Livingwell AZ - August 2015 by LOCALiQ

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Livingwell

a-z

HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILY

AUGUST 2015

IN THIS ISSUE | 2 Advances in orthodontics | 3 Ovarian health | 4 Events & Support Groups | 5 Sleep disorders; Rattlesnake season

Oh, sugar! Learning what to look for can help reduce your intake By Gremlyn Bradley-Waddell

ou might be stunned by the amount of sugar that’s included in such items as pizza, hot dogs, crackers, condiments, peanut butter and lunch meats. Not to sugarcoat the issue, but they’re often full of the sweet stuff. “Generally, Americans eat about twice as much sugar as we should,” said Jessica Lehmann, a registered dietitian and instructor in the nutrition program at Arizona State University’s School of Nutrition and Health Promotion in Phoenix. “On average, Americans eat about 20 teaspoons of sugar per day.” Considering that the American Heart Association recommends an upper daily limit of six teaspoons of sugar for women and nine teaspoons for men, we all have some work to do.

Variety of names Our bodies are not programmed to deal with all the sugar in modern-day foods, so it’s a good idea to know what’s in your food to start with, Lehmann said. That said, it’s not like you can’t ever eat sugar, she added. After all, the human brain functions on glucose and our bodies are naturally drawn to sweet foods. What makes it really tough to avoid unneeded sugar, however, is the fact that it is often disguised, plus it goes by a variety of different names — often ones that don’t look or sound like how we typically think of sugar. Some of the more common culprits you might glimpse on food labels include high fructose corn syrup, honey, molasses, agave, corn sweetener and fruit juice concentrate. What this means is that reading food labels and paying attention to ingredient names as well as serving sizes is key. “There are a lot of different names for sugar out there,” Lehmann said. “If sugar, or a different-named version of it, is in the first three ingredients of a given food, it should be something you don’t use very often.” Words ending in “ose,” for instance, are often a dead giveaway that it’s a sugar, as in the case of dextrose and glucose. But there are caveats; lactose, for example, is a naturally occurring sugar found in unflavored white milk and unflavored plain yogurt and unless someone is lactose-intolerant, it's usually not much of a concern for most people.

Brian McWhorter, D.O., is a hip, knee and shoulder reconstruction specialist with Hedley Orthopaedic Institute. McWhorter, who is also on the medical staff at Mountain Vista Medical Center in Mesa, said that one of the bigger changes in shoulder replacement surgery has been the incorporation of interchangeable parts which allows a surgeon to change the angle, rotation and alignment of an implant without moving where the implant is in the bone. Here, he is demonstrating a robotic arm interactive system that helps him operate with greater efficiency and accuracy while shortening surgery times and patient recovery times.

Moderation is key As with so much in life, moderation is key when it comes to sugar intake. But little touches of it here and there can be rewarding. “I’m okay with using some added sugar to make things that are slightly bitter more palatable, like using agave syrup in a dressing or drizzling honey over plain yogurt,” Lehmann said. To start cutting down your intake Thinkstock of sugar, Lehmann said you should reduce your dependence on commercially prepared food and limit the amount of calories you drink; opt for water instead and flavor it with seltzer, a splash of fruit juice or pieces of diced fruit. “I also suggest that consumers vote with their dollars and buy low-sugar versions of foods whenever possible,” she said.

Jointlydecided Joint-replacement surgery more advanced than ever

BY D E B R A G E L B A R T | PHOTOS BY R I C K D ’ E L I A

oint-replacement surgeries have Customized implants been profoundly improved thanks “The newest technology available for knee replacements is the advent of 100 percent-customized implants,” said to a plethora of new technologies David Nilsen, D.O., an East Valley orthopedic surgeon with Banner Health. He explained that for several years and procedures including the he’s been using “cutting blocks” made by a 3D printer mainstream use of robotics, the that let him plan where the bone cuts and alignment pins expanding use of 3D printers and should be placed in the patient’s knee. “The next evolution is where not only are the 3D the development of better pain managecutting blocks used, but the actual implanted knee ment protocols. replacement is custom-built for the patient’s exact

Robotics-assisted surgery Bringing a robot into the operating room improves accuracy, according to Brian McWhorter, D.O., a hip, knee and shoulder reconstruction specialist with Hedley Orthopaedic Institute, which has offices in Phoenix, Tempe and Mesa. McWhorter is on the medical staff at Mountain Vista Medical Center in Mesa. Robotics-assisted surgery for partial knee replacement has allowed huge advancements in the accuracy of implant placement, agreed Vishal Ganesh, M.D., an independent orthopedic surgeon on staff at Abrazo West Campus in Goodyear. “The best part is that the patient only has the damaged area of the knee replaced and the rest of the knee is left untouched. Recovery is two to three times quicker than total knee replacement and the surgery is completed through a smaller incision,” he said.

shape,” he said. “These new custom-made implants require less bone resection and result in a potentially more normal looking and feeling knee.”

