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Overcoming COVID-19 Anxiety..............6

Caffeine’s Effects on Men.......................28

Benefits of Having a Pet.............................7

Skin Cancer...................................................29

Wrap Up Holiday Stress..............................8 Staying Well on the Go...............................9

GIVING BLOOD Be Prepared: Quick Facts........................ 11 Blood Donations: By the Numbers..... 12 How Your Blood Helps............................. 13

Benefits of Yoga for Men........................30 Lessen Your Heart Disease Risk............31

EYE CARE Top Tips to Prevent Vision Loss...........32 Finding the Right Eye Doctor................33

BABY CARE Choosing Positive Parenting.................34


Baby Checkup Schedule.........................34

Start Meal Prepping.................................. 15

Sleeping Basics...........................................35

Best Foods for Eye Health....................... 16

Secure a Network of Helpers.................37

The Mediterranean Diet.......................... 17

HIT THE GYM HIIT Workout Basics..................................19 Find a Personal Trainer............................ 20 Pick the Right Gym.................................... 21 What to Eat After You Exercise............. 22

Preparing a Sibling for Baby..................38 Taking an Infant’s Temperature...........38

BREAST CANCER Changes in the Breast..............................43 Lowering Your Cancer Risk....................44 Stages of Breast Cancer...........................44 Triple-Negative Cancer............................45 How to do a Self-Exam............................46


Genes and Hereditary Cancer...............46

Get Back to the Basics of Brushing..... 26 Natural Teeth Whitening Myths.......... 26


Helping Kids Improve

Expert columns......................14, 18, 24, 25

Oral Care Habits.......................................... 27

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Practitioner profiles..................................39

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Mental Health

Overcoming COVID-19 Anxiety T

he COVID-19 pandemic caused near-record unemployment and left many people looking for ways to support their families.

This unfortunate situation during the time of year when we are used to heading out on summer vacations has added extra stress for many people. There has also been added fear and anxiety about the unknowns of the disease. When will it end? How can I protect myself and my family from it? Fortunately, there are many ways you can cope with COVID-19related stress to lessen the impact it has on your psychological well-being.

What Is COVID-19 Stress? Stress during any infectious disease outbreak can include the following, according to the Centers for Disease Control and Prevention:

• Fear and worry about your own health and the health of your loved ones. • Changes in sleep or eating patterns.



• Difficulty sleeping or concentrating.

• Worsening of chronic health problems.

• Worsening of mental health conditions.

• Increased use of alcohol, tobacco, or other drugs.

Who is at Risk? Everyone reacts differently to stressful situations. How you respond to the outbreak can depend on your background and the community you live in. The CDC identifies the following types of people as ones who may respond more strongly to the stress of a crisis like the COVID-19 pandemic: • Older people and people with chronic diseases who are at higher risk for severe illness from COVID-19. • Children and teens.

• People who are helping with the response to COVID-19, like doctors, other health care providers, and first responders.

• People who have mental health conditions including problems with substance use.

How to React There are many ways you can take care of yourself and your community during this unprecedented time. And doing so can actually help you cope with COVID-19related stress.

Here are some ideas from the CDC to get you started: • Take breaks from watching, reading, or listening to news stories, including social media. • Take care of your body with plenty of exercise and healthy eating. • Avoid alcohol and drugs.

• Make time to unwind and try to do some other activities you enjoy. Remember that you are not alone in any stress you are feeling. Millions of Americans across the country are in the same boat. Take the time to connect virtually with your friends and family members to keep you active in community. m

Benefits of Having a Pet

O life.

wning a pet means more than just having a fourlegged friend around the house. It can also mean a healthier lifestyle and increased happiness in your

Research has shown that living with pets provides certain health benefits, including lower blood pressure, decreased anxiety and boosted immune systems. So take your pooch for a walk or cuddle with your cat to show them a big thanks for making a positive impact on your life.

Healthier Hearts People who own dogs get more activity in their day simply by mixing in walks around the neighborhood. According to the American Heart Association, dog owners are 54% more likely to get the recommended amount of exercise than their non-dog owning counterparts. As a result, and due to a stronger immune system from being exposed to pet fur and dandruff, many dog owners see a decrease in blood-pressure, triglycerides and cholesterol levels. This puts them less at risk for heart-disease.

Fighting Allergies Researchers at the University of Wisconsin-Madison, in the Journal of Allergy and Clinical Immunology, have found that kids growing up in a home with “furred animals” – whether it’s a pet cat or dog, or on a farm and exposed to large animals – will have less risk of allergies and asthma.

The university has performed recent studies analyzing the blood of babies immediately after birth and one year later. Here are some of the results: • If a dog lived in the home, infants were less likely to show evidence of pet allergies (19% versus 33%).

• They also were less likely to have eczema, a common allergy skin condition that causes red patches and itching. • They had higher levels of some immune system chemicals, which is a sign of stronger immune system activation.

Elderly Benefits Studies have shown that Alzheimer’s patients have fewer anxious outbursts if there is an animal in the home. Walking a dog or simply caring for a pet can provide healthy levels of exercise and companionship for the elderly. Playing with a dog can elevate levels of serotonin and dopamine, which are nerve transmitters that are known to have pleasurable and calming properties, according to studies by the University of Texas School of Public Health. m



Wrap Up Holiday Stress T

he holiday season can be tough. Days are shorter and to-do lists are longer, and the combination may stretch your nerves to the breaking point. But there’s help, this time from the Mayo Clinic. Keep reading to keep yourself sane during the holiday rush.

Learn to Say No If your list is getting too long, don’t be afraid to turn people down. People will be way more understanding than you think. If you just can’t say no, rearrange your schedule to give yourself more space. Which brings us to …

Acknowledge Your Feelings They matter. Really. Your feelings are normal and may even be more common than you realize. It’s OK to express yourself and you shouldn’t force yourself to be happy just because it’s the holiday season. And while we’re at it …

Set Aside Differences Give yourself a huge holiday gift and bury any hatchets with family and friends. If doing so needs a discussion, set a time for after the holidays. Try to be understanding if other people get upset with you or seem distressed. They’re feeling it, too.

Reach Out Sometimes, the holidays can make people feel alone or isolated. Fight those feelings by getting out into the community, maybe at a church event or a holiday celebration. Also consider volunteering for an extra shot of feel-good.

Stick to Healthy Habits One thing you shouldn’t say no to is keeping up your healthy habits. Get lots of sleep and get regular exercise every day. Before you head out to parties, nibble on something healthy at home so you don’t overindulge.

Make Time for Yourself More than usual, please. With the extra stress, you might need extra time to decompress. Set aside time for you to relax and breathe. Suggested activities include getting a massage or spa treatment, listening to soothing music, take a walk or read a book.

Talk to a Professional If life gets too much to handle, don’t be afraid to talk to a doctor or mental health professional. It’s not a weakness, it’s bravery. Look for other mental health symptoms, such as poor sleep, irritability, hopelessness and persistent feelings of sadness or anxiety. m 8


Staying Well on the Go


oliday time means holiday travel for many of us, and that can also mean picking up some unwanted gifts like a cold or the flu. Here are some tips from the University of Texas for keeping yourself well while spreading holiday cheer.

1. Get plenty of sleep. Being well rested can boost your immune system. Grab a few winks when you have some down time while riding in the car or on a layover. And don’t forget to rest up before and after your trip. Your body will thank you. 2. Hydrate, hydrate, hydrate. It can be easy to

forget to drink plenty of water when you’re on the move. But listen to your body. It’s saying put down the coffee and pick up some H20. Carry a bottle of water with you (lots of places have bottle-filling fountains).

3. Eat something. Not a doughnut. Something

green and leafy. We know, it’s hard finding balanced meals when you’re on the road. But with some planning and creativity, you can keep your body fueled up and ready to roll.

4. Wash. Your. Hands. And use hand sanitizer. Anywhere you’ve got lots of people moving through is going to be filthy. Avoid touching your face and wash your hands whenever you’re able. Count to 20 while you’re washing. Use sanitizer in between washing.

5. Stretch and move around. Travel often means sitting still for hours on end, which can keep your muscles sore and stiff. Try to get up and move around at least once an hour to increase blood flow and make you feel more refreshed. You can also sneak in neck and shoulder rolls, back twists and leg stretches, even if you have to remain seated. 6. Stay calm. Travel also means ... challenges.

Lost luggage, delayed flights, traffic. Everyone has a horror story. Stress can negatively impact your health, so try to stay calm no matter what happens. Do breathing exercises to help you calm down. Take a deep breath, hold it, exhale and repeat. Focus on your breathing and stay calm. m

Promoting Population Health and Community Wellness Throughout Southeast Arizona

RESOURCE GUIDE APP Connecting Our Communities Access Resources Throughout the County; Anytime, Anywhere Using the Legacy Foundation’s Resource Guide App or Website. www.legocyfoundotionresourceguide org





: d e r a p e r Be P s t c a F k c i u Q

Giving Blood


s January opens the door for a new year, Americans across the country will welcome the new decade by celebrating National Blood Donor Month.

Whether you’re a first-timer or a veteran in donation, you should know some beneficial tips for a wholesome way to save a life. Check out this helpful information from the American Red Cross to understand the process and how to prepare.

The Process is Quick The entire donation process typically only takes one hour. That’s the same amount of time that an average 1,800 citizens will require life-saving blood treatment in the country. To streamline a make sure to wear a T-shirt or one with sleeves that can be quickly rolled up.

Unbiased to Blood Types A blood bank requires numerous types of fluid to remain productive and beneficial. You won’t be turned away for having a particular makeup, or for not knowing which group you represent. It’s a great way to discover your blood type if you’re unsure, as donors may choose to find out after a donation.

Be in Good Health Never attempt to donate blood while suffering from illnesses like the flu. Be honest about types of medicine you’re taking and concerns you have about how your health may affect donation.

Never Too Old Most states require donors to reach a certain age before they can donate, but there is no upper limit. The Red Cross states many of their dedicated donors are senior citizens, and they encourage more to partake in a donation event.

Pre-Register Take advantage of the RapidPass questionnaire to pre-register for a blood donation. It must be filled out on the day of your appointment and requires relevant information about your state of health. It’s easily discoverable by using the Red Cross Blood Donor App.

Hydrate and Eat Consume plenty of iron-rich foods and water both before and after a blood donation. It will provide your body with the nutrients it needs to recover. Afterward, treat yourself to a free post-donation snack to help quickly replenish yourself. m





B h s

Th a t s u p s r

L h c



thriving blood supply is essential across the country in hospitals, clinics and blood banks. It benefits numerous people during emergencies or to assist when they are overcoming cancer treatment or other chronic illnesses.

In case you’re wondering how giving blood can help the general population, here are a few specific examples from the World Health Organization: • Women with complications of pregnancy, such as ectopic pregnancies and hemorrhage before, during or after childbirth.

• Children with severe anemia often resulting from malaria or malnutrition. • People with severe trauma following disasters.

