Livingwell AZ - July 2015

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Livingwell

a-z

HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILY

JULY 2015

2 The colon | 3 School immunizations | 4-5 Top events and support groups | 6 Sunscreen | 6 Cosmetic surgery | 7 Toenail fungus

Your eye health:

Glaucoma

Deciphering

diabetes

Early detection, treatment are critical to slowing progression of the disease

By Meghann Finn Sepulveda

A

ffecting more than 3 million people in the United States, glaucoma is a disease that damages the eye’s optic nerve as a result of increased pressure from fluid buildup. According to the American Academy of Ophthalmology, glaucoma is considered the leading cause of blindness in people over age 60.

DIABETES CAN C AU S E S E R I O U S C O M P L I C AT I O N S:

Respecting hallmarks of pre-diabetes can delay or prevent onset of the disease

St r o ke Blindness

Risk factors Age is considered one of the major risk factors in the development of glaucoma.

Risk increases at age 40 but is much more prevalent in the more senior population.

By the time a person reaches age 80, the risk of glaucoma can be as high as 10 percent. Family history is also a risk factor, while people of African-American, Hispanic and Northern European ancestry are more susceptible to developing certain types of glaucoma. People who use steroid medication and those who have had eye surgery are also at higher risk.

“Anyone who has experienced trauma to the eye, or those who suffer from systemic and inflammatory diseases such as diabetes, are at increased risk,” said John Lewis, M.D., an ophthalmologist at Southwestern Eye Center.

Those identified as high risk should speak to an eye doctor for an evaluation to identify any deficiencies.

STORY BY DEBRA GELBART AND M E G H A N N F I N N S E P U LV E DA PHOTOS BY RICK D’ELIA

R

osalie Leman, R.N., C.D.E., is a registered nurse and certified diabetic educator at Banner Baywood Medical Center in Mesa. She said that when she started in her field 18 years ago, patients would often say ‘I’m borderline diabetic but I’m not worried’.

“Now, doctors are a lot more aggressive about treating someone with pre-diabetes,” she said.

Pre-diabetes almost always precedes a diagnosis of diabetes, said both Leman and Karla Birkholz, M.D.,

DIABETES R I S K FAC T O R S B e i n g ove r we i g h t To o l i t t l e e xe r c i s e High blood pressure H i g h c h o l e s te r o l Genetics

Heart disease Kidney failure

Early detection Glaucoma begins to occur when fluid can’t drain properly from the eye. The fluid buildup causes a blockage and increases eye pressure to the optic nerve.

Typically, people with primary openangle glaucoma — the most common form of glaucoma — have no symptoms in the early stages of the disease.

Eye pressure levels should be monitored but because levels can fluctuate throughout the day, experts say that checking eye pressure alone is not the most effective way to screen for glaucoma.

“There are more than 50 types of glaucoma,” Lewis said. “In addition to testing eye pressure, a full examination should be performed inside the eye to look at the optic nerve and see if there are any signs of structural damage.”

Along with elevated eye pressure, one of the early signs of glaucoma is gradual changes to peripheral vision. However,

a family physician who is the wellness medical director for HonorHealth. Fortunately, prediabetes can be managed — and even reversed — if the patient is both willing and able to make lifestyle changes.

Insulin resistance Before someone develops pre-diabetes, he or she likely has a problem called insulin resistance, a dysfunction in the way the body uses insulin, Birkholz explained.

The main causes of insulin resistance aren’t surprising: genetics, being overweight and not exercising enough. Exercise is critical, both Birkholz and Leman said. “Just sitting for a period of time and not using your muscles can raise your risk of insulin resistance,” Birkholz said, adding that while any amount of exercise helps, the goals are to get to 30 minutes of exercise at least five days a week and to move at least a few minutes every hour.

To monitor possible insulin resistance, some physicians may order a ‘lipid particle’ test. ‘Bad’ (LDL) cholesterol particles become smaller and denser with excess sugar in your system, Birkholz said. “If you have a large number of these more dangerous small, dense LDL particles, there’s a higher likelihood you may have insulin resistance,” she said. Increasing evidence shows that too much sugar causes cholesterol and inflammation problems that lead to heart disease, she said.

If you have insulin resistance, Birkholz recommends taking the same steps encouraged to treat pre-diabetes — getting more exercise, losing at least 5 percent of your body weight, consuming less sugar and fewer processed foods, and eating more foods in their natural, original state.

Karla Birkholz, M.D., a family physician and the wellness medical director for HonorHealth, says exercise is key in helping to prevent or at least delay the onset of diabetes. She recommends 30 minutes of exercise five days a week and to move at least a few minutes every hour. “Just sitting for a period of time and not using your muscles can raise your risk of insulin resistance,” she said.

DIABETES, continued on page 5

GLAUCOMA, continued on page 5

Tips to manage glaucoma Learn about your medication including name, dosage and frequency Report any side effects or problems to your eye doctor Incorporate your medication into your daily routine — try not to miss a dose Maintain appointments and write down questions for your doctor Keep eyes clean and healthy by avoiding irritants such as cosmetics Protect eyes during swimming and yard work Stay healthy with a well-balanced diet and regular exercise

Loss of toes, feet or legs

Source: Glaucoma Research Foundation More info: glaucoma.org; 800-826-6693 Thinkstock

WE HONOR

Scottsdale Healthcare and John C. Lincoln Health Network are now HonorHealth.

HonorHealth.com

Your commitment to wellness.

Your unique health needs.

Your busy schedule.

Your questions and concerns.

Your right to feel empowered about healthcare.

Making healthcare easier to navigate.

We are making healthy personal.

2 | Livingwell a-z | Wednesday, July 1, 2015

The colon Ascending, descending, transverse: the colon is a complex, important organ

By Debra Gelbart

Y

COLONOSCOPY

our colon is a six-foot-long, flexible tube-like organ that frames the small intestine across much of the abdomen.

Anatomically, your ascending colon is positioned along the right side of your abdomen, the transverse colon travels across the top of your abdomen, the descending colon snakes down the left side and the sigmoid colon is the last part of the colon before it joins with the rectum.

While some folks don’t like to talk about the colon, if it’s not functioning well, you will probably feel miserable.

Tips for a healthier colon

For a healthier colon, Fein said, take these three steps: Eat more fiber Drink more water Stop worrying if you don’t have a bowel movement every day “It’s completely normal not to ‘go’ every day,” Fein said. “What can be concerning is if your pattern changes.”

Tell your doctor, he advised, if you’re suddenly going noticeably less or more often than what’s normal for you over a period of a couple of weeks, or if the appearance of the stool changes significantly. “But there’s simply no need to worry about frequency, as long as you feel fine,” he said.

