THE ARIZONA REPUBLIC
A SPECIAL PUBLICATION CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING
HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILY
Vol. 3, No. 1
Flexible Spending and Health Savings Accounts
Save money while managing your healthcare costs BY JAKE POINIER
As of the beginning of 2012, more than 13.5 million Americans were using health savings accounts (HSAs), up more than 2 million from the previous year. Meanwhile, more than 85 percent of large employers offer flexible spending accounts (FSAs).
Both account types allow participants to set aside pre-tax dollars to pay for qualified healthcare expenses, but there are key differences. HSAs are available only to employees enrolled in highdeductible health plans (HDHPs), and unused funds can grow like an investment account. FSAs have a ‘use-it-or-lose-it’ provision, meaning unused contributions are forfeited at the end of the plan year, so employees should make sure to budget conservatively. “HSAs not only empower you to make thoughtful healthcare decisions, there are three tax advantages,” said Jeff Stelnik, FSA, MAAA, senior vice president of strategy, sales and marketing for Blue Cross Blue Shield of Arizona. “First, your contributions are pre-tax and reduce your taxable income. Second, the investments you make in the account grow tax-free. Third, withdrawals for qualified expenses are also tax-free.”
Lower contributions While maximum contribution levels rise each year for HSAs (up to $6,450 for a family in 2013), rules on FSAs are getting tighter. “As of January 1, the maximum annual employee contribution is $2,500,” said Stephanie O’Dell, an account executive with MJ Insurance. While employees won’t be able to set aside as much for eligible expenses such as braces, contact lenses, prescriptions and dental procedures, O’Dell emphasized the bright side. “If an employee and spouse are both offered FSAs at their places of work, they may each elect up to the annual maximum amount,” she said.
Educated consumers Many carriers offer online cost estimators that allow you to compare different procedures, facilities and pharmacies. “HSAs aren’t only for high-income or very healthy individuals,” Stelnik noted. “They’re for anyone who wants to take control of how their healthcare dollars get spent.”
Craig Primack, M.D., of Scottsdale Weight Loss Center, explains some of the options for weight loss, including prepackaged meals, meal replacements and more. Some programs offer online support, while others offer in-person counseling, either one-on-one or in group settings. Whatever the plan, experts agree that accountability is key.
Diet decisions, decisions... Picking the right weight loss program depends on your preferences
BY DEBRA GELBART
f you want help losing weight through a commercial weight loss program, you can choose from a portion-control approach where you eat your own food and find emotional support at public meetings and/or online (such as Weight Watchers); prepackaged food programs (such as Jenny Craig and Nutrisystem); or meal replacement programs (such as Optifast and Medifast). You can also choose from plans popularized in books or specialized diets that require supplements and/or following a restrictive regimen, such as the hCG diet. “If you have 20 pounds or less to lose,” said Craig Primack, M.D., of Scottsdale Weight Loss Center, “Weight Watchers or Jenny Craig is a great choice, depending on whether you want to prepare meals yourself or you prefer them ready-made. But if you have more than 20 pounds to lose, you may want or need a more intensive program.”
Jenny Craig, like Nutrisystem, offers portion-controlled prepackaged meals. The Jenny Craig program includes one-on-one counseling; Nutrisystem’s does not. Clients can obtain Jenny Craig products through a weight loss center or through the mail, while Nutrisystem’s products are available only by mail. “These programs are especially good for people who don’t like to cook and who struggle with portion control,” said Lisa Galper, Psy.D., a Scottsdale psychologist who specializes in helping clients get control of their weight.
LisaGalper,Psy.D.,specializesinteachingclasses to help people control their weight. Among other options, smartphone applications help users track their progress and stay in control.
Eliminate diet “saboteurs”: Keep “red light” foods out of the house.
Eat fewer carbohydrates: High amounts of carbs each day (more than 150 grams, or about 600 calories of carbs) promote hunger.
Record what you eat: Mobile apps such as My Fitness Pal, Lose It and Calorie King help you keep track of the foods you eat as well as the amount you exercise.
Get more sleep: Studies have shown that among people who sleep five hours a night or less, 80 percent are overweight.
Stay focused: Focus on making changes, both small and large, that will accumulate into a different lifestyle over the long run.
In-person or online support
Weight Watchers is ideal for those who appreciate an in-person support group that promotes accountability, Galper said. “The members and group leader can help you adjust when you feel stuck,” she said. “They can help you make the plan more sustainable for your lifestyle.” Weight Watchers also has an online program for those who are more comfortable with anonymous sharing or who don’t have time or transportation to attend in-person meetings. Continued on page 3 DIET DECISIONS
tips to help you stay motivated
Resources IRS: irs.gov/pub/irs-pdf/p502.pdf Your employer’s benefits administrator
By y The NUMBERS
Your tax adviser
SMALL NUMBERS CAN ADD UP BIG-TIME:
150 CALORIES MORE A DAY THAN YOU BURN CAN LEAD TO AN EXTRA 5 POUNDS OVER 6 MONTHS OR 10 POUNDS IN 1 YEAR EATING JUST
IN THIS ISSUE:
02: CERVICAL CANCER PREVENTION 03: STOPPING BONE LOSS 04: SELECTING PROPER FITNESS SHOES 04/05: SUPPORT GROUPS, EXPERTS 06: HOPE FOR MIGRAINE SUFFERERS
—PAULA HUBBS COHEN
Source: Department of Health and Human Services, National Heart Blood and Lung Institute; nhlbi.nih.gov/health
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2 | LIVING WELL A-Z | WEDNESDAY, January 2, 2013
Cervical cancer can be prevented Doctors urge women to get screened regularly
nlike the lottery, here’s a situation where the odds are mostly on your side: cervical cancer is almost entirely preventable. Even if you do contract it, a local expert points out, you have more than a 90 percent chance of surviving at least five more years if it’s treated in its earliest stage. On the flip side, said Judith Wolf, M.D., a gynecologic oncologist and surgery section chief at Banner MD Anderson Cancer Center in Gilbert, if the disease is not diagnosed until after it has metastasized, a woman has only a 25 percent chance of living for five more years.
