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FALL 2019

Quality HEALTH


Moderonn Salm



e r a c h t l a e Your H

. S.. S E LN AM! L WE E TE R H U YO EET T . 18 M PG

contents issue 2  2019



TRANSFORM The Healthcare Delivery System


Find us online! www.wickhosp.com


Quality HEALTH



Executive Publishers HAL G. FOX & SUZANNE POLK FOX executive publishers Hal G. Fox & Suzanne Polk Fox managing editor Suzanne Polk Fox copy editor Chad Ruiz contributing writers Amber Marie Areralos Kai Bragg Shannon Brown art director Dianne Waller design Tra Pham Design: Wickenburg Sun Wickenburg Community Hospital

production Claire Thomas contributing writers Michelle Brinkley Emily Koelsch Juliane Morris Juan Vasquez, MD Blair Funk, MD Tanner Moore, DPM Kai Bragg

contributing writers Kristy Podruchny Richard Wedig Todd Kravetz, MD, FACP Natalie Schuminkski, PT, DPT, DN Elizabeth Madrie Hardin Lisa Erlinger, PhD, CRNA Peter Stachowicz Crissie Mergogey Caitlyn McKey Matt Jones, FNP-C Dede Schmallen, MA, FABC

"Take The Quality Health & Wellness Satisfaction Survey" © 2019 Fox Printing & Creative Publishing, LLC, New Orleans, LA All rights reserved Printed in the USA by Fox Print Services (igofox.com)

The information contained in Inspire Health is intended for educational purposes only. A reader should never substitute information contained in Inspire Health for the advice of a health care professional. Jumpstart Publishing, LLC and publishers of Inspire Health, do not endorse or promote any of the products or services described in the pages of Inspire Health and the publishers do not verify the accuracy of any claims made in the editorial or advertisements contained in Inspire Health. Readers should not use the information in Inspire Health for diagnosis or treatment of any health problem or for prescription of any medication or other treatment. Readers should consult with a healthcare professional before starting any diet, exercise or supplementation program, before taking any medication, or have or suspect they have a health problem. V7


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Finding a Balance Between School and Activities

Fun Fall and Halloween Puns to Share with Your Kids




Finding Exercise When You’re Traveling



Safety For Pets


One Pan Teriyaki Salmon



Healthy Chocolate Truffles




CEO's letter

Jim Tavary, CEO Wickenburg Community Hospital 520 Rose Lane • (928)684-5421

The history books record a wise person as once saying, “When I was young, I used to admire intelligent people; as I grow older, I admire kind people.” Me too! This is to say thanks to the many incredibly kind people that have given of their time, resources, energy, and ideas to support the Wickenburg Community Hospital Foundation’s capital campaign to renovate and improve Emergency Department facilities at WCH. A nearly $1.2 million capital campaign is nearing its goal as the construction project, already underway, is heading toward a planned completion date in November 2019. I was on the telephone recently with a CEO colleague from a neighboring Arizona hospital describing this exciting new project and the generosity of our community. His comments were profound in their simplicity. He said, “Jim, it just doesn’t happen like this. I’ve never heard of the level of generosity found in your community. Congratulations!”

My friend is exactly right! It just doesn’t happen like this! The WCH Foundation Board, led by Chairman Hunt Spear and Executive Director Brenda Crissman and a unified and motivated team of dedicated Foundation Board members, have exceeded our most optimistic expectations. On behalf of each of them, please accept my sincere thanks to you, our regional community, for responding to them with gifts of all sizes to the ED Renovation Capital Campaign. Because of you, a new ED Registration Entrance and a fully renovated ER Department is becoming a reality, even as I write this article. Think of it! By the end of this year, patients, families and community members will have access to a 24/7/365 ED Registration Entrance and they will experience world class services in a center of excellence environment. We are indeed blessed. And, yes, it is going to happen like this at your community hospital. All because of you!


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Te s t i m o n i a l

“Thank you. Your professional help was invaluable and made the difference in my surviving a very difficult period in which I could barely swallow liquids, even water. My diagnosis of achalasia, an inability of my esophagus to swallow and the lower sphincter to my stomach to open, made it almost impossible for me to get any nourishment down. Your suggestion and provision of “Ensure” clear made all the difference in the world. Just as important was your personal kindness and concern about helping me deal with my limitations. You alerted me to potential medical pitfalls: dehydration, lack of protein, and had remedies for each. You helped concoct the highest caloric “shakes” and gave me recommendations for “liquid vitamins”. It was wonderful having a medical professional who communicates a genuine caring for the “patient”, as this was a scary time. I am happy to say that the Mayo Clinic was able to fit me in early and that the series of diagnostic testing is complete. They have given me a “botox” shot, so I can manage soft foods now.


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"Invaluable, professional help from Debra Loder, RDN" Terry Reps I will be seeing two Mayo Hospital surgeons on Aug 27th, to make a decision on a permanent solution to my “mechanical” problem. I am grateful beyond words. However, the only reason I think I made it as far as I did, was because of your help and resources, and the attention of Dr. Todd Kravetz, and his referral to Dr. Patel. Without this initial referral and support I would be in bad shape. I believe that nutrition is our most powerful drug. I hope that the doctors at Wickenburg Community Hospital make use of your dietary knowledge and skills to help their patients cope with difficult medical situations. Things that we can do for ourselves helps us overcome the feelings of hopelessness when facing real health challenges. Thank you again.

-Terry Reps, Wickenburg Community Hospital Patient


edical Imaging Supervisor and Breast Center Lead Mammographer, Rena Koeneke has been recognized as a Breast Patient Certified Navigator in Diagnostic Imaging by the National Consortium of Breast Centers (NCBC). The certification commenced in March, 2019 during the NCBC conference in Las Vegas. The National Consortium of Breast Centers (NCBC) is an interdisciplinary organization committed to the development, maintenance, advancement and improvement of the highest quality, patient-focused Breast Centers. NCBC collaborated with the Harold P. Freeman patient navigation Institute ( HPFNI) in 2014 to develop its current Certification Program for breast patient navigators with a focus on setting standards and best-practices for all phases of the complex breast patient health care continuum including outreach, screening, diagnosis, treatment and end of life care. Moving a patient through a breast care/cancer continuum is a complex and highly individualized process. Rena’s certification as a breast patient navigator reflects her advanced competency in this area of expertise beyond standard licensure requirements. The commitment to her patients, the community and her profession are exemplified by this achievement. According to NCBC, “Benefits of certification to patients and Wickenburg Community Hospital families include: assurance that the provider of care is qualified and competent at a more than basic level; improved quality, safety and accuracy of care by advanced skilled professionals; expanded knowledge to be shared about choices and treatment options; more empowerment FREE Mammogram in decision making; and knowledge that the professional AND Biopsy Program has shown the desire to improve their quality of patient As a Program of WCH Foundation, the Pink Ribbon care and service delivery.” Angels will provide assistance to qualified residents Rena is a registered radiologic technologist, by the of Wickenburg and surrounding rural areas to cover American Registry of Radiologic Technologists (ARRT) uninsured or under-insured expenses associated with the diagnosis of breast cancer. with additional certification in the areas of Computed Tomography, Mammography, Ultrasound, Bone Density Applicants for free testing must meet the following requirements: and now Breast Patient Navigation. Rena began her · Between Ages 35-63 career in medical imaging first at Johnson County Med· Uninsured or Under-insured ical Center in Tecumseh, Nebraska before moving on · Based on Financial Hardship to Bryan Memorial Hospital in Lincoln. In 2001, Rena · Reside in Aguila, Circle City, Congress, Forepaugh, Hillside, Kirkland, Morristown, Peeples Valley, Salome, made the decision to relocate to Wickenburg where Wenden, Wickenburg, Wittmann or Yarnell she has been able to pursue her passion in medical im· Mammogram prescription from your provider aging in the Breast Center at Wickenburg Community Hospital. To schedule your free mammogram call the “WCH Breast Center is the only center in Arizona, and Wickenburg Community Hospital at one of 58 centers nationally, to be recognized as a Cer928-668-1803; Monday – Friday 8 am. – 5 p.m. tified Quality Breast Center of Excellence by the National Quality Measures for Breast Centers Program *Mention this ad when you make an appointment (NQMBC). Becoming a certified patient navigator was a logical step in the ongoing commitment to provide world class medical care to our patients and our comTax deductible donations are proudly munity. Early detection is key to breast cancer survival, accepted online at www.wickhosp.com/foundation/ways-to-give and helping women navigate that journey is particularly or by mail to: Pink Ribbon Angels rewarding.”- Rena Koeneke, RT(R), CT, M, US (AB), 520 Rose Lane Wickenburg, AZ 85390 CBDT, CN-BI CERTIFIED BREAST PATIENT NAVIGATOR

