his medical training, Navratil still strongly advises Nick to monitor his symptoms during any physical activity.

“It’s also a philosophical belief,” Navratil says. “Our goal at HealthCare Partners is to help patients be as functional and active as they can.”

Ongoing support

Unfortunately, ongoing incidents proved Nick could never be as active as he wanted.

He returned to playing competitive basketball within six months of his surgery for the AICD implant, with Navratil’s approval to continue unless he experienced negative symptoms.

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“I just had to play,” Nick says, admitting his parents didn’t love the idea. “I was a pretty gifted athlete. To go from being on the top rung to not playing at all, that wasn’t a casual thing for me.”

His return to basketball didn’t last long, however. He experienced two cardiac arrests within a month, after which everyone agreed that his days playing competitive sports were over.

It was a heavy blow for Nick, he says. But he simply resolved to find other avenues to find success.

“I refused to let it beat me,” he recalls. “Even if it took away my physical capabilities, it never was enough to stop me from pushing forward in life.”

Navratil was a tremendous help in this transition, Nick recalls.

With limited information available about his condition, Nick always felt free to discuss any questions with his cardiologist.

Navratil continued to meet with him throughout the years to review tests and consult with Nick following any additional incidents.

The cardiologist also personally conducted two more surgeries for Nick’s AICD. When Nick needed a hand operation at 18 and the doctor on duty casually mentioned turning the AICD off, Navratil responded to Nick’s concerns by visiting the hospital and ensuring that the device would stay on during the procedure.

“I wouldn’t go through with the surgery until Dave was in the hospital,” Nick says. “I always know he’s the one who can handle anything related to my condition.”

Navratil was also one of Nick’s first calls following his collapse after running on a treadmill when he was 22. That was the first time Nick had been awake when the AICD administered shocks to his heart, an experience he compares to being kicked in the chest by a horse.

“It was the last rude awakening,” he recalls of being unable to move as the shocks were administered. “In that moment, I thought that was it. It was enough to make me realize it was time to stop pursuing athletics and focus on living a healthy life.”

Looking forward

Nick has since found many accomplishments outside athletics. He recently graduated from law school at the William S. Boyd School of Law, and he is studying for the bar exam.

He still sees Navratil at least twice a year, he adds. He hopes one day to apply his personal experiences to support youths facing similar cardiac conditions.

Navratil commends his patient’s persistence with managing the condition throughout the years.

“Nick has done very well living with a disease that can be challenging for many people,” Navratil says. “He knows his limits, and he lives within the activity level he knows is comfortable for him.

He can still enjoy most things in life.”

Nick plans to continue doing so, with Navratil’s ongoing assistance.

“You couldn’t pay me to go to a different cardiologist,” he says.

Dr. Stephen Portz is a cardiologist with HealthCare Partners Nevada.

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OUT-OF-STATE

PATIENTS SELECTING SOUTHERN NEVADA FOR MEDICAL CARE

By Nicholas J. Vogelzang, M.D. and James Sanchez, M.D.

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as Vegas is home to good health care. That is a fact.

We’ve read negative headlines and heard bad jokes about health care in Southern Nevada. However, there have also been twice as many positive stories told to which we can all be proud. Our health care industry has deficiencies and disparities, but it also has stories of triumph through many local centers of excellence.

Just recently, stories can be told of Las Vegas opening and enrolling the first patient in the world on a life-saving clinical trial.

Another patient relocated his family to Southern Nevada to receive prostate cancer treatment. A patient from Utah was given three years to live and now has celebrated 10 years of life post-diagnosis.

And behind these stories, what is accessible, right here in our city is world-class care and physicians – services, research and treatments that people are actually traveling great lengths to access. Patients are coming from their respective states to Southern Nevada for their medical care.

Some of the most reputable institutions with a focus on health care, including UCLA, Stanford University and Cleveland Clinic, have all either decided to call Las Vegas home, or have affiliated themselves with local health care providers. Our community has quickly become a hub for various specialties, including plastic surgery, fertility, orthopedic surgery and cancer.

In 2013, Comprehensive Cancer Centers of Nevada had 3,577 patients from outside of Southern Nevada visit its 11 treatment centers throughout the Valley. This number includes 1,310 out-ofstate patients. Among these visitors are residents of Switzerland, British Columbia, Hawaii, Alaska and states along the East Coast.

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A significant number of these visiting patients reside in the neighboring states of Arizona (461 patients), California (245), Utah (96), Idaho (30) and Oregon (22).

With so many quality treatment centers and options throughout the United States, the question is: Why are people traveling to Southern Nevada for their medical care?

It all comes down to a level of expertise, experience and access to research and latest technologies offered by nationally renowned physicians.

Brains over brawn

In the world of oncology, for example, we are no longer dealing with just “cancer.” We are actively combating more than 250 different diseases, each with their own unique intricacies, triggers and therapies. In a modern world, where resources and information are instantly accessible, patients are learning to seek out expertise and to not settle for anything less than a proven expert. We’re in an era of increasing specialization and patients are finding the doctors who know the most about their particular conditions.

At CCCN, physicians have a deep level of expertise on a variety of cancer types. From new drugs, technologies and advanced treatments, each doctor has a depth of knowledge that is critical to the vitality of respective patients.

Patients also tend to opt for clinics that are either located at or affiliated with an academic center. These academic locations draw the latest and most promising research and clinical trials.

Locally, CCCN is comparably the academic medical center of Southern Nevada when it comes to cancer. For nearly 20 years,

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CCCN has been affiliated with UCLA’s Jonsson Comprehensive Cancer and the US Oncology Network, which allow us to collaborate on nationwide, state-of-the-art trials at our local clinics.

These national affiliations are one of the major reasons why we have more than 170 clinical trials to offer our patients annually and have participated in the approval of 49 FDA approved cancerfighting therapies.

Connecting the dots to reach patients

Knowledge, expertise and research are the backbone for successfully drawing in out-of-state patients. We also live in a city that people love to visit.

Patients as well as their caregivers and/or family come to Vegas … because it’s Vegas. It’s an opportunity to see and explore an invigorating city and enjoy an authentic experience that is seldom offered in other cities. We have an international airport that is easy for patients to fly in and out of and we are city that offers first-class customer service and hospitality.

Now, how do prospective patients find out what health care options are available here?

Sharing knowledge is just as important as achieving it. In the medical realm, there are several audiences to connect with in order to educate the general public about the latest advancements.

These audiences can include state societies and oncology groups, medical practices and patients.

Connecting with patients is becoming that much easier thanks to interactive technology, including webinars. For example, CCCN recently spoke to a patient group in Las Vegas on the topic of

prostate cancer. Approximately 20 gentlemen attended the event in-person, but we reached nearly 100 more patients in three other states via a live video feed. Many of these webinars ultimately result in patient follow-up and visits.

Road to research At this point in history, our industry is seeing 10- to 20-times more clinical drug trials than we were 20 years ago, and patients across the nation are traveling to access them.

At CCCN, we were the first clinic in the United States to spearhead research of Provenge, which is utilized to treat prostate cancer. In 2010, the Food and Drug Administration approved the use of Provengeand we administered the first treatment in Nevada. Leading up to this milestone, more than 100 patients were on Provenge, traveling from Montana, Idaho, Arizona and states throughout the Mid-Atlantic region.

Our practice was also instrumental in the research phase of Xofigo, an intravenous radiation injection to treat prostate cancer patients with bone metastases. Prior to receiving FDA approval in 2013, CCCN was one of only four sites in the United States offering the trial to patients.

In other recent research news, Immunotherapy research, or immuno-oncology, is the development of a compound that prevents a cancer cell’s over-expressed PD-1 or PD-L1 protein from putting the immune system to sleep. Oncologists agree that immunotherapy represents a significant clinical advancement for the treatment of cancer. This form of treatment has been named a “breakthrough therapy” by the FDA and is available for a variety of cancers at CCCN. Continued on page 44

Photo Credit

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Right: Jeff and Alana Metcalf of Salt Lake City make the drive to Las Vegas about once a month. Below right: William Hawpe, formerly of Virginia, has relocated to our city because of the physician expertise available here.

Continued from page 43

Success stories across statelines

Throughout the years, we have seen a number of individual stories of triumph and progress in the latest treatments, therapies and antibodies available.

Meet Jeff

One of our patients, Jeff Metcalf, is a resident of Salt Lake City and an English professor at the University of Utah. He has a pretty incredible and inspiring story. Jeff was diagnosed with prostate cancer nearly 10 years ago, and since, the disease has been particularly aggressive. Up front, he was given a 30 percent chance of making it three more years. From the get-go, Jeff decided to take a very proactive approach by researching all options and wanted to do everything he could to persevere.

Jeff’s primary physician referred him to CCCN and we began treating Jeff approximately two years ago. Jeff made the drive from Salt Lake City to Las Vegas every month or so, for access to a clinical trial that is now FDA approved known as Zytiga. Using a three-pronged approach, consisting of CCCN and his two physicians back home in Utah, Jeff now describes himself as “feeling better than he ever felt before.”

Approximately five years ago, Jeff was commissioned to write a play about prostate cancer, aptly titled “A Slight Discomfort.” The play, which is an absolute riot, has been shown in four European countries and throughout the country. And, just this year, Jeff was just voted “Distinguished Teacher of the Year” at the University of Utah.

A man that was once given three years to live, has now made it 10.

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Meet William

In 2011, William Hawpe found blood in his urine and discovered he had advanced bladder cancer that had spread outside the ability to have surgery. He had tried chemotherapy and it was partly successful, but partly not.

William was referred to CCCN from another US Oncology practice in Virginia, where he lived at the time. Through research, we were able to identify two next steps for William, in which the standard of care of chemotherapy would have been the last step.

William traveled to Las Vegas for treatment and access to these two research trials that had been identified. He has since relocated to Las Vegas and is now a permanent resident as a result of physician expertise and access to research available in our city.

Currently being treated by a PD-L1 antibody for bladder cancer called MPDL3280A, William is doing well, and if you ask him, he finally knows what normal feels like.

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Meet Maria

Maria is 43 years old, lives in Fort Mojave, Ariz., and has been fighting breast cancer since 2008. This year, the cancer came back for a third time and had spread to her lymph nodes.

Just recently, Maria became the first person in the world to participate in a phase III breast cancer trial for patients that test positive with the BRCA gene mutation. The trial was not open at the time, but physicians and staff worked with regulators throughout United States and Europe to get the trial open and quickly to give Maria the best possible fighting chance.

Maria started the trial in April and currently travels from Arizona to Henderson to receive treatment. Almost immediately her doctors saw a dramatic improvement. According to Maria, to be the first on a trial that has made her feel better, makes her feel special.

Out-of-state give and take

Just as we accept patients from various areas of the country, patients sometimes do leave Nevada for specialized procedures that are not available here.

People leaving Las Vegas for a specialized procedure not available here should ’t be viewed negatively. In some areas, our city does not have the volume, or certain resources needed to provide the appropriate care. To compete with cities such as Los Angeles and New York, which have populations well beyond 10 million, we must continue to build up our medical community with true experts.