Pain management Pain management with joint replacement is far more effective today than just a few years ago, said Bertrand Kaper, M.D., an orthopedic specialist at the HonorHealth Orthopedic Institute in Scottsdale. “Instead of being reactive to pain, we’re focusing on the proactive steps that can be taken in anticipation of pain after surgery,” he said. “These may include nerve blocks, spinal anesthetics, intravenous Tylenol, antiinflammatory medications and medications that can blunt the neurologic pain-signaling to the brain.” JOINT REPLACEMENT, continued on page 5

“Orthopedics is a constantly evolving specialty. Techniques, materials and design all change over time.” — David Nilsen, D.O., an East Valley orthopedic surgeon with Banner Health

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2 | Livingwell a-z | Wednesday, August 5, 2015

a-z H E A LT H C A R E B R I E F S Free weekly yoga classes offered at Banner Boswell in Sun City Banner Boswell Medical Center is hosting weekly yoga classes at 4:30 p.m. on Thursdays in Memorial Hall East at the nonprofit facility, 13180 N. 103rd Drive in Sun City. The class is free of charge; space is limited to 50 participants per class. Banner Health employees, volunteers and surrounding community members are encouraged to attend as well as Banner Boswell outpatients with physician clearance to participate. Those attending are asked to bring their own mat. Yoga has proven health benefits including increased muscle tone, balance, strength and improved mood. More info: 623-832-7620

St. Joseph’s adds liver transplant program A national leader in lung transplantation, Dignity Health St. Joseph’s Hospital and Medical Center in downtown Phoenix will soon offer liver transplantation to patients in Arizona and the Southwest. The United Network for Organ Sharing — the organization contracted by the federal government to manage the nation's organ transplant system — approved St. Joseph’s program, with the first liver transplant expected to occur this fall. Having performed more than 330 lung transplantations since opening eight years ago, St. Joseph’s Norton Thoracic Institute is currently the busiest lung transplant program in the western United States. With the addition of the liver transplant program, St. Joseph’s now becomes the only hospital in Arizona with active liver, lung and kidney transplantation programs. Currently, more than 2,000 people in Arizona are awaiting an organ transplant and of those, more than 450 are in need of a new liver. Arizona residents can register to be an organ and tissue donor online at DonateLifeAZ.org. More info: Donor Network of Arizona DonateLifeAZ.org; 602-222-2200

Livingwella-z

Talk to me about braces

When teeth are not aligned properly because of hereditary reasons, size or shape of jaw, extra or missing teeth, crowding or spacing, it is referred to as malocclusion. Malocclusion categories include:

It's important to identify orthodontic problems early

Class 1 malocclusion: This is the most common type of malocclusion — the bite is normal, but the upper teeth slightly overlap the lower teeth.

By Meghann Finn Sepulveda

hen should your child be evaluated by an orthodontist? It may be sooner than you think. According to the American Association of Orthodontics, a child should be seen by an orthodontist by age 7 with treatment typically occurring between ages 9 and 12.

Class 2 malocclusion: Called retrognathism or overbite, this occurs when the upper jaw and teeth severely overlap the bottom jaw and teeth. Class 3 malocclusion: Called prognathism or underbite, this occurs when the lower jaw protrudes or juts forward causing the lower jaw and teeth to overlap the upper jaw and teeth.

What to look for “Some things to look for in children are crowded teeth, missing teeth, deep overbite, underbite involving one or multiple teeth, and habits that affect tooth position such as thumb-sucking,” said Jae Hyun Park, D.M.D., professor and chair of the postgraduate orthodontic program at Arizona School of Dentistry & Oral Health at A. T. Still University in Mesa. “We usually start treatment when children have all of their permanent teeth in place, but it is a good idea to check with an orthodontist to determine whether there is a need for braces.” Early treatment may From missing teeth to Thinkstock prevent injury overcrowding, narrow jaws to protrusive only evaluate growth but also front teeth, and overbites, orthodontists help parents narrow down a correct harmful for treatment. While are utilizing new treatments timeframe habits and guide a pediatric dentist can help eruption of and technologies to correctly identify issues, it is generally permanent teeth recommended that an orthodonposition teeth and create into a better positist review, confirm and perform tion to prevent treatment. healthy, beautiful smiles. crowding. During growth, for example, it can become an issue Improved treatments if the jaw is too narrow or if the upper jaw Orthodontic treatment has significantly and lower jaw are not proportionate. improved in the last decade or two. Today, “The jaw grows in three dimensions orthodontists use various types of applithrough post-adolescence,” Park said. “For ances to slowly move teeth to where they this reason, it is important to time orthobelong. Conventional metal braces have dontic treatment with dimensional goals in been refined and there are now clear and mind to manipulate the growth in the most invisible options. effective way.” “Lingual braces go behind the teeth and Routine orthodontic wellness checks not have been around since the 1980s but are

August 2015 | Vol. 5, No. 8

Living Well A-Z publishes on the first Wednesday of the month. From A to Z, we tackle a broad range of health issues and offer resources to find more specific information. For questions concerning content in this publication, please contact Editor Paula Hubbs Cohen.

Malocclusion

Source: U.S. National Library of Medicine

now a lot more comfortable and smaller,” said Ken Danyluk, D.M.D., M.Sc., owner of Team Orthodontics which has offices in Ahwatukee and Gilbert. “Patients don’t even know they have them on.” While braces are worn for varying amounts of time depending on the individual, retainers are often needed into adulthood. Why’s that? “There is subtle movement of the teeth after braces,” Danyluk said. “It’s important to wear a retainer to maintain that perfect smile and so that teeth remain straight.”

Communication is key Keeping parents and children informed about treatment options, discussing hesitations or fears, and being open about expectations creates a positive experience and good results. It also helps everyone remain compliant when it comes to oral hygiene and overall orthodontic care. “A conservative approach to treatment tends to be more beneficial in the long run. If the treatment is too long, patients can get burned out and compliance will be affected,” Danyluk said. “In our office we have an open honest discussion with kids so we can listen and understand their needs to get them on board with treatment. This approach has been very successful.”

