HealthSmarts - Spring 2021

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HealthSmarts SPRING 2021

Be Well

Catching up on cancer screenings in 2021

From the Pharmacy

Saving money on prescriptions

Good Eats

What’s for dinner?


Cancer survivor overcomes COVID-19 with help of Banner care team


Welcome to 2021


hank you for reading Health Smarts — this is the first issue for 2021. We welcome our new readers and thank our current readers for your continued support as we look forward to providing you with valuable health information in the coming months. As we look at COVID-19 and what’s happened during this pandemic, we are also looking for that light at the end of the tunnel and the positive impact the vaccines and new treatments will bring. In 2020, it was the year to isolate; in 2021 it’s the year to vaccinate and for 2022, it will be the year to celebrate. However, in order to get to that point of celebration we all must do our part to help bring an end to this pandemic. That’s why now is a great time to take charge of your health. Health Smarts focuses on you and your overall health. You’ll find information about living a healthier lifestyle and practical tips to manage the issues we all face as we age. We invite you to explore our crossword puzzle that is not only fun, but can help keep your brain sharp! You’ve heard about many health care heroes during the past year. You’ll meet a Banner electrocardiogram technician who beat both cancer and COVID-19 and serves on the frontlines of the pandemic, monitoring the heart rhythms of patients who are working to regain their strength. Also, in this latest issue: ■ Learn why it’s safe to visit your doctor’s office during this pandemic and the safety measures that have been put in place to help ease your mind. ■ Find out why it’s important to see your doctor again if you’ve skipped your regular medical screenings during COVID-19. ■ We’ll explore steps that you can take to safely rejoin


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activities you loved doing before COVID-19 hit.

■ Read which foods pack the most punch when it

comes to boosting your immune system. We’ve added a delicious recipe to tempt your taste buds, too. ■ We’ll tell you why it’s important to have good communication with your doctor. Many people feel like they may be an imposition, but you need to know that most doctors are there to listen to their patients so they can answer questions and address any health concerns with them. ■ You’ll find some money-saving tips that might help you the next time you’re due for a prescription refill. We’re proud that we can offer this publication to our Medicare beneficiaries whose doctor participates in the Medicare Shared Savings Program Accountable Care Organization through Banner Health Network. The Medicare Shared Savings Program does not require a sign up and does not change your Medicare benefits. This Health Smarts magazine is an added bonus, providing you with valuable information on the latest health care news, tends, and how to achieve your best personal health. Of course, we are also here to provide you support so you can achieve your health goals! If you have any health-related questions, you have access to our 24hour Banner Health Nurse Now hotline. Our nurses can answer questions about medications or make recommendations about where to get care. You can call us at 602-747-7990 or toll free at 888-747-7990. To your health,

Ed Clarke, MD Chief Medical Officer

Spring 2021 CONTENTS



8 A Most Grateful Journey Cancer survivor overcomes COVID-19 with help of Banner care team 4 Keeping Safe & Engaged Social engagement can have consequences for our overall well-being 5 Primary Communication Don’t shy away from talking to your doctor 6 Hot Topics Banner Urgent Care increases efficiency in response to COVID-19


11 From the Pharmacy Saving money on prescriptions 12 Be Well Doctors stress importance of catching up on cancer screenings in 2021 13 Good Eats Eating healthy to improve your immune system 15 Health Smarts Crossword


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Keeping Safe & Engaged Social distancing might keep us safe from COVID-19, but the decrease in social engagement can have consequences for our overall well-being


By Elise Riley

fter people have been forced to keep their distance because of COVID-19, it’s become evident how much human connection we need in our lives. As months turned into a year, we’ve come to understand that we can show that we care for one another by remaining physically distant. And while it’s true that keeping our physical distance is the simplest way to avoid COVID-19, that doesn’t mean we should become socially isolated.

Depression and anxiety

“Social distancing is, right now, an absolute mandate,” said Sandra


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Stein, MD, Chief Medical Officer for Banner University Health Plans. “But that’s not the same thing as social isolation. It can become easy to turn the world off.” Dr. Stein noted that recent research shows a four-fold increase in depression since the pandemic began. Reports of anxiety also have tripled. “The impact is tremendous on adults and youth as well,” Dr. Stein said. “We need to socially distance to limit the spread of COVID-19. But you can socially distance and not socially isolate. That takes more creativity.”

