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HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILY

NOVEMBER 2015

IN THIS ISSUE | 2 Fall Prevention | 3 Foot Problems | 10 Medicare, ACA Enrollment | 11-12 Support Groups, Events

UNDERSTANDING ALZHEIMER’S In recognition of Alzheimer’s Awareness Month, Livingwell A-Z features a special report on Alzheimer’s disease PAG E S 5 - 9

Breast health The bottom line about new mammography screening guidelines: Talk to your doctor By Debra Gelbart

ew breast health monitoring guidelines from the American Cancer Society (ACS), published in the Oct. 20 issue of the Journal of the American Medical Association, may make it challenging (again) for women to decide what to do about their health. The guidelines call for most women to begin routine screening mammography at age 45, continue every year through age 54 and then, if healthy, either undergo screening every other year or continue annual screening. The ACS does say that women should have the opportunity to begin annual screening mammograms between the ages of 40 and 44 years if they choose. The bottom-line advice from two local radiologists who specialize in breast imaging: talk to your doctor.

Personal medical history “It’s important for a woman who’s considered at average risk for breast cancer near the age of 40 to have a conversation with her doctor about what’s best for her individual situation, taking into consideration personal and family medical history,” said Vilert Loving, M.D., the director of breast imaging at Banner MD Anderson Cancer Center in Gilbert. “The new guidelines aren’t necessarily appropriate for everyone, depending on their circumstances,” said Linda Greer, M.D., medical director for HonorHealth’s Breast Health and Research Center in Phoenix, who points out that approximately 18 percent of all breast cancers detected at the HonorHealth Center are in women under 50.

Clinical breast exams The ACS guidelines also say that a clinical breast exam, performed by a healthcare provider, is not necessary, which baffles both doctors we spoke to. “I recommend that women ask their primary care provider for an annual clinical breast exam,” Greer said, “because if something abnormal is detected, the patient can have further screening to rule out cancer.” Both institutions that Greer and Loving are affiliated with will continue to recommend annual screening mammograms for all women aged 40 and over.

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hronic or persistent pain is defined as that which lasts beyond what doctors would expect to see in a patient with a significant injury (short-term pain is called ‘acute’ pain). The two types of physicians who most frequently treat chronic pain are anesthesiologists and physical medicine and rehabilitation physicians, also known as physiatrists.

Common types of chronic pain

Some physicians, like Minesh Zaveri, D.O., a pain management specialist trained as an anesthesiologist who is on staff at St. Luke’s Medical Center in Phoenix and is in private practice, say pain that lasts three months or more is considered chronic. “About 62 percent of chronic pain patients have experienced their pain for more than a year,” he said, adding that chronic pain is far more common than acute pain and that chronic pain can be caused by osteo- or rheumatoid arthritis, degeneration of or injury to back and neck structures and joints in other parts of the body, or illness.

It doesn’t have toHURT

BY D E B R A G E L B A R T PHOTO BY R I C K D ’ E L I A

CHRONIC PAIN can be eased through a number of techniques Matthew Ranson, M.D., is a pain physician also trained as an anesthesiologist who is on staff at Freedom Pain Hospital in Scottsdale. He and Asim Khan, M.D., a Mesa-based pain management specialist trained as a physical medicine and rehabilitation physician, said that chronic pain occurs as one of three types: • SOMATIC PAIN: Pain that stems from an injury or a surgical incision. • NEUROPATHIC PAIN: Pain that results from injury to peripheral nerves, the spinal cord and the brain. It is typically described as a burning, shooting, stabbing or ‘pins and needles’ sensation. • VISCERAL PAIN: Pain that arises from internal organs and is often diffuse and described as extreme pressure or a squeezing sensation.  CHRONIC PAIN, continued on page 12

Minesh Zaveri, D.O., a pain management specialist at St. Luke’s Medical Center in Phoenix, talks with Eduardo Barrera of Phoenix about the spinal cord stimulator, an option in pain reduction that frequently diminshes pain by 50 percent or more.

You didn’t plan on cancer. Fortunately, we did. At HonorHealth’s Virginia G. Piper Cancer Center, we take cancer personally. Your care team works alongside scienti:c researchers to create a highly personalized, targeted, cancer treatment plan just for you. It’s all part of our plan to make healthy personal.

HonorHealth.com/cancer 480-323-1339

2 | Livingwell a-z | Wednesday, November 4, 2015

Fall prevention 101 Risk factors, injury prevention and balance improvement techniques By Meghann Finn Sepulveda

Take action to keep your home or your loved one’s home safe

ccording to the American Academy of Family Physicians, falls and associated instability can be markers of poor health and declining function in the elderly population. Body imbalances, vitamin deficiencies, slower reflexes, bone and muscle weakness, an overall decreased sense of gravity — along with other age-related factors — are common reasons why seniors fall.

The Arizona Fall Prevention Coalition provides home-modification tips to stop falls from occurring. A sampling of ideas includes adding, installing or modifying the following: Grab-bars Hand-held showers Shower chairs Ramps Roll-in showers High-boy toilets Accessible cabinetry Swing-out hinges Widening doorways and hallways Tub stools

Medical issues “Vision changes and conditions such as glaucoma and diabetic retinopathy can reduce peripheral vision and prevent seniors from seeing obstacles in their path,” said Rhonda Zonoozi, exercise physiologist and health coach at the Sun Health Center for Health & Wellbeing in Surprise. “Some prescription and over-the-counter medications may have side effects such as dizziness or drowsiness which could lead to an increased risk of falling.” Experts say that seniors with chronic medical conditions such as diabetes, arthritis, dementia, Parkinson’s disease and stroke often become inactive, placing them at higher risk. Postural hypotension, a common health condition in the elderly population that occurs when there is a drop in blood pressure, can cause dizziness, lightheadedness, blurred vision and weakness, also increasing the risk of falls.

Environmental issues The environment in which a senior lives could also pose potential fall hazards. For example, Zonoozi pointed out that things like throw rugs, clutter, pets and poor lighting can contribute to falls at home.

When a fall happens The Centers for Disease Control (CDC) reports that each year 2.5 million older adults are treated in emergency departments for fall injuries and more than 700,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture. “An elderly person who experiences a fall is more likely to break a bone,” said Ruth Taylor-Piliae, Ph.D., RN, associate professor at The University of Arizona College of Nursing in Tucson. “Treatment and recovery for an injury such as a hip fracture may require long-term hospitalization which can lead to a secondary complication such as infection or pneumonia, often as a result of a weakened immune system, and could ultimately lead to a person’s demise.” Falls are the most common cause of traumatic brain injuries which can be a serious concern for seniors taking certain medications such as blood thinners, according to the CDC.

Also: Make sure pathways are free from clutter, including stairs Ensure adequate lighting during the day and night Remove throw rugs Keep things within easy reach so a step-stool isn’t needed Wear shoes that provide good support with non-slip soles Seniors may qualify for assistance and funding for home-modification help depending on the city and county of residence, homeownership status and other factors. Source: Arizona Fall Prevention Coalition, azstopfalls.org. Thinkstock

Fear of falling Many seniors are afraid of falling, even among those who have never experienced a fall, which can cause people to withdraw from everyday activities such as walking, grocery shopping or spending time with family members and friends. “People with a fear of falling often reduce physical activity and grow weaker, which can increase the likelihood of a fall,” said Elton Bordenave, M.Ed., director of aging studies at A.T. Still University in Mesa. “These seniors often socially isolate themselves and are more inclined to suffer from depression.”

Prevention techniques Building physical stability is considered to be one of the best ways to prevent a fall. In fact, there are exercises specifically designed to target certain muscles such as the legs and core to help increase balance. “Simple low-impact exercises for the calves, shins, thighs, hips and core are greatly beneficial for seniors and can be done at home,” Zonoozi said. “Upper-body strengthening can also have a positive impact on overall posture and balance.” Physical therapy following surgery is often prescribed to strengthen muscles after a break or fracture.

a-z H E A LT H C A R E B R I E F S New breast radiation therapy at Abrazo Health

Livingwella-z Better bladder cancer detection at Banner MD Anderson

A new procedure at Banner Arleen Kraynak, 77, had 35 MD Anderson Cancer Center in annual mammograms and there Gilbert enables a doctor to use blue was never a problem. But on light technology to better view her 36th procedure, a mass was certain bladder cancers, similar to detected. She was referred to the way black light makes scorbreast surgeon Christa Corn, pions luminescent. The facility is M.D., who diagnosed breast Arleen Kraynak one of a select number of medical cancer during a biopsy. Corn told centers nationwide offering blue light Kraynak about a new alternative to tradicystoscopy for helping detect papillary tional weeks-long radiation treatments: cancer of the bladder. intraoperative radiation therapy (IORT) White light cystoscopy has been the at Abrazo Central Campus. It is the primary method used to view suspicious only hospital in Phoenix to use the lesions during surgery to remove bladder FDA-approved Xoft® Axxent® Electronic tumors, however, when used on its own, Brachytherapy (eBx®) System. harder-to-see tumors can be missed. Blue Kraynak is among 35 patients who have light cystoscopy works by illuminating had the IORT procedure at Abrazo Central the bad tissues via a fluorescent chemical Campus since the program started in placed in the bladder and absorbed by May 2014. IORT may be used for patients cancer cells, turning them hot pink when with early-stage breast cancer who meet under the blue light. Because of the absorpcertain selection criteria. After having tion of the solution, hard-to-see tumors that a lumpectomy to remove a small breast may be present become more visible. tumor, Kraynak received a concentrated “The potential of blue light cystoscopy is dose of radiation at her tumor site while she was still under anesthesia. “With IORT, to identify more tumors and aid in a more you wake up from your outpatient lumpec- complete resection, which is very important in optimally treating bladder cancer,” tomy surgery and you’ve already had your said Joseph Mashni Jr., M.D., a surgeon at radiation,’’ Corn said. Banner MD Anderson. Dan Jones, Abrazo Central Campus Chief Executive Officer, said the technology is a MORE INFO: bannerhealth.com significant development for the hospital as well as for patients needing minimally invasive breast surgery with minimally invasive radiation. MORE INFO: abrazohealth.com

Tai Chi, an ancient Chinese practice of slow movement exercise and stretching, is considered to be one of the best activities for seniors to improve balance. “Tai Chi targets all of the physical components needed to stay upright including leg strength, flexibility, range of motion and reflexes,” said Carol-Ann Henritze, a certified Easy Tai Chi and Qigong instructor at the Sun Health Center for Health & Wellbeing in Surprise. “Tai Chi teaches correct movement of lower limbs, weight transfer and correct posture.” One of the biggest — and often mostunexpected — benefits is the emotional component of Tai Chi. “Seniors often feel more confident and firmer on their feet and have less fear of falling, especially after experiencing a fall or instability in the past,” Henritze added. Home modifications such as installing hand-rails in the bathroom and maintaining adequate lighting can also help reduce the risk of falling. In addition, experts advise seniors to review their medications with their healthcare provider on at least an annual basis. “Gravity does not have to win,” Bordenave said. “Seniors can reduce their likelihood of falling by being proactive, talking to their doctor and taking advantage of fall prevention programs offered around the Valley.”