In the meantime, it’s important to recognize the success stories that are stemming from right here in Southern Nevada and to not take for granted what’s at our fingertips. There are centers of excellence in our community that are doing good work by providing quality medical care and treatment and participating in research.

And more and more, national health care brands are looking to Las Vegas to partner with local community expertise.

Through the collective efforts of the quality health care providers that do exist here, patients will continue to seek out the best possible options for treatment and medical care in our city. By highlighting these successes, we will be able to continue to attract out-of-state patients as well as recruit nationally recognized physicians to relocate and work here.

Dr. Nicholas J. Vogelzang is a medical oncologist at Comprehensive Cancer Centers of Nevada and serves on the research executive committee for US Oncology Research and as the associate chair of its Genitourinary Committee. Dr. James Sanchez is a hematology and oncology consultant and practitioner, board certified in internal medicine and medical oncology. He is also the practice president for Comprehensive Cancer Centers of Nevada .

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SHARED MEDICAL APPOINTMENTS

T

he medical community continues to introduce new ways to provide easy access to health care. One innovation that’s gaining popularity across the country is the Shared Medical Appointment.

If your first mental picture of a Shared Medical Appointment is people sitting with others in their exam gowns, strike that thought.

Shared Medical Appointments provide an opportunity for people to gain support from a medical team and peers who may be experiencing similar issues. These appointments are distinct from other types of health care groups, such as community support groups, 12-step programs or health education classes, because the goal is to deliver medical care.

The support provided by Shared Medical Appointments is effective for improving overall health outcomes. Dr. Ed Noffsinger has been a champion of the Shared Medical Appointment model and has documented these outcomes in the books “Running Group Visits in Your Practice” (2009) and “The ABCs of Group Visits” (2012).

As just one example, Noffsinger cites a study of Shared Medical Appointments at the Naval Medical Center San Diego Cardiology Clinic, which found that one of the most powerful results was a decreased number of hospitalizations. Comparing patient records from before and after participation in shared appointments, admission for all causes decreased from eleven to eight and admissions for heart failure alone decreased from four to two. Other studies showed similar improvements in patient evaluations.

The use of Shared Medical Appointments is on the rise across the country: • Between 2005 and 2010, the percentage of practices across the country offering group visits doubled, from 6% to 13%.

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A NEW WAY TO GET FACE-TO-FACE HEALTH CARE

By Evelyn Papageorge, M.D.

• According to an article in the January 2014 issue of O, the Oprah Magazine, the Cleveland Clinic has logged 8,600 Shared Medical Appointments in the past three years, and nearly 12% of doctors who belong to the American Academy of Family Physicians offer group appointments.

• Texas-based Parkland Health and Hospital Systems introduced Shared Medical Appointments in 2005. Their program increased 13-fold from 619 patients in 2005 to 8,118 patients in 2011.

Southwest Medical brought the first Shared Medical Appointments program to Nevada in June.

Patients with shared needs come together Shared Medical Appointments bring patients who have shared needs together with a health care provider. In Southwest Medical’s program, a group of 10-15 people meet with a physician and a registered nurse as a facilitator. The session lasts about 90 minutes. Just as with individual visits, these shared appointments are covered by most health insurance.

During the meeting, the physician talks to each patient to address his or her medical concerns. The other patients listen to the conversation for their own benefit and join in the dialogue. To ensure privacy, each participant signs a confidentiality agreement.

Private rooms are available if a patient needs to meet with the physician one-on-one. While the physician consults with the patient, the facilitator continues the group discussion. After the consultation, the physician and patient rejoin the group.

When the group finishes, a patient is given an action plan that may include prescriptions to fill, referrals or office tests.

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DECIDE IF A SHARED APPOINTMENT IS FOR YOU People need to decide if a group visit is something they want to try. Shared medical appointments tend to be best suited for the following: • Routine follow-up visits, new patient visits and physical examinations • Geriatric, as well as relatively stable chronically ill patients • All types of medication, lab test and referral follow-ups • Patients needing more time, peer support or extra professional assurances Group visits may not be right for patients such as: Benefits of these appointments Individual physician visits will always be important, but there are advantages to Shared Medical Appointments. One key benefit is that patients gain multiple perspectives about their condition.

Patients gain support from their medical team and group members who share their questions and experiences. New viewpoints and ideas may come from patients who have different conditions.

Family members and caregivers may also be invited to offer their support and ideas.

The shared learning that results from listening to others may trigger questions or observations that participants would not have considered in a traditional one-on-one medical appointment. In addition, information sharing helps people understand they are not the only ones dealing with similar health challenges. Group learning, new perspectives and support all work together to help improve a patient’s overall health outcomes.

• Patients whose primary language is different from that used in the group • Patients with mental disabilities such as dementia • Patients with a hearing impairment • People with serious infectious illnesses such as SARs, TB, bird flu, etc.

Find an appointment at Southwest Medical Southwest Medical offers group appointments for its patients at Siena Heights Health Care Center and North Tenaya Health Care Center. The program will expand to other Southwest Medical centers throughout the year.

To find out more about group appointments, Southwest Medical patients can call 702-877-5199 or ask their doctor for more information.

The prompt access and additional visit time provided by Shared Medical Appointments can improve quality, service, patient education and health outcomes and are another important resource to help people to get and stay healthy.

Dr. Evelyn Papageorge is staff physician for the Siena Heights Campus at Southwest Medical, the largest multi-specialty medical group in Nevada, operating nine health care centers, five urgent care clinics, four convenient care clinics, two senior centers and an outpatient surgery center.

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THE NOTES

Volunteers in Medicine of Southern Nevada received a $35,000 grant from the CVS Caremark Charitable Trust.

Dr. Amy Darukhanavala will practice at Dignity Health Medical Group’s Dream Fund Pediatric Endocrinology Clinic in Henderson. She is board certified in pediatrics and pediatric endocrinology. The clinic is at 10001 S. Eastern Avenue, Suite 209.

Dr. Michael Edwards, a surgeon at Anson, Edwards, Higgins Plastic Surgery Associates, is president of the Clark County Medical Society.

DARUKHANAVALA

Maggie Ozan Rafferty, chief experience officer for Dignity HealthSt. Rose Dominican Hospitals, was published in the Journal of Medical Internet Research. The article, “In the Words of the Medical Tourist: An Analysis of Internet Narratives by Health Travelers to Turkey,” explains medical tourism through the words of travelers.

The trauma center at Dignity Health-St. Rose Dominican, Siena Campus was re-verified as a Level III Trauma Center by the Verification Review Committee, an ad hoc committee of the Committee on Trauma of the American College of Surgeons.

Rod Davis, senior vice president of operations at Dignity Health Nevada and former president and CEO of 23 years for St. Rose Dominican Hospital, Siena Campus, will be honored at the Sixth Annual Volunteers in Medicine Ball on Nov. 8.

The Avon Breast Health Outreach Program awarded a $25,000 one-year grant to Dignity Health-St. Rose Dominican’s R.E.D. Rose Program to increase awareness of breast cancer and provide free screenings. It’s the fourth year that the program has received funding from Avon.

The National Breast Cancer Foundation gave $20,000 to St. Rose Dominican Hospitals’ R.E.D. (Responsible Early Detection) Rose program to pay for mammograms and ultrasounds for underinsured and uninsured women.

Dr. Steven Gregurek is medical director at United Blood Services. He previously was director of transfusion medicine and blood banking for multiple hospitals.

Attorney Albert Marquis, a founding partner at GREGUREK Marquis Aurbach Coffing, was appointed to the board of directors of the Nevada Childhood Cancer Foundation.

Jeffrey Gordon, president and CEO of the Nevada Childhood Cancer Foundation, was named one of the 2014 Governor’s Philanthropists of the Year by the Southern Highlands Charitable Foundation 21st Century Oncology of Las Vegas sponsored the Nellis and Creech Air Force Bases’ Military Veterans Appreciation Day picnic.

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EDWARDS Barbara Atkinson is the planning dean for the UNLV School of Medicine. Atkinson previously was an emeritus vice chancellor and professor at the University of Kansas School of Medicine.

Valley Hospital Medical Center donated an electrocardiogram (EKG) machine to Volunteers in Medicine of Southern Nevada.

Matt Pielecha is a physician’s assistant at Surgical Weight Control Center, a bariatric surgery center. He is responsible for meeting with patients, performing and monitoring lap-band adjustments and assisting Drs. James Atkinson and Darren Soong in the operating room.

PIELECHA

Michelle Northrup is a registered dietician at Surgical Weight Control Center. Northrup previously worked at Desert Springs Hospital Medical Center as a clinical dietician, weight loss and sports nutrition educator.

Susan Vogel, vice president of finance and chief financial officer for UnitedHealthcare of Nevada, Utah and Idaho, joined Goodwill of Southern Nevada’s board of directors.

VOGEL The American Lung Association honored five Southern Nevada respiratory care professionals at its 28th Advances in Respiratory Care Conference. They are Daniel Bloedorn of Sunrise Hospital, Respiratory Therapist of the Year; Patricia Machuca of Mountain View Hospital, Acute Care Respiratory Therapist of the Year; Marla Pitts of Kindred Hospital, Long Term Respiratory Therapist of the Year; John Foresee of Desert View Hospital, Rural Respiratory Therapist of the Year; and Denise Warrick of Bennett Medical, Non-Traditional Respiratory Therapist of the Year.

The Trauma Intervention Program of Southern Nevada recognized local emergency responders during an annual Heroes with Heart Gala. Honored were: Luis Fonseca, battalion chief aide, Las Vegas Fire and Rescue; Amie Modglin, investigator, Clark County Office of the Coroner/Medical Examiner; Brian Pollard, officer, Henderson Police; Scott Vaughn, officer, North Las Vegas Police; and Douglas Gillespie, sheriff, Metro Police.

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THE NOTES

Daniel Shiode is clinical director at Las Vegas Recovery Center. He has nearly 30 years of training and experience.

Oncologist and hematologist Dr. Carlos William Araujo and physician assistant Chet Whitley joined HealthCare PartARAUJO WHITLEY ners Medical Group, a physician-run group that provides primary, pediatric, specialty and urgent care services in Southern Nevada. Araujo sees patients at the San Martin, Maryland Parkway and Pahrump clinics, while Whitley sees patients at the West Craig Clinic.

Physician assistant Courtney Loper and nurse practitioner Josephine Sciacca joined HealthCare Partners Medical Group, a physician-run group proLOPER SCIACCA viding primary, pediatric, specialty and urgent care services. Loper sees patients at Tenaya Oncology/Hematology. She previously worked at Southeastern Medical Oncology Center in Goldsboro, N.C. Sciacca sees patients at the HealthCare Partners Virgin Valley Clinic in Mesquite.

Sunrise, MountainView, Southern Hills and Sunrise Children’s hospitals opened a third H2U Health Center, anchored by Sunrise Hospital and Medical Center. The other centers are at MountainView and Southern Hills hospitals.

Apex Health Care Professionals opened in Village Square, 9400 W. Sahara Ave., Las Vegas.