Get active

While we might not be able to physically attend an in-person yoga class, visit a coffee shop with friends or take a leisurely stroll through a crowded shopping mall, there are ways to stay socially engaged with

the world around you. For example, while an indoor spin class in person might not be the safest experience right now, activities in your own back yard or in a public park that’s not crowded, along with taking the necessary precautions can provide a healthy outlet, in addition to some necessary vitamin D. Technology also offers some creative ways to stay engaged and healthy. Whether it’s connecting with friends through a social network or finding a live, virtual Zumba class, there are ways to interact without occupying the same physical space. Additionally, wellnesscentered apps such as Pyx Health can help users minimize social isolation and loneliness, find support and identify local resources.

Reach out

After a year of self-imposed isolation, it shouldn’t surprise anyone that reports of depression and anxiety have spiked. Dr. Stein stressed that if you’ve started to feel more withdrawn from people, are having a hard time getting enough sleep or keeping a normal daily routine, it’s important to talk to someone. “We’re all struggling with COVID to some extent,” she said. “It really is the norm to feel different. Life as we know it has been turned upside down.”

Need a little extra help right now? In Arizona, dial 2-1-1 or visit

Don’t shy away from talking to your doctor

PRIMARY Communication


By Debra Gelbart

eveloping a relationship with your primary care doctor isn’t complicated; it simply requires attention. The first step is recognizing that your doctor wants to hear from you, said David Hatfield, DO, chief medical officer of Hatfield Medical Group, a primary care practice in the Southeast Valley dedicated to the needs of Medicare patients. “Taking the term ‘primary care’ at its word and looking to your doctor’s office as your first stop for all health concerns will improve your wellbeing and your relationship with your doctor,” said Dr. Hatfield. “Having a ‘quarterback’ for your health care needs will make coordinating with specialists, navigating prescriptions and even becoming more familiar with your health plan benefits much easier and will result in an improved experience as a patient,” he added, “because you’ll more completely understand procedures and recommendations.”

Don’t ignore your mental well-being

Primary care providers (also known as PCPs) can address mental

health concerns and bring in additional resources as needed, Dr. Hatfield noted, “whereas trying to find resources on your own can be a more complicated or time-consuming process. PCPs look forward to hearing from their patients.” When patients are engaged in their own care and initiate contact with their doctor, especially about behavioral health concerns such as depression and anxiety, patients are able to understand how they can find the help they may need, he explained. After all, Dr. Hatfield emphasized, “your physician is your entryway to the health system. Make sure to tell your doctor about all of the other doctors and specialists who are or might be included in your overall care, so that your PCP can assist you and maybe even reduce the amount of coordination and legwork you’ve come to expect.”

Advantages of being part of an accountable care organization

You are part of Banner’s Medicare Shared Savings Program (MSSP), also known as an accountable care organization. The aim of this organization is better coordination of care for patients. With more efficient care from the most appropriate provider (perhaps a specialist to whom your PCP can refer you), you may spend less in co-insurance and deductibles by avoiding unnecessary doctor visits or tests. And you may be healthier while receiving your medical care more conveniently. Your doctor benefits, too, from being part of the MSSP. “It’s helped us achieve our goals to lower our costs and achieve better outcomes for our patients by sharing patient information and care coordination to avoid unnecessary or duplicate tests,” Dr. Hatfield said. |



Speedy &

Safe W

Banner Urgent Care increases efficiency in response to COVID-19

By Elise Riley


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hile COVID-19 has forced us to wear a mask, keep our distance, avoid public spaces and avoid spending time with extended family, probably the last place many of us want to be at is in a doctor’s office. But these precautions can’t

eliminate other ailments such as sprained ankles, sinus infections or other common health issues. One dilemma for families during the past year has been getting care without risking exposure to COVID-19. That’s where Banner Urgent Care has emerged as an efficient solution. From improving its

our lobby,” said Devin Minior, MD, Physician Executive with Banner Urgent Care and Occupational Health Services. “We are seeing alltime highs in terms of the number of patients. And our door-to-door time is about 45 to 50 minutes. That’s pretty quick.”

