HEALTHY Connections - September/October 2019

Volume 1, Edition 7-8

Mi l l e n n ium P h ysician Group’s

HEALTHYConnections ConnectingYou to a Healthier Life

September/October 2019 • Fall Risk Prevention & Breast Cancer Awareness

In this edition: Why Falls Matter – National Fall Prevention Day Annual Wellness Visit and Your Health Family Health and Fitness Day National Suicide Prevention Month Millennium Doctor's Mission to Save Lives National Pancake Day – Packed with Protein Breast Cancer Risk Factors Why 3D Mammograms?

Understanding Your Mammogram Results

Your Connection to a Healthier Life

For more information about Millennium Physician Group, visit www.MillenniumPhysician.com or call (844) CALL-MPG.

What’s the Deal with the Teal Pumpkins?

Trick or Treat? Keeping Halloween Candy from Getting Out of Control

Welcome to Millennium’s Healthy Connections September and October edition!

The month of September we focused on Fall Risk Prevention. Read on to learn more about your risk factors, safety tips, the role of physical therapy and more.

For October Millennium ‘goes pink’ for breast cancer awareness month. Yearly mammogram screenings are essential for detecting breast cancer in its earliest forms, along with knowing your risk factors, and what testing your insurance provides. Don’t delay, a mammogram can save your life.

Why Falls

Matter

Written By: Millennium Lead Physical Therapist Adam Pennell

September 22 was Fall Prevention Awareness Day. This is a good time to reflect on your risk of falling.

Some think falls are a normal part of aging, but the truth is most falls can be prevented. It’s important to talk to your healthcare provider because not only do falls lead to injuries, but they can also double your likelihood of falling again. Even if the fall is not major, it can result in depression or fear.

The most important things you can do are 1) assess your risk for falls, 2) make changes in your home to remove hazards, and 3) work with a physical therapist to improve your balance.

Good Questions In the past 12 months, have you had a problem with balance or walking, feeling unsafe or unsteady on your feet?

In the past 12 months, have you had a fall?

What you can do: 1. Schedule a balance Screen or Test.

2. Find a good balance and exercise program.

3. Consider Physical Therapy.

4. Review medications with your provider that might increase fall risk.

5. Check your vision and hearing and adjust glasses or hearing aids if needed.

6. Consider vitamin D and calcium supplements to improve balance.

7. Let your family know you’re experiencing issues. They can help.

8. Keep your home safe.

How to Keep Your Home Free of Slip-and-Fall Hazards 1. Keep the floor clear: Don’t leave books, papers, clothes, or shoes on the floor. Eliminate throw rugs or small area rugs.

2. Brighten things up: Add nightlights in bathrooms and bedrooms.

3. Make stairs safe: Tighten handrails on both sides of the stairs.

4. Install grab bars: Toilets, tubs and showers can get slippery.

5. Emergency response system: Consider this safety mechanism if you are concerned about falling.

Did you know?

A person with balance concerns might benefit from a physical therapy evaluation to address causes of balance dysfunction.

Physical therapists also work with you to improve bone and muscle strength and coordination. They’re experts on safety strategies, and they help fit and show patients how to properly use assistive devices. For questions about how you could benefit from physical therapy, contact Millennium Physical Therapy Manager Adam Pennell at adam.pennell@mpgus.com.

Is it time for your

Annual

Wellness Visit?

It is not too late to schedule your Annual Wellness Visit before the end of the year. This is a free preventive service, consisting of a screening exam at your healthcare provider’s office. There is no charge and it is available annually to all Medicare patients.

The Annual Wellness Visit is an opportunity to meet with your provider and update your current conditions, prescriptions, medical, and family history. During your visit you will be assessed on different factors that attribute to healthy living. These assessments include

depression screening, fall risk, home safety, and cognitive impairment. It is also an opportunity to discuss preventive care and immunizations.

This is a great chance to speak to your provider about your overall health. Doctor visits are often scheduled when patients are sick, but this appointment is reserved to set a health plan. Regular appointments can increase your likelihood for living a longer, healthier life. Problems can be identified early when the chances are higher for treatment and cures.

Flu Vaccines Are Here!

Millennium has begun receiving the 20192020 flu vaccine. As Healthy Connections told you last month, this year’s shots were delayed by three to four weeks. A late outbreak of the flu this year caused the delay, prompting the World Health Organization and the Food and Drug Administration to reformulate the combination of flu strains in this most recent vaccine to better reflect the circulating virus types.

