Feb 2014 Featuring Heart Health Organization by Healthy Cells Magazine Valley of the Sun

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Promoting Healthier Living in Your Community • Physical • Emotional • Nutritional

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H2O

M A G A Z I N E

Heart Health Organization

A More Effective Way to Deliver Hospital-Based Care for the Heart

Starving to Fit In Cervical Cancer Prevention & Detection

Renewing Your Skin in the Desert

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ebruary is Heart Awareness Month, so this issue includes several articles about heart health. When someone says they have heart problems, your first thought is a heart attack, but there are also smaller, more subtle signs to watch for as well. A friend shared how he first discovered a problem with his heart. One evening while watching a movie, his sweetheart rested her head on his chest and noticed his heart was beating very rapidly. He monitored his heart rate for a couple of days and made an appointment to have it checked. Tests and blood work were done and thankfully, with medication, his heart is now doing fine. But had it gone unnoticed, he could have ended up with a much different outcome. On Feb. 21 and 22, enjoy a light lunch and live entertainment at the Tempe Empty Bowls fundraiser to benefit local hunger programs. Details about this annual event can be found on the Community News page. Happy Valentine’s Day,

Monica Tegg/Owner Healthy Cells Magazine, East Valley Monica@healthycellsmagazine.com 480-204-3090

Here’s what our advertisers are saying about Healthy Cells Magazine:

am writing this note to thank you for inviting iWomen’s Health Care to be a part of your local health magazine, Healthy Cells Magazine. We have gained several new patients who otherwise may not have found the practice or been aware of the OB/GYN services we offer. Through this magazine we have been able to illustrate new services offered with the introduction of Christopher Murphy, MD, to the practice while underlining the established presence of our small private practice. The guidance and support of the editing team has been awesome! I had imagined keeping up with the demands of writing for a magazine to be challenging but your team has made the process quite enjoyable. We at iWomen’s Health Care appreciate the encouragement and guidance!

David N Kells,MD, Practice President/Owner iWomen’s Health Care 480-855-5900 iwomenshealthcare.com To Promote your Business, Contact Healthy Cells Magazine Today. 480-204-3090 monica@healthycellsmagazine.com

February 2014 — East Valley — Healthy Cells Magazine — Page 3

FEBRUARY 5

Women’s Health: Cervical Cancer: Prevention and Detection

Physical: Living With Fibromyalgia

Emotional: Starving to Fit In

Nutritional: Tuning in for Heart Health Harmony

Surgery Prevention: Shoulder Dysfunctions and a Holistic Approach to Pain Relief

Compassionate Care: Hospice Care for Heart Disease

Policy Guidance: Shopping for Medicare Plans? Choose a Broker

A Caregiver’s Story: Where a Need Leads to Passion

Medical News: Cardiac Stem Cell Transplantation Study Focused on Mending Broken Hearts

This Month’s Cover Story:

2014 Volume 2, Issue 2

H2O Heart Health Organization A More Effective Way to Deliver Hospital-Based Care for the Heart pg. 14

L to R: Drs. Daniel Klee, Roger Bies, Marwan Ghazoul, Georges Nseir

For advertising information, contact Monica Tegg, owner, Valley of the Sun Edition Cell: 480-204-3090 • Fax: 309-691-2187 monica@healthycellsmagazine.com

Personal Commitment: Health in the New Year: Forget Resolutions

Children’s Dental Health: Why Should My Child See a Pediatric Dentist?

Goal Setting: Four Reasons Resolutions Fail

1327 E. Kelly Ave., Peoria Heights, IL 61616 • Ph: 309-681-4418 • Fax: 309-691-2187 info@limelightlink.com

Body Performance: Practical Tips for the IDEAL Hiker

Mission: The objective of Healthy Cells Magazine® is to promote a stronger health-conscious community by means of offering education and support through the cooperative efforts among esteemed health and fitness professionals in the East Valley.

Community News: Empty Bowls Provide Food for the Hungry

Healthy Cells Magazine is intended to heighten awareness of health and fitness information and does not suggest diagnosis or treatment. This information is not a substitute for medical attention. See your healthcare professional for medical advice and treatment. The opinions, statements, and claims expressed by the columnists, advertisers, and contributors to Healthy Cells Magazine are not necessarily those of the editors or publisher.

Skin Care Regimen: Renewing Your Skin in the Desert

Healthy Cells Magazine is available FREE in high traffic locations throughout the East Valley, including medical facilities and other waiting rooms. Healthy Cells Magazine welcomes contributions pertaining to healthier living in the East Valley area. Limelight Communications, Inc. assumes no responsibility for their publication or return. Solicitations for articles shall pertain to physical, emotional, and nutritional health only.

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women's health

Cervical Cancer Prevention and Detection Part I

By Cyndi Ayoub, WHNP, iWomen’s Health Care

pproximately 12,000 women are diagnosed with cervical cancer every year. Although this is significantly reduced from past years, it still represents 33 new cases each day. Cervical cancer is caused by certain types of human papilloma virus (HPV). When a woman is infected, the virus causes a change in the cells on the lower part of the uterus called the cervix. These changing cells can slowly develop into cancer if left untreated. The key is prevention and early detection since it is not considered to be passed down through genetics. Prevention includes abstinence and following safe sex practices such as avoiding unprotected sex. Vaccines such as Gardasil can also help prevent cervical cancer. Early detection allows medical providers to treat the suspicious areas that otherwise could eventually develop into cervical cancer. Having regular Pap tests is the best way to detect precancer changes so women can protect against cervical cancer in the future. But what is a Pap smear? Pap is short for Papanicolaou test; when cells are brushed from the opening of the cervix or vaginal lining for examination. Depending on a person’s past Pap results, this screening test is usually performed at the time of a women’s yearly well appointment along with a pelvic and breast exam and general physical. Why is it done? The Pap helps your physician detect certain types of cell changes caused by HPV. This virus causes genital warts and cervical cancer. The Pap doesn’t diagnose HPV but looks for cell changes that are caused by the virus. Most cervical cancers can be detected early if routine Pap smears are performed. The medical provider can order an HPV test with the Pap to determine if the changes seen on an abnormal Pap test are caused by HPV. This combined testing is recommended for women over the age of 30. The test is only a screening; it does not prevent or guarantee a person will not develop cervical cancer. There are a small number of cases when abnormal cells are missed and some vaginal creams such as those that treat yeast infections or spermicides may interfere with results. To help receive the most accurate results, tell your medical provider about: • All the medicines you are taking including birth control • An abnormal Pap smear in the past • Possibility of pregnancy For 24 hours prior to testing, avoid intercourse, a tub bath, douching (douching should never be done), and use of tampons. Always empty your bladder prior to your exam. Also, avoid scheduling your Pap smear during heavy menstruation (your period) since blood may reduce the accuracy of the Pap results.

However, unexpected or abnormal bleeding is a good reason to be evaluated. Do not cancel your exam in this situation. Your doctor will determine if the Pap smear can still be done and if other tests are needed to determine the cause of abnormal bleeding. Look for Part II of this article next month to learn the differences between a Pap and an annual or wellness visit. For information or to schedule a consultation, contact iWomen’s Health Care. Call 480-855-5900; email: info@iwomenshealthcare.com; or visit www.iwomenshealthcare.com. iWomen’s Health Care is a boutique-style practice that believes in partnering with patients for care. “Your care, your comfort, our expertise!”

