LivingWell AZ October 2013

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az

THE ARIZONA REPUBLIC

A SPECIAL PUBLICATION CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING

HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILY

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Vol. 3, No. 10 Vol

October 2013

IN THIS ISSUE: COVER/09: HEALTHY AGING 02: BREAST CANCER/BRCA GENES 03: FLU SHOTS 03: OFFICE ERGONOMICS AND HEALTH 04: INFERTILITY ADVANCEMENTS 05: CHILDHOOD CHOKING 05: ASU SCHOOL OF NUTRITION EXERCISE STUDY 06: SUPPORT GROUPS/ TOP EVENTS 07: SUPPORT GROUPS/INFO ONLINE 07: BE THE MATCH: DONOR REGISTRY 08: MEDICARE: WHAT YOU NEED TO KNOW

HEALTHCARE News

Affordable Care Act

Open Enrollment is Oct. 1, 2013 through March 31, 2014

I

ndividuals who have group insurance through their employer should enroll in their employer’s plan during the plan’s annual Open Enrollment period, as usual.

Likewise, individuals who are Medicareeligible should enroll in Medicare during Medicare’s annual Open Enrollment period, which is Oct. 15 through Dec. 7 (see article on page 8 for more details about Medicare).

TOP 10

The

SECRETS to a long and healthy life Sound advice from the experts

BY DEBRA GELBART

B

elow are 10 steps you can take at any age to supplement the good-sense actions — watching your weight, not smoking, exercising and more — you’ve hopefully already made part of your everyday lifestyle.

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Protect cognitive function. There is a lot of

Levels of coverage

For example, within each company’s products, a bronze plan will probably be more affordable than a silver plan, but almost certainly will not provide as many benefits as a silver plan. Likewise, a silver plan will most likely be more affordable than a gold plan. Some companies may offer a platinum product with premium coverage, but, as its name implies, it will probably be more expensive, so you will need to do a personal cost-benefit analysis that includes items such as monthly premiums, deductibles and co-pays to determine what level of coverage at what price is best for you and your family.

Essential benefits All private health insurance plans offered in the Marketplace will offer the same set of essential health benefits, which are minimum requirements for all plans in the Marketplace.

Some plans may offer additional coverage; you will see exactly what each plan offers when you compare them side-by-side in the online Marketplace at healthcare.gov.

The essential health benefits include: • Ambulatory care (outpatient care you get without being admitted to a hospital) • Emergency services • Hospitalization • Maternity and newborn care • Mental health, substance-abuse and behavioral-health treatment • Prescription drugs • Rehabilitative and habilitative services and devices • Laboratory services • Preventive and wellness services; chronic disease management • Pediatric services More info: Visit healthcare.gov or call 800-318-2596 (TTY: 1-855-889-4325) 24 hours a day, seven days a week.

The September issue of Living Well included several articles on the Affordable Care Act. Topics include: • Explaining the Health Insurance Marketplace • Who can participate • Levels of coverage • Calculating costs • Subsidies and penalties • Questions to ask • Enroll America You can access the e-flipbook at: http://issuu.com/rmcp/docs/livingwellazseptember2013?e=4031137/4702435

RICK D’ELIA

The U.S. Health and Human Services website, healthcare.gov, details which insurance companies are participating in the Marketplace.

It also describes the levels of coverage available, which are called bronze, silver, gold and platinum. Each level will be standardized according to its range of benefits and each is based on how you and the plan can expect to share the costs of your care. The categories do not reflect the quality or amount of care the plans provide.

ABOVE: Aneil Koerper, health and fitness program manager for The Terraces, a continuum of care community, runs a ‘boot camp’ exercise class for residents.

RIGHT: Koerper works with Barbara Quarles on her flexibility and mobility through stretching and walking drills.

information related to warding off mental decline by working on puzzles and taking on mental challenges such as learning another language. While these activities can certainly be helpful, some experts say that they are not the most important thing you can do to preserve cognition as you age.

Indeed, Janko Nikolich-Zugich, M.D., Ph.D., head of the Department of Immunobiology as well as co-director of the Arizona Center on Aging at the University of Arizona College of Medicine in Tucson, said that the most critical factor in preventing neurodegenerative diseases is staying physically active.

1

Fully understand the benefits of exercise. “The bad news

is that the aging process starts at age 30,” said Aneil Koerper, the health and fitness program manager at The Terraces, a continuum of care retirement community in central Phoenix. The good news, she said, is that you can compensate for the aging process by engaging in both cardio and muscle-strengthening activities such as dancing, jumping rope (on carpet, not on a hard surface), using a stair-climber or walking up stairs.

“If you like dancing, take a Zumba or line-dancing class,” she suggested. “Fast dance steps are a great way to increase the power in your leg muscles, and maintaining that power will increase your balance and reduce the possibility of falls as you age.” She also recommends wall-squats, where you stand with your back against a wall and slowly squat down as far as you can. If you go to a gym, use the leg-press machine to accomplish the benefits of wall-squats, she said.

Ideally, you’ll want to incorporate exercise into your routine that promotes endurance (short periods of more intense aerobics), muscle strength (weight lifting), flexibility (yoga) and balance (tai chi), said Walter Nieri, M.D., a geriatrician and internal medicine physician and director of Banner Sun Health Research Institute’s Center for Healthy Aging.

“It’s simple — exercise is best for maintaining cognitive health.”

— Janko Nikolich-Zugich, M.D., Ph.D., Arizona Center on Aging, UA College of Medicine

3

Monitor your health.

If you’re over 30, you should have a yearly well-visit with a primary care provider, Nieri said. “It’s important that your blood pressure, cholesterol, blood sugar and thyroid function be evaluated regularly,” he said.

4

Manage stress. “I’m in favor

of teaching stress management techniques as early as high school,” Nieri said. “It’s important to learn that ongoing stress can significantly impact your health.”

Continued on page 9 HEALTHY AGING

The basics of BRCA genes and cancer

Determining yyour our individual individual rrisk isk Determining

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ccording to Mary Cianfrocca, D.O., director of the Breast Cancer Program and medical director of the Clinical Cancer Genetics Program at Banner MD Anderson Cancer Center in Gilbert, less than 10 percent of breast cancer patients have either the BRCA1 or BRCA2 susceptibility gene mutation. “BRCA genes predispose a woman to breast cancer, ovarian cancer and various other forms of cancer, but it’s not a guarantee that cancer will develop,” she said. “Also, the vast majority of cancers occur sporadically.”

Furthermore, the risk varies between BRCA genes. Robert Kuske, M.D., medical director of Arizona Breast Cancer Specialists, said that the lifetime risk of developing breast cancer is between 75 and 85 percent for BRCA1 and BRCA2 carriers, while the risk of the more lethal ovarian and/or fallopian tube cancer is up to 44 percent.

Not just women

Pointing out that women are not the only ones who need to understand the risks, Kuske said that in addition to passing the genes on to their children, men who are BRCA carriers face their own risk of developing breast cancer or another form of cancer.

“Men usually do not get tested for BRCA1/2, but their risk of breast cancer is between one and 10 percent,” he said.

“If they carry the gene, they have a

BURNETT KRI NE BU RIST STIN ST IN B BURN URN RNET ETTT ET

BY KRISTINE

three- to seven-fold increased risk of prostate cancer. Pancreatic cancer also is associated with BRCA1/2.”

Genetic testing

While having a BRCA gene is certainly cause for concern, not everyone can or should be tested for the mutation.

Determining whether to undergo genetic testing is based on one’s personal and/or family health history.

Mike Janicek, M.D., gynecologic oncologist with Arizona Oncology and medical director of the Virginia G. Piper Cancer Center’s Cancer Genetic Risk Assessment and Prevention Program, clarified the role of genetics and family history. “Disease patterns in families can tell a lot about what to look for, what preventive measures to consider, and even which treatment approaches are most appropriate,” he said. “Recognizing these patterns promptly can be life-saving.”

Cianfrocca stressed the importance of looking at all types of cancer in the family as well as ancestry (including countries of origin) since certain ethnicities have an increased risk. She highlighted factors such as a presence of cancer under age 50, same or related cancers among two or more relatives on the same side of the family, breast and ovarian cancer in the same family, male breast cancer and any rare form of cancer as examples of reasons for genetic testing.

Free online disease mapping and pedigree tools like the Surgeon General’s My Family Health Portrait (available on the U.S. Department of Health and Human Services website, FamilyHistory.hhs.gov) can help determine your individual risk.

Informed decision-making

Confirming the presence of BRCA1/2 enables people to make informed decisions about their health. This could include preventive breast and/or ovary and/or fallopian tube removal or enhanced active surveillance and screening. Janicek noted that there is a relatively new class of drugs called PARP inhibitors that are designed specifically for cancer patients with BRCA genes.