The Centers for Disease Control recommend getting your flu shot as soon as it’s available, and your Millennium primary-care provider will have the most effective vaccine. Additionally, your primary-care provider knows you and loves the chance to give you personalized care. This includes recommending the best type of dose to fit your medical history and needs and documenting the vaccine type used in your medical record.

National Pancake Day, September 26th Celebrate National Pancake Day with a diabetic friendly high protein pancake recipe.

A great way to fuel up for the day with a protein rich pancake!

Low Carb Cottage Cheese Pancakes Prep Time: 5 minutes Cook Time: 5 minutes Total Time: 10 minutes Servings: 1 Ingredients: ❑ 1/2 cup low-fat cottage cheese ❑ 1/4 cup oats ❑ 1/3 cup egg Whites (2 egg whites) ❑ 1 tsp. vanilla extract ❑ 1 tbsp. Stevia in the raw (only if you want

the pancakes to be sweet)

Instructions 1. Pour cottage cheese and egg whites into the blender first, then add oats, vanilla extract, and a little stevia.

2. Blend to a smooth consistency.

3. Put a pan with a little cooking spray on medium heat and fry each pancake until golden on both sides.

4. Serve with berries, sugar-free jam or peanut butter.

Nutrition: Calories: 205kcal | Carbohydrates: 19g | Protein: 24.5g | Fat: 1.5g | Fiber: 2g | Sugar: 5.5g

Get out and enjoy

Family Health & Fitness Day September 29

The last Saturday in September marked Family Health and Fitness Day! It kicked off in 1996 to encourage people of all ages to get physically active.

Obesity is a real problem in our society and can lead to a slew of other chronic health problems.

So why not take this day and spend time together away from the televisions, computers, phones, and video games? Head outside and have some fun! You never know, it might be the first step toward a healthier life. And it doesn’t have to cost a lot. Go for a walk, a swim. Toss or kick the ball around. Take a group exercise class.

Ride bike or head out to the park as a family.

Working out with your family can provide health benefits without feeling like a burden.

Kids no fighting! In all seriousness, we asked some Millennium employees what they do to stay active with their families.

Dr. Brian Taschner and his family white water rafting.

“My family and I walk around the block after dinner each night. We are also in the middle of a 30-day squat challenge.”

-Julie Beam, Medical Assistant, Fort Myers



Go, Julie!

"I go to the gym after work 2-3 times a week. Also, I have a black lab and l I take her out with my parents on the weekends, and we all walk around the community to stay active and spend quality time together."

-Alex Boylan, Human Resources, North Fort Myers

You go, girl!

"My family has been having a great time playing pickle ball at FSW!" -Amy Allen, Business Development, Punta Gorda

What a great family outing!

“We stay physically fit through exercising at home or participating in fitness classes, and our youngest son plays organized basketball. We also try to incorporate fun physical activities such as hiking and biking into our family vacations.”

-Dr. Brian Taschner, Cardiologist, Fort Myers

Nice, Dr. T! “As we all know, today's chief commodity is time. What we do with our time, and how we spend it yield significant outcomes (for better or worse). As a family we stay active by enjoying the outdoor activities as much as time, weather and conditions allow. These activities include swimming after school and on weekends, bike riding, going for a walk in the community, running around at Lakes Park or the beach and walking around Disney on family vacations.”

– Dr. Emie Kuyumjian, Family Medicine, Cape Coral & Dr. Juleidis Quintana, Internal Medicine, Ft Myers

That’s awesome, Dr. Emie and Dr. Quintana!

Bringing Awareness to Depression and Suicide

Content Provided by: Elite DNA Therapy Services

September is National Suicide Prevention Month. Although some might find it to be a bit of a heavy topic, it is important – now more than ever – to raise awareness about suicide, its risk factors, and our role in prevention.

Suicide is especially alarming in younger people, being the 2nd leading cause of death for those between ages 5-25. However, all ages, ethnicities, and socioeconomic groups are affected, and many more still think about or attempt suicide and survive.

Risk Factors: Suicide is often the result of an untreated mental health condition, like depression, but it is important to know suicide is rarely caused by any one single factor. Many people living with mental disorders are not affected by suicidal behaviors and not all people who commit suicide have a mental disorder.