Screening is key
Cervical cancer almost always is caused by the sexually transmitted human papillomavirus (HPV), which is present in 80 percent of all women at some time in their lives. Most cases of HPV do not turn into cervical cancer and the infection typically clears on its own, Wolf said. But if changes are occurring, they can be discovered through a Pap
BY DEBRA GELBART
test, a test that literally takes seconds in a doctor’s office. Because cervical cancer is usually very slow-growing, it’s unlikely that the disease would develop between regular Pap tests, Wolf said. More commonly, she said, HPV can cause pre-cancerous changes in the cervix, called dysplasia. In most cases, dysplasia can be easily treated. Left unmonitored and untreated, dysplasia can develop into cervical cancer. Medical community guidelines for the frequency of Pap tests say this, according to Glendale gynecologist Lisa Jaacks, M.D., of Desert West Obstetrics & Gynecology: if you’re 30 or over and you’ve had three normal Pap tests in a row, you’re advised to be screened every three years. Otherwise, you should have a Pap test every year.
For girls and young women (and males, too) between the ages of 9 and 26, prevention of the four most common types of HPV comes in the form of a vaccine called Gardasil. Although some
A division of The Arizona Republic. 200 E. Van Buren St., Phoenix, AZ 85004
Look for Livingwell a-z on the first Wednesday of each month!
Each month, we bring you local health information you can use to keep you and your family living well. From A to Z, we tackle a broad range of health issues and offer tips for keeping your healthcare costs in check. This publication is produced by Republic Media Custom Publishing. For questions concerning any content included in this publication please contact: Editor Paula Hubbs Cohen, Paula.Cohen@cox.net or call 602-444-8658.
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controversy exists about the vaccine because it’s only been available for about six years, many doctors are adamant about its importance. “This is a vaccine that prevents more than HPV — it can prevent cancer,” Jaacks said. It’s now recommended for boys and young men as well, so that they can protect their future sexual partners from exposure to HPV. HPV is linked in some cases to penile, anal and oral airway cancers, said Shana Wingo, M.D., a gynecologic oncologist with Arizona Oncology in Phoenix. “So boys who get the vaccine are not only protecting themselves from future exposure to genital warts, but malignancies as well,” Wingo said. “Now that there is a vaccine available, I am passionate about preventing HPV and cancers associated with this virus.” “Gardasil works best when administered before someone has become sexually active,” Jaacks said. “In our practice, where hundreds of patients have been vaccinated with Gardasil, the only side effect we’ve seen is pain at the injection site.”
General Manager: CAMI KAISER, email@example.com Manager Creative Development: ISAAC MOYA, firstname.lastname@example.org Editor: PAULA HUBBS COHEN, Paula.Cohen@cox.net
Treatment of cervical cancer depends on the extent of the disease, Wingo said. An early Stage I tumor can be treated with “fertility-sparing excision of the cervix itself,” she explained. “A higher Stage I tumor may require a radical hysterectomy, while patients presenting with advanced-stage cervical cancer are treated with radiation and chemotherapy.” Wingo notes that every patient she has who is diagnosed with cervical cancer that requires advanced treatment has said “I wish I had just gone to the doctor sooner.”
Resources American Cancer Society: cancer.org Medline Plus: nlm.nih.gov/medlineplus National Cancer Institute: cancer.gov
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January 2, 2013 | LIVING WELL A-Z | 3
Continued from cover DIET DECISIONS Meal replacements
Primack said that many of his patients choose Optifast, a meal replacement program that features shakes, soups and protein bars and includes regularly scheduled monitoring by a physician trained and board-certified in obesity medicine. A similar program called Medifast is administered through a different organization with centers around the country. Optifast requires face-to-face medical supervision while Medifast clients have several options for support. “Meal replacement programs work best when patients gradually begin reintroducing regular food after they’ve reached their goal weight,” Primack said. “They may want to consider using at least one meal replacement a day for months after they reach their goal.”
The hCG diet is a 500-calorie-a-day diet supplemented by the pregnancy hormone human chorionic gonadotropin (hCG) delivered either by injection or in liquid drops under the tongue. It is controversial, but healthcare practitioners who make it available to patients cite a high percentage of success among patients as an indication of its effectiveness. “In our practice, thousands of patients have gone on the hCG diet over the past five years,” said Julia Eastman, L.Ac., D.O.M., a doctor of Oriental medicine and licensed acupuncturist whose Phoenix practice is led by gynecologist Eugenie Anderson, M.D. “We have not seen any adverse side effects and patients are extremely satisfied with their results.” A different point of view comes from Primack, who pointed out that the hCG diet is not approved by the American Society of Bariatric Physicians and that the FDA has not approved the liquid drops as a weight loss agent. “There is no published peer-reviewed study showing that hCG helps you lose more fat, even when injected,” he said. “On the contrary, the published studies showed that when compared to saline, there was no improvement with hCG.” Eastman notes that that is not what they’ve seen in their practice. “The hCG helps patients burn their stored fat,” she said, with Primack stating that patients burn fat because of the small amount of calories consumed each day.