“How to proceed following confirmation of BRCA1/2 is an incredibly personal choice and women need to know they have options,” Kuske said. “About 60 percent of my patients choose preventive surgery.

The social and emotional implications of surgery weigh heavily on one’s decision.”

THINKSTOCK

2 | LIVING WELL A-Z | WEDNESDAY, October 2, 2013

Insurance coverage

Though not all insurance plans cover genetic testing, Janicek said many insurance companies do want high-risk patients to be tested. “It’s much less expensive to pay for preventive care than cancer treatment,” he said.

If not covered by their insurance plan, a person can elect to pay out-of-pocket, something Kuske recommends for individuals who may be paralyzed by the fear of not knowing whether they carry a gene mutation.

For those who may worry that genetic testing could lead to denial of insurance coverage, Kuske hopes to calm their fears by discussing the Affordable Care Act and its stance on not allowing coverage exclusions based on pre-existing conditions.

Resources American Cancer Society: cancer.org National Cancer Institute: cancer.gov U.S. Department of Health and Human Services, Office on Women’s Health: womenshealth.gov

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 you a wealth of resources where you can find more specific information. 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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Flu shots 101 It’s that time of year

D

BY ALISON STANTON

uane Wooten, M.D., a pediatrician at Rainbow Pediatrics in Phoenix, said that the American Academy of Pediatrics, the American Medical Association and “pretty much everybody in the world” says that everyone over the age of 6 months should get immunized against the flu.

“This is especially true “The nasal for people who have some mist is an debilitating health condition that puts them at a higher alternative for risk of getting sick,” he said. people who Karen Lewis, M.D., medical have adverse director for the Office of Vaccine Preventable reactions to Diseases at the Arizona needles.”

Department of Health — Duane Wooten, M.D., Services, said the flu vaccine a pediatrician at is particularly important for Rainbow Pediatrics people who are at increased risk for severe complications from influenza, including children under age 5, people 50 years and older, pregnant women, American Indians and Alaska Natives, people with weak immune systems or who are extremely obese, and children and teenagers who are receiving long-term aspirin treatment.

WEDNESDAY, October 2, 2013 | LIVING WELL A-Z | 3

Office ergonomics

Blurry eyes...achy wrists...oh my!

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“In the office, this [proper ergonomics] is made more challenging because sitting for hours doing repetitive functions causes safety issues,” said Jerry Mosteller, a certified ergonomic assessment specialist with Ergo Focus, a company that helps organizations with workplace ergonomic issues.

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People who have had a severe allergic reaction (anaphylaxis) to any previous influenza vaccine or to any ingredient in an influenza vaccine, including eggs, should not get a flu shot, Lewis said.

“However, people who have only mild to moderate reactions to eggs, such as hives, can now get influenza vaccines, but they need to be watched for 30 minutes afterwards to make sure they do not have a severe reaction,” she said.

GET MOVING. “Try to alternate activities which ac require sitting re and a concentrating at a a desk with activities that ac allow allo you to move about,” abou said Denise McGinley, McGinl MSNAd, RN, the directo director of the Center for Orthopaedic Innovation at St. Luke’s Medical Center. McGinley recommended standing and stretching every 45 minutes to an hour.

Nasal spray option

Typical side effects

The most common reaction to an influenza shot is redness, swelling and/or some pain at the injection site, Lewis said, adding that this is a sign that the body’s immune system is recognizing some foreign material and is learning how to become immune to it.

Finding a flu shot Community Information and Referral Services: 211arizona.org/flu HealthMap Vaccine Finder: flushot.healthmap.org

USE A QUALITY CHAIR. Te Teresa Boynton, M MS, OTR, an e ergonomics and in injury prevention sp specialist for Ba Banner Health, said that important featur features are seat-pan depth, se seat width, b k t height and tilt back-support adjustment, lumbar support, active sitting and rocker tension, plus arm-rest adjustability, all of which lead to overall comfort.

The problem

Egg allergy alert

One of the influenza vaccines is a live, weakened form of influenza that comes as a nasal spray, Lewis said, noting that it should only be used in healthy individuals ages 2 to 49 years old who are not allergic to eggs and who do not have an underlying health issue, including pregnancy.

3

here are a wealth of health issues associated with incorrect office ergonomics, issues that are especially problematic for those who log-in long hours sitting at a desk, whether in a traditional office environment or in a home office.

6 solutions from the experts

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REARRANGE YOUR WORKSPACE. “Arrange your work environment so that you can easily reach h your phone, keyboard eyboard and mouse,” Mosteller eller said. “Arrange o your monitor so that you can see without looking down or straining your neck.

Adjust your THINKSTOCK ou chair so that you d are in a relaxed sition.” but neutral position.”

BY MICHELLE TALSMA EVERSON

4 5

REDUCE EYE STRAIN BY ELIMINATING HARSH LIGHTING. For example, if your office has windows, use vertical blinds to deflect sunlight away from your desk, McGinley said.

ADJUST MONITOR/KEYBOARD HEIGHT: Make sure your computer screen isn’t too high and that both your mouse and keyboard are at comfortable levels, leve Boynton said.

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DON’T SIT TOO CLOSE TO YOUR SCREEN. “O “Our eyes are m meant for distance vvision; sitting to too close to your co computer screen [le [less than 18 inches] caus causes the muscles of the eyes to become strained,” McGinley said.

“Careful consideration should be given to the selection of office furniture and accessories that offer the most adjustability while minimizing musculoskeletal strain for the worker.”

— Brenda Taubman, MA, OTR/L, assistant professor at Midwestern University’s Occupational Therapy Program

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4 | LIVING WELL A-Z | WEDNESDAY, October 2, 2013

Advances in infertility treatments

From acupuncture to new meds to chromosomal testing

BY GREMLYN BRADLEY-WADDELL

J

ay Nemiro, M.D., medical director of the Arizona Center for Fertility Studies in Scottsdale, said that the average person doesn’t realize the heartbreak that goes on when a desired pregnancy doesn’t occur. “The disappointment is so profound,” he said.

Thankfully, though, the past several years have seen technological advancements — even low-tech approaches — yield positive results for those struggling with infertility.

Medium-tech methods

While the industry’s high-tech methods, namely in-vitro fertilization (IVF), get most of the media attention, H. Randall Craig, M.D., medical director of the Fertility Treatment Center in Scottsdale, said it’s actually the less complicated, “mediumtech” methods that are more commonly used to treat infertility.

That realm has seen many advances, including the use of: • Aromatase inhibitors, anti-cancer drugs like Letrozole (marketed as Femara).

Although the drugs are not yet officially FDA-approved to treat infertility, aromatase inhibitors are frequently used by clinics and have been shown to triple pregnancy rates.

• Density gradient centrifugation (using G-forces inside a centrifuge to separate better sperm from the weaker ones). The pregnancy rates from using aromatase inhibitors and density gradient centrifugation alone run about 12 to 28 percent per cycle, “pretty good odds,”

•

•

•

•

Craig said, enough to rival some IVF methods. What’s more, this route is considerably more affordable than IVF. Granulocyte colony-stimulating factor, a protein derived from bone marrow used to treat leukemia patients. The hormone boosts white cell counts and also increases the quality of a woman’s eggs when used in conjunction with other treatments.

Acupuncture, which increases blood flow to the uterus. When performed around the same time embryos are transferred to the uterus, acupuncture can increase pregnancy rates up to 8 percent.

Bitter melon, a cucumber from India.

When patients with polycystic ovary syndrome — which leads to irregular periods and poor ovulation — eat five fresh or freeze-dried seeds a day, pregnancy rates are increased.

Glucophage, now sold as metformin, a drug often prescribed for the treatment of diabetes. When patients with polycystic ovary syndrome add glucophage to their medication regime, Craig said there is a significant increase in pregnancy rates and a reduction in miscarriages.

High-tech labs

The doctors also note that numerous breakthroughs have taken place in ART (Assisted Reproductive Technology) labs. Nemiro said these breakthroughs include improved embryo-growing mediums, which are “closer to the natural environment” of the fallopian tubes.

Another milestone has been the ability to grow embryos to the fifth day, or the

blastocyst stage. In the past, clinics typically transferred lab-grown embryos to a woman’s uterus on the third day.

But the uterus is not as receptive to day-3 embryos as it is to day-5 embryos, Nemiro said. The latter are stronger and more viable, therefore improving the odds of a successful pregnancy.

Freezing embryos

Yet another development is vitrification, or the rapid freezing of embryos.

Just a few years ago, slow freezing was the norm, but ice crystals that developed during thawing often damaged embryos. Nemiro said the quick-freeze process, which has FDA approval, eliminates that issue.