Get screened One way to ensure your colon is healthy — especially if you’re age 50 or older — is to get a screening colonoscopy at least once every 10 years or more often as directed by your doctor. A screening colonoscopy doesn’t just alert a doctor to the possible COLON presence of cancer. It actually prevents cancer through removal of pre-cancerous polyps, said Jeffrey Fein, M.D., a gastroenterologist with Banner Medical Group.

Many people forget how much more common colon cancer used to be in the days before colonoscopies were routine, Fein RECTUM said. According to the American Cancer COLONOSCOPE Society and the National Cancer Institute, the number of cases of colon cancer in the U.S. has dropped from nearly 149,000 in 2008 to fewer than 133,000 expected this Above: During a colonoscopy, the doctor inserts a year. A decade ago, “I found colon cancer in colonscope into the anus and slowly guides it through patients often. Now, I go months without the rectum into the colon. finding any in patients,” he said.

Problems and ailments Cancer isn’t the only potential problem with the colon. Another common condition, especially for older adults, is diverticulosis, said Fein and Sushil Pandey, M.D., an independent colorectal surgeon affiliated with Abrazo Arrowhead Campus in Glendale.

Someone who has diverticulosis has pockets or ‘potholes’ in the walls of the colon, Fein explained, and these are often caused by a lack of fiber in the diet. Up to

Livingwella-z

80 percent of people over age 80 may have diverticulosis, Pandey said, adding that up to 20 percent of people with diverticulosis may develop diverticulitis, an infection or inflammation of the pockets.

Diverticulosis usually is asymptomatic, Pandey said, but it also may cause abdominal pain or change of bowel habits.

Consuming plenty of fiber and water can help ease symptoms, Fein said, but avoiding nuts and seeds is not necessary if you have

July 2015 | Vol. 5, No. 7

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.

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.

ANUS

diverticulosis. “That’s old advice,” he said.

“We now know that nuts and seeds have no negative effect on diverticulosis.”

COLON Irritable Bowel Syndrome (IBS) is another common ailment, characterized by constipation or diarrhea — or alternating bouts of both — and associated with COLITIS bloating and abdominal pain. “With IBS, there’s no obstruction or blockage in the GI (gastrointestinal) tract like there can be with other conditions,” Fein said. “There’s typically no weight loss and no bleeding.”

HEALTHY But for IBS sufferers, life can be chalThinkstock lenging. “Probiotics, a high-fiber diet and decreasing stress may help to ease the Diverticular colitis is a particular pattern of active chronic inflammation in the colon affected by diverticular disease. symptoms of IBS,” Pandey said.

DIVERTICULAR COLITIS

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Wednesday, July 1, 2015 | Livingwella-z | 3

Pens, pencils and immunizations Back-to-school shopping should include a trip to a pediatrician or health clinic

By Gremlyn Bradley-Waddell

S

ince it will soon be time to start backto-school shopping, Jessica Rigler said that while families are stocking up on pencils, crayons and notebooks, they should get those other items essential for a good school year: vaccinations.

“Good for everyone” “Shots protect children from infectious disease, they can help save lives and they protect the community because they reduce the likelihood of an outbreak in the state,” said Rigler, who is bureau chief at the Bureau of Epidemiology and Disease Control at the Arizona Department of Health Services in Phoenix. “That’s good for everyone.”

Vaccination schedules vary according to age with shots being especially important for children entering kindergarten and sixth grade, Rigler said. Parents of soon-to-be kindergartners also have the option of beating the back-to-school rush at the pediatrician’s office because their kids’ shots can be given as early as four-years-old, she said.

Plenty of options While the doctor’s office is the usual venue in which to receive vaccinations, there are other options including area pharmacies as well as free and low-cost clinics. Rigler said required vaccines are supposed to be covered without an insurance company co-pay, but since every family’s situation is different, she advises folks to plan in advance if cost might be an issue.

In case you’re wondering, Arizona parents do a highly commendable job when it comes to getting their kids vaccinated, Rigler said. Coverage levels throughout the state for school-required vaccinations hover around the 95-percent rate, and the Arizona Department of Health Services has started tracking coverage rates by school.

Exemptions That said, there are families who choose to opt out of immunizations either through a medical exemption — which is typically requested when a child is receiving treatment for cancer or has a compromised immune system — or a personal belief exemption which may be requested for many reasons, including a family’s belief that vaccinations may be linked to health concerns.

Rigler urges all parents and caregivers to

Arizona school immunization requirements, K-12 Under age 7

7 – 10 years

11 years and older

Vaccine

Kindergarten and above

Kindergarten through 5th grade

6th grade through 12th grade

DTap: Diphtheria, tetanus and pertussis (whooping cough).

Proof of DTP or DT counts toward DTaP requirement.

Four-five doses At least one dose at 4 years of age or older is required. A sixth dose is required if five doses have been given before 4 years of age.

Three DTaP and/or Td doses are required if all doses were given after 12 months of age.

One Tdap dose is required for students 11 years and older.

— or — Four DTaP and/or Td doses are required if any of the doses were received before 12 months of age.

Tdap may be counted to meet the requirements above. Tdap is not required for 11-year-olds until they enter sixth grade.

Td: Tetanus, diphtheria

Students who completed the primary series of tetanus/diphtheria doses must receive a Tdap when five years have passed since the student’s last tetanus/diphtheria dose.

Students who did not complete the primary series of tetanus/diphtheria doses before age 11 are required to receive a total of three doses, including one Tdap and two Td doses.

Tdap doses given prior to age 11 meet the requirement. A Td booster is required 10 years after the Tdap dose.

Tdap: Tetanus, diphtheria and pertussis Meningococcal: Meningitis

Not required but may be counted as valid when given at this time.

One dose is required.

Polio

Three-four doses. Four doses meet the requirement. Three doses meet requirements if the third dose was given at 4+ years of age. (Not required for students 18+ years of age.)

MMR: Measles, mumps, rubella (German measles)

Two doses. A third dose will be required if the first dose was given before more than four days before the first birthday.

Hepatitis B

Three doses. A fourth dose will be required if the third dose was given before 24 weeks of age.

Varicella: Chickenpox

One dose is required if the first dose was given before 13 years of age.

Two doses are required if the first dose was given at 13 years of age or later.

Students attending school or preschool in Arizona prior to Sept. 1, 2011, with parental recall of chickenpox disease are allowed to continue attendance with parental recall of disease. Students enrolling for the first time after Sept. 1, 2011, are required to present proof of varicella immunization or a valid exemption for medical reasons, laboratory evidence of immunity or personal beliefs.

Adapted from and used with permission of the Arizona Department of Health Services; azdhs.gov/phs/immunization/school-childcare/requirements.htm; 602-364-3630 | Thinkstock

“As a parent myself, I certainly understand that you want to do the best thing for your children, but I want to be clear: the science has demonstrated that vaccines are safe.”

