John C. Lincoln HealthBeat March-April 2013

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> Relief for Chronic Sinusitis > A New Wave of Wellness > Spine Surgery Success Story > Medical Mysteries > Desert Mission

Essential Health News and Information

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The Beat Goes On

New Emergency Center

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he John C. Lincoln Sonoran Health and Emergency Center is scheduled to open in December on a 22-acre site off 1-17, south of the Carefree Highway, in Phoenix.

The first phase includes an emergency department, a breast imaging center, and a diagnostic imaging service center.

For more information, please visit JCL.com/Sonoran.

Join Us and Give Back

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he 2013 Gold Ball, the annual fund-raising gala of the John C. Lincoln Health Foundation, supports pediatric, breast health, trauma and Desert Mission community programs of the John C. Lincoln Health Network.

Give back to your community at the 44th Annual Gold Ball on Saturday, March 23, at The Phoenician, 6000 E. Camelback Road, Scottsdale. Ticket, table and sponsorship information are available at JCL.com/Ball or 602-331-7860.

March / April 2013

A Lifelong Problem

Gone in an Instant Edward Guerrero had gotten used to the rude comments and stares. He suffered from extremely bowed legs, a condition known as genu varum. Taunts of other children had driven him to tears as a boy.

To his great surprise, double knee replacement surgery at age 56 changed his life.

“Growing up, it was tough,” he said.

The teasing pushed him to prove he was equal to, and even better than, the other kids in physical activities.

He ran, played sports and excelled so no one could say he was handicapped.

In the Air Force, he met every physical requirement.

But there was pain. His legs caused problems with his back alignment and put unusual pressure on his knees that, over time, deteriorated the cartilage.

Steven R. Kassman, MD, meets with Edward Guerrero to discuss knee replacement surgery that also remedies a lifelong issue for Guerrero.

“After high school, I didn’t realize the more I exercised, the more damage I was doing,” he said.

Eventually, pain forced him to seek a waiver from the service’s physical requirement. After 1995, he stopped high-impact exercise. He stayed fit with cardio workouts and was deployed overseas three times. But when he left the Air Force in 2001, he could no longer run or jump due to the pain. continued on Page 2

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Cover Story

A Precise Fit For Edward Guerrero’s knee replacements, orthopedic surgeon Steven R. Kassman, MD, used an advanced technology that: > Produces patient-customized “cutting blocks” from pre-operative MRI images of the patient’s knees prior to the surgery. > Uses the MRI images to create maps of the patient’s knee and limb alignment.

Steven R. Kassman, MD, shows Edward Guerrero the remarkable images of his legs before and after his double knee replacement surgery.

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In 2010, Edward became diversity director for Maricopa County. But merely standing during presentations was a struggle. The little relief he got from doctors and pain-management specialists was always temporary.

By 2012, at age 56, he had severe osteoarthritis in his knees. For his back pain, he saw a chiropractor as often as three times a week.

Finally, he visited orthopedic surgeon Steven R. Kassman, MD. “Dr. Kassman said I definitely needed my knees replaced,” Edward said. “They were bone on bone.”

“It was obvious that his deformity had taken a serious toll on his knees,” Dr. Kassman said. Fifty-six is young for a total knee replacement, but bad alignment from the genu varum condition meant stress was not distributed evenly across his knees. As he got older, they wore prematurely.”

Straightened Legs Edward was delighted when he learned the double knee replacement surgery (see sidebar) would straighten his legs, too. They now look normal for the first time in his life. The operation couldn’t have come at a better time — Edward had been facing life in a wheelchair due to pain.

“It wasn’t unusual for me to sleep all day on Saturday because of how tired I would get just doing administrative work in an office,” he said. “I could not stand for more than 20 minutes without my knees getting so swollen I could barely walk.

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“But immediately after the surgery,” he continued, “they got me up to walk, and I did it. It was like a lifelong problem was gone in an instant.”

Edward spent four days in recovery in the orthopedic unit at John C. Lincoln Deer Valley Hospital. The first day, he could walk with the aid of a walker.

“I was very leery at first,” he said.

“I had two brand new knees, and I had no idea what was going to happen.

That ortho floor is a really big place.