Screening chromosomes

But perhaps the biggest innovation Nemiro has seen is PGD/PGS: 23-chromosome array, a process that screens embryos for chromosomal abnormalities with the aim of improving pregnancy odds and reducing the possibility of miscarriage. PGD refers to ‘pre-implantation genetic diagnosis’ while PGS refers to ‘pre-implantation genetic screening’.

Older technology was limited to testing 10 chromosomes, but clinics can now screen all 23 chromosomes with over 99 percent accuracy. Nemiro views the test as such an important part of IVF that he charges patients the service at cost.

“I’m so excited about this technology, I want to provide all patients the opportunity to do it, so I give it away,” he said.

Matthew, Laura and Gracen Lasconia, along with the couple’s “other son” Makalani, who is half Chihuahua, half long-haired Dachshund

Successful treatment results in son After trying to conceive for several years, Chandler residents Matthew and Laura Lasconia consulted an infertility specialist. But a few unsuccessful treatments, followed by surgery, prompted Laura, 42, to think a different approach was in order. In January of 2011, she and Matthew, 41, met with Dr. Jay Nemiro, medical director of the Arizona Center for Fertility Studies, and underwent two cycles of IVF as well as chromosome testing.

During the first round of IVF, testing determined the embryos had abnormalities, so they were not implanted. The second IVF cycle, however, was successful. Their son, Gracen Kamahiwaokalamaku — his first name celebrates his arrival occurring “by the grace of God,” and his middle name celebrates Matthew’s Hawaiian heritage and is translated as “the child that is cherished by the sacred light of God” — recently turned one year old.

—GREMLYN BRADLEY-WADDELL

Resources American Pregnancy Association: americanpregnancy.org Arizona Center for Fertility Studies: acfs2000.com Fertility Treatment Center: fertilitytreatmentcenter.com Southwest Region of RESOLVE, the National Infertility Association: southwest.resolve.org

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WEDNESDAY, October 2, 2013 | LIVING WELL A-Z | 5

Choking hazards in young children

Awareness and prevention are key

NEWS Brief

Participants sought for ASU School of Nutrition and Health Promotion exercise study

BY MEGHANN FINN SEPULVEDA

I

n 2011, the Centers for Disease Control and Prevention reported 22,791 children in the United States were treated at an emergency room for choking injuries. That same year, six children died in Arizona from choking incidents.

A

Hot dogs, grapes and more

“A latex balloon acts like plastic wrap when a toddler or child aspirates a piece while choking.

It tightly and completely covers the airway.”

— David Curran, M.D., pediatrician at East Valley Children’s Center and chairman of the department of pediatric medicine at Cardon Children’s Medical Center

Balloons, balls and buttons

Small round objects like coins, marbles and balls, along with household items such as pen caps, paper clips, balloons and buttons, also pose a serious choking risk.

According to the Consumer Product Safety Commission, latex balloons are considered among the most dangerous of these types of hazards and are responsible for half of all choking fatalities in children under age 14. Suffocation can occur when a child tries to blow up a balloon and

THINKSTOCK

“The top food-related choking hazard in young children is hot dogs,” said David Curran, M.D., chairman of the department of pediatric medicine at Cardon Children’s Medical Center in Mesa. “The shape of a hot dog mirrors the size of a young child’s airway and the spongy texture causes it to lock into place so no air can pass through during a choking episode.”

Other common foods that can cause choking include nuts, cheese sticks, grapes, popcorn, peanut butter and raw vegetables.

then deeply inhales. The entire balloon or pieces of it can conform to a child’s airway which then becomes obstructed.

Risk of aspiration

When a child suffers from choking, there is an increased risk of aspiration involving food particles or foreign objects that get trapped in the lungs. This can ultimately lead to respiratory problems such as irritation, infection, or in more severe cases, erosion of the esophagus. Children who experience aspiration typically require surgery, spend time recovering in the intensive care unit and need follow-up therapy.

“We can’t stress enough how important it is to be knowledgeable and aware of choking hazards in your home,” said Sally

Moffat, director of injury prevention at Phoenix Children’s Hospital. “Think of your child’s airway as the size of a paper-towel roll. If an item can fit through that 1.5-inch opening, then it is a choking hazard.”

Where to find CPR classes American Emergency Response Training: ertcpr.com; 623-561-0068 American Heart Association: heart.org; 800-AHA-USA-1; 800-242-8721 American Red Cross: redcross.org; 800-RED-CROSS; 800-733-2767

SU’s School of Nutrition and Health Promotion (SNHP) is recruiting women between the ages of 45 and 60 for an exercise study using the Wii Fit. To participate, women must not be taking hormone replacement therapy or osteoporotic drugs and should be sedentary (no regular, purposeful physical activity). In addition, participants should have low bone mass; study directors can screen for this if candidates do not know their bone mass.

Study details: The 12-week study includes three visits that last approximately one hour each. The visits involve a blood draw, muscular testing, some balance testing and ultrasound measures of the heel bone. The first and last visits also include a DXA scan for bone mass. Testing takes place in the Arizona Biomedical Collaborative (ABC-1) building on the corner of Fifth Street and Van Buren in downtown Phoenix.

All exercises are done in-home; participants will be asked to play directed games three times a week for 30 minutes.

Owning a Wii is not necessary since women randomized into the intervention group will be lent all Wii equipment during the study period. At the end of the initial 12-week study, those in the control group will have the opportunity to borrow a Wii system for 12 weeks.

Participants who complete the study will receive $25, have parking costs reimbursed and be entered into a drawing to win one of two Wii packages consisting of a console, balance board, controller and three games.

More info

Sarah Wherry, MS, Doctoral Candidate and Teaching Associate ASU School of Nutrition and Health Promotion Email: swherry@asu.edu

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“Cigna,”“Cigna Medicare Select Plus Rx” (HMO), and the “Tree of Life” logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries, including Cigna HealthCare of Arizona, Inc. (CHC-AZ), and not by Cigna Corporation. Cigna Medicare Select Plus Rx HMO plans are offered by CHC-AZ under a contract with Medicare. As of the date of publication, Cigna Medicare Select and Cigna Medicare Select Plus Rx plans are offered to employers and individuals in Maricopa County and certain zip codes within Apache Junction and Queen Creek, Arizona only. Enrollment in Cigna Medicare Select Plus Rx depends on contract renewal.

This information is available for free in other languages. Please call our customer service number at 1-800-627-7534 (TTY 711), 8 am–8 pm, seven days a week. For accommodation of persons with special needs at a sales meetings call 1-800-627-7534 (TTY 711). A sales person will be present with information and applications. H0354_892012a Accepted AR-0008086587-01

6 | LIVING WELL A-Z | WEDNESDAY, October 2, 2013

October Take advantage of more than 100 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.

MEDICARE MEDICARE 101 Various dates, times & locations

By John C. Lincoln Register: jclmedicare101.eventbrite.com; 623-434-6265 MEDICARE OPTIONS Oct. 15, noon Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-9355

WELLNESS

CAREGIVERS ONLINE NETWORKING (DUET) Various dates & times Register: DuetAZ.org (Events tab) 602-274-5022 SUPPORT GROUPS (DUET) Various dates, times & locations 602-274-5022 SUPPORT GROUP Oct. 9, 2:30 p.m.

Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-9355 SUPPORT GROUP Oct. 14 St. Joseph’s Outpatient Rehab 114 W. Thomas Rd., Phoenix Call for time: 602-406-6688

MEDICATION CHECKS Various dates, times & locations

By St. Luke’s Register: 877-351-9355

SUPPORT GROUP Oct. 18, 9–11 a.m.

By Benevilla at Birt’s Bistro 16752 N. Greasewood St., Surprise 623-584-4999

WALK-ERCIZE CLASS Various dates, 9–10 a.m.

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

CAREGIVER SUPPORT Oct. 23, 2:30–3:30 p.m.

St. Luke’s 1800 E. Van Buren St., Phoenix Register: 877-351-9355

MANAGING MENTAL HEALTH Oct. 8, noon Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-9355

CAREGIVERS SUPPORT Nov. 6, 10:30 a.m.

By John C. Lincoln at Cowden Center 9202 N. Second St., Phoenix 602-870-6374

ADVANCED WHEELCHAIR SKILLS Oct. 9, 16 & 23, 4:30–6:30 p.m.

By AZ Spinal Cord Injury Assoc. at Banner Good Samaritan 1012 E. Willetta St., Phoenix Register: 602-507-4209 SPINAL STENOSIS Oct. 9, 6–7 p.m.

By John C. Lincoln at Cowden Center 9202 N. Second St., Phoenix 602-870-6374; jclspine.eventbrite.com COOKING WITH CAROTENOIDS Oct. 9, 6–7:30 p.m.

Virginia G. Piper Cancer Center at Scottsdale Healthcare 10460 N. 92 St., Scottsdale Register: 480-882-4636; shc.org/events ROBOTIC KNEE & HIP REPLACEMENT Oct. 10, 6–7:30 p.m.