• Many complex medical and surgical procedures and cancer patients. 12


Blood Donations: By the Numbers How You Can Help There is a constant need for regular blood supply, as blood can be stored for only limited periods. Do your part to ensure local facilities are stocked to support yourself, loved ones and peers in their times of need. These inspiring statistics from the Blood Centers of America show you the importance of taking the initiative of donating seriously. • About one in seven people entering a hospital requires blood.

• In America and Canada, 43,000 pints of donated blood are used each day. • One pint of blood can save up to three lives.

• Plasma is 90% water and makes up about 55% of blood volume.

• Most donated red blood cells can be stored for up to 42 days.

• Blood or plasma that was given for payment cannot be used for human transfusions.

• Shortages of all blood types occur most during the summer and winter holidays.

• The number one reason donors say they give is because “want to help other people.”

• If only one more percent of the American population donated, future shortages would be unforeseeable.

• An estimated 500,000 Americans donated blood in the days following the Sept. 11, 2001, attacks. • A patient could be passed up for a lifesaving organ if compatible blood is not available.

• A single donation typically takes one hour and one pint can save up to three lives. • Fluids are replaced within one hour after a donation. Red blood cells replenish after four weeks, and iron levels are restored within eight weeks. m

B a H

How your Blood Helps


lood donations help a variety of people facing personal emergencies. To get inspired to celebrate National Blood Donor Month this January, learn how your contribution can offer life-saving solutions to those in your community.

The organization Advancing Transfusion and Cellular Therapies Worldwide estimates that 6.8 million people donate blood at its sponsored centers or hospitals each year. A unit of donated blood will benefit multiple patients, as a donation is commonly separated into individual components like red blood cells, plasma and platelets. Learn who your blood donations are helping and how your contribution is changing their lives.

Cancer Patients Blood carries essential components that are often damaged by cancer treatments. Here are three elements that the experts at Dana-Farber Cancer Institute suggest that patients often require as replenishment. Red blood cells: Molecules in charge of

carrying oxygen to organs and remove carbon dioxide from our lungs

Plasma: This combination of water, proteins, fat and hormones transports blood and platelets, vitamins and waste products throughout the body, and Platelets: This component is essential for allowing blood to clot when cuts or open wounds occur.

Cancer patients are often exposed to surgery, which results in blood loss or chemotherapy and radiation that significantly leads to low blood cell counts or risks of infection.

Burn Victims LifeShare estimates that about 12% of donated blood goes to burn victims. It’s used to help regulate oxygen levels, limit anemia and enhance tissue healing, which preserves organ function. A recent study funded by the United States Army Medical Research proved that less is more when treating burn patients. The research found that a median of 16

units of given blood is as capable of lifesaving results as only eight units. Its goal is to set a new industry standard and make better use of the available blood supply in burn centers nationwide.

Help Yourself While the reasons for people who rely on blood donations vary dramatically, did you know that giving can also provide you with benefits? First, each time you give, an expert performs a short health screening to detect diseases that relate to blood pressure or infections. It’s also beneficial to reducing the risk of heart and liver problems that stem from having too much iron in our system. Another exceptional reason is to stimulate the production of new blood cells, which assists in maintaining overall health. m

Emergencies Don’t Wait When an emergency strikes, go to the place where your healthcare heroes are ready to care for everything from broken bones to chest pain.

Learn more at

We have been working hard to ensure our hospital— including our Emergency Department—is safe for everyone. Every minute matters in an emergency. You can have greater peace of mind knowing the right care is close to home when you need it. #YourHealthOurHeroes.




EXPERT | COVID-19 AND EMERGENCY ROOM SAFETY Dr. edward Miller, Do, FACoG board Certified, Gynecology & obstetrics Chief Medical officer, Copper Queen Community hospital

About the expert Dr. edward Miller, Do, FACoG Board Certified, Gynecology & Obstetrics Chief Medical Officer, Copper Queen Community Hospital Dr. Edward Miller was born and raised in Tucson, Arizona. With more than 25 years of experience in obstetrics and gynecology, he has achieved high levels of performance in clinical and teaching endeavors. Since graduating in the top 1% of all OB-GYN residents in the country in 1986, he has been named one of “America’s Top Obstetricians & Gynecologists” by The Consumer Research Council of America. He has served as Chairman of Obstetrics and Gynecology Departments at three hospitals and as the Chief of Staff of Northwest Medical Center in Tucson. Dr. Miller has won numerous teaching awards and is an Assistant Professor of Obstetrics & Gynecology at two universities. He is honored that his colleagues consider him the go-to surgeon during emergencies and complex cases. He is board-certified in Obstetrics and Gynecology and a Fellow of the American College of Obstetricians and Gynecologists.

When concerns about catching COVID-19 encourage people to physically distance, that’s healthy. When those fears keep sick people away from hospitals, though, it could be dangerous. We want everyone to know that emergency rooms are safe. And if you need to go, you should. There’s no question that excess non-COVID-19 deaths are occurring out of fear of going to the emergency room or seeing a healthcare provider. The medical profession is partly to blame for that. In the early days of the COVID-19 pandemic, it was a common refrain: “If you’re healthy, stay home. If you’re sick, stay home.” Well people took that to heart and continue to do so, sometimes to their detriment. Emergency Room visits across the county, state and country fell by 40-50%. Our Emergency Rooms are open and safe. Many conditions like heart attack, stroke and pneumonias end up in much more critical condition (or dead) if care is delayed. We want you to feel safe and confident should you ever need emergency care. So, here are two reasons not to delay a needed trip to the emergency room — and how we’re keeping our ERs safe for everyone. 1. Your health shouldn’t wait. Making a necessary visit to the emergency room can protect your longterm health. If you’re experiencing a medical emergency, such as a stroke or heart attack, it’s important to act fast to get a swift diagnosis and treatment. Our ERs are open 24/7, and our teams are ready when you need us. Among the many reasons that you should go to the emergency room are: • Animal bites • Broken bones Content provided by Copper Queen Community Hospital

• Chest pain • Difficulty breathing • High, uncontrolled fever • Loss of consciousness • Loss of or blurred vision • Head injuries • Severe bleeding or trauma • Severe burns • Sharp abdominal pain • Stroke 2. We’re taking extra steps to keep the er safe for you. From rearranged waiting and exam rooms to masked and gloved care teams, here are some of the precautions we’re taking to keep you protected in our ERs and hospital: • Isolating those with COVID-19 or related symptoms in separate, designated areas. • Requiring everyone to wear a mask. Don’t have one? No problem — we’ve got one for you. • Limiting the number of people in our waiting rooms and expanding the space between chairs. • Arranging our exam rooms to reduce unnecessary contact with hightouch surfaces. • Deep cleaning our care sites between patients and multiple times throughout the day. • Limiting the number of visitors in our hospitals and clinics. • Screening every person when they come in — patients, visitors and employees — including taking temperatures with a no-touch thermometer. By screening all our employees for COVID-19, no matter where they work, we’re taking significant precautions to keep our staff and patients safe.

Start g n i p p e Meal Pr

Eating Well


hile the hustle and bustle of life has temporarily slowed down, there will come a day when the daily demands of life come roaring back full force. Be prepared with a strategy to answer the question: “What’s for dinner?”

Have you had trouble finding the time to get healthy meals on the table? Do you want to eat healthier and avoid resorting to fast food when you’re in a time crunch? Meal prepping might be the solution for you. It’s the practice of preparing a week’s worth of meals ahead of time, economizing the use of ingredients, and portioning meals out for use in the coming week. warns that meal prepping is not for everyone. You will need to eat a lot of leftovers and there can be a lack of variety. “If having control over what you eat, or maximizing your time or budget is more valuable to you than eating something different every single day, meal prepping is your ticket,” according to the website.

You can go big or small with meal prepping. Aim to prep only dinner, or breakfast, lunch, dinner and snacks. Here are some tips to get you started. Plan. Like many endeavors, good meal prepping starts with good planning. Make a list of foods you’d like to prep for the week. Check which ingredients you have on hand, and economize your ingredients to save time, even if it means modifying a recipe. (There’s no need to cook two different kinds of pasta when one would suffice.)

It’s all about the containers. Check through your inventory of plastic or glass storage containers. Purchase more, if needed. You’ll need a lot of containers to keep everything organized in the refrigerator.

Be careful which foods you choose. Not all foods are good for meal prepping. While meat, grains, beans, hearty vegetables, whole fruits, nuts, seeds, cheeses and sauces such as salad dressing are all good options, other foods like lettuce, berries and crunchy options such as chips or crackers are not. To really make the most of your time on cooking day, opt for pre-prepared ingredients, such as cubed butternut squash, diced onions Use spices for variation. If you’re eating healthy, chicken breast can be a good option for three or four days of the week. Mix things up by using different seasonings for each day.

Cook smart. Your slow cooker or pressure cooker is your friend. If the goal is to save time, you can even shorten the amount of time you spend in the kitchen prepping with these time-saving gadgets. Also aim to use your oven space wisely, fitting in as many dishes as you can at once. If you’re making a meal that can easily be doubled, such as soup or chili, make a double batch and freeze the rest for future use. m



Best Foods for Eye Health


an what you eat impact how you see? Research from some of the most well-respected eye health organizations in the world says yes. Organizations such as the American Optometric Association and the American Academy of Ophthalmology continue to recommend specific nutrients for eye health. The best part? Their recommendations come from all major food groups, making it easy for you to find an eyehealthy option to add to your diet.

Here is the list of the 10 foods recommended by these two organizations:

Fish; nuts and legumes; seeds; citrus fruits; leafy green vegetables; carrots; sweet potatoes; beef; eggs; and water.

Fish, Nuts and Seeds Many fish are rich sources of

omega-3 fatty acids, including tuna, salmon, trout and herring. These rich, fatty options can help keep your eye health on track and can even reverse dry eye symptoms. Nuts and seeds are also rich in omega-3 fatty acids and vitamin E, which can help stave off age-related eye damage. Consider these nuts when filling up your grocery cart: walnuts, Brazil nuts, cashews and peanuts. These seeds also pack a positive punch when it comes to eye health: Chia seeds, flax seeds and hemp seeds.

Fruits and Vegetables Citrus fruits are rich in vitamin C, which can help keep your eyes young and healthy. These fruit options include lemons, oranges and grapefruits. For vegetable fans, leafy green options are your best bet in finding eye-friendly vitamin C. Consider spinach, kale and collards when preparing your

upcoming meal prep. Carrots and sweet potatoes are also a great option due to their heavy vitamin A and carotene concentrations.

Beef and Eggs Beef is rich in zinc, which can help delay age-related sight issues and macular degeneration. Chicken breast and pork loin also contain zinc, but at slightly lower levels. Eggs are a great source of lutein and zeaxanthin, which can also reduce the risk of age-related sight loss.

