2019-11-21 - Health Care Quarterly (Vol. 26) - Fall 2019 by Greenspun Media Group

2019 | VOL. 26

L ENDING A

HELPING HAND Southern Nevada making strides on mental health care for youths PRESENTED BY:

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Financing from Nevada State Bank helped two married dental professionals achieve their dream of opening a practice together. Dr. Freddie Martinez is a Las Vegas native who completed his orthodontic residency at UNLV and opened Martinez Braces in 2015, offering orthodontic treatment, braces, and Invisalign treatment. He operated two locations in Las Vegas, splitting his time between a small office on South Rainbow and one on East Bonanza. His wife, Ruth Alvarez, moved to Las Vegas in 2018 after completing a pediatric dentistry residency at UCLA, and joined a local pediatric dentistry practice. Dr. Martinez wanted to move out of the leased Rainbow location, which he had outgrown, and buy a building large enough to contain his growing practice and also provide room for his wife to join him. Thanks to an SBA 504 loan through Nevada State Bank, the young professionals recently opened a joint practice called Smile Squad, offering both orthodontic care and pediatric dentistry for young patients. When the dentists approached Nevada State Bank for a building loan, they were introduced to Chaya Platt, a Certified Medical Banker who specializes in serving the financial needs of medical professionals. Chaya was able to arrange financing for them to purchase a 5,400-square-foot building on West Sahara, large enough to accommodate the new Smile Squad office and provide room for future expansion. The loan also provided funds to build out the new offices to suit their needs. Chaya even put Dr. Martinez in touch with a colleague who provided a life insurance policy required by the SBA. As a medical professional, whether your needs are personal or business banking, lines of credit* or equipment financing*—or possibly a new mortgage* for that dream home you’ve been waiting to purchase—Nevada State Bank is here to help you. If you’re looking for a true banking relationship in which your banker is available when you need them, call us today at 702-855-4887. We’ll be happy to meet with you and discuss how Nevada State Bank’s Certified Medical Bankers can help you achieve your financial dreams. – Raine Shortridge

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CONTENTS

22 LENDING A 48

HELPING HAND

Ryan Linden is executive director of Silver State Health Services.

Southern Nevada is making strides on mental health care for youths

‘TIS THE SEASON The holiday season is a good time to be aware of the potential for allergic reactions

LISTENING TO OUR ELDERS Depression, substance abuse, suicide and the correlation within our senior population

COLUMNS 12

CONCUSSIONS Las Vegas health care professionals take a team approach to concussions

BULLYING Connecting with child’s school, teachers crucial in addressing bullying

INNOVATION The future of MS: A new era of treatment

END-OF-LIFE CARE Hospice stresses quality of life, comfort for patients

Vance Johnson and his mother, Ima Jean Johnson, at the grand opening of The Vance Johnson Recovery Center.

MEDICARE Understanding the Medicare Advantage open enrollment period

NEVADA HEALTH LINK Executive director: Same great access to qualified health plans

CLINICAL TRIALS Pinpointing the right clinical trial for you

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Ryan Linden photo by Christopher DeVargas; Vance Johnson and Ima Jean Johnson photo by Steve Marcus.

A view of the lobby and reception desk at Southern Hills Hospital Pavilion. The $30 million mental health facility opened in March 2019.

FEATURES 44

THE GOOD FIGHT

COMMUNITY 50

Dr. Khoi Doa of Comprehensive Cancer Centers on the latest in the battle against lung cancer

CAPABILITY HEALTH & HUMAN SERVICES

Notes from the health care community

Partnership brings jobs to talented individuals with limited abilities

62 46

GIVING BACK

Former NFL player opens 44-bed psychiatric and addiction facility in Las Vegas

Expectant mothers give the gift of healing through birth tissue donation

54 48

SILVER STATE HEALTH SERVICES Group aims to provide cost-effective, high-quality care to areaâ&#x20AC;&#x2122;s impoverished population

Southern Hills Hospital Pavillion photos by Steve Marcus.

HEALING GIFTS

THE NOTES

CALENDAR Upcoming events and classes

MEET THE PHYSICIAN Get to know Dr. Thomas Hunt of Roseman University

EDUCATION Touro University Nevada student discovers she had cancerous nodule during class exercise

FALL 2019

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concussions

las vegas health care professionals take a team approach to concussions By Renee Eskierka

Desert Radiology was founded in 1966 and has grown to become Southern Nevada’s chief resource for quality diagnostic care at their 11 imaging centers. The practice works closely with several area hospitals and delivers leadingedge diagnostic imaging services to Las Vegas’ sports teams, such as the Vegas Golden Knights, Las Vegas Aces, Las Vegas Lights, the Aviators and UNLV.

s advancements in medical science move forward, health care professionals are working to properly evaluate and treat those suffering from concussions, especially among student-athletes. The doctors at Desert Radiology have seen students with concussion symptoms from a variety of sports — football, soccer, basketball, volleyball, and even non-team activities like skateboarding. Most organized sporting events have athletic trainers in attendance to monitor for signs of injury. The physicians at Desert Radiology feel it is also vital for parents to be involved in the process by increasing their knowledge about concussions and the possible signs that can help determine if their child is injured. Concussions are not always easy to diagnose at the actual time they occur, and symptoms may develop later when the student is at home. A concussion is defined as a type of traumatic brain injury caused by a bump, blow or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells. According to Dr. Alan Weissman, one of Desert Radiology’s board-certified radiologists, any kind of impact to the head during a sporting event can cause a concussion. The effects of a concussion can be serious and long-term. “If a player is hit on the field or court and there’s a possibility of a concussion, stop play and get him or her off the field or court immediately,” Weissman said. “These trained professionals need to assess and evaluate the player to determine any symptoms of a concussion. The worst thing to do is to allow them to continue playing and increase the chances of a second hit that can cause additional and more extensive damage.” Brittany Backofen, the athletic trainer at Chaparral High School, is constantly monitoring game action for possible concussion signs. “I tend to look for a player’s reaction after a hit,” she said. “If they are rubbing or shaking their head or if they stumble when walking, those would be indicators that they need to be

assessed for a possible concussion. I will ask them how they are feeling and gauge their reaction after a hit.” In addition, Backofen said, “I look for the player to make eye contact and to respond to questions when I ask them. I will also ask them if they have any symptoms. The most challenging thing is that with a physical injury, it is easy to see swelling and test the strength of muscles. With concussions, for the most part, we depend on the patient to be honest with us and tell us how they’re feeling. This can be tricky at times when there is a big game or a close-scoring game and students are not completely forthcoming because they want to be involved in the game.” Weissman believes parents also play an important part in monitoring the health of their child. “Concussion symptoms vary from mild to severe,” Weissman said. “A person can suffer from a mild headache, ringing in the ears, seeing stars, vomiting and loss of consciousness or even not acting like themselves. If you are not sure if your child has a concussion, take them to the doctor, or if necessary, the emergency room. Sometimes, the people who are around the patient the most may notice symptoms before the patient does.” Once a health care facility receives a patient, Weissman said that they are assessed by a primary physician and then they are referred for diagnostic imaging. When a patient is sent for imaging, CT scans are done to detect any abnormalities such as bleeding in the brain. MRI is utilized and performed for more extensive imaging diagnosis. Weissman added that it is important for students who may have a concussion to avoid screen time. “No texting, no reading and no looking at TV or computer screens.” When a player is diagnosed with a concussion, they have to do three things before returning to competition, Backofen said. First, the athlete must be cleared to play by a licensed physician. Next, they must pass a standardized concussion test, which includes balance testing, reaction time measurements, vision screening, and other evidence-based

Renee Eskierka is imaging facility manager for Desert Radiology.

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Photo Credit

A concussion is defined as a type of traumatic brain injury caused by a bump, blow or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.

tests. The patient must also complete a five-step graded exercise program, she said. “It’s a very involved process, but we do this in order to make sure that a patient is completely ready to return to play mentally and physically,” Backofen said. Both Weissman and Backofen said parents have asked them what kinds of precautions can be taken to prevent concussions. “There is no true way to avoid concussions,” Weissman said. “Resting is the most important thing you can do to help the brain recover during down time. Most importantly, players need to avoid that second hit

Photo Credit

while playing. Recurring hits without enough treatment in between concussions can lead to long-term cognitive effects in personality, increase anger and loss of concentration.” Health care professionals, like those at Desert Radiology, will continue to work with schools and parents to increase the awareness and treatment of these types of injuries in an effort to improve the long-term health of student-athletes, especially through early intervention practices and procedures.

FALL 2019

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B U L LY I N G

connecting with child’s school, teachers crucial in addressing bullying By Mendi Baron

Ignite Teen Treatment provides mental health and addiction treatment for teens and families at its locations across Southern Nevada. Ignite accepts insurance, making its services accessible and affordable to families. For more information, visit IgniteTeen Treatment.com.

s teens and parents are in the midst of the new school year, things are exciting, fresh and new. However, with the new year it is important to be aware and speak with your teen about the challenges they may face: peer pressure, substance abuse, depression, anxiety and bullying. While issues are common with teens in middle and high school — and tend to show themselves in a variety of ways — bullying is one of the more challenging issues to identify and address. Unlike classic movie tropes, bullying today is not as simple as getting “roughed up” by an older or bigger kid. Today, bullying doesn’t require the other individual to have any sort of additional size or strength — modern bullying can take a variety of ugly forms, through pictures, words, text, social media, shaming and more. Additionally, bullying can be more far-reaching than before, with technology tying multiple “social scenes” and schools together, creating a greater sense of impact and permanence for the victims. For this reason, bullying has led to more suicides than ever before and is incredibly hard to track and beat. Here are some helpful signs that may indicate your child/ teen is a victim of bullying: • Isolating from friends and family members and social events. • Showing a lack of interest in homework and having sliding grades. • Complaining of headaches, stomach aches or other physical ailments. • Having trouble sleeping, eating or suffering from bad dreams. While there are a variety of ways to address bullying, the most critical way to both address and even prevent it is to establish rapport with the system. Reach out to your child’s school and connect with those in charge. Let them know your concerns and that you are willing to be a part of the process.

The collaborative approach is best. Avoid aggressive language and accusations. At first, avoid calling the parents of the bully directly, though it may be necessary later on. Ideally, you should establish a regular line of communication with your child’s teacher(s) from the start of the school year. As a parent, developing a relationship with the education team is key to being heard when you have legitimate concerns. In doing so, you will avoid putting your education team and/or administration on the defensive when problems arise. Be transparent with your teen about this process. If you choose to contact your child’s education team directly, we recommend that you and your child be on the same page. Often part of the bullying process is instilling a fear of social repercussions in the victim, pushing them to avoid taking action. Not being on the same page with your child, or going behind their back, could be counterproductive and deepen the divide between you and your child, hindering the process. Let the school know that you will be transparent and expect the same of them. In this fashion, you feel assured things are being handled, and they can be assured that they won’t have to look out for your next move. Be supportive of your teen. As a parent, you want your child to be in a school environment where they feel safe. Once your child’s “safety” has been compromised, it can be challenging for a parent to process. Put yourself aside and note that the process is far more challenging for your child. Yes, you will help your kid whether they want it or not, but let it feel like they want it more than you, or you will undermine your ability to keep them safe. In the end this may not “fix” the problem, and very often additional support is needed. As mentioned above, this is your child — your baby. There are emotions at play and lives at stake. It is imperative that you seek out a balanced and impartial individual to support you through the process. This could be a friend, relative, consultant/advocate, therapist, educator, etc. In this fashion, you can seek to engage the issue in a way that is both protective as well as collaborative, balanced and solution-focused.

Mendi Baron, LCSW, is founder and CEO of Ignite Teen Treatment.

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Photo by DeCania Photo.

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I N N O VAT I O N

the future of MS: a new era in treatment By Le Hua, M.D.

T Participation in the Lou Ruvo Center for Brain Health’s clinical trials program is FREE and open to the public. Even those with normal cognitive function are needed to participate as normal healthy controls. For more information, visit HealthyBrains.org or call 855-LOU-RUVO.

he Cleveland Clinic Lou Ruvo Center for Brain Health The purpose of the study is to compare the benefits and risks opened its doors to the first Alzheimer’s patient 10 of two common treatment approaches for MS to determine years ago. A decade and 165,000 patient appoint- the better course. This is the first time the two approaches ments later, one of the center’s greatest achievements has have been compared in a head-to-head trial. been the expansion of service lines to study all aspects of brain disease, including multiple sclerosis (MS). While Al- • Reparative Trials Drugs approved for MS are to stabilize the disease and zheimer’s researchers haven’t seen a new drug approved in 15 years, MS researchers are having the opposite issue: an abun- prevent further relapses. We have nothing to repair the damage done by the disease. We are exploring ways to repair the dance of new drug approvals posing challenges in MS care. I am proud that we’ve been on the forefront of drug thera- damage through remyelination and axonal regeneration appies. Two of the new MS drugs approved since 2017 were test- proaches. Remyelination is aimed at altering the course of ed at our center (Ocrevus and Mayzent), and we were also in- MS by rebuilding damaged myelin, the sheath covering nerve fibers in the brain and spinal cord, which becomes damaged, volved with another MS treatment, which should be approved in 2020. While we are excited about the rapidly expanding slowing or blocking electrical signals from reaching the eyes, MS treatment landscape, we are faced with a new challenge: muscles and other parts of the body. Another approach is to the variability of these new medications coupled with the un- both repair myelin and regenerate axons — the nerve fibers that carry the electrical signal. Our patients at the center are predictability of the disease is making it difficult for doctors to the first to test these treatments through the Affinity and the determine the best course of treatment for patients. Radius trials. As the Lou Ruvo Center for Brain Health celebrates its 10th anniversary this year, our MS program — a branch of Cleveland Clinic’s renowned Mellen Program for MS, currently • Real-World Evidence While randomized controlled clinical trials (RCTs) provide ranked as the No. 1 MS program in the country — is focusing on innovative research aimed at answering the burning ques- the highest level of evidence for MS drug safety and efficacy, comparing individual therapies in robust clinical trials is costtion: What is the best way to treat MS? To answer this question, we are focusing on three areas of and time-prohibitive and have more limited applications in the clinical setting. Here at our center, Dr. Hersh and I are inresearch: measuring how these new drugs weigh against each terested in real world evidence to compare existing treatment other in real world practice; determining the best approach to MS treatment: highly effective vs. escalation; and explor- options using both observational studies and comparative effectiveness research to inform clinical decision-making based ing reparative treatments — both remyelination and axonal on value, precision medicine, and quality of care. regeneration approaches to repair damage caused by MS.