Pink Ribbon Angels


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e r a c i d e M e h T PLAN FOR YOU I

f you are considering purchasing insurance in addition to your Traditional Medicare Part A & B, the first thing you want to do is understand what type of plan you are purchasing. For most Medicare recipients the open enrollment period feels overwhelming as there are many insurance companies trying to increase enrollment in their plan. How do you know which plan is best for you? Do you know what questions to ask? Here is a brief explanation of the types of plans available: 1. Medicare Supplement Plan (Medigap) helps cover deductibles and co-pays not paid by your Traditional Medicare plan. When you purchase a Medicare Supplement Plan your Traditional Medicare Plan remains your Primary insurance and your Medicare Supplement Plan becomes your secondary insurance plan. 2. Medicare Part D plan covers prescription medications. 3. Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are an “all in one” alternative to Traditional Medicare. They are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). They also usually offer Medicare prescription drug coverage (Part D), as well as, benefits that Traditional Medicare doesn't cover, such as, vision and dental. Many times the deductibles and co-pays are also lower. Differences between Traditional Medicare and Medicare Advantage Plans:


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Michelle Brinkley | Michelle.brinkley@wickhosp.com Patient Access Manager Wickenburg Community Hospital and Clinics 928-684-5421

When considering which plan is best for you, there are some questions many people don’t know to ask. Here are some questions you should be asking if you are considering an Advantage plan: 1. Are my current providers and hospitals contracted with this plan? 2. Can I choose a nurse practitioner (NP) or physician’s assistant (PA) as my Primary Care Provider? (verify if your primary provider is an NP or PA) 3. How will I know my service area? (Example: If I live in Yavapai county will Wickenburg Hospital & Clinics in Maricopa County be covered as in-network) 4. What happens if I need medical coverage and I am outside my service area, out of state, or out of country? 5. What deductibles and co-pay or co-insurance will I be responsible for after insurance pays? 6. Is Medicare part D (pharmacy) included in this plan? Although WCH cannot make any specific recommendation on which plans you should choose, we can provide a general list of insurance companies we are contracted with. In addition, our Pharmacist can review your current list of medications and discuss which plans might provide the best prescription drug coverage for your individual needs. Please stop by our volunteer desk at the hospital for a list of contracted insurance companies or visit our website at www.wickhosp.com.


October 15th - December 7th is your chance to make changes to your Advantage or Prescription Drug Plan. I have a simple 3 step process to make sure you’re on the right plan for you! You don’t need to be an expert to chose a Medicare plan. Let Matt help! Call Matt Monk and put his 16 years of experience to work for you. I WORK WITH MOST OF THE MAJOR COMPANIES TO HELP MY CLIENTS FIND THE PLAN THAT’S RIGHT FOR THEM

928-308-0903 | matt@kelloggins.com


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FUN FALL AND HALLOWEEN PUNS to share wi th You r


By Emily Koelsch


all is one of the best times of year full of events, cooler days and vibrant colors of changing leaves. The season is particularly fun for kids visiting pumpkin patches, preparing Halloween costumes, picking apples and navigating corn mazes. It’s a great time to get outdoors and experience some special activities with your kids.

While you’re enjoying the season, have some extra fun with creative and seasonal word play. Here are a few of our favorite puns (some might argue a few of our worst) to get you started: • Make sure that you remind your kids how GOURDgeous this time of year is. • While you’re outside enjoying the foliage, let them know that you hope this time LEAVES

them feeling inspired. • It really is the perfect time to let kids know that you beLEAF in them and that you think they’re SPOOKtacular. • Are you having trouble convincing them to pick apples at the orchard? If so, encourage them to at least conCIDER it. • Perhaps they need help fixing a broken Jack-o-

lantern? Easy, just use a pumpkin patch. • It’s always good to incorporate some math into your activities, so see if they can calculate the ratio of a pumpkin’s circumference to its diameter. Obviously, the answer is Pumpkin Pi. • Do you need help coming up with a cosTOMB? How about being a mummy? • Speaking of mummies, do your kids know what kind of music they like? Mostly Wrap. • Or do they know why the ghost wouldn’t dance at the Halloween party? He had no BODY to dance with.

Despite some of our CORNy jokes, we hope you have an aMAIZEing season with your family. And in all seriousness, we hope you and your family enjoy these fall jokes and have fun trying to come up with a few of your own. Puns or no puns, take advantage of this wonderful season to enjoy some quality time together.

The season is kids particularly fun for g as they enjoy visitin ing ar ep pumpkin patches, pr Halloween costumes


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Trusted, Comfortable & Affordable Dental Care Meet Our Caring Team, Dr. Josh Jones & Dr. Troy Jones

Dr. Josh Jones & Dr. Troy Jones

Our team of caring, experienced dental professionals use only the most advanced technologies, materials and procedures. After almost 20 years Dr. Troy Jones has found someone to work beside him and carry on his legacy. Both Dr. Troy and Dr. Josh share the same passion and dedication to the community and look forward to continuing to serve Wickenburg. Your comfort and satisfaction have always, and will continue to be the most important focus of our practice. We would like to invite you to meet Dr. Josh Jones and family!

Trusted, Comfortable & Affordable Dental Care

One Trusted Office for All Your Dental Needs!

Meet Our Caring New Team, Dr. Troy Jones & Dr. Kristina Wilson

The latest

Our team of caring, experienced dental professionals use only the most advanced technologies, materials & procedures. Our practice owner & managing dentist, Dr. Troy Jones, & his associate, Dr. Kristina Wilson, are dedicated to having a procedures, Instruments & Techniques - Gentle Private Practice Dentists community-focused practice where your comfort & satisfaction Cosmetic Dentistry -Low Radiation Digital X-Rays come first.

CEREC - Crowns & Bridges in 1 Day - Laser Procedures - Mouthguards One Cone Trusted Office- Dental for All Your Dental Needs! GLO Whitening Beam Imaging Implants - Dentures/Partials - Veneers The Latest Procedures, Instruments & Techniques • Gentle Private-Practice Dentists • Mercury-Free Dentistry Sleep Apnea Oral Appliance - 3 Hygienists on Staff Low-Radiation Digital X-Rays • Sedation Dentistry • Laser Bacterial Reduction Procedure • Mouthguards • LaserWhite20 Complimentary ~ VELscope Oral Cancer Screening for ALL Patients! ($75 value) Whitening Trays ™

Dental Implants • Dentures/Partials • Veneers • Sleep Apnea Oral Appliance • CEREC® ~ Crowns in a Day • Three Hygienists on Staff for All Patients! $75 value.) Complimentary ~ VELscope® Oral Cancer Screening Walk In! You’re(AAlways Welcome!

We offer courtesy billing for all insurances. Walk In! You’re Always Welcome! 821 West Wickenburg Way • Wickenburg 821 West Wickenburg Way • Wickenburg 928-684-1000 • www.DrTJones.com

928-684-1000 • DrTJones.com www.TheGoodDentistWickenburg.com Monday - Friday 7 a.m. to 5 p.m.

Open From 7am–6pm & on Fridays! All Insurance Is Welcome & Maximized



When You’r e Traveling Stay on Top of Your Fitness When You’re Away from Home By Juliane Morris


acation or business travel tends to lead to over-indulging, treating yourself while away and coming home feeling off course. If your itinerary includes upcoming travel, think about following these ideas or modifications of them to help maintain some great exercise options toward your health and wellness.

re nd illness a a y r ju in e Whil rgo xcuses to fo acceptable e xercise habit, re your regula ou’re traveling y the fact that be a hindrance to doesn’t have p your exercise u to keeping uccess. stride and s


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SKIPPING HIGH KNEES Skipping High Knees challenges and works many muscle groups by activating hip flexors, strengthening legs and enhancing coordination. The movement of the exercise mimics jumping rope and counts on speed and large muscle motor control. Step 1: Skip in place by hopping on one leg while bringing

the other knee up toward your chest. Lift your knee so it is a bit higher than perpendicular with your body. Swing your arms as you skip with the opposite arm. When your left arm is forward then your right knee is up. Step 2: Repeat the skipping motion, alternating sides. Try two to three sets for 30 seconds.