Resources

MORE INFO: Area Agency on Aging Region One, aaaphx.org; 602-264-2255 FOR URGENT NEEDS: 24-hour Senior HELP LINE: 602-264-HELP (4357) or toll-free 888-783-7500 FOR THE HARD OF HEARING/DEAF: TEXT 520-775-1899 SMS (Short Message Service)

Easy Tai Chi and Qigong classes for seniors Offered at Sun Health Center for Health & Wellbeing, 14719 W. Grand Ave., Surprise WHEN: Mondays, Wednesdays and Fridays; 11 a.m.–noon COST: $5 per class; discounted annual memberships are available INFO: 623-832-WELL (9355) or sunhealth.org

Still Standing Fall Prevention Outreach A free community health education program offered by A.T. Still University, this program is aimed at helping seniors prevent falls and address the fear of falling. Classes are offered throughout the year in health and senior centers across the Valley. For more information and a complete class schedule, email Jackie Kalinsky at JKalinsky@atsu.edu or call 480-219-6174 or visit atsu.edu.

November 2015 | Vol. 5, No. 11

Living Well A-Z publishes on the first Wednesday of the month. From A to Z, we tackle a broad range of health issues and offer resources to find more specific information. For questions concerning content in this publication, please contact Editor Paula Hubbs Cohen. A division of The Arizona Republic, 200 E. Van Buren St., Phoenix, AZ 85004. For general advertising inquiries, contact Republic Media at 602-444-8000. Editor: PAULA HUBBS COHEN General Manager: CAMI KAISER paula.cohen@cox.net; 602-444-8658 ckaiser@republicmedia.com Creative Development Director: ISAAC MOYA Contributing Editor: JIM WILLIAMS jlwilliams@republicmedia.com imoya@republicmedia.com Editorial Coordinator: NICK KOSTENKO nkostenko@republicmedia.com

Senior Managing Art Director: TRACEY PHALEN tphalen@republicmedia.com Design: CRAIG KURTZ craigrkurtz@gmail.com

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Wednesday, November 4, 2015 | Livingwella-z | 3

Steps to keep your feet in tip-top shape Painful feet can make life miserable ... but there are plenty of treatment options available By Debra Gelbart

ecause of constant stresses and impact with the ground, your feet can experience plenty of problems. And while help is available for most concerns, doctors say people with diabetes have to be especially vigilant about their foot health.

Diabetes complications Complications from diabetes are among the most common forms of foot pain, said Jennifer Pappalardo, D.P.M., an assistant professor of surgery at The University of Arizona College of Medicine in Tucson.

YO U R H E A LT H HEAD TO TOE Watch for upcoming articles on the following topics as we provide information on your health — from head to toe. DECEMBER: Skin Don Curtis, D.P.M., an assistant professor at the Arizona School of Podiatric Medicine and a podiatrist at the Midwestern University Multispecialty Clinic’s Foot and Ankle Clinic in Glendale, agreed that diabetes puts additional strain on feet. “You have to be more aware of foot problems if you have diabetes,” Curtis said. Peripheral neuropathy, a nerve issue that can affect diabetes patients, may lead to numbness or loss of sensation in the feet, he said, where you can’t feel an injury to the foot. “Those with diabetes are more prone to difficulty treating or managing infections that can occur with injuries,” he added. Curtis said one way to protect feet is with diabetic shoes, which, he says, are far more stylish today than they have been in the past. Diabetic shoes contain a custom-molded liner, he explained, so there are no ridges that can rub against the foot. Curtis also recommends that if you have diabetes and you notice any pain, open sore or inflammation with your feet, see your doctor.

Common foot problems: bunions, fungus and neuromas ... oh my! HAMMERTOES BUNIONS A bunion — an enlargement and deformity of the bone at the base of the big-toe joint (as shown in the X-Ray below) — is often caused by abnormal stresses to the bones of the toes stemming from ill-fitting or tight shoes or by an anatomical structure that makes someone prone to a bunion, Pappalardo said. Protective padding or strapping and wider appropriate-fitting shoes and even surgery may be indicated to treat painful bunions, Curtis said.

FOOT FUNGUS Foot fungus flourishes in warm, moist environments, Pappalardo said, with continued exposure to fungus increasing the risk for infection and complications. “Foot hygiene, including changing socks and shoes daily, is of utmost importance for avoiding and treating fungal infections,” she said.

NEUROMA A neuroma, a benign enlargement of a nerve segment usually between the third and fourth toes, can be caused by trauma, arthritis, high-heeled shoes or abnormal bone structure. Nonsurgical treatment includes padding, strapping, orthotics, activity modification and shoe changes, Curtis said.

Hammertoes, a contracture of the toes that can resemble the hammers inside a piano, is often caused by an imbalance in the tendon or joints of the toe, Curtis said. Nonsurgical treatments are the same as with neuromas, he said.

PLANTAR FASCIITIS Plantar fasciitis is commonly caused by inflammation and stretching of the tendon-like band (the fascia) along the bottom of the foot (plantar surface) that connects the heel bone to the toes, Pappalardo said. Stretching and irritation can occur at the attachment of the plantar fascia to the heel. “Factors such as abnormal stress, weight, activity level and reduced arch support can cause excessive stress and micro-tearing to this tendon-like band,” she said. Icing and stretching before and after activities, supportive shoes, orthotics and antiinflammatories can often alleviate these symptoms and avoid recurrence of the pain.

BUNIONS

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FALLEN ARCHES Fallen arches that often occur with advancing age may sound fairly harmless, but the inflammation of the tendons supporting the arch can lead to arthritis, Curtis noted. This can result in considerable pain and the need for surgery, he said, adding that stretching and physical therapy, activity modification, orthotics and pain-relief injections can help prevent or delay the need for surgery. A treatment called Extracorporeal Pulse Activation Treatment (EPAT®) delivers shock waves to the affected tendons that encourages the body’s own natural repair mechanisms. Nearly 40 million Americans suffer from arthritis that often can affect feet, Curtis said. Treatment can include physical therapy; exercise and weight loss; medications such as corticosteroid injections into affected joints; and over-the-counter and prescription oral medications, he said.

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4 | Livingwell a-z | Wednesday, November 4, 2015

Happy trails to you

“Smoking contributes to cancers of the mouth, lips, nasal cavity and sinuses, as well as organs — not just lungs, but cancers of the stomach, kidney and more.”

Common sense and vigilance can prevent venomous bites and/or stings

—Brittany Conklin, American Cancer Society

A good day to quit Nov. 19 is the American Cancer Society’s Great American Smokeout By Elise Riley

he Great American Smokeout provides awareness that quitting smoking is going to help your health, according to Brittany Conklin, media relations manager for the American Cancer Society. “We’ll certainly be reaching out to the community and helping them get what they need to quit smoking,” she said.

Help is available “People who have tried to quit need to know that it’s normal to have seven or eight attempts before you’re finally successful,” said Mary Kurth, a program director at the American Lung Association in Arizona. Both Conklin and Kurth are former smokers — and Conklin lost her mother to lung cancer. Their experiences are part of what makes them so passionate about helping people quit. Both recommend calling the ASHLine, which is the Arizona Smokers’ Helpline. Funded by Tobacco Free Arizona and operated by the Mel and Enid Zuckerman College of Public Health at The University of Arizona in Tucson, the ASHLine offers coaching, tips and — most important — a friendly ear. “Their coaches are all based in Arizona,” Conklin said. “Most of them are former tobacco users — they know what you’re going through and can offer that perspective. They can set up a personalized quit plan and two weeks of nicotine replacement therapy to help you quit.”

By Susan Lynne Fuchs

“You have to pay attention,” she said. “Know you are sharing the desert with species that were here hundreds of years before we developed it for people. Learn to co-exist. Every living thing has a necessary place in our environment.” Next, Gibson said, don’t ask for trouble. Don’t pick up snakes, lizards or spiders. If you’re hiking with your dog and he or she is reluctant to walk somewhere, look carefully all around you, she said. The dog may know or sense something you don’t; after all, Avoiding trouble As the weather cools, more people, often with children, snakes can be hard to see. Finally, Gibson said, carry a fully charged cell take advantage of Arizona’s amazing desert scenery. phone. If you are stung or bitten by anything venomWhether you’re hiking with a buddy, your kids or your ous, call the free, 24-hour Banner Poison and Drug Golden Retriever, common sense is the key to avoid Information Center hotline at 800-222-1222. adverse encounters, said Debbie Gibson, PHS executive They will help you determine what to do. vice president and reptile sanctuary manager. I did exactly what the snake experts teach at the Phoenix Herpetological Society (PHS) reptile sanctuary in North Scottsdale: I took one giant step back, away from the snake. Unless provoked — stepped on or disturbed by a nearby hand — rattlesnakes will generally leave you alone. As long as you stay at least three feet away from them, they’ll slither away, just like mine did.

If you are bitten en or stung •

Gila Monsters: “It’s really hard to o get bitten by a Gila Monster,” the only venomous lizard zard indigenous to Arizona, Gibson said. “But if you break the he law and pick one up it can turn and start chewing your ur hand.” Removing the lizard quickly is important but difficult, she said, noting that little short of an alcohol bath will make it let go. Get treatment at the nearest hospital.

•

Scorpions: The smallest of Arizona’s 60 scorpion species, the bark scorpion, has a neurotoxin that can cause eye and muscle twitching as well as impair vision, speech or breathing, Ruha said. Bark scorpion antivenom is effective, while stings by other scorpions, while intensely painful, can almost always be treated at home with ice and overthe-counter pain relievers. However, you should always contact your healthcare provider for advice, especially when the person bitten is very young or old, or has an impaired immune system.

•

Black Widow spiders: Distinctive for the bright red/orange hourglass on its abdomen, a Black Widow spider is about 3/8 of an inch long with one-inch legs. Most bites can be managed at home with ice and over-the-counter pain relievers, said Michelle Ruha, M.D., toxicologist at Banner Poison and Drug Information Center. However, if pain is severe or spreads to the lower back or limbs, medical care or even antivenom at the hospital may be needed.

•

Africanized Bees: If the patient is not bee-allergic, very young or elderly and has been stung a minimal number of times, Ruha said that stings can generally be treated at home. In cases when bees swarm and sting by the dozens or hundreds, professional medical help should be sought.

•

Venomous snakes: Bites by any of Arizona’s 13 rattlesnake species are relatively rare compared with the thousands of hikers who enjoy our beautiful Sonoran desert. According to Banner Poison and Drug Information Center, only about a hundred venomous bites were treated this year.