• MS Treatment Approach There are two treatment approaches to MS: the first uses a highly effective treatment early in the disease state and the second uses an escalation approach, where lower efficacy yet safer medications are used first, reserving escalation to higher efficacy medications when the disease is not adequately controlled. Both approaches carry their own risk of side effects, and science has yet to answer which is the better approach. My colleague, Dr. Carrie Hersh, and I are conducting research to help answer this question through trials like DELIVER-MS.

Complementing traditional disease-modifying therapies in the treatment of MS is a healthy lifestyle, and the center is proud to be an innovator in this space through our Health & Wellness and Yoga for MS programs. A healthy lifestyle plays an important role in navigating the challenges and obstacles that come with an MS diagnosis. Those living with the disease experience symptoms ranging from fatigue to problems with flexibility and movement as a result of spasticity and weakness, creating significant challenges that can get in the way of living one’s best life.

Dr. Le Hua is director of the Multiple Sclerosis Program at Cleveland Clinic Lou Ruvo Center for Brain Health.

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Photo courtesy of The Cleveland Clinic.

e n d - o f - l i f e care

hospice stresses quality of life, comfort for patients By Karen Rubel

ach year, hospices across the country recognize November as National Hospice and Palliative Care Month. When people hear the word “hospice,” they generally know it has something to do with end-of-life care. But what is it really? The purpose of a hospice is to provide care, support and comfort to patients and their family members when an illness can no longer be cured. Millions of Americans have experienced hospice firsthand, yet some misunderstandings persist. As the oldest, largest, and only nonprofit hospice in Southern Nevada, officials at Nathan Adelson Hospice are often asked about some of these topics and can offer information about many of the things people seeking answers about hospice care are the most curious about.

Hospice improves the quality of life during the end-of-life journey When a patient is no longer able or no longer wants to treat their terminal illness, their priorities change. The main concern becomes the quality of life during their limited life expectancy. There is an excellent option available hospice care.

Hospice is health care Hospice is the only health care system designed to address the needs of patients and families when a patient is no longer seeking a cure for their life-limiting illness. Hospice strives to make patients as comfortable as possible while making the most of the time that remains. Hospice affirms life and regards dying as a normal process, so it neither hastens nor postpones death. We do all we can to make sure that no one in our care ends the journey of life alone, afraid or in pain.

Hospice gives you a team that you cannot assemble on your own It takes a variety of skilled professionals to deal with all the physical, social, emotional and spiritual care needed by a terminally ill patient. Most families would find it impossible to assemble such a team. Hospice does this for you, using an interdisciplinary team trained in end-of-life care. These uniquely skilled professionals know what patients and families are going through as they enter hospice and are likely to go through

during the end-of-life journey — so they work closely with you and each other to optimize care at every stage.

Which medications are covered under hospice? Medicare and major insurers usually cover all the costs of medications that relate to a terminal diagnosis. But other health-related costs are not covered. For example, if a patient wore glasses before entering hospice, the fees for an eye exam or the cost of new glasses would not be covered under the hospice benefit.

What is palliative care? Palliative care helps patients by mitigating pain and adverse symptoms. Critical illness can produce painful symptoms from both the disease and its treatment. The struggle with these symptoms can be so consuming that it effectively keeps patients from focusing on anything else in their life. Palliative care, sometimes called “comfort care,” uses sophisticated methods to minimize pain and adverse symptoms.

Given a choice, where do most people prefer to receive care? Most people would prefer to be at home when they’re sick. It is no different for people with a critical illness, so almost all hospice care is delivered in the home. For different patients, their home may be their private residence or that of a loved one, a hospital, assisted living center, or skilled nursing facility.

Hospice is for people who have a limited life expectancy, not just for the actively dying Typically, hospice is considered when multiple physicians agree that the prognosis indicates the patient has less than six months to live. This prognosis doesn’t mean the patient will definitely die during the next six months, but it is a realistic possibility. Patients who exceed the six months can be recertified and continue to receive care as long as they continue to meet eligibility criteria. If you are looking into hospice, it does not mean you or your loved one are giving up the fight for life. It means only that the focus of the fight has changed, and it is a fight for quality of life during the time remaining.

Karen Rubel is president and CEO of Nathan Adelson Hospice.

Photo courtesy of Nathan Adelson Hospice.

FALL 2019

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MEDICARE

UNDERSTANDING THE MEDICARE ADVANTAGE OPEN ENROLLMENT PERIOD By CJ Bawden

T Senior Care Plus is a Medicare Advantage Plan from Hometown Health. For more information, visit SeniorCarePlus.com or call 702-832-2552.

he 2020 Annual Election Period (AEP) runs from October 15 to December 7 for Medicare Advantage plans with a January 1, 2020, effective date. During this time, Medicare members may switch from Original Medicare to a Medicare Advantage plan; switch to a new Medicare Advantage plan from an existing one; leave a Medicare Advantage plan for Original Medicare and join a Medicare Prescription Drug plan. What senior residents may not realize is that the government added a new Medicare Open Enrollment Period (OEP) to the calendar. From January 1 to March 31, plan members are also able to make changes to their existing plan. This Open Enrollment Period takes the place of the previous Medicare Advantage Disenrollment Period. So, how does the new Open Enrollment Period differ from the Annual Election Period? First, the changes that plan members can make are slightly more limited than the AEP. Plan members are permitted to:

• Switch from an existing Medicare Advantage plan, to a new Medicare Advantage plan. • Like the original Disenrollment period, drop existing Medicare Advantage coverage and return to Original Medicare, parts A and B. • Join a Medicare Prescription Drug plan if you are switching from a Medicare Advantage plan back to Original Medicare. Now, let’s look at the limitations during OEP. Plan members are not permitted to: • Switch from Original Medicare to a Medicare Advantage plan. • If a member with Original Medicare coverage, they cannot join a Medicare Advantage plan or Medicare Prescription Drug plan. • If a member with Original Medicare coverage, switch from one Medicare Prescription Drug plan to a new plan. The OEP provides Medicare Advantage plan members more flexibility and more time to make the right health care decisions. Members who are newly enrolled in Medicare, are new to the area, get “Extra Help” or Medicaid, or are dropping or losing group health plans have special enrollment rules and timeframes. Contact our office directly if you are in one of those groups. Additionally, interested seniors can find out more about Senior Care Plus Medicare Advantage by visiting our website at SeniorCarePlus.com or by calling us at 702-832-2552. Choosing a Medicare Advantage plan and navigating the enrollment periods can be confusing and complicated; potential members are welcome to visit our office at 8930 W. Sunset Road, #200 Las Vegas, NV 89148. CJ Bawden is director of Government Programs at Hometown Health.

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health i n s ura n ce

nevada health link: new platform, enhanced consumer tools, same great access to qualified health plans By Heather Korbulic

ome believe seven is a lucky number, and I’d like to vada’s call center and enrollment platform mitigated many of think there’s truth to that now that the Silver State the risks associated with establishing an SBE. Health Insurance exchange is three weeks into its sevReturning enrollees are encouraged to visit NevadaHealthenth Open Enrollment Period since we began operations as a Link.com and claim their accounts that were migrated from state agency in 2013. This year comes with a lot of new devel- HealthCare.gov and select a new plan for 2020. New consumopments for the exchange, but our mission remains the same: ers are invited to explore Nevada Health Link’s plans, comcontinue to close the gap of uninsured Nevadans throughout plete an application and enroll for plan year 2020. the state by connecting eligible residents to subsidized, AfNevada Health Link is offering 27 qualified health plans fordable Care Act (ACA)-compliant qualified health plans. through three insurance carriers — Health Plan of Nevada Nevada Health Link, which is the online exchange enroll- (HPN) and SilverSummit, which are returning to the exchange ment platform in the state of Nevada, remains the only place from the previous year, as well as Anthem HMO Co., rejoinNevadans can secure subsidies to help offset the cost of ing the exchange for plan year 2020. Nevada Health Link also health insurance. Nevada Health Link is partners with six different dental carriers, also the only place where Nevadans can offering 17 standalone dental plans. enroll in coverage for plan year 2020 and Nevada Health Link invites consumers On average, Nevadans beyond. to find free enrollment assistance from a on the exchange The most notable change has been the licensed broker/agent or certified enrolltransition away from federal enrollment ment counselors. All of the plans through are paying about $150 marketplace, HealthCare.gov, to an autonNevada Health Link cover the 10 essential per month for their omous State Based Exchange (SBE). This health benefits mandated by the ACA, complex project has required an enorwhich include maternity and newborn monthly premiums. mous amount of strategic coordination care, mental health, preventive care and and collaboration with our partners and pediatric dental care. vendors, but it brings significant advantages — including a While insurance rates have increased by an average of cost savings of more than $4 million during the first fiscal year 1.6 percent, there are still many plans that offer low to zero alone, a better consumer experience, and most importantly, cost premiums. Nevadans who are not insured by their emour ability to enjoy full autonomy and control over our pro- ployer, or who are not eligible for Medicare or Medicaid, are grams and consumer data, allowing us to run our own market- eligible for insurance on the exchange. Nevadans with inplace and put Nevadans’ needs first. comes between 138 and 400 percent of the Federal Poverty Let’s address the much-talked-about state-based imple- Level (FPL) may qualify for financial assistance to help pay mentation that had a significant technology failure in 2014 for their monthly insurance costs. This assistance is known when Nevada was an SBE before it relied on HealthCare.gov for as subsidies, which over 80 percent of consumers who enroll eligibility and enrollment tools. The exchange took extensive in a plan through the exchange are able to access. On average, measures to learn from past mistakes and carefully selected Nevadans on the exchange are paying about $150 per month a proven exchange technology vendor, GetInsured, which not for their monthly premiums — a small price compared to the only has a successful track record of transitioning Idaho to an steep cost of medical bills for those without insurance. SBE, but operates exchange technology in seven other states. Last year, 83,449 Nevadans, 62,663 from Clark County, enGetInsured also developed streamlined technology and rolled in health insurance plans through Nevada Health Link. call center implementation that specifically meets Nevada’s While that number is strong, the exchange is working hard to needs. Working with one experienced vendor for both Ne- reach even more uninsured Nevadans.

Open enrollment for Plan Year 2020 runs through Dec. 15, 2019. Consumers can call our new number at 1-800-547-2927 or visit NevadaHealthLink.com to explore a health insurance plan best suited for their families’ needs. We stand ready to help and guide you through what can be a complicated decision.

Heather Korbulic is executive director of Silver State Health Insurance Exchange.

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cl i n i cal tr i al s

pinpointing the right clinical trial for you By Anthony V. Nguyen, M.D.

M For more information on Conprehensive Cancer Centers, visit CCCNevada.com or call 702-952-3350.

arjorie Nelson made it to the emergency room just in time. In 2017, the 71-year-old Henderson resident was having what she thought was excruciating gas pains. She called her son and he immediately took her to a local hospital. She remembers the staff telling her to come back for more evaluation. But 15 minutes later, her colon ruptured to force her to have emergency surgery. She doesn’t remember anything beyond arriving at the hospital and waking up in a postoperation room. But, when she did wake up, she learned she had something far more severe than simple pains. Nelson was diagnosed with Stage IV colon cancer, which had metastasized to her lungs, shoulder as well as her liver. Her prognosis was serious — she was diagnosed with an incurable cancer. Nelson immediately prepared for the standard colon chemotherapy regimen. Luckily, with the encouragement of her son, she explored a new treatment offered through a clinical trial. Following more thorough examination, molecular and genetic testing, Nelson qualified for an innovative clinical trial utilizing immunotherapy. Immunotherapy acts differently than the traditional chemotherapy and activates the immune system to combat harmful cancerous cells. The drug at the core of Nelson’s treatment, Nivolumab (commercially known as Opdivo), is also approved to treat melanoma, lung and other cancers. It has not yet been approved for colon cancer patients of her molecular profile. The trial is one of the more than 170 Phase I, Phase II and Phase III clinical research studies that Comprehensive Cancer Centers participates in each year. To date, the practice has played a role in developing more than 85 Food and Drug Administration (FDA)-approved cancer therapies. In Nelson’s unique case, she has responded wonderfully to this new combination of immunotherapy and approved chemotherapy. She has completed 17 cycles (or 17 months) of immunotherapy so far and continues to respond. Where there had been minimal hope, Nelson’s tumors have not progressed, she is experiencing minimal side effects as a result of her hard work and progress in this clinical trial. She has maintained a positive attitude which has helped her immensely.

For Marjorie and so many others, clinical trials have been imperative to their vitality. So, after one is diagnosed a cancer or blood disorder, and is reviewing treatment options, how do you find out if you qualify for a clinical trial?

Qualifying for a Clinical Trial

There are more than 250 cancers that have been identified, many of which have their own unique traits. Whereas in prior times, cancer care focused on categories of cancer, there are now individualized treatment plans that can focus on very specific scenarios and cancers. Just as Marjorie was diagnosed with a specific type and stage of cancer, there are many different targeted treatments and trials available for those who qualify. Factors that determine whether or not a patient qualifies for a trial vary. They typically are examining specific molecular profiles and stages of the cancer. Trials also typically use past medical history and current health condition to find a good clinical trial match. In addition to an overall examination to ensure that a patient may be able to physically handle treatment, a genetic test may be required to ensure that the patient has the specific characteristics or genetic markers that the trial will target. Once you qualify for a clinical trial, there are many benefits that complement potentially improving your own livelihood. First and foremost, you’ll have access to treatments not yet on the market. By taking part in clinical research, you have quicker access to therapies that may very well be the next, life-changing, go-to treatment for the generations ahead. Secondly, with trial drugs and treatments, you will have a dedicated team carefully monitoring your progress and side effects. Given their experimental nature, you may withdraw from a trial at any time. And, finally, there is a selfless aspect to any clinical trial. The research obtained from your participation is invaluable in better understanding a specific cancer and shaping the future treatment landscape. At Comprehensive, we recognize and appreciate the importance of clinical research. When you’re ready to explore clinical trials in the modern medical realm, your oncologist should be ready to discuss how they may apply to you. It begins with a simple conversation.

Dr. Anthony Nguyen is a medical oncologist and hematologist at Comprehensive Cancer Centers.