The Down Syndrome Organization of Southern Nevada elected board members: Sue Covey, chairwoman; Sandy Windom, vice chairwoman; Debbie Avery, secretary; Trudy Rutter, treasurer; David Abraham, board member; Joseph Brooks, board member; Joey Calarco, board member; Frank Tiberi, board member; and Lori Wright, board member.

The Cure 4 the Kids Foundation received the Clark County Medical Society’s Winged Heart Award, which recognizes nonprofit organizations committed to quality health care in Southern Nevada. Additionally, a Golf 4 the Kids event raised more than $46,000 for the Cure 4 the Kids Foundation and the Nevada chapter of the National Hemophilia Foundation.

Aid for AIDS of Nevada was accredited by the Commission on Accreditation of Rehabilitation Facilities. The three-year accreditation is the highest level given by CARF. This was the second time AFAN earned the recognition.

Louise Trent is a physical therapist at Matt Smith Physical Therapy. She works at 9499 W. Charleston Blvd., Suite 220, Las Vegas. Trent has more than 20 years of experience in PT, and previously served as senior physical therapist for Mobile Rehab in Brisbane, Australia.

Children’s Specialty Center of Nevada, a nonprofit pediatric treatment center, received laboratory accreditation from the Commission of Office Laboratory Accreditation.

Dr. Darren Swenson is chief medical officer of MountainView Hospital. He previously worked as director of medical affairs at Nevada for IPC – the Hospitalist Company. Swenson also is a founding partner and past chief executive officer and chief medical officer at Optima Credentialing.

Jennifer McDonnell was promoted to vice president of marketing and communications at MountainView Hospital. She joined the hospital in November 2012 and has 15 years of experience in public relations, marketing and journalism.

MountainView Hospital and the University of Nevada School of Medicine are working to develop an expanded graduate medical education program at the hospital. The program will significantly increase GME positions in Southern Nevada, from 233 to 380 or more. The program could start as early as July 2016.

Dr. Robert “Bobby” Moore joined Aliante Integrated Physical Medicine. He is working on an Advanced Fellowship in Clinical Biomechanics through Chiropractic Biophysics.

Dr. Lauren Traveller is a nurse practitioner at Aliante Integrated Physical Medicine. She received her Doctorate of Nursing Practice from the University of Tennessee Health Science Center with a dual practice specialty as a family nurse practitioner and an advanced forensic nurse.

MOORE

TRAVELLER Dr. David Golan is medical director at Aliante Integrated Physical Medicine. After a brief retirement in Maui, he returned to the mainland to pursue a career in age management medicine. He also is medical director at OptimAge Age Management.

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SWENSON

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PATIENT SUCCESS PROFILE

KATY JELUSO

DIAGNOSIS: TRANSVERSE MYELITIS PATIENT OF: MOUNTAINVIEW HOSPITAL

W

hen 37-year-old Katy Jeluso began having numbness in her right leg that moved up her leg, she knew something wasn’t right. The mother of a 5-year-old son and a speech pathologist for the Clark County School District, Jeluso sought out medical attention right away. Finding nothing wrong at the time, she was told to take it easy – perhaps a pinched nerve was causing the sensation.

But within a of couple days, Jeluso couldn’t walk and she had lost all feeling in the lower half of her body.

Jeluso came to MountainView Hospital’s Emergency Room, where an MRI showed a lesion on the T6 level of her spine and she was diagnosed with transverse myelitis, a neurological disorder caused by inflammation across one segment of the spinal cord.

Transverse myelitis is a rare disease that occurs in about 1,400 adults and children each year in the United States. Approximately 33,000 Americans have some type of disability resulting from the effects of the disorder, according to the National Institutes of Health. The disease is found in women and men and in all races, but does appear more often in people between the ages of 10 to 19 years old and 30 to 39 years old, according to the NIH. The exact cause of transverse myelitis is unknown, but it often develops following viral infections.

Jeluso was admitted to the hospital and sent to the Intensive Care Unit where she was given a regimen of steroids and underwent five days of plasmapheresis, a process in which the plasma is separated from the cells and replaces her plasma with new, good plasma.

Jeluso was later discharged to an acute rehabilitation center, where she stayed for a month.

“It was really hard to be away from my family and my son,” she said. “And, not knowing whether whatever caused this to happen would come back.”

Once Jeluso was discharged from rehabilitation, she began outpatient therapy at MountainView’s Outpatient Therapy Center. On her first day in therapy, she was wheelchair bound.

“From my belly button down I was paralyzed,” Jeluso said.

Sitting in her wheelchair, MountainView physical therapist Ole Haisupa approached Jeluso and asked her what she wanted to do. Her response?

“I told him, ‘I’m going to walk again,’ ” Jeluso said.

And his response?

“He said, ‘Then get up.’ ” That first day of outpatient therapy, Katy stood up and walked the parallel bars with assistance.

And so began months of grueling physical therapy.

“I’ve worked very hard in here and have been since day one,” Jeluso said.

“I can’t sit around and wait to get better.”

On a recent day, Jeluso walked into MountainView’s Outpatient Therapy Center. She was greeted with hellos from other patients who had

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“ gotten to know her over the months. One patient recounted how much progress he’s watched Jeluso make, from wheelchair, to walker to cane, to today walking unassisted.

MountainView’s Rehabilitation Unit Director, Michael Mericle, said in his 40-year career, he has rarely seen people recover from transverse myelitis as quickly as Jeluso.

“These outcomes aren’t always good,” he said. “Throughout my career, I’ve encountered only a few patients with transverse myelitis and not all recover.”

According to the NIH, there is no effective cure for transverse myelitis.

Treatments are designed to reduce spinal cord inflammation and manage and alleviate symptoms, which range from total paralysis of the lower extremities including loss of bladder function, to numbness to shooting pain.

Only about one-third of people affected with transverse myelitis experience a good to full recovery from their symptoms. Another one-third experience only partial recovery and are often left with significant deficits in sensory dysfunction, incontinence and the inability to walk normally.

The remaining one-third experiences no recovery and remains wheelchair bound or bedridden, the NIH reports.

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7/22/14 12:39 PM

The Southern Nevada Affiliate of Susan G. Komen invites you to kick off Breast Cancer Awareness Month in October for the 4th Annual...

@ September 27, 2014 6 p.m. to 9 p.m.

“

Join us for an evening of...

Wine & Specialty Drinks Paired with Hors D’oeuvres, a Breast Cancer Survivor and Co-Survivor Fashion Show along with a Spectacular Silent Auction & Live Entertainment

…determination, hard work and keeping a

Tickets $35 | At the Door $40 For more information, call 702.822.2324 Must be 21 to attend.

positive attitude can be

the key to recovery.

— Katy Jeluso

Jeluso said while on the outside she appears fully recovered, she is still battling some symptoms and the fear that she’ll have another attack that’ll leave her wheelchair bound.

While the majority of people who have suffered from transverse myelitis don’t have a relapse, it can occur, and seemingly without rhyme or reason.

Jeluso said during her months of recovery, she has met a couple other young adults – including one mother with five children – with transverse myelitis. She said because the disease is relatively unknown, she spends a lot of time explaining to doctors, and others, what she has.

Because of that, she is hoping to raise awareness in the community with a support group and even a 5K run this fall. While she doesn’t know if she’ll be able to run – she knows she’ll at least be able to accomplish a 5K walk.

“I’m OK with walking it,” she said as she settles into the stationery bike.

“I just want people to know there are others out there with transverse myelitis and that determination, hard work and keeping a positive attitude can be the key to recovery.”

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FALL 2014

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C S M C

VOLUNTEER PROFILE

PEGGY MILLER FRONT DESK VOLUNTEER AT SOUTHERN HILLS HOSPITAL

What is your favorite part or best experience about volunteering at Southern Hills?

The reaction you get from people who come in. The smiles and relief you see after helping someone are great.

How long have you been a volunteer at Southern Hills?

Since March 2009

How many hours do you volunteer each week at Southern Hills?

I volunteer four hours each week.

How can someone else become a volunteer there?

They can visit SouthernHillsHospital.com and click on Community Info/Become a Volunteer.

How long do you plan to work as a volunteer there?

As long as I can get here!

What volunteer activities do you take part in at the hospital?

I am a front desk volunteer. I love to hand out Hospital goodie bags to visitors and also help with the annual Balloon Festival, health fairs, etc.

What things do you do during your shift at the hospital?

Greeting and tend to visitors who need general assistance. However, when you get to be 93, people want to do things for you, but I am here to help them!

What other activities are you involved in when you aren’t volunteering at Southern Hills?

I enjoy walking and spending time with my 13-year-old dog, Mia. I also help my neighbors and family members when help is needed.

What is the biggest reward from volunteering?

It is self-satisfying. It makes me feel good to be of some use to others. I don’t do anything deserving of an award. It’s heartwarming to have someone greet you with a smile and help you. I would be no help to anyone without my front desk volunteer partner, Bob Girard.

What makes for a good volunteer?

What are some of your hobbies?

The willingness to share your experiences, a desire to help others and simply enjoying other people’s company.

I enjoy crossword puzzles and housekeeping. I constantly decorate and redecorate my house. I started playing the violin in orchestra at eight years old in Kansas. I moved to Pasadena, Calif., and attended a junior college. I performed in the symphony, in plays and at weddings.

Are you retired? If so, before retiring, what was your career?

I was an administrative assistant for a title company for 30 years, and retired at age 79 in 2000.

How long have you lived in Las Vegas?

I moved to Las Vegas in 2005 to be with family.

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Anything else you’d like to tell us?

I’ve had a happy life and was married to a wonderful man. We had two children, Susan and Gary. Susan is a business teacher at Green Valley High School in Henderson and has three children. Gary is a retired science teacher in Salem, Ore., and has two children.

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7/22/14 12:41 PM

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H E A LT H T I P S

PROTECT YOUR SKIN ALL YEAR LONG

By Wolfram Samlowski, M.D.

E

ven though the summer months are coming to an end, harmful effects of the sun could remain year-round.

In the heat of the summer, it’s easier to remember to reapply sunscreen more often compared to cooler times of the year. Warmer weather and more daylight hours equate to people being outside longer.

But here in Southern Nevada, it’s beautiful year-round and residents love to enjoy this uniquely pleasant climate.

Staying ahead of skin cancer According to the American Cancer Society, more than 1 million skin cancers and melanomas caused by prolonged exposure to the sun are diagnosed each year in the United States. Skin cancer is the No. 1 form of cancer for men age 50 and older, ahead of prostate, colon and lung cancers. The three most common types of skin cancer are melanoma, basalcell skin cancer and squamous cell skin cancer. Melanoma is the most dangerous form of skin cancer. In Nevada alone, nearly 500 residents will be diagnosed with melanoma this year.

The majority of these staggering statistics can be prevented. There are five tips to follow year-round to protect your skin: • Limit direct sun exposure during midday – between 10 a.m. to 4 p.m.

• Wear protective clothing, including hats, that covers as much skin as possible • Use sunscreen with a Sun Protection Factor (SPF) of 15 or higher — Special Note: SPF number signifies how often you should reap ply sunscreen, i.e. reapply SPF 30 sunscreen every 30 minutes — Use sunscreens that block both UVA and UVB • Wear sunglasses that block UVA and UVB rays • Avoid tanning beds Protecting your skin from the sun is no part-time job. From a day at the park to simply driving in your car, it’s important to recognize your skin’s exposure to potentially harmful rays and take meaningful action.

