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WAR ON SKIN CANCER Dr. U fights on the front lines Ahwatukee Skin & Laser Pages 6-7

DR. NATHAN UEBELHOER

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INSIDE THIS ISSUE

PUBLISHER Steve Strickbine

EDITOR IN CHIEF Roberta Peterson EDITOR Paul Maryniak

CONTRIBUTING WRITERS Shelley Gillespie, Michelle Talsma Everson ADVERTISING DIRECTOR Scott Stowers ADVERTISING SALES Terry Davenport, Karen Mays, Laura Meehan, Jane Meyer

DESIGN AND ART Veronica Thurman

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Chandler is now home to a top-rated lung disease treatment program.

Understanding the complex biopsychosocial experience of pain is critical to finding permanent relief.

Even with the great strides in medicine in recent years, patient-doctor communication remains an issue.

13 14 16

Ahwatukee dental practice aims puts a premium on patient satisfaction. Ahwatukee couple’s holistic approach puts people on the path to wellness.

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As science produces new ways to address concussions, doctors seek more research.

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Chandler lab working on a computer chip for the gut’s well-being.

Children need sufficient sleep for more than their mood, Ahwatukee pediatrician says.

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Chandler pediatrician sees hope for parents seeking nearby care for autistic children.

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Renown lung treatment institute now at Chandler Regional Medical Center TIMES PUBLICATIONS STAFF

orton Thoracic Institute, a top-rated lung treatment program in the western United States, has expanded its services to Dignity Health Chandler Regional Medical Center. Three physicians now provide the institute’s evaluation, diagnosis and treatment of diseases of the lungs, chest or esophagus. “This program has grown significantly in a rather short amount of time. We have patients who come to Norton from around the world,” said Dr. Ross Bremner, the institute’s executive director. “Expanding into the East Valley is a natural progression for us,” he added. “It allows our experts to continue providing excellent and innovative care for our patients who cannot drive downtown to St. Joseph’s.” The Norton Thoracic Institute surgeons practicing at Chandler Regional include Dr. Shair Ahmed, Dr. Samad Hashimi, and Dr. Chirag Patel. They also see patients in Dignity Health’s Comprehensive Cancer Clinic in the East Valley. Norton CardioThoracic and Transplantation Institute specializes in a multidisciplinary approach to evaluating, diagnosing and treating individuals with known or suspected diseases of the lung, chest or esophagus. Programs include: lung transplant, advanced lung disease and genetic lung disease, lung cancer screening, Barrett’s esophageal, pulmonary rehabilitation thoracic oncology, and

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Pain Relief Improved Muscle Strength Joint Flexibility Improved Cholesterol Score Increased Energy Cardiovascular Improvement Enhanced Libido Improved Circulation Weight Management Restful Sleep

Dr. Shair Ahmed

Dr. Samad Hashimi

interventional pulmonology. It also has clinics for cystic fibrosis, lung nodules and mediastinal staging. The institute’s surgeons specialize in treating some of the most complex esophageal diseases in the Southwest by providing a comprehensive and multidisciplinary evaluation and some of the newest technology available. Its manoﬂourography unit was the first in Arizona and one of the first in the nation. The acquisition of a confocal endomicroscopy machine allows physicians to detect cancer at its earliest stages, Dr. Chirag Patel when there is greater chance of long-term survival. Ahmed earned his medical degree from the University of Arizona College of Medicine and completed a residency in general surgery at the Alpert School of Medicine at Brown University in Providence, Rhode Island. He specializes in in lung transplantation, benign and malignant esophageal disease, and lung cancer. Specializing in cardiothoracic surgery using minimally invasive and robotic approaches, Hashimi earned his medical degree at the University of Iowa, where he also completed a residency in general surgery and a fellowship in cardiothoracic surgery. Patel’s clinical specialties include lung transplantation, lung cancer, esophageal disease, and esophageal cancer. He earned his medical degree from the University of Arizona in Tucson, and then completed his residency at St. Joseph’s. In 2015, Norton Thoracic Institute was ranked the second busiest lung transplant program in the country with shorter-thanaverage wait times and above-average one-year survival rates. Since opening in 2007, its lung-transplant team has performed more than 450 transplants for patients from more than 30 different states. Norton Thoracic also provides a second-opinion service for lung cancer patients, conducts groundbreaking research, and trains young physicians to improve patients’ outcomes. n Information: dignityhealth.org/stjosephs/services/ lung-disease