Common efficiencies

Dr. Minior and his colleagues identified common lag points in the urgent care system — scheduling, waiting to get called into an exam room, waiting again to get in front of a nurse or physician — and changed it to reduce the amount of time waiting and lingering indoors. “All of these things became more challenging in the world of COVID,” Find locations and learn more Dr. Minior said. “In an about Banner Urgent Care at emergency room, you might stay two, three, even four hours.” For any of Banner Urgent Care’s 47 locations in Arizona, patients now can schedule their appointments online, have a patient intake process, to adding telehealth appointment with a technological conveniences and physician on a mobile device and reducing time in the clinic, the opt to wait in their vehicle instead of Banner team has made it safe the lobby. to visit the doctor during this Almost half of Banner Urgent pandemic. Care’s patients are scheduling “A lot of it comes down to their appointments before they getting patients into urgent care arrive. That not only eliminates and minimizing how long they’re in

time in the lobby, it also allows patients to explain their symptoms before arrival. If a patient mentions COVID-19 symptoms when scheduling, the Banner team can prepare and take them to a designated COVID room safely. “If you’re symptomatic, we’ll get you into a room as quickly as possible,” Dr. Minior said.

Mask up

Banner Urgent Care requires everyone — staff and patients — to be masked at all times. Providers wear masks, shields and gloves. After a visit concludes, surfaces are disinfected. Since the beginning of the year, Banner Urgent Care is treating a record number of patients. But, Dr. Minior said, that should not dissuade anyone from scheduling a visit — whether it’s to treat an injury or get a COVID test. “Our scope is pretty broad,” he said. “We have X-ray capabilities in all of our urgent cares. People are hiking, running and biking, We see patients come in with mild traumatic injuries. We also are doing a lot of COVID PCR tests. If your symptoms are mild, it’s very reasonable to come in and get tested. Even if you’re young, healthy and low-risk, the concern is your ability to spread the disease.” |


Cancer survivor overcomes COVID-19 with help of Banner care team


| Health Smarts

By Brian Sodoma | Photos by Rick D’Elia


herie Hughes spends her days at work interpreting the heart rhythms of patients as an EKG monitor technician at Banner Boswell Medical Center in Sun City. Her position is a critical behind-the-scenes role that saves lives. However in December 2020, Hughes needed others to watch over her as she navigated a lifethreatening COVID-19 journey. Hughes’ story is unique because she also survived kidney cancer in 2016 but unfortunately lost a kidney in that battle. Having one kidney can complicate COVID treatment, but her care team at Banner’s Del E. Webb Medical Center was up to the task. “The doctors, the nurses, the aides, everyone was wonderful.

They were the ones that brought me back to life. If it wasn’t for them, I wouldn’t be here,” she said.

Fatigue goes overlooked

About a week before Christmas, Hughes felt tired. The busy, happygo-lucky 55-year-old had taken on some extra work hours and was also going to school full-time pursuing an education degree. The Chicago transplant figured she was just doing too much. On her day off from work, her fatigue escalated. Her nephrologist (kidney doctor) was concerned about dehydration so she went to an emergency room near her home. It was there she found out she had COVID-19. Hughes was treated for dehydration and given antibiotics. She appeared to be fine so was |


With her nephrologist’s guidance, the team was able to administer the medications, and Hughes felt an immediate impact. She spent Christmas Day and New Year’s Day in the hospital regaining her ability to breathe while tapering down oxygen doses and medications. On New Year’s Day, she was finally able to stand up on her own again and was released on Jan 2. At home, Hughes began a steady regimen of alternating between daily activity and rest while regaining her appetite and strength. “It still felt like I could not take a deep breath,” she added. “I would go up and down the stairs in my house, just a little bit more every day, to get my lungs back.”

Returning to help others

released to recover at home. The next day, however, other symptoms surfaced. She lost her sense of smell and taste and breathing was becoming more difficult. She called 9-1-1 and by the time she was admitted to the emergency room at Banner Del Webb , her blood oxygen level was down to 80 (95 is a normal reading). “I was hallucinating. I would stare at the wall and I kept thinking the washing machine was being turned on,” she recalled of her time at home leading up to the 9-1-1 call.