Water Water may be one of the most important aspects of eye health. Fluid is essential to the overall longevity of your eyes because of dehydration’s negative impact on vision. Drinking plenty of water, along with the aforementioned foods, can help with your eye health in the short and long-term. m

• Eat a well-balanced diet rich in leafy greens and other vegetables, fruit and omega-3s. • Wear sunglasses that block 99% to 100% of both UVA and UVB rays. • Wear safety glasses or goggles when needed at home, at work and at play. • Rest your eyes regularly when using the computer for extended periods of time. • Have a regular eye exam to guard against eye disease and ensure your eyewear prescriptions are up to date. If you’re age 40 or older, scheduling an eye exam every one to two years is especially important to guard against age-related eye diseases and vision loss.

Follow these simple tips to help protect your sight at any age, and see us for comprehensive eye care focused on preserving healthy vision.

call to set your appointment!


Dr. Ricardo Aviles, M.D. Owner


Dr. Russell Thompson, O.D. Dr. Eric Johansen O.D.

convenient locations! SERVING COCHISE COUNTY SINCE 1977

2445 E. Wilcox • 458.8131 • 4116 AvEnidA cochisE • 452.1125 • BEnson: 880 W. 4th strEEt stE #3 • 520.586.7877 16


Tips and Tricks Here are some tips from the Mayo Clinic for being successful on the Mediterranean Diet. • You don’t have to leave bread and pasta behind. Simply switch to whole-grain versions.

• Replace the red meat in your favorite dishes with chicken, fish or seafood. • Add more seafood into your diet, aiming for twice a week.

• Use olive oil instead of butter whenever possible. Instead of spreading butter on a piece of bread, dip it in olive oil.




he Mediterranean Diet is ranked No. 1 among diets by U.S. News and World Report.

With its roots in the foods of the Mediterranean Sea region, it’s easy to see how this diet can be both delicious and healthful.

There’s no calorie counting, and the diet includes lots of fresh foods. Fat isn’t off the menu, and the menu is massive. The diet gets its flavoring from Mediterranean spices, and wine is allowed (in moderation).

The diet boasts benefits for weight loss, heart and brain health, cancer prevention, and diabetes prevention and control. If you’re sold, here’s how to get started.

The Food A Mediterranean diet includes fruits and vegetables (7 to 10 servings a day), breads and other whole grains such as potatoes and brown rice, as well as beans, nuts and seeds. Olive oil is a primary fat source, and moderate amounts of low-fat dairy, fish and poultry are allowed. Things to avoid include added sugar

(soda, ice cream, syrup), white bread and refined wheat pasta, trans-fats, refined oils such as canola and soybean, processed meats, such as sausages and hot dogs, and processed foods.


Meal Prep Because the Mediterranean diet relies heavily on fresh foods, meal prepping might help you stay on the diet during busy weekdays. You can base multiple dishes during the week on the same ingredients or fully cook meals ahead of time. For example, you can cook high-protein whole oat pancakes on the weekend and freeze them separately, then defrost one each morning for breakfast. You also could cook a batch of brown rice and use it as the grain in dinner on multiple weeknights.

Snack Ideas Although hunger shouldn’t be a problem due to the high protein intake on the Mediterranean diet, there are plenty of ways to snack without breaking the rules. Some ideas include olives, cheese cubes, nuts, seeds, roasted chickpeas, dried fruits, tomatoes and avocados. m




EXPERT | OCCUPATIONAL THERAPY Jane Johnson, OT, CEAS III, OSHA-C Occupational therapy (or OT) is the Art and

each individual to maximize potential and build health

Science of rehabilitation which restores people to

- promoting habits and routines that will empower

independent function so that they may live a quality,

them to thrive.

satisfying life [via occupation of their normal ageappropriate roles]. This specialized rehab discipline was introduced in the mid to late 1800s as an “arts


and crafts” movement, with early beginnings in

Jane Johnson, OT, CEAS III, OSHA-C

mental health hospitals, helping those with a variety

Certified Ergonomics Assessment Specialist - Level III Occupational Safety and Health Administration Certified

long-term care sanatoriums for tuberculosis and of physical, mental and emotional struggles. In 1895 William Rush Denton Jr. became known as the Father of OT and established the National Society for Promotion of OT (MSPOT). In 1912 Eleanor Clark Slagle founded and began directing the Department of OT at John’s Hopkins University in Baltimore, Maryland, and became known as the Mother of OT and would soon serve as OT director at New York State Department of Mental Health, promoting habit training for engagement in structured “occupations“, as a vehicle for maximizing health and well-being. In 1917 OT emerged as a solid profession in the USA when it established it’s major professional association, what would become known as American Occupational Therapy Association (AOTA) for which Ms. Slagle would be Secretary for 15 years. The AOTA continues today to establish professional standards in practice, research and education, and

I have practiced the art and science of OT for over 30 years. As the sole Occupational Therapist at ApexNetwork Physical Therapy, I treat primarily upper extremity orthopedic diagnoses, but also see a variety of other conditions. Treatment may consist of the use of modalities such as thermal, ultrasound, infrared, and electrical stimulation. etc.., to promote healing and as a preparation for joint and soft tissue mobilization. This is followed by a variety of skilled therapeutic exercises and activities to build range of motion, strength and coordination. These are then applied to training in our regular activities of daily living and self-care/vocational/avocational pursuit retraining. Occupational therapists also fabricate custom upper extremity splints to facilitate proper healing through immobilization or progressive static stretching. All through the process I also perform cognitive/ perceptual evaluations and treatments, and sensory/ sensory-motor retraining. When the patient comes to their initial visit, or evaluation (and throughout treatment) I educate them in regards to the pretty, metallic, wind flower on a stick I present, as the only

remains the primary body to oversee legislation

“magic wand“ I own, and explain that we will be

supporting the best interest of Occupational Therapy

working “together” to achieve their individualized

practitioners and their patients. In 1922 Ms Slagle

goals. From the get-go I also promise clients that

established AOTA headquarters in New York City.

I will not be impressed with their diagnoses or

She trained well over 4000 OT‘s in her lifetime. In

symptoms, nor will I sit in limitation with them.

2022 occupational therapy will celebrate 100 years

My intent is to get them focused on goals and

of providing mind, body and spirit rehabilitation

possibilities at the outset, therein “can’t” and “pain”

to promote living a satisfying and purposeful life

are four letter words which are frowned upon; pain

through personal meaningful “occupation” of time.

within reason. I work “with” patients to establish

In many current cases OTs are considered rehab specialists to the upper body and upper extremity,

their plan of care and goals. Empowerment towards independence is of utmost importance.

integrating fine motor, sensory, cognitive, perceptual

I was a single parent throughout my undergrad

aspects, “functional” and ergonomic specialists.

schooling and career which kept me dedicated to

Although many OTs indeed specialize in some of

my purpose. I have sought personal fulfillment by

these areas, OTs are trained to treat the “whole“

participating in a wide variety of sports and leisure

person, (mind, body, spirit), in order to integrate one

activities thought-my life — assisting as an advanced

completely into the necessary, desired and rewarding

diver for search and rescue, leisure and adapted

life roles they may occupy.

disability diving. I have been a lifelong musician and

The primary OT focus areas are work/school,

a spiritual seeker and student.

self-care, and play/leisure. Patients referred to

I am certified as a level III Ergonomic assessment

OT services by their doctors are of all ages and

and rehabilitation specialist as well as being OSHA

afflictions which may interfere with the persons

certified. In approximately the last five years, the

normal ability to function in roles they desire to

study of neuro-plasticity, brain <> heart, brain <>

“occupy“. We also consider the inclusion of those

gut and body coherence and energy work have

significant people in close relationship with our

been developing exponentially, in which I have a

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keen interest and hope to develop further. I have

After taking the full picture into account, strategies

also obtained a certification in therapeutic Hypnosis,

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HIIT Workout Basics H igh-intensity interval training, short but brutally intense, has quickly become one of the most popular workout routines for busy Americans. HIIT allows you to burn more calories and push your heart rate more than you can with normal exercise routines. This helps boost your overall aerobic capacity, which leads to health benefits, leaner muscles and great results.

What Are HIIT Workouts? HIIT workouts typically use interval times with a specific work-to-rest ratio. Many instructors follow a 30:15 model, which means 30 seconds of work and 15 seconds of rest.

This is basically up to the instructor, so be flexible if you’re trying HIIT workouts at your home. The important thing to remember is that the shorter amount of workout time, the more intense your exercise should be to get the best results.

HIIT Workout Examples HIIT exercises combine a variety of movements and workouts, including box jumps, medicine ball slams, battle rope exercises, pushups, pullups, dips, burpees and planks. It also can include exercise done on equipment such as stationary bikes, treadmills and ellipticals.

Benefits of HIIT HIIT has been shown to produce many health benefits, including the improvement of blood vessel function. In a 2015 Sports Medicine study, researchers found that performing HIIT three times per week for 12 to 16 weeks

improved measures of vascular function in the brachial artery — the primary supplier of blood to the arm and hand — twice as well as moderate-intensity training did. HIIT has also been found to reverse age-related muscle decline. The publication Cell Metabolism found that it causes cells to make more proteins for their energy-producing mitochondria, which slows down the aging process for muscles.

Find a Gym Class Overwhelmed at the thought of starting your own HIIT routine? Check with trainers or program managers at your local gym. Find out if you can try a HIIT class for free before committing to it, just in case it’s not something you enjoy.

Your gym likely offers variations of HIIT classes, so you should be able to pick your comfort level with options ranging from basic to advanced. Always pay attention to your body when trying new workout classes for the first time. Your class instructor should be able to customize a HIIT routine to match your level of expertise. m

Hit the Gym

Find a

Personal Trainer


ou’re nervous to work out in front of other people. You’re not sure if you’ll be able to keep up. You’re not even sure where to start.

Does this sound familiar? The key to getting into a consistent workout routine is overcoming barriers keeping you from better health. Finding a great personal trainer will help. By taking your time and doing your research, you can find a great local trainer who can challenge and push you to a better fitness level.

Set Goals The first question a potential personal trainer is going to ask is, “What are your goals?” Beat them to the punch by understanding what you’re hoping to accomplish in the gym.

Are you looking to lose a certain amount of weight? Are you trying



to train for a 5K or other type of fitness event? Is your goal to add some muscle to your upper body?

Regardless of what you’re thinking, putting some goals down on paper is the first step to successfully finding a quality, local personal trainer. That way they can craft a customized workout plan to help you achieve your objectives.

Do Research Once you define your goals, it’s time to dig deep into your gym’s offerings, including the cost and schedule of their personal trainers. Many gyms offer trainers as an upsell package, but you can also find independent personal trainers who can accompany you to the gym. Search your local newspaper for ads or look online for local personal trainers with great reviews. If they work for the gym, ask for success stories or other

gym members who could tell you about their experience. Look for specialties when you’re learning about personal trainers. You’ll want someone whose experience closely matches the goals you’re trying to reach.

