Quality Health Fall 2020

FALL 2020

HEALTH Quality HE WELLNESS LLNESS & WELLN

When Life Gives You Stones Make Lemonade

Refreshing Nursing Leadership

Are You At Risk?

Early Detection Saves Lives

O besity & Severity

of COVID-19

arki&nTseoant ent P Diagnosis r

m

USNS Mercy Coin

contents

ON OUR COVER

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ISSUE 4 2020 executive publishers

Hal G. Fox & Suzanne Polk Fox managing editor Suzanne Polk Fox copy editor Chad Ruiz Terrie Davidson contributing writers Jim Tavary, President & CEO Brittany Miranda, FNP-BC Amicia Sapwell Deborah Lakin, OT, MBA Bruce Cuddy John Ancell, RN Lisa Erlinger, PhD, CRNA Kristy Podruchny Zandra S. Nocera, M.D. Roger Rose, RPh Karen Smith, RN, NMCC, LSSGB Debra Loder, RDN

6 CONNECTING HAPPY & HEALTHY

Prevention & Wellness

8 PARKINSON'S

Diagnosis & Treatment

9 EXERCISE

Pickleball is a Gift

11 USNS MERCY COIN

Hospital Corpsman First Class - John Ancell

13 OBESITY & SEVERITY OF COVID- 19 Link Between Obesity & Increased Rate of Disease

14 WELLNESS

When Life Gives You Stones Make Lemonade

16 ARE YOU AT RISK?

Early Detection Saves Lives

21 INFECTION PREVENTION Best Practices & Tips

22 FLU VS. COVID-19

Similarities & Differences

25 RECIPE

Nellie Palmer

Cinnamon Vanilla Chai Pudding

Juliane Morris

26 Q & A

Linda Rankin, MSN, MBA, MJ, BS, RN

What is an RDN & When do I See One?

Chad Ruiz creative team production and design Suzanne Fox Claire Thomas Chinook Deveraux The Wickenburg Sun

Take our Survey

The information contained in Inspire Health is intended for educational purposes only. A reader should never substitute information contained in Inspire Health for the advice of a health care professional. Jumpstart Publishing, LLC and publishers of Inspire Health, do not endorse or promote any of the products or services described in the pages of Inspire Health and the publishers do not verify the accuracy of any claims made in the editorial or advertisements contained in Inspire Health.

Readers should not use the information in Inspire Health for diagnosis or treatment of any health problem or for prescription of any medication or other treatment. Readers should consult with a healthcare professional before starting any diet, exercise or supplementation program, before taking any medication, or have or suspect they have a health problem. V3

© 2020 Fox Printing & Creative Publishing, LLC, New Orleans, LA All rights reserved Printed in the USA by Fox Print Services (igofox.com)

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Quality HEALTH

& WELLNESS

wickhosp.com

DR. NOCERA Are you at risk?

28 GARDENING

Growing Citrus Trees in Pots

30 MIGHTY KIDS

Teaching Kids the Art of Being a Good Listener

32 NURSING LEADERSHIP Refreshed Leadership Team

EAT FRESH

14

LEMONS

Jim Tavary, President & CEO of Wickenburg Community Hospital

The pervasive topic since early this year has been COVD-19. It was one of those “where were you when the world changed?� moments. It all started officially on March 11, 2020 when the World Health Organization (WHO) declared COVID-19 a pandemic. On March 13, 2020, a national emergency was declared in the United States. In a virtual cloud of uncertainty, confusion, and disbelief we became a mask, wearing, social distancing, fever checking society; all because of this microscopic virus that looks majestically crown-like and quite unassuming. Yet is has wreaked havoc worldwide. It’s an awesomely simple virus with unsettling powers of destruction.

Let’s learn more about this novel virus. Get this: • • • • • • • • • • • • • •

• • • • •

It’s tinier than a bacterium.

The LARGEST virus is smaller than the SMALLEST bacteria.

Viruses, unlike bacteria, are NOT living things Viruses are complicated assemblies of molecules, including proteins, nucleic acids, lipids, and carbohydrates.

On their own, they can do nothing and be nothing until they enter a living cell.

Without a host cell, viruses would not be able to multiply independently, therefore they are not a living thing.

So, were they EVER alive? Most biologists say “NO.�

Viruses are not made out of cells, so they can’t keep themselves in a stable state.

Viruses can’t grow and they can’t make their own energy. Still, viruses can and do replicate and adapt amazingly to their environment.

Viruses (like COVID-19) are more like androids than real living organisms.

Viruses enter a host cell and direct the building blocks of new virus particles (called virions).

Viruses can multiply in the living cells of animals, plants, and bacterium.

It’s unfathomable in so many ways. Viruses are not alive, and they have no destructive power on their own.

Yet fully one-third of the world’s population from 1918 to 1920 (500 million people) were affected by the Spanish Flu. The H1N1 virus resulted in a death toll estimated to have been somewhere between 17 million and 50 million. It was one of the deadliest pandemics in human history.

By comparison, in the United States, COVID-19 has affected a reported 5.74 million people and has resulted in 177 thousand deaths.

Influenza, on average, affects 25 million to 50 million people and results in 20,000 deaths per year.

This from a virus that can do nothing and be nothing without a host cell.

We can each be individually diligent in denying COVID-19 a host cell by socially distancing, wearing masks, washing hands, and disinfecting surfaces.

We are bigger than it and bigger than this challenge.

 �� �

“ May 21, 2020

RE: With Thankfulness and Gratitude for Each One of You! Dear wonderful, kind, compassionate, multi-talented,

Emergency Room:

With friendship and love, much support and encouragement, grateful hearts and thankful spirits, so very everyday prayers for you, your safety and protection, your families, and all of your co-workers.

- Residents from within The Neighborhood

This is the day which The Lord has made; we will rejoice and be glad in it.” ~Psalm 118:24 (NLT) Because of Your giving and caring hearts, you are a beautiful reminder of how much GOOD there is in the world, and we are so very grateful! It really does come easy for us, as well as others in the area of this hospital where you work and serve, to say and/or write, “Thank you”to you! Each of you are the consummate professional in all aspects and necessary skill levels of your position with Wickenburg Community Hospital.

Whether you are dealing with some type of medical emergency or even a possible COVID-19 case, you are the best and quickest course necessary medical care and attention.

The “Serving, giving, and caring for”profession is fortunate to have each and every one of you as part of their Emergency Room Team. Because of your daily example of giving, and giving, and giving some more, you are “God not only Loves you so very much, but He also put His Hand on you for His Special Blessings!” ~ 1 Thessalonians 1:4

Prayer Card Caption: Card shared from“Residents from within The Neighborhood”to the Emergency Department team.

Healthy and Happy

AT THE RANCH

The need to stay healthy is so important for all of us at every age. However, as we enter the “Golden Years”, it becomes even more so!

At My Father’s Retirement Ranch, we deeply believe this and have taken steps to provide all that we can for our residents.

Our three-wheel bicycles are our most fun and often used items. Riding has many benefits - fresh air, building leg muscles, and a feeling of accomplishment after “finishing a good ride”.

We provide an Exercise Room in the clubhouse where residents have the option of a treadmill, stair and step, elliptical, and stationary bike. This room looks out onto the heated Pool and Spa which residents can use after a good work out.

There is also a Physical Therapy room which offers a place for Therapists to meet and train our residents. This room overlooks the pasture with

close-up views of our four Alpaca and Sedona.

During the summer months, those who want really special fun sign up for “Pool Time” and great exercise is had by all! In winter, the heated Jacuzzi is a popular place to relax. In the main clubhouse, the Snap Fitness class is almost outgrowing the space.

The Ranch strives to combine all of this with fresh, wholesome, fun food for Lunch and Dinner.

Rents include 60 Meals a month from our Chefprepared kitchen. We encourage “after dinner strolls” and then a good night’s rest.

We want everyone to take part in as many activities as possible and to partner them with strong fellowships and friendships that add meaning to their lives.

The Ranch is a wonderful, comfortable, safe, secure place to call “HOME”!

400 N. Jefferson St. • (928)684-5925 • myfathersretirementranch.com Swimming & Cycling

60+ Chef Prepared Meals

On-Site Physical Therapy

wickhosp.com

Quality HEALTH

& WELLNESS

5

Community Hospital Clinics, Amie Boucher, FNP-C, and Brittany Miranda, FNP-BC are the Medicare Annual Wellness Visit Family Nurse Practitioners . Amie and Brittany are passionate about disease prevention, wellness and spending ample time with each patient to assist in identifying health concerns.

Brittany Miranda, FNP-BC Community Hospital Clinics You may have received phone calls from Community Hospital Clinics regarding scheduling an appointment for your Medicare Annual Wellness Visit (MAWV). Suppose you have had Medicare Part B for more than one year. In that case, you are eligible to receive a comprehensive wellness visit once every 12 months to create, update, or optimize a prevention plan established by yourself and a medical provider.

These prevention plans are developed to help prevent disease and disability and are customized based on your current health problems or risk factors. Also included in the wellness visit is a thorough cognitive exam performed to identify signs of Alzheimer’s or dementia.

The cost to you for the MAWV is ZERO. The appointment is free. You pay nothing for this visit because the Part B Medicare deductible doesn’t apply. The only time there may be a cost to you associated with this visit would be if additional tests or services are performed during the Annual Wellness Visit at your request.

Additional tests and services are not covered under the preventative benefits provided by Medicare. During this visit, medical providers aim to identify your healthcare needs for the year and assist you in taking these identified needs to your primary care provider to improve your health and wellness or prevent deterioration. Medicare, in general, does not cover a routine physical examination.