The sun’s UV rays can penetrate through light, loosely woven fabrics and wet clothing – that’s why it’s important to wear proper sun protection regularly and correctly.

The window tint on many cars, for example, naturally protects against UVB rays, but UVA rays can seep in through lower-tinted windows. As you take periodic roadtrips, or even during short drives here in town, protect your exposed legs and arms with the appropriate attire.

Successfully treating skin conditions and cancers Many people spend too much time in the sun before learning how dangerous it can be and before they start taking protective measures. In

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most cases, early detection is key for successfully treating skin cancer and melanoma.

If a melanoma invades just three to four millimeters (less than a quarter inch) of skin, starts to bleed (ulcerate) or has many dividing cells, the risk for recurrence or metastasis is extremely high. Cells spread via blood vessels or lymph channels to distant sites within the body, long before a surgeon can remove the abnormal mole. Once melanoma spreads, it’s almost always fatal.

For early detection and prevention you should check your skin monthly for any new or changing blemishes, moles or marks. Any abnormality that persists or continues to change over time is worth noting. If you find anything suspicious, make an appointment with your doctor no matter how minor you perceive the change to be. Also, be sure to consult an oncologist if the tests or a skin biopsy come back positive for cancer.

When you are examining yourself for melanoma, just remember ABCDE: • Asymmetry – One half of a mole doesn’t match the appearance of the other half • Border – Edges are ragged, notched or blurred • Color – Color is not uniform • Diameter – Changes in size, shape or color • Evolution - Change over time Other signs to look for during self-examination include: • Appearance of a new spot on your skin • Skin sores that don’t heal • Redness or new swelling beyond the existing border • Changes in sensation – itchiness, tenderness or pain • Changes in the surface of a mole – Scaliness, oozing, bleeding or the appearance of a bump or nodule

An innovation in treating skin cancer Although the occurrence rate of skin cancer and melanoma can be staggering, with new advances in clinical research, targeted agents and immunotherapy drugs, we’re moving closer to beating this disease. In fact, melanoma has become a poster child for cancer treatment advances!

At Comprehensive Cancer Centers of Nevada, we’re on the frontlines of researching and administering innovative skin cancer and melanoma treatments, many of which are seeing promising results. These skin cancer and melanoma studies are part of the more than 170 clinical trials we conduct in Southern Nevada each year.

One example of our work in the skin cancer realm is our work with CTLA-4 antibodies (ipilimumab or Yervoy) and PD-1 antibodies

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nivolumab and the MK-3475 Expanded Access Program (Pembrolizumab). For our patients with metastatic melanoma, we are one of only a few sites in the United States administering the anti-PD-1 antibody MK-3475. The PD-1 and PD-L1 proteins bind to a tumor, and this specific treatment attacks the PD-1 protein to allow the body’s immune system to fight the cancer.

PD-1 and PD-L1 antibody treatments are proving active in many different cancers. This treatment has proven to be dramatically effective in activating the immune system against cancers, with very low side effects. Thus far, the treatment is showing a 30 to 40 percent response rate in our patients. Hard to treat cancers such as melanoma, which don’t respond to chemotherapy drugs, are showing gratifying responses and sometimes longterm remissions.

Our MK-3475 Expanded Access Program allows CCCN to administer the drug before FDA approval. Ipilimumab, which is also known as Yervoy, is considered standard of care for skin cancer and melanoma. Those that don’t respond to Ipilimumab/Yervoy now have another treatment option thanks to the MK-3475 Expanded Access Program.

Through year-round prevention and protection, education as well as research, we can effectively fight skin cancer and get that much closer to defeating the disease.

Dr. Wolfram Samlowski is a medical oncologist with Comprehensive Cancer Centers of Nevada. He focuses on the treatment of melanoma and kidney cancer.

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WHEN THE SCHOOL BELL RINGS, MAKE SURE YOUR KIDS HAVE BEEN IMMUNIZED

By Blair Duddy, M.D.

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ith the school year quickly approaching, it’s important to enVaccines are biological preparations that stimulate the immune syssure that all students are up to date on their immunizations. tem to create antibodies that fight off a particular bacterial or viral infecUnder state law, children are only exempt from vaccina- tion before it can make you sick. They contain an agent that resembles tion requirements if their parents or guardians have submitted a written the disease-causing microbe or are made from a weakened or killed germ. statement to a school’s governing body indicating their religious beliefs Once stimulated, the antibodies circulate through the bloodstream and prohibit immunizations. Medical exemptions are also permitted. “attack” the infectious agent. Through this mechanism, immunizations are Proof of immunization is a prerequisite for enrollment in all Nevada public usually able to fight the onset of a disease or reduce its severity. schools for children who aren’t exempt. Immunizing your child is extremely According to the Centers for Disease Control and Prevention, the U.S. important, especially when they’re preparing to enter a school environment achieved measles elimination in 2000, meaning the disease no longer where they’ll be exposed to a large population of people and face a greater spreads year-round in this country. However, this year at least 539 people risk of contracting harmful diseases that could cause serious health issues. across 20 states have been infected with the measles virus. The CDC found As your children head back to school, make an appointment with your that cases have been driven by unvaccinated people who obtained the vipediatrician to ensure they receive the necessary immunizations required. rus in other countries, brought it back to the U.S. and subsequently spread A child can receive up to 24 vaccinations by the age of 2. These are it in their communities, where many others were also not vaccinated. targeted to ensure children are protected against as many as 14 different Pertussis, another vaccine-preventable disease, has spread widely in diseases at an early age. Although this may seem like a lot for a young our neighboring state of California. As of late June, 4,558 cases of pertuschild, a vast amoun scientific research supports the fact that the immune sis were reported in California this year alone. system is very capable of handling the vaccines. The human immune sysThe re-emergence of these diseases has been attributed to the anti-vactem is exposed to billions of organic and inorganic substances, or “anti- cination movement, which centers on the myth that vaccines are associatgens,” and thus 24 vaccines in two years is not a burden to the system. ed with an increased risk of autism. This myth gained popularity as a result These vaccines are necessary because the immune systems of young of a medical study published in 1998. The study has since been retracted, children are not fully mature, which leaves them more susceptible to in- and the physician who led the study has had his medical license revoked. fections. Immunization schedules are developed by physicians and pubDisease prevention is a key component of our philosophy at Healthlic health experts to provide the most complete protection for children. Care Partners Pediatrics. Our mission is to ensure that our youngest and Most immunizations are recommended until the age of 18. It’s important most vulnerable patients are immunized and protected. The HealthCare to consult your pediatrician or family practitioner for the most current Partners Durango Pediatrics clinic received the Silver Syringe Award from immunization schedule. the Southern Nevada Immunization and Health Coalition, an honor celThe physicians at HealthCare Partners Pediatrics recommend the fol- ebrating the clinic’s outstanding immunization rates. lowing immunizations for all children up to 6 years old: HealthCare Partners also participates in the federally funded Vaccines • Hepatitis A • Diphtheria, tetanus, pertussis for Children Program. This program helps provide vaccines to children • Rotavirus • Haemophilus influenzae type B whose parents or guardians might not be able to afford them. To find • Poliovirus • Measles, mumps, rubella out if your local HealthCare Partners provider participates in the VFC • Hepatitis B • Varicella (chickenpox) program, or to consult a pediatrician about immunizations for your child, • Influenza • Pneumococcal visit www.hcpnv.com/lasvegaspediatrics.

• Meningococcal (for certain high-risk groups) Immunizations serve to protect your children and the community from the spread of infectious diseases. Preventing diseases is much easier and more cost effective than treating them. This is why vaccines serve such a vital role in safeguarding public health. A recent study published by the American Academy of Pediatrics found that immunizations prevent 42,000 early deaths and 20 million cases of disease, with a savings of $13.5 billion in direct costs and $68.8 billion in total societal costs in the U.S.

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Dr. Blair Duddy is a pediatrician with HealthCare Partners Nevada.

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TIME TO GEAR UP FOR FALL ATHLETICS

By Jason H. Nielson, M.D.

A

s summer comes to an end and kids of all ages prepare to go back to school, parents from across the valley are busy helping their children gear up for the fall sports season. From football to soccer to cross country, fall is an exciting time for parents and their athletes alike.

But in the midst of the hustle and bustle, it’s important for athletes to train safely and take the necessary steps to avoid injury. Keeping your athlete happy, healthy and safe during this and every sports season is essential for long-term development and enjoyment in whatever sport they compete in.

Through my practice, I see athletes with a wide variety of sports-related injuries. Perhaps one of the most common conditions among young athletes is called Patellofemoral Pain. Athletes such as runners, jumpers, and soccer players place a great deal of stress on their knees as part of their activity.

There are a number of reasons why an athlete may experience this type of pain, including malalignment of the patella (or knee cap), flat feet, prior injuries, and weakness in the thigh muscles. Over time, the misuse and over-use of the knee can cause the cartilage of the kneecap to wear. Initial signs of a patellofemoral issue may include pain and swelling in the knee.

If your athlete experiences pain or swelling there, they should avoid activities that cause these symptoms. Treatment of Patellofemoral Pain should include strengthening of the thigh and hip muscles. It’s also important to stretch both before and after physical activity. Before physical activity, athletes should perform dynamic stretches such as walking lunges, knee swings and any movement that helps promote blood flow. Static stretching is more appropriate after physical activity, which requires athletes to hold various poses for approximately 30 seconds.

Another common knee injury among athletes is an Anterior Cruciate Ligament (ACL) sprain or tear. Injuries to the ACL are frequent in soccer, football and basketball players. Female athletes are more susceptible to injure their ACL than male athletes. Experts believe that this may be due to the physical size of the ACL being smaller in women than in men. Women also have relatively weaker hamstrings, and there are landing and deceleration differences between the sexes. Strength training can aide in ACL injury prevention, including leg presses, lunges and squats. Cross-training is also beneficial, such as the use of a stationary bike, stair climber and elliptical machine.

Concussions and other forms of traumatic brain injury continue to remain a high topic among athletes at all levels. Concussions can happen in any sport and should be taken very seriously. Most concussions occur without a loss of consciousness. There are typically no physical indications of a concussion such as a bump, and some athletes may not exhibit the signs of a concussion right away. In 2011, the Nevada State Legislature passed a law that requires the immediate removal of a student from an activity if the student is suspected of sustaining a head injury. In the event of a sports-related head injury, athletes should be assessed by a medical professional.

As the summer heat continues into the fall, athletes should always take precaution from heat exhaustion and dehydration. Make sure that your athlete is taking frequent breaks, drinking plenty of water and retreating to a shaded or air conditioned area when possible. Proper nutrition is also important for athletes. Protein is the key to recovery after practice, game, race or match. Be sure to give your athlete natural sources of protein such as lean meat, poultry, fish, eggs and soy.