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Dr. Fintelmann provides excellence in care of corneal disease, cataract and vision correction surgery (including LASIK and ICL). He performs a range of procedures including partial, full thickness and laser assisted corneal transplants (DSAEK, DMEK, DALK). In addition, he teaches residents and medical students. BARNET DULANEY PERKINS EYE CENTER Locations throughout Arizona 800-966-7000 www.GoodEyes.com

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OBSTETRICS, GYNECOLOGY Phillip Ivey, MD

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A graduate of University of South Florida in Tampa, Dr. Phillip Ivey completed his residency at Banner Good Samaritan Medical Center in Phoenix, AZ. Dr. Ivey is Board Certified and specializes in obstetrics and gynecology including pelvic pain, interstitial cystitis, urinary incontinence, pelvic organ prolapse, ESSURE, Nexplanon and IUD insertion. Banner Health Clinic 1780 E. Florence Blvd., Suite 108, Casa Grande www.BannerHealth.com/ClinicCasaGrandeOBGyn 520-381-6758

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Wednesday, August 5, 2015 | Livingwella-z | 3

O is for ovaries Why they’re important to a woman’s health YO U R H E A LT H HEAD TO TOE

Female reproductive system

By Debra Gelbart

varies serve two basic functions, according to Desiree Brotsky, D.O., an independent OB-GYN on staff at Abrazo Arrowhead Hospital in Glendale. “They make oocytes (egg cells) for reproductive purposes and secrete estrogen and progesterone,” she said. These hormones, she added, have multiple effects on a variety of tissues in a woman’s body, including her uterus, breasts and bones.

Watch for upcoming articles on the following topics as we provide information on your health — from head to toe.

Effects of aging

Diabetes: More information concerning July's article

As a woman ages, Brotsky said, there’s a decline in the number and quality of follicles (cyst-like structures on the ovaries that produce estrogen and progesterone and release an egg every month). Estrogen and progesterone levels slowly decrease and about four years prior to menopause — which on average occurs at age 51 — women may start noticing changes in their menstrual cycle, hot flashes, difficulty sleeping, vaginal dryness, mood changes, breast tenderness or menstrual migraines, Brotsky said. A gradual progression toward menopause is easier to tolerate than an abrupt change in hormone levels, doctors say. But if a premenopausal woman undergoes a complete hysterectomy that includes removal of both ovaries, she will experience a sudden shift into menopause, explained Kristina Butler, M.D., a gynecologic oncologist at Mayo Clinic Hospital in Phoenix. Premature menopause can lead to an increased risk of cardiovascular disease, stroke, neurologic disease, cognitive decline and osteoporosis, Butler said. But those problems may be avoided by choosing to have only one ovary removed, she said, because the remaining ovary still produces hormones.

SEPTEMBER: Prostate OCTOBER: Circulatory NOVEMBER: Feet DECEMBER: Skin

Editor’s note: In response to a reader comment on our story last month on diabetes and pre-diabetes, here is additional information about diabetes:

risk of infertility and diabetes. “Oral contraceptives are the mainstay of treatment for women with PCOS,” Butler said. A benign ovarian cyst can be either solid or cystic (fluid-filled), Brotsky said. “Most of the time these resolve without surgery but this is the fourth most common reason a woman is admitted to the hospital in the U.S., usually with abdominal or pelvic pain,” she said.

Butler said, the risk of ovarian cancer may be lowered by maintaining a healthy weight (obesity is a risk factor for the disease) and using birth control pills. Avoiding the use of talc may be considered, too, because some studies suggest a link with ovarian cancer, Butler said. If you have a family history of ovarian cancer, Brotsky said, it’s important to be especially vigilant about any warning signs of the disease.

Ovarian cancer

Recognizing trouble

According to the American Cancer Society, ovarian cancer accounts for about 3 percent of cancers among women, but it causes more deaths than any other cancer of the female reproductive system. Based on research the past few years, Brotsky said, “we suspect that many cancers of the ovaries and periCommon conditions toneum (the thin layer of tissue that lines Common problems with ovaries include the abdomen) may actually begin in the Polycystic Ovarian Syndrome (PCOS) and fallopian tube. As a result, it’s thought that benign ovarian cysts, Brotsky said. PCOS the incidence of fallopian tube carcinoma is linked to over-production of the male is underestimated. I regularly discuss this hormone androgen, Brotsky said, and with my patients and consider removal of typically is characterized by menstrual fallopian tubes when appropriate.” irregularities, acne or facial hair, multiple In addition to fallopian tube surgery, small cysts on the ovaries and an increased

Ovarian cancer symptoms are vague, Butler cautioned. “Slow down and listen to your body,” she said. Seek a doctor’s advice, she advised, if you have any of the following symptoms for more than 12 days a month: increased abdominal size or bloating; abdominal pain; urinary urgency or frequency; difficulty eating or feeling full after eating only a small amount. “Most ovarian cancer patients experience symptoms three to six months before their disease was diagnosed,” Brotsky said. “A patient with symptoms should undergo a pelvic examination and a pelvic ultrasound.”