Exercise and nutrition put the brakes on bone loss BY DOLORES TROPIANO
arla Birkholz makes no bones about the importance of good nutrition and exercise in warding off osteoporosis, which is a skeletal disease characterized by the deterioration of bone tissue. “Osteoporosis is very scary,” said Birkholz, the wellness medical director of the John C. Lincoln Physicians Network. “It’s painful and deforming and can cause death, so it’s an important thing to prevent. In fact, more women die from hip fractures related to osteoporosis than from breast cancer.”
A Healthier Weigh
For patients with a large amount of weight to lose, one option is “A Healthier Weigh,” a weight reduction program designed and formulated by Sophia Fountis, D.O., of Scottsdale. Fountis, who did M.D. training at the Cleveland Clinic, offers what she refers to as “a unique normal-protein diet with no carbs and no fats.” When following “A Healthier Weigh,” patients eat an individually prescribed amount of lean protein plus a limited amount of low-carbohydrate vegetables. Medically tailored to each individual, Fountis offers patients a promise: “Men will lose on average 0.8 pounds per day, while women will lose on average 0.5 pounds per day. I offer that promise whether someone has 30 pounds to lose or 500.” Because of the diet’s restrictions, patients are required to be medically supervised, have blood-work done every two weeks and also to visit with Fountis every two weeks. More info: chiro-medcenters.com. —Paula Hubbs Cohen
Resources Dr. Eastman: jcl.com/ physician-network/practices/ care-for-women-north-mountain/ physicians Dr. Galper: poweroverfood.com Jenny Craig: jennycraig.com Medifast: medifast1.com
Bone thinning factors
According to the American Academy of Family Physicians (aafp.org), one in two women and one in five men will sustain an osteoporotic fracture after the age of 65. Birkholz said bone thinning usually becomes a problem after menopause, between the ages of 45 and 55. “At that point we are trying to stop the loss of bone,” she said. Multiple factors contribute to osteoporosis. Some people were inactive in their youth and didn’t gain the proper amount of bone, sometimes genetics are a factor, while other times, medicine such as steroids or cortisone can impact bone health. Surprisingly, smoking can also contribute to a lack of bone strength.
Battling bone loss
Nutrisystem: nutrisystem.com Optifast: optifast.com
As with most everything related to your health, experts advise that you consult with your primary care physician before starting on a weight loss plan.
A bone density test, a type of X-ray, is used to calculate bone strength. It is often recommended for post-menopausal women to obtain a baseline assessment of bone density health.
Scottsdale Weight Loss Center: scottsdaleweightloss.com Weight Watchers: weightwatchers.com
John Kearney, M.D., a specialist in non-surgical sports medicine at The CORE Institute, recommends that people follow good nutrition and good exercise habits (30 to 60 minutes a day) to slow and even stop the loss of bone in the body.
Calcium-rich foods • • • • • • • •
Beans, legumes Chinese cabbage ag or bok choyy ucts Dairy products Green leafyy vegetables Nuts Shrimp Tofu Tortillas
“Any form of weight-bearing exercise including walking, running and/or jumping will increase bone mass,” Kearney said. “Resistance training such as light weight training, exercise bands, free weights or weight machines are great.” One of the simplest things that people can do right at home, he said, is to work with free weights or use an exercise ball.
Diet and supplements
Kearney explained that 1,200 milligrams of calcium citrate are recommended daily past the age of 50, plus 400 units of vitamin D. The body can only absorb 500 milligrams of calcium at a time, so any supplements should be taken accordingly throughout the day. Kearney and others are reluctant to recommend additional supplements in lieu of the right foods. “I firmly believe that it’s difficult to supplement your way to optimal health,” Kearney said. “All of these nutrients, vitamins and minerals work much better if you get them in your diet from their natural food sources.”
Resources “BEST Exercise Program for Osteoporosis Prevention” (a book developed by a University of Arizona research team): pubs1. cals.arizona.edu/sales/order.cfm National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center: niams.nih.gov/ Health_Info/Bone
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4 | LIVING WELL A-Z | WEDNESDAY, January 2, 2013
January Take advantage of dozens of opportunities for you 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.
TOP Events Jan. 11 Guardianship Clinic (Duet)
MINIMALLY INVASIVE SPINE SURGERY Various dates, times & locations By Laser Spine Institute Register: spineseminar.com; 866-811-3275
A total shoe-in
How to ﬁnd the perfect shoe for any ﬁtness activity BY MICHELLE TALSMA EVERSON
im Prescott, a training specialist at the Runner’s Den in Phoenix, joked that there are three things in life that you should never skimp on: mattresses, vacations — and shoes. That’s because, according to Prescott, a good pair of shoes can prevent a lot of unneeded injuries. Stephen Geller, DPM, FACFAS, the director of podiatry at Maricopa Medical Center, agreed, since many of the patients he sees have injuries that could have been prevented with better footwear. “When it comes to addressing foot pain, finding the proper shoe is a great place to start,” Geller said.