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HELPING HAND Southern Nevada making strides on mental health care for youths By Miranda Willson Continued on page 24

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ALTHOUGH SPECIALIZED ASSISTANCE HERE REMAINS INADEQUATE, COMMUNITY TAKING MENTAL HEALTH CONDITIONS MORE SERIOUSLY

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hen Char Frost’s adolescent son began to show signs of posttraumatic stress disorder and depression around 2005, she contacted mental health providers in Las Vegas to get him the care he needed. Almost every provider gave her the same response: We don’t serve children. “The one who did had a waitlist that was three or four months long,” Frost said. Inspired by her own experience seeking treatment for her now-adult son, Frost has become an advocate for youth mental health in Southern Nevada. Her goal is to destigmatize mental health conditions, shine a light on the importance of youth mental health services and expose local gaps in services. The gaps are significant. Youth in Nevada have the least access to mental health care relative to their mental health needs in the nation, according to a

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state-by-state ranking from the nonprofit Mental Health America. In Nevada as a whole and Clark County, in which nearly three-quarters of the state’s population resides, youth suicide rates are on the rise, Frost said. The rise in mental health conditions among youth here is in line with national trends. Social media use and a greater awareness of mental health issues are among the reasons why reported anxiety and depression are increasing among young people, some research suggests. But what is perhaps unique to Nevada is the exceptional dearth of mental health care, starting with the limited providers, said Robert Weires, director of the psychological services department at the Clark County School District. “There are challenges for the state of Nevada, real challenges here in terms of service providers and so on,” Weires said. “There’s room to grow.”

RANKING: NEVADA LACKS IN ACCESS TO MENTAL HEALTH CARE

evada is one of 13 states identified by Mental Health America as having youth with higher prevalence of mental illness and lower rates of access to care. The rankings took into consideration seven measures, including: youth with at least one major depressive episode (MDE) in the past year; youth with severe MDE; youth with MDE who didn’t receive service; youth with MDE who received consistent treatment; children with private insurance that didn’t cover mental problems; student identified with emotional disturbance for an individualized education program; and youth with substance use disorder in past year. Nevada ranked last, below Wyoming, Alaska, South Carolina, Oregon and Idaho, respectively. Source: Mental Health America

Other than the UNLV School of Social Work and a new child and adolescent psychiatry fellowship at the UNLV School of Medicine, there are few programs in Southern Nevada to train new mental health professionals, much less youth specialists, Frost said. As a result, the region has struggled to fill the provider gap ever since the recession, she believes. “Our population has been increasing and we just have not been very good about growing our own professionals,” Frost said. In August, the Las Vegas Valley was hit with a major blow to existing youth mental health services: Montevista Hospital, the area’s largest inpatient mental health provider for youth and adolescents, was shut down, Frost said. The facility was one of the few local providers for youth with serious mental health problems in need of full-time care. Without it, more youth will be forced to go out of state for those services, which further disrupts their lives, Frost said. “It’s hard to take a kid who’s been in a very structured situation and transition them back home if the kid has been out of state and the parents have had limited access to the child,” Frost said. Despite this and other challenges, some improvements have been made in recent years to youth mental health care in Southern Nevada. Southern Hills’ new inpatient behavioral health facility, which can accommodate up to 20 young people a time, is one example. Since the Southern Hills behavioral health pavilion opened in March, staff have picked up on a growing need for local youth services based on referrals. Originally designed to serve teenagers

ages 13-17, the youth unit now accommodates children as young as 11. Southern Hills might lower the age limit even further, said Dr. David Gennis, clinical director of the pavilion. Most of the young people who use the pavilion’s services have shown suicidal ideations or behavioral challenges. The average length of stay is 3-5 days, during which time youth receive individualized, group and/or family therapy, Gennis said. “We’re working on determining what led them to feeling so overwhelmed where they felt that suicide was the route they wanted to take at that time,” he said of the intensive program. In addition to identifying factors that trigger destructive behavior, staff at the youth pavilion help young people develop coping skills and regulate their emotions, Gennis said. When they are ready to be discharged, staff work on a transition plan as well. That almost always involves connecting families to geographically accessible outpatient therapy services, which can be difficult, Gennis said. “I don’t believe we have enough licensed service providers throughout all of Clark County to meet the therapeutic needs of everyone,” he said. The behavioral health pavilion will soon be complemented by an intensive outpatient program for adolescents to better facilitate that transition away from inpatient care, Gennis added. Expected to open Dec. 2, the facility will give some patients the opportunity to continue working with their Southern Hills therapists two to three days per week post-discharge. Continued on page 26

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A break room is shown above in the Adolescent Unit at the Southern Hills Hospital Pavilion. The $30 million mental health facility opened in March 2019. Continued from page 25

“A lot of this is consistency. That goes a long way in treatment,” said Jasmine Smith, director of physician and provider relations at the behavioral health pavilion. Meanwhile, schools in the area have taken up some of the slack when it comes to transitioning students out of intensive care, with the psychological services department having created a mental health transition team for that population, Weires said. But CCSD’s resources are also insufficient. The district faces a shortage of school psychologists, whose duties include evaluating students in crisis, intervening when students show suicidal tendencies and helping students post-inpatient care. The shortage means that school psychologists sometimes work across three schools — even though they aren’t supposed to oversee services at more than two schools at a time — and that they have little spare time to devote to anything other than crisis situations, Weires said. “We can’t go as deep, far and wide with any particular skillsets or services for kids if we’re spread out too thin,” he said. The school district recently opted to spend $350,000 per year to contract with the company Columbus Educational Services, which will provide CCSD with 3.5 full-time equivalent school psychologists. Although Weires would prefer to hire more permanent staff instead, local and national school psychologist shortages have made that all but impossible, he said. “(This) helps us spread our services a little wider, a little deeper,” Weires said. In response to a state mandate from the 2019 legislative session, the district is also working to create a suicide prevention plan. All public and private schools in Nevada are required to do so under Senate Bill 204, which Gov. Steve Sisolak signed into law in June. CCSD’s suicide prevention plan is still at an early stage, Weires said, but it will involve strengthening relationships among specialists in the district, such as psychologists, counselors and nurses. More collaboration and communication between the school dis-

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trict and community service providers, such as the United Citizens Foundation, could be a part of the plan as well. United Citizens Foundation delivers therapy to students in area schools, said Frost, who manages government affairs at the nonprofit. By offering those services during the school day, United Citizens Foundation addresses another barrier to care in the valley: For children of working parents, even when care is available, it might not always be accessible financially or time-wise, Frost said. “(Families) only have so many hours after school that therapists might not work. And that’s cutting into homework time and dinnertime and everything else,” she said. Parents nonetheless should try to be proactive about teaching their children healthy mental habits and coping skills, Frost said. The sooner parents are able to identify and deal with potential mental health concerns in their children, the better. “I think there’s an opportunity for us to do a better job with our very young children, to start teaching them how to manage negative or uncomfortable feelings and then how do they express behaviors (and) communicate appropriately,” Gennis said. While Southern Nevada’s youth mental health challenges won’t be fixed overnight, experts agree that at least one thing has improved: From lawmakers to educators to parents, people seem to be taking youth mental health problems more seriously than ever before. Reducing that stigma even more and reminding parents that mental health problems are no one’s fault remains key to addressing the issue, Gennis said. As his staff say to the families of children at Southern Hills’ behavioral health pavilion: No blame, no shame.

Photos by Steve Marcus.

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CREATING HEALTH AND HEALING DURING THE HOLIDAYS By Greta Jackson

ishing someone a polite “Happy Holidays” seems harmless, but for those who have experienced loss, the greeting — and the holidays in general — are painful reminders of their grief. For someone who is feeling unhappy because of grief, anxiety and/or depression, these pleasantries can place a heavy emphasis on the cheerfulness or joy someone just may not be capable of this holiday season. If you or someone you know isn’t having a happy holiday — there is hope. Understanding grief is a vital part of surviving season’s greetings. The holidays are often associated with quality time, family and loved ones. Many of the festivities and celebrations during the holiday season serve as reminders of loss, especially in what is traditionally a joyous time. The behavioral health industry sees an influx of patients during these times. The emotional and financial stress of the holidays, the complexities of family dynamics and with an increase in social engagements, people tend to experience higher amounts of stress, depression and anxiety. Throughout the varying stages of grief (denial/disbelief, fear, anger, depression and acceptance), there are several distinct types which may overlap, or appear at different times. Grief can be better understood when clinically identified into four distinct types including: Bereavement, the state of mourning someone experiences after the loss of a loved one; Loss, which can include any type of loss (financial loss, the loss of a home or relationship); Acute Grief, which is experienced immediately after a loss or the death of a loved one; and lastly, Complicated Grief which is a syndrome that happens when your ability to

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move through the grieving process is prolonged by maladaptive behaviors. In addition to its mental toll, grief can manifest itself physically, causing symptoms such as a lowered immune system, heart and cardiovascular issues and fatigue and sleep disruption. So how can someone tell if they should seek help? Clinical therapists recommend seeking professional help if you or a loved one experience continuous pain or sadness that does not go away, sustained isolation, obsessive thoughts regarding a loved one, suicidal thoughts or if the grief interferes with daily life, causing an inability to function normally. There are a few common practices licensed therapists recommend to patients who may be experiencing these symptoms to help guide them through the healing process:

Be honest with yourself and allow yourself to feel. Give yourself permission to express your emotions. If you feel the urge to cry, cry. Many patients try to repress or normalize themselves during the holidays or participate in holiday events they may not be up to. Therapists encourage patients to give themselves permission to opt out of festivities to give themselves time to feel the sadness, pain or anger.

Celebrate new traditions. Family rituals are at the heart of the holiday season, but for patients experiencing loss, these traditions can bring new waves of sadness. Experts suggest making room for change and letting go of or altering old traditions that are painful. Celebrating a new ritual can set boundaries that can allow patients to be both mindful of their grief and create tangible reminders of their loved ones.

Scale back on responsibility for the moment. In the midst of loss, patients can

be tempted to delve into their obligations too soon into the grieving process. Therapists suggest patients make time for themselves and avoid taking on new responsibilities. Patients should not feel guilty of putting down the phone and enjoying the things like movies or reading. Taking time to absorb the full meaning of the loss in their life is critical to the patient’s coping process and the ultimate act of self-care.

Seek out assistance . Each patient deals with grief differently and seeking assistance is a normal response to the overwhelming emotions associated with grief. By relying on a support system, patients can grieve in a healthy way and in a safe environment without judgment. Patients can join a support group, lean on their family and friends, or seek professional help. The holiday season can be a tough time for those adjusting to the loss of a loved one, and understanding grief as a necessary process can go a long way to acceptance and healing. There is no proper way to grieve, but with the proper support system, practices and understanding, there is hope in the healing for a happier holiday season.

Greta Jackson, LCSW, is a behavioral health therapist and clinical director of Silver State Health Services.

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â&#x20AC;&#x2DC;Tis MORE THAN 30 MILLION PEOPLE IN THE UNITED STATES AND EUROPE NOW LIVE WITH FOOD ALLERGIES.

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the Season THE HOLIDAY SEASON IS A GOOD TIME TO BE AWARE OF THE POTENTIAL FOR ALLERGIC REACTIONS By Dr. Jim Christensen

ood is an important part of our culture, whether it is traditional American fare or dishes specific to another heritage. It’s an important part of celebrations in all nations of the world, no matter what culture or religion. Different countries use food in different ways to help celebrate

special occasions. Many people are looking forward to preparing and enjoying roast turkey, mashed potatoes and pumpkin pie for Thanksgiving or brisket, latkes, kugel

and jelly donuts for Hanukkah meal, or appetizers and hors d’oeuvres of just about every kind for New Year’s Eve celebrations. And yet with every bite of every meal, some of us find ourselves one step closer to danger: More than 30 million people in the United States and Europe now live with food allergies. That number continues to grow. In this country, a food allergy sends someone to the emergency room every three minutes, and food allergies cost about $4 billion per year in direct medical expenses. There is no cure for food allergies, and there are no approved medical treatments. For people living with food allergies, avoidance currently is the only option. Continued on page 32

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It Can Happen Very Quickly People often assume that a food allergy is something a person develops as a child, and that it may or may not stay with them throughout their lives. But people can randomly develop food allergies as adults, too. Food allergy symptoms can appear at any age and affect up to 4% of adults. People can develop allergies to foods they’ve eaten for years with no problem. Experts don’t always know why someone will develop a food allergy as an adult, but people with eczema, asthma or seasonal allergies seem to be more prone than others. Allergic reactions to food are almost always sudden. They happen within minutes of eating a triggering food. At the first sign of severe symptoms such as throat-tightening, it’s important to get to the ER right away. The most common foods that cause food allergies in adults are peanuts, fish, shellfish (such as shrimp or lobster) and tree nuts (almonds, walnuts, pecans and cashews).

Those who have a food allergy must avoid the offending food. An allergic reaction can quickly put their immune system into a state of emergency, affecting many bodily organs. For certain people, even a tiny amount of the food may cause signs and symptoms such as digestive problems, hives, facial swelling or trouble breathing. Some people with a food allergy can be at risk of a life-threatening reaction — anaphylaxis. Anaphylaxis is a severe and potentially life-threatening allergic reaction that can occur within seconds or minutes of exposure. It causes the immune system to release a flood of chemicals that can cause a person to go into shock. Blood pressure may drop suddenly, and airways can narrow, blocking breathing. Signs and symptoms include a rapid, weak pulse, a rash, nausea and vomiting. Anaphylaxis requires an injection of epinephrine and a follow-up trip to an emergency room. If anaphylaxis isn’t treated right away, it can be fatal. Continued on page 34

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THE UNCOMMON STUFF

ome food allergies are so common that the law requires manufacturers to label foods that contain them — they’re often referred to as “the big eight.” These eight allergens are responsible for up to 90% of all allergic reactions related to food. The “big eight” are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat and soybeans. For people who are allergic to other, less common foods, identifying and avoiding them can be difficult. Here is a quick look at eight of the less common food allergies:

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AVOCADO: Avocado allergies are closely tied to latex allergies. People who are allergic to latex and have bad reactions to avocados may want to be alert to potatoes, tomatoes, chestnuts, papaya, bananas or kiwis.

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CORN: While still somewhat uncommon, corn allergies can be severe. Those allergic to corn should stay away from all of its forms, including corn starch and corn syrup, which are both common ingredients in many processed foods in the United States.