If your athlete does experience any injuries, they should seek advice and screening from a medical professional – whether that is a team trainer or a physician. By taking the appropriate care, athletes can enjoy playing their favorite sports and decrease the likelihood of permanent damage from injury.

Dr. Jason Nielson is a pediatric orthopedic surgeon with Children’s Bone and Spine Surgery and is a member of the medical staff at Sunrise Children’s Hospital.

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www.summit-cpa.com 4730 S Fort Apache Rd #220 Las Vegas NV 89147

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MAKING THE ROUNDS To include your photos in the next issue, contact Rob Langrell at rob.langrell@gmgvegas.com

Above: Janet Moran of Volunteers in Medicine of Southern Nevada won the Clark County Medical Society Winged Heart Award for Nurse of the Year. She has been a volunteer there for a year and a half. She is flanked by Thomas Moran and Dr. Florence Jameson. Â

Right: HealthCare Partners Medical Group staff members celebrated the 3rd Annual Community Appreciation Day at I Love Yogurt in Pahrump. Community members of all ages received a free cup of yogurt courtesy of the group, and a doctor was on hand to talk with community members.

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MAKING THE ROUNDS

Above and right: United Blood Services hosted the 14th Annual Celebration of Life Awards and Scholarship Banquet to honor high school students for donating blood.

UBS awarded 16 scholarships totaling $15,250 to local high schools. Awards were based on the total number of blood units collected at each school during the blood drives. The schools donating the most blood units received as much as $1,500.

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MAKING THE ROUNDS

Above: The American Heart Association’s Kerry Sallee (in green) awards MountainView staff for achieving the Gold PLUS and Target Stroke Honor Roll award for implementing “Get With The Guidelines, Stroke.” From left are: Rosemary Thuet, R.N., director of education; Sallee, AHA development director; Diana Grimmesey, R.N., stroke coordinator; Jan Olivas, R.N., vice president of quality; Dr. Azin Azma, neurologist; Natalie Ransom, R.N., chief nursing officer; and Donna Forster, R.N., associate chief nursing officer.

Right: Eleanor Markle, Mountainview Hospital’s robotics program manager, talked to the Sun City Summerlin Women’s Club about lung cancer, lung screenings and available procedures at Mountainview, including thoracic robotic surgery. MountainView is the only Las Vegas hospital offering robotic thoracic surgery and was the first hospital in the valley to perform a robotic-assisted wedge-resection and lobectomy. More than 100 Sun City Summerlin residents attended the luncheon.

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MAKING THE ROUNDS

Left: MountainView Hospital raised more than $300 in support of the American Heart Association and to raise awareness of heart health. Paper hearts were sold in the cafeteria to employees and visitors for $1 and $5.

Below: MountainView Hospital has 33 Junior Volunteers this summer – 24 new faces and nine returners.

They are assigned to nursing floors throughout the hospital.

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cale n d ar To include your calendar items in the next issue, contact Rob Langrell at rob.langrell@gmgvegas.com

BREAST CENTER AT SUNRISE HOSPITAL

MOUNTAINVIEW HOSPITAL

Young Survivor’s Breast Cancer Support Group

This free breast cancer support group is offered to all women 50 years old and younger who have been diagnosed with breast cancer.

Wednesdays, Aug. 13,

Sept. 10 and Oct. 8,6-7:30 p.m.

The Breast Center at Sunrise, 3006 S. Maryland Pkwy., Suite 250 Look Good, Feel Better

Our “Look Good...Feel Better” program helps individuals with cancer look good, improve their self-esteem, and manage their treatment and recovery with greater confidence. To RSVP, please call (702) 784-1947.

Mondays, Aug. 25,

Sept. 22 and Oct. 27, 10 a.m.-noon

The Breast Center at Sunrise, 3006 S. Maryland Pkwy., Suite 250 ONCOLOGY NUTRITION CLASS

This is a free class led by Judy Reinhardt, Registered Dietitian and Certified Nutrition Support Clinician at Sunrise Hospital and Medical Center. Cancer survivors and their loved ones are invited to learn about healthy eating after a diagnosis of cancer.

Saturday, Sept. 13, 10-11:30 a.m.

Wednesday, Oct. 15, 6-7:30 p.m.

The Breast Center at Sunrise, 3006 S. Maryland Pkwy., Suite 250

CENTENNIAL HILLS HOSPITAL TEDDY BEAR CLINIC

Children of all ages can bring their favorite stuffed animal for a checkup and learn all about hospitals and good health. Registration is requested at 702-388-4888. Activities include finger-casting station, doctor dress-up station, baby bear nursery, move and groove cardiac, fishing for health and teddy bear snack shack

Wednesday, Aug. 6, 10 a.m.-noon

6900 N. Durango Drive, main lobby.

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For more information, visit MountainViewHospital.com. Call 233.5300 to register at least 48 hours in advance.

ADULT OUTPATIENT DIABETES CLASS: “OVERVIEW”

Diabetes can lead to complications such as blindness, heart disease and even death.

Learning how to manage your disease is the first step in living a healthy life. The class is one in a three-part series for diabetic adults.

Tuesday, Aug. 5, 10-11:30 a.m.

MountainView Hospital, Mark Howard Classroom, 3100 N. Tenaya Way STROKE SUPPORT GROUP

Join fellow stroke survivors and caregivers and share your experiences and insight on living and coping with life after stroke.

Tuesday, Aug. 5, Sept. 2 and Oct. 7, 2-3 p.m.

H2U MountainView Office, 3150 N. Tenaya Way, Suite 114 LUNCH AND LEARN: TOTAL JOINT EDUCATION SEMINAR

Join Dr. Parminder Kang for an informational lecture on what it entails to have a total joint replacement. This is a free event and lunch is provided.

Wednesday, Aug. 6, noon-1 p.m.

MountainView Hospital, Mark Howard Classroom, 3100 N. Tenaya Way MATERNITY UNIT TOUR

The Maternity Unit Tour gives expectant parents and family an opportunity to view the private birthing suites, nurseries and post-partum rooms. A brief explanation of MountainView’s delivery procedures, visitor rules and items to bring are included. Free.

Wednesdays, Aug. 6, 13, 20 & 27 and Sept. 3, 10, 17 & 24 and Oct. 1, 8, 15 & 22, 7:30-8:30 p.m.

Fridays, Aug. 8 & 22 and Sept. 12 & 26 and Oct. 10 & 24, 7:30-8:30 p.m.

Saturdays, Sept. 6 & 20 and Oct. 18, 1-2 p.m.

MountainView Hospital, Mark Howard Classroom, 3100 N. Tenaya Way

WEIGHT LOSS SURGERY SEMINAR

Learn everything you wanted to know about weight loss surgery from an experienced surgeon. MountainView Hospital is a Bariatric Surgery Center of Excellence. Free.

Saturdays, Aug. 9, Sept. 13 and Oct. 11, 10 a.m.-noon

Wednesdays, Aug. 20, Sept. 24 and Oct. 22, 6-8 p.m.

MountainView Hospital, Mark Howard Classroom, 3100 N. Tenaya Way BREAST IS BEST (BREASTFEEDING CLASS)

This class is designed to help expectant parents learn tips and tricks for successful breastfeeding, the benefits of breast milk, and positioning and latching techniques.

Participants will benefit by bringing a baby doll or stuffed animal that is approximately the size of a newborn for practicing different techniques. Cost is $25.

Saturdays, Aug. 9, Sept. 13 and Oct. 11, 12:30-2:30 p.m.

MountainView Hospital, Mark Howard Classroom, 3100 N. Tenaya Way ADULT OUTPATIENT DIABETES CLASS: “NUTRITION”

Diabetes can lead to complications such as blindness, heart disease, stroke, and even death. Learning how to manage your disease is the first step in living a happy, healthy life.

Thursday, Aug. 14, 1-2:30 p.m.

MountainView Hospital, 1 South Conference Room, 3100 N. Tenaya Way O2 ON THE GO SUPPORT GROUP

The 02 on the Go Support Group is made up of knowledgeable and supportive members who are versed in the area of various respiratory illnesses. O2 on the Go also offers emotional support to those who suffer from anxiety, depression, and fears that typically accompany the diagnosis of a life altering, incurable disease.

Fridays, Aug. 15, Sept. 19 and Oct. 17, 10 a.m.-noon

H2U MountainView Office, 3150 N. Tenaya Way, Suite 114

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ALZHEIMER’S CAREGIVERS SUPPORT GROUP

This support group provides an opportunity for family, friends, caregivers, and others to meet regularly for mutual emotional support and to exchange coping skills with one another in matters relating to Alzheimer’s disease. This support group meets the third Tuesday of every month. Free.

Tuesdays, Aug. 19, Sept. 16 and Oct. 21, 10-11 a.m.

H2U MountainView Office, 3150 N. Tenaya Way, Suite 114 AARP DRIVER SAFETY CLASS

Attend this class and receive a discount on your automobile insurance. $15 for AARP members and $20 for non-members. Checks or money orders only – no cash. Bring your AARP card, driver’s license and something to write with.

Tuesdays, Aug. 19, Sept. 16 and Oct. 21, 11:45 a.m.-4 p.m.

H2U MountainView Office, 3150 N. Tenaya Way, Suite 114 DADDY BOOT CAMP: BASIC TRAINING FOR NEW DADS

Learn how to change diapers like a pro.

Swaddling? No problem. Football hold?

Check! Learn all this and more in our hands-on Daddy Boot Camp. This class is designed to prepare new dads to assist in the care of mom and baby after leaving the hospital. The cost of class is $25.

Tuesday, Aug. 19, 6-8 p.m.

MountainView Hospital, Mark Howard Classroom, 3100 N. Tenaya Way ONE-ON-ONE MEDICARE COUNSELING

Join a State Health Insurance Assistance Program (S.H.I.P.) volunteer as they help you navigate through the Medicare process One-on-One. If you need information on Medicare Part D, you will need to bring a list of all of your medications names, doses and how often you take them.

Wednesdays, Aug. 20 and Sept. 17,

9:15-11:15 a.m.

H2U MountainView Office,

3150 N. Tenaya Way, Suite 114

ADULT OUTPATIENT DIABETES CLASS: MEDICATION CLASS AND “BROWN BAG” MEDICATION REVIEW

The Diabetes Medication Class and “Brown Bag” Medication Review is one in a three part series of informational classes for diabetic adults. Bring your questions and your medications for review with our knowledgeable pharmacy staff.

Wednesday, Aug. 20, 10-11:30 a.m.

MountainView Hospital, Mark Howard Classroom, 3100 N. Tenaya Way CHILDBIRTH CLASS

The class is designed to assist expectant parents in a better understanding of the third trimester of pregnancy and throughout the labor and delivery process. The cost of this class is $40. The week break allows for an opportunity to understand the questions that you would like to have answered.

Saturdays, Aug. 23, Sept. 27 and Oct. 25, 9 a.m.-1:30 p.m.

MountainView Hospital, Mark Howard Classroom, 3100 N. Tenaya Way BARIATRIC SUPPORT GROUP

Join us for a bariatric support group as we encourage members to continue to make healthy changes and choices in their lives.

Mondays, Aug. 25, Sept. 29 and Oct. 27, 7 -9 p.m.