“Wearing the proper shoe size, which I’d estimate 90 percent of people do not, and maintaining proper arch support are a few ways to maintain foot health.” — Sue Orischak, CPED, a certified pedorthist with Foot Solutions in Scottsdale
The right fit • After one hour of running, the average foot swells a half shoe size. After two hours, feet can swell up to a size bigger. Therefore, buy a full size bigger for marathons and other similar strenuous activities. • Tap your heel at the back of the shoe and make sure your arch lines up with the shoe. Source: Jim Prescott, Runner’s Den
• Flat soled/hard rubber shoes: ideal for weight lifting and strength training • Trail/hiking shoes: best for hiking and other outdoor activities • Running shoes: meant for frontto-back motion (i.e., running and walking), not side-to-side motion like in other sports • Specialty shoes: good for specialized sports and activities, such as soccer cleats, etc.
Wear and tear
One of the main differences among various types of athletic footwear is the level of support the shoes offer, Geller noted. He said there are four main support types: motion control, stability, neutral and cushioning. The level of support you need depends on your chosen activity and foot care needs. Garrett Shinoskie, the director of athletic performance at Zone Athletic Performance in Scottsdale, added that people need to consider “what shoe is right for what activity.”
Categories of fitness shoes
Shinoskie and Prescott agreed that some of the most popular categories of fitness shoes include: • Cross training shoes: great for any activity that includes multidirectional movement
Prescott recommended that the lifespan of a shoe should be 400 miles or one year — whichever comes first. For serious athletes, Shinoskie suggested changing your shoes every three months. Both also advised to wear your shoes only for their prescribed activity; it helps the footwear to last longer and is easier on your feet.
EAT REAL & LOCAL ON A BUDGET Jan. 9, 1–2 p.m. By Scottsdale Healthcare at Appaloosa Library 7377 E. Silverstone Dr., Scottsdale Register: shc.org/events; 480-882-4636 BOOST YOUR MEMORY Jan. 10, 1–2 p.m. By Scottsdale Healthcare at Civic Center Library 3839 N. Drinkwater Blvd., Scottsdale Register: shc.org/events; 480-882-4636
Foot Solutions: footsolutions.com The Runner’s Den: runnersdenaz.com Zone Athletic Performance: zoneap.com
Please call to confirm reservations and cost (if any).
Jan. 11 Finding a cure for Alzheimer’s Disease WHAT: This GPS (Giving People Strategies for Memory) lecture by the Banner Alzheimer’s Institute focuses on Alzheimer’s research, progress and more. WHERE: Musical Instrument Museum, 4725 E. Mayo Blvd., Phoenix TIME: 10:30 a.m.–noon COST: Free REGISTER: 602-230-2273
NEUROPATHY: DIAGNOSIS & TREATMENT Jan. 16, 7–8 p.m. By Scottsdale Healthcare at Barnes & Noble 10500 N. 90 St., Scottsdale Register: shc.org/events; 480-882-4636
STROKE SURVIVOR Jan. 10, 2:30–4 p.m. Chandler Regional 1955 W. Frye Rd., Chandler 480-728-5414
TOBACCO CESSATION PROGRAM Jan. 17, 5–6 p.m. Scottsdale Healthcare Osborn 7301 E. Fourth St., Scottsdale Register: shc.org/events; 480-882-5761
HEART-HEALTHY EATING Jan. 15, 11 a.m. Banner Heart Hospital 6750 E. Baywood Ave., Mesa 480-854-5401
MAKOPLASTY Jan. 17, 6 p.m. Arrowhead Hospital 18701 N. 67 Ave., Glendale Register: azhealthyhours.com; 855-292-9355
STROKE CAREGIVER Jan. 24, 2:30–3:30 p.m. Mercy Gilbert 3420 S. Mercy Rd., Gilbert 480-728-5414
TOBACCO CESSATION SUPPORT Jan. 17, 6–7 p.m. Scottsdale Healthcare Osborn 7301 E. Fourth St., Scottsdale Register: shc.org/events; 480-882-5761 NEUROPATHY OF THE FEET Jan. 22, noon–1 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-9355 BLADDER HEALTH Jan. 24, 1–2 p.m. By Scottsdale Healthcare at Civic Center Library 3839 N. Drinkwater Blvd., Scottsdale Register: shc.org/events; 480-882-4636
HEART/STROKE CONGESTIVE HEART FAILURE Jan. 9, 16, 23 & 30, 6:30–7:30 p.m. Chandler Regional 1955 W. Frye Rd., Chandler 480-728-5414 STROKE SUPPORT Jan. 10, 10 a.m. Banner Thunderbird 5555 W. Thunderbird Rd., Glendale 602-865-5450
TOTAL JOINT REPLACEMENT Jan. 9, 16, 23 & 30, 9 a.m. Banner Gateway 1900 N. Higley Rd., Gilbert 602-239-2273
BARIATRIC MEETINGS Various dates & times Banner Gateway 1900 N. Higley Rd., Gilbert 480-543-2606
STROKE SUPPORT Jan. 10, 1:30–3 p.m. Banner Baywood 6644 E. Baywood Ave., Mesa 480-321-4790