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DRIED FRUIT: Many dried fruit allergies originate with sulfites, like sulfur dioxide. These are used to preserve many types of processed foods.

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HOT DOGS: Hot dogs are a highly processed food, often with numerous additives. An allergic reaction after eating hot dogs could be due to any number of these ingredients. However, nitrate and nitrite additives are often to blame.

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MANGO: Another somewhat rare food allergy is mango. As with avocadoes, an allergy to mangoes is often linked to latex allergy.

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MARSHMALLOWS: For those who are allergic to marshmallows, gelatin is most likely the cause. Gelatin is derived from connective tissue of animals, and some people are allergic to the protein in it.

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RED MEAT: Being allergic to meats like beef, pork and lamb is rare and can be difficult to identify. Being allergic to one type of meat is often a sign of being allergic to others.

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SESAME SEEDS: People who are allergic to sesame seeds can experience severe reactions. These allergies are rare and estimated to affect about 0.1% of people in the United States. People with this allergy should be alert to possible use of sesame seed extracts and oils.

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Continued from page 33

Food Intolerance vs. Food Allergy

Physical reactions to some foods are common, but most of these reactions are caused by a food intolerance rather than a food allergy. An intolerance can include some of the same signs and symptoms as a food allergy, so it can be easy to confuse the two. A true food allergy causes an immune system reaction that affects numerous organs in the body. In some cases, an allergic food reaction can be severe or life-threatening. By comparison, food intolerance symptoms are generally less serious and often limited to digestive issues. People who have a food intolerance may be able to eat small amounts of the triggering food without too much trouble. They may also be able to prevent a reaction. For example, those with a lactose intolerance may be able to drink lactose-free milk or take lactase enzyme pills to aid digestion. Anyone who experiences a reaction after eating a particular food should see a doctor to determine whether they have a food intolerance or a food allergy.

Hope on the Horizon

While avoidance is the most common response to the diagnosis of a food allergy, allergens are everywhere, and accidental exposures can happen. Peanut allergy is one of the most common food allergies, affecting more than 6 million people in the U.S. and Europe. It can be a lifelong condition that eight in 10 children affected by it will never outgrow. When exposed to a trigger food, allergic people can have reactions ranging from mild to severe. In some cases, the allergic reaction can be life-threatening. An accidental exposure can be traumatic for families, and just the potential for a severe reaction can dominate a family’s daily routine and interfere with their overall quality of life. There is some progress being made in the treatment of certain food allergies. There are new desensitization treatments being developed to help those with food allergies by reducing the risk of allergic reactions. Several clinical trials are now taking place for an immunotherapy to reduce the frequency and severity of peanut allergy reactions in children and adolescents. A substance called AR101 (a new peanut-derived, oral drug) is designed to reduce the frequency and severity of these allergic reactions. Under a doctor’s supervision, patients ingest controlled, increasing amounts of AR101 over a period of about six months or longer. The result is that the patient’s immune system tolerates larger amounts of peanut. After the dose escalation period, the patient continues to take a daily therapeutic dose to maintain desensitization. Today, more than 3,000 people worldwide, most of them children, have undergone peanut immunotherapy, with the goal of protecting them if they accidentally encounter the food. Other children are trying immunotherapy for allergies to milk, eggs and tree nuts.

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What You Can Do

This holiday season is a good time to be especially aware of the potential for allergic reactions. With so many different meals, treats and social gatherings, the potential for a food reaction increases. Regardless of whether someone is allergic to one of the “big eight” or a less common food allergen, they will likely have similar symptoms during a reaction. Those who experience any of the following symptoms should seek immediate medical attention, as anaphylaxis can be fatal: ●

Coughing

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Cramping

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Difficulty breathing

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Dizziness

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Hives or rash

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Loss of consciousness

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Tingly or itchy mouth

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Swelling of the lip, tongue, throat, or face

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Vomiting and diarrhea

Those who have diagnosed food allergies should speak with friends and family about the severity of the allergies so they understand the seriousness of it. It’s important to be vocal and communicate details about allergies, and ask questions when necessary with family, friends, coworkers, party hosts, even the caterer or food supplier who may be at a social event. Those who have been prescribed an EpiPen should keep it with them at all times, as well. Another precaution to consider is having a business-sized card (sometimes called a chef’s card) with a listing of food allergies. It’s a great way to communicate food allergies to a chef or manager at a restaurant, and it ensures that the allergens noted to servers are communicated to everyone who needs to know. Lastly, people should not ignore a reaction that occurs shortly after eating a particular food. They should see a doctor to determine what’s causing it. Even if they’ve had a relatively mild reaction in the past, later allergic reactions may be more serious.

Dr. Jim Christensen is an allergistimmunologist with OptumCare Lung and Allergy Care.

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Spring Valley Medical Office II

SUMMERLIN VALLEY Goldring Medical Plaza

Shadow Lane Medical Office

Fo r l e a s i n g i nfo r m ati o n:

JAMIE KRAHNE jk rahne@ensemble.net

702-216 -2363 License B.0143850.LLC ensemble.net

listening to our 36

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DEPRESSION, SUBSTANCE ABUSE, SUICIDE AND THE CORRELATION WITHIN OUR SENIOR POPULATION

elders By Christina Cober Continued on page 38

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ore than 44 million American adults have a mental health condition, and depression is among the most common of those conditions. The Nevada Office of Suicide Prevention says the prevalence of depression in Nevada aligns with its high suicide rate, which is second only to Alaska. Also of concern among older adults is substance abuse, sometimes described as the “invisible epidemic” among the elderly. Taken separately, substance abuse,

MILLION AMERICAN ADULTS HAVE A MENTAL HEALTH CONDITION, WITH DEPRESSION BEING THE MOST COMMON

depression and suicide are all growing problems among our older citizens. They form a triad of often-related health care issues that must be addressed by patients, providers, caregivers, families and the community.

Depression and Seniors

Many individuals experience sadness at various times in their life, but depression isn’t the same as feeling sad. The American Psychiatric Association defines

depression as a “common and serious medical illness that negatively affects how you feel, the way you think and how you act. (Depression) can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.” Depression affects more than 6 million Americans age 65 and older, and it’s important to acknowledge that as seniors get older, they experience many unique circumstances and life changes that can lead to these feelings of sadness, loneliness and isolation. Complicated health

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concerns and serious diagnoses can also be a major contributor, as approximately eight out of 10 older adults have at least one chronic health condition, according to the Centers for Disease Control. “Many seniors must deal with the losses of loved ones and close friends, while also suffering from feelings of loneliness and simultaneously battling chronic health issues,” said Dr. Jud Fisher of HealthCare Partners Nevada. “Others may feel anxious about leaving the workforce and

moving into retirement. These types of life events can significantly contribute to a senior developing depression.” With the holidays approaching, many are preparing for a time of family gatherings and fun events. However, despite the joy that is commonly associated with this time, the holidays can also be a source of anxiety and depression for many people. Seniors may be especially vulnerable to depression, due to holiday-related feelings of fatigue, anxiety, financial stress and an inability to spend time with family and friends. There are several ways family members and other caregivers can help seniors beat the holiday blues. Planning holiday outings and activities, for example, can be very beneficial. Examples include decorating, making holiday crafts, going shopping or visiting holiday light displays. Another way that loved ones and caregivers can help seniors battling depression is to share stories and chat about old memories. Start a conversation about his or her memories of previous holidays, even going back to their childhood. Look through their photo albums or watch home movies to spur positive and engaging discussion. It is also helpful to set aside quiet time. The hustle and bustle of the holidays can be quite disruptive to seniors. They may appreciate some relaxation and “down time” between family visits and holiday parties.

Substance Abuse Among Seniors

As reported by the National Institute on Drug Abuse, there is a notable connection

between depression and substance abuse, with depressed individuals being twice as likely to abuse drugs or alcohol than those without a mood disorder. Substance abuse among adults over the age of 60, particularly involving prescription drugs and alcohol, is one of the fastest growing health problems in the United States. According to the National Council on Aging, the number of U.S. seniors with substance abuse problems is rapidly approaching 5 million. And because the problem isn’t well known, it is often overlooked in medical check-ups. From 1999 to 2017, more than 702,000 people died from a drug overdose. Of those deaths, nearly seven out of 10 involved a prescription or illicit opioid. Americans ages 50 and older accounted for nearly 40% of the opioid-related deaths in 2014. Seniors often have a variety of longterm prescriptions and may end up taking more of any given medication than was prescribed. Certain medications are narcotics and can potentially cause a physical addiction. It is always best for seniors to review their entire list of medications with their health care provider. “Seniors taking medication they no longer need is a common occurrence,” Fisher said. “Many times, the patient doesn’t realize that they no longer need the prescribed medicine but continue to take them, and this creates an accidental addiction. That is why our senior-focused physicians at HealthCare Partners myGeneration Senior Clinics strongly advocate for medication reconciliation. This involves getting a consolidated and accurate inventory of all medications a

patient is taking. Doing so can give the patient a clear understanding of their medications while decreasing the chances of accidental addiction.” According to the New York State Office of Alcoholism and Substance Abuse Services, the elderly spend more than $500 million annually on medications. Combining medications and alcohol frequently result in significant and adverse reactions.

Later-life Suicide

As reported by the Centers for Disease Control and Prevention (CDC), suicide rates are rising sharply across the country, and Nevada is often ranked amongst the highest in suicide rates. The reasons for this include easy access to guns, financial issues, social isolation and, in some cases, problem gambling. According to the Suicide Prevention Resource Center, the national suicide rate in 2017 for persons 65 and up was over 15 per 100,000 individuals. Nevada is no exception. In 2002, the American Association for Marriage and Family Therapy (AAMFT) stated, “The annual suicide rate for persons over the age of 65 was over 15 per 100,000 individuals; this number increases for those aged 75 to 84, with over 17 suicide deaths per every 100,000.” This holds true for Nevada as well. As reported by a University of Nevada, Reno, publication, “As Nevadans aged in 2018, they (were) more likely to take their lives — peaking at ages 75-84.” Those numbers don’t take into account “silent suicides,” which can include deaths from overdoses, self-starvation or dehydration, along with other accidents.

“We have found that seniors are not generally inclined to seek treatment for mental health problems, and this illustrates the important role of family members and friends in helping to prevent suicides,” Fisher said. “It’s a community-wide crisis that must be addressed on many levels.” Dr. Fisher said many people who committed suicide had no known or diagnosed mental condition when they took their lives. However, many of them suffered a personal crisis such as “substance misuse, physical health woes, and job, money, legal or housing stress” before their death, he said. Because research shows that seniors do not seek mental support, HealthCare Partners Nevada providers established an integrated, coordinated care approach where all care team members are communicating with regards to the patient’s health and well being. Each patient receives ongoing physical and mental check-ins as part of their comprehensive patient-centered care regimen. During an office visit, HealthCare Partners Nevada providers monitor behavioral traits of patients, including the patient’s level of consciousness, appearance, general behavior, speech and mood. Patient responsiveness will assist providers in determining the mental state of their patient and whether further treatment is needed. HealthCare Partners Nevada providers are trained to detect these related issues and determine the best way to address them at the onset. HealthCare Partners Nevada also recommends routine doctor visits to help patients improve and maintain their overall well being.

Christina Cober is the Director of Communications at HealthCare Partners Nevada. HealthCare Partners Nevada, an Intermountain Healthcare company, is a network of nearly 300 primary care providers and more than 1,500 specialists. With medical clinics and specialty care affiliates throughout Pahrump, Las Vegas, North Las Vegas, Henderson, Mesquite, and Boulder City, HealthCare Partners Nevada is committed to delivering the highest quality care to all our patients.

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Warning signs

epression, substance abuse and suicide are separate issues, but are often related when it comes to seniors. Dr. Jud Fisher of HealthCare Partners Nevada said the increased numbers of seniors experiencing these problems makes it more important than ever to be aware of warning signs that can help address and resolve these problems early on. Below are warning signs and resources for these areas of concern.

Depression warning signs

Substance abuse warning signs

Suicidal ideation warning signs

Below are some of the red flags for depression among the elderly, according to the Centers for Disease Control and Prevention:

The following are indicators for substance abuse among older adults, according to the Geriatric Mental Health Foundation:

Following are some of the suicide warning signs identified by the American Association for Marriage and Family Therapy:

• Feelings of hopelessness and/or pessimism

• Anxiousness or irritability

• Loss of interest in things or activities that

• Feelings of guilt, worthlessness and/

• Memory loss

the person usually finds enjoyable

or helplessness

• Decision-making problems

• Irritability, restlessness • Loss of interest in activities or hobbies once pleasurable

• Difficulty concentrating or paying attention • Lack of interest in usual activities • Sadness or depression

• Fatigue and decreased energy • Difficulty concentrating, remembering details

• Mood swings

• Cutting back social interaction • Decrease in self-care and/or grooming • Breaking medical routines, such as abandoning diets going off prescriptions)

• Experiencing or expecting a significant personal loss

• Chronic pain

• Expressing feelings of hopelessness and/

• Problems with money or the police

or worthlessness

• Falls, bruises and/or burns

• Putting affairs in order or giving things away

• Overeating or appetite loss

• Incontinence

• Changing one’s will

• Thoughts of suicide, suicide attempts

• Headaches

• Stockpiling medications

• Persistent aches or pains, headaches, cramps,

• Dizziness

• Lack of concern about one’s personal safety

• Poor hygiene

• Stating intent or plans to end one’s life

and making decisions

• Insomnia, early-morning wakefulness, or excessive sleeping

or digestive problems that do not get better, even with treatment

• Poor nutrition and/or changes in eating habits

Resources for Depression

• Being out of touch with family and/or friends

• National Institute of Mental Health

• Having thoughts of suicide

Depression: https://www.nimh.nih.gov/health/publications/ depression/index.shtml

• American Psychological Association’s Depression and Suicide in Older Adults Resource Guide: https://www.apa.org/pi/aging/ resources/guides/depression

• National Council on Aging Center for Healthy Aging Mental Health: https://www.ncoa.org/resources/depressionin-older-persons-fact-sheet/

• Strange responses to medications

Web Resources for Substance Abuse • Substance Abuse and Mental Health Services Administration: www.samhsa.gov

• Veterans Crisis Line: https://www.veteranscrisisline.net

• Institute on Aging: https://www.nia.nih.gov • American Society on Aging: https://www.asaging.org

• PACT Coalition:

Behavioral Health: https://dpbh.nv.gov/Programs/ClinicalSAPTA/ Home_-_SAPTA/

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https://suicidepreventionlifeline.org

Alcoholism: https://www.niaaa.nih.gov

• Nevada Division of Public and

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https://nvsuicideprevention.org

• National Suicide Prevention Hotlin:

• National Institute on Alcohol Abuse and

www.drugfreelasvegas.org

Web Resources for Suicidal Ideation • Nevada Coalition for Suicide Prevention:

Dr. Jud Fisher is a Family Medicine physician at HealthCare Partners Nevada.