—Jessica Rigler, Bureau Chief, Bureau of Epidemiology and Disease Control, Arizona Department of Health Services

do some research into the issues themselves and check the credibility of any sources.

Vaccines are safe “As a parent myself, I certainly understand that you want to do the best thing for your children, but I want to be clear: the science has demonstrated that vaccines are safe,” Rigler said.

And one more thing: if your child’s afraid or squeamish about getting shots, remind him or her that they could get really, really sick without them.

“Especially when you’re speaking with older kids, let them know that some of these diseases we vaccinate against can be really terrible,” she said. “So this little ‘pin prick’ is really not that big of a deal.”

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More info ARIZONA IMMUNIZATION PROGRAM OFFICE AT THE ARIZONA DEPARTMENT OF HEALTH SERVICES azdhs.gov/phs/immunization; 602-364-3630 ARIZONA PARTNERSHIP FOR IMMUNIZATION WhyImmunize.org; 602-288-7568 CENTERS FOR DISEASE CONTROL AND PREVENTION cdc.gov; 800-CDC-INFO (800-232-4636) TTY: 888-232-6348

4 | Livingwell a-z | Wednesday, July 1, 2015

JULY 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 COOKING FOR HEALTH Various dates, times & locations

By Cancer Support Community 602-712-1006; rsvp@cscaz.org

GRIEF SUPPORT July 14 & 28, 3–4:30 p.m.

By Hospice of the Valley Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com

PAIN INTRO TO FIBROMYALGIA July 1, 8, 15, 22 & 29, 5:30–6:30 p.m.

Fibromyalgia Wellness Center 8300 N. Hayden Rd., Scottsdale 480-948-4955; FibroWellnessCenter.com

WALKING GROUP Various dates & locations

By Humana; 480-325-4707 HEALTHY EATING OUT July 1, noon–1 p.m.

Humana Guidance Center 5943 E. McKellips Rd., Mesa 480-325-4707

CHRONIC PAIN SUPPORT July 8, 6:30–8 p.m.

Scottsdale Senior Center 10440 E. Via Linda, Scottsdale 480-314-2330; TheACPA.org

HEALTHY COOKING FOR CANCER July 15 & 29, 9–10 a.m.

By Cancer Support Community Sun Health Center for Health and Wellbeing 14719 W. Grand Ave., Surprise Register: 623-207-1703; rsvp@cscaz.org

HEART/STROKE STROKE CHECK Various dates, times & locations 480-882-4636; HonorHealth.com MENDED HEARTS SUPPORT July 2, 6:30–8 p.m.

Deer Valley Medical Center 19841 N. 27th Ave., Phoenix 602-879-1800; HonorHealth.com

CAREGIVERS CAREGIVERS SUPPORT Various dates, times & locations

By Duet; 602-274-5022; DuetAZ.org

STROKE SURVIVOR SUPPORT July 9, 2:30–4 p.m.

Dignity Health Chandler Regional 1955 W. Frye Rd., Chandler 480-728-5414

CAREGIVERS SUPPORT July 8, 2:30 p.m.

Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) MVMedicalCenter.com

STROKE SUPPORT July 15, 1 p.m.

Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) MVMedicalCenter.com

CAREGIVERS SUPPORT July 13 (for time: 602-406-6688) St. Joseph’s Outpatient Rehab 114 W. Thomas Rd., Phoenix

STROKE CAREGIVERS SUPPORT July 23, 2:30–3:30 p.m.

Dignity Health Mercy Gilbert 3555 S. Val Vista Dr., Gilbert 480-728-5414

CAREGIVERS SUPPORT July 17, 9–11 a.m.

By Benevilla; 623-584-4999 16752 N. Greasewood St., Surprise

GRIEF SUPPORT

WOMEN

GRIEF SUPPORT GROUPS Various dates, times & locations

By Banner Hospice Rev. Cindy Darby, cindy.darby@BannerHealth.com 480-657-1167; BannerHospice.com

MULTIPLE SCLEROSIS SUPPORT July 25, 10 a.m.

St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 480-829-6563

GRIEF SUPPORT Various dates & times Dignity Health St. Joseph’s 350 W. Thomas Rd., Phoenix 602-406-3275

DIABETES COOKING FOR PRE-DIABETES July 1, 10–11:30 a.m.

Humana Guidance Center 5943 E. McKellips Rd., Mesa 480-325-4707

GRIEF SUPPORT Various dates, times & locations

By Hospice of the Valley HOV.org/Grief-Support-Groups 602-530-6970

DIABETES SUPPORT July 13, 3 p.m.

Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) MVMedicalCenter.com

PREGNANCY & INFANT LOSS July 2, 6–8 p.m.

Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-3878; HonorHealth.com

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

VARIOUS DATES & TIMES

CHILD LOSS SUPPORT July 20, 6–8 p.m.

Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-3878; HonorHealth.com

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)

MANAGING TYPE 2 DIABETES WHAT: Information and tools to help you adopt healthy lifestyle habits and effectively manage diabetes.

WHERE: Rome Towers, 1760 E. Pecos Rd., Gilbert WHEN: Daytime and evening classes PRESENTED BY: Dignity Health Mercy Gilbert Medical Center COST: Covered by most insurance including Medicare INFO/REGISTER: 480-728-3535

JULY 1, 8, 15, 22 & 29 MOMS ON THE MOVE WHAT: Social interaction, support and practical information for moms and their babies up to 12 months old.

WHERE: Scottsdale Osborn Medical Center, 3624 N. Wells Fargo Ave., Scottsdale WHEN: 1–2:30 p.m.

PRESENTED BY: HonorHealth COST: Free INFO/REGISTER: 623-580-5800; HonorHealth.com/Events

JULY 7, 14, 21 & 28 MOMS ON THE MOVE WHAT: Social interaction, support and practical information for moms and their babies up to 12 months old.

WHERE: Scottsdale Shea Medical Center, 9003 E. Shea Blvd., Scottsdale WHEN: 11 a.m.–12:30 p.m.

PRESENTED BY: HonorHealth COST: Free INFO/REGISTER: 623-580-5800; HonorHealth.com/Events

JULY 8 SMOKING CESSATION SEMINAR WHAT: Tips and guidance on the most successful ways to quit smoking.

WHERE: Humana Guidance Center, 5943 E. McKellips Rd., Mesa WHEN: 10–11 a.m.

PRESENTED BY: Humana COST: Free INFO/REGISTER: 480-325-4707

JULY 8 CLINICAL TRIALS 101 WHAT: Learn how clinical trials operate and how they can benefit you and contribute to a cure or prevention.