LIVING WITH HEART DISEASE Jan. 28, noon–1 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-9355 STROKE SUPPORT GROUP Jan. 29, 3–4 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-9355
DIABETES DIABETES SUPPORT Cardon Children’s Medical Center 1400 S. Dobson Rd., Mesa Call for dates & times: 480-412-4557 DIABETES SUPPORT GROUP Jan. 10, 1–2 p.m. St. Luke’s Medical Center 1800 E. Van Buren St., Phoenix Register: 877-351-9355 DIABETES SUPPORT GROUP Jan. 14, 3–4 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-9355
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WHAT: This seminar focuses on ways to take care of your heart through proper diet and nutrition. WHERE: Banner Boswell Medical Center, 13180 N. 103 Dr., Sun City TIME: 9:30 a.m. COST: Free INFO: 602-230-2273
ALZHEIMER’S/ DEMENTIA COMPASS FOR CAREGIVERS Various dates & times Banner Alzheimer’s Institute 901 E. Willetta St., Phoenix Register: email@example.com; 602-839-6850 KNOW THE 10 SIGNS Various dates, times & locations By Alzheimer’s Association 602-528-0545 CAREGIVER SUPPORT Jan. 7, 3–4:30 p.m. Banner Estrella 9201 W. Thomas Rd., Phoenix 602-528-0545 CAREGIVERS (DUET) Jan. 8 & 22, 12:30–2 p.m. Church of the Beatitudes 555 W. Glendale Ave., Phoenix 602-274-5022 CAREGIVERS SUPPORT Jan. 28, 1:30–3:30 p.m. Banner Sun Health Research 10515 W. Santa Fe Dr., Sun City 623-832-5328
SENIORS GRANDPARENTS RAISING GRANDCHILDREN (DUET) Various dates, times & locations 602-274-5022 HEARING SCREENINGS Jan. 25, 1–4 p.m. Tempe St. Luke’s 1500 S. Mill Ave., Tempe Register: 877-351-9355 FLU BASICS Jan. 31, noon–1 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-9355
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DIABETES SUPPORT Jan. 15, 3–4 p.m. Banner Baywood 6644 E. Baywood Ave., Mesa 480-321-4578
STROKE SCREENING Jan. 28, 8–10 a.m. St. Joseph’s 7727 W. Deer Valley Rd., Peoria Register: 877-602-4111
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WEDNESDAY, January 2, 2013 | LIVING WELL A-Z | 5
WOMEN & CANCER GYNECOLOGIC Jan. 8, 5–6:15 p.m. Banner Desert 1400 S. Dobson Rd., Mesa 480-412-4673 YOUNG WOMEN’S SUPPORT Jan. 8, 6:30 p.m. Banner Thunderbird 5555 W. Thunderbird Rd., Glendale 602-865-5450
CANCER SUPPORT YOGA FOR CANCER PATIENTS Various dates & times Banner MD Anderson 2946 E. Banner Gateway Dr., Gilbert 480-256-4141 COPING WITH CANCER Jan. 9 & 22, 6:30 p.m. Banner Thunderbird 5555 W. Thunderbird Rd., Glendale 602-865-5450 LIVING & COPING WITH CANCER Jan. 15, 5:30 p.m. Banner MD Anderson 2946 E. Banner Gateway Dr., Gilbert 480-256-4141 KIDS CAN COPE Jan. 15, 7 p.m. Banner Thunderbird 5555 W. Thunderbird Rd., Glendale 602-865-5450 JOURNEY TO WELLNESS Jan. 16, 4 p.m. Banner MD Anderson 2946 E. Banner Gateway Dr., Gilbert 480-256-4141 ORAL, HEAD & NECK Jan. 16, 4:30–6:30 p.m. Banner Desert 1400 S. Dobson Rd., Mesa 480-412–4673 COLORECTAL Jan. 17, 6 p.m. Banner Thunderbird 5555 W. Thunderbird Rd., Glendale 602-865-5450 ESOPHAGEAL Jan. 17, 6–7:30 p.m. Banner Good Samaritan 1111 E. McDowell Rd., Phoenix 602-839-4970 PROSTATE Jan. 28, 7–9 p.m. Banner Desert 1400 S. Dobson Rd., Mesa 480-412-4673
SUPPORT GROUPS (DUET) Various dates, times & locations 602-274-5022
ASTHMA SUPPORT GROUP Cardon Children’s Medical Center 1400 S. Dobson Rd., Mesa Call for dates & times: 480-412-7902
PARKINSON’S DANCE Various dates, times & locations By Muhammad Ali Parkinson Center Register: 602-406-6903 PARKINSON’S SUPPORT Jan. 8, 1–2 p.m. HealthSouth Valley of the Sun 13460 N. 67 Ave., Glendale 623-878-8800 PARKINSON’S Jan. 14, 10–11:30 a.m. Banner Sun Health Research 10515 W. Santa Fe Dr., Sun City 602-942-9008
BREASTFEEDING NURSING MOMS SUPPORT Various dates & times Banner Del E. Webb 14502 W. Meeker Blvd., Sun City West 602-230-2273 LACTATION Jan. 7, 14, 21 & 28, 1–2 p.m. Banner Estrella 9201 W. Thomas Rd., Phoenix 623-327-8001 BREASTFEEDING Jan. 8 & 22, 10 a.m. Banner Ironwood 37000 N. Gantzel Rd., San Tan Valley 480-394-4000 BREASTFEEDING Jan. 10, 17, 24 & 31, 1–2:30 p.m. Banner Desert 1400 S. Dobson Rd., Mesa 480-412-3035 BREASTFEEDING SUPPORT Jan. 21, 6–7:30 p.m. Banner Good Samaritan 1111 E. McDowell Rd., Phoenix 602-839-3502
RESPIRATORY Jan. 10, 1:30 p.m. Banner Boswell 13180 N. 103 Dr., Sun City 623-832-5708