VEGAS WE KNOW

702.990.2550 | www.greenspunmedia.com | advertising@greenspunmedia.com 2275 Corporate Circle, Suite 300, Henderson, NV 89074

Driver Vincent Diego helps Barbara Sherman, 88, into a “Helping Hands of Henderson” senior transportation van.

HELPING HANDS FROM DIGNITY HEALTH HELPS SENIORS LIVE INDEPENDENT LIVES By Bryan Horwath

ithout Helping Hands of Henderson, Magda Haggar, who doesn’t have a car and lives on a fixed income, doesn’t know how she would get to the doctor’s office or the grocery store. The largely volunteer transportation and nutrition program has been a lifeline for Haggar and her husband, Abboud, who has cancer and relies on the ride service to get to his medical appointments, she said. “These are great people who run Helping Hands. God bless them,” Magda Haggar said. “They take us to doctor appointments or just to Costco or Sam’s Club for shopping. Everybody in the program, the volunteers and everyone, have been so good to us.” Helping Hands provides rides to people over 60 who don’t have reliable transportation, does grocery shopping for homebound clients and runs errands, among other services. The program allows people to maintain their independence by staying in their own homes. Helping Hands, which has been around since 1995, serves about 460 clients, with another 150 on a waiting list, said Jane Camburn of Dignity Health, who supervises the program. It operates a fleet of seven wheelchair vans and has 50 volunteer drivers who use their own vehicles to transport clients. “It’s not just for medical appointments and nutritional needs,” Camburn said. “That’s what Helping Hands is mainly

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for, but it’s also about fighting isolation and helping seniors to get out of their home and be a part of the community when they’re at a point where they can’t get around anymore and don’t have anyone.” Helping Hands is funded by grants and donations to the St. Rose Dominican Health Foundation. And maintaining it at its current level of operations isn’t easy, said Natasha Meinecke, philanthropy manager for the foundation. “At Dignity Health-St. Rose Dominican Hospitals, we believe in human kindness,” Meinecke said. “That means that just because a patient leaves the hospital, it doesn’t mean that we stop caring about their health and wellness. We need the community’s help to keep our program funded.” Those wheelchair vans, for example, cost about $65,000 each, and there is a need for at least one new vehicle, officials said. “Two of the vans have about 185,000 miles on them,” Camburn said. “Repairs can be very expensive. Those vans have definitely served their usefulness. If one of those vehicles breaks down, we may not fix it because we don’t have the funds right now.” For information about how to donate to Helping Hands, contact the St. Rose Dominican Health Foundation at 702-616-5750. For more information about Helping Hands or to volunteer, call 702-616-6554.

Photos by Steve Marcus.

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THE GOOD FIGHT

THE LATEST IN THE FIGHT AGAINST LUNG CANCER By Khoi Dao, M.D.

et’s clear the air on lung cancer. An estimated 234,000 people are diagnosed with lung cancer each year. This year in Nevada, there will be an estimated 1,880 new lung cancer cases, according to the American Cancer Society. While new cases are projected to be lower than other forms of cancer — for instance, 2,190 new cases of breast cancer and 400 breast cancer-related deaths are projected this year in Nevada — the lung cancer death rate is estimated to be much higher with 1,280 deaths. Lung cancer remains the No. 1 cancer killer of Americans (and Nevadans), with a five-year survival rate of less than one in five. And, while smoking rates have rapidly declined since the 1990s, an estimated 85 to 90% of all lung cancer cases continue to be smoking-related. Beyond the “quit smoking” mantra, there is a lot happening in the lung cancer space, spanning enhanced treatments, the emergence of vaping and how to address it, updated recommendations and new ways to stay lung smart.

The Evolution of Treatment Lung cancer is the rapid and uncontrolled growth of abnormal cells in one or both of the lungs, creating a tumor that depletes oxygen, nutrients and space from healthy cells in the lungs. Symptoms of lung cancer include chronic cough, sometimes with blood, chest pain, shortness of breath and repeated respiratory infections. Throughout the last 20 years, diagnosis, detection and treatment for lung cancer have drastically changed and improved. We now have access to technology such as PET/CT scans and endo-

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bronchial ultrasound to accurately stage patients and determine the best treatment regimens. Patients are living longer with better quality of life, thanks to advancements in surgery, chemotherapy, radiation therapy and targeted therapy. Treatments have become more targeted and individually tailored to each patient based on the identification of genetic mutations and targeted receptors. Approved in 2004, Tarceva was the first genetically targeted treatment for lung cancer. Since, many new classes of systemic treatment have been developed, including immune checkpoint inhibitors, which stimulate the patient immune system to seek and destroy cancer cells. In patients that are able to receive related medications, many are living longer compared to those with cytotoxic chemotherapy. Surgery has also evolved to include video-assisted thoracoscopic surgery (VATS), a minimally invasive alternative to traditional open surgery. Comparatively, VATS has improved mortality and long-term survival among lung cancer patients. Also, radiation therapy has become a popular and trusted treatment option, which uses X-rays or gamma rays directed to a specific part of the body where cancer has grown. CyberKnife Robotic Radiosurgery, a form of stereotactic ablative radiotherapy, delivers large doses of radiation with high precision. A non-invasive technique, this has become a go-to for treating early-stage, inoperable non-small cell lung cancer with minimal side effects. Radiation oncologists at Comprehensive Cancer Centers are the only doctors in Southern Nevada who offer CyberKnife to patients. Long before ever needing a lung-cancer related treatment, early detection remains critical. Most individuals may not know they

have lung cancer until symptoms arise. The five-year survival rate for those whose lung cancer is found in its early stage and when it is localized is nearly 57 percent. Survival rates decline significantly after the cancer has spread to other organs.

Vaping on the Rise Amid declining smoking rates, e-cigarette use (also commonly known as vaping) is on the rise. The U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) are investigating hundreds of cases of severe lung illnesses, and death, linked to vaping. E-cigarette use has especially spiked for teens, a group that has seen a steady decline in traditional smoking use through the last two decades. The Youth Risk Behavior Surveillance System study, conducted by the CDC, found that of the teens surveyed, 42 percent have tried an e-cigarette. In Nevada, 15 percent of high school students surveyed currently use an electronic vapor product, including vape pipes or pens, regularly. Marketed as a safer alternative for smoking, e-cigarettes can contain nicotine and other addictive substances that may cause lung disease, heart disease and even cancer. Vaping has not received FDA approval as a smoking cessation method either. From an oncologist’s perspective, the recommendation for anything you inhale (outside of a prescription/treatment) remains the same: Don’t put anything in your lungs that shouldn’t be there. This recommendation spans cigarettes, marijuana, vaping, hookah and anything related. Clean air is best for your lungs and that will always be the case.

Beyond Putting Down the Cigarette You know it because you live here: The Las Vegas Valley is a truly unique place, culturally and geographically. Unfortunately, this uniqueness brings different challenges with air quality whether indoors or outdoors. Even though smoking has been banned in restaurants and bars serving food, casino floors and other bars remain fair game. While folks may not be frequenting the slots or table games, they may regularly walk through the casino to get to a movie theatre, favorite restaurant or family attraction. For many, they work in a casino environment where smoke is prevalent, furthering the risk of secondhand smoke. It is important to remember that not all who are diagnosed with lung cancer are smokers. According to the American Cancer Society, as many as 20% of people who die from lung cancer in the United States each year have never smoked or used. Another factor contributing to secondhand diagnoses: The environment. According to the American Lung Association (ALA), air quality across much of the United States has worsened in recent years. In the ALA’s annual “State of the Air” report, the Las Vegas and Henderson area landed at No. 13 on the list of most polluted cities when ranked by ozone pollution. At home, do your best to live in a dust-free environment. This includes changing air filters often, keeping linens clean and considering not having pets if asthmatic. Healthful eating habits and regular exercise will help keep lungs flourishing as well. The bottom line is that there are factors working against us, some we can control and others we cannot. Amid the factors, it’s important to mitigate your exposure to the blatantly harmful elements and stay lung smart.

Dr. Khoi Dao is a medical oncologist and hematologist at Comprehensive Cancer Centers, specializing in lung cancer, colorectal cancer and benign and malignant hematology. Recognized as a “Top Physician” by US News & World Report, Dr. Dao joined Comprehensive in 2000 and is a graduate of University of California, Irvine. For more information on Comprehensive, visit www.cccnevada.com or call 702-952-3350.

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GIVING BACK

REDEMPTION: NFL VET LENDS NAME TO LAS VEGAS DRUG RECOVERY CENTER By Ricardo Torres-Cortez

Vance Johnson poses with his Super Bowl 50 ring during the grand opening of the Vance Johnson Recovery Center. Johnson, who played for the Denver Broncos from 1985 to 1995, got the ring from friend Peyton Manning.

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Left: The Vance Johnson Recovery Center. Right: Vance Johnson and his mother, Ima Jean Johnson, pose in a double patient room.

fter a decade-long NFL career with the Denver Broncos ended in 1995, Vance Johnson fell into a downward spiral of drinking and prescription drug abuse. He lost personal relationships, money and his “soul,” Johnson said in his book “Uncovered: Why Becoming Less Became Everything.” He even pawned his NFL championship rings. Things only got worse in 2007, when his 19-year-old son, Vaughn, was killed in a motorcycle crash. The grieving father recalled being so high at the funeral that he could barely stand. He tried sobering up on his own, but it wasn’t until after he contemplated suicide in 2013 that he checked into a Florida recovery facility and got sober — for his late son and for God, he said. Now, he is on a mission to help others by working with Oglethorpe Inc., a national network of psychiatric and addiction centers, at its new Vance Johnson Recovery Center in Las Vegas. The 44-bed facility at 2651 Westwood Drive, near Sahara Avenue and Interstate 15, opened in October. Oglethorpe Inc. brought on Johnson as an ambassador of sorts, but he plans to participate in day-to-day operations, such as working with patients in therapy sessions and at the on-site gym, said Veronica Scala, the center’s marketing director.

Photos by Steve Marcus.

Whether it’s kitchen work or sweeping floors, “I’m all in,” said Johnson, 56, who is buying a home in Las Vegas. The facility had a ribbon-cutting ceremony Sept. 27 attended by local dignitaries, Johnson’s parents, friends and fans. He smiled as he shook hands, took photos with people and signed books and pictures from his football days. Johnson told the group he is still alive by the grace of God and that he wants the facility to be “the home that Vance built.” “I’ve been waiting for this day my whole life,” Johnson said. He said he was humbled to be a “beacon of light” for those facing struggles like those he overcame. One of the people at the ceremony was Tom Byington, an old friend Johnson had not seen in 20 years. Johnson didn’t realize it, but Byington had been hanging onto something for Johnson for all those years. Byington handed him a small wooden box. A smile spread across Johnson’s face as he opened the box. It was his AFC championship ring. “Oh, my God,” Johnson said. “I love you so much.” For more information about the Vance Johnson Recovery Center, go online to vjrc.org, email info@vjrc.org or call 888-82-VANCE.

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bu s i n e s s p r o f i le

Silver state health services offers cost-effective health care By Rebecca Clifford-Cruz Silver State Health Services Phone: 702-471-0420 Email: contactus@silverstate.org Website: SilverStateHealth.org Paradise Behavioral 2255 Renaissance Drive, Suite A, Las Vegas Hours: 9 a.m.-7 p.m. Monday through Friday; 8 a.m.-3 p.m. Saturday Paradise Primary 2215 Renaissance Drive, Suite C, Las Vegas Hours: 8 a.m.-5 p.m. Monday through Friday Spring Valley 2965 S. Jones St., Suite E2, Las Vegas Hours: 8 a.m.-5 p.m. Monday through Friday

ilver State Health Services’ mission is to provide cost-effective care and expand affordable access to high-quality health care for Las Vegas’ underserved and impoverished populations. Its executive director, Ryan Linden, talks about its upcoming expansion, its work to help victims of October 1 and the changing landscape of health care as a result of technology.

Ryan Linden, executive director of Silver State Health Services.

What are your primary duties as executive director? My primary duties include direct oversight of my executive team, creating and maintaining a company culture, eliciting the various passions of my employees, dreaming about the future and learning from the past.

What resources do you offer?

We offer comprehensive primary care, psychiatric and behavioral health solutions to patients in need of service. With After graduating with a degree in political science/busi- a robust case management department, we’re able to assist ness, I began working in the health care field, doing opera- in locating or providing transportation, housing, medical retions in private medical facilities. In 2016, I wrote a grant to ferrals, vocational training and a food pantry. open a nonprofit Federally Qualified Health Center in the Las Vegas area and was awarded the funds to begin operations in How many health care providers are on your team 2017. I’ve been leading the organization ever since, focusing and what specialties do they possess? We have 22 health providers on our staff. Most of these on reaching out to vulnerable populations that have difficulty are clinical social workers providing individual psychotheraaccessing the health care sphere. py, while our medical staff includes a psychiatrist, psychiDo you have any news you’d like to share? atric nurse practitioners, physicians and family nurse pracSilver State Health was just awarded two additional grants titioners. that will help to expand affordable health care services in Southern Nevada. The first is a grant to open a new center Approximately how many patients have location in Pahrump, which we are all very excited about. The Silver State Health clinics treated and are there second is from the United Way Foundation, which granted plans for expansion? Silver State Health has treated over 3,000 unique paus funds to specifically provide mental health services to the Spanish-speaking population experiencing trauma from the tients and is excited to add sites at 2965 S. Jones Blvd. and in Pahrump in early 2020. October 1 tragedy.

Tell us your background.

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Photo by Christopher DeVargas.

Who are your community and/or nonprofit partners? Three Square, the United Way, the CARE Complex, the Harbor, Boy’s Town, the Resiliency Center, HOPE Counseling, Nevada CARES Autism Project, Serenity Mental Health and Never Give Up Counseling.