Resources American Cancer Society Cancer: Cancer.org; 800-227-2345 American Lung Association, Arizona: LungArizona.org; 602-258-7505 Arizona Smoke-Free Living: AZSmokeFreeLiving.org ASHLine, the Arizona Smokers’ Helpline: ASHline.org; 800-556-6222 Freedom from Smoking, from the American Lung Association: FFSonline.org Quit for Life: An app to remind former smokers of milestones; downloadable for iOS or Android devices at QuitForLifeApp.com

UA Eller College Receives $1.4 Million Grant to Create Free Health Tool National Institute of Health funds development of online program to improve patients’ understanding of medical communication

he Management Information Systems (MIS) department at The University of Arizona, Eller College has received a $1.4 million grant from the National Library of Medicine of the National Institute of Health (NIH). The four-year grant funds the creation of a free online tool that simplifies healthcare-related text, making communication from a person’s doctor or medical team easier to understand. Only 12 percent of American adults have proficient health literacy, meaning nearly nine out of ten adults may lack the skills they need to manage their health, according to the U.S. Department of Health and Human Services. “When you’re diagnosed with a serious disease, you are UA Eller College Associate vulnerable,” said Gondy Leroy, grant principal investigator Professor Gondy Leroy and associate professor, MIS. “This is partially due to not understanding all relevant information, a problem we can solve with today’s technology. We need to increase people’s understanding so they’re empowered to make proper decisions about their healthcare.” Leroy is heading up a multi-disciplinary research team tasked with increasing health literacy by creating an online writing support tool for medical professionals. Similar to popular editing software, the tool will provide suggestions for replacing difficult terminology, improving awkward expressions and tuning the flow and structure of the information to make it more understandable for those with little background knowledge on the topic. The project is slated to be complete by the end of 2019 although less sophisticated versions may be available sooner.

More info

mis.eller.arizona.edu and search for “readability”

uring a recent hike near my neighborhood, the rocks in my peripheral vision appeared to be rolling. I focused my vision — and the rocks resolved into a fat five-foot Western Diamondback rattlesnake, less than three feet from my feet.

However, if you are one of the unlucky few who are bitten, call 911 immediately, Ruha said. After that, her best advice is this: • Don’t use home remedies. • Don’t make cross-cuts near the bite. • Don’t try to suck out the venom. • Don’t apply a tourniquet. None of these things can help and they can be harmful. What you should do, she said, is try to stay calm, stay hydrated and get professional medical help as soon as possible because time is critical to recovery. Rattlesnake venom dissolves tissue — a destructive painful process. Antivenom injections are the only treatments that can halt venom’s progress. “On average, it takes 12 vials of antivenom to treat a rattlesnake bite,” Ruha said.

What is it? From a safe distance, snap a cell phone photo of any mysterious reptile you spot during a desert hike and text it to the experts at the Phoenix Herpetological Society. They’ll text back an answer ASAP. • To ID a snake, text a photo to 602-550-1090. • To ID a lizard or scorpion, text a photo to 602-550-7029. Or ask the Banner Poison and Drug Information Center for their free illustrated brochure on venomous bites and stings.

More info

Banner Poison and Drug Information Center: BannerHealth.com (search for poison center); 800-222-1222

Phoenix Herpetological Society: PhoenixHerp.com; 480-513-4377

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Wednesday, November 4, 2015 | Livingwella-z | 5

PRESENTED BY LIVINGWELL A-Z AND THE ALZHEIMER'S ASSOCIATION DESERT SOUTHWEST CHAPTER

UNDERSTANDING ALZHEIMER’S What it is, what it’s not, where to get help

By Paula Hubbs Cohen

he most common form of dementia, Alzheimer’s accounts for 60 percent to 80 percent of dementia cases. Symptoms of the disease, which causes significant problems with memory, thinking and behavior, usually develop slowly and get progressively worse. “As symptoms progress into the later stages of the disease, motor function deteriorates and round-the-clock care is necessary,” said James Fitzpatrick, MAS, program and advocacy director for the Alzheimer’s Association, Desert Southwest Chapter. “Currently, with no treatments to cure or delay the disease, Alzheimer’s is fatal.”

What it’s not As important as it is to know what Alzheimer’s is, it is equally important to note what Alzheimer’s is not. To wit: • Alzheimer’s is not a normal part of aging.

• It’s not occasionally forgetting where you put your car keys. • It’s not having a so-called ‘senior moment’. What’s more, Alzheimer’s is not just a disease of old age. In fact, up to 5 percent of people with the disease have younger-onset Alzheimer's (also known as early-onset, not to be confused with early-stage Alzheimer’s) which often appears when someone is in their 40s or 50s. That said, the greatest known risk factor is increasing age and the majority of people with Alzheimer's are 65 and older.

Early diagnosis critical According to Fitzpatrick, fewer than 50 percent of individuals with Alzheimer’s actually get a diagnosis from a physician, therefore, being aware of the signs of Alzheimer’s or other dementia is highly important if a person is worried about their cognitive health.

“Being forgetful, losing track of time, forgetting a word or having vision problems are signs someone with Alzheimer’s may experience. However, someone can also experience these things due to fatigue, depression, lack of sleep, change in eyesight or as a medication side effect,” he said. “It’s the severity of the signs — not just the signs themselves — one needs to look at.” Fitzpatrick added that early diagnosis is critical so that individuals and families can seek out medical and support services immediately, providing the person with Alzheimer’s the opportunity to make financial and legal plans. “This allows the person with the disease the opportunity to make their life their own with the dignity to make personal choices for the present and future,” he said.

Help is available The Desert Southwest Chapter of the Alzheimer’s Association provides

a wealth of free, local services and support to help individuals and families facing a wide range of dementia disorders including but not limited to Alzheimer’s. From support groups to caregivers’ educational classes to research partnerships with some of the country’s most renowned scientists and physicians, the Chapter’s goal is to empower and support individuals, families, care-partners and communities affected by dementia throughout Arizona and southern Nevada. “With the support of a 24/7 Helpline, one-on-one family care consultation and early-stage programming, the Chapter provides a wide array of supportive services,” Fitzpatrick said. “In addition, we work hand-in-hand with researchers conducting a plethora of clinical trials designed to discover better ways to treat, delay and — hopefully — to eventually prevent this debilitating disease.”

Sandy Wallace of Just For You Salon and Spa in Tempe gives Marianne Mitchell a trim, style and coloring, a regular part of Marianne's day out with her husband Harry Mitchell. Harry had been his wife's primary caregiver up until recently when he realized her Alzheimer's disease had advanced to where she needs fulltime attention. "She's adjusted better than me" he said of moving her to a residential facility. He wants to continue at least some parts of their past routine, so every Saturday, they go to the hair salon and out for a hamburger. Rick D’Elia

WHEN HARRY MET MARIANNE

A love story with a long goodbye By Paula Hubbs Cohen

Personality-plus

arianne and Harry. Harry and Marianne. For more than five decades, the names have been intertwined. But now, Alzheimer’s disease is stealing Marianne Mitchell from her husband, Harry. If Harry’s name sounds familiar, it’s because he taught government at Tempe High School (his alma mater) from 1965 until 1992, including one year at McClintock High School. He served on the Tempe City Council from 1970 to 1978 and was mayor of Tempe from 1978 to 1994. He subsequently served as an Arizona state senator (1999 to 2006) as well as a U.S. Congressman from 2007 to 2011. But lately, Harry has faced the toughest job of his life: as caregiver for Marianne, his bride of 53 years, who has Alzheimer’s.

The summer of 1957 It was the summer of 1957. Jukeboxes around the country were playing the latest hits from Elvis Presley, Pat Boone, Debbie Reynolds and the Everly Brothers. And here in the Phoenix area, Marianne Prevratil and Harry Mitchell were getting ready to start their senior years in high school

Mitchell family photo

— Marianne at North High and Harry at Tempe High. As fate would have it, a friend set the two teenagers up on a blind date — things must have gone pretty well because they dated steadily for the next five years before tying the proverbial knot in 1962.

“We lived our entire married life in Tempe in the first and only house we ever purchased,” Harry said. “We have two children, Amy (a third-grade teacher) and Mark (current mayor of Tempe) and five grandchildren who also live in Tempe.”

Harry said that Marianne has always been very outgoing and social. “She liked people and never really met a stranger,” he said. “She’s been pretty adventurous and enjoyed volunteering for projects and causes. She also liked to travel, which we’ve done to a number of foreign countries.” Marianne also loved children and truly loved teaching, in fact, she taught high school business classes for 35 years. “In addition, she was always active in my political campaigns — collecting signatures, speaking on my behalf, knocking on doors and attending rallies, parties and speeches,” Harry said. “She also loved to dance, taking lessons and never missing an opportunity to dance in a program either as a student or as an adult.” Harry added that when he first met Marianne, she was a cheerleader at North Phoenix High School and later attended Phoenix College on a cheerleading scholarship before moving on to ASU. Proud Sun Devils, both Marianne and Harry graduated from Arizona State University in 1962. MARIANNE, continued on page 9

6 | Livingwell a-z | Wednesday, November 4, 2015

UNDERSTANDING ALZHEIMER’S » More than 5 million Americans are living with Alzheimer’s and as many as 16 million will have the disease in 2050.

10 classic warning signs of Alzheimer’s

s we age, most people eventually notice some slowed thinking and occasional problems with remembering certain things. However, serious memory loss, confusion and other major changes in the way our minds work may be a sign of Alzheimer’s disease. As Alzheimer's advances, it leads to increasingly severe symptoms including disorientation, mood and behavior changes, and deepening confusion about events and situational experiences such as time and place. The disease also often leads to unfounded suspicions about family, friends and caregivers, along with difficulty speaking, swallowing and walking. TYPICAL AGE-RELATED CHANGE: Occasionally needing help to record Warning signs a television show. Here are the ten classic warning Confusion with time or place: signs of Alzheimer’s; individuals Having trouble understanding may experience one or more of these something if it is not happening symptoms in different degrees. immediately; forgetting where they are or how they got there. Memory loss that disrupts daily TYPICAL AGE-RELATED CHANGE: Getting life: Forgetting recently learned confused about the day of the week information, important dates or but figuring it out later. events; repeatedly asking for the same information; increasingly Trouble understanding visual relying on memory aids or family images and spatial relationships: members for things that used to be Having difficulty reading, judging handled on his or her own. distance and determining color or TYPICAL AGE-RELATED CHANGE: Sometimes contrast; this can cause problems forgetting names or appointments with driving. but remembering them later. TYPICAL AGE-RELATED CHANGE: Vision Challenges in planning or solving changes related to cataracts. problems: Experiencing changes in the ability to develop and follow a New problems with words in plan or work with numbers; having speaking or writing: Having trouble following a familiar recipe trouble following or joining a or keeping track of monthly bills. conversation; stopping in the TYPICAL AGE-RELATED CHANGE: Making middle of a conversation and being occasional errors when balancing unable to continue; frequently a checkbook. repeating themselves. Struggling with vocabulary; having problems Difficulty completing familiar tasks. finding the right word; calling things Having trouble driving to a familiar by the wrong name. location or remembering the rules of TYPICAL AGE-RELATED CHANGE: Sometimes a favorite game. having trouble finding the right word.