WHERE: Banner Sun Health Research Institute, 10515 W. Santa Fe Dr., Sun City WHEN: 2–3:30 p.m.

PRESENTED BY: Banner Sun Health Research Institute COST: Free INFO/REGISTRATION: Registration required; 623-832-3248

INFO/REGISTER: 877-924-WELL (9355); MVMedicalCenter.com

JULY 9

MENOPAUSE SUPPORT & EDUCATION WHAT: Information and support for women experiencing premenopausal or menopausal symptoms.

WHERE: Scottsdale Shea Medical Center, 9003 E. Shea Blvd., Scottsdale WHEN: noon–1 p.m.

PRESENTED BY: HonorHealth COST: Free INFO/REGISTER: 480-323-3663; HonorHealth.com/Events

EAST VALLEY ADULT RESOURCES WHAT: Learn about senior programs designed to keep you active and well.

WHERE: Mountain Vista Medical Center, 1301 S. Crismon Rd., Mesa WHEN: noon PRESENTED BY: Gene Van Den Bosch, project director of the Retired Senior Volunteer Program for East Valley Adult Resources, Inc. COST: Free INFO/REGISTER: 877-924-WELL (9355); MVMedicalCenter.com

JULY 13 KNOW THE 10 SIGNS OF ALZHEIMER'S WHAT: Learn about the typical changes in aging versus a sign of concern.

WHERE: Deer Valley Senior Center, 2001 W. Wahalla Lane, Phoenix WHEN: 10:30–11:30 a.m.

PRESENTED BY: Alzheimer's Association, Desert Southwest Chapter COST: Free INFO/REGISTER: 602-528-0545; mburruel@alz.org

JULY 15 DEMENTIA DIALOGUE WEBINAR TOPIC: UNDERSTANDING PSYCHOSIS WHAT: Experts offer a monthly online seminar on various topics related to dementia.

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

JULY 16 MAXIMIZE YOUR DOCTOR'S VISIT WHAT: How to prepare for a doctor’s visit, what to ask and communication techniques.

WHERE: Mountain Vista Medical Center, 1301 S. Crismon Rd., Mesa WHEN: 9–11 a.m.

PRESENTED BY: Humana COST: Free

JULY 20

JULY 21 SAFETY & SECURITY FOR SENIORS WHAT: Tips on keeping safe in your home, online and in the community.

WHERE: Mountain Vista Medical Center, 1301 S. Crismon Rd., Mesa WHEN: noon PRESENTED BY: Mesa Police Department COST: Free INFO/REGISTER: 877-924-WELL (9355); MVMedicalCenter.com

JULY 23 & 30 LIVING WITH MIDDLE-STAGE ALZHEIMER'S WHAT: Helpful strategies to provide safe, effective and comfortable care.

WHERE: Holy Trinity Church, 739 W. Erie St., Chandler WHEN: 10 a.m.–noon PRESENTED BY: Alzheimer's Association, Desert Southwest Chapter COST: Free INFO/REGISTER: 602-528-0545; mburruel@alz.org

JULY 24 MOTHER-TO-MOTHER SUPPORT GROUP WHAT: For new and expecting mothers who are feeling depressed, anxious, overwhelmed or disconnected.

WHERE: Dignity Health St. Joseph’s, 350 W. Thomas Rd., Phoenix WHEN: 10–11:30 a.m.

PRESENTED BY: Dignity Health St. Joseph’s COST: Free INFO/REGISTER: 877-602-4111 MOMS ON THE MOVE: Social interaction, support and practical information for moms and their babies up to 12 months old. Held on various dates at Scottsdale Osborn Medical Center and at Scottsdale Shea Medical Center.

ALZHEIMER’S/DEMENTIA

GRIEF BEFORE LOSS July 8, 15, 22 & 29, 2–3 p.m.

Benevilla; 623-584-4999 16752 N. Greasewood St., Surprise

ALZHEIMER’S CAREGIVERS SUPPORT Various dates, times & locations

By Alzheimer’s Association Desert Southwest Chapter 602-528-0545; ALZ.org/DSW

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WIDOW/WIDOWER SUPPORT July 9, 10 a.m.

Various locations 480-563-2402; SanteCares.com

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

ALZHEIMER’S & MEMORY SUPPORT July 3, 9–11 a.m.

By Benevilla; 623-584-4999 16752 N. Greasewood St., Surprise ALZHEIMER’S & MEMORY SUPPORT July 7, 14, 21 & 28, 10 a.m.–noon

By Benevilla at Faith Presbyterian Church 16000 N. Del Webb Blvd., Sun City 623-584-4999

CAREGIVERS SUPPORT July 7 & 21, 12:30–2 p.m.

Duet, 555 W. Glendale Ave., Phoenix 602-274-5022; DuetAZ.org ALZHEIMER’S SUPPORT July 7, 2 p.m.

Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) MVMedicalCenter.com ALZHEIMER’S SUPPORT July 9, 11 a.m.–12:30 p.m.

Dignity Health Huger Mercy Center 2345 W. Orangewood Ave., Phoenix Lunch provided; 602-406-5600 PLANNING AHEAD FOR CAREGIVERS July 15, 2–4 p.m.

Banner Sun Health Research Institute 10515 W. Santa Fe Dr., Sun City Register: 623-832-3248 DIRECTIONS FOR CAREGIVERS July 24, 1–2:30 p.m.

Banner Sun Health Research Institute 10515 W. Santa Fe Dr., Sun City Register: 602-832-3248

BREAST CANCER BOSOM BUDDIES SUPPORT GROUPS Various dates, times & locations Ahwatukee/Chandler: 602-739-8822; 602-318-8462 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 CIRCLE OF HELP ADVANCED BREAST CANCER Meets as needed Info: Becky Chase, 623-236-6616; Teresa Hill, AdvancedBreastCancer@gmail.com BREAST CANCER SUPPORT July 9 & 23, 6–8 p.m.

Breast Health and Research Center 19646 N. 27th Ave., Phoenix 623-780-4673; HonorHealth.com BREAST CANCER SUPPORT July 11, 10 a.m.–noon Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com BREAST BUDS SUPPORT July 18, 11 a.m.–1 p.m.

MidFirst Bank Conference Room 6508 W. Bell Rd., Glendale 480-657-0500; BreastBuds.org

BRAIN/NEUROLOGICAL YOUNG ADULT BRAIN INJURY July 8, 6–7:30 p.m.

St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 602-996-1396; 602-406-6688 BRAIN ANEURYSM SUPPORT July 15, 6–8 p.m.

St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix Kimberly@JoeNiekroFoundation.org 760-333-7658 PROGRESSIVE SUPRANUCLEAR PALSY SUPPORT July 18, 1:30–3:30 p.m.