MountainView Hospital, Mark Howard Classroom, 3100 N. Tenaya Way WHAT TO EXPECT WHEN YOU ARE DONE EXPECTING

This class provides information for all parents in knowing how to care for a newborn as well as caring for the mother after delivery. How to quiet a crying baby, car seats, helping mom get needed rest and much more is covered. Participants will benefit by bringing a baby doll or stuffed animal that approximates the size of a newborn for practicing swaddling, diaper changing, and other aspects of newborn care. Cost is $25.

Thursdays, Aug. 28, Sept. 25 and Oct. 23, 6 to 8 p.m.

MountainView Hospital, Mark Howard Classroom, 3100 N. Tenaya Way

NATURAL CHILDBIRTH CLASS

This four-week class is to prepare parents for Natural Childbirth, using holistic methods and Lamaze breathing. Breathing and relaxation techniques, as well as optimal positions for labor will be discussed. Class is limited to six couples. Class cost is $80 for all four classes. Call to register prior to your 32nd week of pregnancy.

Wednesdays, Sept. 3, 10, 17 & 24, from 6-8 p.m. AND

Wednesdays, Oct. 29, Nov. 5, 12 & 19, from 6-8 p.m.

MountainView Hospital, Mark Howard Classroom, 3100 N. Tenaya Way SIBLING CLASS

This class is geared to the 2-year-old to 10-year-old sibling of a new infant. The purpose is to acquaint children with the hospital environment prior to the delivery of the baby. This will include a tour of the Maternity Unit. Responsibilities of being an older sibling, along with special characteristics of a newborn, are presented in a playful way. The cost of this class is $15 per family group.

Tuesdays, Sept. 9 and Oct. 14, 6-7:30 p.m.

MountainView Hospital, Mark Howard Classroom, 3100 N. Tenaya Way LUNCH AND LEARN: TOTAL JOINT EDUCATION SEMINAR

Join Dr. James Manning for an informational lecture on what it entails to have a total joint replacement. This is a free event and lunch will be provided.

Wednesday, Oct. 1, noon-1 p.m.

MountainView Hospital, Mark Howard Classroom, 3100 N. Tenaya Way NUTRITION HEART CLASS

Learn how to make your diet hearthealthy and decrease your risk for heart disease. A Registered Dietitian will teach you about ways to maintain your cardiovascular health. Learn about how fat, cholesterol, salt, sugar, caffeine, and alcohol impact your cardiovascular health.

“Know your numbers” and understand what they mean. Learn how to read food

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CALENDAR

labels and choose heart-healthy foods.

Bring your own brown bag lunch. Free.

Wednesday, Oct. 8, noon-1 p.m.

MountainView Hospital, 1 South Classroom, 3100 N. Tenaya Way FREE HEART MURMUR CLINIC Please wear comfortable loose clothing for the screening portion.

Wednesday, Oct. 15, 9 a.m.-3 p.m.

MountainView Medical Office Building, Cardiovascular & Thoracic Associates Office, 3150 N. Tenaya Way, Suite 140

NEVADA NEUROSCIENCES INSTITUTE AT SUNRISE HOSPITAL EPILEPSY SUPPORT GROUP Meet other people with seizures. This group meets the second Wednesday of every month.

Wednesdays, Aug. 13, Sept. 10 and Oct. 8, 5:30 p.m.

Sunrise Hospital Auditorium, 3186 S. Maryland Pkwy.

MULTIPLE SCLEROSIS SUPPORT GROUP Meet other people with MS. This support group meets the third Friday of every other month.

Fridays, Aug. 15 and Oct. 17, 9 a.m.

Nevada Neurosciences Institute Clinic, 3131 La Canada Street, Suite 101

ST. ROSE DOMINICAN HOSPITALS

SAN SGR WEST

San Martín Campus, Las Vegas Siena Campus - Garden Room Henderson WomensCare Center, Las Vegas

BARIATRIC SURGERY SEMINAR AND SUPPORT Learn about new procedures, hear from past patients and get support.

Wednesdays, Aug. 13 and Oct. 8, 6-7:30 p.m. (lecture) and 7:30-9 p.m. (support group) HEND Wednesday, Sept. 10, 6-7:30 p.m. (lecture) and 7:30-9 p.m. (support group) WEST DINNER WITH A DOC Advances in the diagnosis and treatment of pancreatic cancer with Dr. Kiarash Mirkia, licensed in general surgery and critical care. Seating is limited.

Wednesday, Aug. 27, 6-7 p.m. SAN NURTURING NATURALLY Celebrate World Breastfeeding Week with the Southern Nevada Breastfeeding Coalition. Fun activities and education for prenatal women and new moms. Call 702-616-4923 for information.

Saturday, Aug. 9, 10 a.m.-2 p.m.

Springs Preserve, 333 S. Valley View Blvd., Las Vegas

For information, visit www.strosehospitals.org, or call 616-4900 for class reservations and to learn about other programs.

BOOT CAMP FOR NEW DADS Learn the ropes of caring for your baby and supporting mom from fatherhood veterans. Cost is $20.

Tuesday, Oct. 21, 6-9 p.m. HEND

Location Abbreviations FTF Family to Family Connection, Henderson FTF WIC Family to Family Connection, Henderson HEND WomensCare Center, Henderson MAC Siena Campus - MacDonald Room, Henderson RAN Rose de Lima Campus - Annex, Henderson

STANFORD DIABETES SELF-MANAGEMENT PROGRAM Regain control of your life with this six-week program, which offers support, healthy eating, medication management and communication skills. Designed to compliment your current medical treatment. Call 702-533-0849.

Thursday, Sept. 11 through Oct. 16, 2-4:30 p.m. St. George’s Angelican Church, 7676 W. Gilmore Ave.

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Mondays, Sept. 22 through Oct. 27, 9:30 a.m.-noon. HEND DIABETES AWARENESS TREATMENT AND EDUCATION American Diabetes Association accredited diabetes education. All insurances welcome and cash discounts available.

Call 702-616-4975 for pricing and registration.

Tuesdays, Aug. 12, Sept. 9 and Oct. 7, 9 a.m.-1:30 p.m.

Wednesdays, Aug. 13, Sept. 10 and Oct. 8, 9 a.m.-1:30 p.m.

Tuesdays, Aug. 26, Sept. 23 and Oct. 28; 5-9:30 p.m.

Wednesdays, Aug. 27, Sept. 24 and Oct. 29; 5-9:30 p.m.

HEND MY WEIGH 2 PREVENT DIABETES National Diabetes Prevention Program led by the Centers for Disease Control and Prevention (CDC). This 12-month program is delivered in 16 weekly, core sessions followed by monthly post-core sessions. Trained lifestyle coach helps develop healthy eating habits, add physical activity, and keep you motivated to make healthy changes. Call 702-616-4914 for more information.

Thursdays, Sept. 4 through Dec. 18, 1-2 p.m.

HEND DIABETES SUPPORT FOR TYKES AND TWEENS Parents and kids with diabetes (up to age 12) learn to overcome obstacles and succeed.

Mondays, Aug. Aug. 25, Sept. 22 and Oct. 27, 6-7 p.m.

MAC HAPPY FEET SCREENING Foot examinations to prevent diabeticrelated problems and identify circulation issues. Free, but appointment required.

Saturday, Sept. 20, 1-3 p.m. HEND STROKE AND APHASIA GET SOCIAL Games, fitness and fun for those with stroke or aphasia. Monthly activities vary.

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00001082

I SURV IV ED BECAUSE OF

NEVADA’S ONLY LEVEL I TRAUMA CENTER Ron had been on a morning bike ride near his northern Arizona home when he was clipped from behind by a drowsy driver. The impact sent him flying 35 feet, and shattered his pelvis. He was brought over 150 miles to UMC, where the trauma team, against huge odds, ensured he could walk—even ride—again.

Only UMC can provide the highest level of care in the region, making UMC one of our most vital resources.

TOGETHER, WE SHINE. umcsn.com

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Register at cityofhenderson.com/parks or 702-267-4065. Cost is $5.

Tuesdays, Aug. 5, Sept. 2 and Oct. 7, 10:30 a.m.-noon Henderson Multigenerational Center, 250 S. Green Valley Pkwy., Henderson

DASH AWAY FROM HYPERTENSION

Learn the Dietary Approaches to Stop Hypertension for lowering blood pressure from Samantha Louie, RD.

Wednesday, Aug. 27, 9:30-11 a.m. HEND LOWER CHOLESTEROL WITH TLC (THERAPEUTIC LIFESTYLE CHANGES)

Get your numbers right through nutrition, exercise, and relaxation from Samantha Louie, RD.

Tuesday, Sept. 9, 1-3 p.m. HEND HEARTSAVER CPR/AED

Learn American Heart Association adult, child, infant CPR, AED and choking.

Two-year certification for the non-health care provider. Cost is $30 (includes AHA certification card)

Wednesday, Aug. 13, 5-9 p.m.

Tuesday, Sept. 23, 5-9 p.m.

Tuesday, Oct. 21, 5-9 p.m.

WEST BETTER BREATHERS CLUB

Join the American Lung Association to learn new ways to manage lung disease and find support. Caregivers welcome.

Thursdays, Aug. 14, Sept. 11 and Oct. 9, 1-2 p.m.

SMA Lifestyle Center West, 8670 W. Cheyenne Ave., Ste. 105, Las Vegas

Thursdays, Aug. 28, Sept. 25 and Oct. 23, 3:30-4:30 p.m.

Merrill Gardens at Green Valley Ranch, 1935 Paseo Verde Pkwy., Henderson Last Thursdays, Aug. 28, Sept. 25 and Oct. 30, 3-4 p.m.

Prestige Care at Mira Loma, 2520 Wigwam Pkwy., Henderson BECOMING MEDICINE WISE

Meet individually with pharmacist Krystal Riccio, to learn how to take your prescrip-

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tion and over-the-counter medications so they work correctly with minimal side effects. Free, but appointment is required.

Wednesday, Oct. 1, 9 a.m.-noon HEND Wednesday, Oct. 15, 9 a.m.-noon WEST

PERIPHERAL ARTERY DISEASE SCREENING

Do you have signs or symptoms of PAD? Get screened by St. Rose’s Radiology Department. Cost is $10 and appointment is required.

Thursday, Oct.16, 8 a.m.-noon HEND SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM

Three Square will help you complete and submit your SNAP application free of charge. Call 702-616-4905 for an appointment.

Every Tuesday, 8 a.m. - noon

HEND WIC IMMUNIZATIONS

Join the Southern Nevada Immunization and Health Coalition (SNIHC) for no- or low-cost immunizations offered on a firstcome, first-served basis for school-aged children. View full schedule at VaxVegas.org.

Tuesday, Aug. 5, 9 a.m.-noon

Mexican Consulate, 823 S. 6th St., Las Vegas, 89101

Saturday, Aug. 9, 10 a.m.-3 p.m.

Cashman Center, 850 Las Vegas Blvd. N., Las Vegas, 89101

Saturday, Aug. 9, 10 a.m.-4 p.m.