ADDITIONAL SUPPORT GROUPS APHASIA Jan. 8 & 22, 10–11 a.m. Banner Boswell 13180 N. 103 Dr., Sun City 623-972-4263 ESSENTIAL TREMOR Jan. 8, 3 p.m. St. Joachim & St. Anne Church 11625 N. 111 Ave., Sun City 623-975-9638 AMPUTEE Jan. 8, 6–7 p.m. HealthSouth Valley of the Sun 13460 N. 67 Ave., Glendale 623-334-5358 PAIN Jan. 10 & 24, 6–8 p.m. HealthSouth Valley of the Sun 13460 N. 67 Ave., Glendale 623-334-5437 LARYNGECTOMY Jan. 15, 4–5 p.m. Banner Boswell 13180 N. 103 Dr., Sun City 623-832-5349 VESTIBULAR Jan. 17, noon Banner Good Samaritan 1111 E. McDowell Rd., Phoenix 602-839-2317
MEN’S DISABILITY ISSUES Jan. 17, 5:30–7 p.m. Disability Empowerment Center 5025 E. Washington St., Phoenix 602-980-3232; firstname.lastname@example.org
POSTPARTUM DEPRESSION Jan. 8, 15, 22 & 29, 10–11:30 a.m. Banner Desert 1400 S. Dobson Rd., Mesa 480-412-5292
OSTOMY Feb. 3, 2–4 p.m. Banner Boswell 13180 N. 103 Dr., Sun City 623-935-7514
POSTPARTUM SUPPORT Jan. 8 & 22, 11 a.m. Banner Thunderbird 5555 W. Thunderbird Rd., Glendale 602-865-5908
CAREGIVERS SUPPORT GROUPS (DUET) Various dates, times & locations 602-274-5022
NEWBORN PARENTING Jan. 8, 2–3:30 p.m. Banner Baywood 6644 E. Baywood Ave., Mesa 480-321-4455
BOSOM BUDDIES SUPPORT GROUPS Various dates, times & locations Ahwatukee/Chandler: 480-893-8900 East Valley: 480-969-4119 Scottsdale: 623-236-6616 West Valley: 623-979-4279
ONLINE NETWORKING (DUET) Jan. 12 & 22, 9–10 a.m. Register: duetaz.org (Events tab) 602-274-5022
PREGNANCY, PARENTING & PLAY Jan. 10, 17, 24 & 31, 7–9 p.m. Banner Baywood 6644 E. Baywood Ave., Mesa 480-321-4455
CAREGIVER SUPPORT (DUET) Jan. 31, 8:30 a.m.–3 p.m. Church of the Beatitudes 555 W. Glendale Ave., Phoenix 602-274-5022
LEARN AND SUPPORT Jan. 9, 5:30 p.m. Banner Good Samaritan 1111 E. McDowell Rd., Phoenix Register: 602-712-1006
CIRCLE OF MOTHERS Jan. 17 & 31, 5–7 p.m. Banner Estrella 9201 W. Thomas Rd., Phoenix 623-327-4000
SUPPORT GROUP Jan. 22, 5–6:15 p.m. Banner Desert 1400 S. Dobson Rd., Mesa 480-412-4673
PREGNANCY & INFANT LOSS Feb. 4, 7 p.m. Banner Desert 1400 S. Dobson Rd., Mesa 480-412–3595
TRIPLE NEGATIVE Jan. 23, 5:30 p.m. Banner Good Samaritan 1111 E. McDowell Rd., Phoenix Register: 602-712-1006
‘ANONYMOUS’ MEETINGS Obsessive-Compulsive; Alcoholics; Al-Anon; Cocaine; Heroin; Depression Various dates & times Banner Behavioral Health 7575 E. Earll Dr., Scottsdale Info: bannerhealth.com AL-ANON & ALCOHOLICS ANONYMOUS Jan. 5, 12, 19 & 26, 7 p.m. Banner Thunderbird 5555 W. Thunderbird Rd., Glendale Info: bannerhealth.com
ASK An Expert Question: What are gallstones? ANSWER: Gallstones develop inside the gallbladder which is a small organ on the right side of the abdomen that stores and releases bile to help digest fats. Gallstones form when bile hardens into one or more stone-like deposits. There are two main types of gallstones: cholesterol predominant stones and pigment stones. Mixed-type stones (cholesterol and pigment) are also common. Cholesterol gallstones are the most common and, as their name suggests, are primarily made up of cholesterol deposits. Pigment gallstones are the result of excess bilirubin in an individual’s bile. Many people go through life unaware they have gallstones as they do not experience any noticeable symptoms. When gallstones do not cause symptoms, there is usually no need to treat them. Symptoms can occur when a gallstone gets lodged in and blocks either the cystic duct or bile ducts. If this occurs, people often experience symptoms such as sudden and/or intermittent pain in the upper right part of the abdomen, increasing pain below the breast bone in the center of the abdomen, pain between the shoulder blades, and right shoulder pain. Pain can last from a few minutes to several hours. If symptoms occur, it’s generally recommended that the gallbladder
be surgically removed, a procedure known as cholecystectomy, which in most cases is performed laparoscopically (a minimally invasive procedure). There are also medications available that are designed to dissolve gallstones, but these are not used very often as they are either ineffective, or may take months or even years to work. NOOMAN GILANI, M.D., FACG, AGAF, IS THE CHAIRMAN OF THE GASTROENTEROLOGY DEPARTMENT AT BANNER THUNDERBIRD MEDICAL CENTER IN GLENDALE