How has treatment evolved in the past 10 years and what innovative treatments are available to patients? Treatment in health care has changed dramatically over the previous 10 years. With the mandate that providers utilize electronic health records, we have seen a significant rise in the technological applications linked to treating patients. The prevalence of telemedicine has increased significantly for patients located in areas where a physical provider is difficult to secure. Because Nevada is unique in the number of citizens in rural and frontier environments, these services are helping to change the landscape of service delivery.

What’s the biggest issue currently facing Southern Nevada or its residents? With the continual growth that Southern Nevada has experienced over the past decade, the biggest issue we face is having an adequate supply of affordable housing.

What strategic actions are taking place on the local and national level to help curb homelessness and/or those suffering from mental illness? HUD’s Continuum of Care board controls the initiatives and funds used to combat the homelessness issue we face across the country. Through this outlet, new programs are being instituted to house homeless people and through both short-term and long-term housing placements.

It’s been more than two years since the October 1 mass shooting on the Strip. Are your providers still feeling the impact and are they treating those who suffer from post-traumatic stress syndrome? Unfortunately, as we’re all aware, mental health disorders like PTSD can often take many years to help lessen the effects people experience from it. We’re excited at the opportunity to further serve the people affected from the mass shooting through our recent grant acquisition through the United Way, which will allow us to treat these victims at no cost to the patient. Our providers are treating those affected on a daily basis.

Where do you see yourself and/or your organization in five years? I see Silver State Health leading the way with respect to health care delivery in the Valley in a few specific areas. It has always been our shared vision to create health centers that are for the people and by the people. To that end, providing services that are culturally informed is one of our biggest goals. Silver State Health wishes to create an environment for treatment that is as comfortable and individualized as possible, as health outcomes tend to increase when patients feel that their providers are part of the same community.

reimagine Y O U R

S M I L E

A healthy, beautiful smile doesn’t have to be out of reach for you and your family. Fortunately, the faculty and resident dentists at Roseman Dental, the clinical practice of Roseman University College of Dental Medicine, are committed to providing outstanding dental and orthodontic care without the high cost. All of our orthodontic and dental residents are licensed dentists in the State of Nevada and are teamed with highly qualified, board certified or board eligible faculty to provide comprehensive dental and orthodontic care to patients of all ages. DENTAL CARE Dental Examinations & X-Rays Extractions Tooth Sealants Root Canals Dental Fillings Teeth Cleanings Periodontal Procedures Dentures/Crowns/Bridges/Implants ORTHODONTIC CARE Two-Phase Traditional Metal Braces Clear Braces Invisalign® Sleep Apnea TMJ-TMD Retainers Make your appointment for a dental examination or orthodontic screening today by calling 702-968-5222 or visiting rosemandental.com

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RIGHT TIME, RIGHT PLACE

CAPABILITY HEALTH & HUMAN SERVICES AND SEPHORA PARTNERSHIP BRINGS JOBS TO TALENTED INDIVIDUALS WITH LIMITED ABILITIES By Lauren Silverstein

One standout component of Sephora’s hiring process was its commitment that 30% of its full-time staff would be composed of people who are physically or developmentally disabled.

EASTERSEALS NEVADA RECENTLY CHANGED ITS NAME TO CAPABILITY HEALTH & HUMAN SERVICES.

Lauren Silverstein is a senior account executive with The Ferraro Group.

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evada’s economy is growing at a healthy pace, especially when looking at where the Silver State was a decade ago. More than 250,000 new jobs have been created locally since the recession, and that number will increase with dozens of new projects across the state. One of those projects, which opened its doors this year, is the new 715,000-square-foot Sephora distribution center in North Las Vegas. The warehouse will house close to 1,000 employees when the building is at full scale. One standout component of Sephora’s hiring process was its commitment that 30% of its full-time staff would be composed of people who are physically or developmentally disabled. In an effort to reach that number, Sephora partnered with local nonprofit Capability Health & Human Services (formerly known as Easterseals Nevada) and the Nevada Bureau of Vocational Rehabilitation (BVR) to launch a training-toemployment program for adults with disabilities. Founded in 1976, Capability is a health care and human services nonprofit with five locations, 350 employees and 50 contract employees throughout the state. For adults who have physical or intellectual limitations, Capability offers health care, educational training and career-launching services with the goal of helping its clients attain the highest possible level of independent living. The partnered employee training program was inspired by retired Walgreens Senior Vice President Randy Lewis and his book, “No Greatness Without Goodness.” Capability conducts nine-week training courses that include both soft skills training and on-the-job training, specific to positions within Sephora’s North Las Vegasbased distribution center. At the end of nine weeks, candidates who meet productivity metrics and attendance goals are offered jobs at Sephora. The inaugural training class started Aug. 5. “Capability Health & Human Services has a robust pipeline of talented individuals with disabilities and a proven track record of providing meaningful pathway training for placing these individuals into full-time jobs,” said Ryan Hitsman, Sephora’s senior manager of human resources. “In addition, we feel Capability is a viable long-term partner due to its sound infrastructure, great history in the com-

Silverstein photo by Peter Harasty Photography.

“

Working with their tools and equipment proves that with my determination, I can still get the job done. I’m not going to let my disability hold me back; I’ve come a long way. — Charles Deary

munity and purposeful vision to make a real difference. We are tremen- day, our team inspires our trainees to overcome their individual medical dously excited for the future of this partnership.” diagnoses and to not allow the word disability to define them. Our 100% Participants received wages at the rate of $12.50 an hour during train- graduation rate in the first Sephora class of trainees is a testament to the ing, and if they reach full-time status, that increases to $14 an hour. The success of our philosophy and programs.” inaugural class saw seven graduates receive full-time employment as of It is employees like Deary and David Stiles, another warehouse associate Oct. 7. One of those graduates is Charles Deary, who had previously been assistant who graduated through the Capability training program, who have forced to stop working because of his glaucoma. He is 100% blind in his already made this training program successful. According to an Accenture left eye and his right eye has 5% visibility. Now, he is once again an en- study, 29% of Americans between the ages of 16 and 64 with a disability thusiastic worker. were employed, compared with 75% of those in the same age bracket with “As far as my job responsibilities, I first started on the put wall, then no disabilities. Companies that make commitments like Sephora’s have acthe pack wall, and I just recently finished up in the pick area,” Deary said. cess to more than 10.7 million people with diverse strengths, leadership “Working with their tools and equipment proves that with my determination, styles and ways of thinking. I can still get the job done. I’m not going to let my disability hold me back; “The entire community benefits when employers hire members of our I’ve come a long way.” disabled community,” said Doug Geinzer, CEO of Las Vegas HEALS. “This partnership is designed to provide work training and create career “The employer finds competent and capable workers and the community opportunities for individuals with disabilities who otherwise may experi- member becomes a contributing member of the economic system that ence barriers to employment,” said Janice John, deputy administrator for drives our economy.” Bureau of Vocational Rehabilitation. “This partnership is a great opportunity The future looks bright for this partnership, as a second class of trainees to make a difference in the lives of people who desire to join the workforce.” is running and a third class is scheduled to start on Dec. 2. As Deary says, Capability CEO Christine Zack added, “Drawing on our 43 years of health “the people here want to help me in any way they can. It has been such a care and human services in Nevada and our innovative partnership with great opportunity for me and for the first time in a while, I’m looking forSephora, we focus on what individuals can do in our training classes. Every ward to the future.”

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heal i n g g i f t s

expectant mothers give the gift of healing through birth tissue donation By Audra Holmes

here is great joy when a mother brings her baby into the world. Now, through the advancement of technology and regenerative medicine, expectant mothers can also bring hope and healing to others through birth tissue donation. Birth tissue, which includes the placenta, umbilical cord and amniotic fluid, provides nutrients and protection to support fetal development in the womb and is normally discarded after birth. With a mother’s permission, these birth tissues — made up of components that promote the body’s own healing mechanisms — can be donated to benefit patients who have a variety of medical needs including sports injuries, difficult to heal wounds, ophthalmic and dental procedures. Las Vegas native Kelley Sly this August donated her birth tissue at Summerlin Hospital Medical Center after giving birth to her daughter. They became the first duo to take part in Nevada Donor Network’s new birth tissue program.

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One birth tissue donor has the potential to help up to 50 people. The number of lives healed can vary due to the size and number of grafts created.

“My experience was so easy. I really didn’t have to do anything besides say ‘yes’ to giving a healing gift rather than it going to waste,” Sly said. “It didn’t change anything about my delivery experience, and I can’t wait to learn more about how it was used to help others.” Birth tissues possess cytokines, growth factors, extracellular components and cell communication signals giving it the ability to heal patients in need. Tissue grafts derived from donated birth tissues are primarily used to cover and treat wounds such as diabetic foot ulcers and venous leg ulcers. This natural immune privileged wound covering is easily applied and contains components the body uses to heal, protect, and grow tissue. Future benefits continue to be discovered through advancing medical research, education, and development. “When my doctor told me about the opportunity to donate birth tissue, he said the tissues would be thrown away if I didn’t want to donate

them,” Sly said. “I told him I was interested without hesitation. If it can help other people, why not? It’s great knowing others can be healed because of my decision.” Expectant mothers with a scheduled cesarean section can be referred to Nevada Donor Network (NDN) by their doctor or via a self-referral made by a mother-to-be through the donor network website at nvdonor.org/mom. The team at NDN works with the expectant mother to provide more information and complete consent for donation over the phone as well as a medical social interview prior to the delivery. On the day of delivery, two tubes of blood are drawn from the expectant mother to confirm the safety of the donated tissues. An NDN technician will be present to coordinate acquisition of the donated tissues. Donated birth tissues are then sent to a processor who screens and tests the tissues to ensure safety prior to the creation of transplantable

grafts for healing uses. One birth tissue donor has the potential to help up to 50 people. The number of lives healed can vary due to the size and number of grafts created. Donated birth tissues have been used for many years in wound and surgical applications. Birth tissue donation is safe for both mother and baby. Donated birth tissues can provide healing to many people, made possible by tissues that would otherwise be discarded after delivery. Several heroic moms and babies have already given the gift of healing in just the first two months since launching the program. As interest in the opportunity grows, the birth tissue donation program will continue to expand through new partnerships with obstetrician offices and hospitals across the valley. “I would tell other moms who are thinking about it to just do it — you won’t regret helping someone else.” Sly said. “It’s a great feeling to give the gift of healing.”

Audra Holmes is the Birth Tissue Donation Coordinator for Nevada Donor Network.

FA L L 2 0 1 9 H E A LT H C A R E Q U A R T E R LY

“

MEET THE PHYSICIAN

THOMAS HUNT, M.D. professor and chair | family medicine Physician ROSEMAN UNIVERSITY of health sciences

director valley health system family medical residency Program

The advice I give to young physicians is to follow your heart and passion. If you stay true to yourself, you can make a difference and be happy with your choices. — Dr. Thomas Hunt

By Rebecca Clifford-Cruz

s a physician who has been involved in medical education almost his entire career, Dr. Thomas Hunt jumped at the opportunity to join and help shape a new Southern Nevada medical school four years ago. As chair in the Roseman University College of Health Sciences and director of Valley Health System Family Medical Residency program, he has a hand in ensuring that the area’s doctor shortage is addressed over the next several years. According to the Association of American Medical Colleges 2017 State Physician Workforce Data Report, Nevada ranked 48th in the country for active primary care physicians per capita. The Valley Health System’s newly accredited Family Medicine Residency Program was created to address this disparity and increases Nevada’s Family Physician residency training slots by 33%.

Describe your medical specialty and why it’s vital for our community. Family physicians are the backbone of the health care system in the United States. We are present in every community, providing medical care in both urban and rural America and everywhere in between. The specialty of family medicine evolved from the old general practitioner, providing medical care regardless of one’s age and medical condition. It’s a specialty of breadth where we have to be familiar with 99% of the diseases that come through the door and feel comfortable taking care of all aspects, such as pregnant women, the elderly and all in between. The training is very broad-based and programs include specialties such as pediatrics, adult medicine, surgery, obstetrics and gynecology. More Americans depend on family physicians than on any other medical specialty. The program will help alleviate the family physician shortage in Nevada and has been designed to retain these doctors in our community.

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When did you know you wanted to be a doctor? I knew I wanted to be a doctor when I was in high school, looking for a challenging profession to provide a real difference for people. During medical school, I enjoyed every aspect of medicine. I liked using my hands in surgery, working with kids, solving puzzles of medical mysteries, and was fascinated by the brain and how it affected mental health. Family medicine covers such a wide range of health care for people that you know you can go to any community in the world and be of assistance.

What is the most important part of your job? To create an environment for future medical students to train and also provide an answer to our physician workforce shortage in the U.S. Creating a strategic partnership with the Valley Health System, the College of Medicine is sharing resources to make the Family Medicine residency a reality. The three-year program focuses on primary care and preventive medicine and will include training in both outpatient clinics and hospitals. We started in July with our first 10 residents for a three-year training program, and soon we hope to have 30 physicians in the program. Through this collaborative effort, residents will rotate through Roseman Medical Group, Southwest Medical outpatient clinics and the Spring Valley and Summerlin Hospitals.

You’ve practiced medicine in both rural areas and big cities. How do they compare? After I completed my residency program with the National Health Service Corps, I was placed in rural upstate New York through the National Health Service Corps. I was a solo physician, and the only doctor for approximately 20 miles. I had the opportunity to care for everybody in my community, which included making house calls, delivering babies, treat-

ing patients suffering from heart attacks, intensive care, and being the school physician. While it was demanding, it was very gratifying. When I first moved to Las Vegas 20 years ago, I was surprised and shocked that the access to medical care in Las Vegas was worse than the rural county I had moved from. Examples included long wait times to see a specialist and the fact that many specialty services were unavailable in the state. It is much better now, but there is still a lot of work to be done.

What challenges come with the local health care industry, on both sides of the stethoscope? The biggest challenge is access to care on both the primary and specialty care side. Patients who get discharged from the hospital have to wait weeks to see physicians for follow-up. We are under-resourced and doctors are working late hours and long weekends to meet the demand.

What’s the best professional advice you’ve received or given? The advice I give to young physicians is to follow your heart and passion. There are many areas of need throughout our community; if you stay true to yourself, you can make a difference and be happy with your choices. I get a lot of joy from giving back to community and volunteering with Volunteers in Medicine of Southern Nevada. It leads to greater joy in my work and truly makes a difference. How might an overhaul of health care at the federal level affect what you do? As a family doctor, it is about caring for the people in front of you, and there is always a need for individuals to receive primary care. The physician/patient relationship will never change.