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Coordinating care

In a lifesaving move, the Banner team moved quickly to improve her blood oxygen levels. She required an 18-liter oxygen dose, Hughes said, and the help of a CPAP machine. The treatment team would also need to consult with her nephrologist, Dr. Shailesh Patel of Southwest Kidney Institute in the West Valley, to coordinate care. The Banner team felt the drug, Remdesivir, along with steroids, would help but there was concern about kidney and liver side effects.

On Jan. 11, Hughes was back to work at Banner Boswell watching over the health of others. In telling her story, she cautions others to not overlook a symptom like fatigue, especially if it lingers. “One thing is for sure now, I don’t underestimate anything,” she concluded. “Everybody’s symptoms can be different, too. … I would have never thought that feeling tired and fatigued would turn into what I went through in a million years.” While the COVID vaccine is now being administered, if you have not received it and it does become available to you, we encourage you to get it. Please continue to wear your masks properly and shrink your circle even after you are vaccinated. We ask this to help prevent further spread of the virus in our communities.


Saving Money on Prescriptions Part D is still the best option


By Julie Maurer

t may be a good time to get a handle on your medical spending now that tax season has arrived. One of the biggest medical expenses incurred by senior citizens can be the costs of their prescribed medications. But there are ways for customers to save money on their prescriptions. According to Betty Louton, Pharm.D, FAzPA, Clinical Pharmacist, Population Health Management for Banner Health, the first thing you’ll want to have is the right drug coverage. “A lot of people think that just by signing up for Medicare it gives you drug coverage, but that is not the case,” Louton said.

Addressing misconceptions

She noted that Medicare A and B do not cover prescriptions. Medicare B, which is a drug coverage, only provides for medications administered by a provider, such as immunizations

or medications prescribed while you’re in the hospital. For medications from the pharmacist to be covered, a standalone Part D drug plan is needed. There are also Medicare Advantage Plans, which include Parts A, B and D all rolled into one. One benefit of having prescription through Medicare Advantage plans, according to Louton, is that there are low copays on generic drugs. Another way to save money on copays with Part D is to sign up to receive your prescriptions by mail. “Mail order is safe, and usually cheaper. For some Part D plans, using mail order will reduce the cost of your generic medications to $0 for a 90-day supply. There are also reduced costs on your brand name drugs, which can be as low as $10 for a 90-day supply,” Louton said.

Using GoodRx

Some people opt out of Part D and use GoodRx, which searches for

your prescription at all the local pharmacies and finds it at the best discount. This service includes a free-to-use website and mobile app to help consumers track prescription drug prices. “This is great for someone who doesn’t have insurance and is not on a lot of medications,” Louton said. However, there are some drawbacks to such a program. “If you don’t have immediate access to a computer or smart phone, you may not get the best GoodRx price. That is because the best price may not be at your regular pharmacy. If that happens, to get the best price, the prescription needs to be transferred to the pharmacy where they offer the best price,” Louton said. And many of those generic prescriptions that don’t seem to cost much on GoodRx would have a $0 co-pay through mail order with a Medicare Advantage Plan. Louton said that using GoodRx instead of insurance can be very costly when someone starts getting prescribed brand name medications. This usually occurs after a major medical emergency. “If someone is only taking a few drugs, and around $15 a month for each seems manageable with the GoodRx card. What happens if they have a stroke or a heart attack? Some of the drugs needed are name brand drugs and could cost hundreds of dollars with the GoodRx card if you are without insurance,” Louton said. “That would be hard on anyone’s budget, so it’s important to plan ahead.” |



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By Brian Sodoma

n online survey in 2020 of more than 500 patients at Massachusetts General Hospital, revealed that more than one-third decided to delay their routine cancer screenings. Other research, happening around the same time in the United Kingdom, estimated a nearly 10% increase in cancer deaths over the next five years because of delayed care and screenings as a result of the COVID-19 pandemic. Kelly Rosso, MD, a breast surgical oncologist at Banner MD Anderson Cancer Center at Banner Del E. Webb Medical Center, encourages patients who struggle with decisions about resuming their cancer screenings to get back on schedule. “Treatment delays for breast or any other cancer increases the chances of it spreading and adversely impacting outcomes,” she said. “The survival rate with early stage breast cancer is very good and getting better. But if caught at a more advanced stage, it’s hard to treat and the survival rates suffer.” If you haven’t met with your doctor, it’s strongly recommended to get back on schedule with all of your health screenings. Here are a few more reasons why you shouldn’t delay medical care.