Get Started Before you sign up for a longterm — or even a short-term — contract with your personal trainer, ask what kinds of options they have for new clients. They may be able to give you a complimentary workout so you can gauge their style and personality. See if you can book a consultation with your potential trainer so you can get an idea of how they would specifically support you. Don’t be afraid to ask a lot of questions. Remember, their job is to give you the confidence that they can help you optimize your fitness. m

Pick the Right Gym


here are more than 32,150 health clubs in the United States. Now is a great time to get started on meeting your workout goals by joining your local gym. Sure, we all get the urge to start working out more as the calendar year changes to January, but there are many benefits to signing up whenever you feel the urge to get more active.

But what will be the key to showing up month after month to your gym? That’s a little trickier. The International Health, Racquet and Sports Club Association estimates that gyms lose about 28% of their members every year. That means nearly a third of the fitness population loses interest, motivation or both. Here are some tips to keep you from becoming a statistic.

Work Out Locally The further you have to drive to get to your gym, the more likely you are to find excuses not to go. Try to find a gym within 15 minutes of your home. When you’re researching local gyms, keep geography in mind. Punch your potential gym’s address into your favorite navigation app to find its distance from you.

Ask for a trial so you can get a better feel of the gym before committing to longterm payments. If you have a friend who works out at the gym you’re scouting, ask if you can come along to try out some machines. Most gyms will allow one-time guests to check out the gym. m

Now is a great time to get started on meeting your workout goals by joining your local gym.

Consider the Machines If you’re relatively new to working out, you’ll want to take a tour of your potential new gym to check out the equipment it offers. Look for equipment that is simple to use and that is clean.

Look for mandatory cleaning signs on the equipment and watch to see if employees are regularly wiping down workout machines. If cleanliness doesn’t seem to be a focus, you may want to take your muscles elsewhere.

Check the Contract Before signing on the dotted line, get all verbal promises in writing from your gym. Ask your potential gym how they handle complaints and what their member satisfaction rating is. They should be able to put your mind at ease that they deliver great member service while maintaining a healthy retention rate.



What to Eat

after you

Exercise T

ime at the gym requires a lot of energy, which can lead your body feeling exhausted and undernourished when you get home. It can be difficult for the body to recover if energy levels are not replenished within 15 to 30 minutes after finishing a workout.

This means eating a snack shortly after exercising can play a big role in restoring your energy, curbing your appetite and maximizing the effectiveness of your workout.

But how do you know what to eat? Are all foods created equally when it comes to revamping your body’s energy levels? Unfortunately, no. You need to be strategic.

Benefits of Proper Eating Eating the right things after your workout is critical to your recovery and overall energy levels. Getting nutritional balance after exercise restores your energy and reduces fatigue. This helps your body repair muscles and build strength. When you’re considering how to boost your energy levels after a great workout, consider proteins, carbohydrates and healthful fats from nuts — all essential for your body’s recovery.

Protein Consuming protein after your exercise helps the muscles to heal and prevents the loss of lean mass, which contributes to a muscular and toned appearance. Good protein choices include fish, chicken, nuts and healthy protein shakes.

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Dairy Protein You can also try dairy protein to help your recovery. This type of protein can repair new cells and rebuild your amino acids. Other than milk, dairy products rich in protein include Greek yogurt and cottage cheese.

Omega-3 Fatty Acids A 2017 Washington University School of Medicine study suggests that supplementation with omega-3 fatty acids helps boost the synthesis of muscle proteins and increase the size of muscle cells in healthy young and middle-aged adults. Tuna and fatty fish, including salmon, are rich in omega-3 fatty acids. Research also shows that oil drawn from these types of fish can help reduce muscle soreness after exercise. m

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EXPERT | FAMILY MEDICINE Taking Charge of Your Health: How Your Primary Care Provider Can Help You Stay Ahead of the Curve by Jeff Bushman, DO

Since the onset of COVID-19, many of

Additionally, regular primary care can

us have probably focused more intently

help you establish a healthy and trusting

on our health than ever before – paying

relationship with your provider, making it


close attention to how we are feeling,

Dr. Jeff Bushman received his Doctor of Osteopathic Medicine from Des Moines University. He specializes in Prolotherapy, an injection to heal ligaments and joints, osteopathic manipulation, skin-biopsy and excision of lesions, and spider vein treatment.

staying alert to any signs that we might not be well and doing what we can to stay healthy. While a pandemic is certainly a bad thing, being more in

easier and more comfortable for you to discuss any health concerns you have with a healthcare professional who can help.

tune with and focused on our health is

So, what is a primary care

definitely a good thing.

provider? Primary care providers include family

Typically, most of us will visit a doctor when we are sick, experiencing a new

physicians, general practitioners, general pediatricians and geriatricians,

health problem or are in pain. However,

and nurse practitioners. They commonly

to truly optimize our health, it is

diagnose new illnesses, help manage

important that we visit our primary care

chronic conditions, advocate for

provider for regular check-ups – even

preventive care and help protect the

when we are well.

overall wellness of their patients.

Annual physical exams can play

They are usually your first contact when

a very important role in your

seeking care and your principal point

health. While a yearly examination may seem unnecessary, especially if you feel great, this regular visit with your primary care provider can offer valuable help in preventing health surprises

of continuing care. In fact, continuity is a key characteristic of primary care. Having a go-to primary care provider offers you a trusted source

and setbacks down the road. Early

for routine check-ups, preventive care

diagnosis of many conditions – from

and conversations about your health

cancer to heart disease and other

concerns. Your provider knows and

ailments – offers the best chance to

understands your health history and

achieve the best outcome possible

potential risk factors, which gives them

and help keep you on the road to good

a more complete picture of your health


and how to best manage it.

Content provided by Sierra Vista Medical Group

EXPERT What happens during an annual exam with a primary care provider? Your primary care provider uses your regular check-ups to see how your body is performing and monitors your vital signs, including weight, blood pressure, cholesterol and other important health markers. Depending on your personal health history, your primary care provider might choose to focus on certain areas during your exam, like additional blood pressure and cholesterol screenings if you have a family history of heart disease.

Beyond monitoring and improving your health, an annual check-up allows you and your provider to develop a strong provider-patient relationship, which can go a long way in helping identify even the smallest changes in your health or lifestyle. If you suffer from any chronic conditions, your primary care provider can help you manage them and stay tuned in to any changes in your condition that may need attention.

Are annual exams expensive?

Getting an annual exam doesn’t have to Yearly exams are also the best way for a primary care provider to ensure that you are getting the preventive health screenings and important vaccinations you need at the right times.

be expensive. In fact, most insurance plans fully cover one check-up each year. You should contact your insurance provider for details regarding your plan’s coverage.

If you haven’t scheduled your annual check-up, now is a great time to get it on the calendar. Provider offices are taking extra precautions to protect the health and safety of their patients, so it’s never been safer to visit your primary care provider. Your primary care provider may even have a few more openings for annual exam visits than usual.

If you don’t have a primary care provider, Sierra Vista Medical Group can help. Call 520.263.3762 and get connected with primary care today to help you stay healthy for all your tomorrows. Content provided by Sierra Vista Medical Group

Dental Health Get Back to the Basics of Brushing


rushing your teeth has gone hightech. There are apps that tell you exactly how long to brush.

You can find smart toothbrushes that optimize the brushing experience.

But if you still have trouble staying consistent with your brushing habits, consider the following brushing basics from the Mayo Clinic to improve your oral health.

Brush your teeth twice a day. Take about two minutes to do a thorough job. Clean your tongue. We may not always remember to use our toothbrush or tongue scraper, but this is an important part of your oral health. Your tongue contains bacteria, which can lead to other health issues if not cleaned properly. Use the best equipment. This includes

a fluoride toothpaste and a soft-bristled toothbrush that fits your mouth comfortably. Practice makes perfect. Remember to hold your toothbrush at a slight angle. Gently brush with a circular motion. Brush too hard, and you can damage your gums and possibly your enamel.

Keep it clean. Always rinse your toothbrush with water after brushing and store your toothbrush in an upright position to allow it to air out.

Replace your toothbrush often. The Mayo Clinic recommends investing in a new toothbrush or a replacement head for your electric or battery-operated toothbrush every three months.

Become the Boss of Floss No matter how well you brush, you’ll

likely miss some of the food and bacteria in the tight spaces between your teeth, not to mention the hard-to-reach gum line. Here are some flossing tips to complement your brushing basics.

Use floss generously. The Mayo Clinic suggests breaking off about 18 inches of floss per usage. Wind most of the floss around the middle finger on one hand, and the rest around the middle finger on the other hand.

Get a grip. Experts recommend you grip the floss tightly between your thumbs and forefingers but remember to gently guide the floss between your teeth using a rubbing motion. Don’t forget the gums. When the floss reaches your gum line, curve it against one tooth, making a “C” shape. m

Natural Teeth Whitening Myths


eeth whitening tips, tricks, trays and treatments abound. The tricky thing about keeping our pearly whites bright and healthy is knowing exactly how to go about it.

But how do we know if these methods are effective or safe? Can we be sure we aren’t putting our oral health in jeopardy by using some of these DIY methods? Let’s break down a few together.

Helping Kids

Improve Oral Care Habits T

he earlier your start educating your child about good oral health, the more likely they will be to continue these healthy habits later in life. Tooth decay is one of the most common chronic diseases among children in the United States.

According to the National Center for Health Statistics, a 2011 survey found that more than 15 percent of American children ages 5 through 19 had untreated cavities. Tooth decay is four times more common in adolescents than asthma, according to the Centers for Disease Control and Prevention.

While these statistics may make you feel like sprinting to your child’s dentist in a panic, remember that you are the most influential example in your household. What you do and how you teach your kids to take care of their teeth is crucial to their oral and overall health.

How to Set a Good Example Remember that your child is watching your every move when it comes to dental care. You are their behavior model, so try to keep up on your own oral health to make a difference in their lives. Here’s how:

When to See A Dentist Your child should be seeing their dentist at least twice a year. If you are concerned with anything outside of those visitation time periods, be sure to call your dentist. Here are some warning signs from the American Dental Association that definitely require a check-up. •  Red, tender or swollen gums

•  Gums that bleed during brushing or flossing

•  Gums that begin pulling away from the teeth •  Loose permanent teeth

•  Unusual sensitivity to hot and cold

•  Persistent bad breath or an unusual taste in the mouth •  Painful chewing

Activated Charcoal

Acidic Solutions

Solutions that Work

There are many activated charcoal toothpastes on the market that claim scrubbing your teeth with their ingredients will whiten your smile. There is actually no evidence that shows dental products with charcoal are safe or effective for your teeth, according to the September 2017 issue of the Journal of the American Dental Association.

Some DIY whitening articles maintain you can make your teeth whiter and brighter using household staples like lemons, oranges or apple cider vinegar. The American Dental Association warns against using these ingredients as a scrub, as acid can wear away your enamel. This thin outer coating protects you from tooth sensitivity and cavities.