Many patients coming to the clinic for their MAWV have the misconception that the visit is a physical where labs are ordered, and a head-to-toe examination is performed. On the contrary, the visit is designed to identify health needs and provide critical health advice relevant to you. The visit also is intended to assist you in identifying related health problems that need routine follow-up with your primary care provider.

The Medicare Annual Wellness Visit is an eight-part appointment that includes: • A review of your medical and family history • Updating a list of your current providers and prescriptions • Obtaining your height, weight, blood pressure and other routine vital signs • Detection of cognitive impairment • Personalized health advice • An assessment of risk factors relevant to you and the treatment options available • A screening schedule for appropriate preventative services • Advanced Directive planning.

What is the MAWV? • A conversation with a medical provider (i.e., NP, PA, MD, DO) • An in-depth analysis of your medical records • Identification of preventative tests that can potentially be performed based on your needs (i.e., colonoscopy, mam mogram, bone density test, hepatitis C testing, abdominal ultrasound, low dose CT scan) • Providing Advanced Directive paperwork for you to complete What the MAWV is NOT • Not a routine physical examination • Not a visit where routine labs are orderd

To Schedule Please Call Community Hospital Clinics: 928-668-1833 Questions can be emailed to Brittany Miranda, FNP-BC: brittany.miranda@wickhosp.com

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If you have any privacy-related concerns or questions on how WCH uses your patient information, please reach out to WCH’s Privacy Officer, Amicia Sapwell, directly at 928-668-1846.

Ensuring privacy can promote more effective communication

between a physician and patient, which is essential for the quality of care, enhanced autonomy, and preventing economic harm, embarrassment, and discrimination (Institute of Medicine, 2009). A pandemic in our nation does not change the importance of confidentiality. The HIPAA Privacy Rule protects the privacy of patients’ health information (protected health information) but is balanced to ensure that appropriate use and disclosure of the information may be made when necessary to treat a patient, to protect the nation’s public health, and for other critical purposes. (Office for Civil Rights, 2020) During the Covid-19 public health emergency, Wickenburg Community Hospital and Clinics (WCH) remain committed to protecting the privacy of our patients’ health information.

As a patient, that means you can rest assured that WCH will only release information in accordance with the Health

Insurance Portability and Accountability Act of 1996 (HIPAA).

As a community member, that means we will continue to keep you updated on CDC guidelines and recommendations impacting our community, while our response to inquiries remains in compliance with HIPAA.

Amicia Sapwell

Privacy Officer Wickenburg Community Hospital

atment e r T & s i s o n Diag

Deborah Lakin, OT, MBA Director of Rehabilitation Wickenburg Community Hospital DaTscan Example

Think BIG! Wickenburg Community Hospital (WCH) now offers the Lee Silverman Voice Treatment (LSVT) BIG program for the treatment of Parkinson's disease (PD). The program is based on the most effective, evidence-based strategies for learning and neuroplasticity (the brain's ability to change).

LSVT BIG is an intensive treatment customized to help individuals with PD and other neurological conditions, address activities of daily living through all stages of disease progression.

LSVT BIG can help provide more confident steps, improved balance and torso movement, and reduction of fall risk. Consisting of 16 individual 1-hour sessions with an LSVT BIG certified occupational therapist, patients spend four consecutive days per week in therapy for a period of four weeks.

Each patient is provided personalized daily tasks to accelerate training progress in functional skills.

Continued practice of LSVT BIG exercises is needed several times per week with follow up therapy sessions scheduled on a case-by-case basis.

Approximately 60,000 Americans are diagnosed with PD each year. Many individuals may be experiencing symptoms such as slowed movement, rigid muscles, impaired posture and balance, loss of automatic movements, speech or writing changes, yet are unsure if those symptoms stem from Parkinson's disease. In addition to Parkinson's treatment, individuals and loved ones living with uncertainty can find diagnostic testing for PD at Wickenburg Community Hospital. The synergy created between diagnosis, therapy, and care planning helps ensure the right treatment can begin quickly.

Dagnostic testing for PD takes place in the Nuclear Medicine

department at WCH with a specialized test called a DaTscan. A neuro-imaging test approved by the Food and Drug Administration (FDA) in 2011, DaTscan utilizes the radiopharmaceutical drug Ioflupane ( 123I) to assist in evaluating patients with suspected Parkinson's Disease. In addition, DaTscan can help differentiate between a diagnosis of PD over other disorders presenting with similar symptoms.

Wickenburg Community Hospital has been performing DaTscan for about two years. It has been a fantastic tool in the diagnosis of patients with Parkinson's and those with non-essential tremors. It is a test that not all imaging facilities perform, and WCH is one of the first in Arizona’s rural healthcare market to have this capability.

Though it is never too late to improve body function, like many other progressive diseases, diagnosing and treating Parkinson's early has been shown to improve PD patients' quality of life significantly. Whether you or a loved one have already been diagnosed or are among the many living in uncertainty, Wickenburg Community Hospital's multidisciplinary approach to diagnosis, treatment, and care planning ensures individuals get the care they need no matter where they are in the PD journey. “To engage in this program, contact your provider and request a referral to Occupational Therapy for LSVT BIG. Early treatment will enhance your therapy outcomes. Wishing you the best in health�.

-Deborah Lakin, OT, MBA, Director of Rehabilitation

exercise

Pickleball

IS A GIFT

I

By Chad Ruiz

t’s tennis…no! It’s badminton…no! It’s ping-pong…no! It’s pickleball! The sport no one is talking about but everyone loves to play. If you’re like me and looking for activities to fill the void left by sports leagues on hold, grab yourself a plastic ball with holes, an oversized ping-pong paddle, a friend (or an enemy) and let the hitting commence! But please hit the ball, not your friend.

It’s fun, easy to play and great exercise for all ages. Yes, I’m looking at you!

Two or four players line up opposite each other separated by a low net, like tennis, and use their paddles to lob the plastic ball back and forth. Players complete each match when someone reaches 11 points with 2 points more than the opponent.

You’ll build cardio, balance, stamina and friendships!

One of the fastest growing sports, the Sports & Fitness Industry Association reported over 3.3 million pickleball players in 2019. That ranks just below basketball and football participation.

Did you know there’s a U.S.A. Pickleball Association, an International Federation of Pickleball, state, national and international leagues? ESPN even now covers pickleball tournaments.

So what is driving so many people to pickleball? Maybe they’re craving a pickle? Or more likely, after just a few minutes of playing they lose themselves in the exciting and friendly competition of the game.

Look for pickleball at your local tennis courts, recreation facilities and fitness centers where you can play indoors and outdoors. Best of all, the camaraderie may be the greatest part of this budding sport.

Players stand closer together than tennis, making it easy to share laughs and conversations (and heckles) while competing. But don’t worry, it’s virus and body odor-friendly because you’ll maintain a safe distance from others.

Plus, it’s affordable! Most athletic retailers sell inexpensive pickleball paddles and balls.

If you’re already playing, you know what fun it is! If you haven’t and want a new activity you, your family and friends will love, I encourage you to try it. What better way to burn calories while having fun?

Local pickleball Contacts: * Wickenburg Ranch – Dale Marin 949-633-2368, symbol321@cox.net * Wickenburg Area – Wendy Pierce 817-805-2818, admin@queenofheavenacademy.org

Drop in rates: 1 day 1 Week 1 Month

$15 $45 $100

$25 $75 $150

WICKENBURG’S ONLY 24-HOUR GYM

FREE WEEK WITH 24-HOUR ACCESS INCLUDES FITNESS CLASSES MUST LIVE OR WORK LOCALLY and provide VIsa or Mastercard for security.

Expires March 31, 2021

Staffed Hours: 8:00-1:00 & 2:30 - 6:00 p.m. M-F (weekends by appt.)

Treadmills, ellipticals, aerobic machines, recumbents, selectorize weight machines, free weights, TRX, bands, balls, mats, functional fitness zone, core zone, classes, FOD, showers, massage chairs, TV, WiFi, body image scanning (when available) and fun.

340 W. Wickenburg Way • Wickenburg, AZ 85390 | 928-232-4200

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Your Local Medicare Resource Center In a small town, time slows down and personal connections matter. We value that and take the time to thoroughly explain your Medicare health plan options and help you to better understand how to maximize the benefits of the plan you choose.

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• Turning 65 • Receiving “Extra Help” for Prescription Costs • New to the Area • A Veteran • Retiring or losing Group Coverage • Interested in looking at your options!

We offer most Medicare Advantage Plans, Medicare Supplements & Prescription Drug Plans. Plus, Special plans are available for Medicare Beneficiaries living with Diabetes or Chronic Heart Conditions.

Joe Holm

Senior Health Plan Advisor

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US NS Me rcy Co i n Finds New Home at WCH

From Left to Right: Lisa Erlinger, PhD, CRNA John Ancell, RN Jim Tavary, President, CEO Wickenburg Community Hospital John Ancell, a Hospital Corpsman First Class in the Navy Reserve and Surgical Center RN at Wickenburg Community Hospital (WCH), recently gifted his department a United States Naval Ship (USNS) Mercy Challenge Coin.

WCH caught up with Ancell to ask about the coin and it’s meaning.

Can you tell me about your experience and how you earned the coin?

First, Challenge Coins represent organizations, units and teams. They can also represent an achievement, an anniversary or special event. Challenge coins build close-knit, lasting bonds between people who receive them and represent unity. Challenge Coins have a long-standing tradition in military history.

For instance, many Navy commands will make a Challenge Coin to represent their command, a unit, an achievement, or a special event. High ranking officials will make a personal challenge coin that represents position at the command like a “Commanding Officer Challenge Coin” or “CO Challenge Coin.” That CO will give out this coin to his junior members as a gift for an achievement.