Scottsdale Healthcare Thompson Peak 7400 E. Thompson Peak Pkwy., Scottsdale Register: 480-882-4636; azkneereplacement.com YOGA WISDOM IN THE WORKPLACE Oct. 16, 5:30–6:30 p.m.

Tempe Public Library 3500 S. Rural Rd., Tempe 480-350-5500 BREAST HEALTH 101 Oct. 16, 6 p.m.

Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-9355 KNEE & HIP ATHLETIC INJURIES Oct. 17, 6–7 p.m.

By St. Luke’s at Tempe Mission Palms 60 E. Fifth St., Tempe Register: 877-351-9355 KNEE REPLACEMENT SEMINAR Oct. 17 & 23, 6–7 p.m.

Arrowhead Hospital 18701 N. 67 Ave., Glendale Register: 855-292-9355; azhealthyhours.com TOTAL HIP REPLACEMENT Oct. 17, 6–7:30 p.m.

Scottsdale Healthcare Thompson Peak 7400 E. Thompson Peak Pkwy., Scottsdale Register: 480-882-4636; azhipreplacement.com COMMUNITY HEALTH FAIR Oct. 19, 8–11 a.m.

By St. Joseph’s Peoria North & the City of Peoria St. Joseph’s Peoria North 7727 W. Deer Valley Rd., Peoria 623-773-7137 ORTHOPEDIC SCREENINGS & LECTURE Oct. 24, 4–6 p.m.

Scottsdale Healthcare Shea 9003 E. Shea Blvd., Scottsdale Register: 480-882-4636; freescreeningevent.org OSTEOPOROSIS OF THE KNEE (MAKO) Oct. 24, 6 p.m.

Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-9355

GRIEF CHILD/TEEN GRIEF SUPPORT Various dates, times & locations Hospice of the Valley 480-951-8985; hov.org/grief-support-groups GRIEF SUPPORT Various dates, times & locations Hospice of the Valley 602-636-5390; hov.org/grief-support-groups GRIEF SUPPORT Oct. 10 & 24 St. Joseph’s 350 W. Thomas Rd., Phoenix Call for time: 602-406-3275 GRIEF & BEREAVEMENT SUPPORT Oct. 30, 10 a.m.–noon

By Benevilla at Birt’s Bistro 16752 N. Greasewood St., Surprise 623-584-4999

PAIN PAIN SUPPORT Oct. 9 & 23, 6:30–8 p.m.

By Chronic Pain Assoc. at Via Linda Senior Center 10440 E. Via Linda, Scottsdale 480-314-2330 PAIN SUPPORT Oct. 11 & 25, 6–8 p.m.

By Chronic Pain Assoc. at Catholic Outreach Center 12301 W. Bell Rd., Sun City 602-532-2981

HEART/STROKE STROKE SURVIVOR Oct. 10, 2:30–4 p.m.

Chandler Regional 1875 W. Frye Rd., Chandler 877-728-5414 STROKE SUPPORT Oct. 22, 3 p.m.

Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-9355 STROKE CAREGIVER SUPPORT Oct. 24, 2:30–3:30 p.m.

Mercy Gilbert 3420 S. Mercy Rd., Gilbert 877-728-5414 STROKE SURVIVOR SUPPORT Nov. 6, 10–11 a.m.

HealthSouth Scottsdale 9630 E. Shea Blvd, Scottsdale 480-551-5440

DIABETES TAKING CONTROL OF DIABETES Various dates, 6–7 p.m.

Phoenix Baptist Hospital 2040 W. Bethany Home Rd., Phoenix Register: 602-841-5505; pastoralcareaz.org DIABETES SUPPORT Oct. 10, 1–2 p.m.

St. Luke’s 1800 E. Van Buren St., Phoenix Register: 877-351-9355

HIP & KNEE HEALTH Oct. 24, 6–7 p.m.

By St. Luke’s at Embassy Suites 2630 E. Camelback Rd., Phoenix Register: 877-351-9355

DIABETES SUPPORT Oct. 14, 3 p.m.

Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-9355

WHOLE FOODS HEALTHY COOKING DEMO Oct. 29, 5:30–6:30 p.m.

Tempe Public Library 3500 S. Rural Rd., Tempe 480-350-5500

DIABETES PUMPERS GROUP Oct. 15, 7–8 p.m.

By Mercy Gilbert at Rome Towers 1760 E. Pecos Rd., Gilbert 877-728-3535

ARTHRITIS TALK Oct. 29, 6–7:30 p.m.

John C. Lincoln 19842 N. 27 Ave., Phoenix 602-212-9900

ALZHEIMER’S/ DEMENTIA COMPASS FOR CAREGIVERS Various dates & times Banner Alzheimer’s Institute 901 E. Willetta St., Phoenix Register: 602-839-6850

MEMORY LOSS, DEMENTIA & ALZHEIMER’S Various dates, times & locations

By Alzheimer’s Association Register: 602-528-0545 ALZHEIMER’S & MEMORY SUPPORT Oct. 4, 9–11 a.m.

By Benevilla at Birt’s Bistro 16752 N. Greasewood St., Surprise 623-584-4999 LEWY BODY DEMENTIA Oct. 4, 12:30–2 p.m.

Banner Alzheimer’s Institute 901 E. Willetta St., Phoenix 602-830-6850 CAREGIVER SUPPORT Oct. 7, 1:30–3 p.m.

By St. Luke’s at Pyle Adult Rec. Center 655 E. Southern Ave., Tempe Register: 877-351-9355 ALZHEIMER’S & MEMORY SUPPORT Oct. 8, 15, 22 & 29, 10 a.m.–noon

By Benevilla at Faith Presbyterian 16000 N. Del Webb Blvd., Sun City 623-584-4999 ALZHEIMER’S, YOUNGER-ONSET Oct. 9, 6–7:45 p.m.

By Alzheimer’s Association at Foothills Library 19055 N. 57 Ave., Glendale Register: 602-528-0545; mburruel@alz.org FINDING TREATMENTS Oct. 11, 10:30 a.m.–noon Banner Sun Health Research Institute 10515 W. Santa Fe Dr., Sun City Register: 602-230-2273 COMMUNICATION & BEHAVIORS Oct. 11, 10:45 a.m.–11:30 p.m.

By Alzheimer’s Association at Peoria Community Center 8335 W. Jefferson St., Peoria Register: 602-528-0545

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

PSA TEST: WHAT YOU NEED TO KNOW Oct. 24, noon Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-9355

BREAST CANCER BOSOM BUDDIES SUPPORT GROUPS Various dates, times & locations Ahwatukee/Chandler: 480-893-8900 East Valley: 480-969-4119 Banner Boswell Northwest Valley: 623-236-6616 Scottsdale: 623-236-6616 West Valley: 623-979-4279 LEARN & SUPPORT Oct. 3, 6–8 p.m.

By The Wellness Community 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@twccaz.org YOUNG SURVIVOR GROUP Oct. 8, 6–8 p.m.

John C. Lincoln 19646 N. 27 Ave., Phoenix 602-780-4673; bhrc@jcl.com BREAST CANCER AWARENESS SEMINAR Oct. 9, 10–11 a.m.

Humana Guidance Center 5943 E. McKellips Rd., Mesa 480-325-4707 NEW CLINICAL RESEARCH Oct. 9, 6–7:30 p.m.

Banner Gateway 1900 N. Higley Rd., Gilbert 480-543-2000 YOGA FOR RECOVERY Oct. 9, 16 & 23, 6–7:30 p.m.

John C. Lincoln 19841 N. 27 Ave., Phoenix 602-780-4673; bhrc@jcl.com

PLANNING AHEAD FOR CAREGIVERS Oct. 14, 10 a.m.–noon Banner Alzheimer’s Institute 901 E. Willetta St., Phoenix Register: 602-839-6850

LEARN & SUPPORT Oct. 10 & 24, 6–8 p.m.

John C. Lincoln 19646 N. 27 Ave., Phoenix 602-780-4673; bhrc@jcl.com

CAREGIVER SUPPORT (DUET) Oct. 15, 12:30–2 p.m.

Church of the Beatitudes 555 W. Glendale Ave., Phoenix 602-274-5022

PROSTHESIS SHOWING Oct. 18, 10 a.m.

Banner Desert 1400 S. Dobson Rd., Mesa 480-412-4673

LIVING WITH MODERATE-STAGE ALZHEIMER’S (3-WEEK CLASS) Oct. 15, 22 & 29, 4–6p.m.

Alzheimer’s Association 1028 E. McDowell Rd., Phoenix Register: 602-528-0545; mburruel@alz.org

SUPPORT GROUP Oct. 22, 5–6:15 p.m.