They were shocked that I walked the entire way around it.”

He also used the unit’s Secure Track, a 110-foot monorail ceiling track that runs the length of the back hall. Strapped into the system, Edward was able to put weight on his legs. “Yet I had no fear of falling. It’s great,” he said.

> Allows precise sizing of the components, aligned to the mechanical axis of the knee.

This provides significant improvement in the final fitting and alignment of limbs in such surgeries.

During the surgery, the plastic blocks fit over the end of the thigh and shin bones and serve as templates for making cuts in the bone for the new knee components.

Those components are universally metal-on-plastic. The ones used for Edward have a special coating that reduces friction and improves the longevity of the new knee. The manufacturer expects them to last 30 years, not the more standard 15.

Dramatic Change “Out of five stars, I’d give it a five,” he said of the Deer Valley Hospital.

“I felt like they cared about me, not just as a number but as a person.”

“As total knee replacements go, it was a pretty standard procedure,” Dr. Kassman said. “But because of how badly bowed his legs were, the change is dramatic. His legs turned out nicely, and I’m very happy with his progress.”

Edward is much more effusive. “It’s changed my life. I feel really blessed.

Everyone tells me I look so much happier.

My quality of life is so much better. I feel like I’m 15 years younger.”

For more information, please visit JCL.com/ortho.

March / April 2013

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Your Health

Breathe Better D

o spring flowers bring nasal allergies? For most people, simple over-the-counter medications – and a change of season – can relieve symptoms. But if your nasal allergies turn into chronic sinusitis, you may benefit from an outpatient technique that opens up the sinuses with minimum discomfort.

“The sinuses are a series of interconnected, hollowed spaces in the skull, lined with mucus-secreting membranes,” said Shawn B. Mathews, MD, an ear, nose and throat (ENT) surgeon at John C. Lincoln Hospitals.

“When these membranes become infected or inflamed because of a cold or allergies, the sinuses swell up and block the nasal passages, causing pressure, pain and infection.”

Left untreated, patients suffer symptoms ranging from sinus pain and pressure to headaches and congestion to coughing and fatigue.

With balloon sinuplasty, an ENT doctor opens inflamed sinuses in the same way that heart surgeons open blocked arteries during balloon angioplasty.

This allows the nasal passages to drain, the infection to clear and patients to breathe easier.

Free Seminar Dr. Mathews will give a free talk on balloon sinuplasty at 6:30 p.m.

Wednesday, March 20, at the Cowden Center, 9202 N. Second St., Phoenix, on the campus of John C. Lincoln North Mountain Hospital. Please RSVP via e-mail to RSVP@JCL.com or call 623-434-6265 by March 18.

Therapies include body work, life coaching, wellness programs, nutrition counseling, prevention programs, fitness classes, counseling, supplements and more.

Joh n C . Li nco ln

Wellness Elements The New Wave of Wellness

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You might come to us for a wide variety of reasons. You might be suffering from a chronic condition such as cardiovascular disease, hypertension or diabetes. Or you may just want to find ways to improve your health or participate in our nutrition and lifestyle programs.

Q:

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What is alternative medicine?

How can Wellness Elements help me?

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lternative medicine is an increasingly popular trend in the medical industry. You might be searching for a wider range of options beyond acute care to improve your chronic conditions, find alternatives to medications and their side effects, and use a professional guide to help lead you to optimal wellness.

John C. Lincoln’s Wellness Elements, part of the John C. Lincoln Physician Network, helps you with your wellness goals by developing an individualized plan. Karla Birkholz, MD, family physician and founder of Wellness Elements, offers answers to some frequently asked questions about wellness and her alternative medicine services.

A: Alternative medicine can also be called lifestyle medicine. It involves a variety of wellness providers evaluating the unique needs of each patient, focusing on education and offering expanded options for treatment. Therapies include body work, life coaching, wellness programs, nutrition counseling, prevention programs, fitness classes, counseling, supplements and more.

JCL.com

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What goes into a wellness program?

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We offer in-depth evaluation of medical history, fitness levels, laboratory testing and a nutritional evaluation. Based on these results, we develop an individualized plan to meet the patient’s goals. Along the way, we offer coaching, classes and other services for optimal outcomes for patients.