Pre-diabetes only occurs with Type 2 diabetes, which used to be called adult-onset diabetes. According to the National Institute of Diabetes and Digestive and Kidney Diseases, Type 2 affects people at any age, even children. But adults who are overweight and inactive are more likely to develop Type 2 diabetes which usually begins with insulin resistance, a condition that occurs when fat, muscle and liver cells do not use insulin to carry glucose into the body’s cells to use for energy. As a result, the body needs more insulin to help glucose enter cells. This condition can progress to pre-diabetes which, if left untreated, can become Type 2 diabetes. Type 1 diabetes (which used to be called juvenile diabetes) develops most often in young people, but Type 1 also can develop in adults. In Type 1 diabetes, a person’s body no longer makes any or enough insulin because the body’s immune system has attacked and destroyed the cells that make insulin. Source: National Institute of Diabetes and Digestive and Kidney Diseases niddk.nih.gov 301-496-3583

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4 | Livingwell a-z | Wednesday, August 5, 2015

AUGUST Take advantage of opportunities to meet others with similar issues and learn more about various aspects of your health – from A to Z. All groups and events are believed, but not guaranteed, to be free unless otherwise stated. Every effort has been made to verify accuracy, but please call before attending to confirm details.

CHILD LOSS SUPPORT Aug. 17, 6–8 p.m. Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-3878; HonorHealth.com

WELLNESS & MORE

PAIN

COOKING FOR HEALTH Various dates, times & locations By Cancer Support Community 602-712-1006; rsvp@cscaz.org

INTRO TO FIBROMYALGIA Aug. 5, 12, 19 & 26, 5:30–6:30 p.m. Fibromyalgia Wellness Center 8300 N. Hayden Rd., Scottsdale 480-948-4955 FibroWellnessCenter.com

MEDICATION CHECKS Call to schedule a personal meeting St. Luke’s, 1800 E. Van Buren St., Phoenix Tempe St. Luke’s, 1500 S. Mill Ave., Tempe Register: 877-351-WELL (9355) WALKING GROUP Various dates & locations By Humana; 480-325-4707 RELIEVING GERD August 6, noon Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) MVMedicalCenter.com TOBACCO RECOVERY GROUP Aug. 11 & 25, 9–9:45 a.m. Banner MD Anderson Cancer Center 2946 E. Banner Gateway Dr., Gilbert Appointment required: 480-256-5177 HEALTHY COOKING FOR CANCER Aug. 12 & 26, 9–10 a.m. By Cancer Support Community Sun Health Center for Health and Wellbeing 14719 W. Grand Ave., Surprise Register: 623-207-1703; rsvp@cscaz.org HIP & KNEE REPLACEMENT Aug. 12, 6–7:30 p.m. By HonorHealth Prescott Resort & Conference Center 1500 E. State Route 69, Prescott 623-580-5800; HonorHealth.com OSTEOPOROSIS SUPPORT Aug. 19, 9–10 a.m. Scottsdale Shea Medical Center 9003 E. Shea Blvd., Scottsdale 623-580-5800 LYME DISEASE Aug. 27, 1–2 p.m. By HonorHealth Civic Center Auditorium 3898 N. Drinkwater Blvd., Scottsdale 623-580-5800; HonorHealth.com

CAREGIVERS CAREGIVERS SUPPORT Various dates, times & locations By Duet; 602-274-5022; DuetAZ.org CANCER CAREGIVERS SUPPORT Various dates & times By Cancer Support Community 360 E. Palm Lane, Phoenix 602-712-1006; rsvp@cscaz.org CAREGIVERS SUPPORT Aug. 10 (for time: 602-406-6688) St. Joseph’s Outpatient Rehab 114 W. Thomas Rd., Phoenix PATIENT & CAREGIVERS SUPPORT Aug. 11, 5:30–6:45 p.m. Banner Thunderbird 5555 W. Thunderbird Rd., Glendale 602-865-5450 CAREGIVERS SUPPORT Aug. 12, 2:30 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) MVMedicalCenter.com CIRCLE OF FRIENDS CAREGIVERS SUPPORT Aug. 18, 12:30–2 p.m. Fellowship Square Mesa 6945 E. Main St., Mesa 602-839-6850

GRIEF SUPPORT GRIEF SUPPORT GROUPS Various dates, times & locations By Banner Hospice Rev. Cindy Darby, cindy.darby@BannerHealth.com 480-657-1167; BannerHospice.com GRIEF SUPPORT Various dates & times Dignity Health St. Joseph’s 350 W. Thomas Rd., Phoenix 602-406-3275 GRIEF SUPPORT Various dates, times & locations By Hospice of the Valley HOV.org/Grief-Support-Groups 602-530-6970 GRIEF BEFORE LOSS August 5, 12, 19 & 26, 2–3 p.m. Benevilla; 623-584-4999 16752 N. Greasewood St., Surprise PREGNANCY & INFANT LOSS August 6, 6–8 p.m. Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-3878; HonorHealth.com GRIEF SUPPORT Aug. 11 & 25, 3–4:30 p.m. By Hospice of the Valley Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com GRIEF BEFORE LOSS Aug. 12, 19 & 26, 2–3 p.m. Benevilla; 623-584-4999 16752 N. Greasewood St., Surprise

RESPIRATORY

a-z T O P E V E N T S Please call to confirm reservations and cost (if any).