Other risk factors may include issues with:

Personal relationships Physical health Substance abuse Employment or finances Feeling a stigma associated with asking for help.

What to look out for in others: ❑ Talk or thoughts of committing suicide. ❑ Suffering acute loss or rejection. ❑ Sudden withdrawal from friends or

regular activities. ❑ Increased use of alcohol or drugs. ❑ Taking unnecessary risks or exhibiting self-destructive behavior. ❑ Becoming preoccupied with death or dying. ❑ Making statements about feeling hopeless, helpless or worthless. ❑ Giving away important possessions.

People with a previous suicide attempt or history of violence or trauma may be at higher risk.

The good news is good news is we all can help prevent suicide.  Communities can help by creating more programs and events to increase a sense of belonging and reduce isolation.  Schools can help by embracing the presence of mental health professionals, so children can learn early how to be more resilient and manage everyday stress.  Employers can work to create healthy work environments and reduce the stigma associated with seeking help.

Suicide prevention involves all of us. We can all help by: being aware, checking in with and listening to one another, reducing loneliness, and eliminating the stigma against mental health and treatment.

What you can do: If you think someone may be at risk, show your love and support in a calm manner.

Ask questions like, “Are you feeling sad or depressed?” and “Are you thinking about hurting or killing yourself?” can provide assurance that somebody cares, along with helping to determine the level of risk.

Express empathy and keep the person safe by reducing access to lethal means.

Encourage others to seek out professional help and assure them that getting help is not a sign of weakness.

Remember if you have immediate safety concerns, call 911 or go to your local emergency room.

There is also the National Suicide Prevention Lifeline for help

24/7: (800) 273-8255 and the Crisis Text Line at: 741741

Elite DNA Therapy Services is making inroads by providing mental health services to underserved areas and reaching even more people by incorporating in-home and telehealth services. The mental healthcare provider also offers different kinds of group therapies to promote the development of adaptive coping tools.

Dr. Cabrera on a Mission to Save Lives

Punta Gorda’s Dr. Jorge Cabrera recently returned from a medical mission trip to Cambodia’s Koh Rong Archipelago. Dr. Cabrera and other volunteers from the non-profit International Medical Relief spent nearly two weeks distributing medical and sanitary supplies throughout the island chain, along with providing acute medical and dental care to about 2,000 villagers. Dr. Cabrera tells Healthy Connections this type of community health is the foundation for saving lives. And he invites other medical professionals to volunteer their time as well.

Breast Cancer Risk Factors WHAT YOU CANNOT CHANGE

Being born female This is the main risk factor for breast cancer, but men can get it too.

Getting older The risk increases as you get older. Most breast cancers are found in women age 55 and older.

Inheriting certain gene changes 5 - 10% of breast cancer is considered hereditary.

Family history of breast cancer Most women who get breast cancer do NOT have a family history of the disease, but women who have close blood relatives have a higher risk.

Personal history of breast cancer A woman with cancer in one breast has a higher chance of developing a new cancer in the other breast or another part of the same breast.

Race and ethnicity White women are at a slightly higher risk than African American women.

Being taller Taller women have a higher risk than shorter women. The reasons are not clear, but it may be related to growth, nutrition, hormonal or genetic factors.

Dense breast tissue Women with dense breasts have up to 2 times the risk of women with average breast density.

Certain benign breast conditions Women diagnosed with certain benign (non-cancer) breast conditions may have a higher risk of cancer.

Starting menstrual periods early Earlier exposure to estrogen and progesterone hormones might increase your risk.

Menopause after age 55 The increase may be because they have a longer exposure to estrogen and progesterone hormones.

Prior radiation to your chest The risk depends on the age of the patient when radiation was administered. The risk is highest for women who had radiation as a teen or young adult.

Exposure to diethylstilbestrol (DES) This was a drug given to some pregnant women from the 1940s to the early 1970s, which could increase the breast cancer risk for them and their children, both male and female.

WHAT YOU CAN CHANGE

Drinking alcohol The risk increases with the amount of alcohol consumed.

Overweight or obese Having more fat tissue after menopause can raise estrogen levels and increase your chances of getting breast cancer. Also, women who are overweight tend to have higher blood insulin levels. Higher insulin levels have been linked to some cancers, including breast cancer.