Banner Desert 1400 S. Dobson Rd., Mesa 480-412-4673

SUPPORT GROUP Lunch provided Oct. 20, 11 a.m.–12:30 p.m.

St. Joseph’s Huger Mercy 2345 W. Orangewood Ave., Phoenix 602-406-5600 PLANNING AHEAD FOR CAREGIVERS Oct. 21, 10 a.m.–noon Banner Sun Health Research Institute 10515 W. Santa Fe Dr., Sun City Register: 602-230-2273 CAREGIVER SUPPORT Oct. 21 & Nov. 4, 1:30–3 p.m.

By St. Luke’s at Pyle Adult Rec. Center 655 E. Southern Ave., Tempe Register: 877-351-9355 COMMUNICATION & BEHAVIORS Oct. 23, 1–2 p.m.

By Alzheimer’s Association at Appaloosa Library 7377 E. Silverstone Dr., Scottsdale Register: 602-528-0545 FREE MEMORY SCREENING Oct. 25, 9 a.m.–1 p.m.

Banner Alzheimer’s Institute 901 E. Willetta St., Phoenix Register: 602-839-6850 LIVING WITH EARLY-STAGE ALZHEIMER’S (3-WEEK CLASS) Oct. 30, Nov. 6 & Nov. 13, 1:30–3:30 p.m.

By Alzheimer’s Association at Rio Salado College 619 N. Seventh Ave., Phoenix Register: 602-528-0545; mburruel@alz.org

COOKING FOR WELLNESS Oct. 22, 6–8 p.m.

John C. Lincoln 19646 N. 27 Ave., Phoenix 602-780-4673; bhrc@jcl.com TRIPLE NEGATIVE SUPPORT Oct. 23, 5:30–7 p.m.

By The Wellness Community at Banner Good Samaritan 1111 E. McDowell Rd., Phoenix Register: 602-712-1006; rsvp@twccaz.org

Throughout October ‘Think Pink’ events for Breast Cancer Awareness Month WHAT: Experts in mastectomy fittings will offer consultations and answer questions on breast forms and bra styles.

WHERE: Tina’s Treasures Boutique, Virginia G. Piper Cancer Center, 10460 N. 92 St., Scottsdale TIME: 9 a.m.–4 p.m. throughout October COST: Free INFO/REGISTER: 480-323-1027

Oct. 8 Prostate Cancer Seminar WHAT: Learn about new screening guidelines and whether a screening is right for you.

WHERE: Ocotillo Golf Resort, 3751 S. Clubhouse Dr., Chandler TIME: 6–8 p.m.

COST: Free PRESENTED BY: Dignity Health and Ironwood Cancer & Research Centers INFO/REGISTER: 480-728-5414; mercygilbert.org; chandlerregional.org

Oct. 19 Super Sealant Saturday WHAT: Free dental care for children ages 6-12. Cleanings, screenings and molar sealants.

WHERE: Midwestern University Dental Institute, 19369 N. 59 Ave., Glendale TIME: 8 a.m.–1 p.m.

COST: Free INFO/REGISTER: 623-806-7150; mwuclinics.com/az/sealant

HOSPICE, DEMENTIA, ASK THE DOC Oct. 30, 9 a.m.–noon

By Hospice of the Valley at PebbleCreek Country Club 16222 Clubhouse Dr., Goodyear Register: 602-636-5393; events1@hov.org STEADY ON YOUR FEET Nov. 4, 9–10 a.m.

By St. Luke’s at Chandler Senior Center 202 E. Boston St., Chandler Register: 877-351-9355

PROSTATE CANCER PROSTATE CANCER LEARN & SUPPORT Oct. 3, 6–8 p.m.

By The Wellness Community 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@twccaz.org AR-0008086110-01

Nov. 9

(register by Nov. 5)

Shun the Sun Skin Cancer Event

WHAT: For all skill levels. Funds used to raise awareness and prevention of skin cancer.

WHERE: Hohokam Stadium, 1235 N. Center St., Mesa TIME: 4–8 p.m.

COST: Varies by event INFO/REGISTER: shunthesunfoundation.org

ORAL, HEAD & NECK SUPPORT Oct. 16, 4:30–6:30 p.m.

Banner Desert 1400 S. Dobson Rd., Mesa 480-412-4673

MULTIPLE MYELOMA SUPPORT Oct. 3, 10 a.m.–noon

By The Wellness Community 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@twccaz.org

CAVE CREEK CANCER SUPPORT Oct. 12, 10 a.m.–noon

By Scottsdale Healthcare at Good Shepherd Episcopal Church 6502 E. Cave Creek Rd., Cave Creek Register: 480-488-3283

WOMEN’S HEALTH A TO Z Oct. 9, 10:30–11:30 a.m.

By St. Luke’s at Senior Opportunities West 1220 S. Seventh Ave., Phoenix Register: 877-351-9355

WHAT: 10K/5K run and 1-mile walk to benefit the Arizona chapter of the American Parkinson’s Disease Association. Oktoberfest celebration follows the run.

WHERE: Carefree Sundial Park, Carefree TIME: Run at 4 p.m.; Oktoberfest from 5–8 p.m.

COST: $25 adults; kids free INFO/REGISTER: 623-703-9553; apdaarizona.org

CANCER SUPPORT

LIVING WITH LYMPHEDEMA Oct. 28, 6:30–8:30 p.m.

Virginia G. Piper Cancer Center at Scottsdale Healthcare 10460 N. 92 St., Scottsdale Register: 480-882-4636; shc.org/events

SENIORS

Oct. 26 Sunset Sprint & Oktoberfest for Parkinson’s

LUNG CANCER SUPPORT Oct. 12, 1–3 p.m.

By The Wellness Community 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@twccaz.org

FOR MEN ONLY Oct. 24, 6–8 p.m.

John C. Lincoln 19646 N. 27 Ave., Phoenix 602-780-4673; bhrc@jcl.com

GYNECOLOGICAL CANCER SUPPORT Oct. 8, 5–6:15 p.m.

Banner Desert 1400 S. Dobson Rd., Mesa 480-412-4673

WHAT: A celebration of wellness, fitness and health. Information booths, activities.

WHERE: Tumbleweed Park, 2250 E. McQueen Rd., Chandler TIME: 9 a.m.–1 p.m.

COST: Free; some events have a fee. See website for details.

PRESENTED BY: Banner Children’s at Cardon Children’s Medical Center & the City of Chandler INFO: chandleraz.gov/special-events

OVARIAN CANCER SUPPORT Oct. 19, 10 a.m.–noon

By The Wellness Community 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@twccaz.org

NON-HODGKIN’S LYMPHOMA SUPPORT Oct. 10, 6–8 p.m.

Virginia G. Piper Cancer Center at Scottsdale Healthcare 10460 N. 92 St., Scottsdale Register: 480-882-4636; shc.org/events

WOMEN & CANCER

Oct. 26 Chandler Mayor’s Day of Play

LYMPHOMA SUPPORT Oct. 12, 10 a.m.–noon

By The Wellness Community 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@twccaz.org PANCREATIC CANCER SUPPORT Oct. 12, 10 a.m.–noon

By The Wellness Community 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@twccaz.org

ORAL, HEAD & NECK SUPPORT Oct. 17, 6:30–8 p.m.

Virginia G. Piper Cancer Center 10460 N. 92 St., Scottsdale 602-439-1192 COLORECTAL CANCER SUPPORT Oct. 19, 10 a.m.–noon

By The Wellness Community 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@twccaz.org

PARKINSON’S CAREGIVERS SUPPORT (DUET) Various dates, times & locations 602-274-5022 DANCE, EXERCISE, YOGA, ART & TAI CHI Various dates, times & locations By the Muhammad Ali Parkinson Center Register: 602-406-6903 SUPPORT GROUP Oct. 11, 10 a.m.–noon HealthSouth Scottsdale 9630 E. Shea Blvd., Scottsdale Register: 602-406-3840

WEDNESDAY, October 2, 2013 | LIVING WELL A-Z | 7

BRAIN ANEURYSM SUPPORT Oct. 16, 6–8 p.m.

St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 760-333-7658; kimberly@joeniekrofoundation.org

POSTPARTUM DEPRESSION SUPPORT Oct. 9, 16, 23 & 30, 1–2:30 p.m.

Chandler Regional 1875 W. Frye Rd., Chandler 877-728-5414

GASTROINTESTINAL

ADULT BRAIN INJURY SUPPORT Oct. 24, 6–7:30 p.m.

St. Joseph’s 350 W. Thomas Rd., Phoenix 602-508-8024

GUARDIANSHIP CLINIC (DUET) Oct. 11, 3–5 p.m.