We help you learn where you are with your health, and we monitor and give you regular feedback on how you’re doing and where you want to be.

Q:

How can I learn more about your programs?

You’re welcome to stop by our office and speak with our staff about our programs and services. A variety of literature is available as well. You can also call 623-561-3103 to schedule an appointment.

Our office is located at 6320 W. Union Hills Dr., Bldg. B, Ste. 2200, in Glendale.

For full descriptions of the programs and services offered at John C. Lincoln Wellness Elements, visit JCL.com/practices.

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Surgery Success Story

Pain Relief at Any Age Spine Surgery Sets North Phoenix Retiree Free to Hike Desert with Wife

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years have made it possible to few months ago, it was expand the group of people a struggle for Russell we can help with surgical Anderson to get out procedures so that age is not of bed in the morning. the barrier to surgery that it “It just hurt so badly,” he said. once was.

“It came on gradually, over For five days following eight months to a year, but it surgery, Russell recovered in a got to the point where my legs private room in the hospital’s and back hurt to the point that spacious Orthopedic Unit on I couldn’t do almost anything.” the fourth floor. “It was a Being confined by pain was a really nice place, and my wife major and difficult change for a was able to stay with me on hale and hearty 78-year-old who the foldout guest bed in my regularly hiked with his wife, room,” he said.

Dorothy, rode his exercise bike Orthopedic nurses helped and enjoyed frequent family him begin to regain mobility, activities with their grown slowly moving down the hall daughters and their families. with the aid of a walker. They “Finally,” Russell said, “I was were really good,” he said. in such pain all the time that I “Also, I want to say that Dr. couldn’t figure out what to do.

Having recovered from spine surgery, Russell Anderson once again Landsman is a really good Surgery is a big deal so it took a enjoys an active life with his wife, Dorothy. doctor and a nice guy. He did while to decide. But we knew good work – I’m feeling a lot better, now. I liked his partner, too.”

Dr. Landsman, and that’s why we went back to him.” John C. Lincoln After Russell was released from the hospital, he avoided time orthopedic surgeon Jonathan Landsman, MD, had performed back in a rehab facility by going home to the care of his wife. “I had to surgery on Anderson many years earlier. do a lot for him when he first came home, but he’s doing well now,” Dorothy Anderson said.

Vertebrae Fusion For more information, please visit JCL.com/neurosciences.

“Surgery is almost never the first option,” Dr. Landsman said.

“But when other options no longer work, it may be necessary. “Years ago, I had done surgery to fuse the lowest two vertebrae on Russell’s back, but over the years, problems developed above the fusion. That made it necessary to fuse the next two vertebrae in his lower back.”

Russell’s lower spine was exerting significant pressure on egenerative conditions such as osteoporosis or injury the sciatic nerves that run into the legs. “In a case like this,” can cause abnormal motion of spinal bones, or Dr. Landsman said, “you have to free the nerves and make sure vertebrae, leading to progressively more severe pain. the structure of the spine is intact so it can continue to protect the nerves from future pressure over time.”

Immobilization of the affected vertebrae can eliminate the What that means for the patient is pain relief. pain. Fusing a portion of the spine immobilizes the Russell went to John C. Lincoln Deer Valley Hospital for back vertebrae. surgery. Because Russell is older than most spine patients, Spinal fusion is a surgical technique used to join two or Dr. Landsman asked one his partners at Phoenix Orthopedic more vertebrae and is done most commonly in the lower Consultants, John Ehteshami, MD, to work with him during back, the lumbar region of the spine.

Russell’s surgery. “Whenever I have a patient with special Fusions frequently are done with supplementary bone needs, I like to have a trusted colleague assisting me. Similarly, tissue, either from the patient or a donor, used in conjunction Dr. Ehteshami often asks me to assist him.” with the body’s natural bone growth processes.

Working in tandem, along with advances in surgical procedures, In most cases, the fusion is accompanied by a process made it possible to fix Russell’s problem with spine surgery, called fixation, which involves placing metallic screws, rods Dr. Landsman said. or plates, or cages to stabilize the vertebra during the bone Age Not a Barrier fusion process. Fusion typically takes six to 12 months after surgery. During this time, external bracing may be required.