Diagnosing Alzheimer's There is no one test to determine if someone has Alzheimer’s. Doctors make their diagnosis based on medical history, physical examination, laboratory tests and being cognizant of the changes in thinking, day-to-day function and behavior associated with the disease. Although current treatments cannot cure or stop Alzheimer's from progressing, they can temporarily slow the worsening of symptoms and improve the quality of life for those with Alzheimer's and their caregivers. Thinkstock

Misplacing things and losing the ability to retrace steps: Putting things in unusual places; losing things and being unable to go back over their steps to find them again. This sometimes leads Alzheimer’s patients to accuse others of stealing. TYPICAL AGE-RELATED CHANGE: Occasionally misplacing things.

Decreased or poor judgment: Experiencing changes in judgment or decision-making; paying less attention to grooming or cleanliness. TYPICAL AGE-RELATED CHANGE: Making a bad decision once in a while.

Withdrawal from work or social activities: Removing themselves from hobbies, social activities, work projects or sports. TYPICAL AGE-RELATED CHANGE: Sometimes feeling weary of work, family and social obligations.

Changes in mood and personality: Becoming easily upset, confused, suspicious, depressed, fearful and/or anxious. TYPICAL AGE-RELATED CHANGE: Developing specific ways of doing things and becoming irritable when a routine is disrupted.

Resources ALZHEIMER’S ASSOCIATION (Na onal organiza on): alz.org; 800-272-3900 ALZHEIMER’S ASSOCIATION, DESERT SOUTHWEST CHAPTER alz.org/dsw; 602-528-0545 (Phoenix oﬃce) AREA AGENCY ON AGING, REGION ONE aaaphx.org; 602-264-HELP (4357); 888-783-7500; TTY/TDD 602-241-6110 ARIZONA HEALTHCARE COST CONTAINMENT SYSTEM (Arizona’s Medicaid system) AZahcccs.gov; 602-417-4000; 800-654-8713 (outside Maricopa County) ELDERCARE LOCATOR A service of the U.S. Administra on on Aging with informa on about services for older adults: ElderCare.gov; 800-677-1116 NATIONAL ACADEMY OF ELDER LAW ATTORNEYS NAELA.org; 703-942-5711 NATIONAL COUNCIL ON AGING NCOA.org; 571-527-3900

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Wednesday, November 4, 2015 | Livingwella-z | 7

UNDERSTANDING ALZHEIMER’S » Many people have memory loss issues — this does not mean they have Alzheimer's or another dementia.

8 myths and realities of Alzheimer’s Myth 1

Myth 4

Myth 6

Alzheimer’s and memory loss are a natural part of aging

There are treatments available to stop the progression of Alzheimer's

Head injuries can lead to Alzheimer's

REALITY: Occasional memory loss can be a normal part of aging, however, Alzheimer's is much more than occasional memory loss. It's a disease that causes brain cells to malfunction and ultimately die. When this happens, an individual will not only often eventually forget the name of their spouse and their children, they may very well not remember they even had a spouse or children. They will become unable to communicate and often undergo extensive personality and behavioral changes.

Myth 2 Alzheimer’s disease is not fatal REALITY: Alzheimer's destroys brain cells and causes memory changes, erratic behaviors and loss of body functions. It is a progressive disease that affects the brain and in the later stage affects motor functions including eating and swallowing. Although there are medications that can potentially slow the symptoms for some individuals, Alzheimer’s is the only chronic disease in the top 10 that has no known treatment to delay or stop the progression of the disease nor treat it. This disease has no survivors.

Myth 3

REALITY: Unfortunately, there is no treatment to cure, delay or stop the progression of Alzheimer's disease. However, FDA-approved drugs can sometimes temporarily slow worsening of symptoms for about 6 to 12 months (on average) for about half of the individuals who take them.

Myth 5 Alzheimer's disease is genetic

REALITY: Studies have shown that Alzheimer's disease is common in people who have been impacted by a traumatic brain injury, also known as TBI. However, there is no clear evidence as to how or why such brain injuries are related to Alzheimer's.

Myth 7 Who was Dr. Alois Alzheimer?

Flu shots increase the risk of Alzheimer’s

REALITY: Several years ago, a theory REALITY: In some cases that is true, linking flu shots to an increased however it’s in the low 5 percent of risk of Alzheimer’s disease was those diagnosed. If a person carries proposed by a doctor whose license the gene for Alzheimer's, it is not was suspended by the South Carolina a determining factor in actually Board of Medical Examiners. Several developing the disease, nor does it mainstream studies link flu shots and provide an exact time when someone other vaccinations to a reduced risk will develop the disease if they even of Alzheimer's disease as well as to do. Beyond these limited genetic overall better health. factors, there is no known cause as to why some people develop Alzheimer's disease, therefore there is no known way to avoid getting it. While some studies have shown that Aluminum, as well as living a healthy lifestyle, eating right metal dental fillings, and exercising can be beneficial, can lead to Alzheimer’s age is the most common factor in REALITY: Studies have failed to confirm developing the disease. The bottom any role for aluminum in causing line: If you have a brain, you can get Alzheimer’s. Likewise, according to Alzheimer’s. the best available scientific evidence, there is no relationship between dental fillings and Alzheimer's.

Myth 8

Only older people get Alzheimer's REALITY: While the most common factor related to those with Alzheimer’s is age, younger-onset Alzheimer's can — and does — strike people in their 50s, 40s and even 30s. In fact, of the more than 5 million people living with Alzheimer’s in the U.S., approximately 200,000 of them are younger than age 65.

“Those with Alzheimer's live an average of eight years after their symptoms become noticeable to others, but survival can range from four to 20 years depending on age and other health conditions.” — James Fitzpatrick, MAS, program and advocacy director for the Alzheimer’s Association, Desert Southwest Chapter

The year was 1906. Theodore Roosevelt was in his second term as president of the United States. In San Francisco, a massive earthquake and subsequent fire killed nearly 4,000 residents and destroyed 75 percent of the city. And in a quiet setting across the Atlantic Ocean in what was then known as Bavaria, a German physician named Alois Alzheimer was haunted by the case of Auguste D., a patient who had profound memory loss, language problems, unpredictable behavior, unfounded suspicions about her family and other worsening psychological changes. After Auguste’s death, Dr. Alzheimer examined her brain tissue, where he noticed dramatic shrinkage, tangled bundles of fibers and abnormal deposits in and around nerve cells. A few years later, in 1910, this dreaded disease was named for the forward-thinking Dr. Alzheimer, who set a new standard for scientific understanding of neuro-degenerative disorders, including the physically, emotionally and financially disastrous disease that carries his name. – Paula Hubbs Cohen

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8 | Livingwell a-z | Wednesday, November 4, 2015

ALZHEIMER’S » Someone in the U.S. develops Alzheimer’s every 67 seconds.

SENIOR CARE SERVICES

$10 million in new research funding awarded to Banner Alzheimer’s Institute Groundbreaking research focused on potential new treatments to prevent or delay emergence of symptoms By Paula Hubbs Cohen

Alzheimer's Prevention Registry

n May of 2015, the Alzheimer’s Association, the GHR Foundation (a private family foundation) and Fidelity Biosciences Research Initiative announced $10 million in new research funding to Banner Alzheimer’s Institute (BAI) in Phoenix to support a groundbreaking Alzheimer’s disease prevention trial.

The Alzheimer's Prevention Registry, championed by the Banner Alzheimer's Institute, is a community of people interested in the possibility of participating in Alzheimer’s prevention studies, now or in the future. Every person who joins accelerates Alzheimer's research and improves the chances of ending Alzheimer’s before we lose another generation.

Evaluating potential treatments Part of BAI, the Alzheimer’s Prevention Initiative (API) was established to rapidly evaluate potential new treatments in people prior to developing clinical symptoms of Alzheimer’s who, based on their age and genetic background, are at highest risk of developing symptoms of the disease. API is led by BAI’s executive director, Eric Reiman, M.D., its director, Pierre Tariot, M.D., and one of its principal scientists, Jessica Langbaum, Ph.D. Reiman said that these new funds will not only help make it possible to evaluate two promising Alzheimer's prevention therapies, but to do so in a way that will help the field find treatments that work as soon as possible.

“The goal is to accelerate the global effort to eliminate Alzheimer's disease.” —Maria Carrillo, Ph.D., Alzheimer’s Association Chief Science Officer

Supporting targeted trials Specifically, this new funding supports and extends an API trial known as APOE4 that is focused on determining whether therapies targeting amyloid proteins in the brain may prevent or delay the emergence of Alzheimer’s symptoms in people at particularly high genetic risk for developing the disease at older ages.

MORE INFO: EndAlzNow.org or through the Prevention Registry link on the Arizona Alzheimer’s Consortium website, AZalz.org. The funding will support three aspects of the trial that otherwise would not be possible:

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Wednesday, November 4, 2015 | Livingwella-z | 9

UNDERSTANDING ALZHEIMER’S » Alzheimer’s is the sixth-leading cause of death in the U.S.; it is the fifth-leading cause of death in Arizona.

Marianne  continued from page 5

Early signs of dementia Life was good for Harry and Marianne for many, many years. But about ten years ago, things started to change. Marianne told Harry that she thought she needed to see a doctor. “She said she couldn’t remember things,” he recalled. “I thought maybe it was stress — we had started going back and forth to D.C. — Alzheimer’s never entered my mind. But as I look back, Marianne had behaviors that now I know were clearly signs of dementia.” Some of these signs included leaving notes all around the house and not being able to take phone messages correctly. “Plus, if she was driving to an unfamiliar place, she needed a map and written instructions, not verbal,” Harry said. Seeking help and a diagnosis, Harry and Marianne visited a neurologist in 2008. “We had already talked to our primary care doctor and Marianne had started taking medicine even before we went to the neurologist,” Harry said. “Her first official diagnosis from the neurologist was mild cognitive impairment.”

Rick D'Elia

And inally… Every Saturday, Harry takes Marianne out for a hair appointment and a casual meal. Harry said it was a hard decision for him to make, but his beloved wife is much happier with the 24/7 structure of living in a residential care center.