Church of the Beatitudes 555 W. Glendale Ave., Phoenix Register: 602-274-5022

BREASTFEEDING

INFANT BRAIN DEVELOPMENT Oct. 12, 9 a.m.–1 p.m.

Tempe St. Luke’s 1500 S. Mill Ave., Tempe Register: 480-784-5588

OSTOMY SUPPORT Oct. 20, 2–4 p.m.

First Presbyterian Church 161 N. Mesa Dr., Mesa 480-812-0324

BREASTFEEDING SUPPORT Oct. 4, 11, 18 & 25, 10 a.m.

Mercy Gilbert 3555 S. Val Vista Dr., Gilbert 877-728-5414

CELIAC DISEASE SUPPORT Nov. 6, 7–8:30 p.m.

Paradise Valley Retirement Center 11645 N. 25 Pl., Phoenix 623-587-8885

BREASTFEEDING SUPPORT Oct. 7, 14, 21 & 28, 10–11:30 a.m.

St. Joseph’s 350 W. Thomas, Phoenix 602-406-4954

RESPIRATORY LUNG TRANSPLANT SUPPORT Oct. 8, 11:45 a.m.–1 p.m.

St. Joseph’s 350 W. Thomas Rd., Phoenix 602-406-7009 ALPHA-1/COPD SEMINAR & SCREENING Oct. 12, 8–11 a.m.

By St. Joseph’s North & the City of Peoria St. Joseph’s Peoria North 7727 W. Deer Valley Rd., Peoria 623-773-7137 BETTER BREATHERS Oct. 16, 2–3 p.m.

Chandler Regional 1875 W. Frye Rd., Chandler 877-728-5414 BETTER BREATHERS Oct. 24, 1:30 p.m.

John C. Lincoln 250 E. Dunlap Ave., Phoenix 602-870-6060, ext. 5793

BRAIN APHASIA SUPPORT Oct. 3, 10, 17, 24 & 31, 10–11 a.m.

HealthSouth Scottsdale 9630 E. Shea Blvd., Scottsdale 480-551-5442 BRAIN INJURY SUPPORT FOR YOUNG ADULTS & CAREGIVERS Oct. 9, 6–7:30 p.m.

St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 602-996-1396 PROGRESSIVE SUPERNUCLEAR PALSY (PSP) SUPPORT Oct. 12, 1:30–3:30 p.m.

Pyle Adult Rec. Center 655 E. Southern Ave., Tempe 480-966-3391; aludwig@asu.edu

BREASTFEEDING SUPPORT Oct. 8, 2–3:30 p.m.

Banner Baywood 6644 E. Baywood Ave., Mesa 480-321-4455 BREASTFEEDING SUPPORT Oct. 9, 16, 23 & 30, 11 a.m.

Chandler Regional 1875 W. Frye Rd., Chandler 877-728-5414

PARENTING CHILDBIRTH EDUCATION (2–WEEK CLASS) English and Spanish Various dates, 6:30–9:30 p.m.

Maryvale Hospital 5102 W. Campbell Ave., Phoenix Register: 855-292-9355; azhealthyhours.com GRANDPARENTS RAISING GRANDCHILDREN

By Benevilla; various dates, times & locations 623-207-6016 GRANDPARENTS RAISING GRANDCHILDREN

By Duet; various dates, times & locations 602-274-5022 SUPPORT THROUGH OTHER PARENTS (S.T.O.P.) Various dates & locations, 7–9 p.m.

623-846-5464 MOTHER-TO-MOTHER SUPPORT Oct. 4 & 25, 10–11:30 a.m.

St. Joseph’s 350 W. Thomas, Phoenix 877-602-4111

WEIGHT LOSS WEIGHT LOSS SURGERY SEMINARS Various dates, times & locations

By St. Luke’s Register: 800-248-5553 BAND CAMP: BARIATRIC SUPPORT Oct. 22, 4–5 p.m.

By St. Luke’s at Bridges Center 555 N. 18 St., Phoenix Register: 602-251-8828 BYPASS/SLEEVE/DS: BARIATRIC SUPPORT Nov. 5, 5–6:30 p.m.

By St. Luke’s at Bridges Center 555 N. 18 St., Phoenix Register: 602-251-8828

ADDITIONAL SUPPORT GROUPS INTERSTITIAL CYSTITIS SUPPORT Oct. 13, 2–3:30 p.m.

Phoenix Baptist Hospital 2000 W. Bethany Home Rd., Phoenix heatherbarrowbrown@gmail.com; 623-349-4611 MEN’S DISABILITY ISSUES Oct. 17, 5:30–7 p.m.

Disability Empowerment Center 5025 E. Washington St., Phoenix 602-980-3232; donp@abil.org HUNTINGTON’S DISEASE Oct. 21, 6–8 p.m.

St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 602-402-1774

BANNER HEALTH: BannerHealth.com BARNET DULANEY PERKINS EYE CENTER: GoodEyes.com

CHANDLER REGIONAL MEDICAL CENTER: ChandlerRegional.org CIGNA: Cigna.com JOHN C. LINCOLN HOSPITAL: JCL.com LASER SPINE INSTITUTE: LaserSpineInstitute.com MAYO CLINIC: MayoClinic.com

BARROW NEUROLOGICAL INSTITUTE:TheBarrow.org

MERCY GILBERT MEDICAL CENTER: MercyGilbert.org

CARDON CHILDREN’S MEDICAL CENTER: BannerHealth.com

MOUNTAIN VISTA MEDICAL CENTER: MVMedicalCenter.com

BY MARY VANDEVEIRE

A

stem cell or bone marrow transplant is standard treatment for patients with life-threatening blood, immune system or genetic disorders, replacing unhealthy blood-forming cells with healthy ones.

Be The Match Foundation, which is operated by the National Marrow Donor Program and has a regional center in Phoenix, provides a link for patients and donors.

How to donate

Be The Match donor drives, where potential donors can register and provide cell samples through cheek-swabs, are listed on the Be The Match website (BeTheMatch.org), or can be found by calling the Phoenix office of Be The Match at 602-277-1390.

In addition, those interested in being a potential donor can sign up on the Be The Match website and a swab kit will be mailed out with instructions. Please note that the Phoenix office is not set up to register potential donors on a walk-in basis.

Who can donate

Be The Match recruits for donors ages 18-44; there is no cost to these potential donors to register. Potential donors ages 45-60 must pay for their own testing, which costs $100. (For the Be The Match system, 60 is the upper age limit.)

State Sen. Anna Tovar (D-Tolleson)

A second chance Patients get a second chance at life and donors can be heroes, said State Sen. Anna Tovar (D-Tolleson). “To know that one person can make that difference, it’s such a great act of kindness,” she said.

When Tovar was diagnosed with a severe and rare form of leukemia in 2001, her brother donated bone marrow for a transplant.

“If I didn’t have my transplant, I would have died,” Tovar said. Tovar needed a second transplant in 2002, and her brother was able to donate stem cells.

Since then, she’s been cancer-free.

MULTIPLE SCLEROSIS (WOMEN) Oct. 26, 10 a.m.

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

POISON CONTROL

BE THE MATCH WALK+RUN

BANNER GOOD SAMARITAN Poison & Drug Information Center Hotline: 800-222-1222

The Walk+Run will raise money that will be spent in Arizona to grow the Be The Match Registry. Potential donors will be able to sign up and get swabbed.

INFO Online ABRAZO HEALTH CARE (AZ Heart Institute and AZ Heart, Arrowhead, Maryvale, Paradise Valley, Phoenix Baptist and West Valley hospitals): AbrazoHealth.com

Giving hope to leukemia, lymphoma and other blood cancer patients

PHOENIX CHILDREN’S HOSPITAL: PhoenixChildrens.com

WHAT: 5K, 1K and Tot Trot WHEN: Oct. 26 TIME: Activities start at 7:30 a.m.

WHERE: Wesley Bolin Plaza, 1700 W. Washington St., Phoenix REGISTRATION/INFO: BeTheMatchWalkRun.org/phoenix; 602-277-1390

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 HOSPITAL: TempeStLukesHospital.com

239) 231, -4>.>1,=B 3.A8)B MEDICARE ADVANTAGE PLANS Learn About Medicare Advantage HMO Plans from Cigna.

A sales person will be present with information and applications.

For accommodation of persons with special needs at sales meetings call 855.298.4382 (TTY 711).

Join us for these and other exciting events in October.

morning and afternoon seminars are available

WEEKLY

Walk from Obesity October 5, 7 - 9:30 AM Freestone Park, Gilbert

WHERE: Cigna Medical Group locations throughout the valley COST: Free seminar, receive a free no obligation gift

Spirit Girls and Moms, Too October 26, 9:30 - 11: 30 AM Banner Baywood Medical Center

REGISTER: 855.298.4382

AR-0008086592-01

ULCERS & ACID REFLUX Oct. 16, noon Mountain Vista Medical Center 1301 N. Crismon Rd., Mesa Register: 877-924-9355

Be The Match Donor Registry PHOTO USED WITH PERMISSION OF ANNA TOVAR

SUPPORT GROUP Oct. 15, 3–5 p.m.