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physical

Living With Fibromyalgia Causes, Symptoms, and Treatment Therapies By Martin S. Fekete, DHSc, CSP, SPHR, National Employers Organization

ibromyalgia syndrome (FM) is a chronic condition associated with widespread pain that affects the muscles and soft tissues. Typical FM patients experience abnormal and reduced pain thresholds, fatigue, sleep problems, and painful trigger points. Fibromyalgia can be relieved through a combination of medications, lifestyle changes, and stress management. Approximately five million Americans are affected by FM according to the American College of Rheumatology estimate. FM usually occurs in adults ranging in ages between 30 and 60 years of age. It is more common in women than men, with a ratio of 5 to 1. After osteoarthritis, it is the second most common musculoskeletal condition. Because symptoms can vary between patients, it is often misdiagnosed and misunderstood. Fibromyalgia dates as far back as 1904 when Sir William Gowers termed the pain as fibrositis and claimed that it was from the inflammation of subcutaneous and fibrous tissue. Causes The term fibromyalgia was first used in 1976 after researchers tried to describe the primary symptom (Fibro – meaning fibrous tissue, my – meaning muscle, and algia – meaning pain). FM was not well studied or defined until 1990, when the American College of Rheumatology established a criteria for diagnosing fibromyalgia. From that time on, the term fibromyalgia has gained notoriety and common usage. Page 6 — Healthy Cells Magazine — East Valley — February 2014

Martin S. Fekete, DHSc, CSP, SPHR

Initially, FM was thought to be a muscle disease, as the name implies, and also was thought to be a psychiatric or psychosomatic disorder due to the lack of any physical or medical abnormalities. However, the new century brought with it new laboratory and brain imaging technology that has provided factual evidence of fibromyalgia being a real physical disorder. These recent findings have linked FM to a malfunctioning of the central nervous systems (CNS) referred to as central sensitization syndrome. Central sensitization is basically defined as a condition where the central nervous system overreacts to pain. Linked to central sensitization syndrome, researchers have identified a number of psycho-physical co-morbidities that may in combination act as contributing factors to FM. Recent studies on FM patients have yielded documented evidence through brain imaging showing abnormal pain processing. This research has unlocked the secrets of how FM patients process pain. These studies have shown that FM patients frequently lack the capacity to modulate pain known as the diffuse noxious inhibitory control (DNIC) process. In the research study, FM patients also showed no normal decay of temporal summation after repetitive painful stimulation; a phenomenon referred to as temporal summation of second pain (TSSP). Symptoms As noted earlier, fibromyalgia patients may experience a wide array of symptoms, most common of these are the sensitive trigger

points typically associated with FM. Much of the research in recent years has indicated that many FM sufferers have had a lifetime history of pain. Many of these patients have multiple symptoms; including chronic fatigue, disturbed sleep, and associated problems with memory and concentration. As these multiple symptoms increase, the patient is more likely to suffer an increase in both pain and the other symptoms, resulting in a downward spiraling effect of the patient’s health. The resultant outcome is a reduced activity level or no activity, which based on current research, can adversely affect the patient. Other areas of potential concern for FM patients is a lack of sleep which can increase fatigue and stress levels resulting in potential elevated blood pressures, stress, and decrease in one’s immune system. Clearly, the effects of fibromyalgia are real with real consequences if not properly treated. Treatment Therapies The most current literature and research indicates a holistic approach to the treatment of fibromyalgia using a psychological and physical approach. This three tiered approach focuses on: 1) treatment through pharmacological options targeting pain processing, 2) physical fitness and exercise, and 3) stress reduction and relaxation techniques. Given recent studies identifying that FM has neurological implications in the central nervous system allows for effective treatment through a number of new drugs that work on the central pain processing center. The second area proven highly effective in pain reduction is exercise and other physical activities. Research studies, ones similar to Angela Bush with the University of Saskatchewan, indicate that various physical fitness and exercise regimens improved

FM patients overall health and decreased pain levels. Similar studies by Dr. Chenchen Wang at Tuft’s University School of Medicine have shown that fibromyalgia patients experienced lessened pain symptoms when they were involved in an ongoing Tai Chi program. Finally, because of the sleep disturbances and chronic fatigue experienced by many FM sufferers, a program of stress and relaxation techniques is also beneficial. In a recent article in the August edition of Clinical Rheumatology (2013), the results of a two-year study were discussed and how a total holistic approach to mind and body showed improvement in fibromyalgia patients. Many times FM patients suffer depression due to their inability to cope with this syndrome, and as a result, additional physical and mental symptoms may manifest. The study indicated that FM participants were more positive and were more receptive to health-care interventions than non-participants. In conclusion, fibromyalgia is no longer revered as only a psychological disorder. Modern science has proven physiological changes and deficiencies in the many patients. More studies are underway to discover how this syndrome affects people and possible prevention opportunities. People experiencing these and similar symptoms should always start with their primary care doctor or pain management specialists. The one important issue is to manage FM using a holistic approach that includes all three approaches and is designed specifically for the individual patient. Dr. Martin Fekete is Director of Human Resources and Risk Management at National PEO, LLC, a professional employer organization devoted to assisting small and medium businesses. He is also a member of the American College of Epidemiology.

Shoebox Ministry Restoring dignity to the homeless since 1988.

We need your help getting some much needed toiletry products. The most needed items are: • Toothpaste • Shampoo • Shaving cream

• Wash cloths • Free hotel toiletries

Financial donors may qualify to take a dollar-for-dollar tax credit when you file your Arizona state taxes. Any donation amount qualifies, up to $200 for single filers or $400 for married filers. Shoebox makes bulk purchases and will put your donations to good use by purchasing items like deodorant for .33 cents each and toothbrushes for only .06 each. Please join us in making a difference in the lives of the Valley’s homeless and working poor. Drop off locations listed on website.

www.shoeboxministry.org • info@shoeboxministry.org • 480-905-1610. February 2014 — East Valley — Healthy Cells Magazine — Page 7

emotional

Starving to Fit In

Yvette Saint Thomas, MD

By Yvette Saint Thomas, MD, Sliding Doors Therapy

hile traveling recently I met a young lady, Sarah, who was somewhere in her mid-twenties. She hadn’t seen her family for several years, and feared what they would think of her. She spoke of a weight problem and her family, where food was the comfort and answer to most things. Sarah shared a photo of a seemingly happy, loving family including her at 17 years of age, but all of them were overweight or borderline obese. Sarah grimaced and then shared a sense of pride that she had broken the cycle of overeating. I inquired about her ability to lose the weight, but Sarah avoided the question and talked about her family’s insistence she’s beautiful and her weight is not what people see and about the struggles growing up as the “fat” girl. This resulted in a deep depression and left her believing the only escape was to move away from her family. I again asked how she lost weight; she described a healthy diet and fitness routine. We decided to have lunch together during the layover. Sarah was a delight, yet I felt a bit of sadness and nervousness in her demeanor. Sarah ordered an extremely large meal including desert but she again told me that she had learned to control her eating and balances it with exercise. After we ate, Sarah excused herself to the restroom and I had waited for some time before the waitress came asked if my friend was OK and explained that she was in the restroom vomiting. I found Sarah splashing cold water on her face. Although she claimed to be fine, I know that look, and knew she wasn’t OK. The scars from her past and obviously present still haunted her. Bulimia nervosa is characterized by an addictive and dangerous bingepurge cycle in which a bulimic compulsively overeats before purging. Binge eating, which often occurs in secret, usually involves eating large quantities of food during a short period of time. For most Bulimics, binges are followed

Page 8 — Healthy Cells Magazine — East Valley — February 2014

by purging behavior. There are several ways that bulimics purge themselves including self-induced vomiting, laxative abuse, diuretic abuse, ipecac, chew-spitting, vigorous exercise, restrictive diets, and a variety of other compensatory behaviors designed to restrict weight-gain. Much like anorexics, bulimics have the tendency to become obsessed with their weight and body shape. Bulimia nervosa, like anorexia, can result in severe complications including esophageal tears, cardiac arrhythmia, digestive issues, dental problems, and electrolyte imbalance. If left untreated, bulimia nervosa can be fatal. Bulimia has a variety of triggers including: • Dissatisfaction with body image • Boredom • Prolonged dieting • Dysmorphic mood (depression, anxiety, irritability, sadness, and restlessness) • Family and interpersonal stress It is important to know there is help for eating disorders and through proper treatment and counseling, you can begin the process of a positive path of lifelong recovery and a better self-image of yourself. Beauty begins within, and it shines outwardly at any size. Sarah and I spent the next hour talking. She revealed seeing her college roommate purge food after eating a vast amount and was instantly drawn to the “quick way” of losing weight and still having the opportunity to eat anything she wanted. She was ashamed of taking such drastic measures to lose weight risking damage to her body. The fear of being judged by her family also weighed heavily on her mind.