New Dignity Health emergency room expands care for Ahwatukee patients TIMES PUBLICATIONS STAFF

new level of health care has come to Ahwatukee with the community’s first free-standing emergency room. The facility is a joint effort between Dignity Health, which operates the nearby Chandler Regional and Mercy Gilbert hospitals, and Adeptus, a health care provider that specializes in free-standing emergency rooms. The facility is a full-service 24/7 emergency room staffed by board-certified physicians, emergency-trained nurses and radiology experts. As part of the Dignity Health Arizona General Hospital system, it also has access to Dignity Health’s network of physicians and specialists. “We live to provide excellent patient care and do it in the spirit of kindness, but also the goal of Dignity Health is to partner with others in the community to improve the health of the communities we live and work in,” said Tim Bricker, CEO of Dignity Health. “We are very active in this community already with the urgent care clinic, and now we bring this wonderful 24/7 emergency care to the community.” The emergency room, on the northwest corner of Chandler Boulevard and 44th Street, differentiates itself from oth-

er urgent cares in various ways. For example, the Dignity Health General Hospital ER is equipped with a full radiology suite that includes an X-ray machine as well as a CT scan. “This CT scanner is 16 slices, which is what is recommended for emergency care,” said Trinity Barnes, facility administrator and nursing leader. “This type of radiology suite allows us to see deep tissue, meaning we can identify problems within organs. “The walls are also lined with lead to prevent any radiation from getting into the hallway or nearby rooms.” Also setting it apart is the lab’s certification by the Commission on Office Laboratory Accreditation. It provides a new degree of testing, including cardiac markers tests which can show if someone is having a heart attack. The facility also has a reverse-isolation room that will allow patients with potentially serious contagious illnesses to be set apart in an environment that includes a separate ventilation system. Because the facility is staffed by emergency-trained physicians and nurses who are also pediatric-certified, several rooms are designed especially for children. There are seven examination rooms in total.

“It sits in a really convenient position for most individuals in Ahwatukee,” said Bricker. “Those who are seeking emergency care can expect to come in and be seen and treated very quickly.” Leading the facility is Dr. Frederick Johnson, who has more than 37 years in medicine and whose previous post was as medical director for Valley View Medical Center in Fort Mojave, Arizona. Although the ER is equipped to handle far more procedures than typical urgent-care facilities in Ahwatukee, there are still numerous procedures that will require a fully-staffed hospital, including surgery and long-term care. Patients requiring higher levels of care will be transported from the ER to Chandler Regional Hospital. n

2016-2017 AHWATUKEE MEDICAL

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Former Navy commander at cancer-fighting helm at Ahwatukee Skin & Laser here’s a new commander in the treatment of skin cancer in Ahwatukee. Dr. Nathan Uebelhoer, a former Navy commander, is Ahwatukee Skin and Laser’s top skin cancer surgeon. Uebelhoer has more than 15 years’ experience in dermatologic surgery, including more than 3,000 complex Mohs surgeries under his belt and “is quickly becoming a well-known name in the Valley,” said Ahwatukee Skin and Laser manager Sarah Neumann. Uebelhoer is in the right place. “Skin cancer affects nearly one in three adults in Arizona and our state sees more skin cancer cases than any other state,” he said. “So, it’s important everyone knows about Mohs surgery and skin cancer prevention.”

mor and results in higher recurrence rates. “Mohs micrographic surgery is different. During Mohs, 100 percent of the skin margin is examined under a microscope as part of the procedure, so the unhealthy tissue is removed stage by stage, ensuring complete clearance” he added. Mohs “is great for highly sensitive areas on the head and neck when the goal is to minimize the risk of scarring,” Neumann noted. Not all skin cancer is treatable with Mohs surgery, but it is curable when detected early, Uebelhoer said. “You need to find a physician and practice you trust; that’s sometimes the hardest part in the journey to treat skin cancer” he said. “But time isn’t a luxury. Find a practice you like now, schedule routine skin evaluations (especially here in Arizona) and be vigilant about sun protection.” Uebelhoer is no stranger to healing or