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Low risk is still a risk

Dr. Rosso acknowledges that early in the pandemic, when information about the COVID-19 virus’s spread was limited, many screenings were put on hold for about a month. However, since resuming screenings, some patients are still reluctant to come in. For retirees in particular, maintaining screenings for colorectal, prostate, cervical, breast and skin cancers should be a top priority. Having just had her own annual mammogram in September, Dr. Rosso also says women at low risk for breast cancer may not realize they have the most to lose. “A lot of women make the excuse they don’t have a family history of breast cancer or don’t have risk factors and never had an abnormal mammogram, so they put it off,” she added. “What we’ve found is that most women diagnosed with breast cancer don’t have many risk factors nor a family history.”

Safety, listening to your gut

With COVID-19 safety protocols strictly enforced, cancer screenings are extremely safe, even during the pandemic. Social distancing and mask wearing is required in doctor offices, appointments are staggered, patient numbers in the waiting room are extremely limited and facilities are sanitized to the highest recommended levels by the Centers for Disease Control and Prevention. If you’re still nervous about visiting your doctor’s office in person for a checkup, try a telehealth visit first. That can serve as a bridge to the in-person appointment you may need, Dr. Rosso noted. Above all, if something feels different about your body Dr. Russo says to pay attention to your instincts. “If there’s that little voice in your head that says something might not be right, you should probably listen to it and see your doctor,” she emphasized. “You have to be an advocate for yourself. That’s something I encourage all my patients to do.”


What’s for Dinner? Eating healthy to improve your immune system


By Michelle Jacoby

ow more than ever is it important to have a strong, healthy immune system. While there is no magic pill that prevents you from becoming sick, there are things you can do to keep our immune system in tip-top shape. “I encourage people to emphasize lifestyle habits, such as good nutrition and hydration, regular physical activity, adequate sleep, and practicing stress reduction as pathways to maintain and improve your immunity,”said Tracy Garrett, registered dietitian nutritionist and certified diabetes

educator for Population Health Management. Garrett says there a number of ways to strengthen your immune system, including strengthening the microbiome (the genetic material of all the microbes that live inside the human body) with fermented foods and fiber; and maintaining moist mucosal tissues by hydrating with water or teas. “Safely heating the body to create a sweat is also good for the immune system,” Garrett explains. “You can create an ‘artificial fever’ through physical activity, sleeping under heavy blankets or safe use of sauna or hot baths. Add fueling the body through healthful nutrition and you can further strengthen your immunity.”

Food with a boost

According to Garrett, are there specific foods to help boost the immune system such as fermented foods, plant-based foods and a variety of proteins. “Fermented foods, such as yogurt and kombucha, help boost immunity, as do fermented vegetables like natural sauerkraut, which is known for its probiotic content,” she explained. “A wide variety of plant-based foods can also strengthen immunity. Look for brightly colored fruits and vegetables, beans, and nuts and seeds for their provision of vitamin A, C and E and zinc.” Garrett also points to such IMMUNITY continued on page 14 >> |



Chicken & Spinach Skillet Pasta with Lemon & Parmesan

8 ounces gluten-free or whole-wheat pasta 2 tablespoons extravirgin olive oil 1 pound boneless, skinless chicken breast or thighs, trimmed, if necessary, and cut into bite-size pieces ½ teaspoon salt ¼ teaspoon ground pepper 4 cloves garlic, minced ½ cup dry white wine Juice and zest of 1 lemon 10 cups chopped fresh spinach 4 tablespoons grated Parmesan cheese, divided Cook pasta according to package directions. Drain and set aside. Meanwhile, heat oil in a large high-sided skillet over mediumhigh heat. Add chicken, salt and pepper; cook, stirring occasionally, until just cooked through, 5 to 7 minutes. Add garlic and cook, stirring, until fragrant, about 1 minute. Stir in wine, lemon juice and zest; bring to a simmer. Remove from heat. Stir in spinach and the cooked pasta. Cover and let stand until the spinach is just wilted. Divide among 4 plates and top each serving with 1 tablespoon Parmesan. Source: recipe/267768/chicken-spinachskillet-pasta-with-lemon-parmesan/