Unfortunately, the negative stigma of being overweight has never left Sarah and when she looks in the mirror, she sees her body image as negative. She still sees herself as the “fat girl” who was never asked out, who was ridiculed, who was always the friend that was dependable, and who was the funny girl. Sarah’s parents and friends did not see the signs of a very unhappy girl with a self-image issue. The smiling family photos were a mask for a very troubled, insecure teen who went on to become a troubled young lady struggling with self-image and with the way the world views women. It often starts very young, with magazines of airbrushed bodies, giving the impression that men are only attracted to thin or waif-like images. This presents unrealistic expectations for adolescences and teens, as both genders attempt to “fit in.” I gave Sarah several resources, including my information, for further counseling and guidance for a healthier life and emotional support. I hoped I made a dent in this young woman’s cry for help. Sarah promised she would stay in touch and 18 months later I received an email, subject line: “I fit.” The smile in the photo showed a young woman now comfortable in her own skin and 25 pounds healthier. Sarah sought the help she needed and understands that it is a lifelong recovery and practices a healthy self-image every day. For additional information about eating disorders or other conditions you may be experiencing, please contact Dr. Yvette Saint Thomas at ymd@slidingdoorstherapy.com or 602-460-1229. The Rader Program is an excellent source for someone struggling with or using eating disorders to numb their pain. Visit www.raderprograms.com or call 866-643-6887.

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February 2014 — East Valley — Healthy Cells Magazine — Page 9

nutritional

Tuning In for Heart Health Harmony By Steven M. Sabatier, MD, Real Health Arizona

sad song is being sung in the United States. Every minute of every day in 2014 an American, both males and females, will die from heart disease. It affects 1 out of every 3 people we know. Despite amazing technological advances over the years, many are still grasping to get a handle on the prevalence of this top killer. It is now evident that many conventional approaches to diagnosis and treatment are failing to make a healthy difference, and some cause more harm than good. Few conventional strategies actually address the root cause of the problem, a diet high in sugars (known and unknown) and processed foods. A little fine-tuning of prevention will keep your heart on key. Our first step in treating or preventing heart disease is to understand the person who has it. A thorough history, exam, and discussion usually elicit some of the underlying causes implicated such as nutritional status. The doctor must be an expert in human health, how it is achieved and maintained, in order to identify influences and factors that increase health while decreasing disease and vice versa. This knowledge of the individual and their health also determines which assessments will be utilized in measuring and understanding each individual’s risks for heart disease. Page 10 — Healthy Cells Magazine — East Valley — February 2014

Steven M. Sabatier, MD

Our second step involves discovering and addressing the cause. Most people dealing with heart disease are experiencing an elevated amount of oxidative damage and inflammation in their bodies. Oxidative damage is a process that converts non-harmful cholesterols and fats into more dangerous forms that are more likely to end up in plaques. Oxidation itself, however, like inflammation, is a process of normal everyday health. Abnormal oxidation and inflammation can get out of harmony when there are too many unhealthy substances in your bloodstream. Usually these substances are coming from your food sources and personal care products. On the reverse side, the same disharmony can occur if there are not enough healthy substances in your bloodstream such as anti-oxidants and necessary nutrients. Preventing harmful exposures within your control and ensuring adequate amounts of anti-oxidants and nutrients helps restore optimal cardiovascular health from both sides of the equation. Thirdly, we support healthy function of the affected organ systems. After identifying harmful substances that cause heart disease and preventing them from entering your body, you have set the stage for healing to occur within. Supporting your circulatory system with natural therapies helps to heal the micro damages that serve as precursors to

artery blocking plaques. Nutritional support has been proven to directly benefit heart health. For example, eating fish rich in omega 3 fatty acids once a week has shown to cut the risks of coronary heart disease in half while nutrient rich vegetables can harmonize cholesterol levels. Supporting your gastrointestinal (GI) tract helps to ensure that harmful substances are being passed out of your body rather than into your bloodstream. For example, having certain beneficial bacteria in your GI tract can increase the break down and excretion of BPA — a toxicant we get from canned foods, plastic beverage containers, paper money, etc. BPA has been consistently associated with higher incidences of heart disease in both animals and humans. The reverse is true as well. A healthy GI tract ensures that healthy nutrients are being absorbed into your bloodstream, rather than passing out of your body, and prevents unnecessary inflammation from raging out of control. Additionally, having your liver on key helps your body adequately process cholesterol and prevent the formation of harmful fats. The aforementioned three-step process has helped thousands prevent and, in some cases, reverse heart disease. Throughout the process you can monitor and measure certain biomarkers that indicate the direction of progress. You want to see these indicators moving in the direction of heart health and away from heart disease. These could include nutrient levels such as: glucose, vitamin B-12, folate, ferritin, essential fatty acids, vitamin D, and homocysteine. Measuring blood cholesterol levels is not the best nor the only indicator. We know today that dietary cholesterol is not a predictor of heart disease. In fact, dietary cholesterol is not even necessary to develop atherosclerosis (plaques that harden and clog arteries). The amount of oxidized cholesterol and harmful fats, such as trans fats, are part of the

• Integrated midwife and physician practice • Routine and high risk pregnancy • Minimally invasive and robotics surgery • Female pelvic medicine • Menopause • Urinary leakage testing and treatment • In office tubal occlusion • In office uterine ablation to treat abnormal bleeding • Pelvic reconstruction • Tubal ligation reversal

atient and community education includes but not P limited to the following: • iWomen’s Sharing ~ prenatal education • Daddy Basic ~ daddy survival training • Menopause and a Movie ~ light hearted but valuable discussion about menopause

issue. An accurate and inexpensive way to measure your risks for heart disease is through an NMR Lipoprofile (a specialty lab we use). Cholesterol is not fatal. Cholesterol is vital! Our bodies are composed of trillions of cells that are each built with cholesterol. In addition to each cell in your body, cholesterol contributes to healthy functions. For example, cholesterol is a precursor to bile acids necessary for optimal function of your digestive system. Many of your hormones including testosterone and estrogen are built from cholesterol. Vitamin D, with its numerous functions, is synthesized from a cholesterol-related molecule. Your brain is home to about 25 percent of the cholesterol in your body. The connections (synapses) made in your brain for learning, thinking, and forming memories are made possible due to cholesterol. The causes of heart disease involve a multi-player symphony of events — even still it can be prevented. A doctor properly trained and equipped with a nutritional background and up-to-date medical information, can help you tune-in and direct your symphony for optimal health. Heart disease affects 1 in 3 people in our community and most cases are preventable. To book an expert speaker, access specialty testing, schedule a complimentary consult, explore your risks for heart disease, or discuss prevention and reversal, call 480-726-7800 today. Licensed by The State of Arizona Naturopathic Physicians Medical Board, our doctors are especially trained to diagnose and treat the cause of heart disease. Working for our community’s health, we can be found online at www.RealHealthArizona.com and on Facebook at www.facebook.com/realhealthaz.

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February 2014 — East Valley — Healthy Cells Magazine — Page 11

surgery prevention

Shoulder Dysfunctions and a Holistic Approach to Pain Relief

Dustin Hall, LMT, SIP

By Dustin Hall, LMT, SIP, Structura Body Therapies

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e all know someone (maybe even ourselves) that has some sort of shoulder pain or range of motion (ROM) issues. The anatomy of the shoulder makes it extremely susceptible to injury. Think of our shoulder joint compared to our hip joint. Both are a ball and socket joint but in the hip, the ball (head of the femur) fits much deeper into the socket (acetabulum) than the shoulder (head of the humerus to the glenoid cavity). The reason for this difference is the function of the joint. The hip has to support the weight of the entire body so it has less movement but more stability. The shoulder joint needs to move in many directions and doesn’t need to support our weight so it gains mobility but loses stability. But what is the cause of the pain or dysfunction in our shoulders? Rotator cuff tear, tendinosis (muscle overload), shoulder elevation and slumped shoulder account for the largest percent of shoulder disorders. Rotator cuff tears and tendinosis frequently result from sport injuries (throwing, catching, falling), accidents, and/or any repetitive activity.