GRASSHOPPER PUSH-UP The Grasshopper Push-Up is a variation of the traditional push up. This exercise is challenging and may not be for everyone. They take some getting used to, so practice your form and do them slowly and carefully to get the hang of them. The different angles used with these train different sets of muscles. They enhance flexibility in your lower body and because the movements are intense, after just a few reps you’ll feel the burn.

Step 1: Place the palms of your hands flat on the floor shoulder-width apart but in line with your shoulders. If your wrists are unable to bear much weight, modify with a closed fist floor placement. Steady your toes on the floor and squeeze your glute muscles to stabilize the body. Form your body into a strong, straight line from your shoulders to your toes. Your face should be downward toward the floor. Step 2: Tighten your core and bend your right leg under your body. Keep your leg

under your body as you inhale and then bend at your elbows to lower your body until your chest is near the floor without allowing your right leg to touch the floor. You can turn your head as you move so as not to strain your neck. Inhaling when you move down to the floor relaxes your ribcage while expanding your abdomen. Step 3: Exhale slowly, pressing your body back to the starting position, returning and straightening your right leg next to the straight left leg. Exhaling as you push yourself to the starting

plank position releases air to help your ab muscles contract, making the push-up easier and safer. Step 4: Repeat the steps with the left leg.

MODIFICATION: These exercises are not for everyone. Only those who are used to a regular exercise program should attempt them.


BIRD DOG PLANK The Bird Dog Plank strengthens your lower back, works your glute, and targets the core abdominal muscles that line the front of your stomach wall. A staple for home or away, this will help you stay on top of your exercise

commitment, even when you’re dragging from jetlag. Step 1: Place your hands and knees on the floor–down on all fours–hips square, knees under hips and hands under shoulders and at shoulder-width, keeping your back straight and your core engaged.

Step 2: Lift up one arm parallel with the floor while lifting up the opposite leg parallel with the floor, forming a straight line from fingertips of raised arm to toes pointed of raised leg. Step 3: Hold the position for ten seconds with hips squared and core engaged and without

leaning forward or back but centered and balanced over hand and knee, hips level and not curved up sideways. Step 4: Repeat eight to ten times on each side, two to three sets.


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Primary Providers


Re-Inventing Oneself By Juan Vasquez, MD Internal Medicine 928-668-1833

Coming home to Arizona this time has presented some new challenges. These challenges are quite unlike returning from the Army some forty years ago. At that time, I was starting out in life as a young single man. I am now an older seasoned husband, father, grandfather and a physician in the Zenith of his career. I find that I challenge myself in ways I didn’t forty years ago. I’ve made the conscious decision to eat better. A bit less red meat, more vegetables, less sugar. To exercise more; at least a half hour per day, preferably in the morning. Sleep more than my current five to six hours per night, for me seven would be good. I challenge myself to stimulate my mind in different ways; play chess and a game of cards with a bit of skin in the game now and again (a few nickels at stake seems My approach to patient care is a holistic one in which I like to look at the whole patient and not just individual complaints or disease processes. I believe that the body and the mind are connected and it is important to address overall health and wellness in order to achieve optimal health. My idealistic goal as a physician is for all my patients to have excellent health and wellness without taking multiple medications. I am a strong believer that the vast majority of conditions I treat patients for are mostly diseases preventable by living a healthy and

Body & Mind Connected

balanced lifestyle. I especially like to focus on diet and nutrition, as these are the foundations for total mind and body health. I specifically promote a plant-based diet with plenty of fruits, vegetables, beans, legumes, and whole grains and low in animal products and processed foods. In addition, I like to focus on mental health, for which mindfulness, meditation and yoga are all great ways to decrease stress and promote mental wellbeing. Anything that you love can be meditative and release stress. For example if you like hiking, knitting, drawing, crocheting, fishing—any


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to stimulate the mind more), read more for pleasure and be more receptive of ideologies different than mine. My evolution as a person has been very interesting and overall a wonderful experience. I have accepted challenges offered by others and more importantly, challenges put to myself. I have approached these challenges with the goal of gaining knowledge to benefit myself and most of all- putting that knowledge to work in a way that might benefit others. As physicians; we come in to contact with people from all ethnicities, religions, nationalities, and across all socioeconomic positions. It has been a gift and a privilege to serve my patients all these years and I have nothing but praise for our system of government. Coming home to Arizona as a husband, father, grandfather and physician; the challenges are different now, but I continue to serve the public, just in a different capacity.

By Blair Funk, MD Family Medicine 928-668-1833 hobby you may have, can help decrease stress. I encourage doing something fun that you love at least every day, even if just for a few minutes! Some things that I love doing to improve my own mental health are cooking, hiking, camping, yoga, and dancing. If you come in to see me, feel free to ask me for some of my favorite plant based recipes and to share your own favorite hiking or camping spots around Arizona! I also love working in a smaller community since it enables me to get to know my patients on a more personal level which I think helps the overall patient-doctor relationship flourish.


New Docs in Town Surgeon

Diabetes and Foot Health Tanner Moore, DPM Podiatric Surgeon 928-668-5506


iabetes is a growing problem in the United States and throughout the world. There are two general types of diabetes that are simply named Type I and Type II diabetes. Type I is something that comes from birth or can develop later in life from an abnormality in the production of insulin from the pancreas. Type II is more commonly later onset in life and is caused by a desensitization of the receptors in our body to insulin. Insulin is not able to work at the same level it once was, which can cause elevated sugar in the blood. The two types are difficult to differentiate from a diagnostic standpoint, but which ever it is important to see our wonderful primary care providers here at Wickenburg Community Hospital for management of diabetes. How does diabetes relate to podiatry? Why is a podiatrist writing about diabetes? There are a few specific areas of the body that diabetes seems to affect more than others. It is a disease that can affect all other organs of the body in certain ways, but the ones that seem to take the brunt of the attack are the eyes, kidneys and feet. The role of a podiatrist in the management of diabetes is keeping feet healthy so patients can remain active. The most common affect that diabetes has on the feet is loss of sensation or neuropathy. Nerves are extremely sensitive and do not like high levels of glucose. In response to long term elevated blood sugar, the nerves can begin to degenerate and die. The most common places for nerve endings to die is in the toes and fingers. It is not uncommon to have numbing of the big toe first that will spread to each toe and then slowly up the foot and leg. It can be associated with burning tingling sensations that can be very painful. There are medications that can help with the symptoms of nerve pain that our primary providers can manage, but as

feeling begins to fade, that is when seeing a podiatrist is critically important. Peripheral neuropathy, or loss of sensation to the extremities, can cause many other issues because of the loss of sensation. Patients are more susceptible to skin break down and ulcerations because they don’t feel calluses building up on the bottom of the feet. I have seen patients come to my office with a nail in their foot and they didn’t know it was there because they couldn’t feel it. Diabetes can also affect how much moisture gets to the skin of the foot, which can cause excess dryness and callusing. Calluses, if left unattended, can create ulcerations underneath them, Toenails can even grow thicker and are more susceptible to fungal infections. If toenails are not properly trimmed, they can rub on other toes and cause cuts and ulcerations. Unfortunately, diabetic patients do not heal as well as non -diabetic patients and often need constant wound care to stimulate healing of an open wound and to monitor for infection. Diabetes can also affect blood flow to the extremities by causing calcification of vessels. It is important to have regular evaluation of blood flow and sensation from a podiatrist to help prevent ulcerations and healing issues. If blood flow and sensation are damaged enough, the digits and feet are at high risk for not surviving even minor abrasions and cuts. Regular follow up with a primary care provider, podiatrist and eye specialist as well as good nutrition and exercise. Can significantly improve the prognosis of diabetes. There are simple non-invasive tests that can be done routinely to monitor blood flow and nerve health. If calluses are building up, we can take care of them and help get the right shoe gear to offload these problem areas. Our goal is to keep Wickenburg on its feet to lead active healthy lives! Come see me and let’s talk about how we can help keep you on your feet!