The USNS Mercy Coin was a Special Event Challenge Coin made for the mission that we were on. In this case,

the coin wasn’t one that you earned. Instead, you had to be on the ship in LA for that particular mission in order to purchase. I bought the coin for the hospital OR department as a gift to say thank you for their support at home and while I was on the ship.

Tell me about the role you play at WCH. How long have you been with us, and what department are you serving now?

I have been with the surgical team going on four years now. I started as a surgical tech when the Surgical Center first opened and worked PRN while I went through nursing school. Once I received my RN license, I began working at WCH in that capacity.

Can you tell me about your military background and how long were you on the USNS? As a surgical tech in the Navy, my rank is Hospital Corpsman First Class. My military experience goes back a total of nine years. Five years of Active Duty and currently in my fourth year for the Navy reserves. I served on the ship for two months after being called to help with the mission.

we are honored. Thank you for your service!

“John, - Wickenburg Community Hospital

Covid-19 Results in 15 Minutes!

Lisa Erlinger, PhD, CRNA Director of Surgical Services and Anesthesia Wickenburg Community Hospital

T

Marilyn Ward, the Surgical Center at Wickenburg Community Hospital has been fortunate in obtaining Antigen FIA, used with the 2 instrument, provides qualitative detection of the nucleocapsid protein antigen from SARS-CoV-2, permitting automated and objective results in approximately 15 minutes.

Enhanced Safety Authorized for emergency use by the FDA, this advanced testing measure has been implemented as part of the pre-surgery process at Wickenburg Community Hospital in

Explanation This virus, as with the novel coronavirus SARS-1 and MERS, is thought to have originated in bats. However, SARS-CoV-2 may have had an intermediary host such as pangolins, pigs, or civets.

The World Health Organization (WHO) declared that COVID-19 was a pandemic on March 11, 2020, and human infection has spread globally, with hundreds of thousands of time is estimated to be 5.1 days, with symptoms expected to be present within twelve days of infection. COVID-19 shares

common symptoms with other viral respiratory diseases such as fever, cough, and shortness of breath.

Process Upon being scheduled for a procedure, surgical patients are contacted by an RN trained in COVID testing to schedule day prior to their surgical procedure.

On the day of the test, patients check in to registration and are accompanied to the COVID-19 testing room. Each patient completes a questionnaire related to potential symptoms and possible exposure. After the patient's identiRN and immediately sent to the WCH laboratory.

The patient collects a nasal swab sample by carefully inserting the swab (provided in the kit) into the nostril that presents the most secretion under visual inspection. The swab is pushed into the nostril using gentle rotation until resistance is met at the level of the turbinates (less than one inch into the nostril). The swab is then rotated several times against the nasal wall before being removed. After the nasal of testing outcomes is only provided in the event of a COVID-19 positive test result. If no phone call is received, surgery may proceed as scheduled.

While testing is typically completed the day before a scheduled surgery, if testing is performed the day of surgery, entering the surgical department.

Orthopedic, Orthopedic, General General and and Podiatric Podiatric Surgery Surgeryy

Dr. Mitch Wagner Orthopedic Surgeon

Dr. Robert Ripley General Surgeon

Dr. Tanner Moore Podiatric Surgeon

928-668-5506 | wic wickhosp.com/service/surgicalcenter

Obesity and Severity of COVID-19 Written by Lisa Erlinger, PhD, CRNA

Increasing evidence indicates that obesity is an independent

have dangerously low oxygen levels. The use of a ventilator risk factor for severe illness and death from COVID-19. Often is a necessity for some but does not come without risks.

Multiple concerns are explained in the relationship a precurser to obesity, overweight is a condition identified as between weight and COVID-19. Studies have found that having body fat that exceeds what is considered healthy for an idividuals height. When the human body has an excessive the adipose tissue of overweight people may be a potential amount of body fat, the condition is identified as obesity. target and viral reservoir, leading to the severity of the infection Obesity is a complex disease leading to medical problems and longer length of spread to others. Excess body fat has that increase the human body's risk of disease and health also been shown to alter immune responses. In addition, conditions. These conditions include, but are not limited to, patients admitted to intensive care are at greater risk during heart disease, diabetes, high blood pressure, delayed wound the administration of ventilation measures to improve healing, and certain cancers. The prevalence of overweight oxygen saturation levels. This is a result of restrictive patterns and obese individuals has now reached 70% of the U.S. imposed by high body weight to the respiratory system and can lead to COPD and sleep apnea. Notably, population. overweight patients also had a longer hospital There are many reasons why some individustay. 4-6 This is especially important in recovery als may have difficulty avoiding obesity.

The balance between calories-in and definitive link from surgery.

Obesity can accompany a multitude of calories-out differs for each person, and obesibetween that may significantly impact a ty occurs over time when more calories are obesity and an comorbidities patient's recovery from elective orthopedic consumed than are used. Baring the presence surgery. Although no strict upper weight limits of medical complications such as Prader-Willi increased rate of disease and have been established that would contraindisyndrome, Cushing syndrome or others; obesicate elective orthopedic surgery, surgeons ty typically results from a combination of envihealth ronment and personal diet and exercise choiccomplications understand the unique risks overweight 1 patients face, and how to optimize and treat es. Factors that may increase one's weight each of them on an individual basis. According include overeating, eating high-fat foods, and to an article published in the American Academy of Orthopenot being physically active.

The standard index used to classify obesity in adults is called dic Surgeons, it is recommended that patients with morbid Body Mass Index (BMI). This simple index of weight-to-height obesity (BMI of 40 or higher) should be 7 advised to lose ratio is calculated by dividing one's weight in kilograms by weight before total joint arthroplasty (TJA), offered resources the square of one's height in meters. A high BMI can be an for weight loss before surgery, and counseled about the possiindicator of high body fatness. While BMI can be used as a ble complications and inferior results that may occur if they screening tool, a trained healthcare provider should perform do not lose weight.

In conclusion, there is a definitive link between obesity appropriate health assessments in order to evaluate an 2 and an increased rate of disease and health complications individual's health status and risks. that may also lead to increased risk during the COVID-19 Severity of COVID-19 Researchers have shown a dose-response relationship pandemic. The good news is that even modest weight loss between excess weight and severity of COVID-19. The can improve or prevent the health problems associated with relative risk of critical illness from Covid-19 increased by 44% obesity. Dietary changes, increased physical activity, and for people who are overweight. The risk of dying from behavior changes can improve weight loss efforts.

Now is an excellent opportunity to promote healthy COVID-19 increased with obesity severity, from a 27% higher eating and exercise habits. Try incorporating new fresh and risk in the first obesity category (body mass index (BMI) 30-34.9; to more than doubling of the risk in the most obese unpackaged foods and getting creative with exercise to raise category (BMI) >40. (BMJ 2020;369:m2237). The proportion the levels of infection-fighting white blood cells, antibodies, 8 of patients requiring invasive mechanical ventilation in a increase circulation, and decrease stress hormones.

9

There is a

study from France increased with increasing BMI and reached 90% in those with BMI > 35.3 A mechanical ventilator is a form of life support. This is used by placing a specialized tube in the airway to assist breathing in patients who are extremely short of breath and

Article & References @ wickhosp.com/blog/obesity-covid19 wickhosp.com

Quality HEALTH

& WELLNESS

13

Make emonade WHEN LIFE GIVES YOU STONES

L

Simple Healthy Lemonade Recipe: Juice One Lemon Per Cup of Cold Water Sweeten with Stevia in the Raw Garnish with mint Relax, enjoy, live healthy

By Kristy Podruchny nyone who has had kidney stones knows it’s something they never want to experience twice.

If you’ve had a stone in the past, you’re more likely to have more stones in the future. The only way to ensure you’ll never have that painful experience again is to do what you can to prevent kidney stones from developing.

The most common types of kidney stones are calcium oxalate and uric acid stones. These are formed when the right chemicals sit in concentrated urine long enough to form crystals. These crystals adhere to each other and form one or many stones. Ouch! Even if you’re predisposed to forming kidney stones, you can eat and drink your way to keeping them at bay. If you’ve had a stone, knowing what kind you’re forming is imperative to prevention.

Drink water—hydration is essential. The less

A

concentrated your urine is, the less likely you are to develop stones. Sugary drinks like soda can encourage kidney stones to develop. Fluids like water, lemonade (with little to no sugar) and coffee are all encouraged by the National Kidney Foundation (NKF). They recommend 2-3 quarts of fluid intake per day.

Certain foods can make a hospitable environment for stones. According to the NKF, there’s no specific diet to follow to prevent kidney stones, but you can choose to avoid certain foods depending on what kind of stones you develop. Avoid foods that are high in oxalate—like sweet potatoes, spinach, chocolate and peanuts—if you’re prone to developing calcium oxalate stones.

Uric acid stones are more likely to form with a diet comprised of high-purine foods like red meat, shellfish and organ meat. They need a highly acidic environment, so the NKF recommends that people who are predisposed to these types of stones should avoid alcoholic beverages.

Choose high calcium foods and aim to supplement your diet with 1000-1200 mg of calcium per day. When life hands you kidney stones, make lemonade! The natural citrate present in lemons helps prevent stones, too. Consuming 4 ounces of lemon juice daily can increase urine citrate levels, which is needed to prevent stones. Lemonade is one way to get your daily lemon juice, but beware of the sugar because it can increase kidney stone production. An all-natural lemonade is better so you can control the sugar and replace it with an all-natural sugar substitute.

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Are You at Risk? Early Detection Saves Lives love that I got you feeling when I uncover a “Isubtle cancer trying to hide among normal tissue. I hate breast cancer and go after its discovery with a vengeance.