Sedentary lifestyle Evidence is showing that regular physical activity reduces the chances of breast cancer, especially for women past menopause. The American Cancer Society recommends that adults get at least 150 minutes of moderately intensive or 75 minutes of vigorously intensive activity each week (or a combination of these), preferably spread throughout the week.

Not having children Women who have not had children or had their first child after age 30 have a slightly higher risk.

Not breastfeeding Most studies suggest that breastfeeding may slightly lower breast cancer risk, especially if it is continued for a year or more.

Birth control Some birth control methods use hormones, which might increase breast cancer risk.

Hormone therapy after menopause Some therapies increase the risk of breast cancer.

Breast implants Implants have been linked to a rare type of non-Hodgkin lymphoma called breast implant-associated anaplastic large cell lymphoma.

Why 3D Mammograms At some point in her life, every woman faces the prospect of a mammogram. Studies have shown that 1 in 8 women in the United States will develop breast cancer in her lifetime. Breast cancer treatment is most successful when the cancer is identified early. Dr. Dana Planer is a Millennium physician and a breast cancer survivor who urges women to make their annual appointment, “I don’t have a history of breast cancer in my family. And it is such a misconception that having a family member with breast cancer is the only risk factor.” Annual mammograms can discover breast changes before symptoms develop. In fact, research has proven that breast cancer is detected earlier in women who have regular mammograms. Early discovery might avoid aggressive treatment like chemotherapy and mastectomy.

At Millennium Physician Group, cutting edge 3D mammography accounts for almost 90 percent of mammograms performed at our centers across Southwest Florida. “My diagnosis came from a 3D mammogram at Millennium’s Women’s Center in Port Charlotte. Because of my history of dense breast tissue, this was the recommended test for me,” says Dr. Planer.

It can be used as a screening tool for patients without signs or symptoms, or to identify breast problems, nipple discharge, breast mass or pain. Traditional mammograms are 2D technology and only provide a few top and side images of the breast. However, our 3D technology combines multiple breast X-rays to create a three-dimensional picture. The 3D

mammogram (breast tomosynthesis) creates 2D and 3D images. It provides the radiologist better information with approximately 300 images. They can be viewed as a whole or in parts for more detail. Dr. Planer credits this technology for her early detection. “I’m so thankful for the care team that was there for me during my treatment. The same doctors that I recommend to my patients are the same ones that cared for me.”

Why should I get a 3D mammogram?

• The 3D mammogram is a safe procedure.

• The test can detect breast cancer early and provide the best outcome for patients.

• It detects slightly more cancers than a standard 2D mammogram.

• The detail improves detection in dense breast tissue because it allows doctors to see beyond areas of density.

• This technology offers fewer false positives.

• It reduces the need for additional imaging because many pictures have already been taken.

Our Millennium Women’s Imaging Centers are dedicated sites, with highly skilled radiologists, that focus solely on our patients who need their yearly mammograms. When you see a Millennium healthcare provider and then go to a Millennium Imaging Center, you receive the continuation and coordination of care.

Our Millennium radiologist will communicate directly with your healthcare provider through

Millennium Offers 3D Mammography at Our State of the Art Imaging Centers Across Southwest Florida Port Charlotte Women’s Center 19621 Cochran Blvd., Ste. 1 Port Charlotte, FL 33948 Women’s Center at Cape Coral Imaging 1528 Del Prado Blvd S. Cape Coral, FL 33990 Naples Women’s Center 4330 Tamiami Trail E. Naples, FL 34112 Women’s Center at Fort Myers Imaging 13813 Metro Pkwy.

Fort Myers, FL 33912

Call (855) 674-4624 to Schedule Your Mammogram our Electronic Medical Record (EMR). The results are faster and more efficient.

Please check with your insurance provider because not all companies cover 3D mammograms. Some insurance companies may cover the standard mammogram portion of the test, and you would be responsible for the cost of the 3D portion.

Understanding Your Mammogram Waiting to get your results from a mammogram can be stressful. It’s nice when your doctor calls with the results, but still reading your mammogram report can be scary. Doctors use a standard system to describe mammogram findings and results. Knowing what terms your report might contain can make things a little less scary.

By sorting the results into these categories, doctors can describe what they find on a mammogram using the same words and terms. This makes accurately communicating about these test results and following up after the tests much easier.

How to Read Your Mammogram Report The Breast Imaging Reporting and Data System (BI-RADS) was established by the American College of Radiology. This grid describes the framework used by radiologists to put the findings from mammogram screening into seven of well-defined categories.