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Page 12 — Healthy Cells Magazine — East Valley — February 2014

The rotator cuff is actually a set of four muscles in your shoulder joint that perform rotation. Those muscles are the supraspinatus, infraspinatus, teres minor, and subscapularus. The supraspinatus is the most vulnerable, but any of these muscles can be affected. The residual pain can be described as a deep in the shoulder pain with a loss in ROM. Sometimes numbing or pins and needles can be felt in the hand due to the way the nerve is affected by the shoulder injury. Often a pain cycle is created when the body’s self-protective mechanism overreacts to the tissue damage. When tissue is damaged, a pain signal is sent to the spine. This signal tells the muscle cells to contract in an effort to protect and support the injured tissue. It is very common for this contraction to be too strong; therefore squeezing and compressing the injured area creating more pain and continually sending pain signals to the spine creating a cycle of pain that perpetuates itself. With advanced structural physiotherapy techniques and muscle re-education via postural re-patterning, you can help to prevent future injuries and usually reverse the damage to the tissue as well as break the pain cycle. Shoulder elevation commonly associated with poor posture or a sedentary lifestyle, can also affect the musculoskeletal structure and cause dysfunctions throughout the body. Shoulder elevation may result from chronic holding patterns like holding the phone between the head and shoulders, texting, and working at a desk or on a computer for long periods of time. Chronic stress can also manifest these holding patterns in the body. The tension in the shoulders frequently produces headaches, aching pain in the neck and shoulders as well as a loss of ROM in the shoulders and neck. People have even presented sinus issues and a change in their vision because of this tension! The key treatment for this disorder starts with the postural re-patterning along with deep tissue massage and fascia lengthening. Although shoulder elevations look the same in everyone, the treatment may not be due to tissue health and dysfunction. The treatments must be designed specifically for each individual and their needs. Slumped shoulders is a postural distortion commonly seen in older clients that maintain a stressful posture or work with their arms directly out in front of them. Because the head moves forward and down (thanks to gravity), this disorder can make you look shorter. The upper back and neck muscles become weak and overstretched while muscles associated with the chest become short and tight. This results in the loss of height and can cause vertebral degeneration. Typically this disorder starts with an aching pain in the neck and shoulders, then manifest into headaches. The focus of treatment will be deep tissue work on the key muscle structures that are pulling the shoulders down. In addition, postural re-patterning should be utilized to retrain the structure to function correctly. By using advanced massage techniques that manipulate the soft tissues (fascia, muscles, and tendons), along with postural re-patterning, surgery can be prevented in most cases. Structura Body Therapies treat most all musculoskeletal disorders. We Heal by Design! Schedule your free consultation and get 20 percent off your first session! Call 480-686-8647 today, or check us out at www.structurachandleraz.com.

compassionate care

Hospice Care for Heart Disease

Cathy Peterson

By Cathy Peterson, Gemini Hospice

ardiovascular disease is caused by narrowed, blocked, or stiffened blood vessels that prevent your heart, brain, or other parts of your body from receiving enough blood. I am not a clinician, so I won’t go into the technical details of heart disease. However, as an owner of a hospice, I can describe a day in the life of someone with heart disease. Let’s call him Bob, a 76-year-old man who lives alone. He is not ambulatory, meaning he’s not able to walk, and is confined to a scooter. He has poor circulation to his arms and legs, which can cause pain and numbness. Bob uses his scooter to go to a local diner for breakfast each day, and then does his daily grocery shopping. He is frequently out of breath when resting and after exertion, therefore he’s encouraged to space his activities to conserve energy. Bob frequently has chest pain, referred to as angina. This is usually alleviated with morphine or nitroglycerin and rest. He also has a pacemaker to maintain a safe heart rate and takes blood thinners to avoid blood clots along with blood pressure medication to reduce the workload on his heart.

If you or a loved one have experienced some of these symptoms, it’s very important to talk with your doctor to rule out the possibility of heart disease. Other contributing factors to consider include age, gender, weight, and family history when determining your risk of developing heart disease. Bob is eligible for hospice care because of the symptoms expressed above and the fact that he is not a surgical candidate and is not seeking aggressive treatment at this time. For more information about hospice, please contact Cathy Peterson at Gemini Hospice. We are a family owned and operated hospice with the goal of providing care, comfort, and compassion to those nearing the end of their life. For more information, call 480883-1353; email: cathyp@geminihospice.com; or visit our website: www.geminihospice.com. We are located at 3960 E. Riggs Rd #4, Chandler, AZ 85249. February 2014 — East Valley — Healthy Cells Magazine — Page 13

feature story

H2O

Heart Health Organization

A More Effective Way to Deliver Hospital-Based Care for the Heart Submitted by Dignity Health

Heart Health Organization — East Valley

hanks to a unique approach to delivering care, heart patients at two East Valley hospitals are receiving more coordinated and efficient medical assessment and treatment. Thirty cardiovascular specialists from a number of different practices and several subspecialties in the East Valley have formed their own management organization to provide optimal specialized medicine in hospital emergency departments and to inpatients. It’s a rare concept in health care, and it’s paving the way for other hospitals and other clinical specialties in Arizona. Page 14 — Healthy Cells Magazine — East Valley — February 2014

From Competition to Cooperation Much like any other entrepreneurs, primary care physicians and medical specialists may regard themselves as competitors with others in their specialty, especially with those who happen to practice in the same geographic region. It’s unusual to see doctors in the same specialty who are not already partners in practice agree to work together serving a particular population of patients to ensure a higher level of care and greater efficiency in delivering that care.

Typically, when heart patients go to a hospital emergency department, they are evaluated and initially treated by the emergency medicine physician on duty at the time while they wait for an on-call cardiologist to arrive at the hospital. That system generally works well, but administrators and doctors at Chandler Regional Medical Center and Mercy Gilbert Medical Center know there is a more efficient way to care for emergency and inpatient heart patients. That was part of the motivation for the 30-member group composed of medical cardiologists (heart doctors who patients see most often), interventional cardiologists (who perform procedures such as angiograms), electrophysiologists (who specialize in assessing and treating abnormal heart rhythms) and cardiovascular surgeons from 15 separate practices in Mesa, Tempe, Chandler and Gilbert to band together to form the Heart Health Organization-East Valley (known as “H2O”). The doctors provide on-site care at both Chandler Regional and Mercy Gilbert Medical Centers. H2O is the only program in Arizona that has private practice cardiovascular doctors available in the hospital from 7 a.m. to 9 p.m. every day and who are there to help patients avoid waiting for the on-call heart specialist to arrive at the hospital. The Heart of the Matter The partnership of cardiovascular specialists was created in March 2013 by the hospitals’ parent, Dignity Health East Valley and local cardiologists led by Roger Bies, MD. Administrators at Dignity Health approached Dr. Bies and other cardiologists about forming an alliance, partly in response to provisions in the Affordable Care Act. “We are excited about this partnership,” said Tim Bricker, President and CEO of Dignity Health East Valley. “It aligns the incentives of Dignity Health and our cardiovascular physician partners around quality and performance improvement. We see this arrangement as a promising model for integration with physicians in a rapidly changing health care environment, and we anticipate positive outcomes for our patients.”