Adjustments in caregiving Until very recently, Harry was Marianne’s primary caregiver. “For us, the greatest help from a caregiving perspective was a daycare program called Oakwood Creative Care in Mesa,” he said. “She started attending the program in April of 2014 which was good for both me and for Marianne, who eventually attended the program five days a week.” Marianne liked Oakwood because she had structure and programs and people with whom she could interact. However, when she was home with Harry — even though he tried to keep her busy — she often cried and whined. “I really felt bad because I could tell she just wasn’t happy,” he said. “So I made the decision to move her to a full-time residential facility. I felt

that if she was at a place that gave her constant structure 24/7, she would be better — and that has been the case for her. She has adjusted very well, much better than me.”

Advice from the trenches Harry said that he has read at least 13 books — some more than once — related to caregiving and Alzheimer’s — and he advises others on the long Alzheimer’s journey to make sure to stay informed by attending programs

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about Alzheimer’s and reading, reading, reading. “I faithfully read the blog ‘Alzheimer’s Reading Room’ and I also attend two monthly support groups — one is a men’s group called ‘Men Who Care’ sponsored by Banner Alzheimer’s Institute and the other is sponsored by Oakwood Creative Care,” he said. “In addition, I attend lectures put on by Banner Alzheimer’s Institute and workshops sponsored by the Alzheimer’s Association.”

Finally, Harry said that he has to be honest and say that while knowledge is power, it can also be frightening. “For example, when I first went to a support group, I told the group that I already knew a lot about Alzheimer’s,” he said. “But as good as it is to be educated — and it is definitely good to be informed — it was also kind of the bad news for me, because I know where this journey is going to end.” Marianne Mitchell has resided in a residential care center since August. On Feb. 6, 2016, Harry Mitchell is scheduled to be the keynote speaker at ‘A Love Not Forgotten’, a gala whose proceeds will benefit the Alzheimer’s Association Desert Southwest Chapter. For more information on tickets or sponsorships, call 602-528-0545 or email AKrautstrunk@alz.org.

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10 | Livingwella-z | Wednesday, November 4, 2015

Medicare Open Enrollment here again To change your plan, you must sign up by Dec. 7

Senior Medicare Patrol: Fighting Medicare fraud Composed of volunteers who are retired seniors, members of the Senior Medicare Patrol (SMP) give community presentations to teach Medicare beneficiaries how to do their part to prevent fraudulent Medicare claims. The program is operated by the Administration on Aging, part of the U.S. Department of Health and Human Services. In Arizona, the program is overseen by the Division of Aging and Adult Services within the Department of Economic Security. To find out more about becoming an SMP volunteer or to arrange a presentation about preventing Medicare fraud for an organization such as a church or community group, social organization, senior center or the like, call the Area Agency on Aging Region One at 602264-2255 or visit azdes.gov/landing. aspx?id=7621.

By Debra Gelbart

he 2016 Medicare Open Enrollment Period (OEP) is going on right now. It continues through Dec. 7, 2015. This matters to you if: • You’ve turned 65 and you already have Parts A and B Medicare coverage. • You want to sign up for a Medicare Advantage plan (officially called Part C, it operates similarly to an HMO or PPO with a limited network of providers) or a prescription drug plan (officially called Part D). Part D as a separate plan may be chosen if you have opted for traditional Medicare (where you can choose any provider who accepts Medicare but fewer of your costs are covered).

Are you required to sign up? If you’re still working and have an employer or union group health insurance plan, it’s possible you don’t need to sign up for Medicare Part B (for doctor and other provider coverage) right away, according to medicare.gov. First, you need to find out from your employer whether the employer's plan is the primary insurer. If Medicare is considered the primary insurer, you will need to sign up for Part A (for hospital coverage) and Part B. If Medicare would be considered secondary, some employers’ health plans might require age 65+ employees to enroll in Part A. Again, if you are in this situation, be sure to check with your provider for specific details. If you’re not covered by an employer or union health plan, Medicare enrollment is required during Medicare’s initial enrollment period that begins three months before you turn 65 and ends three months after you turn 65. If you don’t sign up during this time you will pay a late enrollment penalty for all future Part B premiums for the rest of your life. If you’re already receiving Social Security benefits, you are automatically signed up for Parts A and B. If you don’t receive Social Security benefits, you’ll need to sign up for Medicare by calling the Social Security Administration at 800-772-1213 or online at socialsecurity.gov/medicareonly.

you’re going to select in 2016,” he said. “Provider contracts can change from Thinkstock year to year, even with the same plan.” He added that with traditional Medicare, you can see any provider who accepts Medicare — but provider networks within a Medicare Advantage Plan are limited. MEDICARE • Prescription drugs are typically part of a Medicare Advantage plan, but are separate when you have traditional Doctor and other Medicare. You should enroll in Part D to provider insurance that go along with Parts A and B if you’re not carries a monthly premium choosing an Advantage plan. in most cases of $104.90. • If you think you may need surgery or another procedure in the next 12 months, you’ll want to find out if the doctor and hospital or outpatient center you prefer are included in your plan’s network of providers. • Are you a part-time resident? If you spend part of the year outside Maricopa MEDICARE County, Spencer said, and you want to select a Medicare Advantage plan, you’ll need to arrange to receive your routine Drug coverage. medical care in Maricopa County in Prices vary by insurer. most cases.

MEDICARE

PART A

PART B

Hospital insurance (according to medicare.gov, most people get this premium-free).

MEDICARE

PART C

PART D

Also known as Medicare Advantage, this is offered by private health insurance companies that contract with Medicare. Prices vary by insurer.

Resources AREA AGENCY ON AGING, REGION ONE: aaaphx.org; 602-264-2255 MEDICARE.GOV (the official U.S. website for Medicare): medicare.gov; 800-MEDICARE

Already have an Advantage plan? director for the Area Agency on Aging, Region One.

Changing plans? How do you decide which plan is best for you? Here are some considerations: • Medicare Advantage plans are offered by private health insurance companies that contract with Medicare. If you’re thinking of changing to a Medicare Advantage plan (or keeping your current Advantage plan), make sure your preferred doctors are part of the plan’s network, Spencer advised. “If you like a particular doctor, it’s important to determine if he or she will be contracted with the Medicare Advantage plan

pen Enrollment through the Health Insurance Marketplace began on Nov. 1. It continues through Jan. 31, 2016. To be covered on Jan. 1, 2016, you must sign up by Dec. 15, 2015. Jan. 31, 2016 is the deadline for signing up to avoid having to pay a penalty for not being covered. There are three ways to enroll for coverage:

• Visit healthcare.gov. Or, call 800-318-2596 to enroll over the phone. • Work with an insurance broker. You can obtain the names of insurance brokers near you from insurance companies represented in the Health Insurance Marketplace such as Blue Cross Blue Shield of Arizona (888-559-2583), Health Choice (855-452-4242) or Phoenix Health Plans (855-463-7275). • Enroll directly through the insurance carrier you choose.

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Experts say it’s a good idea to review your current Advantage plan and find out during Open Enrollment if anything has changed. If you want to keep the Advantage plan and options you currently have, chances are you don’t have to do anything — you will be automatically re-enrolled for 2016 with the same plans and options that you have now, but be sure to check with your plan provider to be certain. There are a couple of exceptions in Maricopa County. Caremore and Scan Health Plan are terminating their Medicare Advantage plans for 2016. That means the 14,000 Maricopa County enrollees in those plans must choose another plan, said Glen Spencer, benefits assistance program

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STAY HEALTHY AND LIVE WELL!! Make an appointment to visit any one of these quality health experts.

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Wednesday, November 4, 2015 | Livingwell a-z | 11

NOVEMBER Take advantage of opportunities to meet others with similar issues and learn more about various aspects of your health – from A to Z. All groups and events are believed, but not guaranteed, to be free unless otherwise stated. Every effort has been made to verify accuracy, but please call before attending to confirm details.

WELLNESS & MORE AVOIDING COLD & FLU Various dates, times & locations 623-277-3013 CignaMedicalGroup.com COOKING FOR HEALTH Various dates, times & locations By Cancer Support Community 602-712-1006; rsvp@cscaz.org MEDICATION CHECKS Call to schedule a personal meeting St. Luke’s, 1800 E. Van Buren St., Phoenix Tempe St. Luke’s, 1500 S. Mill Ave., Tempe Register: 877-351-WELL (9355) VOLUNTEER People impacted by cancer volunteering Various dates, times & locations Cancer Survivors Circle of Strength info@azcscs.org; azcscs.org WALKING GROUP Various dates & locations By Humana; 480-325-4707 TOBACCO RECOVERY GROUP Nov. 10, 9–9:45 a.m. Banner MD Anderson Cancer Center 2946 E. Banner Gateway Dr., Gilbert Appointment required: 480-256-5177 FABULOUS FIBER Nov. 12, 1–2 p.m. Civic Center Auditorium 3839 N. Drinkwater Blvd., Scottsdale RSVP: 623-580-5800; HonorHealth.com HEALTHY HOLIDAY COOKING Nov. 14, 10 a.m. Abrazo Central Campus 2000 W. Bethany Home Rd., Phoenix AbrazoHealth.com artistryofyou@abrazohealth.com

PAIN INTRO TO FIBROMYALGIA Nov. 4, 11 & 18, 5:30–6:30 p.m. Fibromyalgia Wellness Center 8300 N. Hayden Rd., Scottsdale 480-948-4955 FibroWellnessCenter.com AVOID INJURY & PAIN Nov. 7, 10 a.m. Abrazo Scottsdale Campus 3929 E. Bell Rd., Phoenix AbrazoHealth.com artistryofyou@abrazohealth.com KNEE & HIP PAIN Nov. 10, 6 p.m. Abrazo West Campus 13677 W. McDowell Rd., Goodyear AbrazoHealth.com artistryofyou@abrazohealth.com BACK PAIN Nov. 18, noon By Tempe St. Luke’s Tempe Public Library 3500 S. Rural Rd., Tempe TempeStLukesHospital.com 877-924-WELL (9355) OSTEOARTHRITIS & JOINT PAIN Nov. 19, 6–7:30 p.m. Encanterra Country Club 36460 N. Encanterra Dr., San Tan Valley MVMedicalCenter.com 877-924-WELL (9355) NECK PAIN Nov. 30, noon Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa MVMedicalCenter.com 877-924-WELL (9355) BACK PAIN TREATMENT Dec. 1, 6 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa MVMedicalCenter.com 877-924-WELL (9355)

HEART/STROKE STROKE CHECK Various dates, times & locations 480-882-4636; HonorHealth.com

FAMILY HEALTH AWARENESS Nov. 21, 8:30–11 a.m. Sonoran Health and Emergency Center 33423 N. 32nd Ave., Phoenix RSVP: 623-580-5800; HonorHealth.com

STROKE SUPPORT Nov. 4, 5:45–7 p.m. HonorHealth Outpatient Therapy 3134 N. Civic Center Plaza, Scottsdale 480-882-6821; HonorHealth.com