The ADA recommends the following behaviors to keep your teeth white and healthy: •  Brushing your teeth twice a day for two minutes. •  Use a whitening toothpaste with the ADA Seal of Acceptance.

•  Cleaning between your teeth once a day.

•  Limiting foods that stain your teeth, like coffee, tea and red wine.

•  Not smoking or using tobacco.

Don’t skip the dentist. A good way to keep everyone on the same schedule is to make family dental appointments for checkups and routine cleanings. This will help your children see visiting the dentist as a family experience.

Put on a strong face. Even if you don’t like visiting the dentist, you better believe your kids are picking up on your attitude toward your appointment. Be positive when talking about your dentists with your kids. This will help keep them at ease ahead of their checkups. m

•  Regular visits to your dentist for checkups and cleanings. If you want whiter teeth, check in with your local dental professional to get their recommendations. They may suggest specific toothpaste, or they may offer safe whitening treatments in the office.

Regardless, getting their professional advice is always preferred versus relying on your own research or DIY methods. Book an appointment with your dentist today to discuss your whitening options. m



Men’s Health

Caffeine’s Effects on Men


any American men rely on the mental and physical boost they receive from caffeine. Whether it’s consumed through coffee, energy drinks or pre-workout mixes, the potent stimulant helps maintain focus and increase alertness throughout the day.

The Food and Drug Administration estimates that 80 percent of adults ingest some form of caffeine every day.

According to The Harvard Medical School, the effects of caffeine can impact the central nervous system instantly and peak within an hour of consumption. The body ultimately eliminates half of it within four to six hours. Since reactions can vary dramatically between people, studying its exact risks is challenging to medical and scientific experts. However, there are several factual statistics that provide a better perspective on the effects that caffeine has on men.

Heart Facts


The Journal of the American Heart Association states that high doses of the natural stimulant can temporarily raise your heart and blood pressure, which is dangerous to those suffering from heart disease. On the contrary, regular consumption for those with healthy cardiovascular systems, won’t disrupt the heart’s rhythm enough to cause events like irregular patterns.

Experts have found that consuming caffeine can protect against dementia. In a study of adults aged 65 and older, the Journals of Gerontology: Series, found that those who ingested two to three eight-ounce cups of coffee for 10 years, reported fewer dementia symptoms. Those who ingested about a half-cup of coffee said that they experienced more signs of memory loss.





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Manage Your Intake If you rely on caffeine to propel you through your hectic schedule, you can gain peace of mind that it’s safe by visiting your physician. Discuss your intake and ensure that it is not creating detrimental damage to your heart or body.

When consuming caffeine, it’s essential to limit the sources you use for the stimulant. Drinks like black coffee and numerous teas can provide health benefits, but you should limit how much cream or sugar you add to sweeten the taste. A study by the Journal of the American Medical Association suggests avoiding energy drinks, as too much can cause abnormal electrocardiograms after only two hours from consumption. m

Skin Cancer


hile melanoma and most skin cancers have a high success rate for a cure, men face more significant health risks than women, when it isn’t treated early.

The Skin Cancer Foundation reports that males under the age of 49 have a higher probability of developing melanoma than any other cancer.

A particular age group at the most risk are men ages 15 to 39. The foundation suggests that of this group, American males are 55% more likely to die from melanoma than women in the same age group. Fortunately, the disease is highly preventable when you take the proper steps before spending time in the sun.

By the Numbers To understand the dangerous link between men and skin cancer, check out these statistics reported by the American Academy of Dermatology. • By the age of 50, men are more likely to develop melanoma than women.

• Men’s skin contains more collagen and elastin, which makes UV rays more dangerous.

• A 2016 study showed that men were less educated about the dangers of the sun.

Prevention Regular wellness examinations are your best bet for discovering and treating skin cancer at an early stage. You should also practice prevention when going outdoors. If you can’t avoid the sun entirely, make sure to cover your exposed skin with a broad-spectrum sunscreen

with an SPF 15 or higher. If you are spending time in the water, use protection that provides a resistant barrier, even when wet.


You can also create more protection by wearing a broad-brimmed hat and UVblocking sunglasses.

Cosmetic Bleaching Porcelain Veneers Tooth Colored Fillings Preventative Sealants Cleanings Exams • Bonding Restorative Crowns / Bridges Dentures / Repairs Root Canals Oral Surgery (Extractions) • Implants Conscious Sedation

A Genetic Factor The most common form of skin cancer is called basal cell carcinoma, or BCC. The National Cancer Institute states that a family history of BCC can be a strong predictor of its development. When discussing your health concerns with a physician, be honest about the history of cancer in your bloodline. They can create a protection strategy or insist on more frequent screenings.

Aside from a genetic association, those with a personal history of the cancer have about a 20% chance of the disease returning within the first year of a diagnosis. m


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Benefits of Yoga for Men


f the 20.4 million people who participate in yoga, only 18% are men, according to a study by the Yoga Journal. Participating in the workout, however, offers numerous health benefits for men and women alike. Mixing up your routines with a few yoga classes can significantly improve your body and mind.

If you’re used to intense workouts that involve weightlifting or longdistance running, yoga can be a beneficial complement to release tightness that develops in your muscles.

The increased tension relief will enhance your fitness potential by creating a greater range of motion. Find a personal trainer in your area who specializes in yoga or sign up for a local class to learn how to unlock your true athletic form.

Improves Breathing 30


According to the American

Lung Association, yoga involves breathing-based exercises that promote lung health and capacity. Many movements made during a yoga workout stretch and strengthen the muscles around the upper torso. In turn, these poses support the respiratory system by keeping the associated tissue strong and flexible.

Keep in mind, if you suffer from breathing problems like asthma or COPD, you should check with your physician before beginning a routine.

Balance Your Mind Experts at Mental Health America state that yoga is beneficial to the mind, especially for those who suffer from depression, anxiety or post-traumatic stress disorder. Researchers credit the relaxation response as the practice that leads to better physical and mental health. Psychology Today reports that relaxing yourself deeply into a yoga

pose changes the firing pattern of the body’s nerve and chemical makeup. When concentrating on our posture and alignment, adrenaline development halts, and our body stops releasing fatty acids and sugar into the bloodstream. The result of the change of nerve firing causes relaxation in the brain, heart and muscles.

Physical Benefits When practicing yoga, the body also receives numerous health benefits. Check out the physical changes you can feel, as reported by the American Osteopathic Association. • Increased muscle strength and tone. • Maintaining a balanced metabolism.

• Less chronic back pain, arthritis and headaches. • Lower blood pressure and less insomnia. m

Lessen your Heart Disease Risk


guidelines for adult men:

eart disease is the leading killer of both men and women in the United States. In 2017, the Centers for Disease Control and Prevention reported that it contributed to the deaths of 347,879 men, or about one in every four male deaths.

An effective way to monitor your heart health is by participating in regular wellness checks with your preferred medical provider. Under their watchful eye, a physician may recommend more regular examinations or recommend medicine or lifestyle changes to limit your risks. Whether you’re already suffering from heart disease, or are adamant about avoiding it, use these tips from the United States National Library of Medicine to improve your heart health.

Quit Smoking Smoking cigarettes is a direct contributor to the development of high blood pressure. This disease is known for increasing the chances of heart attack and stroke. If you’re struggling to quit a tobacco habit, check out the U.S. Department of Health and Human

• Perform at least 150 minutes per week of moderate-intensity aerobic activity, or exercise for at least 75 minutes per week of vigorous physical movements. • Spend less time sitting. A light-intensity activity can lessen the risk of becoming sedentary. Services for free tips and guidance to find local resources.

An expert can give you the support you need when addressing addiction and may recommend medication to make the process easier.

Regular Exercise In addition to lowering your weight for a better heart function, exercising also improves circulation and strengthens your cardiovascular muscles. You don’t have to be a marathon runner to gain significant cardio benefits. In fact, the American Heart Association suggests these

• Increase the amount and intensity of your workouts over time.

Manage Stress An intense feeling of stress can be a crucial trigger for a heart attack as it can raise a man’s blood pressure. It is also associated with participating in coping behavior that causes damage to our heart like heavy drinking, overeating or smoking. Find the stress management that works best for you by trying different exercises, mediation or simply finding time for yourself. If you can’t overcome the stress or anxiety that is inhibiting your life, don’t hesitate to reach out to an expert in your area for therapy or assistance. m

Call (520) 559-8370 or Visit LIVING WELL


Eye Care


to Prevent Vision Loss


ore than 150 million Americans suffer from some type of correctable vision loss, according to the American Academy of Ophthalmology.

Not all eye diseases or injuries can be prevented, but there are many good habits that can help you ensure optimal eye health. As always, consult with your local physician for any tips or recommendations that may be custom to your specific health situation. Your eye doctor will be able to look over your history and give you guided advice to best care for your eyes and vision.

Protect Your Eyes Looking to delay the development of cataracts? UV-blocking sunglasses can prevent retinal damage and keep your eyes in top shape. Sunglasses can also protect your sensitive eyelid skin to stave off wrinkles and skin cancer around the eye. When buying glasses, check for 100% UV protection. 32


Sunlight isn’t the only potential danger to your eyes. The AAO estimates that about 2.5 million eye injuries occur in the U.S. each year. Home improvement projects or sports like baseball and hockey commonly cause eye injuries. Always wear protective glasses when there is chance of injury.

Make Healthy Lifestyle Choices The body is like a complex machine. Every part works together to form the whole. So when you make poor dietary decisions or pick up bad habits like smoking, you can cause damage to your body, including your eyes.

Tobacco smoking is directly linked to many adverse health effects, including age-related macular degeneration, according to the AAO. Studies have shown that smokers and ex-smokers are more likely to develop AMD than people who have never smoked. When it comes to your diet, not getting enough vitamins from healthy foods can

impair your retinal function. A variety of vegetables, especially leafy green ones, are an important part of your diet. Research also shows that people who eat diets with higher levels of vitamins C and E, zinc, lutein, zeaxanthin, omega-3 fatty acids DHA and EPA are less likely to develop early and advanced AMD, according to the AAO.

Care for Your Contacts Follow your eye doctor’s instructions regarding the care and use of contact lenses, as improper usage can be a common culprit for eye injuries. If you wear contacts, don’t do these things:

Sleep in contacts that are not approved for overnight wear.

Use saliva or water as a wetting solution. Use expired solutions.

Use disposable contact lenses beyond their wear. m

Finding the Right Eye Doctor


hoosing an eye doctor can be a challenging and intimidating experience if you haven’t had an appointment recently. There are many kinds of eye experts who specialize in different areas, so who you choose should depend on your symptoms. The two main types of eye doctors are optometrists and ophthalmologists. Optometrists can treat some eye diseases but do not perform surgery on the eyes. Ophthalmologists, on the other hand, treat all types of eye disease, prescribe medication and perform surgery on the eyes. Don’t be overwhelmed by the various specialties outside these two main doctors. With a little research, you can find a great local professional to meet your specific eye care needs.