Meadows Mall, 4300 Meadows Lane, Las Vegas, 89107

Thursday, Aug. 14, 9 a.m.-noon

Mexican Consulate, 823 S. 6th St., Las Vegas, 89101

Saturday, Aug. 16, 10 a.m.-4 p.m.

Boulevard Mall, 3528 S. Maryland Pkwy., Las Vegas, 89169

Saturday, Aug. 23, 9 a.m.-1 p.m.

Southern NV Health District, 330 S. Valley View Blvd., Las Vegas, 89107

Saturday, Aug. 23, 10 a.m.-4 p.m.

Galleria Mall, 1300 W. Sunset Rd., Henderson, 89104

SUPPORT GROUPS

AA for Women - Mondays, 7:30 p.m. & Wednesdays, Noon HEND; Mondays, Noon WEST

AA Co-Ed - Sundays, 6 p.m. RAN; Thursdays, 7 p.m. SGR; Sundays, Mondays, Tuesdays, Fridays, 7 p.m. SAN

Alzheimer’s Support Group 4th Tuesday, 4:30 p.m. HEND

Aphasia Lunch Bunch 1st & 3rd Wednesdays, Noon HEND;

1st Tuesday, Noon SAN

Bereavement Support Group 2nd & 4th Wednesdays, 6 p.m. HEND

Breast Cancer Support 2nd & 4th Mondays, 6 p.m. HEND

Daughters without Mothers 1st Thursday, 6:30 p.m. HEND

Diabetes Support 1st Wednesday, 10 a.m. HEND

Eating Disorders Recovery Support 1st Saturday, 9:15 a.m. SGR

Fibromyalgia Friends 3rd Thursday, 6:30 p.m. HEND

Gamblers Anonymous - Tuesdays, 6 p.m.; Fridays, 7 p.m.; Saturdays, 6 p.m. COND

Infertility Support Group 2nd Monday, 6 p.m. SAN

Multiple Sclerosis Support Group 3rd Wednesday, 6 p.m. HEND

Narcotics Anonymous Wednesdays, 5:30 p.m. COND; Wednesdays, 7 p.m.; Thursdays, 7:30 p.m.

SAN; Mondays, 6:30 p.m. RAN

Pediatric Epilepsy Support Group 2nd Monday, 6 p.m. MAC

Stroke Club @ St. Rose 4th Thursday, 6 p.m. MAC

Substance Abuse Help Call 702-486-8250

Suicide Prevention Lifeline – Call 1-800-273-8255

Surviving Suicide, Bereavement Support for Adults 1st & 3rd Tuesdays, 6:30 p.m. HEND

Transitions 1st & 3rd Tuesdays, 11 a.m. HEND

Prostate Cancer Education and Support 3rd Wednesday, 7 p.m. SAN

Widows Support 1st & 3rd Tuesdays, 2 p.m. HEND

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INFLUENCE OTHERS

Yearly flu shots are recommended for everyone age 6 months and older. No-cost vaccine available for the uninsured on a first-come, first-served basis in partnership with SNIHC.

Saturday, Sept. 13, 9 a.m.-2 p.m.

Doolittle Community Center, 1950 North J St., Las Vegas

Saturday, Oct. 4, 8 a.m.-1 p.m.

East Las Vegas Community Center, 250 N. Eastern Ave., Las Vegas

Saturday, Oct. 11, 10 a.m.-2 p.m.

Chinese Baptist Church, 8705 Lindell Rd., Ste. 150, Las Vegas

Wednesday, Oct. 15, 9 a.m.-noon

RDL: Saint Therese Center for HIV

Saturday, Nov. 1, 10 a.m.-2 p.m.

Green Valley Library, 2797 N. Green Valley Pkwy., Henderson HEALTHIER LIVING

Join Stanford School of Medicine’s 6-week Chronic Disease Self-Management Program to regain control of your life with techniques to deal with frustration, fatigue, pain and isolation; exercise strategies to improve strength, flexibility and endurance; healthy eating; and more.

Wednesdays, Sept. 3 – Oct. 8, 9-11:30 a.m.

United Healthcare Lifestyle Center , 8670 W. Cheyenne Ave., Ste. 105 Call 702-242-7261 to register

Tuesdays, Oct. 21 – Nov. 25, 1-3:30 p.m.

Lend a Hand of Boulder City, 400 Utah St. Call 702-294-2363 to register

SUNRISE HOSPITAL AND SUNRISE CHILDREN’S HOSPITAL Registration is required for all events. Call (702) 233-5454 to register at least 48 hours in advance. For more information, visit www.

SunriseHospital.com MATERNITY UNIT TOUR

Get to know our expert team and tour our Labor and Delivery suites and Level III NICU. Tours meet in the Sunrise Children’s Hospital Lobby. Park in the south parking lot and follow the signs to Sunrise

Children’s Hospital. Free.

Every Sunday, 2-3 p.m.

Sunrise Children’s Hospital, 3186 S. Maryland Pkwy.

PREPARED CHILDBIRTH CLASS

The class is designed to acquaint expectant parents with everything they need to know about the third trimester of pregnancy, labor and delivery, cesarean section, postpartum and newborn care.

A tour of Labor and Delivery and the Maternal Infant Unit is available at the completion of the class. NICU tour available upon request. Cost is $45.

Saturdays, Aug. 9 & 23, Sept. 6 & 20 and Oct. 4 & 18, 8:30 a.m.-12:30 p.m.

Tuesdays, Sept. 9 and Oct. 21, 8:30 a.m.-12:30 p.m.

The Breast Center at Sunrise Hospital, 3006 S. Maryland Pkwy., Suite 250 (located in the Diagnostic Center on the north end of the Sunrise campus).

ONE-ON-ONE MEDICARE COUNSELING

Join a State Health Insurance Assistance Program (S.H.I.P.) Volunteer as they help you navigate through the Medicare process one-on-one. By appointment only, every 20 minutes.

Tuesdays, Aug. 12, Sept. 9 and Oct. 14, 10 a.m.-noon

Sunrise Hospital H2U Office, 3131 La Canada St., Suite 107 AARP DRIVER SAFETY CLASS

Attend this class and receive a discount on your automobile insurance. $15 for AARP members and $20 for non-members. Bring your AARP card and driver’s license plus a check or money order for the fee.

Wednesdays, Aug. 13, Sept. 10 and Oct. 8, noon-4:15 p.m.

Sunrise Hospital H2U Office, 3131 La Canada St., Suite 107 FREE CAR SEAT CHECKS

Saturdays, Aug. 16, Sept. 20 and Oct. 18, 10 a.m. -noon

The District at Green Valley Ranch,

2225 Village Walk Dr., Henderson (behind R.E.I.) Wednesdays, Aug. 20, Sept. 17 and Oct. 15, 5-7 p.m.

Sunrise Children’s Hospital Circular Driveway, 3186 S. Maryland Pkwy.

PRENATAL BREASTFEEDING CLASS

The class is designed to educate expectant mothers on the benefits and rewards of breastfeeding. Registration is required as space is limited. A complimentary tour of the Maternal Infant Unit is available upon completion of the class. Expecting moms who have pre-registered at Sunrise Children’s Hospital are eligible to enroll in the class and the cost is included in their delivery fees. The fee for the breastfeeding course is $30 to community members who wish to take part in our education offerings but have not yet pre-registered to deliver at Sunrise Children’s Hospital.

Mondays, Sept. 1 and Oct. 6, 11 a.m. -noon

Sunrise Children’s Hospital, Maternal Infant Unit Classroom, Third Floor, 3186 S. Maryland Pkwy.

ADULT DIABETES CLASS: “OVERVIEW AND MEDICATIONS”

This class provides an introduction to the diabetes disease, process and the actions and effects of medications on the diabetic patient. This class is for adults only; you are welcome to bring a guest.

Tuesday, Oct. 14, 2-4 p.m.

3121 S. Maryland Pkwy, Suite 600

(Located across from Sunrise Hospital, two buildings south of Denny’s restaurant).

ADULT DIABETES CLASS: “NUTRITION”

This class will provide an introduction to the dietary needs of the diabetic patient and the benefits of diet and exercise. This class is for adults only; you are welcome to bring a guest.

Wednesday, Oct. 15, 2-4 p.m.

3121 S. Maryland Pkwy, Suite 600

(Located across from Sunrise Hospital, two buildings south of Denny’s restaurant)

FALL 2014

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T he l i s t

RESIDENTIAL CARE Facilities

Ranked by number of licensed beds as of April 30, 2014

Rank

1a

Atria Sutton

1b

Emeritus at The Plaza

Licensed beds

Category 1 beds

Category 2 beds

Owner

Top executive

150

—

150

Atria Senior Living Group

Cathy Helton administrator

150

50

100

Emeritus Senior Living

Don Parker administrator

144

103

41

Atria Senior Living Group

Andrew Levin administrator

139

—

139

Atria Senior Living Group

Tad Weight administrator

132

—

132

Julie Haltom

Jessica Rodriguez administrator

113

85

28

Willow Creek

Elizabeth Aragon administrator

108

—

108

Merrill Gardens

Diane Mcintyre administrator

108

—

108

Pacifica Senior Living

Trudy Andrews executive director

105

89

16

Emeritus Senior Living

Julie Liebo executive director

105

60

45

Health Care Reit

Michael Korin administrator

100

100

—

Ensign Group

Julie Mason executive director

96

82

14

Nevada Hand

Did not disclose

96

82

14

Nevada Hand

Robert Colbert administrator

3185 E. Flamingo Road Las Vegas 89121 (702) 436-9000 • AtriaSeniorLiving.com 6031 W. Cheyenne Ave. Las Vegas 89108 (702) 658-5882 • Emeritus.com

3

Atria Seville

4

Atria Sunlake

5

Willow Creek at San Martin Assisted Living

6

Willow Creek at Buffalo Assisted Living

2000 N. Rampart Blvd.

Las Vegas 89128 (702) 804-6800 • AtriaSeniorLiving.com 3250 S. Fort Apache Road Las Vegas 89117 (702) 256-6500 • AtriaSeniorLiving.com 8374 Capovilla Ave. Las Vegas 89113 (702) 222-3600 • WillowCreekLV.com 3890 N. Buffalo Drive Las Vegas 89129 (702) 396-1700 • WillowCreekLV.com

7a

Merrill Gardens at Green Valley Ranch LLC

7b

Pacifica Senior Living Green Valley

9a

Emeritus of Las Vegas

9b

Sunrise of Henderson

11

68

Facility

1935 Paseo Verde Parkway Henderson 89012 (702) 568-7900 • MerrillGardens.com 2620 Robindale Road Henderson 89074 (702) 992-0000 • PacificaSeniorLiving.com 3025 E. Russell Road Las Vegas 89120 (702) 451-7896 • Emeritus.com 1555 W. Horizon Ridge Parkway Henderson 89012 (702) 837-6582 • SunriseHenderson.com

Desert Springs Senior Living 6650 W. Flamingo Road Las Vegas 89103 (702) 732-2800 • DesertSpringsLiving.com