L to R: Drs. Suntharo Ly, Jagwinder Sraow, Himal Shah

L to R: Drs. Ahtisham Shakoor, Ziad Elghoul, Robert Hamburg, Zaki Lababidi H2O “is the only provider group in Greater Phoenix that provides in-hospital coverage by attending heart doctors with years of experience to immediately diagnose and treat cardiac patients,” said Dr. Bies, an interventional cardiologist. “All 30 physicians — acknowledged as leaders in their areas of expertise — “have adopted guideline-based ‘best practice’ treatment plans for the spectrum of heart disease that assures consistent high quality and effective care delivery,” he said. “We’re fortunate to work in an area where we have a great group of physicians who demonstrate a genuine collegial respect and collaborative attitude toward their fellow providers,” Dr. Bies added. “We also recognize the importance of the common challenges we all face with the evolving structure of health care. As care delivery demands push for better outcomes with higher efficiency somehow at a lower cost, we all recognized we could not survive without working as a team to achieve these common goals.” Heart patients “presenting in an emergency room in the East Valley are seen by a cardiologist right away,” Dr. Bies said, “instead of an initial assessment by a physician who doesn’t specialize in heart disease. We’re already seeing that this saves lives, spares patients unnecessary testing or admissions, and reduces costs.” Recognizing the Benefits of Collaboration While Tackling the Challenges “Creating the H2O eliminated the boundaries between different cardiologists, opening the path to sharing ideas and thoughts about a specific case or patient and thus improving the outcomes in our hospital and community,” said George Nseir, MD, another interventional cardiologist in the Heart Health Organization. “We are currently more open to positive and constructive criticism among ourselves.” Some of the cardiologists had to be persuaded to join the organization, Dr. Nseir pointed out. “The biggest challenge was convincing solo or small practices to buy into the idea,” he said. “They were fearing initially that being in a big group would eliminate their February 2014 — East Valley — Healthy Cells Magazine — Page 15

feature story

continued

L to R: Drs. Zaki Lababidi, Ahtisham Shakoor, Abdul Memon

“Among heart attack patients, 100 percent are treated within 90 minutes of arrival to an emergency department, the nation’s top benchmark. Patients treated for heart attacks or heart failure in the two hospitals also have fewer complications and fewer readmissions than in the majority of U.S. hospitals” Page 16 — Healthy Cells Magazine — East Valley — February 2014

autonomy and ultimately their group. It took a while to work through the issues and make sure that every individual and every group voice is heard and that they participate actively in the decision making.” One of the administrative challenges that many “co-management” arrangements face is integrating the role of the management company into the fabric of the traditional medical staff leadership and the clinical staff at the hospital, explained Mark Kem, a management consultant for the cardiologists. “The doctors developed a management structure that includes making sure the various hospital department leads are represented on committees established by the H20. This has greatly assisted the doctors in bringing about change.” Clear Advantages The results for patients already have been dramatic. In both hospitals, there are fewer heart re-operations than in the top 10 percent of hospitals nationally. Among heart attack patients, 100 percent are treated within 90 minutes of arrival to an emergency department, the nation’s top benchmark. “Patients treated for heart attacks or heart failure in the two hospitals also have fewer complications and fewer readmissions than in the majority of U.S. hospitals,” Dr. Bies said. In addition, Medicare patients with heart disease experience a shorter length of hospitalization in the two hospitals than in a majority of U.S. hospitals. And these statistics have led to greater patient satisfaction. The scores of patients who have been treated at Chandler Regional and Mercy Gilbert average 94.5 out of 100, Dr. Bies said. The national benchmark is 92.9.

“We are already outperforming a majority of U.S. hospitals in these areas, and within the next two years, we plan to be better than the top 10 percent in the nation,” Dr. Bies added. “Our need for re-operation after heart surgery is one of the lowest rates in the state and in the country. What is unique about our program is that we have added a number of goals that the doctors thought were important. These include minimizing radiation and kidney problems from imaging tests, reducing unneeded admissions and delays in appropriate care and improving patient satisfaction to an even greater degree.” “In our group we have the best talents ‘under one roof’ trying to improve the quality of care of patients in a cost-effective manner,” Dr. Nseir said. Could this work for other specialties? Orthopedics may work well with a co-management arrangement, Dr. Bies said, “particularly due to the high patient volume and cost for joint replacements in the baby boomer era. Cancer treatment centers are likely another area where quality and cost can be comanaged effectively. Patients want good care and good value and co-management seems to be an attractive alternative to the less attractive possibility of a national government run health care system.”

H2O Physician Members Central AZ Heart Specialists

Premier Cardiovascular Center

480-786-9100

Gautam Kedia, MD Zaki Lababidi, MD Mohammed Hojjati, MD

Cedars Heart Clinic

480-656-5711

Daniel F Klee, MD Jon E Stevenson, MD

Gilbert Cardiology

480-814-0266

Georges Y Nseir, MD Estela Apolinar, MD Ashok C Solsi, MD Lyndon C Xavier, MD Ziad El Khoury, MD

Valley Heart Associates

480-899-2020

Roger D Bies, MD Robert J Hamburg, MD Suntharo Ly, MD Rizaldy Villegas, MD Andrew Cassar, MD

480-917-5900

Ziad M Elghoul, MD Bashar Markabawi, MD Faisal Bahadur, MD

Pioneer Cardiovascular Consultants 480-345-0034

Rajiv M Ashar, MD Mehul P Shah, MD

Southwest EP Clinic

Heart Sciences Center

L to R: Drs. Huy Phan, Zaki Lababidi, Ziad Elghoul, Andrew Cassar Is this the right move for most hospitals? “H2O has taken a proactive strategy that has already proven itself,” Dr. Bies explained. Hospitals are faced with a daunting task of providing better care and avoiding financial penalties, he said. “It took us three years to create our program, and for many facilities with a less cohesive atmosphere, it may take longer. The clock is ticking as health care promises to remain at the forefront of the national political stage. Most hospitals are already under fiscal pressure with narrow operating margins, and if they don't act soon they may find that a wait-and-see strategy will make them less desirable for prospective insurers and patients.”

For more information about Heart Health Organization — East Valley, visit www.chandlerregional.org or email: HeartCare@DignityHealth.org.

480-219-6840

Abdul Q Memon, MD

Sun State Cardiology

480-782-0101

Ahtisham Shakoor, MD

Lifeline Internal Medicine

480-612-0400

Nabil Dib, MD

Chandler Cardiology Associates

480-776-6844

Drory Tendler, MD Huy Phan, MD

480-821-3800

Jagwinder S Sraow, MD

Heart & Lung Institute, St. Joseph’s 480-728-7564

Marwan Ghazoul, MD

Metro Heart Care

Arizona Advanced Arrhythmias

480-289-4550

Himal Shah, MD

East Valley Cardiology

480-398-3770

Rajdeep Gaitonde, MD

Heart & Rhythm Solutions, LLC

602-776-3464

Michael Kralik, MD

480-899-9430

Robert Dappen, MD February 2014 — East Valley — Healthy Cells Magazine — Page 17

policy guidance

Shopping for Medicare Plans? Choose a Broker By Patty Vieira, Independent Broker, Arizona Senior Health

hopping for Medicare plans can be very overwhelming. First, Medicare sends you a large book with all the plans that exist. Then, all the major insurance carriers send you pamphlets telling you why you should pick them. Next come all the insurance agents. Your mailbox explodes daily. The question is, who should you trust? Often, when I’m with a client, they ask, “What’s the best plan?” Medicare absolutely forbids me to answer that question and for a very good reason. There is no such thing as the "best plan.” There is, however, the plan that will work best for you. The challenge is finding that plan. To determine what the best plan is for you, there are many factors to take into consideration. Do you have a doctor that you want to keep? Do you care which hospital you use when needed? Do you have conditions like diabetes or congestive heart failure? Within each insurance company are various plans and networks to choose from if you’re looking at Medicare Advantage plans. I can’t tell you how many times I’ve arrived at an appointment and when the potential client realizes how many different companies I can research, I see the relief flooding through their faces. A broker will take your particular doctors and research the plans they accept. Physicians rarely contract with all companies, so this can Page 18 — Healthy Cells Magazine — East Valley — February 2014

influence your choice of plans. In addition to looking for your doctors, a broker may access which plan is the most cost effective for your medical conditions and current medications. Many companies have plans that cater to the special needs of diabetics or those with certain heart conditions and often those plans offer lower out-of-pocket cost. Overall, a broker has your best interest at heart. Medicare regulates the compensation agents receive to ensure fairness among the insurance companies. From a broker’s perspective, it makes no difference which plan you choose because the compensation is the same. With multiple companies to offer a client, you can feel good that their recommendation is truly for your benefit. When shopping for a Medicare plan, ask if they are a broker and how many companies they have available. The more companies they represent, the better chance you have of finding the best plan for you. Have questions about health insurance? Call me at 480-220-7233, email: pattyjvieira@gmail.com, or visit www.insurancebypatty.com. With 25 years experience, I can simplify insurance quotes and policy term so you can understand them.