Start with Your Network When starting your search, talk to your doctor or pediatrician. They will have a strong network of eye specialists to refer you to, especially if you are able to explain your specific symptoms. Referrals from people you trust are oftentimes the best source of high-quality medical professionals. Aside from your doctor, you can also ask family, friends and coworkers where they have received

care. You’ll be surprised by how many step up with recommendations and suggestions for you.

Things to Look For Before selecting a long-term eye doctor for your personal needs, here are some things to consider.

Quality care: Look for eye doctors that give you a comprehensive examination. You never want to feel rushed during your appointment. Talk to office staff about the average time patients typically wait when they arrive for their checkup.

Communication: You want your eye doctor to listen closely to your questions and answer them clearly. A doctor who seems aloof or disconnected during your interaction is usually not a great first sign. Availability: When it comes to available appointment times, find a practice that offers evening and weekend hours. This can come in handy, especially if you have a busy professional or family schedule.

Insurance: You’ll want to make sure your potential doctor accepts the health insurance you carry. The difference between covered and out-of-network insurance costs can be a major factor in your decision. m

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Baby Care Choosing Positive Parenting


elcoming a newborn is an exciting milestone, but merely the first step during the long journey of parenthood. Commit to being a positive reinforcement in your child’s life from infancy to adulthood. This practice builds an incredible bond with a little one. It will make them feel comfortable discussing problems later in life.

Of course, there is a fine line between becoming friends with your child and being a disciplinarian authority. By correcting mistakes through constructive reinforcement, children will learn lessons that are carried throughout their lives. Check out these tips to act as a positive parent, as suggested by the Centers for Disease Control and Prevention.

Infants Throughout infancy, parents can build a wholesome bond by being an influence on their children. Even if they don’t respond through words, infants enjoy the soft tone of their voices. Communicate with them by reading books, Page 35



Baby Checkup Schedule W elcoming a baby into the world comes with many lifestyle changes and alterations to a familiar routine.

In addition to nurturing them through infancy to the toddler age, you can expect numerous trips to the pediatrician to make sure your little one is developing healthfully.

While the baby checkup schedule can vary between children and recommendations from their doctor, the American Academy of Pediatrics recommends these visits during their first year: three to five days, one month, two months, four months, six months, nine months, 12 months.

During the first 12 months of your child’s life, a pediatrician can expertly perform screenings and assessments to ensure they are growing correctly. It’s also a great way to familiarize your baby with the medical professionals who will protect them during childhood development. The AAP urges new parents to be diligent when visiting their child’s doctor for these significant reasons.

Prevention Since infants are more susceptible to developing illnesses, a pediatrician recommends numerous immunizations to offer support. Within the first few months, babies should be treated for hepatitis B, polio,

rotavirus and pneumonia. If left untreated, the development of these diseases may cause lifelong complications for a person.  

Tracking Growth

Pediatricians insist on regular checkups to analyze how a baby is developing physically and emotionally. If they deem that children are not growing correctly, they can make recommendations on diet changes or find underlying health conditions. Visits to the doctor’s office are also a great time to discuss your child’s social behaviors and learning milestones.

Resolve Concerns Checkups are not only crucial for the health and growth of a little one, but parents can also benefit from addressing concerns that arise during parenthood. Create a list of pertinent questions before the appointment. Here are some sample questions as recommended by the AAP. • Why is my baby always getting diaper rashes? 

• What should I do if I am worried about my child’s development? • How much formula or breast milk should my infant have? • Is telemedicine a good alternative for healthcare for a growing child? m

Sleeping Basics I f you’re an expecting first-time parent, you have probably heard the horror stories about the upcoming lack of sleep you will face.

However, the Nemours Foundation experts suggest that newborns can sleep up to 16 hours a day. As a caregiver, it’s crucial to ensure they are sleeping well and create a routine that allows you to rest so you can be at your best.

During the first few weeks, it’s common for an infant to sleep in short bursts of a few hours. This is mainly due to their developing digestive system, which requires regular nourishment. Plan to create a schedule that allows a feeding time at least every four hours to help a newborn become accustomed to a beneficial routine. Follow these tips from the National Sleep Foundation to encourage positive sleep patterns during infancy.

Follow Their Lead

Newborns are prone to sharing their need for sleep by fussing, crying or rubbing their eyes. Watch for these patterns throughout the day to strategize a sleeping schedule. The NSF recommends putting a baby down for a nap when they are sleepy, rather than allowing them to fall asleep before transferring them to their crib or bassinet.

This practice helps an infant understand that the area is meant for slumber and encourages them to learn how to get themselves to sleep. During the day, expose your newborn to light, noise and playtime. Once nighttime approaches, introduce a dimmer environment with less activity to prepare them for a full night’s sleep.

Strict Routine A routine is crucial when teaching an infant about bedtime. It will be a process

they expect and remember as they grow into the toddler stage. To establish a sleeping schedule, be diligent about incorporating a wind-down phase to build a sleep association. The NSF recommends: • Use softer vocal tones as the evening nears.

• Put on pajamas around the same time each night. • Follow with brushing teeth alongside your little one.

• Tuck a child in, in the same manner each time. Before long, your kiddo will find comfort in the familiarity of slumber. m

From Page 34

Moms and dads can also make the little one feel secure and comfortable by cuddling and holding their child.

Toddlers As your child becomes more familiar with speaking, utilize learning games like shape sorting and puzzles. Pay attention to their language and help develop skills by correcting mispronounced words with the correct phrase. This is also the stage where parents should begin setting

expectations for their child’s behavior. Respond to unwanted conduct by utilizing brief time outs and showing them what they should do instead.

Cochise County’s Pediatric Dentist ✔ Most Dental Insurances Accepted ✔ Caring and Professional Staff ✔ Televisions in Each Room ✔ Sedation Dentistry and Nitrous Oxide ✔ Theater Room and Video Game Room ✔ Se Habla Español

Middle Childhood By now, your little one will be exerting more independence and finding satisfaction when completing tasks with little assistance. Encourage their growth by helping them set goals and showing enthusiasm and affection once they are achieved. It’s also beneficial to begin teaching children about patience. For instance, insist they allow their peers to go first or finish a task before taking a break to play.  During these formative years, think of discipline to guide and protect your child rather than punishment. Make sure to praise good behavior and

Children’s dentistry at its


1718 Paseo San Luis, Sierra Vista, AZ 520-458-1835 214252

singing lullabies or repeating their sounds while including new words.



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Engage. Inform. Entertain

I Secure a Network of


t’s no secret that babies don’t come with an owner’s manual. New parents are required to learn on the fly and experience situations they aren’t always prepared to face.

Before your child is due, take the time to network with experts and loved ones to ensure you can ask for advice when guidance is needed. When visiting with your obstetrician during regular checkups, ask for referrals to medical professionals who will help you after the pregnancy.

Consider inquiring about feeding specialists, behavior experts and mental health advocates. With a team of professionals on your side, resolving problems or answering questions is easily accomplished.

Pediatrician It’s essential to begin your search for a pediatrician while an infant is still in utero. Once a newborn is welcomed into the world, this

medical professional will typically visit the hospital or discuss the birth with on-site experts via phone call. They will then lead the way in scheduling checkups, analyzing developmental progress and offering advice for your little one to thrive. Finding a pediatrician is not a task to take lightly. It may require several meetings or facility visits before deciding on the right choice. During interviews, consider asking these questions, as suggested by the American Academy of Pediatrics. 

• Is the office accepting new patients and do they accept your insurance? • What are the office hours; are emergency calls available day and night? • When is the best time to call with routine questions?

• Are billing and insurance claims handled in house, and is payment due in full at the time of a visit?

When finding a network of pediatricians to interview, a valuable resource is asking friends and family about their experiences.

In-Home Help Raising a newborn can be exhausting and may require assistance to ensure you receive enough rest to be an efficient parent. Talk to a medical professional for referrals for traveling night nurses or home health agencies. You may only need assistance for a short period as you adjust to your new lifestyle. Whether you choose to breastfeed or use a bottle, sometimes an expert’s hand is required to ensure an infant is eating correctly and getting the necessary nutrients. Your local hospital will likely employ a specialist who can offer advice on how often to feed, techniques and digestion issues. m



Preparing a Sibling for Baby


hen expecting your second child, it’s common to feel stress or uncertainty about how their big brother or sister will respond. You can make the experience of a newborn’s arrival positive by preparing your kiddo and making them feel included throughout the pregnancy. Remember that an older sibling will likely become a role model for the new arrival. The experts at the Child Mind Institute recommend that expectant mothers reveal their pregnancy news to other children as soon as the pregnancy begins to show.

By preparing early, your little one can absorb the information and ask questions about the new addition to their family. Make

sure to stress that the news is positive and that your love will not change once the new infant arrives.

Set Aside Special Time Together Understand that a newborn will require an immense amount of attention and protection. This may lead to an older sibling feeling left out or jealous. It’s a good idea to find time to do things as a duo throughout the week.

Consider playing their favorite game or reading a book together while the baby naps or is eating. When possible, ask your partner or a loved one to babysit for an afternoon so you can take your other child for a fun-filled day around town.

If they are old enough, ask for help in jobs like diaper changes or preparing a crib for a night’s sleep. Ensuring they are involved in raising a newborn will help form a bond between parents and siblings.

for how to remediate these common behaviors.

Plan for Regression

The experts at Child Mind Institute remind parents that these actions are typical for older siblings. It’s their way of telling mom and dad that their care is still needed and helps achieve the attention they crave. m

Even if your child is excited about the arrival of their brother or sister, it’s normal for them to show disobedience to gain the attention a newborn receives. It’s essential to prepare yourself

Toilet-trained children may backtrack and have accidents, insist that they should wear diapers again or ask to be bottle fed.

Taking an Infant’s Temperature


ince a baby’s body temperature isn’t as adaptable as adults, it’s crucial to ensure they are properly warmed or cooled.

The Children’s Hospital of Philadelphia reports that a drop of only one degree from 97.7, increases an infant’s oxygen use by 10%. A digital thermometer is a beneficial tool to keep in the nursery to ensure their temperature is within safe levels. Not only does the American Academy of Pediatrics urge parents to avoid mercury thermometers, but they also encourage us to remove them from the home altogether. The dangerous metal component used to display the results can lead to extreme poisoning if children are accidentally 38


exposed. Before investing in your baby’s first thermometer, consider the different ways the AAP recommends to take baby’s temperature.

It should be administered by placing the sensor directly in the middle of a baby’s forehead and then is slowly moved across the skin toward the top of the ear. Scan up until to hairline before releasing the button to find the outcome.

Rectally Forehead Using the forehead to find a newborn’s temperature is called temporal artery thermometry. While it’s a relatively new way to discover results, it is thought to be one of the less stressful tools for a newborn. The incredibly accurate process gets its name by measuring the blood’s temperature flowing through one’s temporal artery.

For even more accuracy, the AAP recommends taking a temperature rectally for babies and toddlers up to age 3.