- Dr. Nocera

Zandra S. Nocera, MD Breast Center Radiologist Wickenburg Community Hospital

OurOur Approach Approach

whywhy theythey are asked to return and and often believe thatthat an error are asked to return often believe an error I amI am the the breast breast radiologist radiologist at Wickenburg at Wickenburg Community Communitywaswas made on the original mammogram, requiring them to to made on the original mammogram, requiring them Hospital Hospital (WCH).

(WCH).

Our Our goalgoal is tois provide to provide personalized personalized and andreturn for corrective images.

Often, the the additional timetime and and return for corrective images.

Often, additional compassionate compassionate breast breast imaging imaging to each to each patient. patient.

In the In usual the usualcostcost can can leave a patient feeling agitated and and less less cooperative. leave a patient feeling agitated cooperative. setting, setting, a patient a patient withwith no breast no breast problem problem will will come come in for in afor aBy integrating a personal intervention approach, the patient By integrating a personal intervention approach, the patient routine routine screening screening mammogram, mammogram, I interpret I interpret the mammogram the mammogramis afforded an opportunity to be informed of the findings andand forward forward the the results results of my of findings my to the to the patient's patient'sand and be provided a recommendation for further action.

ThisThis be provided a recommendation for further action. referring referring physician. physician.

The The patient patient alsoalso receives receives a letter a letterrecommendation maymay come in several forms.

It may be be recommendation come in several forms.

It may informing of the result recommendation. informing her her of the result and and recommendation.

ThisThisassuring the the patient thatthat everything is normal.

I may alsoalso assuring patient everything is normal.

I may sequence sequence of events of events is the is the standard standard approach approach of handling of handlinginform her that a benign finding was found that requires no screening screening mammograms mammograms in most in most breast breast centers. centers. additional imaging or that a questionable abnormality additional imaging or that a questionable abnormality waswas Our approach at WCH differs in the handling of what is found, found, which requires sequential imaging to ensure which requires sequential imaging to ensure thatthat the the called a diagnostic mammogram.

Diagnostic mammograms called a diagnostic mammogram.

Diagnostic mammogramsfinding or lesion is benign. On the other extreme end, I may are are targeted mammograms aimed at solving a problem targeted mammograms aimed at solving a probleminform the the patient thatthat a biopsy is needed to provide a a inform patient a biopsy is needed to provide presented by the patient, suchsuch as aaspalpable lump, nipple presented by the patient, a palpable lump, nippledefinitive diagnosis. diagnosis. discharge, unexplained breast pain,pain, or aor problem found on on In the discharge, unexplained breast a problem found 33 years I have provided this this personalized breast In the 33 years I have provided personalized breast the screening mammogram.

Under these circumstances, the theservice, the screening mammogram.

Under these circumstances, it has become apparent thatthat the patient has has no idea service, it has become apparent the patient no idea mammogram becomes a targeted, problem-solving mammogram becomes a targeted, problem-solvinghowhow we come up with our our diagnosis, and and many havehave the the we come up with diagnosis, many mammogram, called a diagnostic mammogram.

Special mammogram, called a diagnostic mammogram.

Specialopinion that that the mammogram provides the complete diagnosis. opinion the mammogram provides the complete diagnosis. mammographic images are are taken in the areaarea of concern mammographic images taken in the of concernNothing could be further fromfrom the the truth.

The The diagnosis is is Nothing could be further truth. diagnosis under my my direct supervision to visualize and and assess the thearrived under direct supervision to visualize assess at byatthe careful analysis of the images and and further arrived by the careful analysis of the images further finding. Frequently an ultrasound of the breast is also investigation of suspicious findings with ultrasound as performed as an study to analyze and and characterperformed asadjunctive an adjunctive study to analyze character-needed and,and, ultimately, a biopsy of questionable abnormality. needed ultimately, a biopsy of questionable abnormality. ize the finding.

For For instance, one one of the mostmost common concerns I have instance, of the common concerns I have In our this problem-solving engages my involvement In facility, our facility, this problem-solving engages my involvementheard in speaking withwith patients is their lacklack of trust in the heard in speaking patients is their of trust in the in directing the the images obtained and and supervising the the ultrain directing images obtained supervising ultra-mammogram because theythey havehave had had a friend or relative whowho mammogram because a friend or relative sound images captured by the technician.

Once sound images captured by ultrasound the ultrasound technician.

Oncehad had a normal mammogram and and yet had breast cancer.

ThisThis a normal mammogram yet had breast cancer. all the and and ultrasound images are completed, all mammogram the mammogram ultrasound images are completed,misguided opinion provides an opportunity for for me me to to misguided opinion provides an opportunity my practice is toissee the the patient personally, do adophysical my practice to see patient personally, a physicalexplain, and and eveneven illustrate on the howhow breast explain, illustrate on mammogram, the mammogram, breast breast examination, re-ultrasound the the areaarea as necessary to tocancer breast examination, re-ultrasound as necessary can can be present and and yet not on the cancer be present yet seen not seen on mammogram. the mammogram. verify the findings, and correlate the ultrasound findings FirstFirst of all, problem occurs mostmost frequently in women of this all, this problem occurs frequently in women with the mammographic or physical findings. This personal withwith dense breasts.

A dense breast is considered one one in in dense breasts.

A dense breast is considered involvement affords me the chance to explain to the patient which the the preponderance of the make-up of the breast is is which preponderance of the make-up of the breast whywhy she she waswas recalled for this additional diagnostic imaging recalled for this additional diagnostic imagingprimarily thatthat of glandular tissue and and ducts withwith veryvery littlelittle fat. fat. primarily of glandular tissue ducts and and to inquire of other breast concerns. to inquire of other breast concerns.

In this case,case, the breast tissue shows up white or dense on on In this the breast tissue shows up white or dense I have found thatthat so many patients do not understand I have found so many patients do not understandthe mammogram because the breast tissue absorbs much of of the mammogram because the breast tissue absorbs much

the x-ray beam. The breast's fatty portion has no density to absorb the beam, so the beam passes through, leaving the area black. Since breast cancers, cysts, and benign solid tumors are derived from the breast's glands and ducts, they also will absorb the x-ray beam very much like the normal glands and ducts, therefore, showing up white on the mammogram. When the two are superimposed, it is nearly impossible to identify the offending cancer or lump on the mammogram. When the tumor grows in a fatty breast, which is displayed as black on the mammogram, the cancer is a lot easier to spot.

Interacting directly with patients gives me a chance to explain any proposed biopsy procedure and give them clear guidance on what to expect next. This one-on-one contact provides the patient with an opportunity to ask and express other breast concerns. Over the past 33 years that I have been a practicing breast radiologist, this one-on-one approach has been my practice for delivering breast care.

cancer can hide behind the dense breast tissue. With 3D imaging, many slices are taken throughout the entire breast, allowing the evaluation of each layer of breast tissue unveiling hidden cancers.

Furthermore, in many cases, normal tissue layers are stacked on each other, creating an abnormally dense or white area on the mammogram, giving the illusion that cancer may be present.

When this occurs, we, as radiologists, must pursue that dense area and are forced to recall the patient to get additional views. We do focused compression images over the suspected area in an effort to separate the tissue and unveil a potentially hidden cancer.

In many cases, this also invokes an obligatory ultrasound that uses utterly different imaging physics to look at the breast. With this modality, solid and cystic masses interact differently with the ultrasound beam, creating a different image. For example, solid masses absorb the ultrasound beam and show up with a grey image, whereas fluid material does not absorb any of the beams, leaving a hole or black area in the tissue.

On the contrary, because many slices are taken throughout the entire breast, a 3D mammogram often shows no mass but merely a summation of normal glandular tissue, requiring scrutiny of each layer by the radiologist. This method often obviates the need for a callback examination. I feel the 3D mammogram adds to our detection rate and decreases our call back rate for re-evaluation.

Surprisingly, many women are more alarmed by breast pain than breast lumps.

Why I Chose to Practice at WCH After completing my residency, I was privileged to work under the apprenticeship of Dr. Avi Ben Ora, formerly of the then Good Samaritan Hospital. He was a key pioneer in the community in the use of film-screen imaging for mammography over the former xeromammography. Dr. Ora was committed to the art of breast imaging, utilizing breast ultrasound and light scan imaging as adjunctive investigative tools. His passion was contagious, and as I ventured into starting my practice in 1987, breast imaging was at the forefront. At Wickenburg Community Hospital, the staff and administrative board shared the same passion for providing quality services. The hospital culture was focused on delivering quality, individualized service, and was not just interested in volume production.

The hospital also enjoys the support of the locally formed Pink Ribbon Angels, which not only supports quality care but also provides financial support for those unable to afford breast care. This support is God sent. I was recently analyzing the mammogram of a woman in the Phoenix area whose mammogram showed advanced breast cancer with multifocal bilateral disease and extensive unilateral lymphadenopathy.

Upon further investigation, I found out that this was a grandmother who bore the financial burden of taking care of her grandkids and, although aware of the lump for two years, was financially unable to obtain medical treatment. My thought was, "If only there were an organization like the Pink Ribbon Angel Program in her area."

Impact of 3D Mammography

3D mammography has benefitted the screening program in detecting breast cancer, particularly in patients with dense breasts. In the dense breast, there are multiple layers of superimposed breast tissue, which creates a setting where

Risk Factors & Tools

Ask Your Doctor About 3D Mammography with Comfort Paddle

The most well-understood risk factor for breast cancer is the lifetime exposure to endogenous estrogen and, as with all cancers, any damage to the immune system or DNA. Most people are familiar with the frequently listed contributors to increasing endogenous estrogen, like weight gain, alcohol intake, inadequate exercise, smoking, sleep deprivation, and its consequent low melatonin levels.