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Dr. Isabel Nino de Guzman Clinical Psychologist; CSAT-S CMAT-S Premium Services:

 Psychological Evaluations and Risk Assessments  Psychotherapy: • Alcohol/substance-use disorders • Sex addiction • Gambling disorders • Dual diagnosis • Unresolved trauma • Depression and anxiety • Personality disorders • Chronic pain • Anger management  Clinical Supervision Wickenburg Community Hospital Specialty Clinics 601-325-7313 519 Rose Lane, Wickenburg, 85390


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FOR PETS By Kai Bragg

Make sure you securely strap in pets when riding in a car or fast moving boat.


hen you’re out for a day of fun and recreation, safety is always an important thing to consider. If you take your pets along for the fun, be sure to think of them too. Whether taking a walk, going for a car ride or spending time on the water, it’s up to us to keep our furry companions safe. If you go out for a walk, be sure to keep your pets close. Pets can easily stray into traffic, and using a leash is a great way to prevent them from getting injured. Using a leash also helps prevent them from chasing potentially dangerous animals. If you use a retractable leash, pay extra attention to what’s going on around you and your pets. A retractable leash can allow excited pets to bolt into dangerous situations. When riding in a car, be sure to strap your pets in. We wear seatbelts for a reason, and our pets need

them too. Seatbelts can make a huge difference in an accident, and can also help prevent your traveling companions from jumping out of moving vehicles. If you take your animals on car rides, and especially if they ride in the open bed of a truck, make sure they are securely fastened. If you spend time on the water, whether swimming or boating, make sure your pets are protected. For weak swimmers, a PFD can be a huge benefit. Keeping unsure pets afloat, PFDs are a great way to introduce pets to water. Preventing the worry of injury from fatigue, they can also help older pets continue to enjoy a nice swim. If boating is your recreation of choice, be sure to secure your pets as you would in a car. If an animal jumps out of a boat traveling at higher speeds, they can be severely injured from impacting the water. Always provide your pets with an easy way to get out of the water. There are many op-

tions for attachable boat steps, ramps and lifts that will allow your tired pets to climb safely out of the water. Keeping your pets safe takes little extra time. Consider these basic things when you bring your pets along for the fun. Keep them out of traffic and safe from wild animals by using a leash. Make sure you securely strap in pets when riding in a car or fast-moving boat. Make use of a PFD for weak swimmers and always provide an easy way to get out of the water for swimming pets.

Keeping your pets safe takes little extra time.


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eat fresh



Fresh Salmon is a buttery pink meat that happens to be one of the best sources of omega-3 fatty acids like DHA and EPA. It is a high protein, low calorie food that is a great source of vitamin D, B12 and selenium to name a few. What’s not to love?

unt of The amo fatty omega-3sent in acids pre pends on de salmon e ďŹ sh has h t t wha ng. been eati


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almon also contains a pigment called astaxanthin (ASX) that, according to a study from Nutrients, has “potent antiwrinkle and antioxidant effects” and “may prevent UV-induced immunosuppression.” Another study from Molecular Nutrition and Food Research found that ASX improves brain health and spatial memory! The high omega-3 fatty acid content in salmon is what gives this fish much of its reputation for being a healthy food. These are essential fatty acids that can’t be produced in our bodies and must be eaten. This high omega-3 content means that digging into salmon on a regular basis could also help manage symptoms of ADHD. Researchers who published a study in Journal of Lipids concluded “omega-3/6 fatty acids offer great promise as a suitable adjunctive therapy for ADHD.” According to the Washington State Department of Health (WSDH), DHA and EPA mega-3 fatty acids help reduce inflammation in our bodies and are important for heart and brain health. The amount of omega-3 fatty acids present in salmon depends on what the fish has been eating. Farmed salmon are fed a specific diet meant to keep those amounts even with, or higher than wild salmon. If you’re trying to avoid soy or GMO’s, keep in mind that farmed salmon are often fed fishmeal, grains and oilseeds that are often soy-derived. The highly controversial genetically engineered salmon are also set to hit the market in 2020.

Did you know that eating salmon may help prevent and treat certain types of cancer? According to the National Institutes of Health, “some studies have shown associations between higher intakes and/or blood levels of omega-3s and a decreased risk of certain cancers, including breast and colorectal cancers.” A study of women aged 50-76 cited by the NIH found that women who took fish oil supplements had “32 percent lower risk of breast cancer after a mean of six years than those who did not take fish oil.” Overfishing and environmental pollutants like PCB’s and POP’s have given the farmed version of this flavorful and nourishing fish a dark side. The pollutants come from industrial chemical waste, pesticides and pharmaceuticals and are stored and accumulate in fatty tissue. A study published in BMC fed mice POP’s sourced from farmed Atlantic salmon and discovered that POP’s can increase the risk of developing type 2 diabetes. A similar study published in the International Journal of Environmental Research and Public Health noted that “POPs via salmon oil consumption induced abdominal obesity, dyslipidemia, glucose intolerance, insulin resistance and hepatic steatosis.” This is something to keep in mind while you’re seeking out the perfect salmon fillet. Next time you’re out grocery shopping, take time to glance at the label to make sure you’re buying sustainably harvested wild salmon.


Teriyaki Salmon

Serves 4 Time: 25 minutes

INGREDIENTS: • 4 (5-ounce) salmon fillets • 16 ounces asparagus, trimmed • 2 carrots, peeled and julienned cut into 1/8-inch slices or 1/2 cup baby carrots • 1/2 cup cherry tomatoes • 1/2 cup soy sauce • 1/4 cup orange juice or water • 3 Tbsp honey • 2 Tsp grated ginger • 3 garlic cloves, minced • 1/8 tsp chili flakes • 2 Tsp flour • 2 Tbsp olive oil • Sea salt and freshly ground black pepper, to taste • 2 green onions, thinly sliced • 1/2 Tsp sesame seeds DIRECTIONS:  Preheat oven to 400 degrees F. Lightly oil a baking sheet or line baking sheet with parchment paper for less of a mess.  Combine the soy sauce, orange juice, honey, ginger, garlic and chili flakes into a sauce pan over medium heat. Slowly whisk in flour to desired thickness. Simmer and remove from heat.  Place salmon, asparagus and carrots in a single layer onto the baking sheet.  Spoon teriyaki sauce over the salmon.  Drizzle asparagus and carrots with olive oil; season with salt and pepper, to taste.  Place into oven and cook until the fish flakes easily with a fork, about 16-18 minutes.  Serve immediately, garnished with green onions and sesame seeds, if desired. Calories 240.3. | Calories from Fat 76.5 | Fat 8.5g. Sodium 779.8mg. | Carbohydrate 11.0g | Protein 31.3g wickhosp.com

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Richard Wedig, Chief Clinic & Surgical Services Officer Amie Boucher, FNP-C Anne Broumel, Clinic Resource Manager Sue Ball, LPN Celina Cox, MA, Patient Access Supervisor Tess Dickenson, RN Todd Kravetz, MD, FACP, Internal Medicine, Clinical Medical Director & Hospital Chief of Staff

Transforming the Healthcare Delivery System How often do you see your primary care provider? How often do you discuss preventive care with your provider? There are many of us in the community that see our provider on a regular basis but only due to chronic issues. Some of us only see a medical professional if there is an acute illness or injury. While modern preventive care began in the mid-nineteenth century, many patients have no idea what this model of care entails. Preventive medicine focuses on health and maintenance with the intention of preventing disease, disability and death. For instance, in today’s medical environment diseases like diabetes can be caught early and controlled before becoming a debilitating condition. Uncontrolled diabetes can lead to many other chronic illnesses and poor quality of life, which is compounded by the need for increased health care, which increases the cost of the treatment. By utilizing a preventive care model, a medical professional can evaluate risk factors, screen for disease and create a personal prevention plan that can often lead to prevention of many major health problems before they become chronic illnesses. Although preventive care is not new, it is taking the lead in the new direction of health care. Wellness programs that utilize preventive medicine to man-


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age patient’s health are becoming more and more popular in the medical community and with insurance carriers, and for good reason: Improved patient health and wellness! For some of us, this may not be an easy transition; we have always been used to going to the “doctor’s office” when we are sick and only when absolutely necessary. Therefore, as a community, to make that transition from disease-based care and treatment to preventive care treatment, several things must take place including: 1. Asking the question, does my current provider understand the practice of preventive medicine? 2. Have you switched primary care practices or has your clinic recently changed their electronic health record (EHR) system? Often, your new provider does not have records from the previous provider. Also, new EHR systems often do not interface with the previous system. Changes in the provider/clinic and changes in the EHR systems can lead to medical records that are not always complete or accurate. 3. For all Medicare and Medicare Advantage patients:

You should schedule an annual wellness visit at your primary care clinic. These are annual visits that are usually covered by your insurance plan at no cost to you. 4. Identify health issues or risks that need to be evaluated and included in a treatment plan. 5. Review your medications and identify whether they are effective based on the health condition for which they have been prescribed. Ensure your medication list is complete and accurate to include prescriptions and over-the-counter drugs or supplements. 6. Check your insurance coverage to make sure you understand how your plan works regarding annual visits and overall coverage. Your insurance coverage will change from year-to-year, based on your insurance carrier. Don’t be surprised by what it does and does not cover. Many insurances companies are beginning to place more responsibility on the individual to be accountable for their health. One important change in most insurances is they are now covering several preventative care services including annual wellness visits for patients over 65 years of age. At Wickenburg Community Hospital Clinics, we are pleased to recognize and adopt the positive changes of preventative medicine in the evolving health care environment. As a result, we have developed a special wellness Program team to address each of our patient’s health care needs on an individual basis. The team consists of experienced health care providers, nurses and administrative staff that will review each of our patient’s charts to ensure accurate and

current information. The program is designed to provide the following services: 1. A nurse to review your charts for accuracy and completeness of data and demographic information. The nurse will call you and review your medical information from the comfort of your own home to make sure that your medical records are accurate and current. 2. After your consult with the nurse you will be scheduled with a provider in the clinic who specializes in the wellness and preventive medicine program to assess your risk factors, discuss areas of concern, and identify preventive needs. For Medicare or Medicare Advantage patients, this will be done in an annual well visit. The provider will, in addition, develop a preventative care plan for you and your primary care provider to review. This program does not require you to change your primary care provider. The annual wellness program simply prepares your primary care provider for your visit with him/her. This annual wellness visit is covered by most insurance carriers at no charge to you. 3. Scheduling a follow up appointment with your primary care provider will be recommended to review areas of concern as discussed in the preventive care/annual wellness visit. Your primary care provider will help you to set up a treatment plan for you. 4. In the future, preventive care campaigns and community outreach programs for specific population issues will be provided to the community (i.e., diabetes and heart failure prevention, breast and prostate cancer awareness, etc.)

“These visits allow us to maintain the most up to date information about our patients. The Wellness Program is a great tool for us to have another set of checks and balances.” Todd M. Kravetz, MD, FACP, Physician of Internal Medicine, Clinic Medical Director & Hospital Chief of Staff 928-668-1833


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Treat your Vertigo


Natalie Schuminkski, PT, DPT, DN Wickenburg Community Hospital Rehabilitation Center 928-668-1833

One of the leading causes of falls, particularly in older adults, is dizziness. As falls are the leading cause of accidental death in adults age 65 and older, identiďŹ cation of dizziness, its cause(s), and treatment thereof is integral to overall wellness. 30% of adults over the age of 60 report dizziness. As the population continues to grow, so does the number of people experiencing dizziness symptoms and the detrimental effects that generally accompany it.

BPPV typically presents as brief bursts of dizziness when rolling over in bed or turning your head quickly. Some symptoms associated with BPPV are nausea and sometimes vomiting, a spinning or rocking sensation, fatigue, or feeling imbalanced. If left untreated, the symptoms may last hours, days, weeks, or even months. Did you know that your physical therapists at WCH can evaluate and treat these symptoms?

Dizziness, or vertigo as it is commonly called, may have many causes. One of the most common is benign paroxysmal positional vertigo or BPPV. BPPV is characterized by sudden episodes of dizziness provoked by head movement or a change in position. What leads to the development of BPPV is not fully understood, but it is more common in older adults.

Fortunately, with appropriate assessment and diagnosis, a simple procedure done in the clinic could be all it takes to treat BPPV. If you or someone you know is currently experiencing BPPV, do not hesitate to contact the WCH Rehabilitation department with questions or to schedule your vertigo assessment. Take control of your wellness and safety by preventing falls before they happen. Consult your physical therapist or physician today.



Vertigo and Dizziness in the Elderly. Lara FernĂĄndez,1 Hayo A. Breinbauer,2,3 and Paul Hinckley Delano1,4,* Published online 2015 Jun 26. Front Neurol. 2015; 6: 144. Quality HEALTH & WELLNESS


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mighty kids




he average American child’s day doesn’t end when school lets out. About 42 percent of school-aged children play sports, 28 percent are active in clubs, and 30 percent take lessons after school. These extracurricular activities are beneficial. Learning to work and play together with other children hones skills that school may not. A 2015 study published in the American Journal of Public Health highlights the importance of strong social and emotional skills. The study claimed that these skills are better indicators of a child’s future academic and career success than cognitive skills. A HEALTHY BALANCE Children can become overscheduled which can lead to stress. The key is finding a healthy balance between school and extracurricular activities. How do parents know how many activities their child should take part in? When it comes to sports, try to limit it to one sport per season. Remember that most after school sports involve both practices


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and games every week. The same goes for music lessons. Your child might only attend lessons one afternoon per week, but musicians need to practice. There is no “magic number” of activities that is best for children though. Every family is different. Take a look at your children’s schedule and see if they have some time for unstructured play. Make sure that your family has time to spend together. Family meals are also important, so ensure you have time to sit down for dinner together at least a few times per week. Work in enough time for homework and plenty of sleep. KNOWING WHEN TO CUT BACK Watch your child for cues. Joan Grayson-Cohen of Jewish Family Services warned that children who make excuses about not attending activities may be overscheduled. If they can never find their shin guards before soccer practice or if they are happy when practice is canceled, they might be ready for a break. Also, watch for a drop in grades, an inability to entertain themselves and fatigue.

LETTING CHILDREN CHOOSE There may be activities that you don’t want your children to quit. Psychiatrist Alvin Rosenfeld advised parents to categorize extracurriculars as required (like religious school) or optional. Let the child choose from the optional category. Another good rule is to require them to finish out the year or the season and then decide whether to take the activity up again next time.

Watch for a drop in grades, an inability to entertain themselves and fatigue

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Cutting Edge Technology Ends Surgical Smoke in OR

Dr. Lisa Erlinger PhD, CRNA, Director of Surgical Services and Anesthesia 928-668-5506

The Bad News Before we can discuss how surgical smoke impacts the hospital staff and patients ULTRA we mustVAC™ attempt to defiEvacuation ne or describe surgiMEGADYNE™ Smoke cal smoke. Electrocautery devices, lasers, orthopedic devices, Pencil is designed to meet your surgical and and ultrasonic devices are used during surgery to cut tissues economic needs Unfortunately, these devices do emit what and to ligate vessels. ULTRA VAC™ Smoke Evacuation isMEGADYNE™ known as surgical smoke. MEGADYNE™ ULTRA VAC™ Smoke Evacuation MEGADYNE™ ULTRA VAC™ Smoke Evacuation Pencil is designed to meet your surgical and Pencil is designed to meet your surgical and ULTRA VAC™ Smoke Evacuation Pencil Pencil is designed to meet surgical and MEGADYNE™ ULTRA VAC™your Smoke Evacuation economic needs economic needs economic needs Pencil is designed to meet your surgical and economic needs

ULTRA VAC™ Smoke Evacuation Pencil

ULTRA VAC™ VAC™ Smoke Smoke Evacuation EvacuationPencil Pencil ULTRA ULTRA VAC™ Smoke Evacuation Pencil

Telescopic nose

Ergonomic features

Telescopic nose to adjust the working Ergonomic features Allows surgeons Swivel elbow was designed to reduce torque Allows surgeons adjust the length of theto pencil byworking a full length of the pencil by a full 6 inches

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Telescopic Telescopic nose nose

length of the pencil by a full 6 inches

Allows surgeons to adjust the working length of the pencil by a full 6 inches

Less smoke and eschar

Less smoke and eschar

on a surgeon’s hand for ease of use

cancer, hepatitis B, hepatitis C, and human papillomavirus (HPV) cells from patients. (2-5) Roughly 150 different chemicals have been identified in surgical smoke. Exposure to surgical smoke is equal to smoking 27 cigarettes in a day. The symptoms of exposure are: irritation and inflammation of the airways, coughing, headaches, dizziness, nausea and vomiting, eye irritation and conjunctivitis, as well as the development of cancer, hepatitis B, hepatitis C, and HPV. (6-8)

The Good News Surgical smoke evacuation systems are high flow vacuum sources used to capture, at the surgical site, the smoke aerosols and gases generated during the use of the devices listed above.(9) In 2018, Rhode Island & Colorado instituted laws requiring the use of such systems in all hospitals within those states.(10) For the rest of us, it is on a voluntary basis.