By Benevilla at Shepherd of the Hills United Methodist 13658 Meeker Blvd., Sun City West 623-584-4999

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Visit www.BannerHealth.com/Events for more.

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I’m a daughter. A wife. A mother.

And I have a gene that puts me at risk for breast cancer. When I got sick, I was determined to win.

For me, and for them.

My answer was Mayo Clinic.

Monique Sisneros

Mayo Clinic Cancer Center specialists worked together to ensure Monique received a timely, &==-5&/9 ;.&3?<2.2 &?; /09 A<2/ 9>9=/.+9 /59&/A9?/* If you are diagnosed with breast cancer, you deserve the best as well. Mayo Clinic patients with breast cancer have substantially 0.3095 C+9K@9&5 2-5+.+&' 5&/92 =<A:&59; /< /09 H*J* F&/.<?&' 4&?=95 1&/&$&29* G9 &59 &? .?K?9/E<5) :5<+.;95 6<5 A<2/ :9<:'9 &?; & :0@2.=.&? 596955&' .2 5&59'@ 598-.59;* I< 2=09;-'9 &? &::<.?/A9?/( =&'' D!,%B "%#K,%%% <5 =&'' <-5 759&2/ 4'.?.= ;.59=/'@ &/ D!,%B "%#K!%%%*

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8 | LIVING WELL A-Z | WEDNESDAY, October 2, 2013

THINKSTOCK

VITAL Signs

Medicare:

What you need to know Open Enrollment dates are Oct. 15 through Dec. 7 BY DEBRA GELBART

If you are Medicare-eligible, you need to sign up for Medicare coverage during the Medicare Enrollment Period which is completely separate from the Affordable Care Act’s Health Insurance Marketplace and its coverage for those under age 65.

Considering changing plans?

How do you decide whether you should change plans or options? Here’s advice from Robert Matura, vice president of Cigna Medicare of Arizona, and Jaime Perikly, chief operating officer for Health Choice Arizona, which operates Health Choice Generations, HMO SNP, a health plan for dual-eligible enrollees who qualify for both Medicaid and Medicare.

• Medicare Advantage plans are offered by private health insurance companies that contract with Medicare. If you’re thinking of changing to a Medicare Advantage plan (or keeping your current Advantage plan), make sure your favorite doctors are part of the plan’s network. “If you’re attached

If you have questions about coverage options, free assistance is available by calling the senior helpline that’s part of the State Health Insurance Assistance Program (a nationwide program operated in Arizona by the Area Agency on Aging Region One) at 602-264-2255. In addition, you can call Medicare at 1-800-MEDICARE.

Medicare definitions • Medicare Part A: Hospital insurance (according to medicare.gov, most people get this premium-free) • Medicare Part B: Traditional Medicare • Medicare Part C: Also known as Medicare Advantage, these plans are offered by private health insurance companies that contract with Medicare

Resources

• Medicare Part D: Drug coverage to a particular doctor, it’s important to determine if he or she will be contracted with the Medicare Advantage plan you’re going to select in 2014,” Matura said. Provider contracts can change from year to year, even with the same plan, Perikly said. “With traditional Medicare (Part B), you can see any provider you wish,” she said. “But provider networks within a Medicare Advantage Plan are limited.”

• If you want to select or keep Medicare Part B (traditional Medicare), make sure your doctors will continue to accept Medicare-enrolled patients. A reduction in reimbursement rates from the government in 2014 may prompt some doctors to change their policy and no longer accept Medicare patients, Matura said.

Using veterans to help reduce Medicare readmission rates Program is a national winner of the 2012 White House Healthcare Policy Challenge

A

Area Agency on Aging Region One: aaaphx.org; 602-264-2255 Medicare.gov (the official U.S. website for Medicare): medicare.gov; 800-633-4227

Senior Medicare Patrol: Fighting Medicare fraud Composed of volunteers who are retired seniors, members of the Senior Medicare Patrol (SMP) give community presentations to teach Medicare beneficiaries how to do their part to prevent fraudulent Medicare claims.

The program is operated by the Administration on Aging, part of the U.S. Department of Health and Human Services.

In Arizona, the program is overseen by the Division of Aging and Adult Services within the Department of Economic Security.

To arrange a presentation about preventing Medicare fraud for your church group, community group or senior center, call the Area Agency on Aging Region One at 602-264-2255. To find out more about becoming a SMP volunteer, call 602-542-6439 or visit www.azdes.gov/daas/ship/ ferretoutfraud. Currently, 176 SMP volunteers conduct outreach in Arizona; more volunteers, both English- and Spanish-speaking, are needed statewide.

EXPERTS CATARACT & REFRACTIVE SURGERY Scott A. Perkins, MD

As a nationally recognized ophthalmologist with Barnet Dulaney Perkins Eye Center, Dr. Perkins has performed more than 50,000 cataract surgeries and more than 10,000 vision correction procedures such as LASIK and Implantable Contact Lenses (ICLs). As an innovator in the field of ophthalmology, he has participated in over 25 clinical trials for both pharmaceutical and ophthalmic devices.

In addition, Dr. Perkins serves on the Board of Directors for Arizona Visionaries, a donor driven non-profit organization providing cataract surgery and eyeglass fittings in third world countries. He is not only trusted for his surgical talents and modest nature, but is also well known for his compassion and ability to connect with and comfort patients.

Board Certified by the American Board of Ophthalmology Member of the American Society of Cataract and Refractive Surgery Fellow of the American Academy of Ophthalmology

penalties for readmission rate increases were built into the CMS campaign.

John C. Lincoln’s program hires veterans as transition coaches who provide designated Medicare patients with support and guidance related to follow-up medical instructions, doctor appointments, nutrition and costs of care.

In the long run, reduced readmissions generated by the transition coaches produce significant savings for John C. Lincoln that far exceed program costs. But initial assistance to maximize the program’s effectiveness was needed. To help, the Del E. Webb Foundation awarded a $500,000 grant to support and expand the transition coach service. The funds will allow the program to expand to 14 transition coaches by 2014.

PHOTO USED WITH PERMISSION OF JOHN C. LINCOLN

program that hires military combat medics and corpsmen to care for discharged elderly patients has reduced the John C. Lincoln Hospitals’ Medicare patient readmission rates to 6 percent.

Before the program started last year, the rates were approximately 18 percent (the national average is 20 percent).

The Centers for Medicare and Medicaid Services (CMS) launched a campaign to encourage hospitals to do whatever necessary to maintain the health of discharged Medicare patients with congestive heart failure, heart attacks or pneumonia, so fewer of them would be readmitted within the first 30 days after leaving the hospital. Financial incentives for readmission rate reduction and

“Most Medicare Advantage plans will cover urgent and emergency care only while you’re away from home, not routine care,” Matura said. “So if you see your doctor every few months because you have a chronic medical condition, you would have to pay for a routine visit outof-pocket while you’re somewhere else.”

Traditional Medicare (Medicare Part B) and a Medicare supplement plan (also called “Medigap”) might be more appropriate if this scenario applies to you, he said.

Questions?

Medicare Open Enrollment

If you are a current Medicare enrollee and want to change your current Medicare plan or options for 2014 (adding/deleting drug coverage, or Part D, for example), you can do so during the Medicare Open Enrollment Period which begins Oct. 15, 2013 and runs through Dec. 7, 2013.

Even if you’re satisfied with your current Medicare plan and options, experts say that it’s still a good idea to review your plan and find out during Open Enrollment if anything has changed, which often happens. If you want to keep the plan and options you currently have, you don’t have to do anything — you will be automatically re-enrolled for 2014 with the same plans and options that you have now.

• Check to see if the benefits important to you are part of the Medicare Advantage plan you’re considering. Prescription drugs are typically part of a Medicare Advantage plan, but are separate when traditional Medicare is selected. You must enroll in Parts B and D if you want traditional Medicare with a prescription drug benefit. Medicare Advantage plans typically offer lower limits for out-ofpocket spending and co-pay amounts, Matura said.

• Consider whether your health has changed in the past year. If you think you may need surgery in the next 12 months, for example, you’ll want to find out if there are restrictions related to surgery in a Medicare Advantage plan, Perikly said.

• Are you a part-time resident? If you spend part of the year outside Maricopa County, Matura said, and you want to select a Medicare Advantage plan, you’ll need to arrange to receive your routine medical care in Maricopa County.