CAREGIVERS

STROKE SUPPORT Nov. 5, noon Abrazo Scottsdale Campus 3805 E. Bell Rd., Phoenix 602-923-5546 sritchie@abrazohealth.com

CAREGIVERS SUPPORT Various dates, times & locations By Duet; 602-274-5022; DuetAZ.org CANCER CAREGIVERS SUPPORT Various dates & times By Cancer Support Community 360 E. Palm Lane, Phoenix 602-712-1006; rsvp@cscaz.org CAREGIVERS SUPPORT Nov. 7, 10 a.m.–noon Ironwood Cancer & Research Centers 8880 E. Desert Cove Ave., Scottsdale Register: 602-588-4367; IronwoodCRC.com CAREGIVERS SUPPORT Nov. 11, 2:30 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa MVMedicalCenter.com 877-924-WELL (9355) CAREGIVERS SUPPORT Nov. 20, 9–11 a.m. Benevilla; 623-584-4999 13576 W. Camino Del Sol, Sun City West

GRIEF SUPPORT GRIEF SUPPORT GROUPS Various dates, times & locations By Banner Hospice Rev. Cindy Darby, cindy.darby@BannerHealth.com 480-657-1167; BannerHospice.com GRIEF SUPPORT Various dates & times Dignity Health St. Joseph’s 350 W. Thomas Rd., Phoenix 602-406-3275 GRIEF SUPPORT Various dates, times & locations By Hospice of the Valley HOV.org/Grief-Support-Groups 602-530-6970 GRIEF BEFORE LOSS Nov. 4, 11, 18 & 25, 2–3 p.m. Benevilla; 623-584-4999 16752 N. Greasewood St., Surprise PREGNANCY & INFANT LOSS Nov. 5, 6–8 p.m. Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 623-580-5800; HonorHealth.com GRIEF & BEREAVEMENT Nov. 12 & 26, 2 p.m. Benevilla; 623-584-4999 13576 W. Camino Del Sol, Sun City West CHILD LOSS SUPPORT Nov. 16, 6–8 p.m. Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-3878; HonorHealth.com COMMUNITY GRIEF SUPPORT Nov. 22, 6–7 p.m. By Hospice of the Valley Steele Indian School Park 300 E. Indian School Rd., Phoenix 602-530-6900; HOV.org

a-z T O P E V E N T S

MENDED HEARTS SUPPORT Nov. 5, 6:30–8 p.m. Deer Valley Medical Center 19841 N. 27th Ave., Phoenix 623-879-1800; HonorHealth.com PERIPHERAL ARTERY DISEASE Nov. 12, 6 p.m. Abrazo Arrowhead Campus 18701 N. 67th Ave., Glendale AbrazoHealth.com artistryofyou@abrazohealth.com STROKE SUPPORT Nov. 18, 1 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa MVMedicalCenter.com 877-924-WELL (9355)

HEARING LOSS HEARING LOSS & TINNITUS Nov. 4, 7–8 p.m. Barnes & Noble 10500 N. 90th St., Scottsdale RSVP: 623-580-5800; HonorHealth.com HEARING LOSS SUPPORT Nov. 10, 1:30–3:30 p.m. First Presbyterian Church 12225 N. 103rd Ave., Sun City 301-657-2248; HearingLoss.org melanie.orourke@gmail.com HEARING LOSS SUPPORT Nov. 12, 12:45–2:30 p.m. Ed Robson Library 9330 E. Riggs Rd., Sun Lakes 602-652-3000; HearingLoss.org reggiefaith@gmail.com HEARING LOSS SUPORT Nov. 18, 1:30–3:30 p.m. Fountain Hills Church 13001 N. La Montana Dr., Fountain Hills 301-657-2248; HearingLoss.org kfonville@fhfh.az.gov

WOMEN MENOPAUSE SUPPORT Nov. 16, noon–1 p.m. Scottsdale Shea Medical Center 9003 E. Shea Blvd., Scottsdale RSVP: 623-580-5800; HonorHealth.com

NOV. 14: WALK TO END ALZHEIMER'S Alzheimer’s Association Desert Southwest Chapter

Please call to conirm reservations and cost (if any).

NOW THROUGH NOV. 20 WALK ON! CHALLENGE: TEACHER REGISTRATION WHAT: Registration for the 2016 Walk On! Challenge is underway. Open to all 4thand 5th-graders across the state. Teachers and school administrators can sign up for the no-cost program online. WHERE: 4th- and 5th-grade classrooms WHEN: Registration open through Nov. 20 PRESENTED BY: Blue Cross Blue Shield of Arizona COST: Free INFO/REGISTER: WalkOnAZ.com

NOV. 4, 11 & 18 MINDFULNESS TRAINING FOR CAREGIVERS WHAT: How to release stress through mindfulness and learning to live in the present moment. WHERE: Friendship Village, 2645 E. Southern Ave., Tempe WHEN: 10 a.m.–noon PRESENTED BY: Hospice of the Valley COST: Free INFO/REGISTER: 602-636-5300, HOV.org

NOV. 4 & DEC. 2 MINI-MED SCHOOL WHAT: Experience a glimpse of what medical students are learning. WHERE: Virginia G. Piper Auditorium, 600 E. Van Buren St., Phoenix WHEN: 5:30–7 p.m. PARTICIPANTS: For high-schoolers to retirees; can sign up for one or more sessions PRESENTED BY: The University of Arizona College of Medicine - Phoenix COST: Free INFO/REGISTER: 602-827-2024; phoenixmed.arizona.edu/ mini-med

NOV. 6 HEALTHCARE PUZZLE FOR DEMENTIA WHAT: Experts in aging and dementia come together for this event. WHERE: Valley of the Sun Jewish Community Center, 12702 N. Scottsdale Rd., Scottsdale WHEN: 8 a.m.–4 p.m. PRESENTED BY: Home Care Assistance and Measurabilities Home Safety, LLC COST: Free INFO/REGISTER: 480-448-1059; nhpevents.com

NOV. 7 MIDWESTERN UNIVERSITY OPEN HOUSE WHAT: The Midwestern University Fall Open House opens the campus to students interested in a career in healthcare.

DIABETES

RECIPES FOR DIABETES Nov. 4, 11:30 a.m.–1 p.m. Humana Guidance Center 5943 E. McKellips Rd., Mesa 480-325-4707 DIABETES SUPPORT Nov. 9, 3 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa MVMedicalCenter.com 877-924-WELL (9355)

MANAGING DIABETES Various dates, times & topics Dignity Health Center for Diabetes 1760 E. Pecos Rd., Gilbert 480-728-3535

DIABETES SEMINAR Nov. 11, 10:30–11:30 a.m. Humana Guidance Center 5943 E. McKellips Rd., Mesa 480-325-4707

WOMEN & CANCER THERAPY Nov. 17, 10–11 a.m. Banner MD Anderson Cancer Center 2946 E. Banner Gateway Dr., Gilbert Register: 602-230-CARE (2273)

WHERE: Midwestern University Glendale Campus, 59th Ave. and Utopia Rd., Glendale WHEN: 10 a.m.–1 p.m. PRESENTED BY: Midwestern University COST: Free INFO/REGISTER: Midwestern.edu

NOV. 9 VALLEY FEVER: THE SILENT EPIDEMIC WHAT: Experts will provide info and discuss Valley Fever. WHERE: Banner Del E. Webb Medical Center, 14502 W. Meeker Blvd., Sun City West. (Additional seminars will take place in Tucson and Cottonwood; see website below for details.) WHEN: 9–11:30 a.m. PRESENTED BY: The University of Arizona Valley Fever Center for Excellence COST: Free INFO/REGISTER: 520-626-6517; vfce.arizona.edu

NOV. 14 WALK TO END ALZHEIMER'S WHAT: The Walk to End Alzheimer’s® is the world’s largest event to raise awareness and funds for Alzheimer’s care, support and research. Information provided about support programs and services, advocacy initiatives and clinical trial enrollment. In Arizona, funds raised beneit the Alzheimer’s Association Desert Southwest Chapter’s programs as well as prevention and treatment research. WHERE: Wesley Bolin Plaza, 1700 W. Washington St., Phoenix WHEN: 7:30–11 a.m. PRESENTED BY: Alzheimer's Association Desert Southwest Chapter COST: Free INFO/REGISTER: 602-528-0545; JRogers@alz.org; PhoenixAlzheimersWalk.org

PRESENTED BY: Cancer Support Community Arizona COST: Free INFO/REGISTER: 623-207-1703

NOV. 19 IMMUNE SYSTEMS & CANCER LECTURE WHAT: How do we use our immune systems to detect cancer? Refreshments served. WHERE: Bluewater Grill, 1720 E. Camelback Rd., Phoenix WHEN: 6–7:30 p.m. PRESENTED BY: Cancer Support Group COST: Free; registration required INFO/REGISTER: 602-527-3776

NOV. 21 8TH ANNUAL PHOENIX UNDY RUN/WALK WHAT: USAT-certiied 5K Run and One Mile Fun Run/Walk that is

NOV. 11 FREE MEALS FOR VETERANS WHAT: Free breakfast/lunch for veterans; others can buy meals for $3.50 cash donation. Proceeds donated to Soldier's Best Friend which provides therapeutic companion dogs for veterans. WHERE: Breakfast at Abrazo Arrowhead Campus, 18701 N. 67th Ave., Glendale; lunch at Abrazo Arizona Heart Hospital, 1930 E. Thomas Rd., Phoenix WHEN: Breakfast 6:30–9:30 a.m.; Lunch 11 a.m.–2 p.m. PRESENTED BY: Abrazo Community Health Network COST: Free for veterans; $3.50 for others INFO: 623-537-3470; amber.gorichs@abrazohealth.com

NOV. 12 ALZHEIMER’S & CARE-PARTNERS CONFERENCE WHAT: Learn the basics of Alzheimer’s care as well as how to approach challenging behaviors, efective communication and legal/ inancial planning for individuals with Alzheimer’s. WHERE: 7373 E. Dixileta Dr., Scottsdale WHEN: 9 a.m.–1 p.m. PRESENTED BY: Alzheimer’s Association COST: Free INFO/REGISTER: 602-528-0545; ALZ.org/DSW

NOV. 13 GUARDIANSHIP OF YOUR GRANDCHILD WHAT: Free clinic to help grandparents complete the proper paperwork. A volunteer attorney from the Children’s Law Center will guide you through a guardianship petition and provide legal advice. WHERE: Duet, 555 W. Glendale Ave., Phoenix WHEN: 3–5 p.m. PRESENTED BY: Duet and the Children’s Law Center COST: Free INFO/REGISTER: 602-274-5022

DIABETES OVERVIEW Nov. 11, 5–7 p.m. HonorHealth Medical Group 6320 W. Union Hills Dr., Glendale 623-561-3103; HonorHealth.com UNDERSTANDING GLUCOSE NUMBERS Nov. 16, noon Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa MVMedicalCenter.com 877-924-WELL (9355) DIABETES PREVENTION STRATEGIES Nov. 25, 1–2 p.m. Humana Guidance Center