Mohs is a highly precise skin cancer removal technique that eliminates all cancerous skin while sparing healthy skin. It’s become the gold-standard to treat skin cancer since its method and results are more advanced than the traditional surgery, according to Uebelhoer. “Traditional skin cancer surgery fails in two main ways,” he said. “First, it often removes more healthy, non-cancerous skin than is necessary resulting in larger scars. Second, due to the nature of the most common forms of skin cancer, non-Mohs surgery often misses the edges of the tu-

to giving medical advice. Board certified in dermatology, he completed a one-year dermatologic surgery fellowship and has received numerous awards for his excellence in teaching other dermatologists and plastic surgeons internationally. He helped pioneer laser-surgical techniques in the Navy for burn and traumatic scars, improving the quality of life for hundreds of wounded warriors and other victims of burn injuries around the world. He continues to lecture internationally on this work.

TIMES PUBLICATIONS STAFF

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AHWATUKEE MEDICAL 2016-2017

Dr. Nathan Uebelhoer

Though retired from the Navy, he stays connected by volunteering his time and expertise to the military to heal and treat active duty service members and veterans. “Giving back, keeping people healthy and skin cancer awareness are important to me, so I found a practice with the same beliefs. Ahwatukee Skin and Laser hosts fundraisers, gives to charity and not only treats skin cancer, but promotes skin cancer awareness. They also treat the bigger picture to make sure the entire body is healthy” said Uebelhoer. Neumann calls Uebelhoer “an excellent asset to the Ahwatukee Skin and Laser team.” “With over 15 years of experience in Mohs surgery, wound repairs and cosmetic laser surgery, Dr. U brings a wide array of skills to the party that not many offices have the privilege of offering,” she said, adding: “Even though you may hope to never meet him, rest assured you will be in excellent hands should the time ever come.” Skin cancer diagnosis and treatment comprise the main focus at Ahwatukee Skin and Laser, but it’s not the practice’s only strength. “Ahwatukee Skin and Laser follows a whole-body approach to treat all conditions that affect patients’ overall health,” said Neumann, noting her business has won back-to-back Best of Ahwatukee awards. Ahwatukee Skin and Laser has won Best of Ahwatukee for Best Derm, Skin Care and Neumann for Best Physician’s Assistant since 2013. Neumann’s state-of-the-art facility also treats psoriasis, acne, hair loss and other skin related auto-immune conditions. n For a check-up or skin cancer evaluation: 480-704-7546 or ahwatukeeskincare.com.

The types of skin cancer TIMES PUBLICATIONS STAFF

Skin cancer is an abnormal growth of skin cells. It most often develops on areas of the skin exposed to the sun’s rays. Skin cancer affects people of all colors and races, although those with light skin who sunburn easily have a higher risk. Here are the basic kinds of skin cancer, explained by the American Academy of Dermatology. Basal cell carcinoma (BCC) • This is the most common type of skin cancer. • Frequently develops in people who have fair skin, yet they can occur in people with darker skin. • Looks like a ﬂeshcolored, pearl-like bump or a pinkish patch of skin. • Develops after years of frequent sun exposure or indoor tanning. • Common on the head, neck, and arms, yet can form anywhere on the body. • Early diagnosis and treatment is important. It can invade the surrounding tissue and grow into the nerves and bones, causing damage and disfigurement.

Actinic Keratoses (AK) • These dry, scaly patches or spots are precancerous growths. • People who get AKs usually have fair skin. • Most people see their first AKs after 40 years of age because AKs tend to develop after years of sun exposure. • AKs usually form on the skin that gets lots of sun exposure, such as the head, neck, hands, and forearms. • Because an AK can progress to a type of skin cancer called squamous cell carcinoma (SCC), treatment is important.