Banner Thunderbird 5555 W. Thunderbird Rd., Glendale 602-920-4632; tsebastiani@cox.net HUNTINGTON’S SUPPORT July 20, 6–8 p.m.

St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 602-402-1774 BRAIN INJURY SUPPORT July 23, 6–7:30 p.m.

St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 602-508-8024; 602-406-6688 BRAIN TUMOR SUPPORT July 28, 6–8 p.m.

St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 623-205-6446

SPINAL

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SYRINGO & CHIARI SUPPORT July 11, 11 a.m.–1 p.m.

St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 602-504-0883

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7B4@$= 2' 5#$4<;#& #@ >!B$;45<' <# 1&" 0@;%#&4-> <#! !@#AB>>;#&45>+ 7$@BB&B" 2' <=B /4><5B /#&&#55' !='>;$;4&,5B" @B>B4@$= <B4(. $=#>B& "#$<#@> 4@B &#(;&4<B" 2' <=B;@ !BB@> 4&" !4>> B)<B&>;8B 24$6?@#:&" $=B$6> 4&" $@B"B&<;45 @B8;B*>+ …that pretty much sums it up. For more than 30 years, patients from across The Southwest have turned to Arizona Institute of Footcare Physicians for comprehensive, compassionate and expert care.

Whether you suffer with a new or chronic condition, including bunions, hammertoes, plantar fascitis, heel pain, sports or ankle injuries, nail fungus, ingrown nails or neuropathy, meeting one of our doctors can be an important step closer to a better quality of life.

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Wednesday, July 1, 2015 | Livingwella-z | 5

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

CANCER SUPPORT GROUPS CANCER SUPPORT COMMUNITY SUPPORT GROUPS 360 E. Palm Lane, Phoenix Info: 602-712-1006; rsvp@cscaz.org • CANCER SUPPORT Various dates & times • MULTIPLE MYELOMA July 2, 10–noon • PROSTATE CANCER July 9, 6–7:30 p.m.

• LYMPHOMA July 11, 10–11:30 a.m.

• PANCREATIC CANCER July 11, 10–11:30 a.m.

• CARCINOID July 11, 1–2:30 p.m.

• LUNG CANCER July 11, 1–2:30 p.m.

• COLORECTAL CANCER July 18, 10–11:30 a.m.

• OVARIAN CANCER July 18, 10–11:30 a.m.

• TEEN CANCER July 18, 6–7:30 p.m.

IRONWOOD CANCER & RESEARCH CENTERS SUPPORT GROUPS 685 S. Dobson Rd., Chandler Info: 480-340-4013; IronwoodCRC.com • BREAST CANCER July 13, 2–4 p.m.

• LUNG CANCER July 13, 2–4 p.m.

• PROSTATE CANCER July 14, 7–9 p.m.

• PANCREATIC CANCER July 16, 2–3:30 p.m.

• CAREGIVERS July 18, 10 a.m.–noon • HEAD & NECK CANCER July 20, 3–4:30 p.m.

• METASTATIC CANCER July 22, 3–4:30 p.m.

LYMPHEDEMA SUPPORT July 27, 6–8 p.m.

Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com

PARKINSON’S PARKINSON’S EDUCATION, EXERCISE & SUPPORT GROUPS Various dates, times & locations

By Muhammad Ali Parkinson Center 602-406-3840; 602-406-4921 PARKINSON’S SUPPORT July 21, 3–4 p.m.

Shepherd Hills Methodist Church 13658 W. Meeker Blvd., Sun City West 623-584-4999

GASTROINTESTINAL OSTOMY SUPPORT July 14, 6 p.m.

Elite Home Healthcare Services 2140 W. Greenway Rd., Phoenix 602-246-8221

RESPIRATORY BETTER BREATHERS/ COPD SUPPORT Various dates, times & locations By the American Lung Association 602-429-0005; BreatheEasyAZ.info GET PAST ASTHMA July 10, 6:30–8 p.m.

Deer Valley Medical Center 19841 N. 27th Ave., Phoenix 623-879-5452; HonorHealth.com

PARENTING BREASTFEEDING SUPPORT Various dates, times & locations

By Dignity Health 480-728-5414; 602-406-4954

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

GRANDPARENTS RAISING GRANDCHILDREN Various dates, times & locations

By Benevilla Benevilla.org; 623-207-6016

LOOK GOOD FEEL BETTER

By Ironwood Cancer & Research Centers Various dates, times & locations 480-855-2224; IronwoodCRC.com

T.E.E.N.S. 4 TEENS SUPPORT (FOR PREGNANT TEENS & NEW TEEN MOMS) July 2, 9, 16, 23 & 30, 6–7 p.m.

Dignity Health Chandler Regional 1875 W. Frye Rd., Chandler 480-728-5414

CANCER SURVIVOR SUPPORT July 1, 5:30–6:30 p.m.

Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com NON-HODGKIN’S LYMPHOMA SUPPORT July 9, 6–8 p.m.

Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com LIVING WITH LOSS July 14 & 28, 1–2:30 p.m.

By Cancer Support Community 360 E. Palm Lane, Phoenix Register: 602-712-1006; rsvp@cscaz.org SURVIVING & THRIVING July 14 & 28, 1–2:30 p.m.

By Cancer Support Community 360 E. Palm Lane, Phoenix Register: 602-712-1006; rsvp@cscaz.org PANCREATIC CANCER SUPPORT July 14, 4–5:30 p.m.

Virginia G. Piper Cancer Center 10510 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com CAREGIVERS & FAMILY SUPPORT July 15, 6:30–8 p.m.

Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com ORAL, HEAD & NECK CANCER July 16, 6:30–8:30 p.m.

Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com LOOK GOOD FEEL BETTER July 27, 5:30–7:30 p.m.

Banner Desert Cancer Center 1400 S. Dobson Rd., Mesa Register: 602-230-2273

BREASTFEEDING SUPPORT July 6, 13, 20 & 27, 1 p.m.

Banner Estrella 9201 W. Thomas Rd., Phoenix 602-230-2273 POSTPARTUM DEPRESSION SUPPORT July 8, 15, 22 & 29, 1–2:30 p.m.

Dignity Health Mercy Gilbert 1760 E. Pecos Rd., Gilbert 480-728-5414 INFANT BRAIN DEVELOPMENT CLASS July 11, 9 a.m.–1 p.m.

Tempe St. Luke’s 1500 S. Mill Ave., Tempe Register: 480-784-5588 POSTPARTUM DEPRESSION SUPPORT July 20, 9:30–11:30 a.m.

Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-3878; HonorHealth.com

SENIORS SENIOR EDUCATION CONNECTION July 16, 1–2 p.m.