It’s good to ask for advice from a medical professional, as inserting the thermometer may perforate the rectum or spread bacteria from the stool. Tips from Stanford Children’s Health include: 

• Insert the thermometer only a half to 1 inch, just past the anal muscle.

• Point the tool towards a child’s belly button.

• Comfort a baby with one hand while managing the thermometer and allowing it to move with the infant’s motions.

• Immediately remove the device once it beeps and achieves an accurate reading.

• Once you have recorded the results, clean the tool with soap and water or rubbing alcohol.

When to get Help Because a fever within an infant can be extremely dangerous, it’s crucial to reach out to a healthcare provider if the reading is 100.4 degrees. Plan to discuss symptoms and the method you used to find the results with a pediatrician. m






Suzanne Daly, MD Board Certified, Gastroenterology Education

Board Certified, Gastroenterologist, Suzanne Daly, MD, treats patients at both Copper Queen Community Hospital Palominas Rural Health Clinic and Bisbee Rural Health Clinic. With more than 15 years of experience in Gastroenterology, Dr. Daly provides quality, advanced comprehensive treatement and management of conditions of the digestive system. Her office also provides important Endoscopy and Colonoscopy screenings.

For appointments call the Douglas Medical Complex 520-364-7659 or CQCH Bisbee 520-432-2042

General Surgery Andrew Adams, MD

Jody Jenkins, MD

75 Colonia de Salud, Suite 100C Sierra Vista, AZ 85635 Phone: 520.452.0144 Hours: Monday - Friday: 8 am - 5 pm

Douglas Opie, DO

Cherokee Carrillo, PA Roland Haj, DO

Roland Snure, MD Board Certified, General Surgery EDUCATION Residency: University of Arizona, Department of Surgery, Tucson, Arizona Internship: University of Arizona, Department of Surgery, Tucson, Arizona Medical Degree: University of Arizona, College of Medicine, Tucson Additional Languages: Spanish Dr. Snure was born in Douglas and grew up in Southeastern Arizona on the Snure Ranch. Most recently Dr. Snure was General Surgeon at Tairawhiti District Health in Ginsborne, New Zealand. “I wanted to return home (Douglas) to give back to the community that supported me through my childhood and education. Growing up in Southeastern Arizona I saw the need for high quality Rural Healthcare providers,” stated Dr. Snure.

For appointments call CQCH at 520-432-6500 or Douglas Medical Complex at 520-364-7659

Dr. Monica Vandivort, MD Medical Director for Haven Skilled Nursing Facility Graduating from the University of Kansas School of Medicine in 1989 Dr. Monica Vandivort, is a Board Certified Geriatric Medicine Specialist. Currently the Medical Director of Haven Health of Sierra Vista, a Skilled Nursing Facility, focusing on quality care, physical, occupational and speech thereapy. Dr. Vandivort continues her dedication of over 31 years of expertise to our community. Dr. Vandivort’s unique bedside approach to those needing care outside of the traditional Dr.’s office, allows her to provide attention to each patient and to strive to bring them the expert care for their individual needs.

Haven of Sierra Vista 660 S. Coronado Drive Sierra Vista (520) 459-4900




Internal Medicine Family Medicine

Sherry Hron, FNP

5750 E. Hwy 90, Suite 200 Sierra Vista, AZ 85635 Phone: 520.263.3762 Hours: Monday - Friday: 8 am - 5 pm

Roberto Molina, MD

Jeff Bushman, DO Blair Goodsell, DO



Edward Miller, DO, FACOG Board Certified, Obstetrics & Gynecology Education

Obstetrics and Gynecology Certificate of Added Qualification: Menopause Clinician Residency: Fitzsimmons Army Medical Center, Obstetrics & Gynecology Medical Degree: Kirksville College of Osteopathic Medicine, Kirksville, MO Bachelor Degree: University of Arizona, Biology Dr. Edward Miller was born and raised in Tucson, Arizona. With more than 25 years of experience in obstetrics and gynecology, he has achieved high levels of performance in clinical and teaching endeavors. Since graduating in the top 1% of all OB-GYN residents in the country in 1986, he has been named one of “America’s Top Obstetricians & Gynecologists” by The Consumer Research Council of America.

Obstetrics & Gynecology

Natalie Andress, CNM Misty Decker, CNM, RNC-EFM Sidney Semrad, DO, FACOOG Mary Schlotterer, MD Mamie “Liz” Ramchandani, WHNP

For appointments call the Douglas Medical Complex 520-364-7659 or CQCH Bisbee 520-432-2042

5750 E. Hwy 90, Suite 300 Sierra Vista, AZ 85635 Phone: 520.263.3620 Hours: Monday - Friday: 8 am - 5 pm



Stephen D. Phillips, O.D. Education

B.S. Pacific University O.D. Pacific University College of Optometry

At Phillips Eye Care, we utilize the latest equipment, technology and techniques to diagnose, monitor and treat a wide variety of eye disease including glaucoma, cataract, macular degeneration, and monitoring diabetic patients. In addition, we have a large selection of designer eyewear and contact lenses to choose from.

Orthopedics & Sports Medicine Randall Roy, MD Jared Haymore, PA-C Laurence M. Susini, MD Brian Daines, MD Dean Marturello, PA-C

960 East Fry Blvd Sierra Vista, AZ (520) 515-EYES (3937)

5750 E. Hwy 90, Suite 200 Sierra Vista, AZ 85635 Phone: 520.263.3761 Hours: Monday - Friday: 8 am - 5 pm


University of St. Augustine for Health Sciences – Doctorate of Physical Therapy

Cal Poly, San Luis Obispo – Master of Science in Kinesiology

University of Hawaii, Hilo Bachelor of Arts, Kinesiology & Exercise Science

Dr DeMarco specializes in orthopedic physical therapy and has a background in a manual therapy approach from the University of St Augustine. Outside the clinic he is an active member of the Professional Disc Golf Association and enjoys outdoor recreational activities

For appointments, call 520-335-1615

T O M G O U L D I N G , P T, D P T

Clinic Owner •

Arizona School of Allied Health Sciences, A.T. Still University— Doctorate of Physical Therapy

California State University, Long Beach—Masters of Physical Therapy

California State University, Fresno—Bachelor’s of Science, Biology with Physiology emphasis

Dr. Goulding has been practicing physical therapy in Sierra Vista since 2001, working in various settings such as inpatient rehab, acute care, wound care, aquatics (certified) and outpatient orthopedics.

For appointments, call





N AT H A N D E M A R C O , P T, D P T

Physical Therapist


M E G H A N G U L E R , P T, D P T, C E R T D N , D N S  A

Physical Therapist • • • • •

Daeman College, Doctorate of Physical Therapy Daeman College, Bachelor’s of Science in Natural Science – Health Science Certified in Dry Needling Certified in Dynamic Neuromuscular Stabilization (part A) Dr Guler has recently settled into Sierra Vista after spending some time as a traveling therapist. She specializes in Dry Needling and has training in McKenzie methods for back and neck pathology (part A and B). She enjoys her time outdoors and has worked hard in training and running/ cycling for various charities. For appointments, call 520-335-1615

A N D R E W W. M I L L I GA N , P T, D P T, O C S , C S C S

Clinic Owner • • • • •

Doctor of Physical Therapy Degree: Rocky Mountain University, Provo UT (2010) Master of Physical Therapy Degree: Northern Arizona University, Flagstaff AZ (1995) Bachelor of Exercise Science Degree: Northern Arizona University, Flagstaff AZ (1993) Board Certified, Orthopedic Clinical Specialist (OCS) Dr Milligan specializes in Orthopedic and Sports Medicine rehabilitation. He has 24 years of service in the US Army (Active and Reserve). LTC Milligan is an Iraq war veteran and is currently assigned to the 7450th Medical Backfill Battalion in Aurora, CO. For appointments, call 520-586-3663

TO D D W I L D E , P T, D P T

Assistant Clinic Manager–Sierra Vista, AZ •

Doctor of Physical Therapy, University of New England, 2016

Bachelor of Science, Exercise Science, Brigham Young University, 2012

Dr. Wilde has been working with ApexNetwork since 2016 and has been treating a broad spectrum of diagnoses. He has become clinic specialist in treatment of vestibular related vertigo. Last year he assumed the role of Assistant Clinical Manager and enjoys spending time with his wife and 4 kids when he’s not rigorously training on the bicycle. For appointments, call 520-335-1615



5750 E. Hwy 90, Suite 200 Sierra Vista, AZ 85635 Phone: 520.263.3761 Hours: Monday - Friday: 8 am - 5 pm

Jarrett Hamilton, DPM, FACFAS


Kara L. Montes, DPM Board Certified, Podiatry Board Certified, Podiatrist, Kara L. Montes treats patients at both Copper Queen Community Hospital Palominas Rural Health Clinic and Douglas Rural Health Clinic.


Residency: Saddleback Valley Outpatient (Health South) Medical Degree: Barry University School of Podiatric Medicine Bachelor Degree: Florida Atlantic University

For appointments call CQCH at 520-432-6500 or Douglas Medical Complex at 520-364-7659

For appointments call 520-459-3339




Ryan D. Bingham, FPMHNP-BC Family Psychiatric Mental Health Nurse Practitioner-BC Family Psychiatric Mental Health Nurse Practitioner-BC, Ryan D. Bingham, treats patients at Copper Queen Community Hospital Douglas Rural Health Clinic. Ryan received his Master Degree, Family Psychiatric Mental Health Nurse Practitioner from the University of Utah. He received his Bachelor Degree in the Science of Nursing from Bringham Young University. Ryan received his Associates Degree in Nursing from Eastern Arizona College.

Urology Peter Niemczyk, MD, FACS

Advanced Wound Care Center Advanced Wound Care provides specialized treatment for chronic or non-healing wounds, which are defined as sores or wounds that have not significantly improved from conventional treatments. Associated with inadequate circulation, poorly functioning veins, and immobility, non-healing wounds lead to lower quality of life and may lead to amputations. When wounds persist, a specialized approach is required for healing. Typically, a wound that does not respond to normal medical care within 30 days is considered a problem or chronic wound.

For appointments call 520-805-6800

75 Colonia de Salud, Suite 200C Sierra Vista, AZ 85635 Phone: 520.263.2690 Hours Monday - Friday: 8 am - 5 pm

5750 E. Hwy 90, Suite 150 Sierra Vista, AZ 85635 Phone: 520.263.3770 Hours: Monday - Friday, 8 am - 4:30 pm

Changes IN THE Breast


change in breast tissue doesn’t automatically mean you have cancer. Some changes in the breast are normal for your stage of life.

If you’re concerned, of course call the doctor, but there’s probably not a reason to panic.