Squamous cell carcinoma (SCC) • Second most common type of skin cancer. • People with light skin are most likely to develop SCC, yet they can develop in darker-skinned people. • Often looks like a red firm bump, scaly patch, or a sore that heals and then re-opens. • Tends to form on skin that gets frequent sun exposure, can grow deep in the skin and cause damage and dis figurement. Early diagnosis and treatment can prevent this and stop SCC from spreading.

Melanoma • The deadliest form of skin cancer. • Frequently develops in a mole or suddenly appears as a new dark spot on the skin. • Early diagnosis and treatment are crucial. If you think you might have one of these forms of skin cancer, call 480-704-7546 or visit ahwatukeeskincare.com.

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The Team at Ahwatukee Skin & Laser

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Nathan S. Uebelhoer, DO

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www.ahwatukeeskincare.com 480.704.SKIN (7546)

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Bethany Cheatham, MSN, FNP-C

Mark Weaver, MPAS, PA-C

Physical Assistant Sarah Neumann

Kelly Fields, LPN, LE, CLT

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Understanding pain and how physical therapy works can lessen the hurt BY TED CARTER TIMES PUBLICATIONS GUEST WRITER

et’s face it, no one likes to be in pain. Pain is the number one reason why people visit healthcare providers, especially physical therapists. Most people do not understand how exactly pain works, or more appropriately why we hurt. The pain experience is a complex biopsychosocial experience, which means that tissues (biology), cognitive beliefs (psychological) and context (social) all play a role in determining if we will experience pain or not. This makes pain a much more complex process than most people understand. Here are two myths on pain and how physical therapy can help: Myth 1: Pain only occurs when you are injured. How many times have you finished yardwork and gone inside to get something cold to drink and noticed several cuts and scratches on your arms and legs? Have you ever woken up and noticed a bruise somewhere on your arm and don’t remember how it got there? Your body can sustain tissue damage even if you didn’t have any pain. There have been several studies where people who are asymptomatic (no pain or symptoms) underwent medical imaging and 40 percent had a bulging disc or low-back degeneration that started in their 20s. Myth 2: The body tells the brain when it is in pain. The one basic concept is that pain is an output by the brain that comes from thousands of various inputs. There are no special pain fibers in your body. We have nociceptors, which are special nerve fibers that send information from tissues to the spinal cord and up to the brain.

Nociceptors can send messages in the absence of tissue damage. A few inputs that stimulate nociceptors include: movement, stress, thoughts, temperature, blood flow, and immune system. For example, studies have shown that decreased blood flow to tissues will cause increased nociceptive activity. This does not mean pain. Think about how long you’ve been sitting in your chair reading the newspaper. Have you shifted your body position at all? Leaned forward or backward in your chair? Crossed one leg over the other? The nociceptors in your body told you to move around because they weren’t getting enough blood flow; you probably didn’t even notice that you changed positions until right now. Whether you have a nagging pain from sitting at your computer all day, achy muscles from a long weekend of yardwork or are planning on surgery, physical therapy can help relieve pain and help people feel better. Physical therapists can help explain the complexity of pain and work to create a plan to help Ted Carter reduce it in many cases. Treatments can range from manual “hands on” therapy, such as joint mobilization, soft tissue mobilization and trigger point dry needling. These techniques are designed to stimulate blood flow, improve movement, and alter nociception. Therapists also use modalities such as electrical stimulation (TENS), heat and ice to alter nociception. Another way to combat pain is through physical activity. Exercise has been shown to increase blood flow which brings oxygen and nutrients to tissues, decrease the sensitivity of the nervous system, regulate hormones such as adrenaline and cortisol, improve sleep, release our body’s natural pain relievers (endorphins and enkephalins), and improve mood. n Ted Carter is a physical therapist at Foothills Sports Medicine Physical Therapy, 15410 S. Mountain Pkwy, Ahwatukee. Information: www.foothillsrehab.com or 480-940-8299.