What is something that people might not know about you? I am a tournament poker player.

Other than saving lives, what are you passionate about? I’m a big fan of the Vegas Golden Knights.

Dr. Hunt photo by 501 Studios/Leui Ellyson.

FALL 2019

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E D U C AT I O N

TOURO UNIVERSITY NEVADA STUDENT DISCOVERS SHE HAD CANCEROUS NODULE USING ULTRASOUND EQUIPMENT IN CLASS By Steven Slivka

Touro University Nevada is Nevada’s largest school of medicine, the state’s only school of osteopathic medicine and a private, non-profit, Jewishsponsored institution. Opened in 2004, Touro was established to address critical needs in health care and education and as a resource for community service throughout the state. Fully accredited by all the requisite bodies, Touro is now home to nearly 1,500 students.

hen Erica Stiles volunteered to have her thyroid checked in class, she didn’t think anything would be out of the ordinary. Students in the Touro University Nevada School of Physician Assistant Studies use ultrasound machines to enhance their clinical skills. On the last day of her radiology class, Stiles volunteered to have her thyroid examined for a demonstration. “I hopped up there and they discovered that I had a nodule,” Stiles said. “After class, the instructor advised me to get it checked out.” So, Stiles visited her primary care provider, who found nodules on both sides of her thyroid during an ultrasound. “The nodules had calcifications, so they recommended biopsies since calcification usually means cancer,” she said. A few days later, Stiles received a phone call with the news. “I know they don’t deliver bad news like that over the phone, but I asked them if I had cancer and they said ‘yes,’” she recalled. “I was an absolute mess. To hear the word ‘cancer’ is terrifying.” Stiles was later sent to an ear, nose, and throat specialist to learn more about surgery, and a full thyroidectomy was recommended. She had her thyroid removed shortly after and was back to class the following week. “After surgery, I felt great,” she said.

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Stiles said she was never the type of person who slept all day, but she enjoyed taking two-hour naps. It was just one sign of possible thyroid issues that she didn’t connect until her ultrasound. “I just thought everyone liked taking long naps every day,” she said with a laugh. With her thyroid removed, Stiles is required to take levothyroxine once a day for the rest of her life. Living cancer free, she is grateful for the support she’s had from her classmates, faculty, and family along the way. “It’s very much still a shock to me. I don’t know if another program would practice ultrasounds for students like Touro does. I’m not sure when I would’ve started showing symptoms,” she said. “I believe that I was supposed to be in this program at this time.”

Steven Slivka is the communications coordinator for Touro University Nevada.

TOURO PROFESSOR’S INTEREST IN MEDICINE STARTED DURING CHILDHOOD IN PENNSYLVANIA COAL COUNTRY By Steven Slivka

s a coal miner’s daughter growing up in Robindale, ic Medicine in Erie, Pennsylvania, McKenna stayed in Erie Pennsylvania, Dr. Sharon McKenna had a familiarity to complete a family medicine residency at the St. Vincent with medicine at a young age. Health System. McKenna, assistant professor of osteopathic medicine at McKenna eventually relocated to Florida and was workTouro University Nevada College, watched as her mom was ing as a physician when she applied for a faculty position at in and out of hospitals, drawing a keen interest in learning Touro University Nevada in 2018. more about medicine. “I never really thought about Southern Nevada, but it Robindale, the blue-collar town is Southwestern Pennsyl- seemed like a natural progression for us since both of our vania, no longer exists. A flood ravaged the town in the late kids live out West,” she said. “I loved the people I inter1970s, and residents who survived were forced to relocate. viewed with and Touro seemed like a great fit for me.” “What was once Robindale is now a power plant located Throughout the last year, McKenna has developed great next to a coal mine,” McKenna said. relationships with her colleagues and loves connecting with After majoring in biology and chemistry during her under- the students. graduate years, McKenna chose to teach since she wasn’t “The faculty are very concerned about educating good entirely sure if medicine was a career she wanted to pursue doctors in a way that helps them become life-long learners. after college. I’m so impressed by that,” she said. “Every meeting and disAt one point, she and her husband took on a few differ- cussion we have are focused on helping the students learn ent business ventures, including owning a children’s cloth- the best way they can.” ing store and a restaurant. While owning the clothing store, McKenna credits the university’s open-door policy for McKenna’s husband suffered a heart attack. From there, her creating a close-knit culture that lends its students the abilcareer trajectory steered her toward her calling. ity to thrive inside and outside the classroom. “We had a talk about what the future held for our careers, “The students can drop by our offices any time,” she said. and I told him that I really wanted to be a doctor,” McKenna “We want them to understand everything they need to know; said. “He told me that I should go for it.” not only to pass their boards but to help them become good After graduating from the Lake Erie College of Osteopath- and effective doctors later in life.”

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THE NOTES

Centennial Hills Hospital Expansion Above: Dignitaries take part in a groundbreaking ceremony for the tower expansion at Centennial Hills Hospital. Featured guests included: Alan B. Miller, Chairman and CEO of Universal Health Services, Inc. (UHS), the parent company of Centennial Hills Hospital; Marvin Pember, Executive Vice President and President Acute Care Division for UHS; Karla Perez, Regional Vice President, The Valley Health System; Larry Brown, Clark County Commissioner; Michele Fiore , Las Vegas Ward 6 Councilwoman / Mayor Pro Tem; Scott Hammond, District 18 State Senator; and Connie Munk , District 4 Assemblywoman. Shovels go into the ground October 17, 2019, during a ceremonial groundbreaking for the addition of a five-story patient tower at Centennial Hills Hospital. The $98 million project will add 56 patient beds to increase capacity in the Neonatal Intensive Care Unit, Intensive Care Unit, Intermediate and Medical Surgical Units across the hospital.

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Photos by 501 Studios/Levi Ellyson.

THE NOTES

An artist rendering of the Centennial Hills Hospital tower, which will help expand the inpatient pharmacy, surgical services, and the post-anesthesia care unit.

Meet Your Local Banking Experts: Kim MacClafferty AVP, Business Banking kmacclafferty@bankofnevada.com (702) 252-6309 Walter Hashimoto Director, Commercial Banking whashimoto@bankofnevada.com (702) 252-6318

Bank on Accountability bankofnevada.com

Top 10 – Forbes Best Banks

Bank of Nevada, a division of Western Alliance Bank, Member FDIC. Western Alliance ranks top ten on Forbes’ Best Banks in America list, four years in a row.

“

Their knowledge of healthcare and my particular practice has helped me successfully steer decision-making for this business over many years.”

– Andrew J. Bronstein, M.D., Bronstein Hand Center, Las Vegas

FALL 2019

H E A LT H C A R E Q U A R T E R LY

THE NOTES

Diana Quach, Pharm.D. and clinical pharmacy manager at Southwest Medical Pharmacy, was presented the 2019 “Bowl of Hygeia Award” at the annual meeting of the Nevada Society of Health-System Pharmacists. The award, established in 1958, recognizes one pharmacist in each participating state who possesses outstanding records of civic leadership in their communities and encourages pharmacists to take active roles in their communities.

HCA Healthcare appointed Jennifer Berres as senior vice president and chief human resource officer effective November 1. There are four HCA facilities in Las Vegas.

QUACH

Comprehensive Cancer Centers was named Healthcare Partner of the Year at the Nevada Cancer Control Summit Awards Luncheon last month. Comprehensive was honored for its outstanding provider education and community involvement and support, particularly in the area of skin cancer prevention. OptumCare Lung and Allergy has added a new physician to help meet the growing need for health services in the Las Vegas community. Aaron Donz, APRN, joins OptumCare Lung and Allergy (4750 W. Oakey) as an advanced practice nurse. Dr. Nilesh “Neil” Gokal of Southwest Medical Associates, part of OptumCare, has been awarded an honorary Pi Alpha Award by the Pi Alpha Honor Society. The recognition took place Oct. 30 as part of the physician assistant banquet at Sunset Station for GOKAL the students of Touro University in Henderson. The award recognizes accomplishment in the areas of significant academic achievement, leadership, research, community/professional service, and the encouragement of a high standard of character and conduct among PA students and graduates.

Foluso Ogunleye, MD, joins OptumCare Cancer Care (2300 W. Charleston Blvd.) as a physician in medical oncology. Pamela Kurtzhals, MD, FACS, joins OptumCare Cancer Care (2300 W. Charleston Blvd.) as a breast surgeon in the Breast Care department. Carlos Araujo, MD, joins OptumCare Cancer Care (2300 W. Charleston Blvd.) as a physician in medical oncology. Tamara Komes, MSN, APRN, FNP-BC, joins OptumCare Cancer Care (2300 W. Charleston Blvd.) as an advanced practice nurse. Rachael Taylor, MSN, APRN, joins OptumCare Cancer Care (2300 W. Charleston Blvd.) as an advanced practice nurse. Janice Enriquez, APRN, joins OptumCare Cancer Care (2300 W. Charleston Blvd.) as an advanced practice nurse in the Breast Care department.

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BERRES The Nevada Donor Network has re-earned its accreditation from the Eye Bank Association of America after temporarily stopping in its eye bank’s operations in a precautionary move. The donor network says it took the necessary steps to replace leadership and retrain staff while working collaboratively with the eye association to satisfy improvement requirements. “This accreditation is confirmation that we made the right decision to self-report and improve our process before resuming operations after having resolved the issues identified,” said Joe Ferreira, the donor network president and CEO. OptumCare Orthopaedics and Spine has added two new physicians to its location: 4750 W. Oakey Boulevard. Benjamin Hansen, MD, joins as an adult joint reconstruction orthopedic surgeon; Karen Nelson, DO, joins as a trauma physician. HANSEN Utah’s Intermountain Healthcare acquired HealthCare Partners Nevada. The work of HealthCare Partners Nevada providers and employees will continue largely unchanged. They’ll be led by Mark Price, who serves as president of HealthCare Partners Nevada. Price will report to Rajesh Shrestha, Intermountain’s Community-Based Care chief operating officer. Modern Healthcare magazine named Dr. Anthony Slonim, president and CEO of Renown Health, as one of this year’s 50 Most Influential Clinical Executives in the nation. Cullen Brown is chief operating officer of Southern Hills Hospital. Three people joined the board of directors of Las Vegas HEALS (Health, Education, Advocacy, and Leadership in Southern Nevada): Dr. Dan Burkhead, president of the Clark County Medical Society; Dr. Bill Resh, managing partner of Nevada Heart & Vascular; and Derek Parent, vice president of Cross Country Mortgage. Southwest Medical Associates added three physicians to help meet the growing need for health services in Las Vegas: Dr. Doyle Huey specializes in pain management at Southwest Medical’s Oakey Health Care Center, 4750 W. Oakey Blvd. Dr. Bryan Werner specializes in adult medicine at the Tenaya Health Care Center, 2704 N. Tenaya Way. Dr. Olivia Yuson specializes in pediatrics at the Nellis Health Care Center, 420 N Nellis Blvd. Centennial Hills Hospital broke ground on a $98 million, five-story patient tower. The project will add 56 patient beds, increasing the bed count to 318 beds, and enhance the capacity of the neonatal intensive care unit, intensive care unit, and medical surgical units. The project will also expand the inpatient pharmacy, surgical services, and the post-anesthesia care unit.

Berres photo by Tony Hayes/Verve Studios Photography.

Leading the way in

teaching

the health care providers and educators of tomorrow while

caring

for our community.

Largest Medical School in Nevada • Master of Science in • Doctor of Osteopathic Medicine Medical Health Sciences • Doctor of Physical Therapy • Master of Science in Nursing • Doctor of Nursing Practice ~ Family Nurse Practitioner • Master of Education • Doctor of Education ~ Education Administration and Leadership

~ Curriculum & Instruction – School Counseling ~ School Administration

• Occupational Therapy • RN to Bachelor of Science in Doctorate Nursing • Master of Science in Physician Assistant Studies • Education Advanced Studies Certificate Programs

For more information about supporting the work of Touro University Nevada or if you are interested in a campus tour, please call: 7 0 2 . 7 7 7 . 3 1 0 0 or visit our web site at t u n . t o u r o . e d u

874 American Pacific Drive | Henderson NV 89014

Accredited by the WASC Senior College and University Commission (WSCUS). Licensed in Nevada by the Commission on Post-Secondary Education. Touro University Nevada does not discriminate on the basis of race, color, national origin, sex, sexual orientation, disability, or age in its employment, programs, or activities.

cale n d ar To include your calendar items in the next issue, contact Jennifer Inaba at jennifer.inaba@gmgvegas.com

CENTENNIAL HILLS Hospital

Mother-Baby Support Group

General Cancer Support Group

CentennialHillsHospital.com 6900 N. Durango Drive

Mondays Jan. 6 - Feb. 3, 1 p.m. - 2 p.m. Free Meet other mothers. Bring a blanket, pillow, lunch and snacks

Nov. 21, Dec. 19, 2 p.m. - 3 p.m. Free This Cancer Support Group is devoted to helping patients with cancer improve their quality of life while undergoing treatment or if they are in survivorship. It is open to patients, caregivers, and families.

Breastfeeding Class Nov. 21, 6 p.m. - 8 p.m. $25 per couple A certified lactation consultant will demonstrate the proper techniques to help you succeed with breastfeeding. Bring a stuffed animal for demonstration purposes. Topics include breastfeeding basics (for cesarean delivery and vaginal delivery), positioning, latch-on, weaning, jaundice and dealing with challenges. Strategies for moms returning to work will also be discussed. Women are encouraged to ask their partner or a friend to attend the class with them.

Childbirth Preparation Class Dec. 7, 9 a.m. - 2 p.m. $60 per couple Whether you are first-time parents or have not had a baby in several years, this course can help you prepare for the childbirth process. Prenatal nutrition, labor, medical procedures, and pain relief methods will be covered, including vaginal and cesarean births, induction of labor, epidurals, breathing techniques, relaxation and more! Expectant mothers are encouraged to bring a support person along for the class. Baby Basics for Moms and Dads Dec. 11, 6 p.m. - 8:30 p.m. $30 per couple Learning about early parenting skills can calm your fears about infant care. This course will teach you the fundamentals of child-care and is designed for both firsttime parents and existing parents who would like a refresher.