Fellowship Square Mesa 35 W. Brown Rd., Mesa 480-290-7025; AZFS.org

BARIATRIC SURGERY SEMINARS BANNER HEALTH BannerHealth.com; 480-543-2606 HONORHEALTH BariatricSurgeryAZ.com; 480-882-4636 ST. LUKE’S MEDICAL CENTER BridgesAZ.com; 800-248-5553

Diabetes continued from the cover While there isn’t a guarantee that lifestyle changes will prevent diabetes if you’re diagnosed with pre-diabetes, there is a “100 percent chance that if you do nothing, the condition will progress to diabetes,” Leman said.

Foot problems Some patients may be unaware of the serious health risks and complications that can arise as a result of diabetes, with some of the biggest concerns being foot and nerve damage. While these issues can be debilitating, there are ways to potentially prevent or at least lower the risk of such complications from occurring.

When it comes to feet, a sore, crack in the skin or even a blister can progress very rapidly to an infection that can spread up the leg and to the bone, said John Tassone, D.P.M., podiatrist at Thunderbird Internal Medicine Karla Birkholz, M.D., wellness medical director for HonorHealth, meets with dietician Debbie Richmond at in Glendale. “The tendons and the tissues in the legs act as pathways for the HonorHealth Wellness Center in Glendale. the infection, allowing it to spread rapidly,” he said.

Diabetes and Alzheimer’s Because of possible numbness and poor circulation, patients sometimes Diabetes may be contributing to the increasing numbers of Americans aren’t even aware that a foot injury afflicted with Alzheimer’s disease and other forms of dementia, says a or deep wound occurred until there researcher at the Barrow Neurological Institute in Phoenix. is bleeding or fluid drainage. This can “I am not aware of any studies suggesting that pre-diabetes is a risk factor for cause a delay in treatment, which in Alzheimer’s. However, many studies have found that people with diabetes, turn, can lead to serious complications. especially Type 2 diabetes, have a lower level of cognitive function and are In extreme circumstances, an at a higher risk of dementia including Alzheimer’s,” said Elliott Mufson, PhD, infection might not heal and ampudirector of the Alzheimer's Disease Research Laboratory and professor in the tation may be required. In 2010, Department of Neurobiology and Neurology at Barrow Neurological Institute. the American Diabetes Association “Type 2 diabetes is a relative insulin deficiency related to uncontrolled insulin reported 73,000 non-traumatic lowerresistance. While I would hesitate to give odds on getting Alzheimer’s disease, limb amputations were performed the risk is greatly increased for those with Type 2 diabetes. If you are prein adults diagnosed with diabetes. diabetic, follow your doctor’s orders. Preventing the onset of Type 2 diabetes “It’s critical for diabetics to pay can only help.” attention to and protect their feet Two recent studies concluded that blood-sugar levels can affect the brain, with the right pair of shoes,” Tassone providing new evidence of the link between diabetes and Alzheimer’s disease, said. “This, along with addressing said Mufson, who has spent his career studying the causes of the disease. any issues quickly with a healthcare provider, can prevent a lot of problems.”

Nonalcoholic steatohepatitis (NASH)

Nerve damage Nearly half of all people with diabetes have neuropathy — or nerve damage — according to the American Diabetes Association.

“Diabetic neuropathy is a diminished sensation or complete loss of feeling typically experienced in feet or hands,” said Mandeep Brar, M.D., medical director for Abrazo Diabetes Care Center. “It doesn’t always stop there.

The nerves that supply the stomach and heart can also be affected.”

Retinopathy occurs when chronically elevated blood sugar damages the retina in the eye, Brar said. “It causes bleeding in the back of the eye which can significantly impair vision,” she said. However, Brar noted that with treatment and effectively controlling blood sugars, “we can usually stop further damage of neuropathy and other complications associated with diabetes.”

Researchers at The University of Arizona College of Pharmacy have discovered that nonalcoholic steatohepatitis (NASH), an increasingly common but often undiagnosed liver disease, could have significant medical implications for people with Type 2 diabetes.

People develop NASH when early liver disease, characterized by too much fat in the liver, is exacerbated by inflammation. Obesity is thought to contribute to the development of NASH. The disease has no symptoms that most people notice and since testing for it requires a needle biopsy of the liver, it often goes undetected. Current estimates indicate that between 6 percent and 17 percent of Americans have NASH. John Clarke, PhD, research associate, and Nathan Cherrington, PhD, professor, both of the college’s Department of Pharmacology and Toxicology, recently published a study in the journal Diabetes showing that a mouse model of obesity, diabetes and NASH retained the anti-diabetic drug metformin longer than a control group of healthy mice. The study found that NASH can change the way drugs are eliminated from the body, potentially leading to toxic levels of metformin being retained in the body.

The researchers say that the next step is to continue the investigation to demonstrate the metformin-retention phenomenon in human patients with Type 2 diabetes. This study may lead to individual treatment strategies, where patients get the appropriate dose of metformin based on their ability to metabolize and eliminate the drug.

Source: The University of Arizona College of Pharmacy, Tucson

Glaucoma continued from the cover people usually lose peripheral vision at such a slow rate that it isn’t normally noticeable, Lewis said. “Since there are no changes to central vision, it is often ignored,” he added.

Experts say the progression of the disease can span as long as a decade before any symptoms occur. If left untreated, damage to the optic nerve in the late stages of glaucoma cannot be restored and can ultimately lead to vision loss and blindness.

National Eye Institute, National Institutes of Health/nei.nih.gov/glaucoma

Consistent treatment If glaucoma is detected, further testing should be done to determine the severity of the disease.

“There are a range of therapies for treatment depending on the stage of glaucoma including medication, in-office laser procedures and surgical options,” said Neil Atodaria, M.D., an ophthalmologist at Barnet Dulaney Perkins Eye Centers.

“There are two main pathways for treatment that include opening up the drain or creating a new drain in the eye, and reducing fluid production, both of which help to lower eye pressure.”

While there is no cure for glaucoma, advanced treatment can significantly slow the progression of the disease, but patients need

to be compliant with their doctor’s treatment regimens.