AUG. 19

AUG. 20

DEMENTIA DIALOGUE WEBINAR WHAT: Experts in dementia care offer this monthly online seminar. TOPIC: Maintaining realistic expectations as dementia progresses. WHERE: Online; BannerSHRI.org WHEN: noon–1 p.m. PRESENTED BY: Banner Alzheimer’s Institute COST: Free; registration required INFO/REGISTER: 623-832-3248; BannerHealth.com/ResearchOnlineEdu

FOOD AS MEDICINE WHAT: Christi Kirk, RD, a board-certified specialist in oncology nutrition with Banner MD Anderson Cancer Center, will talk about what foods to eat to help keep the body strong and healthy in cancer survivorship. WHERE: 360 E. Palm Lane, Phoenix WHEN: 10–11:30 a.m. PRESENTED BY: Cancer Support Community Arizona COST: Free INFO/REGISTER: 602-712-1006; rsvp@cscaz.org

STROKE SUPPORT Aug. 6, noon Abrazo Scottsdale Campus 3805 E. Bell Rd., Phoenix 602-923-5546 sritchie@abrazohealth.com

HUNTINGTON’S SUPPORT Aug. 17, 6–8 p.m. St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 602-402-1774

MENDED HEARTS SUPPORT Aug. 6, 6:30–8 p.m. John C. Lincoln Medical Center 9202 N. Second St., Phoenix 602-870-6368; HonorHealth.com

BRAIN ANEURYSM SUPPORT Aug. 19, 6–8 p.m. St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix Kimberly@JoeNiekroFoundation.org 760-333-7658

STROKE CAREGIVERS SUPPORT Aug. 27, 2:30–3:30 p.m. Dignity Health Mercy Gilbert 3555 S. Val Vista Dr., Gilbert 480-728-5414

BRAIN TUMOR SUPPORT Aug. 25, 6–8 p.m. St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 623-205-6446

WOMEN

BRAIN INJURY SUPPORT Aug. 27, 6–7:30 p.m. St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 602-508-8024; 602-406-6688

MULTIPLE SCLEROSIS SUPPORT Aug. 29, 10 a.m. St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 480-829-6563

PARENTING

DIABETES

BREASTFEEDING SUPPORT Various dates, times & locations By Dignity Health 480-728-5414; 602-406-4954

MANAGING DIABETES Various dates, times & topics Dignity Health Center for Diabetes Management 1760 E. Pecos Rd., Gilbert 480-728-3535

GRANDPARENTS RAISING GRANDCHILDREN Various dates, times & locations By Benevilla 623-207-6016; Benevilla.org

DIABETES SIDE EFFECT PREVENTION Aug. 12, 5:30–7:30 p.m. HonorHealth Medical Group 6320 W. Union Hills Dr., Glendale 623-561-3103; HonorHealth.com

GRANDPARENTS RAISING GRANDCHILDREN Various dates, times & locations By Duet; 602-274-5022; DuetAZ.org

ALZHEIMER’S/DEMENTIA

ALZHEIMER’S & MEMORY SUPPORT Aug. 11, 18 & 25, 10–11:30 a.m. By Benevilla at Faith Presbyterian Church 16000 N. Del Webb Blvd., Sun City 623-584-4999; Benevilla.org ALZHEIMER’S SUPPORT Aug. 16, 11 a.m.–12:30 p.m. Dignity Health Huger Mercy Center 2345 W. Orangewood Ave., Phoenix Lunch provided; 602-406-5600 ALZHEIMER’S CAREGIVERS SUPPORT Aug. 17, 1:30–3 p.m. By Tempe St. Luke’s 655 E. Southern Ave., Tempe Register: 877-351-WELL (9355) CAREGIVERS SUPPORT Aug. 18, 12:30–2 p.m. Duet, 555 W. Glendale Ave., Phoenix 602-274-5022; DuetAZ.org

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a-z I N F O R M AT I O N O N L I N E ABRAZO COMMUNITY HEALTH NETWORK: AbrazoHealth.com; 602-674-1400; Abrazo Arizona Heart Hospital; Abrazo Arrowhead Campus; Abrazo Central Campus; Abrazo Maryvale Campus; Abrazo Scottsdale Campus; Abrazo West Campus BANNER CHILDREN’S-CARDON CHILDREN’S: BannerChildrens.com; 480-412-KIDS (5437) BANNER HEALTH: BannerHealth.com; 602-747-4000; Numerous hospitals and medical centers BANNER POISON AND DRUG INFO CENTER HOTLINE: 800-222-1222 BARROW NEUROLOGICAL INSTITUTE: TheBarrow.org; 877-602-4111 DIGNITY HEALTH CHANDLER REGIONAL MEDICAL CENTER: DignityHealth.org/chandlerregional; 877-728-5414 DIGNITY HEALTH MERCY GILBERT MEDICAL CENTER: DignityHealth.org/mercygilbert; 877-728-5414 DIGNITY HEALTH ST. JOSEPH’S HOSPITAL AND MEDICAL CENTER: DignityHealth.org/stjosephs; 877-602-4111 DIGNITY HEALTH ST. JOSEPH’S WESTGATE MEDICAL CENTER: DignityHealth.org/westgate; 877-602-4111 HONORHEALTH (formerly Scottsdale Healthcare): HonorHealth.com; 623-580-5800; HonorHealth Scottsdale Shea; HonorHealth Scottsdale Thompson Peak; HonorHealth Scottsdale Osborn HONORHEALTH DEER VALLEY MEDICAL CENTER: HonorHealth.com; 623-580-5800 HONORHEALTH JOHN C. LINCOLN MEDICAL CENTER: HonorHealth.com; 623-580-5800 MARICOPA INTEGRATED HEALTH SYSTEM: MIHS.org; 602-344-5011 MAYO CLINIC: MayoClinic.org; 800-446-2279 MOUNTAIN VISTA MEDICAL CENTER: MVMedicalCenter.com; 480-358-6100 MUHAMMAD ALI PARKINSON CENTER: TheBarrow.org; 602-406-6262 PHOENIX CHILDREN’S HOSPITAL: PhoenixChildrens.org; 602-933-1000 ST. LUKE’S MEDICAL CENTER: StLukesMedCenter.com; 602-251-8100 TEMPE ST. LUKE’S HOSPITAL: TempeStLukesHospital.com; 480-784-5500 VALLEY FEVER CENTER FOR EXCELLENCE: vfce.arizona.edu; 602-406-8253