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AHWATUKEE MEDICAL 2016-2017

Migraines may signal need for brain stem check BY CAMERON CALL TIMES PUBLICATIONS GUEST WRITER

ave you ever been in pain and were told, “Suck it up! It’s just a ______”? You can fill in the blank with whatever you want: It’s just a headache, a scratch, a sore foot, a bum knee,

brainstem function. Focusing on this area of the body allows them to help even the most chronic conditions—such as migraines—find resolution to their health conditions instead of just temporary symptom relief. If you have an improperly functioning nervous system (and brainstem), it can lead to migraines and a whole lot more. The sad truth is most people have never had an evaluation of their nervous system or brainstem before. There is hope to finding resolution to your chronic health conditions, especially your migraines. You can get better and back to living the life you truly desire. n

etc. Sometimes we have difficulty empathizing with people in pain because we all experience it differently. However, when it comes to headaches, most people experience similar symptoms. According to the Migraine Research Foundation, in the first nine months of 2016 alone, 38 million people suffered from migraines on a daily basis. Cameron Call If you Google the phrase “causes and symptoms of migraines,” most of the sites give you the same information, Dr. Cameron Call, clinic director of The Specific Chiropractic mostly focused on pain and what medication you should take. Center in Ahwatukee, focuses on restoring brainstem function Nothing really talks about how to get rid of migraines, but merely treating chronic health conditions. Reach him at 602-763manage them. 7782 or cameron@thespecific.com. You can read in multiple sources that a migraine is defined as, “a painful headache often accompanied by nausea, vomiting, and sensitivity to light.” Well, that information doesn’t really help. If you have migraines, you don’t really need to have someone explain what it SCREENING feels like to have one. AVAILABLE As far as treatments, most websites will recommend you see your medical doctor for prescription medication. The medication options include anti-epileptic drugs such as Depacon, Depakote, Topiragen and Topamax. There are also beta-blockers such as Blocadren, Inderal, Innopran XL, Lopressor, ToprolXL. Or you can try botox injections. Botox is a type of toxin produced by the bacteria clostridium botulinum. It weakens or paralyzes muscles. Stunning Results! Then there are standard pain relievers such as aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen • Non-surgical laser procedure (Advil, Motrin IB, others). Those may help relieve mild migraines. • Minimal recovery time Yet, if you had the choice, wouldn’t you want a solution that • Done in the office by a physician didn’t require you to take anything? Many “experts” talk about avoiding triggers, such as alcohol, • 15,000 patients treated! caffeine, chocolate, and stress. I would argue that these triggers do not cause migraines. If these triggers caused a migraine, why doesn’t everyone have a migraine when they eat chocolate? Why do some people have Met Your foods or situations that cause a migraine and others don’t have any problem at all? Deductible? So that brings us to the question, “What really causes a miCall Us Today! www.optimaveincare.com graine?” The Mayo Clinic has this to say: “Although much about the cause of migraines isn’t understood, genetics and environmenDr. Paul Sos, MD • Dr. John Opie, MD • Dr. Kenneth Seifert, MD tal factors appear to play a role. Migraines may be caused by Covered by Most Insurance, Medicare & AHCCCS changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway.” Read that last sentence again. (No, seriously. Read it again). If the Mayo Clinic says the brainstem could play a role in causing migraines, wouldn’t you want to see if your brainstem function 485 S. Dobson Rd., Suite 103 | Chandler 85224 was working properly, especially if you have migraines? (888) 985-1765 There are doctors out there who focus solely on checking

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AZ Spine Disc & Sport provides one-stop care and coordinated communication BY ROBERT BAWOL TIMES PUBLICATIONS GUEST WRITER

EYE PRIORITY, PC Dr. Kelly de Simone, O.D., FCOVD Dr. Monica Sawitzke, O.D.

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AHWATUKEE MEDICAL 2016-2017

Times Publications

he landscape of today’s healthcare system is ever evolving. New practices are being implemented almost daily. Cutting edge procedures—surgical, alternative, and otherwise—are resulting in better recovery times and a faster return to everyday life. Better diagnostics, better medication and better technology are available to all. Yet, while all the new advancements are being introduced at light speed pace, communication between healthcare and medical providers seems to have stayed inconsistent. Whether it is a delay or a complete lapse, communication problems are a common concern among many patients across the Valley. But what if communication problems didn’t exist? What if your team of providers can interact face-to-face with you daily? What if the topic of discussion was you, the patient, and how the healthcare providers could come together to make sure that your care is as effective as possible? That is the kind of care that patients can expect out of AZ Spine Disc & Sport in Ahwatukee.