Question: WhatisLewybody dementia? ANSWER: Lewy body dementia, the second most common type of progressive dementia after Alzheimer’s disease, causes a progressive decline in mental abilities. In Lewy body dementia, abnormal round structures called Lewy bodies develop in regions of the brain involved in thinking and movement. The disease may cause visual hallucinations, which may take the form of seeing shapes, colors, people or animals that aren’t there or, more complexly, having conversations with deceased loved ones. Another indicator may be significant fluctuations in alertness and attention, which may include daytime drowsiness or periods of staring into space. Like Parkinson’s
disease, Lewy body dementia can result in rigid muscles, slowed movement and tremors. There’s no cure for Lewy body dementia, instead, doctors treat the symptoms. Medications such as those used for Alzheimer’s disease work by increasing the levels of neurotransmitters — chemical messengers believed to be important for memory, thought and judgment — in the brain. This can help improve alertness and cognition, and may help reduce hallucinations and other behavioral problems. Parkinson’s disease medications can help reduce Parkinson’slike muscular symptoms in some people, but they can also cause increased confusion, hallucinations and delusions. Antipsychotic medications may somewhat improve delusions and hallucinations, however, at least a third of the people who have Lewy body dementia have a dangerous sensitivity to some of these types of drugs. Because antipsychotic drugs can worsen the symptoms, it might be better to initially try non-drug approaches, such as modifying the environment, modifying caregivers’ responses and/or modifying tasks. BRYAN WOODRUFF, M.D., IS A NEUROLOGIST AT MAYO CLINIC IN ARIZONA
Living Well a-z invites readers to submit questions to a panel of healthcare experts. The short questions and answers will offer readers a little more information about hot topics in medicine and refer you to other resources where you can learn more. Responses will also arm you with information so you know what to ask your own healthcare providers. If you would like your question to be considered for the February 6, 2013 issue of Living Well a-z, please write to editor: Paula Hubbs Cohen, Paula.Cohen@cox.net or c/o The Arizona Republic, 200 E. Van Buren St., CA22, Phoenix, AZ 85004.
INFO Online ABRAZO HEALTH CARE (AZ Heart Institute and AZ Heart, Arrowhead, Maryvale, Paradise Valley, Phoenix Baptist and West Valley hospitals): abrazohealth.com BANNER HEALTH: bannerhealth.com BARNET DULANEY PERKINS: goodeyes.com BARROW NEUROLOGICAL INSTITUTE: thebarrow.org CARDON CHILDREN’S MEDICAL CENTER: bannerhealth.com CHANDLER REGIONAL MEDICAL CENTER: ChandlerRegional.org
BARIATRIC PROGRAM Hear about medical & surgical treatments for obesity.
THURS., JAN 10: 6-6:45PM
TUES., JAN 22: 6-6:45PM
(480) 301-4533 MayoClinic.org/Arizona
HEALTHSOUTH REHABILITATION: healthsouth.com IRONWOOD CANCER AND RESEARCH CENTERS: IronwoodCRC.com JOHN C. LINCOLN HOSPITAL: JCL.com LASER SPINE INSTITUTE: laserspineinstitute.com MAYO CLINIC: mayoclinic.com MERCYGILBERTMEDICALCENTER: MercyGilbert.org MIRACLE EAR: miracle-ear.com
Join us for free health assessments and tours of Banner Children’s Mobile Health Clinic
MOUNTAIN VISTA MEDICAL CENTER: mvmedicalcenter.com NORTHVALLEYPLASTICSURGERY: nvpsaz.com PHOENIX CHILDREN’S HOSPITAL: phoenixchildrens.com SCOTTSDALE HEALTHCARE:shc.org ST. JOSEPH’S HOSPITAL AND MEDICAL CENTER:stjosephs-phx.org ST. LUKE’S MEDICAL CENTER, PHOENIX: stlukesmedcenter.com TEMPE ST. LUKE’S: tempestlukeshospital.com
plus snacks and other fun activities.
HEARING TEST 26 Arizona Locations
Banner Ironwood Medical Center Saturday, January 19 10:00 a.m.- 1:00 p.m.
Banner Estrella Medical Center Saturday, January 26 10:00 a.m.- 1:00 p.m.
Not a medical exam.Audiometric test to determine proper ampliﬁcation needs only. Good only from participating Miracle-Ear providers. See store for details.
I taught my children to never give up. After my breast cancer diagnosis, I followed my own advice and got a second opinion. My answer was Mayo Clinic. Kim Loving
Kim had an entire team of world-renowned Mayo Clinic Cancer Center experts focused on her recovery. If you are diagnosed with breast cancer, you deserve the best as well. Mayo Clinic patients with breast cancer have substantially higher five-year survival rates compared to the U.S. National Cancer Database. We are an in-network provider for most people and a physician referral is rarely required. To schedule an appointment, call (480) 301-8000 or call our Breast Clinic directly at (480) 301-4000.