“There was a time that we didn’t do surgery for people Mr. Anderson’s age,” Dr. Landsman said, “but advances in recent

What is Spinal Fusion?

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March / April 2013

JCL.com

Solving the Mysteries

of Medicine

If people were machines with instruction books and interchangeable mechanical parts, treating disease would be easy. But life’s not like that, and it’s the complexities of human health, the mysteries of medicine, that keep the best doctors enthusiastically engaged in practice.

It starts with the challenge of diagnosis. So many diseases have similar symptoms. Sometimes doctors have to be detectives to unearth the key to effective patient care.

Ask John C. Lincoln neurologist Islam Abujubara, MD. He recently treated two patients who floundered with physical problems for decades without a correct diagnosis. “Paying attention to the patient’s story to make sure we are not missing a treatable disease can be lifesaving,” Dr. Abujubara said.

Medical Excellence He does have enough energy to hit the casinos or play cards at a favorite hangout. “They always make a serious effort to watch out for my health,” he said. “And I can now swallow and eat. So I’d say things are going fairly well.”

Rare Disease Diagnosis June Yvonne Coleridge echoes Victor’s hopeful sentiments.

Like him, she suffered for decades with a very rare disease that wasn’t diagnosed until she came to North Mountain Hospital.

She’s been told she had multiple sclerosis, but that didn’t explain the stroke symptoms that sent her to the Emergency Department, where she met Dr. Abujubara.

“She has a history of migraine and cognitive problems in addition to ischemic stroke, which are hallmarks of her disease,” Dr. Abujubara said. “After genetic testing and reviewing the MRI of her brain, I was able to diagnose her disease as CADASIL: cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.”

While that’s not good news – the disease is hereditary vascular dementia currently without a cure – June says having a diagnosis is a relief. “It’s scary, but it feels better to know what’s going on.

I’m going to participate in clinical trials with Brown University, so maybe I’ll be part of finding a cure.”

She’s also going to make sure her son is tested because CADASIL is genetic. In the meantime, she hopes to return to outdoor activities, socializing with her book club and spending quality time with her large extended family.

Learn more at JCL.com/neurosciences.

June Yvonne Coleridge is grateful for an accurate diagnosis made by neurologist Islam Abujubara, MD.

More than COPD A perfect example is Victor Kunisada, who had asthma all his life. In his 40s, he was diagnosed with COPD, an assortment of respiratory issues. He was treated for the next 20-plus years with bronchodilators.

“Theophylline and albuterol helped Mr. Kunisada breathe,” Dr. Abujubara said. “But COPD was not his only disease, so those medications never resolved his problems.”

Victor’s true diagnosis is a rare autoimmune disorder called myasthenia gravis, Dr. Abujubara said. In this disease, antibodies cause progressively worse muscle weakness.

Victor came to the Emergency Department at John C. Lincoln North Mountain Hospital because his “ability to breathe was bad, and then my speech got slurred and I couldn’t swallow,” he said.

“His symptoms are all manifestations of myasthenia gravis, which is treatable,” Dr. Abujubara said. “The fact he had to stay on a ventilator for many days — eight times in the past — made me question the strength of his breathing muscles.”

With the proper diagnosis and treatment, Victor says his health is better. But he has a long way to go before he can again play basketball or softball, or bowl in a league.

JCL.com

March /April 2013

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Foundation News

If Only We’d Known

The John C. Lincoln Health Foundation recently received a surprise bequest from a woman’s estate.

“We appreciated the gift immensely,” said Scott Showers, director of Development and Operations for the foundation. “It will certainly help us accomplish our mission. But we felt somewhat cheated because we never had the opportunity to express our gratitude to her for such kindness before her death. We didn’t know we were in her estate plan, so we were unable to let her know how much her gift meant. We would have loved to say ‘thank you.’”

If you plan to include the John C. Lincoln Health Foundation in your estate plans, Foundation staff also would be happy to send you a helpful brochure on the topic. It’s worth reading whether or not you choose to make a future gift to the foundation.

“If we know that the foundation is in your estate plan, we can not only express our appreciation, we also can make sure you’re kept up to date with developments and progress within the John C. Lincoln Health Network,” Showers said.