BREAST CANCER BOSOM BUDDIES SUPPORT GROUPS Various dates, times & locations Ahwatukee/Chandler: 602-739-8822; 602-318-8462 East Valley: 480-358-0198; 480-969-4119 Sun City (Banner Boswell): 623-547-2206; 623-236-6616 West Valley: 602-531-9123; 623-979-4279 CIRCLE OF HELP ADVANCED BREAST CANCER Meets as needed. Info: Becky Chase, 623-236-6616 or Teresa Hill, AdvancedBreast Cancer@gmail.com BREAST CANCER SUPPORT Aug. 8, 10 a.m.–noon Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com BREAST CANCER LEARN & SUPPORT Aug. 13 & 27, 6–8 p.m. Breast Health and Research Center 19646 N. 27th Ave., Phoenix 623-780-4673; HonorHealth.com BREAST BUDS SUPPORT Aug. 15, 11 a.m.–1 p.m. MidFirst Bank Conference Room 6508 W. Bell Rd., Glendale 480-657-0500; BreastBuds.org

PULMONARY FIBROSIS SUPPORT Aug. 14, 1–2 p.m. Banner-University Medical Center 1111 E. McDowell Rd., Phoenix 602-255-7600

YOUNG ADULT BRAIN INJURY Aug. 12, 6–7:30 p.m. St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 602-996-1396; 602-406-6688

STROKE CHECK Various dates, times & locations 480-882-4636; HonorHealth.com

ALZHEIMER’S & MEMORY SUPPORT Aug. 7, 9–11:30 a.m. By Benevilla at Sun City West office 13576 W. Camino Del Sol, Sun City West 623-584-4999; Benevilla.org

GET PAST ASTHMA Aug. 13, 6:30–8 p.m. Deer Valley Medical Center 19841 N. 27th Ave., Phoenix 623-879-5452; HonorHealth.com

BRAIN/NEUROLOGICAL

HEART/STROKE

ALZHEIMER’S CAREGIVERS SUPPORT Various dates, times & locations By Alzheimer’s Association Desert Southwest Chapter 602-528-0545; ALZ.org/DSW

BETTER BREATHERS/ COPD SUPPORT Various dates, times & locations By the American Lung Association 602-429-0005; BreatheEasyAZ.info

CANCER SUPPORT GROUPS CANCER SUPPORT COMMUNITY SUPPORT GROUPS 360 E. Palm Lane, Phoenix Info: 602-712-1006; rsvp@cscaz.org • CANCER SUPPORT Various dates & times • MULTIPLE MYELOMA Aug. 6, 10–noon • LYMPHOMA Aug. 8, 10–11:30 a.m. • PANCREATIC CANCER Aug. 8, 10–11:30 a.m. • CARCINOID Aug. 8, 1–2:30 p.m. • LUNG CANCER Aug. 8, 1–2:30 p.m. • OVARIAN CANCER Aug., 10–11:30 a.m. • PROSTATE CANCER Aug. 13, 6–7:30 p.m. • COLORECTAL CANCER Aug. 15, 10–11:30 a.m. • TEEN WHOSE PARENT HAS CANCER Aug. 15, noon–1:30 p.m. IRONWOOD CANCER & RESEARCH CENTERS SUPPORT GROUPS 685 S. Dobson Rd., Chandler Info: 480-340-4013; IronwoodCRC.com • BREAST CANCER Aug. 10, 2–4 p.m.

• LUNG CANCER Aug. 10, 2–4 p.m. • PROSTATE CANCER Aug. 10, 7–9 p.m. • CAREGIVERS Aug. 15, 10 a.m.–noon • HEAD & NECK CANCER Aug. 17, 3–4:30 p.m. • PANCREATIC CANCER Aug. 20, 2–3:30 p.m. • METASTATIC CANCER Aug. 26, 3–4:30 p.m. LOOK GOOD FEEL BETTER By the American Cancer Society Various dates, times & locations 800-ACS-2345 LookGoodFeelBetter.org LOOK GOOD FEEL BETTER By Ironwood Cancer & Research Centers Various dates, times & locations 480-855-2224; IronwoodCRC.com CANCER SURVIVOR SUPPORT Aug. 5, 5:30–6:30 p.m. Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com LIVING WITH LOSS Aug. 11 & 25, 1–2:30 p.m. By Cancer Support Community 360 E. Palm Lane, Phoenix Register: 602-712-1006; rsvp@cscaz.org

SURVIVING & THRIVING Aug. 11 & 25, 1–2:30 p.m. By Cancer Support Community 360 E. Palm Lane, Phoenix Register: 602-712-1006; rsvp@cscaz.org PANCREATIC CANCER SUPPORT Aug. 11, 4–5:30 p.m. Virginia G. Piper Cancer Center 10510 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com NON-HODGKIN’S LYMPHOMA SUPPORT Aug. 13, 6–8 p.m. Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com ORAL, HEAD & NECK CANCER Aug. 19, 4:30 p.m. Banner MD Anderson Cancer Center 2946 E. Banner Gateway Dr., Gilbert 602-230-2273 GYNECOLOGIC CANCER SUPPORT Aug. 19, 5:30–6:45 p.m. Banner Thunderbird 5555 W. Thunderbird Rd., Glendale 602-865-5450 CAREGIVERS & FAMILY SUPPORT Aug. 19, 6:30–8 p.m. Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com PROSTATE CANCER SUPPORT Aug. 20, 3 p.m. Banner MD Anderson Cancer Center 2946 E. Banner Gateway Dr., Gilbert 602-230-2273 ORAL, HEAD & NECK CANCER Aug. 20, 6:30–8:30 p.m. Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com LYMPHEDEMA SUPPORT Aug. 24, 6–8 p.m. Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-1321; HonorHealth.com