Sunday Tours of the Women’s Center Every Sunday, 3 p.m. Free The Women’s Center offers weekly tours to expectant families. Tours are held every Sunday. Children are welcome to attend. Appointments are not required. Tours start at 3 p.m. Meet in the second-floor lobby.

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Desert Springs Hospital DesertSpringsHospital.com 2075 E. Flamingo Road

Diabetes Basics Dec. 7, Dec. 12, 8:30 a.m. - 12:30 p.m. Free If you have Type 1 or Type 2 diabetes, or have been told you have pre-diabetes, this three-part interactive educational session on diabetes from Desert Springs Hospital Medical Center’s Diabetes Treatment Center is for you. You’ll get the knowledge you need and learn about tools that can help you manage diabetes and achieve success in self-management.

Senior Holiday Health Fair Dec. 7, 1 p.m. - 3 p.m. Free The Senior Holiday Health Fair will include more than 60 health and wellness vendors, as well as health and wellness education and free health screenings. Also included: balance, blood pressure, glucose/cholesterol checks, spine checks and vision checks.

mountainview Hospital Mountainview-Hospital.com 3100 N. Tenaya Way

MS Stretch and Flex Nov. 21, Dec. 5, Dec. 12, Dec. 19, 10:30 a.m. - 11:30 a.m. Free for individuals with Multiple Sclerosis, $5 for others The class provides circulation to the body while keeping all muscles working. All aspects of the exercises are planned and provide the work to keep the body strong. Also, discussion on nutrition and the latest information that is available from the multiple sclerosis community.

Meditation — Stretching and Balance Nov. 22, 8 a.m. - 9 p.m. $5 (cash only) Learn how to relax and shift your focus away from busy thoughts through Brain Wave Vibration and other moving mediation forms. You can take this class in a chair or bring a mat and start to build the foundation of your own.

Pre-surgery Orthopedic and Spine Education Class Nov. 22, Dec. 6, Dec. 13, 9 a.m. - 10 a.m. Free This class is only for patients who are already scheduled for orthopedic and/or spine surgery at MountainView Hospital.

Childbirth Education Class Nov. 23, Dec. 14, 9 a.m. - 1:30 p.m. $40 Childbirth Education is designed to offer expectant parents a better understanding of what to expect in the third trimester of pregnancy, through labor and the delivery process. Topics include: physical and emotional changes of the third trimester, when to go to the hospital, what to expect at the hospital, comfort techniques, labor process and possible medical interventions, cesarean section and vaginal delivery.

MountainView Stroke Support Group Dec. 3, 2 p.m. - 3 p.m. Free The Stroke Support Group is intended to help patients, caregivers and families share experiences related to stroke, as well as learn about the recovery process and life after stroke. Meeting others who understand what you are going through can help you throughout the process.

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Hernia Education Class

Diabetes Nutrition Overview

Pre-operative Joint Replacement Class

Dec. 3, 6 p.m. - 7 p.m. Free Join for a discussion with MountainView physicians on the types of hernias, the surgical methods to correct them and what to expect after hernia surgery.

Dec. 19, 1 p.m. - 2:30 p.m. Free Join for a discussion with our knowledge Registered Dieticians about the role nutrition plays in diabetes management. Light refreshments will be served.

Nov. 22, 9 a.m. - 10 a.m. Free Free pre-operative joint replacement education class.

Stop the Bleed

O2 On The Go — Support Group

Dec. 10, 1:30 p.m. - 2:30 p.m. Free This hands-on course intended to cultivate grassroots efforts that encourage bystanders to become trained, equipped, and empowered to help in a bleeding emergency before professional help arrives.

Dec. 20, 10 a.m. - 12 p.m. Free Knowing all about your illness not only makes you a more informed health consumer, but will help you take control of your disease. O2 on the Go members have a good common-sense understanding of their affliction and are dedicated to helping others become more informed so they too can lead the best quality of life possible.

MountainView Ostomy Support Group Dec. 11, 5:30 p.m. - 7:30 p.m. Free The Ostomy Support Group is devoted to reach, aid and educate those people who need help with emotional acceptance and physical maintenance of their ostomy or related surgery.

Bariatric Seminar Dec. 14, 10 a.m. - 12 p.m. Free Learn about bariatric (weight loss) surgery, the different types and steps toward making this life change.

Medicare Counseling — One on One Dec. 18, 9:15 a.m. - 3:30 p.m. Free Free Medicare counseling for Medicare beneficiaries only. If you need information on Medicare Part D, you will need to bring in a list of all of your medications, doses and how often you take them.

Labor and Delivery Tour Dec. 21, 9 a.m. - 10 a.m. Free Tour MountainView’s private birthing suites and meet its staff. Tour guides will meet you at the lobby classroom. This free, one-hour tour includes: where to go upon arrival for your birth, labor and delivery suite, postpartum suite, newborn and level II nurseries.

Free Blood Pressure Screenings Tuesdays, 9 a.m. - 10 a.m. Free High blood pressure increases the risk for serious health problems. Come get your blood pressure taken.

Southern Hills Hospital SouthernHillsHospital.com 9300 W. Sunset Road

Infant CPR Classes Every other Friday, 10 a.m. - 11 a.m. Free The class will help parents recognize and care for a variety of breathing emergencies involving children and infants. Parents will be guided through an interactive video followed by a question and answer portion.

Breast Feeding Support Group Every Wednesday, 11 a.m. - 2:30 p.m. Free When a new mom has a new baby, it can be difficult. You can meet other breastfeeding mothers to share experiences and for support.

spring valley Hospital SpringValleyHospital.com 5400 S. Rainbow Boulevard

Joint Camp First Tuesday and Third Thursday of every month, 10 a.m. - 11 a.m. If you are having hip or knee replacement surgery at Spring Valley Hospital, don’t go through it alone. Attending Joint Camp can help you prepare for your surgery physically, mentally and emotionally. Instructors will define common terms, explain procedures and answer your questions.

Childbirth Preparation Classes Lunch and Learn — Stress, Mental Health and YOU Dec. 19, 12 p.m. - 1:30 p.m. Free Join Dr. Hossein Akhondi, Associate Program Director, Internal Medicine, MountainView Medical Associates, who will talk about stress and mental health. Learn how stress can affect your overall well-being and learn ways to lead a more centered life.

Maternity Tours Every Thursday and Saturday, 7:30 p.m. - 9 p.m. Free Southern Hills Hospital will welcome families into its labor and delivery unit. It believes visiting the place where you’re planning to have your baby can help relieve pre-birth anxiety and make your birthing experience more enjoyable.

Every Wednesday, 6 p.m. - 8 p.m. Taught by a registered nurse, the class helps first-time parents have a more comfortable experience during pregnancy, labor and delivery. Expecting moms and their labor partners will learn about the stages of labor, relaxation skills, epidurals and other medications, cesarean birth, and also get a tour of the birthplace.

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cale n d ar

SUMMERLIN Hospital

Car Seat Installation

Ostomy Support Group

SummerlinHospital.com 653 N. Town Center Drive

Dec. 14 (all second Saturdays of the month), 10 a.m. - Noon Free If you have a new car seat for a baby who is on the way or want your current seat checked, please take advantage of this opportunity. The event is free and open to the public on a first-come first-serve basis.

Dec. 10, 7 p.m. - 9 p.m. Free Sunrise Hospitalâ&#x20AC;&#x2122;s Ostomy Support Group is dedicated to improving the quality of life by offering support of those who have or will have bowel or urinary diversion surgery. The group is open to ostomy patients and their spouses, partners, caregivers, family and friends.

Birthplace Tours Nov. 23, Dec 28, 10 a.m. and 11 a.m. Take a free group tour of our maternity unit, The Birthplace. The tour group is limited to 20 couples (two adults per group).

Baby Care Basics Childbirth Basics Dec. 3, 6 p.m. - 8 p.m. $80 per couple This three-part series is tailored for firsttime parents, but all are welcome. The instructor will discuss keys to a healthy pregnancy, basic anatomy, both epidural and natural comfort measures available while in labor, as well as postpartum and newborn care. There will be a Birthplace tour during the class.

Infant Loss Bereavement Support Group Second Thursday of Every Month, 6 p.m. - 7 p.m. This support group is for family and close friends who have experienced an infant loss. There is no charge and refreshments are provided.

Dec. 19, 6 p.m. -8 p.m. $30 per couple Baby Care Basics provides information for when you bring your new baby home â&#x20AC;&#x201D; feeding, bathing, diapering, safety, signs of illness and a review of the basics of infant CPR.

Stroller Strides Wednesdays through Dec. 18, 5:30 p.m. - 6:30 p.m. Free Stroller Strides is a fitness program that moms can do with their babies. Activities include power walking/jogging as well as intervals of strength and body toning exercises that use exercise tubing, baby strollers and the environment.

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FALL 2019

UMCSN.com 1800 W. Charleston Boulevard

Infant Massage

SunriseHospital.com 3186 S. Maryland Parkway

Nov. 26, 10 a.m. - 11 a.m. Free Learn techniques to calm and relax your baby as well as relieve any discomfort. Massage also promotes better sleep.

Stop the Bleed

Infant & Child CPR

Nov. 25, 6 p.m. - 8 p.m. Free Sunrise Hospital Trauma Services will host a free community education course to learn how to Stop the Bleed. Through the course, you will learn the life-saving techniques to properly apply pressure and a tourniquet.

Dec. 19, 2 p.m. - 4:30 p.m. $10 The class infant and child CPR skills. You must register in person. This class requires a $10 cash deposit, which will be refunded to you when you attend the class.

sunrise hospital

Joint Camp Tuesdays, Noon - 1 p.m. or 5 p.m. - 6 p.m. Free The one-hour class is designed for patients who are about to undergo joint surgery for hip or knee replacement. Instructors will define common terms, explain procedures and answer questions.

University Medical Center

Birth Center Tours Nov. 30, Dec. 14 English Speaking: 11 a.m. - 12 p.m. Spanish Speaking: 1 p.m. - 2 p.m. Free Tour the Labor and Delivery, and Maternal Infant units of Sunrise Hospital. They will review information regarding their birthing process and needs during post-partum stay.

St. Rose dominican HospitalS DignityHealth.org/Las-Vegas

St. Rose Community Access Center 2651 Paseo Verde Parkway, Suite 180

Weight Loss Surgery Seminars

Young Survivor Support Group

Dec. 3 and Dec. 19, 5 p.m. - 6 p.m. Free Learn about the benefits of bariatric surgery, and meet bariatric surgeons and support team.

Dec. 3, 6 p.m. - 7:30 p.m. Free Women diagnosed with breast cancer 50 and younger are invited to join in this support group specifically designed towards the support needed through her breast cancer journey.

Tuesdays, Thursdays, Fridays, 10 a.m. - 11 a.m. $5 per session Gain flexibility and balance through gentle yoga movements. Bring a yoga mat.

Gentle Yoga

cale n d ar

Zumba Tuesdays 4:30 p.m. - 5:30 p.m. $5 per session For everybody and everybody. Sweat it out by mixing low- and high-intensity moves in this dance fitness party. Ageless Woman Workout Tuesdays and Thursdays, 9 a.m. - 10 a.m. $5 per session Target aging zones with breathing and movement. Zumba Kids Tuesdays, 3:30 p.m. - 4:30 p.m. Free Zumba routines for kids ages 7 to 11.

Stop Smoking with Hypnosis

Infertility Support Group

Dec. 11, 6 p.m. - 8 p.m. $25 Ready to stop smoking?

Second Wednesday of every month, 6 p.m. Free For couples experiencing infertility to connect.

Surviving Suicide First and third Tuesdays of each month, 6:30 p.m. Free The support group is for suicide loss survivors to connect and support each other.

Widows Support Group First and third Tuesdays of each month, 2 p.m. Free Receive guidance and support while sharing experiences and concerns with others.

Prostate Cancer Education & Support Third Wednesday of each month, 7 p.m. Free For prostate cancer survivors and caregivers. Learn more about prostate cancer and get support from others.

WomensCare/Outreach Center 7220 S. Cimarron Way, Suite 195

Belly Dancing New Mommy Mixer Fridays, 11 a.m. - noon Free New moms and babies drop in for support, lactation help, baby weighing and education. Got SNAP? Tuesdays, 8 a.m. - Noon (Call 702.616.4905 for an appointment) Free Get help completing and submitting your SNAP application. Healthy Hearts Club Third Wednesday of the month, 10 a.m. - 11 a.m. Free Learn ways to manage your medications, make healthy lifestyle choices and set goals. Prepared Childbirth Express Dec. 14, 9 a.m. -2 p.m. $35 Meet with other parents who are awaiting the arrival of new family members and learn how you can prepare. Topics include the differences between true labor and false labor, vaginal birth, Caesarean birth, role of the support person, pain management during labor and post-partum care for mom.

Stroke & Aphasia Lunch Bunch First and third Thursdays of each month, 2:30 p.m. - 4 p.m. For those struggling with communication due to a stroke or brain injury. Meet others, practice communication skills and find support. Caregivers are welcome.

Siena Campus 3001 St. Rose Parkway

Dec. 14, 10:30 a.m. - Noon Free All proficiency levels have fun while belly dancing. Drop-in class. No preregistration required.

Zumba Kids Thursdays, 3:30 p.m. - 4:30 p.m. Free Zumba routines for kids ages 7 to 11.

Narcotics Anonymous

New Mommy Mixer

Wednesdays, 6 p.m. - 7 p.m. Free Support group for those suffering with narcotics addiction. No registration required.

Wednesdays, 11 a.m. - Noon Free New moms and babies drop in for support, lactation help, baby weighing and education.

Ostomy Support

WomensCare/Outreach Center

Second Saturday of the month, 2 p.m. Free Wound Ostomy Care Nurses attend most meetings to answer questions and address concerns.

98 E. Lake Mead Parkway

San Martin Campus 8280 W. Warm Springs Road

Toddlers in the Kitchen Dec. 5, 11 a.m. - Noon Free Get your toddler engaged in healthy eating through fun tips and activities â&#x20AC;&#x201D; from the garden to the kitchen. For children ages 1-4 years.

Narcotics Anonymous Wednesdays, 7 p.m. - 8 p.m Free Support group for those suffering with narcotics addiction. (Group also meets on 7:30 p.m. on Thursdays; 7 p.m. on Sundays)

New Mommy Mixer Mondays, 11 a.m. - Noon Free New moms and babies drop in for support, lactation help, baby weighing and education.

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