Swivel elbow was designed to reduce torque Cord is integrated into smoke evacuation tubing on a surgeon’ s hand forthe ease of use

Cord is integrated into the smoke evacuation tubing

Cord is integrated into the smoke evacuation tubing

• MEGADYNE™ ULTRA VAC™ Smoke Evacuation Pencil comes with a MEGADYNE™ E-Z CLEAN™ Electrode

Wickenburg Community Hospital

• MEGADYNE™ E-Z CLEAN™ Electrodes produce 68% less smoke vs. uncoated stainless steel blades Less smoke and eschar • MEGADYNE™ ULTRA VAC™ Smoke Evacuation Pencil comes with a MEGADYNE™ E-Z CLEAN™ Electrode 1

Less smoke and eschar • MEGADYNE™ E-Z CLEAN™ Electrodes are designed to reduce eschar buildup, require less frequent cleaning

It is a desire of Wickenburg Community Hospital to have a balance between health of and safety for our patients and • MEGADYNE™ E-Z CLEAN™ Electrodes are designed to reduce eschar buildup, require less frequent cleaning staff. Patient safety benefits of a smoke free environment and may saveE-Z ORCLEAN™ time vs. Electrodes stainless steel • MEGADYNE™ are electrodes designed to reduce eschar buildup, require less frequent cleaning and may save OR time vs. stainless steel electrodes include increased visibility during laparoscopic procedures, “Surgical Smoke,” “Surgical Plume,” “Plume,” “Aerosols” are all decreases in smoke absorption by red blood cells that may in1 In a preclinical porcine model at 60W vs. uncoated stainless steel blades at 60W (p<0.001). Kisch T, et al. Electrocautery Devices With Feedback Mode and Teflon-Coated Blades Create Less Surgical Smoke for a Quality Improvement the Operating Theater.the Medicine, unwarranted 2015;94(27). terms to indescribe by-products of vaporiza- crease levels of carboxyhemoglobin and methemoglobin, and in carbon monoxide levels in the peritoneal cavity. tion cauterized by surgical energy generating devices. Evidence decreases (4) Workplace safety benefits of a smoke free environment inof the harmful effects of surgical smoke has been recognized clude reduction of perioperative team members exposure to in the literature and by professional organizations for many surgical smoke, and prevention of health affects attributed to years. In fact, the National Institute for Occupational Safety (4) surgical smoke exposure. Therefore, the Wickenburg Comand Health (NIOSH) published and distributed a health hazard munity Hospital surgical department, in collaboration with (1) Some identified substances of evaluation report in 1985. decisions from administration, uses specialized smoke evacusurgical smoke include aromatic hydrocarbons, unsaturated hyator’s and is completely smoke free! drocarbons, aldehydes, alcohols and ketones, dioxins, as well as • MEGADYNE™ ULTRA VAC™ Smoke Evacuation Pencil comes with a MEGADYNE™ E-Z CLEAN™ Electrode

and may save OR time stainless steel electrodes produce 68% less smoke vs. uncoated stainless steel blades1 Less smoke and eschar MEGADYNE™ E-Zvs. CLEAN™ •• MEGADYNE™ ULTRA VAC™ SmokeElectrodes Evacuation Pencil comes with a MEGADYNE™ E-Z CLEAN™ Electrode

• MEGADYNE™ E-Z CLEAN™ Electrodes produce 68% less smoke vs. uncoated stainless steel blades1 • MEGADYNE™ ULTRA VAC™ Smoke Evacuation Pencil comes with a MEGADYNE™ E-Z CLEAN™ Electrode 1 •• MEGADYNE™ E-Z CLEAN™ Electrodes produce 68% smoke vs.touncoated bladesrequire MEGADYNE™ E-Z CLEAN™ Electrodes areless designed reducestainless escharsteel buildup, less frequent cleaning • MEGADYNE™ E-Z CLEAN™ Electrodes are designed to reduce eschar buildup, require less frequent1 cleaning • and MEGADYNE™ E-Z Electrodes produce 68% less smoke vs. uncoated stainless steel blades andmay may ORvs. time vs. stainless steel electrodes savesave OR CLEAN™ time stainless steel electrodes

1 In a preclinical porcine model at 60W vs. uncoated stainless steel blades at 60W (p<0.001). Kisch T, et al. Electrocautery Devices With Feedback Mode and Teflon-Coated Blades Create Less Surgical Smoke for a Quality Improvement in the Operating Theater. Medicine, 2015;94(27).

1 In a preclinical porcine model at 60W vs. uncoated stainless steel blades at 60W (p<0.001). Kisch T, et al. Electrocautery Devices With Feedback Mode and Teflon-Coated Blades Create Less Surgical Smoke for a Quality Improvement in the Operating Theater. Medicine, 2015;94(27).

1 In a preclinical porcine model at 60W vs. uncoated stainless steel blades at 60W (p<0.001). Kisch T, et al. Electrocautery Devices With Feedback Mode and Teflon-Coated Blades Create Less Surgical Smoke for a

1Quality In a preclinical porcine at 60W vs. uncoated stainless steel blades at 60W (p<0.001). Kisch T, et al. Electrocautery Devices With Feedback Mode and Teflon-Coated Blades Create Less Surgical Smoke for a Improvement inmodel the Operating Theater. Medicine, 2015;94(27). Quality Improvement in the Operating Theater. Medicine, 2015;94(27).


Quality HEALTH



Wickenburg Community Hospital announced on July 9th, 2019 that it has earned the Go Clear Award™ for its achievement in eliminating hazardous smoke from its surgical procedures. The Go Clear Award is presented by the Association of periOperative Registered Nurses (AORN) to recognize health care facilities that have committed to providing increased surgical patient and health care worker safety by implementing practices that eliminate smoke caused by the use of lasers and electrosurgery devices during surgery. Wickenburg earned its award by undergoing comprehensive surgical smoke education and testing and for providing the medical devices and resources necessary to evacuate surgical smoke during all smoke-generating procedures.

“Total evacuation needs to become the standard for all procedures that generate surgical smoke,” said Linda Groah, MSN, RN, CNOR, NEA-BC, FAAN, CEO/Executive Director of AORN. “With this award, Wickenburg Community Hospital is demonstrating its deep commitment to the health and safety of its staff and community.” “I am so proud of our surgeons and staff! They all took a serious interest in the health and safety risks for their patients and themselves. We are the pioneers for making our State smoke free in all Operating rooms, as Wickenburg is the second hospital in Arizona to become smoke free,” said Dr. Lisa Erlinger PhD, CRNA, Director of Surgical Services and Anesthesia at Wickenburg Community Hospital. (Facility Boilerplate)

About AORN AORN represents the interests of more than 160,000 perioperative nurses by providing nursing education, standards, and practice resources—including the peer-reviewed, monthly publication AORN Journal—to enable optimal outcomes for patients undergoing operative and other invasive procedures. AORN’s 40,000 registered nurse members manage, teach, and practice perioperative nursing, are enrolled in nursing education or are engaged in perioperative research.


1. Okoshi, K., Kobayashi, K., Kinoshita, K., Tomizawa, Y., Hasegawa, S., & Sakai, Y. (2015). Health risks associated with exposure to surgical smoke for surgeons and operation room personnel. Surgery Today, 45(8), 957–965. https://doi-org.mwu.idm.oclc.org/10.1007/s00595-014-1085-z 2. Dobrogowski, M., Wesolowski, W., Kucharska, M., Paduszyńska, K., Dworzyńska, A., Szymczak, W., … Pomorski, L. (2015). Health risk to medical personnel of surgical smoke produced during laparoscopic surgery. International Journal Of Occupational Medicine And Environmental Health, 28(5), 831–840. https://doi-org.mwu.idm.oclc.org/10.13075/ijomeh.1896.00374 3. Barrett WL, Garber SM. Surgical smoke: A review of the literature. Is this just a lot of hot air? Surg Endosc. 2003;17(6): 979–87, http://dx.doi.org/10.1007/s00464-002-8584-5 4. https://www.aorn.org Retrieved 6/29/2019 5. Zhou, Q., Hu, X., Zhou, J., Zhao, M., Zhu, X., & Zhu, X. (2019). Human papillomavirus DNA in surgical smoke during cervical loop electrosurgical excision procedures and its impact on the surgeon. Cancer management and research, 11, 3643–3654. doi:10.2147/CMAR.S201975 6. Mihashi S, Ueda S, Hirano M,Tomita Y, Hirohata T. Some problems about condensates induced by CO2

laser irradiation. In: Proceedings of the 4th Congress of the International Society for Laser Surgery, 1981 Feb 21–24;Tokyo, Japan.Tokyo: Japan Society for Laser Medicine; 1981:2.25–22.27. 7. Ott DE. Smoke and particulate hazards during laparoscopy procedures. Surg Serv Manag. 1997;3:11– 3. 8. Rioux, Margo et al. “HPV positive tonsillar cancer in two laser surgeons: case reports.” Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale vol. 42,1 54. 18 Nov. 2013, doi:10.1186/1916-0216-42-54 9. Surgical smoke evacuation systems. Health Devices. 1997 Apr;26(4):132-72 10. https://leg.colorado.gov/bills/hb19-1041 Retrieved 6/29/2019 Wickenburg Community Hospital Surgical Center National Recognition Dr. Lisa Erlinger PhD, CRNA, Director of Surgical Services and Anesthesia AORN Information: Gayle Davis, gdavis@aorn.org