Former U.S. Navy corpsman and John C. Lincoln transition coach Kathy Orona, right, checks the blood pressure of Medicare patient Kathleen Reed, Glendale, during a wellness visit. Reed’s health-check results are entered into her electronic medical record by John C. Lincoln transition coach Letty Fred, also a former U.S. Navy corpsman.

Locations throughout Arizona (800) 966-7000 / www.GoodEyes.com

PAIN RELIEF Dr. Theodore Manos Dr. Manos is a Board Certified Specialist in Anesthesiology and Pain Management. He specializes in procedures such as epidural steroid treatments and facet joint block procedures that can relieve lower back pain and help improve patient’s daily comfort level. Whether it’s arthritis, a herniated disc, sciatica or spinal stenosis of the lower back, his treatments can help patients regain mobility and functionality. These treatments can help eliminate or reduce the use of oral pain medications that patients may be taking on a regular basis. Anyone experiencing chronic lower back pain may be a candidate. In most cases, pain therapy can last for long periods of time. During the first appointment Dr. Manos will evaluate the patients’ unique condition and develop a treatment plan specific to their needs.

Cigna Medical Group | Outpatient Surgery Center 3003 N. 3rd Street, 2nd Floor Phoenix, AZ 85012 602.282.9600

GENERAL SURGERY G. Paul Dabrowski, MD, FACS Dr. Dabrowski joined the full-time faculty and staff of Banner Good Samaritan Medical Center in 2008. He is currently the medical director of Banner Good Samaritan’s Level I Trauma Center. He received his medical degree from the St. Louis University School of Medicine in St. Louis, Mo. in 1990 and completed his general surgery training and two additional years of fellowship in Surgical Critical Care and Trauma Surgery at Tulane University School of Medicine in New Orleans, La. He is board certified in both General Surgery and Surgical Critical Care. Dr. Dabrowski has many years of experience in trauma leadership. He is a member of many state and national and is State Faculty for the Advanced Trauma Life Support program. He is a captain (select) in the Medical Corps of the U.S. Navy, He is presently the chief of Professional Services for the 4th Medical Battalion, 4th Marine Logistics Group, U.S. Marine Corps.

Banner Good Samaritan Medical Center Specializing in General Surgery 1111 E. McDowell Road, Phoenix (602) 839-2000 www.BannerHealth.com/GoodSam AR-0008084428-01

WEDNESDAY, October 2, 2013 | LIVING WELL A-Z | 9

Continued from cover HEALTHY AGING

6

9

RICK D’ELIA

Address symptoms of depression.

5 frail.

Avoid becoming

“Frailty is the most under-diagnosed condition in older people,” said Nikolich-Zugich of the Arizona Center on Aging at the UA College of Medicine. Frailty, he explained, is not dependent on body type. “Frailty is partly defined by loss of grip strength and loss of muscle mass that results in an inability to walk well,” he said, adding that muscle strengthening exercises throughout life can combat this.

Frailty can also be characterized by depression and diminished mental capacity, Nikolich-Zugich said, emphasizing that both of those conditions can be kept at bay with regular exercise. “Once you become frail, your health can get onto a downward slope,” he said.

“But we know that you can prevent frailty with the right steps, including exercise and good nutrition.”

“The World Health Organization conducted a survey and found that depression is the leading cause of quality life years lost,” said Aaron Boor, D.O., a family medicine physician with John C. Lincoln’s Del Lago Family Medicine in Peoria. “If people talk with their doctor about their symptoms and either start talk therapy or take appropriate medication, the vast majority will get better with time.”

Mitigate unnecessary

risk. “Make sure you wear a

helmet when you ride a bike and make sure if you’re going to climb a ladder that it’s situated safely,” Boor said. “Accidents and injuries are the most common cause of death for people up to age 45.”

“Activity is critically important. ‘Use it or lose it’ is really true.”

7

Choose supplements carefully.

10

Stay on-guard against health threats. “Research has

demonstrated,” Nieri said, “that if by age 70, you don’t smoke, don’t have diabetes, don’t have high blood pressure (or it’s under control), you’re not obese and you are physically active, you have greater than a 50 percent chance to live to 90.”

— Aaron Boor, D.O., family medicine physician at John C. Lincoln’s Del Lago Family Medicine

More is not better when it comes to supplements, said NikolichZugich, whose research focuses on how the immune system declines with aging. “The supplement industry is poorly regulated,” he said, “and there are no national guidelines.” He suggests Vitamin D supplementation and encourages people to consume adequate amounts of Omega-3 fatty acids, which can be found in foods like salmon. He also advises talking with your physician about nutritional supplements.

8

Maintain social connections.

“Socialization is extremely important,” Nieri said. “Social support can help you have a successful recovery from a heart attack.”

ABOVE: Walter Nieri, M.D., a geriatrician and internal medicine physician and director of Banner Sun Health Research Institute’s Center for Healthy Aging, works with Barb Feyereisen, 73, of Sun City, tracking various indicators of her health.

RIGHT: Feyereisen turns the tables on Dr. Nieri by asking him to try the grip strength test. Nieri has been conducting a longevity study for six years. He says that as you age, it is important to incorporate exercise that promotes endurance, muscle strength, flexibility and balance.

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Dr. Kevin Ellis Chief Medical Officer, Cigna Medical Group

Coordinated Care: The Team Approach to Better Health

W

hat is Coordinated Care?

Coordinated care is a way to deliver health care through teamwork among primary care doctors, specialists and other health care professionals, with a special focus on prevention and the management of chronic disease. Many studies show that more efficient primary care also helps lower costs in the long term by emphasizing prevention and reducing unnecessary procedures.

By linking specialists, hospitals and other caregivers, patients can count on a single point of contact – a “medical home” – for clear answers, personal help and peace of mind. This is especially important for seniors, who often live with many chronic conditions.

Studies show roughly half of patients do not follow their doctor’s orders. Coordinated care provides more patient education and encouragement to comply with the doctor’s orders so they stay healthy. As a result, coordinated care has been proven to reduce emergency room visits, hospitalizations, nursing home stays and other expensive interventions by increasing control of the chronic diseases of age.

A Focus on Quality The traditional healthcare system treats patients after they are already sick or experiencing complications, forcing doctors to practice reactive rather than preventive medicine. Under this system, doctors get incentives to bill early and often.

Coordinated care takes a different approach. Rather than pushing doctors to see high numbers of patients and spend a short amount of time with each one, coordinated care brings the focus back to the allimportant doctor-patient relationship. Doctors receive assistance with patient tracking, communication and paperwork, so they have more time for face-to-face

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interaction. They can also provide more preventive services and screenings, which lead to earlier diagnosis and better health outcomes.

At Cigna Medical Group, for example, we’ve had great success with the coordinated care concept. We see the primary care doctor as the “quarterback” working with specialists to manage each patient’s health. In fact, Cigna Medical Group has been certified by the National Committee for Quality Assurance (NCQA) as a level three Patient-Centered Medical Home. This means that all 22 locations have received the highest level of recognition for meeting national quality standards in coordinated care.

This doctor-led, patient-centered team approach enables open communication among all health care professionals and specialists. The coordinated care method helps doctors practice medicine the way it was intended, with the patient’s good health as the top priority.

The result is better care, healthier patients and reduced healthcare costs.

Coordinated Care in Action People over age 65 are especially vulnerable to medication mishaps. It’s vital that you communicate with your doctors, and crucial that your doctors communicate with each other. In fact, it’s not exaggerating to say good communication can mean the difference between life and death.

Now’s the Time One of the most important aspects of coordinated care is the emphasis on preventive healthcare. Talk with your primary care doctor today about annual exams, tests and other preventive steps you can take now to stay healthy.

Go from a life of back pain

to a lifetime of living.

Not an actual patient of Laser Spine Institute

FINALLY, AN ALTERNATIVE TO TRADITIONAL OPEN BACK SURGERY. It’s time for you or a loved one to stop suffering. Do what more than 35,000 people have done and get your life back. If you’ve been putting off neck or back surgery, come learn about a proven technique that’s minimally invasive. BRING YOUR MRI OR CT SCANS and meet one-on-one with our physicians who will review them and discuss treatment for your specific condition.

Learn more by attending our

FREE MEDICAL SEMINAR on neck and back surgery options.

Saturday, October 5 at 10 a.m.

Windemere Hotel & Conference Center 5750 E. Main St. | Mesa, AZ 85205

Saturday, October 26 at 11 a.m.

Laser Spine Institute 8888 E. Raintree Drive | Scottsdale, AZ 85260

EXPERTS IN TREATING CONDITIONS SUCH AS: Pinched nerve Bulging/herniated disc ] Scoliosis

THE ADVANTAGES OF MINIMALLY INVASIVE SURGERY AT LASER SPINE INSTITUTE • 97% patient recommendation rate

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Medicaid currently not accepted.

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To register, call: 1-855-333-7854 or visit SpineSeminar.com