BI-RADS reporting breast density Your mammogram report might also include an assessment of your breast density, which is a description of how much fibrous and glandular tissue is in your breasts, as opposed to fatty tissue. The denser your breasts, the harder it can be to see abnormal areas on mammograms.

Category

Definition

What It Means

0

Additional imaging evaluation and/or comparison to prior mammograms is needed.

This means the radiologist may have seen a possible abnormality, but it was not clear and you will need more tests, such as another mammogram with the use of spot compression (applying compression to a smaller area when doing the mammogram), magnified views, special mammogram views, or ultrasound. This may also suggest that the radiologist wants to compare your new mammogram with older ones to see if there have been changes in the area over time.

1

Negative

There’s no significant abnormality to report. Your breasts look the same (symmetrical) with no masses (lumps), distorted structures, or suspicious calcifications. In this case, negative means nothing bad was found.

2

Benign (non-cancerous) finding

This is also a negative mammogram result (no sign of cancer), but the radiologist chooses to describe a finding known to be benign, such as benign calcifications, lymph nodes in the breast, or calcified fibroadenomas. This ensures that others who look at the mammogram will not misinterpret the benign finding as suspicious. This finding is recorded in your mammogram report to help when comparing to future mammograms.

3

Probably benign finding – Follow-up in a short time frame is suggested

The findings in this category have a very high chance (greater than 98%) of being benign (not cancer). The findings are not expected to change over time. But because it’s not proven to be benign, it’s helpful to see if the area in question does change over time.

You will likely need follow-up with repeat imaging in 6 months and regularly after that until the finding is known to be stable (usually at least 2 years). This approach helps avoid unnecessary biopsies, but if the area does change over time, it still allows for early diagnosis.

4

Suspicious abnormality – Biopsy should be considered

Findings do not definitely look like cancer but could be cancer. The radiologist is concerned enough to recommend a biopsy. The findings in this category can have a wide range of suspicion levels. For this reason, some, but not all, doctors divide this category further: 4A: Finding with a low suspicion of being cancer 4B: Finding with an intermediate suspicion of being cancer 4C: Finding of moderate concern of being cancer, but not as high as Category 5

5

Highly suggestive of malignancy – Appropriate action should be taken

The findings look like cancer and have a high chance (at least 95%) of being cancer. Biopsy is very strongly recommended.

6

Known biopsy-proven malignancy – Appropriate action should be taken

This category is only used for findings on a mammogram that have already been shown to be cancer by a previous biopsy. Mammograms may be used in this way to see how well the cancer is responding to treatment.

THE DEAL WITH THE TEAL PUMPKINS

You might have seen them in the stores and on stoops. These cute teal-colored pumpkins are not only stylish but also special! The Teal Pumpkin Project launched in 2014 to create a safe and happy Halloween for everyone, especially those who might be living with food allergies. Setting out a teal pumpkin on your front porch shows all trick-or-treaters your home offers non-food goodies on this otherwise potentially scary day.

If you want to celebrate Halloween the teal way, you can either paint or dress a regular pumpkin teal, turning it into a fun family activity. You could go out and buy a teal pumpkin, or you could simply put out a sign that states non-food treats are available on the big night. Instead of candy you could offer: Spider rings Bouncy balls Glow sticks Bracelet or necklace

Bubbles Erasers Pencils or crayons Stickers

You can find these inexpensive goodies at dollar stores, party stores, and online shops.

Trick or Treat ?

Keeping Halloween Candy from Getting Out of Control TIPS FOR SURVIVING HALLOWEEN WITH YOUR KIDS: Don’t buy candy too early to avoid the temptation of opening the bags and digging in.

Serve a healthy, filling meal before trick or treating.

After trick or treating, check candy wrappers for any torn or open packages.

Dispose of the candy that you do not want.

Allow your child to pick a few pieces to eat that night.

Store the candy out of reach for your kids.

After Halloween, set a limit for daily pieces.

Encourage your child to sell or donate candy. Dentists, orthodontists and armed forces organizations accept donations.

Exchange candy for other treats like a trip to the movies.

Be a good role model for your children. Avoid temptation!

Thank you for reading!

To learn more about Millennium Physician Group visit www.MillenniumPhysician.com or call (844) CALL-MPG to schedule an appointment today!

Your Connection to a Healthier Life