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Wickenburg Community Hospital Earns Echocardiography Reaccreditation by the IAC

By Peter Stachowicz, Chief of Ambulatory Services, Medical Imaging Manager 928-684-5421

Echocardiography is used to assess different areas of the heart and detect heart disease or signs of serious conditions. Heart disease is the leading cause of death in the United States, followed closely by stroke as the fourth highest cause of death. According to the American Heart Association, more than 2,150 Americans die from cardiovascular disease which amounts to about one every 40 seconds. There are many factors that contribute to an accurate diagnosis based on echocardiography. The training and experience of the sonographer performing the procedure, the type of equipment used and the quality assessment metrics each facility is required to measure, all contribute to a positive patient outcome. IAC accreditation is a “seal of approval” that patients can rely on as an indicator of consistent quality care and a dedication to continuous improvement. Wickenburg Community Hospital has been granted an additional three-year term of accreditation by the Intersocietal Accreditation Commission (IAC) in Echocardiography. This latest accreditation awarded to Wickenburg Community Hospital demonstrates the facility’s ongoing commitment to providing quality care in echocardiography. Accreditation by IAC indicates that Wickenburg Community Hospital has undergone an intensive application and review process and is found to be in compliance with the published Standards. Comprised of a detailed self-evaluation followed

by a thorough review by a panel of medical experts, the IAC accreditation process enables both the critical operation and technical components of the applicant facility to be assessed, including representative case studies and their corresponding final reports. The IAC accreditation program is dedicated to ensuring and promoting quality patient care supporting one common mission: Improving Health Care through Accreditation. IAC accreditation is widely respected within the medical community, as illustrated by the support of more than 40 national medical societies. To date, the IAC accrediting divisions have granted accreditation to more than 14,000 sites.

To learn more about the Echocardiography program, Nuclear Stress Testing or the many other diagnostic imaging services at Wickenburg Community Hospital, please call Peter Stachowicz at (928) 684-4382.


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Serves 2 Time: 25 minutes

 Ingredients Dressing  2 Tbsp tahini  1 Tbsp hummus  1-2 Tbsp water, depending on desired consistency  1Tbsp ground flaxseed  1 Tsp Dijon mustard  1 Tsp lemon juice  ½ Tsp apple cider vinegar Salad  2 cups chopped spinach  2 cups chopped dinosaur or Tuscan kale  ½ acorn squash, peeled and chopped into 1-inch pieces  1 Tbsp olive oil  ¼ Tsp onion powder  ¼ Tsp garlic powder  ¼ Tsp turmeric  Salt and pepper to taste  1 avocado, chopped  1 Tbsp hemp seeds

 Directions  Make the dressing by whisking all ingredients in a small bowl until well combined.  In a medium bowl, mix ½ the dressing with the spinach and kale. Mix until the greens are well coated. Set aside in the fridge for the greens to soften.  Steam the chopped squash for 5 minutes. Transfer squash to a pan with the olive oil and add the onion powder, garlic powder, and turmeric. Cook for 5-10 minutes, stirring frequently until the squash is tender.  Add the squash to the greens and top with avocado, hemp seeds, and the remaining dressing.

healthy mind




By Caitlyn McKey looking intently into one ne of the many another’s eyes. One of the aspects of living participants should focus on life as a human being non-reactive, while is trying to find the other simply smiles. happiness. Most of us have In displays of this brief been advertised a promise that someone has discovered experiment, the person who is supposed to remain nonthe key to happiness. reactive eventually begins Unfortunately, what we to smile. Thus, providing are sold is temporary and evidence that what or who leaves us still starving for we surround ourselves with happiness. Shawn Achor, a will innately become the Harvard graduate in the field energy or “vibe” we carry of positive psychology and with us. Achor explains author of The Happiness Advantage, is trying to change that this happens because humans, through evolution, the way we quantify, define have come to work off an and experience happiness. invisible network where Achor’s studies have we are influenced by our discovered how humans are surroundings. This invisible intrinsically wired to connect network is also linked to our and feed off of each other’s behaviors or “vibes.” To prove survival instinct, helping us navigate the world around this, he provides an example us. So, what does all of this where he explains that two mean? people should sit directly across from one another

Achor has crafted his research into a list of seven principles that we can follow in order to attain and experience true happiness.  The first principle discusses meditation, or what I like to think of as brain breaks. These brain breaks allow for moments of contemplation, reflection and gratitude. Achor also lists buying an experience rather than an object, random acts of kindness, finding something to look forward to and exercising a signature strength as a means of gaining true happiness.  In the second principle, Achor discusses how shifting perspective to a more positive or optimistic outlook can drastically alter your experience into a happier one.  The third principle teaches us how to notice and identify patterns in our own behavior and how we can alter them to take advantage of every opportunity we face.  The fourth principle discusses the idea of “falling up” rather than failing. Achor explains that we can turn a failed experience into a positive one when we

have a take-away from the overall experience. Changing the failure into a lesson learned alters the experience into a positive one because we focus on what we’ve gained (the lesson) rather than the negatives or where we failed.  In the fifth principle, Achor discusses what he calls the “Zorro Circle.” This principle explains that in situations where we begin to lose our balance, there is a need to refocus on smaller steps in order to get back on track to the bigger goal. In a sense, this principle tells us to practice mindfulness by pulling our attention to what is present and what needs our attention in the now. The sixth principle titled “the 20-second rule,” teaches us how to replace bad habits with good ones by taking 20 seconds to pause and reflect on the action we are taking.  Finally, the last principle focuses on social investment. Achor explains that by investing in our friends, family and community we find a key to excellence. By supporting our own socia l support system, we gain ten-fold and build an infallible network that will invest in us equally. This practice also continues the wave of happiness; your happiness becomes contagious. Having this impenetrable force proves essential in our overall success. Achor provides evidence that we can change the neuro paths of our brain to not only seek out positivity, but to live as bright beacons of happiness and optimism for ourselves and the world around us.


Inves ti frien ng in our d and s, family com helps munity inc happi rease ness Quality HEALTH



Ear Health & Hygiene By Matt Jones, FNP-C Community Hospital Clinics 928-668-1833

A common but reversible cause of hearing loss is impacted cerumen, ear wax in the external auditory canal. Cerumen is produced by sebaceous and apocrine glands in the outer portion of the external auditory canal and serves to lubricate and protect the canal. Normally produced in small amounts, cerumen is gradually propelled out of the ear by the action of the cilia (small hairs) and the movements of chewing and talking. While some individuals will form only small amounts of cerumen other people tend to form excessive amounts, which may accumulate and obstruct the ear canal. The obstruction or impaction may interfere with the passage of sound vibrations through the external canal to the middle ear and affect a person’s ability to hear and communicate. With increased age, changes occur in the external auditory canal that may affect the production and movement of cerumen. For example, older men often develop stiff, course hairs in the ear canal that interfere with the normal movement or removal process of cerumen. Loss of elasticity of the cartilage also may result in a abnormal narrowing of the ear canal, which makes it difficult to remove cerumen. Characteristically, hearing loss is slowly-developing, bilateral high frequency impairment with a lack of ability to hear and understand conversational speech. If the defect is cerumen impaction, identification and removal of the impaction may restore hearing acuity and relieve symptoms associated with impactions. Individuals with cerumen buildup may experience a feeling of fullness, itching, ear pain, or hear ringing in the ear. Cerumen removal should be performed in a doctor’s office and may be attempted by irrigation of the external auditory canal, with or without the use of ceruminolytics or by manual removal using

curette, forcepts, or suction. Have your ears checked regularly by your primary care provider. It is very important that you clean your ears with extra care. Wipe the outer ear with a washcloth or tissue. Do not put anything into the ear smaller than your elbow. Do not use Q-tips, bobby pins or sharp pointed objects to clean the ears. These objects may injure the ear canal, eardrum, or pack the cerumen further down the ear canal.