PARKINSON’S PARKINSON’S EDUCATION, EXERCISE & SUPPORT GROUPS Various dates, times & locations By Muhammad Ali Parkinson Center 602-406-3840; 602-406-4921 PARKINSON’S SUPPORT Aug. 18, 3–4:30 p.m. By Benevilla Shepherd Hills Methodist Church 13658 W. Meeker Blvd., Sun City West 623-584-4999

GASTROINTESTINAL OSTOMY SUPPORT Aug. 20, 12:30 p.m. La Casa de Cristo Church 6300 E. Bell Rd., Scottsdale 623-580-4120

MOMS ON THE MOVE By HonorHealth Various dates, times & locations 480-323-3878; HonorHealth.com POSTPARTUM DEPRESSION SUPPORT Aug. 5, 12, 19 & 26, 1–2:30 p.m. Dignity Health Mercy Gilbert 1760 E. Pecos Rd., Gilbert 480-728-5414 T.E.E.N.S. 4 TEENS SUPPORT Aug. 6, 13, 20 & 27, 6–7 p.m. Dignity Health Chandler Regional 1875 W. Frye Rd., Chandler 480-728-5414 POSTPARTUM DEPRESSION SUPPORT Aug. 7, 9:30–11:30 a.m. Virginia G. Piper Cancer Center 10460 N. 92nd St., Scottsdale 480-323-3878; HonorHealth.com MOTHER-TO-MOTHER SUPPORT Aug. 7 & 28, 10–11:30 a.m. St. Joseph’s; 877-602-4111 350 W. Thomas Rd., Phoenix INFANT BRAIN DEVELOPMENT CLASS Aug. 8, 9 a.m.–1 p.m. Tempe St. Luke’s Hospital 1500 S. Mill Ave., Tempe Register: 480-784-5588 BREASTFEEDING SUPPORT Aug. 10, 17, 24 & 31, 1 p.m. Banner Estrella 9201 W. Thomas Rd., Phoenix 602-230-2273 SUBSTANCE ABUSE WEBINAR Aug. 19, noon–12:30 p.m. DrugFreeAZKids.org/Webinars

SENIORS STEADY FEET Aug. 14, noon By St. Luke’s Medical Center Burton Barr Library 1221 N. Central Ave., Phoenix Register: 877-351-WELL (9355) SUMMER SAFETY Aug. 18, noon Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) MVMedicalCenter.com SENIOR EDUCATION CONNECTION Aug. 20, 1–2 p.m. Fellowship Square Mesa 35 W. Brown Rd., Mesa 480-290-7025; AZFS.org

BARIATRIC SURGERY SEMINARS BANNER HEALTH BannerHealth.com; 480-543-2606 HONORHEALTH BariatricSurgeryAZ.com 480-882-4636 ST. LUKE’S MEDICAL CENTER BridgesAZ.com; 800-248-5553

Wednesday, August 5, 2015 | Livingwella-z | 5

Sleep disorders can affect health, quality of life Improve sleep hygiene, evaluate sleep habits and seek treatment By Meghann Finn Sepulveda

chronic brain disorder that involves poor control of sleep-wake cycles, according to the National Institute of Neurological Disorders and Stroke. It occurs when someone falls asleep unwillingly — at school, work, the dinner table or even while driving. Episodes can last anywhere from a few seconds to several minutes. People with narcolepsy can experience vivid dreams, hallucinations and total body paralysis. While Insomnia there is no cure for narcoInsomnia is when a person experiences difficulty falling lepsy, it can be managed with lifestyle changes and asleep or staying asleep, even when he or she has the medication. chance to do so, accordObstructive sleep apnea ing to the National Sleep Foundation. There are many Obstructive sleep apnea occurs when a person reasons why insomnia can stops breathing for a short occur. amount of time, multiple “It’s important to find out what is causing the insomnia,” times throughout the night. Usually a person with said Troy Anderson, M.D., obstructive sleep apnea is an independent neurologist unaware of what is occuron staff at Abrazo Central ring, but may snore loudly, Campus in Phoenix. “It could gasp or awaken abruptly be anxiety about work or the and feel extreme sleepiness stress of a divorce.” during the day. “When someone has Narcolepsy sleep apnea, despite making Narcolepsy is a rare and an effort to take a breath, potentially dangerous

hypertension, diabetes, heart attack and stroke. “CPAP [continuous positive airway pressure] therapy is often the initial treatment option [for sleep apnea],” Gomez said. “It is very effective compared to an oral breathing device or surgical intervention.” CPAP therapy increases oxygen by providing continuous air flow through a small mask that is worn at night.

o you often have trouble falling asleep or staying asleep throughout the night? Do you frequently wake up feeling tired or drowsy? If so, you may be one of the estimated 50 to 70 million Americans who have a sleep disorder, according to the Centers for Disease Control and Prevention.