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>> IMMUNITY continued from page 13

proteins as legumes, lentils and lean animal protein for cell production, as well as healthy fats from salmon, tuna, avocados, nuts and olive oil for their anti-inflammatory properties. And while she advises “food first” in strengthening your body, Garrett says supplements can play a supportive role in assisting people to meet their nutritional needs. “The commonly accepted dietary supplements associated with immunity are vitamin D3, vitamin C and zinc,” she said. “However, extra caution needs to be taken with long-term supplementation of high doses of zinc, which can result in physical symptoms and a decline in immunity.”

Herbal supplements

In addition to supplements, Garrett says there are some herbals that have been touted to benefit the immune system. “The challenge is that due to lack of regulation, inconsistent research and potential interactions with other medications, there is a risk of toxicity. I recom-

mend always using foods first before herbal supplements.” Some examples include using garlic and turmeric in cooking for their disease-fighting properties, and adopting the Mediterraneanstyle of cooking, which is known for incorporating beneficial and tasty herbs and spices into its recipes. “As always, consult your pharmacist, physician or registered dietitian for individualized recommendations,” she said. In the end, the role of diet in promoting a strong immune system is more significant than you may think. Every cell and tissue in the body is a product of the building blocks from what we consume. To produce a high-quality body that is ready to wage war against bacteria and viruses, we need to ensure that all the components that body requires are available, Garrett said. “Many people choose foods based upon taste or convenience. It’s wise to switch our prospective and choose foods that promote life and vitality. The goal is to ‘eat to live and live well.’ ”


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Healthy Living CALENDAR Register now to take part in any of the free virtual classes below. Registrants will receive a link 1-3 days before the class date. Dates in some cases are to be determined. Call 602-230-CARE (2273) to register or visit weblink/classes/find

Mediterranean Diet (2 hour class)

Learn about the components of the Mediterranean Diet, a delicious and healthy way of eating. Learn how the Mediterranean Diet’s anti-inflammatory properties can help prevent and manage chronic disease. This style of eating can play a big role in preventing heart disease and stroke while reducing other risk factors like obesity, diabetes,

high cholesterol and high blood pressure.

Living Well with Diabetes

Thursday, Mar. 25, 2-4 p.m. MST A class focusing on blood sugar management to optimize health and vitality. Get an overview of diabetes basics, along with the for pillars of diabetes management: eating healthy, being active, taking medications and self-monitoring. Gain the skills to build a healthy meal plan, count carbohydrates, read nutrition labels and improve your overall management of diabetes at home.

For life’s potential emergencies

Call us when you are sick, injured or need care advice — we want to help.

602-747-7990 or 888-747-7990

Alzheimer’s ASK: Q&A Session

Thursday, April 22, 10-11 a.m. MST Did you view a program on Alzheimer’s

Banner Nurse Now has a team of experienced nursing staff available to help with your immediate health care questions 24 hours a day, seven days a week

disease that has left you with questions? What about that tip that you heard from your neighbor — will that work for you? Join us for an open question and answer session called Alzheimer’s A.S.K., which provides you an opportunity to connect with dementia experts. This session will feature Dr. David Weidman, Banner Alzheimer’s Institute dementia specialist. We highly encourage if you have specific questions that you would like answered, please email them ahead of time to bannerresearch@bannerhealth. com. In order to participate in this event, you must have an internet connection, a computer and/ or a phone. Registration is FREE but required at www.BannerAlz. org/Calendar to obtain the Zoom connection Information.

Feel better each day with companionship and humor

Get the free Pyx Health app today…use your smart phone to go to Or call 1-855-477-4999 for a helping hand.

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