Although they may affect your risk factor, these factors are not controllable in preventing breast cancer. For instance, you can prevent lung cancer by not smoking, but there is no such behavioral change that can prevent breast cancer. If you are destined to get breast cancer, you will get it, and there is no known way to avoid it. That's the bad news. The good news is that if the cancer is detected and removed when it is small, the total cure rate is very high. Therefore, the key to survival is detection, not prevention.

To date, by far, the best tool we have for early detection is mammography! The gold standard is mammography supplemented with targeted ultrasound and sometimes MRI. I ascribe the ACR guidelines, which are annual screening mammograms beginning at age 40 for asymptomatic women. For patients who fall into the high-risk group, screening may begin as early as age 30. In addition, comparison is vital, and the images should optimally be compared with at least three prior exams.

The lifestyle risk factors mentioned above are likewise risk factors for general health, and adopting a change in lifestyle is beneficial for many diseases. My personal favorite is a dietary modification to build the immune system through food choices and supplements. However, in breast health, our focus MUST be on preventing death from breast cancer by focusing on early detection.

Signs & Symptoms to Initiate a Screening

Any change in your breast that concerns you; a lump, nipple discharge, change in the appearance of your nipples such as inversion or red or scaly areolar tissue, change in the skin overlying your breast, such as redness, prominent pores with an orange peel appearance—should trigger a trip to your doctor for evaluation. These are but some of the many possible signs and symptoms of breast cancer, but far and away, the most important concern would be a lump in the breast, particularly a painless lump.. This is the reason self-examination is strongly advised. Breasts are often lumpy. If you never do a breast self-examination, examining the breasts for the first time can be a scary venture. When you become familiar with your breast's topography, you are more likely to detect a lump. Many breasts are so lumpy that even with frequent exams, lump detection is near impossible.

Along this line, many patients have revealed that they don't examine their breasts because they don't know how. First of all, there is no magic formula for examining the breast. The whole idea is to get coverage, whether you feel in circles, up and down, zig-zag, or diagonal. As you do this, realize that you may very well not detect any lump. However, it is the best tool we have in between our yearly mammogram. Applying a topical lotion, soap, baby oil, or even putting on a T-shirt

facilitates easier detection of lumps.

Surprisingly, many women are more alarmed by breast pain than breast lumps. Note that of all the changes in the breast, breast pain, particularly generalized breast pain, does not rank high on the list as an indicator of breast cancer. Most generalized breast pain is due to hormonal or cyclical changes.

Dietary substances such as caffeine and certain supplements and medication may also be a contributor. Less thought about, but relatively common, is a musculoskeletal origin of generalized breast pain, such as costochondritis.

Costochondritis is an inflammation of the cartilage attached to the end of the ribs. Whenever I see a patient presenting with unbearable breast pain, I can almost always predict that costochondritis is the underlying cause. A quick examination and activation of trigger points, generally along the lateral mid rib cage, the cartilage under and inferior to the breast, and along the sternum, replicates the breast pain and usually elicits a loud "ouch" from the patient. This pointed tenderness confirms the musculoskeletal origin and indicates that the pain is not arising from the breast or due to breast cancer. This feedback is often relieving to the patient, and she can leave the office knowing that her problem has been addressed.

The Impact of COVID-19 / Coronavirus

This unprecedented pandemic has challenged the performance of all industries, medicine being no exception. All practices have cut back on staff and some continue to practice through telemedicine. I believe common sense should be utilized in making a health decision. Certainly, if you are in a high-risk area, your thought process will be more prolonged. But as it is in all of medicine, decision making comes from weighing the risks and the benefits.

Being cognizant of patient concerns and the importance of continued patient care, Wickenburg Community Hospital has implemented enhanced infection practices in keeping with CDC guidelines. Temperature checks are made at the door upon entry, housekeeping has increased sanitation measures, and all staff and patients wear masks, which decreases the chance of unwittingly transferring or becoming affected by an asymptomatic carrier.

If you consider that mammography's purpose is to allow for early detection of breast cancer, a prolonged delay in obtaining the mammogram puts you at risk of discovering breast cancer at a more advanced, less easily treatable stage.

™

WHAT CAN I DO TO REDUCE MY RISK OF

Breast Cancer?

Cancer - the dreaded word. It changes lives in an instant.

While some risk factors, such as family history, can't be changed, there are lifestyle changes you can make to lower your risk.

• Limit alcohol. The more alcohol you drink, the greater your risk of developing breast cancer. The general recommendation is to limit yourself to less than one drink a day, as even small amounts increase risk.

• Don't smoke. Evidence suggests a link between smoking and breast cancer risk, particularly in premenopausal women.

• Control your weight. Being overweight or obese increases the risk of breast cancer. This is especially true if obesity occurs later in life, particularly after menopause.

• Be physically active. Physical activity can help you maintain a healthy weight, which helps prevent breast cancer.

Most healthy adults should aim for at least 150 minutes a week of moderate aerobic activity or 75 minutes of vigorous aerobic activity weekly, plus strength training at least twice a week.

• Breast-feed. Breast-feeding might play a role in breast cancer prevention. The longer you breast-feed, the greater the protective effect.

• Limit dose and duration of hormone therapy.

Combination hormone therapy for more than three to five years increases the risk of breast cancer. If you're taking hormone therapy for menopausal symptoms, ask your doctor about other options. You might be able to manage your symptoms with nonhormonal therapies and medications. If you decide that the benefits of short-term hormone therapy outweigh the risks, use the lowest dose that works for you and continue to have your doctor monitor the length of time you're taking hormones.

• Avoid exposure to radiation and environmental pollution. Medical-imaging methods, such as computerized tomography, use high doses of radiation. While more studies are needed, some research suggests a link between breast cancer and cumulative exposure to radiation over your lifetime. Reduce your exposure by having such tests only when absolutely necessary.

This and more information on Breast Cancer Prevention can be found at mayoclinic.org.

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IPREVENTION N F EC TIO N Karen Smith, RN, NMCC, LSSGB Manager, Infection Prevention & Employee Health Wickenburg Community Hospital

ItIt isis always alwaysimportant importantto tofollow followpractices practicesthat thatprevent prevent the spread of germs. germs. Standard Standard precautions precautions include includestaystaying home when feeling ill, ill, covering covering aa cough cough or or sneeze, sneeze, and proper handwashing, which includes these five steps: 1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.

2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.

3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.

4. Rinse your hands well under clean, running water.

5. Dry your hands using a clean towel. Turn tap off with towel.

If your hands are not visibly visibly dirty dirty or or ififsoap soapand andwater waterare are not available, available, use usean analcohol-based alcohol-basedhand handsanitizer sanitizerwith with at at least least 60% 60% alcohol alcohol using using these these three three steps: steps: 6. Apply the gel product to the palm of one hand (read the label to learn the correct amount).

7. Rub your hands together.

8. Rub the gel over all the surfaces of your hands, including between your fingers, until your hands are dry. This should take around 20 seconds.

During During viral viral respiratory respiratory illness illnessoutbreaks, outbreaks,the theimporimportance of infection prevention prevention isis heightened. heightened. There There are are added precautions, such as the the use use of of personal personal protecprotective equipment and limiting limiting contact contact with with those those outside outside of your household, especially ifif you you are are in in aa high-risk high-risk

group groupeven evenwhen whenno nosymptoms symptomsare areapparent. apparent.When Whenout out in in public, public, ititisisimportant importantto tomaintain maintainatatleast leastsix sixfeet feetofof distance distance from others othersand andwear wear a mask a mask or cloth or cloth face coverface covering ing to help to keep help your keepgerms your from germs spreading from spreading to otherstoor others contracting or contracting germs from germs those from around thoseyou. around you.

Current CurrentRespiratory Respiratoryoutbreaks outbreaksinclude includeCOVID-19 COVID-19and and the the Flu. Flu. IfIfone onedoes doesbecome becomeill, ill,ititisisimportant importanttotoknow know when when to toseek seekmedical medicalattention. attention.IfIfyou youhave haveworsening worsening symptoms, symptoms,especially especiallydifficulty difficultybreathing, breathing,call callyour your healthcare healthcareprovider, provider,or orseek seekmedical medicalattention. attention.

In Inadults, adults,emergency emergencywarning warningsigns signsinclude: include:** ••Difficulty Difficultybreathing breathingor orshortness shortnessof ofbreath breath ••Persistent Persistentpain painor orpressure pressurein inthe thechest chest ••New Newconfusion confusionor orinability inabilityto toarouse arouse ••Bluish Bluishlips lipsor orface face **This Thislist listisisnot notall-inclusive. all-inclusive.Please Pleaseconsult consultyour yourmedical medical provider providerfor forany anyother othersymptoms symptomsthat thatare aresevere severeor orconcerning. concerning.

Before Beforeyou yougo gototoaadoctor’s doctor’soffice officeororemergency emergencyroom, room, call callahead aheadto toinform informthem themabout aboutyour yoursymptoms symptomsand andany any recent recenttravel. travel.Calling Callingahead aheadhelps helpsprepare preparefor foryour yourarrival arrival so sothat thatsteps stepscan canbe betaken takentotoreduce reducesymptom symptomexposure exposure to tohealthcare healthcareworkers workersand andother otherpatients. patients.