Sleep testing

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oxygen levels drop, the heart rate fluctuates and pressure in the chest increases,” said Mike Gomez, M.D., a pulmonary and sleep specialist with Banner Medical Group. “The person begins to choke

and the heart has to do more work at a time when it should be resting.” More than half of all people with sleep apnea are overweight, according to the National Heart, Lung

Joint replacement continued from the cover

Reverse shoulder replacement Reverse shoulder replacement is another relatively newer technology, McWhorter and Nilsen said. When a patient has arthritis of the shoulder but does not have a healthy functioning rotator cuff (the tendons and muscles that connect the upper arm to the shoulder blade), the normal “ball and socket” are reversed in this type of shoulder replacement surgery. The socket on the shoulder blade is replaced with a ball, while the ball on the top of the arm is replaced with a socket. This allows for the intact muscles around the shoulder to lift the arm, McWhorter, of Hedley Orthopaedic Institute, said. This reverse shoulder design has revolutionized shoulder replacement for this specific population of patients, Nilsen, of Banner Health, noted.

Osteoarthritis a big culprit In the knee, hip and shoulder, osteoarthritis (degenerative joint disease) is the single biggest reason patients end up needing a joint replacement, Kaper, of HonorHealth Orthopedic Institute, said. In the knee, degenerative osteoarthritis can be

David Nilsen, D.O., an orthopedic surgeon with Banner Health, said that most materials and design advances make an invasive surgery less invasive. "When a surgery is less invasive, it helps with reducing blood loss, allows for a smaller incision and lessens the chances of damaging tissue during surgery.”

caused by a torn ligament at a young age that leads to arthritis as a patient gets older, he said. In the hip, abnormal development of the hip ball or socket can bring on altered mechanical function that can lead to arthritis over time, Kaper said. In the shoulder, a rotator cuff tear can lead to degenerative arthritis. Whether you end up needing a joint replacement depends somewhat on how active you are and how active you want to be as you get older and whether you can avoid injuries in or near the joints that result in the onset of arthritis, the doctors said.

A promising therapy not yet ready for widespread use to treat arthritis in the joints is stem cell injection therapy, Kaper said. “This holds tremendous potential,” he said, “but it needs more research support for us to be able to say yes, this is a bona fide way to treat arthritis.” Several studies in animals show that stem cell injections may help by reducing the inflammation in the joint, McWhorter said. Amniotic stem cells (not from an embryo but from the amniotic fluid) “appear to have a natural capacity to produce antiinflammatory molecules,” he said, “and once injected into the joint, can slow down the degenerative process in osteoarthritis.”

Surgery vs conservative treatments “Joint replacement surgery is typically considered a viable option for patients xxx when conservative treatments are no longer providing any relief of symptoms,” Ganesh, on staff at Abrazo West Campus in Goodyear, said. Conservative treatment can include activity modifications, nonsteroijoint — may benefit patients dal anti-inflammatory who do not have advanced medications, weight loss, bracing of the joint, physical arthritis, Ganesh said. Patients who are therapy and injections of morbidly obese, have heart medication into the joint, failure, poorly controlled McWhorter said. Less invasive procedures such as diabetes, poor physical arthroscopy — a minimally conditioning and previous invasive surgical procedure joint infection may not be good candidates for that treats damage in the

Poison center cautions about baby rattlesnake season

and Blood Institute. Others at risk include men and women over age 55, people with small airways and those with a family history of sleep apnea. Sleep apnea has been linked to

he Arizona Poison and Drug Information not realize they, their child or their pet Center in Tucson, part of The University has been bitten by a snake. Even if you’re not sure, if you are of Arizona College of Pharmacy, serves concerned that you or someone else may all parts of the state except Maricopa have been snake-bitten, experts urge County. The Banner Poison and Drug victims or caregivers to Information Center, part of immediately call 800-222-1222. Banner - University Medical “We will ask a few questions Center Phoenix, provides that will help identify a possible services for Maricopa County. snakebite or eliminate it,” says They are warning gardeners, Keith Boesen, PharmD, director hikers, youngsters and others of the Arizona Poison and Drug to be especially cautious Information Center. “With about rattlesnakes in the Thinkstock snakebites, the sooner medical weeks ahead since baby Poison and Drug Information treatment occurs, the better rattlers are typically active Centers Hotline: the outcome.” this time of year. 800-222-1222 The poison and drug inforThese tiny snakes are born mation centers at The University of Arizona with what’s called a “button” that develops College of Pharmacy in Tucson and at into a rattle when they first shed their skin Banner – University Medical Center Phoenix — meaning at this very young age, they provide free and confidential poison control won’t offer a warning-signal rattle before and medication information to the public they strike. Although they generally range and healthcare professionals. The hotlines in length from just six to 12 inches, these operate 24 hours a day, seven days a week. pint-sized critters pack enough poisonous The two centers serve all of Arizona and punch in their venom to seriously injure are part of 55 across the nation that make or potentially even kill a person or pet. up the American Association of Poison Brush and grass may camouflage these Control Centers. — Paula Hubbs Cohen small slitherers so well that people may

Sleep experts like Jeffrey Plemons, manager of the HonorHealth Sleep Disorders Center, recommend a sleep study monitored by a sleep technician to thoroughly evaluate, diagnose and treat a sleep disorder. During the sleep test, patients have electrodes, sensors and respiratory belts placed on their body to monitor breathing patterns, brain waves, eye patterns and blood oxygen levels. “We try to make it as non-clinical as possible so patients feel comfortable and can get sleep while they are here,” Plemons said.

joint replacement surgery, Ganesh said.

Popular treatments and promising therapies With hip replacement surgery, Ganesh said, an “anterior” (front) approach has become the more popular method instead

of the “posterior” approach. With the anterior approach, a surgeon accesses the joint through the front of the hip instead of the buttock. It’s much less invasive because the surgeon avoids cutting any muscle, Ganesh said. Patients recover faster and with minimal pain, he added.

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