a caregiver’s story

Where a Need Leads to Passion By Gina Y. Bowser, Comfort Keepers, Inc.

y 76-year-old mother was diagnosed with stage 4 breast cancer a couple of years ago. Being a breast cancer survivor myself, I understood the diagnosis and the course of chemotherapy and radiation. Surprisingly, I discovered I could become her caregiver, and I learned everything that entailed. As a caregiver, I drove her to chemo, radiation, blood work, heart specialist, dentist, and podiatrist appointments. I handled daily chores like cooking, cleaning, shopping, monitoring her medications, and just spending time with her: laughing, telling jokes, and watching her favorite television shows. When her oncologist explained there was nothing else he could do, I realized I would need additional help. Not just because her care was becoming more difficult, but I wanted to spend my mother’s final days loving her and spending quality time with her. I began searching for in-home care. I thought it would be impossible to find someone to handle all the responsibilities I managed, and at the same time meet the family's and mom’s needs, be trusted in her home, and fit her personality. Some important questions I asked when looking for in-home care: • Ask about the certifications and qualifications the employees meet

• What continued training are employees required to take? • Do they offer skilled nursing (RN), a social worker, or other specialty services? • Do the employees pass background checks? While caring for my mother I found my passion, being a caregiver. The rewards are endless, knowing in my heart that I’m providing a service that will benefit the patient and family and yes, even me. It’s never too early to learn about and prepare for in-home care, because the time may come when you need someone to care for your loved one, a dear friend, a child or you. Comfort Keepers of Chandler provides all levels of care and a wide variety of services. For more information, call 480-659-9201, visit www.comfortkeepers.com or email chandler@comfortkeepers.com. Our caregivers are certified and have on-going training to give them the all the skills to be the best caregiver they can be.

Sliding doors therapY Yvette Saint Thomas, M.D. Specializing In: • Lectures on marriage and family counseling • Seminars • Depression • Adolescence Behavioral Disorders • Elder care/dementia • Private and Group Retreats Available

Satisfy the body and the mind in a comfortable, relaxed atmosphere at the healing cafe. Have a healthy drink and snack, then we’ll talk.

Finding you an answer when no one else can. February 2014 — East Valley — Healthy Cells Magazine — Page 19

medical news

Cardiac Stem Cell Transplantation Study Focused on Mending Broken Hearts By Kristine Burnett, Banner Health

edical research is a cumulative process of discovery and development driven by the desire to make a difference in people’s lives. Just ask Mohamed A. Gaballa, PhD, Director of the Center for Cardiovascular Research and senior scientist at Banner Sun Health Research Institute (BSHRI) in Sun City, Arizona. For nearly 20 years, he has been on the hunt for a treatment for heart disease, the nation’s number one killer according to the Centers for Disease Control and Prevention. With the support of those passionate about mending broken hearts, BSHRI is paving the path toward adult cardiac stem cell transplantation and, ultimately, a revolutionary treatment for heart disease. Suffering a heart attack causes irreparable damage that weakens the heart and impairs its ability to pump blood. While the heart makes adjustments to compensate, the damage is done and the effects linger. Scientists have spent decades researching treatments aimed at rebuilding and regenerating the heart, but one tool appears particularly promising: stem cells. “Stem cells essentially have the ability to become anything,” explained Gaballa. “But even stem cells are programmed for certain functions. For instance, bone marrow cells are programmed to treat bloodborne diseases and/or form blood vessels. To treat heart disease, we need stem cells that are programmed to become heart cells just as nature intended.” While stem cells were recently found in the heart, albeit in small number, their regenerative abilities may be compromised after a heart attack. In fact, a person can lose up to one billion cardiac cells during a single heart attack, which is daunting for the resident cardiac stem cells. The heart typically heals by replacing dead cells with non-contracting scar tissue. While the heart initially adapts to the new conditions, this buildup of scar tissue leads to a condition called heart failure. The goal for researchers is to identify ways to harvest heart stem cells, multiply them and later deliver them in mass quantity following a heart attack to replace and improve function of the damaged heart muscle. “With funding from Sun Health Foundation, we made a lot of progress expanding cells, characterizing their biological activities and delivering them using various approaches in disease models” said Gaballa. “Now we’re focused on translating almost 20 years of research into clinical work and putting those cells directly back into the heart. The foundation continues to be an invaluable partner in the process.” Philanthropic support led to the creation of a new state-ofthe-art clean room, one of the first in Arizona built specifically for growing stem cells. Such a facility is critical to any study’s ability to move from the research phase to the clinical trial phase, and it underscores Gaballa’s stance that no research institute can survive without philanthropic support. “It’s not just a building,” noted Gaballa. “It’s a highly regulated facility in which very exact government guidelines for manufacturing a biological agent must be followed to ensure that cells are suitable for human transplantation. The air quality is optimal; air Page 20 — Healthy Cells Magazine — East Valley — February 2014

pressure, flow, humidity and temperature are specific; monitoring is constant; and procedures are exact.” In preparation for the clinical trial phase of the study, Gaballa and his colleagues at Banner Boswell Medical Center in Sun City are working diligently to identify patients who will be undergoing cardiac bypass surgery and are willing to participate. The study will be limited to 20 patients, and it is expected to begin this year. When the clinical trial launches, heart tissue/cells collected during cardiac bypass surgery will be processed in the clean room at BSHRI. Approximately three to four weeks later, the processed and multiplied cells will be implanted back into the same patient’s heart via a minimally invasive procedure using a catheter. Patients will be hospitalized for one day for observation and monitored for a year. “Starting a first-in-man clinical study, such as our cardiac stem cell study, is a colossal undertaking for any research institution,” commented Gaballa. “It requires enormous amounts of time and funding and a commitment from all stakeholders.” Banner Health is a nonprofit health care system with 24 hospitals in seven states. For more information, visit www.BannerHealth.com or Facebook.

personal commitment

Health in the New Year: Forget Resolutions! The Daily Choices You Make Are Key to Achieving Goals

Judith Garner

By Judith Garner, Independent COPE Certified Health Coach with Take Shape For Life®

t’s that time of year again — we’ve settled into 2014 and the resolve to keep a New Year’s resolution may be starting to wane! According to the University of Scranton-Journal of Clinical Psychology, published Dec. 13, 2013, Just 8 percent of Americans are successful in achieving their New Year’s resolutions. Making a decision and setting a goal are necessary first steps toward making significant changes to improve our lives. But in order to have ultimate success, we must make the best daily choices — those that will support habits of health and not habits of disease. Health is All About Choice The small daily habits and choices you make, not one huge thing, change the state of your health. There has never been a medication, herb, or diet supplement that by itself creates longterm health. There is no magic bullet. You’re the dominant force in your life. Are your daily choices moving you toward health or disease? The Motivation Factor Why do you want health? The answer might seem obvious — so obvious, in fact that we don’t often think to ask the question of ourselves, or to consider the answer. After all, if you’re overweight, have health problems, feel tired, and lack energy, the obvious answer is that you want to solve those problems. Conflict-driven motivation is one of the major reasons people yo-yo. This type of motivation almost never leads to lasting change! Typically you make some changes at first, but later you fall back into your old habits and behavior. Why? Because when you experience emotional conflict — that is, feelings of negativity — you want to stop it. You think about your health problems, or how much you hate the way you look, and your natural response is to feel terrible. In order to end the discomfort, you take actions that make you feel better about yourself — maybe you go on a diet, or vow to change your couch potato ways and start exercising. But, those actions aren’t motivated by what you want — and the outcome you desire — and so they lead you into a predictable four step yo-yo pattern: 1) intense emotional conflict, 2) leads you to taking action, 3) emotional conflict decreases, and 4) leads you to less action. Inevitably, the most natural thing in the world is to fall back into your previous habits: eating, smoking, whatever it is you’re trying to change. Problem Solving vs. Desired Outcome Relying on self-control is nearly impossible to reach goals and unlikely to lead to success because it just doesn’t work long-term. What will work? Changing the way you motivate yourself — focusing on what you want instead of what you don’t want — and in the process creating a fundamental new Habit of Health. Let’s consider these choices. You can: 1) think in terms