NOV. 21: 8TH ANNUAL PHOENIX UNDY RUN/WALK Colon Cancer Alliance

NOV. 14 ADULT EPILEPSY SEMINAR WHAT: Educational seminar for anyone afected by epilepsy. WHERE: Gateway Community College, 108 N. 40th St., Phoenix WHEN: 9 a.m.–2 p.m. PRESENTED BY: Epilepsy Foundation of Arizona COST: Free INFO/REGISTER: 602-406-3581; EpilepsyAZ.org

about having fun and running in the streets in your boxers, briefs or crazy costume while raising money to ight colon cancer. WHERE: Wesley Bolin Memorial Plaza, 1700 W. Washington St., Phoenix WHEN: 7:30 a.m. packet pickup & on-site registration; 9 a.m. race start PRESENTED BY: Colon Cancer Alliance COST: See website for costs INFO/REGISTER: UndyRunWalk.org

NOV. 18

NOV. 21

DEMENTIA DIALOGUE WEBINAR WHAT: Experts in dementia care ofer this monthly online seminar. This month’s topic: preparing for the holidays. WHERE: Online; BannerSHRI.org WHEN: noon–1 p.m. PRESENTED BY: Banner Alzheimer’s Institute COST: Free; registration required INFO/REGISTER: 623-832-3248; BannerHealth.com/ ResearchOnlineEdu

PARENTING THROUGH CANCER WHAT: How to navigate parenting when there’s a cancer diagnosis in the family. Fun activity for children ages 5-18 during presentation. Dinner provided. WHERE: Cancer Support Community, 360 E. Palm Lane, Phoenix WHEN: 4–7 p.m. PRESENTED BY: Cancer Support Community Arizona COST: Free INFO/REGISTER: 602-712-1006; emilie@cscaz.org

NOV. 19 COPING WITH THE COST OF CANCER WHAT: How to navigate the challenges of managing the cost of cancer care. Learn about health insurance, obtaining prescriptions, employment and more. WHERE: Sun Health PORA, 13815 W. Camino Del Sol, Sun City West WHEN: 9:30–11 a.m.

5943 E. McKellips Rd., Mesa 480-325-4707 DIABETES NUTRITION & ACTIVITY Nov. 25, 5–7 p.m. HonorHealth Medical Group 6320 W. Union Hills Dr., Glendale 623-561-3103; HonorHealth.com

ALZHEIMER’S/DEMENTIA ALZHEIMER’S CAREGIVERS SUPPORT Various dates, times & locations By Alzheimer’s Association Desert Southwest Chapter 602-528-0545; ALZ.org/DSW

NOV. 22 LIGHT UP A LIFE WHAT: A community remembrance event honoring loved ones who have died. WHERE: Steele Indian School Park, 300 E. Indian School Rd., Phoenix WHEN: 6–7 p.m. PRESENTED BY: Hospice of the Valley COST: Free INFO/REGISTER: 602-530-6900; HOV.org

10 SIGNS OF ALZHEIMER’S Various dates, times & locations By Alzheimer’s Association Desert Southwest Chapter 602-528-0545; ALZ.org/DSW ALZHEIMER’S & MEMORY SUPPORT Nov. 6, 9–11:30 a.m. Benevilla; 623-584-4999 13576 W. Camino Del Sol, Sun City West ALZHEIMER’S & MEMORY SUPPORT Nov. 10, 17 & 24, 10 a.m.–noon By Benevilla at Faith Presbyterian 16000 N. Del Webb Blvd., Sun City 623-584-4999; Benevilla.org

12 | Livingwella-z | Wednesday, November 4, 2015

a-z I N F O R M AT I O N O N L I N E ABRAZO COMMUNITY HEALTH NETWORK: AbrazoHealth.com; 602-674-1400; Abrazo Arizona Heart Hospital; Abrazo Arrowhead Campus; Abrazo Central Campus; Abrazo Maryvale Campus; Abrazo Scottsdale Campus; Abrazo West Campus BANNER CHILDREN’S-CARDON CHILDREN’S: BannerChildrens.com; 480-412-KIDS (5437) BANNER HEALTH: BannerHealth.com; 602-747-4000; Numerous hospitals and medical centers BANNER POISON AND DRUG INFO CENTER HOTLINE: 800-222-1222 BARROW NEUROLOGICAL INSTITUTE: TheBarrow.org; 877-602-4111 DIGNITY HEALTH CHANDLER REGIONAL MEDICAL CENTER: DignityHealth.org/chandlerregional; 877-728-5414 DIGNITY HEALTH MERCY GILBERT MEDICAL CENTER: DignityHealth.org/mercygilbert; 877-728-5414 DIGNITY HEALTH ST. JOSEPH’S HOSPITAL AND MEDICAL CENTER: DignityHealth.org/stjosephs; 877-602-4111 DIGNITY HEALTH ST. JOSEPH’S WESTGATE MEDICAL CENTER: DignityHealth.org/westgate; 877-602-4111 HONORHEALTH (formerly Scottsdale Healthcare): HonorHealth.com; 623-580-5800; HonorHealth Scottsdale Shea; HonorHealth Scottsdale Thompson Peak; HonorHealth Scottsdale Osborn HONORHEALTH DEER VALLEY MEDICAL CENTER: HonorHealth.com; 623-580-5800 HONORHEALTH JOHN C. LINCOLN MEDICAL CENTER: HonorHealth.com; 623-580-5800 MARICOPA INTEGRATED HEALTH SYSTEM: MIHS.org; 602-344-5011 MAYO CLINIC: MayoClinic.org; 800-446-2279 MOUNTAIN VISTA MEDICAL CENTER: MVMedicalCenter.com; 480-358-6100 MUHAMMAD ALI PARKINSON CENTER: TheBarrow.org; 602-406-6262 PHOENIX CHILDREN’S HOSPITAL: PhoenixChildrens.org; 602-933-1000 ST. LUKE’S MEDICAL CENTER: StLukesMedCenter.com; 602-251-8100 TEMPE ST. LUKE’S HOSPITAL: TempeStLukesHospital.com; 480-784-5500 VALLEY FEVER CENTER FOR EXCELLENCE: vfce.arizona.edu; 602-406-8253 ALZHEIMER’S CAREGIVERS SUPPORT Nov. 16, 1:30–3 p.m. By Tempe St. Luke’s 655 E. Southern Ave., Tempe 877-351-WELL (9355)

East Valley: 480-358-0198; 480-969-4119 Sun City (Banner Boswell): 623-547-2206; 623-236-6616 West Valley: 602-531-9123; 623-979-4279

DEMENTIA CONVERSATIONS Nov. 17, 10–11 a.m. First Methodist Church 7102 N. 58th Dr., Glendale RSVP: 602-528-0545; ALZ.org/DSW

CIRCLE OF HELP ADVANCED BREAST CANCER Meets as needed Info: Becky Chase, 623-236-6616 or Teresa Hill, AdvancedBreastCancer@gmail.com

ALZHEIMER’S SUPPORT Nov. 17, noon–2 p.m. By Duet; 602-274-5022; DuetAZ.org 555 W. Glendale Ave., Phoenix ALZHEIMER’S SUPPORT Dec. 1, 2 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa MVMedicalCenter.com 877-924-WELL (9355)

BREAST CANCER SUPPORT Nov. 12, 6–8 p.m. Breast Health and Research Center 19646 N. 27th Ave., Phoenix 623-780-4673; HonorHealth.com BREAST CANCER SUPPORT Nov. 24, 5:30–6:45 p.m. Banner Thunderbird 5555 W. Thunderbird Rd., Glendale 602-865-5450

BREAST CANCER BOSOM BUDDIES SUPPORT GROUPS Various dates, times & locations Ahwatukee/Chandler: 602-739-8822; 602-318-8462

CANCER SUPPORT GROUPS LOOK GOOD FEEL BETTER By the American Cancer Society Various dates, times & locations 800-ACS-2345; LookGoodFeelBetter.org

• By Ironwood Cancer & Research Centers Various dates, times & locations 480-855-2224 IronwoodCRC.com • By Breast Health and Research Center Nov. 10, 4:30–6:30 p.m. 19646 N. 27th Ave., Phoenix RSVP: 623-780-4673; HonorHealth.com • By Banner Desert Cancer Center Nov. 23, 5:30–7:30 p.m. 1400 S. Dobson Rd., Mesa 602-230-CARE (2273) CANCER SUPPORT COMMUNITY SUPPORT GROUPS 360 E. Palm Lane, Phoenix Info: 602-712-1006; rsvp@cscaz.org • CANCER SURVIVORS Various dates & times • MULTIPLE MYELOMA Nov. 5, 10 a.m.–noon • SURVIVING & THRIVING Nov. 10 & 24, 1–2:30 p.m. • PROSTATE CANCER Nov. 12, 6–7:30 p.m. • LYMPHOMA Nov. 14, 10–11:30 a.m. • PANCREATIC CANCER Nov. 14, 10–11:30 a.m. • CARCINOID Nov. 14, 1–2:30 p.m. • LUNG CANCER Nov. 14, 1–2:30 p.m. • COLORECTAL CANCER Nov. 21, 10–11:30 a.m. • OVARIAN CANCER Nov. 21, 10–11:30 a.m. HONORHEALTH SUPPORT GROUPS Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale Info: 480-323-1321; HonorHealth.com/cancer • CANCER SURVIVORS Nov. 4, 5:30–6:30 p.m. • PANCREATIC CANCER Nov. 10, 4–5:30 p.m. • NON-HODGKIN’S LYMPHOMA Nov. 12, 6–8 p.m. • BREAST CANCER Nov. 14, 10 a.m.–noon • GYNECOLOGICAL CANCER Nov. 17, 3–4:30 p.m. • CAREGIVER & FAMILY Nov. 18, 5:30–6:30 p.m. • ORAL, HEAD & NECK Nov. 19, 6:30–8:30 p.m. • LYMPHEDEMA Nov. 23, 6–8 p.m.