Probably Not Anything to Worry About Many changes in the breast are because of fluctuating hormones, such as when a woman is about to start her menstrual cycle or when she’s pregnant. Here are some times you may notice a difference in your breasts that’s not worrisome. Before or during your cycle. Your breasts may feel swollen or tender, and that’s normal. You may even feel a lump because of extra fluid in your breast. You should always call a doctor if you feel a lump, but the doctor may schedule a return visit when you’re not on your cycle to check the breast. During pregnancy. Your body undergoes a lot of changes during pregnancy, and one of them may be larger and more painful breasts. They may even feel lumpy as the glands that produce milk gear up for breastfeeding. While breastfeeding, you may also get a painful condition called mastitis when a milk duct becomes blocked. Mastitis causes the affected breast to become warm and feel lumpy and painful. You can get medications from your doctor to help. Before and after menopause.

Breast Cancer

Your hormone levels are changing, and that can make your breasts feel tender and lumpy. As your levels drop off after menopause, these conditions usually stop.

If you’re taking hormones, such as menopausal hormone therapy or birth control. These hormones may cause your breasts to become more dense, making a mammogram more difficult to read. Let your provider know about these and all other medications you take.

Symptoms to be Concerned About If you feel any change in your breast that you’re worried about, even if it’s explained by one of the above reasons, call your doctor and have it checked out. Some symptoms that should raise a red flag are:

A lump or firm feeling in your breast or under your arm. It could be a hormonal change, but it could be something more nefarious. Do regular self-exams so that you know what your breasts feel like but remember, they’re no substitute for a mammogram.

Nipple changes or discharge. This discharge can be any of several colors or textures. It could be something as simple as an infection of the side effect of medications, but it should always be checked out. Itchy, red, dimpled or puckered skin. Again, this could just be minor irritation, but it could be something worse. Call the doctor. m



Lowering your Cancer Risk T

here are lots of factors that contribute to your risk of breast cancer, not just genetics or family history. Lower your risk for breast cancer by following these tips from the Centers for Disease Control and Prevention.

Keep a Healthy Weight Try to keep your body mass index, or BMI, at between 18.5 and 24.9. This is a ratio or your weight to height, but it may not be accurate for all body types. This is particularly true after menopause, the Susan G. Komen Foundation says. Talk to your health care professional about an ideal weight for you.

Limit alcoholic Drinks Exercise Regularly Physical activity helps you maintain a healthy weight, reduces risk of cardiovascular disease and diabetes, lowers your blood pressure, reduces your risk for stroke, can ease arthritis pain and reduce depression and anxiety. Get at least 150 minutes of moderate activity or 75 minutes of vigorous aerobic activity per week. Talk to your doctor before you begin an exercise regimen.

Alcohol consumption raises the risk of cancer proportional to the amount of alcohol consumed, the CDC says. That means that the more you drink, the more at risk you are for breast cancer and other cancers. Limit drinks to one per day.

Hormone Replacement therapy and Oral Contraceptives Women who take these kinds of replacement hormones can affect your risk of breast cancer. Talk to your health care provider about the type of therapy or birth control you take and the associated risks.

Stages of Breast Cancer


ou may have heard someone talk about their cancer in stages. This is the level of progression to which the cancer has spread. The stage of the cancer at detection often determines the treatment.

In breast cancer, the stage is based on the size and location of the primary tumor, the spread of the cancer, the tumor grade and whether certain biomarkers are present, the National Cancer Institute says. After you receive your diagnosis of breast cancer, doctors will perform tests such as biopsies, X-rays and various scans to see how far it’s spread. 44


Cancer can spread through tissue by growing into nearby areas, through

the lymphatic system by spreading through lymph vessels to other parts of the body or through the blood. When cancer spreads to another part of the body, it’s called metastasis. The metastatic tumor is the same kind of cancer as the primary tumor. If breast cancer spreads to the bones, it’s metastatic breast cancer, not bone cancer. There are three types of breast cancer stage groups. The clinical prognostic stage is the first stage for all patients based on health history, physical exam, imaging tests and biopsies. Mammography or ultrasounds can be used to check the lymph nodes for signs of cancer. In the pathological prognostic stage, patients have surgery as their

Triple-Negative Cancer


riple-negative breast cancer is a form of breast cancer that doesn’t have receptors commonly found in breast cancer: estrogen, progesterone and human epidermal growth factor, or HER2.

If your cancer has any of these receptors, doctors have an avenue for treatment they can use to help destroy the cancerous cells. But with triple-negative breast cancer, doctors must look to other treatment options, such as chemotherapy. Triple-negative breast cancer tends to be more aggressive and have a poorer prognosis than other breast cancers and the cancerous cells tend to resemble healthy breast tissue.

Who Can Get It? Breastfeed Your Children Mothers who breastfeed their children have a lower risk of breast cancer, ovarian cancer, type 2 diabetes and high blood pressure. The longer a woman breastfeeds, the greater the benefit. Women how breastfed for a lifetime total of more than two years got the most benefit from the practice, the Susan G. Komen says. Breastfeeding may

first treatment. It’s based on clinical information, biomarker status and lab results. The anatomic stage is based on the size and spread of the cancer. It’s used in parts of the world where biomarker testing is not available, which doesn’t include the United States.

The TNM system — tumor, lymph node, metastatis — is used to describe cancers, including breast cancer. T values refer to the size of the tumor and range from TX, meaning the tumor can’t be assessed, to T4, meaning the tumor has grown into the skin or chest wall or is inflammatory. N values refer to the size and location of lymph nodes

be particularly good at lowering the risk of estrogen receptornegative cancers, which do not need hormones to grow.

If you have a high risk of breast cancer, there are options, Susan G. Komen says. These include risk lowering drugs such as tamoxifen or raloxifene or a prophylactic mastectomy. Talk to your doctor if you think these options are right for you. m

where the cancer has spread. When the lymph nodes are checked using mammography or ultrasound, it’s called clinical staging. M values show if the cancer has spread to other parts of the body. M0 means it hasn’t; M1 means it has. Breast cancer most often spreads to the bones, lungs, liver or brain. This system, along with grading that describes how quickly the tumor is likely to grow and spread, and biomarker testing is used to determine the breast cancer stage and the treatment of the cancer. Your doctor will be able to explain how your cancer was staged and discuss treatment options going forward. m

Anyone can get triple-negative breast cancer, but it tends to affect more younger people, Black and Hispanic women and people with a BRCA1 mutation. About 10-20% of breast cancers or triple-negative breast cancers.

Types of Treatment Without these receptors to reach the cancer cells, doctors turn to other forms of treatment. The first step is usually to have the tumor removed – a lumpectomy – or the whole affected breast removed – a mastectomy. These surgeries are usually followed by radiation therapy, where high-energy radiation is given to your breast to kill any remaining cancer cells. Chemotherapy can kill any cancer cells that have spread elsewhere in the body and lowers the chance that cancer will recur.

Side Effects These treatments, though they may be successful, aren’t without side effects. The Centers for Disease Control and Prevention says to expect hair loss, nausea, tiredness and skin changes. There are new treatments that may be able to help with hair loss from chemotherapy; talk to your doctor if losing your hair is a concern. Chemotherapy can also cause nausea, but your doctor can give you medication to help. Fatigue is associated with both chemotherapy and radiation. It will subside a few weeks after your therapy ends. There may also be skin changes with radiation, including redness or peeling like with a sunburn.

Genetic Counseling People of Ashkenazi Jewish heritage have a higher risk of certain types of cancer, including triple-negative breast cancer. Genetic testing followed by genetic counseling can help you determine a course of treatment and risk management both for you and your family. m



Genes and Hereditary Cancer


bout 3% of breast cancers are the result of inherited mutations in the BRCA1 and BRCA2 genes. These two genes normally protect you from getting certain cancers, but mutations can prevent them from working properly.

How to Do a



ou should be checking your breast for changes at least once a month, according to the National Breast Cancer Foundation and Johns Hopkins Medical Center. About 40% of diagnosed breast cancers are detected by women who feel a lump and get it checked out. Here’s how to properly conduct a self-exam.

It’s Not a Mammogram A self-exam is useful, but remember, it’s not the same as a mammogram or other imaging that can detect cancer in its very earliest stages. For the most effective medical care, combine self-exams with regular doctor’s appointments and age- and healthappropriate cancer screenings.

Some signs to look for during your breast exam are nipple tenderness, lumps, thickening, changes in skin texture or enlargement of pores in the skin of the breast. Also examine your underarm area as the breast tissue spreads around your sides and armpits.

Lying Down When lying down, your breast tissue will spread against the chest wall. Place a pillow under your shoulder and raise that arm above your head. Using the opposite hand, move the pads of your fingers around your breast, covering the entire area and 46


armpit. Use light, medium and firm pressure. Check for nipple discharge and lumps, then repeat for the other side.

In Front of a Mirror With your arms at your sides, look at your breasts as you raise your arms over your head. You’re looking for changes in the contour, swelling, dimpling of the skin or changes in the nipples. Rest your palms on your hips and press firmly to flex your chest muscles. Look for dimpling, puckering or changes, particularly on one side. Don’t be alarmed if your breasts aren’t symmetrical; most women’s aren’t.

In the Shower Hold one arm up and behind your head. Using your fingertips, check the entire breast and armpit area on that side by pressing down with light, medium and firm pressure. Look for lumps, thickening, a knot or any other changes.

If you notice any changes, don’t panic. Most lumps, even, aren’t cancer. But you do need to check with your doctor for a clinical exam whenever you have concerns. Combined with regular medical care and more in-depth screening, such as mammography, self-exams are a powerful tool in the early detection and successful treatment of breast cancer. m

These mutations can cause breast, ovarian and other cancers, but not everyone who inherits the mutation will get cancer.

How it Works Everyone has two copies of the BRCA1 and BRCA2 genes, one from their mother and one from their father. If a person inherits a mutation from one parent, they can still have the normal copy from the other parent. Cancer occurs when a second mutation happens that affects the normal copy of the gene so the person no longer has a properly functioning BRCA1 and BRCA2 gene. Unlike an inherited mutation, the second mutation is only present in the cancer tissue.

Other Mutations Breast cancer can also be caused by inherited mutations in genes other than BRCA1 and BRCA2. In some families with a history of breast cancer, mutations can be identified through genetic testing using multi-gene panels.

Genetic Testing Genetic testing is usually recommended, the Centers for Disease Control and Prevention says, if you have a strong history of breast cancer, a moderate family history of breast cancer and are of Ashkenazi Jewish or Eastern European ancestry, a personal history of breast cancer and meet certain criteria, a personal history of other cancers or a known history of inherited gene mutation in your family. Your testing should be paired with genetic counseling to help you get the most from your results. Having a family history of breast cancer doesn’t mean you have an inherited mutations. The CDC says that most women identified as being as having an increased risk for BRCA1 and BRCA2 mutations based on family health history do not have the mutations. In fact, some women who the BRCA1 and BRCA2 mutations have no known history of breast cancer.

Talk to your health care provider to see if you’re a candidate for genetic testing and counseling to assess your risk for breast cancer. You should bring with you a family health history, especially if you have a family history of breast and ovarian cancer. m

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Living Well 2020  

Living Well 2020  

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