6 | LIVING WELL A-Z | WEDNESDAY, January 2, 2013
Hope for migraine sufferers
How to keep a ‘vascular and electromagnetic ﬁrestorm’ at bay
BY GREMLYN BRADLEY-WADDELL
igraine headache sufferers’ pain is often confined to the area of the head, but experts think it could be what folks put in their mouth — and how they treat the rest of their bodies, especially in regard to relaxation and exercise — that can play a role in these incapacitating episodes. “We can control a lot by what we eat,” said Denise McGinley, R.N., M.S.N.Ad., director of the Center for Orthopaedic Innovation at St. Luke’s Medical Center in Phoenix, “and food is a big culprit when it comes to migraines.” Proper food and drink intake is key, she added, because being dehydrated is linked to increased headaches, while skipping meals also makes one more susceptible. McGinley recommends keeping a food diary to try and detect if a food allergy or a combination of two or more foods is causing an issue.
Some common migraine triggers: • • • •
cheese, particularly aged varieties processed luncheon meats nuts foods containing MSG (monosodium glutamate) • cold foods • alcohol
Resources American Headache Society: americanheadachesociety.org American Migraine Foundation: americanmigrainefoundation.org Southwest College of Naturopathic Medicine and Health: scnm.edu
Overall, about 12 percent of the population suffers from migraines, said Paul Mittman, N.D., Ed.D., president and CEO of the Southwest College of Naturopathic Medicine and Health Sciences in Tempe, and the pain they deal with is often excruciating. In fact, he describes a migraine as “a vascular and electromagnetic firestorm inside the body,” one that usually includes a pulsating or throbbing sensation in the head, sometimes so painful it’s “blinding.”
“While no one knows exactly what causes migraines, genetics is often a cause and up to 90 percent of sufferers have a family history.” — Denise McGinley, R.N., M.S.N.Ad. Many people report a migraine starting on one side of the head and moving to the other side. About a quarter of sufferers also experience a visual “aura” or what’s been referred to as a premonition that a headache’s about to occur. This can be commonly experienced as spots, “shooting stars” or flecks of light in the peripheral vision. Nausea and vomiting may also occur, “which some people find as debilitating as the pain itself,” Mittman said. Sufferers might also be sensitive to light, sound or touch.
St. Luke’s Center for Orthopaedic Innovation: stlukesmedcenter.com
Diet and stress
Although migraines have been around for centuries, both Mittman and McGinley say doctors are just starting to understand them. And if food is thought to be a main trigger, stress is right up there, too, they both said. For that reason, McGinley suggests investing in “yoga or some other exercise that teaches relaxation techniques,” like Tai Chi, since mild exercise is thought to mitigate migraines. While it’s important to speak with your primary care provider before considering any new treatment, Mittman said complementary approaches to standard medical treatment may include: • Decreasing inflammation in the diet by decreasing fats • Stress management techniques, chiefly exercise or biofeedback • Acupuncture • “Mindful meditation” (Mittman suggests visiting umassmed.edu/cfm to learn more) • Spinal manipulation • Herbs, namely Feverfew (Tanacetum parthenium) and Butterbur (Petasites vulgaris), which may reduce frequency of headaches, but should not be taken by pregnant women
EXPERTS GYNECOLOGY/OBSTETRICS David Forest, M.D. With a commitment to providing the most reliable information and treatment options, Dr. Forest is dedicated to serving women in the northwestValley. He is certiﬁed by the American Board of Obstetrics & Gynecology and is afﬁliated with the American College of Obstetricians and Gynecologists. Dr. Forest is a graduate of Rosalind Franklin University of Medicine and Science in Chicago, Illinois and completed an internship and residency at Naval Medical Command in Oakland, California. He specializes in full pregnancy care, general gynecological evaluation and treatment, minimally invasive gynecological procedures and surgery. Banner Health Center Specializing in Obstetrics and Gynecology 13995 W. Statler Blvd., Surprise 623.478.3100 • www.BannerHealth.com/ HealthCenterSurprise
GYNECOLOGY/OBSTETRICS Teresa Malcolm, M.D. With a sincere belief that each woman has unique needs and deserves compassion and respect, Dr. Malcolm works to provide clear explanations of tests, diagnoses and therapies. A graduate of Tulane University School of Medicine, she completed an internship at University of California, Los Angeles; a family practice residency at Advocate Christ Medical Center at University of Illinois; and an obstetrics and gynecology residency at Phoenix Integrated Residency.
Banner Health Center Specializing in Obstetrics and Gynecology 13995 W. Statler Blvd., Surprise 623.478.3100 • www.BannerHealth.com/ HealthCenterSurprise
GYNECOLOGY/OBSTETRICS Frank Fara, M.D. Like his father and grandfather before him, Dr. Fara is dedicated to women’s health and wellness. He is certiﬁed by the American Board of Obstetrics & Gynecology and is afﬁliated with the American College of Obstetricians and Gynecologists. Dr. Fara is a graduate of the Southern Illinois University School of Medicine. He completed an internship and residency at Bayside Medical Center in Springﬁeld, Mass.
Banner Health Center Specializing in Obstetrics and Gynecology 13995 W. Statler Blvd., Surprise 623.478.3100 • www.BannerHealth.com/ HealthCenterSurprise