IRONWOOD CANCER & RESEARCH CENTERS SUPPORT GROUPS — CHANDLER 685 S. Dobson Rd., Chandler Info: 480-340-4013; IronwoodCRC.com • BREAST CANCER Nov. 9, 2–4 p.m. • PROSTATE CANCER Nov. 9, 7–9 p.m. • HEAD & NECK CANCER Nov. 16, 3–4:30 p.m. • METASTATIC CANCER Nov. 25, 3–4:30 p.m. IRONWOOD CANCER & RESEARCH CENTERS SUPPORT GROUPS — GLENDALE 5810 W. Beverly Lane, Glendale Info: 602-588-4367; IronwoodCRC.com • METASTATIC CANCER SUPPORT Nov. 9, 2–4 p.m. • HEAD & NECK CANCER SUPPORT Nov. 10, 2–3:30 p.m. • MULTIPLE MYELOMA SUPPORT Nov. 23, 2–4 p.m. BANNER MD ANDERSON CANCER CENTER 2946 E. Banner Gateway Dr., Gilbert Info: 602-230-CARE (2273) • LYMPHEDEMA SUPPORT Nov. 5, 2:30–3:30 p.m. • MULTIPLE MYELOMA SUPPORT Nov. 16, 2:30–4:30 p.m. • CHEMOTHERAPY CLASS Nov. 16, 3–4 p.m. • ORAL, HEAD & NECK CANCER Nov. 18, 4:30 p.m. • PROSTATE CANCER SUPPORT Nov. 19, 3 p.m. BANNER THUNDERBIRD MEDICAL CENTER 5555 W. Thunderbird Rd., Glendale Info: 602-865-5450 • PATIENT & CAREGIVER SUPPORT Nov. 10, 5:30–6:45 p.m. • GYNECOLOGIC CANCER SUPPORT Nov. 17, 5:30–6:45 p.m.

PARKINSON’S PARKINSON’S EDUCATION, EXERCISE & SUPPORT GROUPS Various dates, times & locations By Muhammad Ali Parkinson Center 602-406-3840; 602-406-4921 CAREGIVERS SUPPORT Various dates, times & locations By Duet; 602-274-5022; DuetAZ.org PARKINSON’S SUPPORT Nov. 17, 3–4:30 p.m. By Benevilla at Shepherd Hills Methodist 13658 W. Meeker Blvd., Sun City West 623-584-4999

GASTROINTESTINAL OSTOMY EDUCATION & SUPPORT Nov. 5, 1–2 p.m. Banner MD Anderson Cancer Center 2946 E. Banner Gateway Dr., Gilbert 602-230-CARE (2273) OSTOMY SUPPORT Nov. 5, 2 p.m. Banner Boswell; 602-678-4441 13180 N. 103rd Dr., Sun City OSTOMY SUPPORT Nov. 10, 6 p.m. Elite Home Healthcare Services 2140 W. Greenway Rd., Phoenix 602-246-8221 OSTOMY SUPPORT Nov. 19, 12:30 p.m. La Casa de Cristo Church 6300 E. Bell Rd., Scottsdale 623-580-4120

RESPIRATORY BETTER BREATHERS/ COPD SUPPORT Various dates, times & locations By the American Lung Association 602-429-0005; BreatheEasyAZ.info COPD & LUNG DISEASE Nov. 11, noon Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa MVMedicalCenter.com 877-924-WELL (9355) GET PAST ASTHMA Nov. 12, 6:30–8 p.m. Deer Valley Medical Center 19841 N. 27th Ave., Phoenix 623-879-5452; HonorHealth.com

BRAIN/NEUROLOGICAL EPILEPSY EMPOWERMENT GROUPS Info: 602-406-3581; EpilepsyAZ.org • Nov. 5, 6:30–7:30 p.m. Banner Thunderbird 5555 W. Thunderbird Rd., Glendale • Nov. 9, 6:30–7:30 p.m. Banner University Medical Center 1111 E. McDowell Rd., Phoenix • Nov. 10 & 24, 7–8 p.m. NAU Communications Building 307 W. Tormey Dr., Flagstaff • Pediatric Epilepsy Group Nov. 14, 2–4 p.m. Harvest of Tempe 710 W. Elliot Rd., Tempe • Nov. 16, 7–9 p.m. Mayo Clinic 5777 E. Mayo Blvd., Phoenix • Nov. 19, 6:30–7:30 p.m. Old Chicago 1656 S. Alma School Rd., Mesa

PROGRESSIVE SUPRANUCLEAR PALSY SUPPORT Nov. 21, 1:30–3:30 p.m. Banner Thunderbird 5555 W. Thunderbird Rd., Glendale 602-920-4632; tsebastiani@cox.net

PARENTING BREASTFEEDING SUPPORT Various dates, times & locations By Dignity Health 480-728-5414; 602-406-4954 GRANDPARENTS RAISING GRANDCHILDREN Various dates, times & locations By Benevilla 623-207-6016; Benevilla.org GRANDPARENTS RAISING GRANDCHILDREN Various dates, times & locations By Duet; 602-274-5022; DuetAZ.org MOMS ON THE MOVE Various dates, times & locations By HonorHealth 480-323-3878; HonorHealth.com POSTPARTUM DEPRESSION SUPPORT Nov. 6, 9:30–11:30 a.m. Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 623-580-5800; HonorHealth.com YOUTH SUBSTANCE ABUSE WEBINAR Nov. 18, noon–12:30 p.m. DrugFreeAZKids.org/Webinars

SENIORS ASK THE PHARMACIST Nov. 10, 2–3:30 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa MVMedicalCenter.com 877-924-WELL (9355) Appointment required HEARING SCREENINGS Nov. 13, 9 a.m.–noon Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa MVMedicalCenter.com 877-924-WELL (9355) Appointment required

BARIATRIC SURGERY SEMINARS BANNER HEALTH BannerHealth.com 480-543-2606 HONORHEALTH HonorHealth.com/bariatrics 623-580-5800 ST. LUKE’S MEDICAL CENTER BridgesAZ.com 800-248-5553

Embracing Your Heart Passion for the rhythm of life is an amazing thing. At Abrazo Community Health Network, we are passionate about embracing the combination of cardiac innovation with personal care. That’s why our Heart Murmur Clinic implements lifesaving procedures and innovations for patients who are not candidates for traditional open-heart surgeries. Isn’t it time you get the kind of cardiac care you deserve? To ﬁnd out more about your heart, take our Heart Disease Risk Assessment Test at AbrazoHealth.com/Heart, or call 1-855-422-7296 for more information.

Abrazo Community Health Network. Embracing Care. Embracing Tomorrow. AR-0008454519-01

Wednesday, November 4, 2015 | Livingwell a-z | 13

Chronic pain continued from the cover Zaveri and Khan most commonly see patients who have low back pain; musculoskeletal injuries; nerve pain from diabetes, lupus or multiple sclerosis; pelvic pain; or knee, ankle, hip, shoulder or elbow pain. Ranson said he commonly treats patients with low back and lower extremity pain resulting from injuries to the bones and soft tissue structures of the spine. Between 54 and 80 percent of the population will suffer from spinal pain at some time in their lives, he said. At Freedom Pain Hospital in Scottsdale, doctors also treat patients for a condition called Complex Regional Pain Syndrome (CRPS), a chronic pain condition most often affecting one of the limbs following injury or trauma to that limb. CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems.

Array of treatments An array of available treatments for chronic pain can bring long-lasting relief to patients, doctors say. These include oral medications; conventional injected medications such as cortisone and epidural anesthesia; physical therapy; spinal cord stimulation for back pain; radiofrequency ablation that deadens nerve sensation of pain; and newer injected pain management approaches such as amniotic stem cells. • Among the most often used first-line treatments for short-term use are NON-STEROIDAL ANTI-INFLAMMATORY MEDICATIONS Thinkstock and PRESCRIPTION NARCOTICS. But because of side effects and — in the case of narcotin a deadening of pain signals from that in the spine and a pain-relieving injection ics — potential dependency, most pain specific area, Zaveri said. This technique into affected joints relieves inflammation specialists will offer patients a variety can help patients with back and neck pain and swelling. of other treatments. and pain associated with joint degenera• A NEUROSTIMULATION DEVICE about the size of “Over the past few years, more pain tion from osteoarthritis, he said. a pacemaker — implanted in the epidural specialists have begun to examine the • INJECTED AMNIOTIC STEM CELLS for chronic pain space in the patient’s back — replaces research conducted on the long-term that doesn’t respond well to other remea sensation of pain in the spine with a effects of opioids on patients,” Ranson dies is still considered experimental by mild vibration. “A spinal cord stimulator said. “In the absence of any significant health insurance companies, so patients can be geared toward patients who have evidence that chronic opioid therapy are required to pay the cost out of their had failed back surgery and are taking is beneficial and in light of mounting own pockets. But some physicians are increasing doses of narcotics for pain,” evidence of the deleterious effects from seeing dramatic results. Zaveri said. “The device can alleviate pain chronic use, there is a national move“This is a treatment that, at this point by 50 percent or more.” He added that it’s ment among physicians to limit the use because it’s not covered by insurance, important for patients to seek out either of opioid medications for the long-term should be considered after all other a specially trained anesthesiologist or a treatment of pain.” modalities fail,” said Khan, who is on physical medicine and rehab physician to • INJECTED PAIN-RELIEVING MEDICATIONS are staff at Banner Desert Medical Center in perform implantation of a device. delivered directly to the location of the Mesa. “And though we’ve seen impressive • RADIOFREQUENCY ABLATION (RFA) is an elecpain and include epidural and facet-joint long-lasting reduction or elimination of trical current produced by radio waves injections, Zaveri said. Facet joints are pain, the treatment does appear to work used to heat up a small area where positioned between each set of vertebrae better in patients under the age of 40.” nerves are perceiving pain. This results

The treatment is not given to children under 18, pregnant women or to anyone being treated for an infection or cancer, he said. The treatment works by injecting 1 cc. or less of amniotic stem cells (derived from the amniotic sacs of babies who have been born in good health) into the area of the body where pain is occurring, Khan said. For five to seven days, the patient cannot apply ice or heat to the area or take non-steroidal antiinflammatory medications such as ibuprofen, because the growth factors in the treatment are trying to replace damaged cells in the body and most pain-relief approaches interrupt that process, Khan explained. After seven days, about 80 percent of his patients experience significant pain relief that can last for years. His practice charges between $1,000 and $1,500 for a treatment, depending on how large an area of the body requires injection. It’s most commonly injected into the spine for back pain or into various joints, Khan said. “There are numerous other diseases that show early promise with stem cell therapies,” Ranson said. “As regenerative medicine is a relatively new field, welldesigned prospective studies are not readily available at this time but should be forthcoming in the next few years. As the evidence mounts that these therapies are beneficial and safe, I would expect to see FDA approval and therefore insurance coverage in the future for many of these treatments.”

When all else fails What can a patient do if all conventional and newer therapies fail to relieve their pain? “At that point, the focus is on quality of life through use of pain relief medications that don’t affect cognition,” Khan said. He offers either what are known as membrane stabilizers — such as Neurontin or Lyrica — that help with musculoskeletal and neuropathic pain; antidepressants such as Cymbalta or Effexor that also can relieve musculoskeletal and neuropathic pain; anti-inflammatory medications; or opioid medications such as oxycodone, codeine or hydrocodone. Or, he may suggest medical marijuana. “Medical THC (the active ingredient in marijuana) can be smoked or consumed through edible products,” he said. “For some patients it really can offer substantial or complete relief from pain.”

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