of trying to fix your bad health (a problem orientation) or 2) shift your focus to creating health (an outcome orientation). Three Types of Choices: Primary, Secondary, and Fundamental • F undamental choice: Is what defines our state of being. It’s where we stand. It’s what we’re willing to fight for! • Primary choice: Is a major choice. It is deciding that we want one thing more than something else; for example, optimal health. • S econdary choice: Is about taking the daily actions, even if we don’t really want to, that support our primary choice; for example, choosing not to have a banana split. Putting Our Choices Together to Stay Motivated and Create Our Desired Outcome I hope you’ve decided that you want to make optimal health your fundamental choice. Once you’ve made this choice, you simply need to arrange your primary and secondary choices to make it happen. Sound simple? It really is! Our task now is to: • Organize the primary choices that will produce optimal health. • O utline the secondary choices, or action steps, that will support those primary goals. Start making these actions part of your daily life, step by step, and you’ll be on your way to Habits of Health that will help you Take Shape For Life! Keep your healthy choice momentum going by joining Judith Garner and thousands across America (between January 1 – March 1, 2014) as they transform themselves mentally and physically during the "Stop. Challenge. Choose." 12-Week Health Transformation. Win exciting prizes, giveaways, and more! Get enrolled today — NO FEE TO ENTER. For more information, contact Judith Garner, Independent COPE Certified Health Coach with Take Shape For Life® at 480-560-7842 or judithgarner@cox.net.

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2370 W Ray Rd Suite I • Chandler, AZ 85224 February 2014 — East Valley — Healthy Cells Magazine — Page 21

children’s dental health

Why Should My Child See A Pediatric Dentist? By Griffith Haeggquist, DDS, Every Kid’s Dentist

t’s common for children to have some anxiety and fear when visiting the dentist, doctor, or other health practitioner. More than likely these offices have white sterile walls, scary equipment with unfamiliar noises, and people wearing a mask. A dentist that specializes in pediatrics is trained to reduce these fears so children have a good experience when being treated. A dentist that specializes in pediatrics has made a commitment to their small patients by attending two or more years of specialized training after completing four years of traditional dental school. This prepares them to handle the many challenges and behaviors often presented by patients from infants through adolescents and adults with special needs. A child's first visit to the dentist should occur around their first birthday. This visit is usually referred as a "lap exam" where the dentist will exam and clean the child's teeth while in the lap of their parent or caregiver. This is also an excellent age for parents to begin introducing the child to a soft toothbrush and reduce the risk of cavities. Many pediatric dentists offer a variety of safe sedation techniques that are recommended for children to safely treat cavities. It reduces the risk of the child moving, which decreases the risk of complications and allows the dentist to treat more areas in one visit than he could do if the child was awake. There are two commonly used sedation techniques. One is oral sedation, where a child drinks a flavored beverage that puts them into a "twilight" state, basically a deep sleep. Oral Sedation is very Page 22 — Healthy Cells Magazine — East Valley — February 2014

successful in the majority of cases. The second is IV sedation, where an anesthesiologist puts the child under and monitors them while the doctor does the treatment. This is used for extreme cases and for children with special needs or behavioral difficulties such as autism, Down syndrome, ADD, ADHD, and others. The pediatric dental office usually has a very inviting, kid-friendly waiting room and exam area filled with activities to help kids feel comfortable and at ease. Some offices offer televisions for children to watch their favorite movie while being treated. Chairs and most equipment are smaller and scaled down to fit the needs of children. When a child is introduced to dentistry at a young age and continues to receive a positive experience in a friendly environment, they are more likely to continue regular scheduled dental visits into adulthood. "I love working with kids. My goal is to give children a positive experience when visiting the dentist so they have no fears when they become adults. I try to treat my patients as I would my own kids." — Griffith Haeggquist Every Kid’s Dentist and Tempe Modern Dentistry are accepting new patients and offer evening and Saturday appointments to fit your busy schedule. Call 480-3454017 or visit www.everykidsdentist.com. Stop and meet our staff at 1835 E Guadalupe, Tempe, SE corner at McClintock. We offer one-day crowns using CEREC® CAD/CAM technology.

goal setting

Four Reasons Resolutions Fail By Terry Packer, Title Boxing Club

t’s February and by now 88 percent of people’s New Year’s Resolutions have failed. Various research studies suggest different reasons for these failures but the most common reasons include: • Too vague: Lose weight, save money, get healthy, etc. Without being specific it is hard to measure progress and envision success. • Too much: Many experts suggest focusing on one major goal at a time. Let’s face it; most of our resolutions require big effort to make the necessary changes. More than one big goal at a time becomes overwhelming and we end up giving up on all of our resolutions. • T oo hard: Finding small actions that lead to habits that enable our goals is key to long term success. For instance, I can lose 5 pounds this month by (choose one): eating breakfast every morning; eliminating one latte a day; drinking a glass of water before meals; working out on Mondays, Wednesdays, Fridays, etc. • T oo negative: Using guilt or fear as motivation for goals usually does not work. The fat picture on the fridge just makes us feel negative about our ability to succeed. We all need rewards, reinforcement, and wiggle room. Even the most dedicated Iron-

man triathletes all have one day off a week. Having weekly pizza night or having a small dessert once a day is better than trying to maintain a spartan 1000 calorie-a-day diet for months. Celebrating losing 2 pounds this week with a small purchase or a positive Facebook post goes a long way to generate positive feelings and chances of a repeat performance. • Too isolated: We all need support systems. Even the most accomplished athletes in individual sports like golf have a team of trainers, caddies, nutritionists, mentors, family, etc. to support them. Share your goals and enlist the help of trusted friends, family, and professionals. Title Boxing Club can help you increase fitness or achieve weight loss. We offer a family-oriented fitness club featuring onehour classes with trainers to keep you engaged and motivated. Just three one-hour classes a week can lead to real results, guaranteed. Contact Title Boxing Club at 480-422-3736 to schedule a free class. Located at 5037 E Ray Rd, in Ahwatukee. February 2014 — East Valley — Healthy Cells Magazine — Page 23

body performance

Practical Tips for the IDEAL Hiker Submitted by IDEAL Physical Therapy

t’s a perfect day for a hike! The Arizona weather allows for nonstop outdoor activities throughout the year. As the rest of the country is pulling out their ski boots, Phoenicians are dusting off their hiking boots. You have the shoes, backpack, and water bottle ready to hit the hiking trails, but is your body ready to take the challenge? You don’t have to be an elite athlete to enjoy the great outdoors, but you do need a moderate fitness level for hiking. Start every hike by stretching and warming up to prepare your muscles, joints, and mind. You’ll have a safer, more enjoyable hike, avoid injuries, and help you feel your best. When finished, before jumping in your car, elongate the muscles and re-establish them to their normal resting length. Here are a few stretches and tips for hiking that will help your performance on the trail: • Calf stretch: When hiking, your calves get a substantial workout. Find a flat rock or stump that gives you enough room to stand several inches off the ground. Stand on the rock and back your feet up so that your heels are hanging off the rock. Lower both heels until you feel the stretch in your calves — raise both heels, stretching for about 30 seconds. • Hamstring stretch: Sit on the ground and extend your legs out in front of you. Pull one leg in towards your body and reach for your

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toes. Make sure you bend at the waist until you feel the stretch in your hamstring. Alternate legs and repeat. • Quadriceps stretch: Stand tall with your abdominals pulled in and hold onto a stable surface for balance (tree, car, fence, etc). Hold onto your right foot with your right hand —your knee pointing straight down to the ground. Hold the stretch for 20–30 seconds and then repeat on the opposite leg. • Stretch your spine: Avoid a stiff neck and shoulders by loosening them before, during, and after your hike. Press your hands against a wall or tree as you bend to create an L shape with your body. Feel your spine extend as you press with your hands and feet. Cardio Engage in cardiovascular exercise five days a week for 30–60 minutes per session, at a moderate intensity where you are breathing heavier than usual and working up a sweat. Work the major muscle groups in the lower body since the legs are predominantly used in hiking. Running, cycling, and stair climbing are all good options to simulate a hilly hike. Strength Train Hit the weights two to three days a week in preparation for hiking. Strength training will build up your lower and upper body — select six to eight exercises per workout for the arms, shoulders, chest, back, legs, and gluteals.