12a

Silver Sky Assisted Living

12b

Silver Sky at Deer Springs Assisted Living

8220 Silver Sky Drive Las Vegas 89145 (702) 835-9040 • SilverSkyLasVegas.com 6741 N. Decatur Blvd., Bldg. #3 Las Vegas 89130 (702) 462-7700 • SilverSkyLasVegas.com

H E A LT H C A R E Q UA R T E R LY

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Rank

Facility

14

The Bridge at Paradise Assisted Living

15

The Homestead of Boulder City

16

Red Rock Residential Care Center

17

Lakeview Terrace Retirement Community

18

Aegis of Las Vegas

19

Prestige Assisted Living at Henderson

20

Pacifica Senior Living Regency

21

Las Ventanas Retirement Community

22

Acacia Oasis

23

Pacifica Regency Memory Care

24

Willow Creek Memory Care West

Licensed beds

Category 1 beds

Category 2 beds

Owner

Top executive

91

81

10

Century Park

Jane Micali manager

84

53

31

Volunteers of America

Joyce De Hass administrator

83

—

83

Mike Ganti

Saraah Ganti administrator

78

66

12

Did not disclose

Joanne Misuraca administrator

72

—

72

Aegis Living

Peter Cowley executive director

69

52

17

Prestige Senior Living

Erin Garner executive director

64

54

10

Pacifica Senior Living

Aleksandrina Takov administrator

60

—

60

Las Ventanas Retirement Community

Susan Clinton administrator

50

—

50

BPM Senior Living

Penny Munn administrator

45

—

45

Pacifica Senior Living

Aleksandrina Takov administrator

42

—

42

Willow Creek

Heather Lankford administrator

2205 E. Harmon Ave. Las Vegas 89119 (702) 369-6964 • TheBridgeParadiseValley.com 1401 Medical Park Drive Boulder City 89005 (702) 294-8720 • HomesteadBoulderCity.org 5975 W. Twain Ave. Las Vegas 89103 (702) 368-7700 180 Ville Drive Boulder City 89005 (702) 293-0181 • LVTerrace.com 9100 W. Desert Inn Road Las Vegas 89117 (702) 240-3070 • AegisLiving.com 1050 E. Lake Mead Drive Henderson 89015 (702) 564-1771 • PrestigeCare.com 3985 Pearl St. Las Vegas 89121 (702) 436-6400 • PacificaRegency.com 10401 W. Charleston Blvd.

Las Vegas 89135 (702) 360-2662 • LasVentanasLV.com 8630 W. Nevso Drive Las Vegas 89147 (702) 942-8700 • AcaciaSprings.com 4025 S. Pearl St. Las Vegas 89121 (702) 436-6400 • PacificaRegency.com 3351 N. Buffalo Drive Las Vegas 89129 (702) 395-3100 • WillowCreekLV.com

Notes: Category 1 beds are for residents without memory loss; category 2 beds are for residents with some form of memory loss. Sources: Nevada Division of Public and Behavioral Health and VEGAS INC research. Note: It is not the intent of this list to endorse the participants or to imply that the listing of a company indicates its quality. Although every attempt is made to ensure the accuracy and thoroughness of VEGAS INC charts, omissions sometimes occur and some businesses do not respond. Please send corrections or additions on company letterhead to Pashtana Usufzy, Research Associate, VEGAS INC, 2360 Corporate Circle, 3rd Floor, Henderson, NV 89074.

FALL 2014

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BY THE NUMBERS

3,952,841

Number of births in the United States in 2012. About 8 percent of those infants had a low birth weight.

78.74

Average U.S. life expectancy as of 2012, according to the World Bank.

51.8 percent

Percentage of adults with hypertension in 2011-2012 who had their blood pressure controlled, according to the National Health and Nutrition Examination Survey.

9,945

Number of tuberculosis cases reported in the U.S. in 2012, a rate of 3.2 cases per 100,000 members of the population.

$53,282

Average cost of hospitalization involving a heart valve procedure nationally in 2011.

79 million

Number of Americans currently infected with HPV, according to the Centers for Disease Control.

91.3 percent

Five-year survival rate of individuals diagnosed with melanoma of the skin, which amounts for 1.7 percent of all cancer deaths. According to the National Cancer Institute, there will be about 76,100 new cases this year.

69,071

Number of American deaths attributed to diabetes in 2010.

30 percent

Percentage of Nevada’s 4- and 5-year-olds who are overweight or obese, according to a report by the Nevada Institute for Children’s Research and Policy. The number is a 1.4 percent increase from last year.

23 million

Estimated number of adults in the U.S. who have epilepsy, according to the Centers for Disease Control. About 150,000 new cases are diagnosed every year.

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FALL 2014

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00001097

FROM LEFT TO RIGHT: Dr. Mark Stradling, Dr. Douglas Lorenz, Dr. Surjeet Singh, Dr. Rajy Rouweyha, Dr. Rudy Manthei, Dr. Glen Hatcher, Dr. Darrick Neibaur, Dr. Shoib Myint, Dr. Douglas Orton, Dr. Vincent Gassen.

QUALITY CARE, ALL UNDER ONE ROOF. Nevada’s premier source for ophthalmology and optometry.

At Nevada Eye & Ear, we’ve assembled a team of top physicians to deliver care at the highest level of excellence. Nevada Eye & Ear has five Refractive Cataract Surgeons experienced in offering advanced technology of premium IOL’s which offers you the advantage of seeing better near or far. We are also proud to announce the addition of Dr. Stephen Solomon as a new specialist. Dr. Solomon specializes in Pediatric and Adult Neuro-Ophthalmology.

Call 702-896-6043 to schedule your appointment today.

We accept most insurances including Medicare and Medicaid.

2598 Windmill Parkway Henderson, Nevada 89074 9455 Russell Road, Suite 1 Las Vegas, Nevada 89148 2020 Goldring Avenue Las Vegas, Nevada 89106 893 Adams Boulder City, Nevada 89005 3640 S. Highway 160, Suite 101 Pahrump, Nevada 89048 1301 Bertha Howe Avenue, Suite 1 Mesquite, NV 89027 *Not all physicians shown

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2:56 PM 7/21/14 2:08 5:23 7/22/14

LOOKING BACK

DESERT SPRINGS MOVING AHEAD

By Rebecca Clifford-Cruz

D

esert Springs Hospital opened in November 1971 under the Charter Medical Corp. with a 200-bed capacity. The $6.5 million acute-care medical and surgical facility was the first hospital in the state to install an EMI Computerized Neuro-Scan Center for evaluation of brain disorders. In 1993, Quorum Health Group acquired the hospital when it purchased 10 hospitals located in Nevada, Georgia, Louisiana, Texas, California, Iowa and Virginia from Charter Medical for $340 million. The following year, registered nurses at Desert Springs made history when they became the first health care workers in the state to unionize at a private facility. In 1997, Universal Health Services and Quorum Health Group merged their Nevada operations creating the state’s largest integrated system of health care services. Desert Springs has grown to a 293-bed facility covering more than 450,000 square feet at the medical complex.

Top: Dr. Sharon Frank prepares for surgery at Desert Springs Hospital on July 23, 1988.

Above: Drs. Dale Glicken and Sharon Frank are flanked by nurses Vi Stocks and Charmaine Gilden as they perform an ear operation on Skyler McDaniel in July 1988.

Above: Former Las Vegas City Commissioner Ron Lurie proclaimed March 23-29, 1975, as “Las Vegas Food and Fitness Week.” Joining him Nutrition Consultant Lesley J. Johnson (left) and Director of Food Service Bonnie Stanley.

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FALL 2014

Photos courtesy of The Las Vegas Sun archives

7/22/14 2:10 PM

MEDICAL ADVERTISING SECTION

Your Practice Name Here Your Address Here Your Website Here

(702) 444-4444

CALL NOW to find out how you can buy a profile and put YOUR information here!

702.990.2443

Linda S. Woodson, M.D.

Thomas Umbach, M.D.,

B A R I AT R I C S U R G E R Y

Your Bio Here Your Bio Here Your Bio Here Your Bio Here Your Bio Here Your Bio Here Your Bio Here Your Bio Here Your Bio Here Your Bio Here Your Bio Here Your Bio Here Your Bio Here

medicalprofiles

D E R M AT O LO G Y

Y O U R P R A C T I C E S P E C I A LT Y H E R E

Your Name Here, M.D.

Dr. Linda Woodson is a Board-Certified Dermatologist by the American Academy of Dermatology and the American Board of Dermatology. She has been serving the skin care needs of her patients in the Valley since 1994. Because of her expertise in skin care, she is often called upon by local news programs and publications for suggestions and comments on skin care and skin protection in our sunny climate. A graduate of M.I.T. and the University of Southern California Medical School, Dr. Woodson completed residencies at the Wadsworth V.A. Hospital and the King Drew Medical Center in Los Angeles. Over the years, Dr. Woodson’s office has participated in a number of clinical studies for conditions such as Plaque Psoriasis, Basal Cell Carcinoma, Psoriatic Arthritis and Acne. Besides her expertise in medical dermatology, Dr. Woodson also excels in administering Botox, Restylane, Juvederm and other cosmetic fillers as well as her office offering skin care solutions through laser skin tightening, resurfacing, hair removal and Hydrafacials. Dr. Woodson is a member of the Clark County Medical Society and the American Medical Association.

Linda Woodson Dermatology

F.A.C.S.

Dr. Thomas Umbach is a fellowship-trained Las Vegas bariatric surgery specialist devoted 100 percent to bariatrics with more than seven years training in laparoscopic and bariatric surgery. His memberships include Fellow of American Society of Metabolic and Bariatric Surgery, Fellow of American College of Surgeons and American Board of Surgery.

After starting up the laproscopic surgical weight loss program at Kaiser Permanente South San Francisco, which services all of northern California, Dr. Umbach then created a Center of Excellence program in Eugene, Ore., and rejuvenated the Bariatric Program at Desert Springs Hospital. His other achievements include being named America’s Top Surgeon in 2008, 2009 and 2010, and Newsweek’s 15 Leaders in Bariatric Surgery in 2011.

Board-Certified: American Board of Surgery Fellow: American College of Surgeons, American Society of Metabolic & Bariatric Surgeons Fellowship: Advanced Minimally Invasive Surgery, University of Southern California M.D.: Medical College of Virginia

2800 N. Tenaya Way, Suite 203 Las Vegas, NV 89128

Blossom Bariatrics

305 N. Pecos Road, Suite F Henderson, NV 89074

3235 E. Warm Springs Road, Ste. 100, Bldg. 24 Las Vegas, NV 89120

(702) 202-2700

(702) 463-3300

LindaWoodsonDermaltology.com

BlossomBariatrics.net

FALL 2014

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H E A LT H C A R E Q U A R T E R LY

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From left to right: Michael A. Trainor, D.O.; Thommam Kuruvilla, D.P.M.; Randall E. Yee, D.O.; Timothy James Trainor, M.D; Xin Nick Liu, D.O.; Matthew H.C. Otten, D.O.; Sep Bady, M.D.

The doctors of Advanced Orthopedics & Sports Medicine have been cited by US News & World Report, Las Vegas Life, Desert Companion, Seven Magazine and Castle Connelly as “Top Doctors.”

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