Adults over 65 and andindividuals individualswho whohave havechronic chronicmedical medical conditions, conditions, likelike heart, heart, lung lung disease diseaseand anddiabetes, diabetes,are areat at higher higherrisk riskfor formore more serious serious COVID-19 illness. illness. IfIfyour your symptoms symptomsworsen, worsen,especially especiallyififyou youhave havetrouble troublebreathbreathing, ing,remember rememberto toseek seekmedical medicalcare careimmediately. immediately. wickhosp.com

Quality HEALTH

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s e i t i r a l i Sim

aanndd

SIGNS & SYMPTOMS

Similarities Both COVID-19 and flu can have varying degrees of signs and symptoms, ranging from no symptoms (asymptomatic) to severe symptoms. Common symptoms of COVID-19 and flu include: • Fever or feeling feverish/chills • Cough • Shortness of breath or difficulty breathing • Fatigue (tiredness) • Sore throat • Runny or stuffy nose • Muscle pain or body aches • Headache • Some people may have vomiting and diarrhea, though this is more common in children than adults.

Differences- COVID May include change in or loss of taste or smell.

COVID-19

Differences- Flu

flu

Flu viruses can cause mild to severe illness, including the common signs and symptoms listed to the right.

HIGH-RISK FOR SEVERE ILLNESS

Differences- COVID

COVID-19

School-aged children infected with COVID-19 are at highest risk of Multisystem Inflammatory Syndrome in Children (MIS-C), a rare but severe complication of COVID-19.

Differences- Flu Young children are at higher risk of severe illness from flu.

flu

Similarities

Both COVID-19 and flu illness can result in severe illness and complications. Those at highest risk include: • Older adults • People with certain underlying medical conditions • Pregnant people

For more information on Flu vs. COVID-19 visit: WICKHOSP.COM/BLOG/FLU_COVID

s s e e c c n n e e r r e e f f DDiiff VID -19 F LU v s . C O

spreading the virus

Similarities

For both COVID-19 and flu, it is possible to spread the virus for at least 1 day before experiencing any symptoms.

Differences- COVID This is still under investigation.

It’s possible for people to spread the virus for about 2 days before experiencing signs or symptoms and remain contagious for at least 10 days after signs or symptoms first appeared. If someone is asymptomatic or their symptoms go away, it’s possible to remain contagious for at least 10 days after testing positive for COVID-19.

COVID-19

Differences- Flu flu

Most people with flu are contagious for about 1 day before they show symptoms.

Older children and adults with flu appear to be most contagious during the initial 3-4 days of their illness but many remain contagious for about 7days. Infants and people with weakened immune systems can be contagious for even longer.

APPROVED TREATMENTS T

Similarities

People at high-risk of complications or who have been hospitalized for COVID-19 or flu should receive supportive medical care to help relieve symptoms and complications.

Differences- COVID The National Institutes of Health (NIH) has developed guidance on treatment of COVID-19, which will be regularly updated as new evidence on treatment options emerges. While remdesivir is an antiviral agent that is being explored as a treatment for COVID-19 and is available under an Emergency Use Authorization (EUA), there are currently no drugs or other therapeutics approved by the Food and Drug Administration (FDA) to prevent or treat COVID-19. Studies are in progress to learn more.

COVID-19

Differences- Flu Prescription influenza antiviral drugs are FDA approved to treat flu. People who are hospitalized with flu or at high-risk of flu complications with flu symptoms are recommended to be treated with antiviral drugs as soon as possible.

flu

WEST VALLEY COLON & RECTAL SURGERY CENTER

Our experienced surgical team is committed to providing the best quality and most advanced care. We treat patients in the Sun City and the greater Phoenix area. We specialize in treating colon and rectal diseases and disorders.

Our team of doctors consists of the few board certified colon and rectal surgeons in the Valley area. Our whole team has received specific and expert training in the care of a wide variety of issues. You can count on receiving the best care and compassionate service from our colorectal surgeons and staff.

TYPES OF COLORECTAL TREATMENTS AND SURGERIES At the West Valley Colon & Rectal Surgery Center, we offer a wide variety of services and procedures for colorectal patients. The advanced treatment methods we have available allow us to better accommodate your specific need. This is a partial list of our services including:

Screening Colonoscopy High-sensitive fecal occult blood tests (FOBT) Crohn’s Disease Ulcerative Colitis Diverticulosis and Diverticulitis

Hemorrhoid Treatment Bowel incontinence Virtual colonoscopies Abscess drainage

Robotic Minimal Invasive Surgery Fissure treatment Sphincter sparing rectal surgery Fecal incontinence and Anorectal Pilonidal disease treatment

Dr. Najafian & Dr. Pandey

now seeing patients in Wickenburg

Dr. Sushil Pandey MD, FACS, FASCRS

Surgery Center

Dr. Hadi Najafifia an DO, FACS, FASCRS

10503 W Thunderbird Blvd. Suite # 372 Sun City, AZ - 85351

Dr. Paravasthu Ramanujam MD, FACS, FACG, FASCRS

Dr. Arthur Yushuva MD, FACS, FASCRS

Wickenburg Clinic 519 Rose Lane Wickenburg, AZ 85390

623.875.7330

www.westvalleycrs.com

Ingredients • 2 Tablespoons Chia Seeds • ½ Cup Milk of Choice; Cows, Almond, Oat, Coconut, Cashew, etc.

• 1 Teaspoon Sweetener of Choice; Sugar, Maple Syrup, Agave, Honey, etc.

• ¼ Teaspoon Vanilla • ¼ Teaspoon Cinnamon • Fresh Fruit, Nuts, etc. for Topping

Featuring nutrient-rich chia seeds, this easy make ahead pudding is loaded with heart healthy fiber, anti-oxidants and omega-3 fatty acids.

Directions

1. Pour milk into a ½ pint sized jar or container with a tight-fitting lid.

2. Add remaining ingredients and stir well to combine.

3. Refrigerate at least 2 hours, shake jar a few times.

4. Top with fresh fruit, nuts, etc.

In Need of a Meal Plan? Call Debra Loder, RDN 928-668-1811 Gather a few slices of your favorite bread, some leafy greens, mash an avocado to spread if you like, and this is one great sandwich. Full of protein, fiber, texture and flavor!

Basic Recipe

Use your favorite Egg Salad, Chicken Salad, or Tuna Salad recipe. Substitute drained and rinsed Garbanzo Beans for the protein source. For class we used finely shredded carrot, green onion, dill relish, mayonnaise and seasonings.

Make it Vegan You can use Vegan Mayonnaise or Avocado that is mashed/blended until completely smooth.

Wickenburg Community Hospital

with Debra Loder, RDN Wickenburg Community Hospital

something that you might want to change to align your diet It’salways not always when or why we should out thesomething that you might want to change to align your diet Iexpertise t’s not clearclear when or why we should seekseek out the of a Registered Dietitian Nutritionist. Debra Loder, with your nutrition goals. We will discuss changes you might

with your nutrition goals. We will discuss changes you might expertise of a Registered Dietitian Nutritionist. Debra Loder, want to consider. Helping you set reasonable goals for at Wickenburg Community Hospital, provides answerswant to consider. Helping you set reasonable goals for RDNRDN at Wickenburg Community Hospital, provides answers improving diet, losing weight, improving labs, or other goals to some frequently asked questions. improving diet, losing weight, improving labs, or other goals to some frequently asked questions. that you may have. Accountability is one of the things that that you may have. Accountability is one of the things that can be hard when trying to make dietary changes. You can is a Registered Dietitian Nutritionist (RDN), WhatWhat is a Registered Dietitian Nutritionist (RDN), and and whatwhatcan be hard when trying to make dietary changes. You can speak to an RDN about how you are doing, just like you isdifference the difference between an RDN a Nutritionist? speak to an RDN about how you are doing, just like you is the between an RDN and and a Nutritionist? would talk to your physician about your goals. Those discuswould talk to your physician about your goals. Those discusDietitian is a Nutritionist, butevery not every Nutritionist EveryEvery Dietitian is a Nutritionist, but not Nutritionist is is sions can help you be more accountable and meet your goals. a Dietitian.

To become an RDN, a 4-yearsions can help you be more accountable and meet your goals. a Dietitian.

To become an RDN, one one mustmust havehave a 4-year degree in dietetics or nutrition, complete an internship We hear that eating a healthy diet can help strengthen our degree in dietetics or nutrition, complete an internship hear that eating a healthy diet can help strengthen our program, and pass a board-certified national examination.We immune system to help us fight off viruses and diseases. program, and pass a board-certified national examination. immune system to help us fight off viruses and diseases.

In addition, an RDN must complete 75 hours of continuing In addition, an RDN must complete 75 hours of continuing This is important today as we face COVID, other viruses, education five years.

This is important today as we face COVID, other viruses, education everyevery five years. and flu and cold season. A healthy diet, along with regular a long we were referred as Registeredand the the flu and cold season. A healthy diet, along with regular For aFor long time,time, we were just just referred to astoRegistered exercise, can help you maintain a healthy weight. All three Dietitians, Academy for Nutrition Dieteticsexercise, can help you maintain a healthy weight. All three Dietitians, but but thenthen Academy for Nutrition and and Dietetics work together to strengthen your immune system and are added the word Nutritionist to make sure all bases were work together to strengthen your immune system and are added the word Nutritionist to make sure all bases were critical in defending against disease. A diet rich in phytochemicals, covered.

Some people call themselves "Nutritionists"; they critical in defending against disease. A diet rich in phytochemicals, covered. Some people call themselves "Nutritionists"; they which are essential food compounds, is very important to the may have a degree or may not have any education and may which are essential food compounds, is very important to the may have a degree or may not have any education and may immune system. We are finding more and more that the stillthey say they are Nutritionists.

To make youtalking are talking system. We are finding more and more that the still say are Nutritionists.

To make sure sure you are to toimmune immune system and these phytonutrients work together to someone who is giving you excellent nutrition advice, seek immune system and these phytonutrients work together to someone who is giving you excellent nutrition advice, seek help fight inflammation. Inflammation is damage to our out a Registered Dietitian Nutritionist. help fight inflammation. Inflammation is damage to our out a Registered Dietitian Nutritionist. bodies that causes pain and other complications. For instance, bodies that causes pain and other complications. For instance, arthritis and surgical scarring are examples of inflammation. role does medical nutrition therapy in preventivearthritis and surgical scarring are examples of inflammation.