Cutting the ribbon on the expanded AZ Spine Disc & Sport clinic in Ahwatukee are, from left: Ahwatukee Chamber of Commerce repreentative Devida Pi’ilani Lewis, clinic marketing and fitness manager Robert Bawol, office manager Ivonne Lopez, and co-owners Dr. David Stone and Dr. Angela Christopher.

Until recently, AZ Spine Disc & Sport offered sports medicine, pain management, chiropractic, physical therapy and massage therapy. With a recent 20,000-square-foot expansion, AZ Spine Disc & Sport has added primary care, acupuncture, personal training and nutritional counseling to the list of sits menu of services. By housing all these services in one location, AZSDS providers work together to improve patients’ quality of care and return them to the daily activities they love in a significantly shorter amount of time. Say that an individual gets injured in a motor vehicle collision. That patient can come into the office for a preliminary evaluation by the clinic’s physical medicine and rehabilitation doctor. After evaluation and diagnostic imaging, the patient would be referred to supportive rehabilitative therapies such as physical therapy and chiropractic care. Patients also have the opportunity to utilize the clinic acupuncturist and massage therapists to help speed up the recovery process. Throughout their care, every provider stays on the same page without days or weeks of a lag in information. In many other clinics, care stops when rehab is done. Not at AZSDS. Once patients are able to return to daily life, they also have the option of improving on the life they had. With an exercise physiologist on staff, patients can dive into a fully customized training program to make sure that they stay healthy, active, and injury free. Patients who aren’t suffering from injuries but just want to make sure that they are healthy also can benefit at AZ Spine Disc & Sport. A primary care provider on site provides their yearly physicals and check-ups in one spot. If a physical shows that the patient needs to focus on a little bit of weight loss, AZSDS offers options for healthy weight reduction and lifestyle modification to get back on track. All services are available to all patients no matter where they fall on the spectrum of pain, rehabilitation, preventative care, or basic self-improvement. And patients only have to worry about going to one place to get all that care and feel confident that all the providers are communicating to get them the best results possible. n Robert Bawol M.S., C.S.C.S, is ﬁtness and marketing manager for AZ Spine Disc and Sport, 4530 E. Ray Road, Ahwatukee. Information: 480-759-1668; azspinediscandsport.com.

Don’t mix aspirin and other pain relievers without a doctor’s advice BY AGNES OBLAS TIMES PUBLICATIONS GUEST WRITER

to promote clot formation. This is a good thing, especially for individuals who have already had a heart attack. What about other anti-inflammatory medications, such as ibuonsider the following scenario: You are one of the growing profen or naproxen? Although their mode of action is different numbers of individuals who, on the advice of a healthcare from aspirin, their ability to minimize the symptoms of inflammaprovider, takes an aspirin every day because of its car- tion is similar. dio-protective properties. So why should there be a problem for patients taking aspirin on Then, one day you sprain your ankle and you consider taking a the same days as taking any other anti-inflammatory medication? couple of over-the-counter ibuprofen two or three times a day for The answer is that all these anti-prostaglandin medications a few days for its anti-inflammatory effects. compete with each other when ingested together or Is it advisable to be taking aspirin and ibuprofen too soon to each other. In fact, aspirin’s beneficial efsimultaneously? fects are actually negated. Before answering this question, consider the workIf your healthcare provider has prescribed aspirin as ings of “anti-inflammatory” medicines. part of your heart health regimen and you find yourself When any body tissue is injured, the injured cells proin a situation where you would like to use an additional duce a chemical called prostaglandin. There are about over-the-counter anti-inflammatory agent, make sure 30 known prostaglandins that the body can produce. you consult your prescriber first. These prostaglandins act as a signal for other But a general rule of thumb would be to wait at blood components to commence the inflammatory releast 30 minutes after taking the aspirin (as long as it sponse that often results in pain, swelling, and maybe is “baby” aspirin and as long as it is not enteric coated) redness and fever. and ideally eight hours before taking an ibuprofen or In the cardiovascular system, when the inner wall naproxen. Agnes Oblas of a blood vessel is disrupted because of plaque formaWith occasional use, there is likely to be minimal tion, certain of these 30 prostaglandins are released. risk of lessening the antiplatelet effect of aspirin. That signals blood components called platelets to get sticky for If you could get by with using acetaminophen (better known as the purpose of patching up the disrupted blood vessel wall. Tylenol) for the pain, wouldn’t you rather do that? The sticky platelets then begin to coalesce, or glob up, to form When in doubt, check it out. n clots within the blood vessels—generally not a good thing. Aspirin is a potent anti-prostaglandin compound, which is why Agnes Oblas is a nurse practitioner in Ahwatukee and works it works so well in cases of pain, swelling, and fever. at New Paths to Healthcare, LLC, Ray Road Medical Center, But in terms of heart health, the anti-prostaglandin effects 13838 S. 46th Place, Ahwatukee. Reach her at 602-405-6320 make the above-discussed platelets less sticky, thereby less likely or newspathshhealth.com.