• • • •

Fuel Up Adopting healthier eating habits in the weeks prior to your hike will boost energy levels and fuel those muscles for extended exercise. Stay hydrated — drinking plenty of water keeps muscles strong and improves endurance.

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Following these tips will help your body recover faster and you’ll be ready to go out for another hiking adventure!

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Page 24 — Healthy Cells Magazine — East Valley — February 2014

Have an injury? Call IDEAL Physical Therapy at 480-222-0655 to schedule a free screening at a location near you or visit Ideal Physical Therapy Chandler at 235 S Dobson Road, Suite 3, NE corner at Frye Road.

community news

Empty Bowls Provide Food for the Hungry 13th Annual Event Involves Local Students and Artisans

or the hungry in our community, an empty bowl signifies a lack of food. At the Tempe Empty Bowls event, it signifies a chance for the local community to help fight hunger. With the $10 purchase of a handmade bowl, Whole Foods Market will offer a simple meal of soup and bread, symbolic of the caloric intake that must sustain many in our community for an entire day. Whole Foods has donated the soup for the past 13 years! Proceeds from the sale of the bowls is split between TCAA and United Food Bank. The 2014 Tempe Empty Bowls is held, rain or shine, from 11 a.m. to 2 p.m: • Friday, February 21 at the 6th Street Park, just east of Mill Avenue. Spend your lunchtime selecting a bowl and having a meal while enjoying the music of Walt Richardson before returning to work.

•S aturday, February 22 in the Community Center Courtyard, 3500 S. Rural Rd., between Tempe Public Library and Vihel Center buildings on the southwest corner of Rural and Southern. Bring the kids and teach them about the art of clay creations. Entertainment is provided by Randy Olson and Friends. Tempe Empty Bowls started with just handcrafted bowls, but has grown to include planter pots, mugs, necklaces, platters, and vases — all available for purchase. The items are made at the City of Tempe Ceramics Program by local artists and students ranging from elementary to high school. Proceeds support hunger programs at Tempe Community Action Agency (www.tempeaction.org), the Escalante Community Garden, and the United Food Bank’s Kid’s Café program (www.unitedfoodbank.org). For more information, contact Tempe Community Action Agency at 480-350-5883, the United Food Bank at 480-926-4897, email: info@tempeemptybowls.org or visit www.tempeemptybowls.org. February 2014 — East Valley — Healthy Cells Magazine — Page 25

skin care regimen

Renewing Your Skin in the Desert By Barbara Dryburgh, Nerium International

few years after moving to Arizona, I looked in the mirror and noticed that my skin was changing, and rapidly! I saw fine lines, wrinkles, discoloration, sagging jowls, and a dullness I had never experienced when living on the East Coast. Was I really getting older? Was it the desert climate? The answer to both was yes. Not only did it show up on my face and neck, but it also surfaced in my mind, often referring to myself as “old” though still in my 50s. And once that attitude was adopted, it spilled over into other areas of my life creating a barrier to new and exciting life experiences. I always took care of my skin, but it never occurred to me that the skincare regimen I used in Pennsylvania would not apply in this sunny, arid climate. After all, I was using quality products. My “ahha” moment came when a friend suggested I make a change. Brilliant! In the search for my lost, youthful complexion, I discovered the following that has made all the difference to me, both mentally and physically: •H ydrate! Drink a minimum of eight glasses of water a day to flush out toxins and stay healthfully hydrated. • Watch your diet. The quality of your skin is affected by what you eat. For example, a dull spotty complexion can indicate a diet high in fats, sugars and processed foods. Simple and healthy changes in your eating habits can improve the quality of your complexion. • U se warm, not hot water. Hot water strips your body of its natural oil barrier. That barrier is needed to help trap moisture and keep your skin smooth and moist. • Wear sunscreen daily. This is a must! The sun is brutal on your skin. SPF 15 is adequate for general use, but bump it up to 30 when outdoors for a while, and wear sunglasses and a hat, too. • C leanse gently. Wash with a gentle, fragrance free cleanser. Products with deodorant or antibacterial additives are harsh on skin. Consider cleansers that contain ceramides, which are fatty molecules that make up the outer barrier of your skin and help hold in moisture. Avoid products with alcohol, which is drying. When exfoliating, don't scrub too much or too hard as it can irritate and thicken skin. • Moisturize More. As seasons change, so should your skin care routine. In winter, try a moisturizer that is oil-based, creating a protective layer on the skin that retains more moisture than a cream or lotion. Look for products containing avocado oil, mineral oil, primrose oil, or almond oil that do not clog your pores. Lotions containing glycerine, sorbitol, and alpha-hydroxy acids also attract moisture to your skin. Apply daytime moisturizer throughout the day as needed. • O ther skin-renewing options. Check out new breakthroughs in anti-aging night creams containing powerful antioxidants. Page 26 — Healthy Cells Magazine — East Valley — February 2014

Look for those that have been clinically tested and proven to reduce fine lines, wrinkles, and discoloration, and to improve the tone and texture of your skin. Finally, it is a good idea to seek the advice of both a dermatologist and an aesthetician. Visit a dermatologist for regular checks for skin cancer prevention. An aesthetician can provide an analysis of your skin type and recommend the best products on the market for you and the environmental conditions in which you live. NeriumAD® is a breakthrough anti-aging night cream containing powerful antioxidants, proven through third party clinical trials to reduce fine lines, wrinkles and discoloration, and to improve skin tone and texture by an average of 30 percent. For more information, contact Barbara Dryburgh, Independent Brand Partner with Nerium International. Call 610-331-5618, email Barb.dryburgh@gmail.com, or visit www.barbdryburgh.nerium.com.

Our Services Gemini Hospice is a family owned and operated company with the goal of providing care with compassion and dignity to those nearing the end of life. Our team of qualified professionals will partner with you and your loved ones to assure this goal is accomplished.

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• Nursing Care • Social Services • Bereavement Services • Personal Care • Volunteer Services • Medications for pain or other symptoms • Medical supplies and durable medical equipment • Homemaker services • 24 hour availability • General Inpatient Care • Respite Care • Spiritual Services • Physical Therapy, OT and Speech • Physician • Care and Comfort

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CARDIAC VASCULAR CARDIAC/ CARDIAC/VASCULAR SURGEON

CARDIOLOGIST INTERVENTIONAL CARDIOLOGIST

ELECTROPHYSIOLOGIST

Your heart is like a house. Your heart is like a house. It needs nurturing and attention to stay in good shape. Sometimes, as a heart or a house ages, it develops a problem, and a professional needs to be consulted to fix it. Your team of experts may include: A CARDIOLOGIST – Your primary heart AN INTERVENTIONAL CARDIOLOGIST – You may be doctor is like a general contractor. The cardiologist is concerned with the overall referred to a specialist who focuses on the plumbing in construction and function of your heart. your heart and can diagnose and sometimes treat your heart condition by performing a specialized procedure.

AN ELECTROPHYSIOLOGIST – You may be referred to a cardiologist who specializes in diagnosing and treating problems with the electrical system in your heart just like the circuitry in your house.

A CARDIAC/VASCULAR SURGEON – If you need surgery, this structural engineer for your heart is the expert who can fix or repair a complex problem with the architecture or function of your heart.

All of these heart specialists and leading-edge technologies are available to you – under one roof. We offer the latest and most advanced medical, diagnostic and surgical cardiovascular services including being at the forefront of conducting transformative basic and clinical research.

To learn more about our heart services or to be referred to a heart specialist, please call ResourceLink at (480) 728-5414.