WhatWhat role does medical nutrition therapy play play in preventive Phytonutrients really help defend our body against inflammation medicine and disease management?

Phytonutrients really help defend our body against inflammation medicine and disease management? and help improve our immune system. Thus, helping prevent and help improve our immune system. Thus, helping prevent Medical nutrition therapy is what an RDN it is what or lessen the effects of COVID, other viruses, or other diseases.

Medical nutrition therapy is what an RDN does;does; it is what or lessen the effects of COVID, other viruses, or other diseases. we do.

Meaning we are basing that therapy on how medicine we do. Meaning we are basing that therapy on how medicine nutrition together.

An RDN a patient How would one know what vitamins they lack in their diet? and and nutrition workwork together.

An RDN can can teachteach a patient How would one know what vitamins they lack in their diet? how their diet affects any disease they may have.

Diabetes, how their diet affects any disease they may have. Diabetes, There are a few ways we can detect vitamin and mineral disease, and kidney disease few examples.

But we There are a few ways we can detect vitamin and mineral heartheart disease, and kidney disease are aare fewa examples.

But we deficiencies. One way is through lab tests; you can ask your deficiencies. One way is through lab tests; you can ask your prevent disease.

We hear the term "diabetes also also helphelp prevent disease.

We hear the term "diabetes runsruns in in medical provider to discuss this option with you. They will do medical provider to discuss this option with you. They will do my family."

If that is the case and you don't have diabetes, an my family." If that is the case and you don't have diabetes, an blood work that will show if you lack any vitamins or minerals. blood work that will show if you lack any vitamins or minerals.

RDN can help you change your diet and exercise program so RDN can help you change your diet and exercise program so The two I think about right now are vitamin B12 and vitamin The two I think about right now are vitamin B12 and vitamin get diabetes.

Helping manage that that you you may may not not get diabetes.

Helping you you manage or or D. Those are important vitamins to pay attention to, especially D. Those are important vitamins to pay attention to, especially prevent disease through proper nutrition are examples prevent disease through proper nutrition are examples of of as we get older. Another thing you can do is keep a food as we get older. Another thing you can do is keep a food medical nutrition therapy. journal and review that with an RDN. The RDN can help determine medical nutrition therapy. journal and review that with an RDN. The RDN can help determine what vitamin and minerals you may be lacking. For example, if you can seeing an RDN benefit nutrition lifestyle? what vitamin and minerals you may be lacking. For example, if you HowHow can seeing an RDN benefit youryour nutrition lifestyle? never drink milk, you might lack calcium. So, we can help you find never drink milk, you might lack calcium. So, we can help you find There are a few things we can do based on how you are foods that are good sources of specific vitamins and minerals and There are a few things we can do based on how you are foods that are good sources of specific vitamins and minerals and eating now.

Using a food journal, we look to see if we find recommend a supplement if necessary. eating now. Using a food journal, we look to see if we find recommend a supplement if necessary.

blood test,test, which is aispicture of your blood glucose over blood which a picture of your blood glucose over What should I bring to my appointment withwith an RDN? What should I bring tofirst my first appointment an RDN?A1CA1C thethe lastlast three months.

If that comes back andand thethe doctor sayssays three months.

If that comes back doctor GoodGood question.

If you a current set ofsetlab you you question.

If have you have a current oftests, lab tests, your blood glucose is high andand your A1CA1C is high, then youyou your blood glucose is high your is high, then can bring those.

I loveI love it when a patient brings theirtheir last set can bring those. it when a patient brings last set might want to make an appointment to see an RDN. might want to make an appointment to see an RDN. of labs in a folder ready for me The next thingthing is a is a of labs in a folder ready forto mereview. to review.

The next Another thing your doctor might talktalk to you about is your Another thing your doctor might to you about is your weight history.

When I seeIasee patient for the I always weight history.

When a patient forfirst the time, first time, I always blood lipids, which areare your cholesterol andand triglycerides.

YouYou blood lipids, which your cholesterol triglycerides. ask them about theirtheir highest and and lowest weight as anasadult ask them about highest lowest weight an adult might want to see an an RDN if your doctor sayssays youyou need to to might want to see RDN if your doctor need and ifand they havehave lost or gained weight in theinlast months. if they lost or gained weight thethree last three months. watch your fat intake to get your lipids in line. watch your fat intake to get your lipids in line.

FromFrom there, we can why why that that might be. For there, we discuss can discuss might be.example, For example, Other reasons to make an appointment with an RDN would Other reasons to make an appointment with an RDN would somesome elderly patients will lose weight unintentionally, so we elderly patients will lose weight unintentionally, so we be be for for weight or appetite concerns, food cravings, or worry weight or appetite concerns, food cravings, or worry will want to explore reasons for that and look at ways to help will want to explore reasons for that and look at ways to help about thethe quality of your diet.

Those areare all excellent reasons about quality of your diet.

Those all excellent reasons themthem regain, or ator least stop,stop, the weight loss. loss. regain, at least the weight to see an RDN. Right now, a lot of us stress eating duedue to to to see an RDN. Right now, a lot of are us are stress eating A food journal is anisimportant thingthing to have to review so so A food journal an important to have to review COVID. I have heard people refer to the COVID fifteen, meanCOVID. I have heard people refer to the COVID fifteen, meanwe can out what you you usually eat and whatwhat you you may may we figure can figure out what usually eat and inging people areare gaining an average of fifteen pounds because people gaining an average of fifteen pounds because wantwant to change.

I always do what we call 24-hour diet recall. to change.

I always do what weat call at 24-hour diet recall. they areare stressed about COVID. An An RDN cancan help youyou make a a they stressed about COVID. RDN help make So, we together and go whatwhat you ate breakfast, lunch, So,sitwe sit together andover go over youatate at breakfast, lunch, meal plan thatthat focuses on on good nutrition andand cancan help youyou meal plan focuses good nutrition help dinner, and and snacks for the day. day.

But that is only one one dinner, snacks for previous the previous But that is only with strategies to help control stress eating andand improve your with strategies to help control stress eating improve your day, day, so I love it when someone keeps a record of five seven so I love it when someone keeps a record ofto five to seven health. health. days,days, especially if they record whatwhat theythey eat during the week especially if they record eat during the week and over the weekend sincesince we tend to eat on the and over the weekend we tend todifferently eat differently on the DoDo I need a doctor's referral to make an an appointment?

I need a doctor's referral to make appointment? weekend. weekend. cancan always make an appointment with an RDN without always make an appointment with an RDN without The next thingthing I recommend is anisopen mind.

Talking about The next I recommend an open mind.

Talking about YouYou However, if you want to submit to your insurance a referral.

However, if you want to submit to your insurance nutrition can be for some people because people nutrition canuncomfortable be uncomfortable for some people because people a referral. it isitaisgood ideaidea to have a referral from your doctor, company, a good to have a referral from your doctor, tendtend to think RDN's may may judge themthem based on what theythey eat. eat. company, to think RDN's judge based on what who has a specific code that describes the diagnosis related who has a specific code that describes the diagnosis related ThatThat is notisthe at all.atWe judge; we just to help. notcase the case all.don't We don't judge; wewant just want to help. nutrition health.

I amI am currently credentialed withwith Medicare to your nutrition health. currently credentialed Medicare So, ifSo, youif come withwith an open mindmind and aand willingness to work you come an open a willingness to work to your Humana, andand Aetna/Coventry & First Health.

Of course, Cigna, Humana, Aetna/Coventry & First Health.

Of course, withwith an RDN and and provide feedback, that that is a is really goodgood Cigna, an RDN provide feedback, a really private paypay is an as well.

If you callcall to make an appointprivate is option an option as well.

If you to make an appointthing.

We just that that open-mindedness. thing.

We love just love open-mindedness. ment, we we cancan go go through anyany insurance questions youyou may ment, through insurance questions may HowHow do you know when it's time to make an appointment do you know when it's time to make an appointment have. have. to see to an seeRDN? an RDN? Another goodgood question.

ThereThere are some obvious things.

Another question. are some obvious things.

Blood glucose is one of them.

Suppose youryour doctor has said Blood glucose is one of them.

Suppose doctor has said youryour blood glucose is a little highhigh and and orders a hemoglobin blood glucose is a little orders a hemoglobin

Nutrition Education 2020/2021 Schedule - Free Classes!

Facebook Live | facebook.com/WickenburgCommunityHospital/events

October 28, 2020: Cooking Oils; Facts & Fiction November 18, 2020: Fall Foods; Delicious & Nutritious December 16, 2020: Safe & Healthy Holiday Tips January 20, 2021: Health at Every Size February 17, 2021: Omega 3 & Omega 6 Fatty Acids March 17, 2021: Nutrition & the Immune System Phone: 928-668-1811 | wickhosp.com/blog/nutrition-education-series

gardening

GROWING CITRUS TREES IN

S T PO

By Nellie Palmer

Step One:

Choosing Your Citrus Tree Some larger or standard sized citrus varieties can be challenging to grow for long periods in containers due to their eventual size and vigorous root growth. Dwarf varieties typically grow to a mature height of about twelve feet tall, and are far better suited to the container life. Some dwarf varieties include Dwarf Persian Lime, Dwarf Improved Meyer Lemon, and Dwarf Moro Blood Orange. Calamondin Oranges and Kumquats are

A CITRUS TREE CAN PROVIDE AMAZING AND NUTRITIOUS FRUIT THAT YOU CAN SIMPLY PICK, PEEL, AND EAT. THIS ENTICING IDEA OFTEN LEADS PEOPLE TO WONDER IF CITRUS CAN BE GROWN IN A POT OR CONTAINER. THE ANSWER IS YES. WITH A SUNNY SPOT AND A LARGE POT, YOU CAN GROW LEMONS, ORANGES AND MORE.

also great specimens of citrus to grow in a pot at home. Dwarf citrus can be pruned to even smaller stature if necessary. Choose the best tree for you, and then follow these remaining steps to successfully grow your own containerized citrus trees.