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Making your next move... When is the right time? “Carefully choosing the right Senior Living Community can be a daunting task whether it’s for you, your spouse, or your parents. But with the proper information and help, it can be a successful process!”

Any life change can be intimidating! Making the move to a Retirement/Assisted Living Community does not have to be. Many people have been in the same situation, and for many of them the decision to take that step was a great one! With the proper information and help, it can be a successful process. Whether you are a senior thinking about moving to a Retirement Community or an adult child considering a place with more help and services for your parent, there are many things to consider. When it comes to certain daily tasks, like bathing, getting dressed or personal grooming, are you or your loved one able to accomplish them safely? If it is a struggle to perform daily tasks, then Assisted Living might just be the right answer. At an Assisted Living Community, caring staff members are available to help accomplish these tasks, and many more. If there is a yearning for real relationships with people who are in the same stage of life, a Senior Living Community can provide the perfect environment to make that happen. We hope that you will share in the activities, fun, and friendships that our other active residents enjoy! We have outings and daily activities, along with massage and physical therapy services provided by professionally trained and licensed therapists. At My Father’s Retirement Ranch we are here to help you transition into being affirmed, valued, and pampered. There are wonderful things going on and as always,

the choice is always yours. Do come and see for yourself just what “The Ranch” is all about. Understand how lovely this time in your life can be and find out how you or your loved one can benefit from Life at My Father’s Retirement Ranch. Know the pleasure of new friends, special companionship, and living life to the fullest ---- with dignity, grace and love. What does Life at “The Ranch” look like? “The Ranch” has an owner/manager available on property that works closely with the staff to promote independence, safety, comfort and an environment that recognizes and respects each individual. • • •

Enjoy DELICIOUS Chef Prepared Meals Casitas/Ranchitas-All GARDEN Level-Private Apartments-Private Rooms in the Lodge FRIENDSHIP & FELLOWSHIP with ActivitiesBirthdays-BibleStudy-Celebrations- Events-MusicParties-Programs-Transportation...and so much MORE! Please visit our website to learn more! www.myfathersretirementranch.com

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Celebrating 40 years of Earning Your Trust 400 N. Jefferson St. • (928)684-5925 wickhosp.com

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Makes 20 truffles Time: 15 minutes


– 1 lb. pitted medjool dates (the softer the better) – 1/3 cup cacao powder – 1/4 cup almonds – 1/4 cup oats – Shredded coconut, cacao powder, or almond meal for rolling


 1. Blend the dates, cacao power, almonds, and oats in a food processor until well combined and a thick dough is formed.  Roll the dough into 1 to 2-inch balls.  Roll the ball through the shredded coconut, cacao powder, or almond meal to coat the surface.  Eat immediately or store in the refrigerator for up to a week.


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Large vs Small Hospitals Dede Schmallen, MA, FABC Chief Human Resources Officer | Wickenburg Community Hospital & Clinics 928-668-1827

Throughout my career in healthcare, I have worked in Respiratory Therapy and Human Resources. In both careers, I worked at very large healthcare systems for many years. By large, I mean a system with five hospitals and over 12,000 employees. After 15 years, I did down-size at first, to a system with only two hospitals. But after an “affiliation” between that system and another similar system, the two smaller organizations combined to compete with the other larger healthcare system creating a new organization also with a total of five hospitals.

been known to say numerous times, that I never felt more welcomed than when I started at WCH. People went out of their way (whether they were co-workers, volunteers, board members, or even members of the community of Wickenburg) to welcome me. Additionally, I quickly felt valued for the knowledge, skill and experiences I provided when either an employee or leader reached out with a question. These experience sincerely afforded me the opportunity to realize how much of what I had learned over the years could be used in some way in this new adventure.

There are many opportunities afforded to employees who work in a big organization. There are often a wide variety of resources in people, equipment and technology. The large number of employees and variety of specialty positions can offer career growth potential (either laterally or vertically). One can easily get lost in the maze of hallways, offices, rooms and people, should that be your game plan. It’s quite easy to work with someone on a project, but then never see them again.

Now, eighteen months later, my eyes are truly opened. I am extremely grateful for being afforded the opportunity to become embedded in an environment where the mission puts the patient, family and community first. It’s an opportunity for those who live in the community of Wickenburg to serve the community by being part of an important healthcare resource to its residents and visitors. However, it’s just as much an opportunity for someone like me who lives in the northwest part of the Valley to serve the Wickenburg community as well. I drive thirty minutes less a day in almost no traffic to work side by side with the best group of employees, volunteers and providers I’ve ever met. All it takes is like-minded values and the passion to care for others in an unprecedented way.

Back in September of 2017, I found myself in a completely different environment as I began a new role at Wickenburg Community Hospital. Admittedly, I thought the pace and volume of work just had to be less than what I was used to. There were only approximately 250 employees compared to the 10,000+ for which my previous Senior Leadership role was responsible. Just what the doctor ordered, one might say. However, it didn’t take me long to realize that with a smaller size, comes fewer people to do the work. Almost everyone has mastered the art of wearing many hats. It also means that a small organization has very likely mastered the art of efficiency when it comes to being a steward of every type of resource. What I also did not expect is how extremely different the culture was. I’ve

Many years ago, I read a management book titled “Managing From the Heart”. It resonated with me then and has remained with me every since. If that book title describes how you like to lead, how you would like to be led and/or how you would appreciate approaching the care of others, do yourself (and WCH) a favor and consider becoming part of our team. I’m confident that, like me, you would quickly see what our smaller, community hospital has to offer: a small place which has a big heart.


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Be on the look out for Holiday Sales and Specials!

Featuring hand picked gift items, purses, jewlery and more...

The Gift Shop is operated by generous and friendly volunteers. All purchases are tax-free and beneďŹ t the Wickenburg Community Hospital Foundation.

Wickenburg Community Hospital 520 Rose Lane Wickenburg, AZ 85390 (928) 668 -1834

Community RESOURCE DIRECTORY Congress Clinic Pharmacy Mon-Fri 8:00 am - 5 pm 26750 B, Santa Fe Road Congress, AZ 85332 (928)668-5502

Wickenburg Chamber of Commerce and Visitors Center 216 N Frontier St Wickenburg, AZ 852390 928-684-5479

Congress Community Clinic

Wickenburg Community Clinic

Mon – Wed

523 Rose Lane,

8:00 am – 5:00 pm Thurs 1:00 pm – 5:00 pm

Wickenburg, AZ 85390

Call to schedule an appointment at 928-668-1833 26750 B, Santa Fe Road Congress, AZ 85332

Wickenburg Community Hospital Pharmacy

Wise Owl Senior Center

Free local delivery

Lunch - M-F at 11:30 AM with $3.50 contribution requested

Wickenburg, AZ 85390

Deliver Hot Meals from

Mon-Fri 8:00am - 6:00pm

Wittmann to Aguila five days a week to qualifying clients

520 Rose Lane (928) 684-4380

Exercise Daily Silver Sneakers on Wednesday and Thursday at 10:00 AM ($2.00 per day) Licensed Bingo games on Monday morning and Thursday afternoon ($3.00 for ten games) 256 N Washington Street Wickenburg, AZ 85390 (928) 684-7894

at 928-668-1833 same-day appointments are available.

Wittmann Community Clinic Mon and Fri. 8:00 am – 5:00 pm Call to schedule an appointment at 928-668-1833 Located in the Nadaburg School District Office: 32919 Center St. Wittmann, AZ 85361

Sat 8:00am - 12:00pm

Coffee and Pastries starting at 8:00 AM daily

Mon – Fri | 8:00 am – 5:00 pm Call to schedule an appointment

Wickenburg Ducks in a Row Foundation Advocate for People with

Developmental Disabilities PO Box 1364 Wickenburg, AZ 85358 wickenburgducksinarow@gmail.com ducksinarowaz.com 928-231-3735

Wickenburg’s Freedom Express Transports seniors 60+ anywhere within Wickenburg (and up to 5 miles out) It operates on contributions from riders. 9:00 AM - 4:00 PM Monday - Friday To register; call to schedule 24 hours in advance (928) 684-7894 x 102 wickhosp.com

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