If you’d like to talk with someone personally about your giving plans, please contact the foundation at 602-331-7860.

One-Stop Health Care Has

BIg Impact O

ne door opens all doors for Desert Mission Health Center clients— low-income uninsured or underinsured families and individuals living in North Phoenix. They can access medical, dental and mental health services at one convenient location at 9201 N. Fifth St. in Phoenix.

The community services arm of the John C. Lincoln Health Network, Desert Mission has served North Phoenix since 1927.

“By working together in an integrated way, Desert Mission can make the biggest impact on its clients’ lives,” said Cindy Hallman, Community Services vice president. “Families and individuals don’t have to travel to have their basic health care needs met in a bilingual/bicultural environment.”

Health Center clients also can access other nearby Desert Mission services, such as the food bank, accredited child care center, resource coordination and help with determining eligibility for public subsidies.

Targeted Goals Desert Mission’s goal with its integrated care model in 2013 is to provide excellent: > Primary health care to 1,800 children and their families.

More than half of Desert Mission patients are uninsured and cannot afford the cost of care. A partnership with the North Mountain Hospital links patients to lab work, imaging and emergency and specialty care.

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March / April 2013

> Low-cost dental care to 1,500 children ages one through 20.

This includes preventive care as well as treatment. The dental staff also reaches out to nearly 10,000 children per year in local schools, providing free dental screenings. Children with dental disease are referred for care; approximately 30 percent seek it at Desert Mission.

By working together in an integrated way, Desert Mission can make the biggest impact on its clients’ lives. > Behavioral health counseling to 200 families in crisis.

Licensed counselors help families set goals to improve their day-to-day functioning. Staff also reach out to 150 children through school-based group sessions, offering coping skills for anger, conflict and grief.

By opening one door, many Desert Mission clients have discovered additional resources to help them pursue selfsufficiency and success in life.

You can help by volunteering your time or donating funds. For more information, please visit JCL.com/desertmission.

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What’s Happening >

March & April

Breast Cancer Learn and Support Group 6 to 8 p.m. on

> Helpful Seminars

Free Acupuncture Seminar

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not need to have children to attend.

Co-sponsored by Arizona Young Breast Cancer Survivor Support Initiative and Men Against Breast Cancer. RSVP at azbreastcancer@ JCL.com or 623-434-2784.

Join Julia A. Eastman, L.Ac., DOM, CCH, of John C. Lincoln’s Specialists in Nature Medicine as she discusses how acupuncture works and what conditions can be treated from 6 to 8 p.m. Tuesday, March 19, at the Cowden Center, 9202 N. Second St., Phoenix, on the campus of John C. Lincoln North Mountain Hospital. All attendees will receive a free acugraph. RSVP via e-mail to RSVP@JCL.com or call 623-434-6265

by March 15. Limited space available.

Learn more at JCL.com/practices.

John C. Lincoln audiologist Kristin Wells, AuD, will conduct free hearing tests for adults from 8 a.m. to 4 p.m.

March 12, 13 and 14 and April 23, 24 and 25 at the Tatum Health Center, 18404 N. Tatum Blvd., Suite 101, Phoenix. Appointments are required and can be scheduled by calling 602-494-6237. Special offers on hearing aids also will be available.

Free Back Pain Seminar

> Breast Cancer

Learn about what causes back pain, how to prevent injury, and some surgical and non-surgical ways to alleviate back pain. The seminar will feature Jonathan Landsman, MD, board-certified and fellowshiptrained spine surgeon from 6 to 8 p.m.

Wednesday, April 24, at the John C. Lincoln Medical Office Building 1, 19841 N. 27th Ave., Suite 400, Phoenix.

RSVP via e-mail to RSVP@JCL.com or call 623-434-6265 by April 22. Learn more at JCL.com/neurosciences.

> Community Health

Events and Screenings

Breast Cancer Coping Camp

A breast cancer diagnosis affects the entire family. Those who have been impacted by breast cancer are invited to a day of free seminars for breast cancer survivors, their spouses or caregivers, and children.