“Patients with glaucoma usually feel fine and often don’t notice improvement with ongoing treatment,” Atodaria said. “It’s imperative for us to treat patients during the early stages of glaucoma to avoid permanent vision loss and blindness.”

a-z H E A LT H C A R E N E W S B R I E F S Abrazo Community Health Network Abrazo Health recently changed its name to Abrazo Community Health Network. Along with the system name change, there are also changes to Abrazo’s hospital and emergency center names as follows: MORE INFO: AbrazoHealth.com

ABRAZO BUCKEYE ABRAZO ARIZONA HEART HOSPITAL ABRAZO MARYVALE CAMPUS Prior name: Maryvale Hospital EMERGENCY CENTER Prior name: Arizona Heart Hospital Location: 5102 W. Campbell Ave., Phoenix Prior name: West Valley Emergency Location: 1930 E. Thomas Rd., Phoenix Center ABRAZO SCOTTSDALE CAMPUS ABRAZO ARROWHEAD CAMPUS Location: 525 S.Watson Rd., Buckeye Prior name: Paradise Valley Hospital Prior name: Arrowhead Hospital Location: 3929 E. Bell Rd., Phoenix ABRAZO PEORIA Location: 18701 N. 67th Ave., Glendale EMERGENCY CENTER ABRAZO WEST CAMPUS ABRAZO CENTRAL CAMPUS Prior name: North Peoria Emergency Prior name: West Valley Hospital Prior name: Phoenix Baptist Hospital Center Location: 13677 W. McDowell Rd., Location: 2000 W. Bethany Home Rd., Location: 26900 N. Lake Pleasant Pkwy, Goodyear Phoenix Peoria

6 | Livingwell a-z | Wednesday, July 1, 2015

Sun(screen) smarts Protect yourself the right way from the sun’s damaging rays

By Gremlyn Bradley-Waddell

I

t’s July in Arizona – do you know where your sunscreen is?

If you’re heading outdoors for even a short time, it should already be applied to any exposed skin. And as you probably know by now, the experts say you really should wear sunscreen year-round — especially if you live in Arizona — and not just in summer.

Being that it’s pool season and a time when so many folks are enjoying the state’s many outdoor offerings, let’s brush up on some of the basics of sunscreens and other types of sun protection.

TERMINOLOGY: Sunscreen terminology can be a little daunting, but don’t let that scare you from buying a bottle. Matthew Roach, climate and health program manager at the Arizona Department of Health Services in Phoenix, said SPF refers to a product’s sun protection factor, or how well a sunscreen works from keeping the sun’s rays from “roasting your skin.”

Both Roach and Xuan Nguyen, M.D., chief of dermatology at Maricopa Medical Center’s Comprehensive Health Center in Phoenix, said to choose a sunscreen with an SPF of at least 15 — although Nguyen said she reaches for at least an SPF of 30, noting SPF 15 sunscreens aren’t as plentiful anymore.

When choosing a sunscreen, Roach said that a super-high SPF number doesn't necessarily mean you’re getting that much higher level of protection. In fact, products with an SPF of 45 or higher are going to provide only slightly more protection than those with an SPF of 30.

Also, choose a product labeled as having “broad spectrum” protection, which means it protects against the sun’s UVA (ultraviolet A) and UVB (ultraviolet B) rays, Nguyen said. UVA rays are associated with tanning, premature aging of the skin, and basal and non-melanoma skin cancers, while UVB rays — which don’t penetrate the skin as deeply — are linked more with sunburns and melanoma skin cancer. What’s more, Roach added, not all sunscreen products have the same ingredients, “so you have to find the one that works for you.”

APPLICATION: What’s just as important as SPF is how you wear the sunscreen. “You

The artwork of Jennifer Villa, a seventh-grade student in teacher Lucia Bigelow's class at Calabasas Middle School in Rio Rico, snagged her the grand prize in the "Be SunWise and Play Sun Smart" poster contest sponsored by the Arizona Department of Health Services. Artwork used with permission of the Arizona Department of Health Services. may put on an SPF of 45, but the way some people put it on, it may only be giving you an SPF of 30,” Nguyen said.

In general, she explained, there are two types of sunscreens: physical blockers, which deflect the sun’s rays and include zinc oxide or titanium dioxide, and chemical absorbers, which absorb the rays and include avobenzone. Whichever type you use, if it’s in a cream form, you should gently coat the skin — rather than rubbing the product into the skin — and apply it at least 30 minutes before heading outside.

If the sunscreen is in spray form, take time to make sure your skin’s getting coated. “Lots of parents prefer the sprays, but you have to make sure it sticks,” Nguyen said. No matter if you use a spray or a

Cosmetic surgery Latest procedures for the face, skin and body

By Meghann Finn Sepulveda

C

osmetic surgery is on the rise with more than 15 million procedures performed in the U.S. in 2013, up 3 percent from the previous year, according to the American Society of Plastic Surgeons. From minimally invasive procedures like BOTOX® injections and facial fillers to surgical transformations such as breast augmentation and liposuction, more Americans are opting for cosmetic surgery to not only boost confidence but also to attempt to slow the aging process.

Plastic vs cosmetic A plastic surgeon is a physician who specializes in the repair, reconstruction or replacement of physical defects of form or function of the skin and body, as defined by the American College of Surgeons.

Meanwhile, cosmetic surgeons may or may not be plastic surgeons. Cosmetic surgery is not recognized as a specialty of medicine by the American Board of Medical Specialties because it crosses over several other specialties such as plastic surgery, dermatology and ophthalmology. In addition, cosmetic surgery is not traditionally covered under most health insurance plans.

“A cosmetic surgeon can legally be any licensed physician with training in any area of medicine from gynecology to cardiology,” said Susan Van Dyke, M.D., a board-certified cosmetic dermatologist at Van Dyke Laser & Skin in Paradise Valley. “Patients should become familiarized with the training and qualifications of the physician and learn about the types of procedures that have been performed.”

Various procedures Today many traditional cosmetic surgical procedures and non-invasive techniques are available to improve and enhance appearance, increase sexual function and reverse some of the cosmetic effects of aging.

“Our body affects the way we feel about ourselves,” said Steven Gitt, M.D., founder and medical director of North Valley Plastic Surgery. “We perform approximately six to 10 cases of breast augmentations and ‘mommy makeovers’ per week for women following childbirth.”

Gitt is also pioneering innovative ways to increase sexual function for men and women by using advanced medical

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More info ARIZONA MEDICAL BOARD azmd.gov; 480-551-2700 technology. “We recently introduced a revolutionary procedure to relieve the problems of painful intercourse and dryness after menopause as well as stress urinary incontinence for women,” he said.

Identifying risks While significant advances have been made in cosmetic surgery, there are risks including possible anesthesia complications, bleeding and infection.

“Risks with non-invasive cosmetic dermatology procedures are minimal but could include pigment changes and scarring,” Van Dyke said. “In extremely rare cases there have been reports of skin damage and even rarer cases of blindness as a result of injectables and fillers that were not performed properly.”

Choosing a surgeon The Arizona Medical Board recommends that when choosing a surgeon for a cosmetic procedure, patients should thoroughly perform research, evaluate training, verify board certification and assess the physician. Patients should also become educated on every aspect of the procedure including the cost, risks, length of recovery and post-discharge care.

cream, reapply sunscreen at least every two hours, even more frequently if you’re swimming, exercising, perspiring or wiping off sweat with a towel.