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Step Two: Choosing The Pot For Your Citrus Tree

New, young citrus trees come in small, but often deep, nursery pots. When you are selecting a pot to move your new tree into, choose one that is slightly larger than the pot the tree came in. All new pots that you use to grow citrus must have adequate holes in the bottom for drainage. A basic starting point for most new container grown citrus is a three-gallon sized pot. Three-gallon pots are usually about nine inches in diameter and ten inches tall. A new tree can typically live in this size pot for up to two years. At two years, when roots appear at the drainage holes, move the tree up to a six or seven gallon pot. As long as the next container is at least two inches bigger by depth and circumference, it will be fine. Re-pot your tree in this manner every two years until you reach a container size of about twenty gallons. Plastic nursery pots are durable and light, while clay or fiberglass pots can be more attractive, but heavier to move.

Step Three: Potting Your Citrus Tree

When you are ready to pot your tree, place enough well draining soil in the bottom of the pot to position the surface of the new tree’s root ball about two inches below the pot rim.

Remove the original pot and inspect the root ball. Cut away any obviously dead roots or roots that have grown into extreme coils within the pot. If the roots are densely packed, loosen them by gently prying them apart.

There is no need to fully untangle the roots. Simply loosen them a bit if needed. Begin to fill the pot with soil and fully cover the root system. Stop at the halfway point, water the soil and then continue to fill the container the rest of the way. Fill the soil up to a point where the surface of the

tree’s previously potted root ball is at the level of the new soil. Leave about two inches of space between the top of the soil and the pot rim. This will allow you to water the tree properly.

Do not bury the root ball deeply, or stack soil over the trunk base. Water the newly potted citrus tree well and let it drain.

Step Four: Watering Your Potted Citrus Tree

Citrus roots like moist but not soggy conditions. The watering needs of citrus are different when they are in pots because the roots will dry out more quickly. Use a moisture meter to determine when its time to water.

Water until it begins to drain out of the drain holes. Pay attention to the foliage. Leaves that are wilted and perk up after watering are a sign of roots that have been allowed to dry out too much. Water more often.

Yellow or curled leaves that do not improve after watering may mean they are getting too much water, so water less.

Step Five: Citrus

Trees Need Regular Fertilizer

The more frequent watering required, the more your fertilizer will wash through the soil. Use slow-release granular citrus fertilizers that contain trace minerals like iron, zinc and manganese. Follow the label instructions for amounts needed.

Yellow leaves can be a sign of lack of fertilizer.

Step Six: Prune Dead Branches

Prune in the spring, after the chance of freeze has passed and before new growth appears.

For more information on growing potted citrus trees, go to growinginthegarden.com and find tips from Angela Judd, Master Gardener

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29

mighty kids

r e n e t s i L d o o G A B Teaching Kids the Art of Being

By Juliane Morris

ecoming a genuinely good listener is a common human lifelong goal -- with areas for ever-improvement, right? As a relationship building life skill, listening requires practice, time and feedback to develop. A good listening skillset is something that we typically expect with maturity and enjoy to see demonstrated in our own circles, whether among friends, at work meetings with colleagues, or in challenging political or moral discussions between exploring individuals.

Cultivating the art of listening and improving listening skills in children means developing the ability to critically listen effectively by processing and responding to provided information.

Properly equipping children from a young age with the necessary listening skills helps ensure more successful personal and professional relationships.

Listening etiquette like keeping quiet and sitting still can be a challenge for little ones. The important thing is to provide many different listening and listening response opportunities.

Children enjoy hearing stories, and telling stories. Select topics of interest to the child – topics of daily exposure, games, foods, activities of enjoyment.

Model that you are listening by responding during a pause to state back a portion of what you heard in your own words, and ask a follow up question. Set reasonable expectations about active listening skills like mak-

Keep in mind that your listening training should be informal and casual.

30

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ing eye contact, nodding on occasion, encouraging remarks like, “Ah ha” or, “Mmm-hmm”, and asking appropriate follow up questions that demonstrate your own active listening.

Keep in mind that your listening training should be informal and casual.

Be intentional, creative and encouraging.

Provide gentle and constructive direction and guidance.

While teaching children to become better listeners, ask questions like these: • What would you like to learn more about?

• What was the best thing about school today?

• What book or game have you been enjoying lately?

• What goal are you working towards?

• Tell me about your day today.

• What is happening tomorrow?

You can also suggest the two of you talk about a particular topic such as: • Discussing an item in the news or current affairs topic • Sharing with one another a character trait you can be working on • Exploring ideas about a weekend getaway • Planning a household improvement project together • Explaining a new board game or school game The effort of practicing creativity and intentionality to help children develop great listening skills is a reward for families, society and your children as they grow.

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www.TheGoodDentistWickenburg.com Monday - Thursday 7 a.m. to 5 p.m.

Friday by appointment - 928-684-1000

There is a refreshing leadership team guiding our exemplary nurses at Wickenburg Community Hospital and Clinics. With a combined experience of 299 years in healthcare and leadership, these professionals are leading the way to ensure quality, individualized, compassionate healthcare is received by every patient who comes to Wickenburg Community Hospital and Clinics.

As part of the vision to provide World Class Healthcare, the charge of these leaders is to ensure all nursing candidates are meticulously selected to demonstrate an exceptional nursing skillset and provide the best fit for our community and customer service orientated focus. Please read further to learn a little bit more about these unique professionals who make up our extraordinary nursing leadership team.

Jodie Allen, RN, MSN, Emergency Department Nurse Manager - Jodie brings extensive emergency and trauma care leadership to Wickenburg Community Hospital honed from her experience at multiple hospitals accross the nation with an emphasis on state-of-the-art, customer service focused care. In addition, she has taken advantage of the new Emergency Department renovation by organizing and implementing dynamic practice workflows to best meet the needs of patients requiring emergency services.

Peter Stachowicz, Chief of Ambulatory Services, Medical Imaging Manager - Peter has been with Wickenburg Community Hospital and Clinics for twenty years. He continues to provide exceptional nursing and clinical leadership to a unique service line, focusing on continual customer service and process improvement. Peter's advanced knowledge and experience of interventional radiology, laboratory, diagnostic imaging, and customer service ensures the highest quality ambulatory services and state-of-the-art equipment to fit the needs of all patients.

Patty Church, MHA, RN, NE-BC, Director of Patient Care Services - Patty oversees Acute Care, Transitional Care, Observation and Infusion Services at Wickenburg Community Hospital. She brings extensive high-level service line experience to our team, focusing on patient care individualization and best practices to ensure all patients receive the highest quality of care designed especially for them.

Karen Smith, RN, NMCC, LSSGB, Infection Prevention, Employee Health Manager - Karen is the direct connection to all infection prevention programs at Wickenburg Community Hospital & Clinics, ensuring all federal, state, and local regulatory practice guidelines are followed and upheld reliably in all areas. Karen currently spearheads our interdisciplinary COVID-19 practice initiatives and works closely with various business facilities within the local community. Karen also leads our house-wide Safety Committee working directly with Wickenburg police and fire department leaders to ensure safety standards and training are exceeded.

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ADVENTURE aWAITS

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Amigos Trail Ride & Drive

November 12-15, 2020 Boyd Ranch Wickenburg AZ.

Call Now to Register!

Let’s Hit the Trails!

For More Information Visit

WCH FOUNDATION

Diamonds & D enim Hospital Benefit Dinner Dance

23 OF

5:30 PM

eVENING

For More Information Visit: wickhosp.com/foundation

Community

RESOURCE DIRECTORY Congress Clinic Pharmacy

Mon-Fri 8:00 am - 5 pm

Congress Community Clinic

Mon – Wed 8:00 am – 5:00 pm Thurs 1:00 pm – 5:00 pm

26750 B, Santa Fe Road Congress, AZ 85332

Call to schedule an appointment

(928)668-5502

26750 B, Santa Fe Road Congress, AZ 85332

Wise Owl Senior Center 466 W Wickenburg Way Wickenburg, AZ 85390 (928) 684-7894

Wickenburg’s Freedom Express

Transports seniors 60+ anywhere within Wickenburg (928) 684-7894 x 102

at 928-668-1833

Wickenburg Community Hospital Pharmacy Free local delivery

520 Rose Lane, Wickenburg, AZ 85390 (928) 684-4380 Mon-Fri 8:00am - 6:00pm Sat 8:00am - 12:00pm

Wickenburg Community Clinic 523 Rose Lane,

Wickenburg, AZ 85390 Mon – Fri | 8:00 am – 5:00 pm Call to schedule an appointment at 928-668-1833 same-day appointments are available.

Wittmann Community Clinic Mon and Fri. 8:00 am – 5:00 pm Call to schedule an appointment at 928-668-1833 Located in the Nadaburg School District Office: 32919 Center St. Wittmann, AZ 85361

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Nonprofit Wickenburg Community Hospital

You can make a difference in the well-being of your friends, family and neighbors by donating to nonprofit Wickenburg Community Hospital & Clinics.

Recent contributions provided our community with a newly renovated Level IV Trauma Emergency Department, an image intensifier used in foot and upper extremities surgery (Mini C-arm), and advanced 3D mammography equipment.

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