Educators from the John C. Lincoln Breast Health and Research Center and the 24/7 Children’s Emergency Center, Mendy’s Place, at John C. Lincoln Deer Valley Hospital, will teach three separate seminars from 9 a.m. to 2:30 p.m. Saturday, March 9, at Country Inn and Suites Deer Valley, 20221 N. 29th Ave. Each seminar is separate and tailored to each group. Learn communication strategies and coping skills. You do JCL.com

Hearing Screenings

the second and fourth Thursdays of every month for those with breast cancer to find support and learn from one another.

Co-sponsored by The Wellness Community-Arizona. RSVP by calling 602-712-1006 or email rsvp@twccaz.org.

Lincoln Deer Valley Hospital.

Co-sponsored by The Wellness Community-Arizona. RSVP by calling 602-712-1006 or email rsvp@twccaz.org.

Sexuality and Intimacy for Breast Cancer Patients

6 to 8 p.m. April 30. Note: meets at John C. Lincoln Medical Office Building 1, 19841 N. 27th Yoga for Recovery 6 to 8 p.m. Ave., Suite 400, on the campus on the first and third Thursday of John C. Lincoln Deer Valley of every month. Note: meets at Hospital. Co-sponsored by the John C. Lincoln Medical Office Wellness Community-Arizona.

Building 1, 19841 N. 27th Ave., RSVP by calling 602-712-1006 Suite 400, on the campus of John C. or email rsvp@twccaz.org.

Support Groups

The John C. Lincoln Breast Health and Research Center hosts the following free support groups at 19646 N. 27th Ave., Suite 205, Phoenix. For more information about any of the groups, call 623-780-HOPE (4673) or visit JCL.com/breasthealth.

THRIVE! Young Breast Cancer Survivor Group 6 to 8 p.m. on

the second Tuesday of every month.

Meet other young women facing similar experiences. Co-sponsored

by The Wellness CommunityArizona and Southwest Ambulance.

RSVP by calling 602-712-1006 or email rsvp@twccaz.org.

Cooking for Wellness

6 to 8 p.m. April 19. Learn about cancer-related nutrition. Cooking demonstrations. Co-sponsored by the Wellness Community-Arizona.

RSVP by calling 602-712-1006 or email rsvp@twccaz.org.

Look Good … Feel Better! 4:30 to 6:30 p.m. March 12 and May 14.

Join in and learn about beauty techniques and receive support, courage and community that will help you face the challenges of cancer treatment. Register by calling 623-434-2784. Co-sponsored by the American Cancer Society.

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It iPhone letsinformation youormanage your own and computer, your digital tablet tablet or or Android phone. digital tablet oriPhone iPhoneor orAndroid Android phone. digital phone. digital tablet or iPhone or Android phone. children’s – health information easily from your computer,

4 Receive test and lab results online. digital tablet or iPhone phone.

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Receive test Receivean test andlab labresults results online.

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Call 623-580-5800 formore more information or visit JCLMyChart.com CallCall 623-580-5800 visitJCLMyChart.com JCLMyChart.com 623-580-5800for for more information information ororvisit 623-580-5800 for Call 623-580-5800 for more more information informationor orvisit visitJCLMyChart.com JCLMyChart.com Call 623-580-5800 for more information or visit JCLMyChart.com

March / April 2013

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John C. Lincoln > Honored by Experts. Honored to Serve.

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e’re a not-for-profit organization that includes hospitals, physician p ­ ractices and a network of charitable community service programs. The honor and privilege of serving the people of North Phoenix has been a mission that’s driven our efforts for more than 80 years.

Although our focus is local, we hold ourselves to standards of health care and business excellence worthy of national recognition. From nursing care to community service to business ethics and more, we’ve been honored by experts with awards for practically every aspect of what we do.

But it’s not the trophies that matter. The way we see it, the greatest honor of all is that people trust us with their lives in moments of their greatest vulnerability. That’s a privilege we take seriously.

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John C. Lincoln North Mountain Hospital 602-943-2381 Emergency Department and Level 1 Trauma Center.

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John C. Lincoln Urgent Care 623-434-6444 John C. Lincoln Immediate Care 623-580-5800 Provides walk-in care 7-days a week.

John C. Lincoln Health Foundation 602-331-7860 Embodies community service, medical excellence and human dignity.

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Providing service for our community’s most vulnerable.

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