TIMING: Roach and Nguyen said sunscreen isn’t the only way to stay safe from the sun. Limiting outdoor exposure between 10 a.m. and 2 p.m. in the summer months (and between noon and 4 p.m. in winter), when the sun is at its most intense, is a wise approach.

Wearing a wide-brimmed hat, sunglasses and a lightweight shirt with sleeves when you do venture out is also a good idea, as is seeking shade whenever possible.

And drink plenty of water and stay out of tanning salons, they added.

Thinkstock

There’s a fungus among us Keeping your toes in tip-top shape against dreaded toenail fungus

By Susan Lynne Fuchs

A

rizona is a haven for all kinds of nasty fungi, including the kind that painlessly turns toenails into a yellow, thick, misshapen mess.

That’s because — like all fungi — toenail fungus spores thrive in dark, damp warmth. And in Arizona, plenty of feet sweat it out day after day in dark, damp shoes creating an environment where fungi flourish.

More than just cosmetic While toenail fungus is unsightly, it’s a lot more than a simple cosmetic issue, said Kerry Zang, DPM, a podiatrist with the Arizona Institute of Footcare Physicians.

Zang is on staff at St. Luke’s Medical Center in Phoenix and Mountain Vista Medical Center in Mesa.

Zang wants people to know that if left untreated — especially in people with diabetes, peripheral arterial disease or hip/knee implants — toenail fungi can lead to dangerous infections that spread to other parts of the body.

This is particularly true for people with debilitating diseases or compromised immune systems, said Phoenix podiatrist Andrew Lowy, DPM. He said that for these folks, a toenail fungus can lead to wounds that won’t heal and then develop into systemic bacterial infections.

Anti-fungal medications However, the good news is that if caught early, simple treatment with a topical anti-fungal medication may take care of the problem. Lowy said that there are also oral anti-fungal medications, “but because they can affect the liver, it’s important to first get liver function studies to be sure the medication is safe for the patient.”

Laser therapy “We also treat toenail fungus with laser therapy,” said Chandler Foot and Ankle Care podiatrist Alan Discont, DPM, who serves as president of the Arizona Podiatric Medical Association.

“Your toenail is layered, rather like the pages of a book, and fungus grows in between the layers,” Discont explained.

“The laser kills the spores that lurk inside the layers.”

Thinkstock

Proper hygiene important

Risk factors

Proper hygiene and regular inspection of the feet and toes are the first lines of defense against fungal nails. To help keep fungus at bay, follow these tips for keeping your toes in tip-top shape: Wash your feet with soap and water, remembering to dry thoroughly Wear shower shoes when possible in public areas Change shoes, socks or hosiery more than once daily Clip toenails straight across so that the nail does not extend beyond the tip of the toe Wear shoes that fit well and are made of materials that breathe Avoid wearing excessively tight hosiery to decrease moisture Wear socks made of synthetic fiber that wicks moisture away from your feet faster than cotton or wool socks do Disinfect instruments used to cut nails Disinfect home pedicure tools Don't apply polish to nails suspected of infection

Factors that can increase your risk of developing nail fungus include: Being older Perspiring heavily Being male Working in a humid or moist environment Wearing socks and shoes that hinder ventilation and don't absorb perspiration Living with someone who has nail fungus Walking barefoot in damp communal areas Having athlete's foot Having a minor skin or nail injury or a skin condition, such as psoriasis Having diabetes, circulation problems or a weakened immune system Source: MayoClinic.org

Source: American Podiatric Medical Association (APMA; apma.org)

Enjoy my favorite

foods again.

Th That’s hat’s ssomething omething to to

Cataract & Glaucoma Surgeon

smile about.

Neil J. Atodaria, MD

AR-0008366208-01

Dr. Atodaria specializes in the diagnosis and treatment of glaucoma and advanced technology cataract surgery. He serves patients in our Phoenix, Mesa, Sun City and Surprise locations. In addition to providing care at Barnet Dulaney Perkins Eye Center, Dr. Atodaria enjoys volunteering his time and expertise for the benefit of those who are less fortunate.

BARNET DULANEY PERKINS EYE CENTER Locations throughout Arizona (602) 955-1000 www.GoodEyes.com

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A graduate of Creighton University School of Medicine, Dr. C. Alan Richardson completed a surgery residency at Maimonides Medical Center/State University of New York and a family medicine residency at University of Wyoming. Dr. Richardson is Board Certified and specializes in all aspects of family medicine from newborn to geriatric care.

Choose Total Freedom dental implants.

• Locally owned and operated by dentists with 20+ years of experience placing and restoring dental implants.

Banner Health Center 17900 N. Porter Road, Maricopa 520-233-2500 www.bannerhealth.com/healthcentermaricopa

• All procedures and labs performed under one roof.

• Competitive pricing without the national overhead.

PEDIATRIC ENDOCRINOLOGY

• State-of-the-art technology.

Alvin Perelman, MD

• Highest quality implants customized to your needs.

A graduate of University of Calgary, Dr. Alvin Perelman completed a pediatric residency and two pediatric endocrinology fellowships - Children’s Hospital and Harbor General Hospital, both in Los Angeles. Dr. Perelman is Board Certified and specializes in diabetes, thyroid conditions, growth and puberty disorders and other pediatric endocrine-related conditions.

AR-0008410064-01

After

• Financing available.

Schedule your FREE consultation today!

Banner Children’s Specialists 8840 E. Chaparral Road, Suite 210, Scottsdale 480-827-5370 www.BannerChildrens.com/ClinicAZEndo

PEDIATRIC NEUROPSYCHOLOGY

480-494-8404 480-907-3922 TotalFreedomImplants.com

Mia Gregor, PhD

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A graduate of University of Michigan and Chicago School of Professional Psychology, Dr. Mia Gregor completed her internship at Vista St. Therese Medical Center in Illinois. She specializes in cognitive effects of traumatic brain injury, epilepsy, in-utero drug and alcohol exposure, tumors and cancer and neurodevelopmental and medical condition-related learning deficits.

9002 East Desert Cove Ave, Suite #101 Scottsdale

FREE

Banner Children’s Specialists 1432 S. Dobson Road, Suite 403, Mesa 480-412-7473 www.BannerChildrens.com/ClinicAZNeuro

consultation with 3D CAT scan ($700 value).

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+

$

500 OFF

any dental implant package.

THE COLOGUARD ÂŽ GUIDE TO

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Use noninvasive Cologuard in the privacy of your home No special preparation 0# >='G #* DGF<=DG" ;=%"B -5)2 #E $#8#% $6%$GDB

Covered by Medicare. Visit CologuardTest.com to learn more.

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Cologuard is a registered trademark of Exact Sciences Corporation. Š2015 Exact Sciences Corporation. All rights reserved. CG-00208-01-March 2015

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