2016-2017 AHWATUKEE MEDICAL

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News about flossing could lead to gum disease resurgence, dentist fears BY DR. RASHIMI BHATNAGAR TIMES PUBLICATIONS GUEST WRITER

hwatukee dental offices were bombarded by calls late last summer after shocking national news. Prominent national television, radio, and online news sites announced that the U.S. Departments of Health and Human Services and Agriculture in 2015 issued guidelines negating the need for flossing as a part of recommended oral hygiene. For centuries, dentists and hygienist have been stressing the need to floss as a requirement in preventing tooth decay and gum disease. The Associated Press reviewed the research over the past 10 years, evaluating the result of toothbrush only versus the use of toothbrush and dental floss. It found the evidence of flossing’s benefits weak and unreliable. Ahwatukee’s specialist in gum disease, Dr. Randy Fitzgerald, of AZPerio of Ahwatukee, sees on average 120 Ahwatukee residents per week specifically for treatment of gum disease. “With the short-term studies, the data does show that flossing decreases gingival inflammation,” says Fitzgerald. “But to have more accurate and strong

data, research would require expensive man Services said: studies, long duration, large data pool, and “Tooth decay and gum disease can deaccuracy in the flossing technique,” he add- velop when plaque is allowed to build up on ed. “The researchers would basically have to teeth and along the gum line. Professional bring the patients in daily to floss for them cleaning, tooth brushing, and cleaning beto obtain accurate data tween teeth (flossing and over the course of many the use of other tools such years.” as interdental brushes) The American Dental have been shown to disrupt Association released an and remove plaque.” announcement in response On reaction to the flossto the national headline ing story, Fitzgerald stated, stating: “My main concern is that if “The bottom line for our patients read this infordentists and patients is mation and feel flossing is that a lack of strong evinot needed, they may not dence doesn’t equate to a follow the regimen we have lack of effectiveness. As recommended for them. doctors of oral health, denThen, their gum disease tists are in the best position may rebound.” to advise their patients With 30 years at AZ on oral hygiene practices Perio of Ahwatukee, Fitzbecause they know their gerald insists, “Flossing is patients’ oral health status instrumental along with Dr. Rashimi Bhatnagar and health history.” brushing in maintaining oral “If retained food or dehealth.” n bris is not removed, patients are going to have an increased risk of bad breath, a bad Dr. Rashmi (Rush) Bhatnagar, taste in the mouth, and an increase in bleedDMD, MPH, is an Ahwatukee dentist. ing when brushing,” the ADA added. Reach her at 480-598-5900 or The U.S. Department of Health and Huwww.BellaVistaDentalCare.com.

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Sonoran Hills Dental drills down to patient care BY SHELLEY GILLESPIE TIMES PUBLICATIONS CONTRIBUTING WRITER

ver since he went into private practice 15 years ago in Ahwatukee, Dr. Collin Ito has been driven by a determination to be a people-friendly dentist. Ito, 45, had no intention of cramming as many appointments in a day as possible, stranding already anxious patients in the waiting room. Nor did he want to send them off to a gamut of specialists. He wanted his practice, Sonoran Hills Dental, to make patients feel their dentist cared about them, and that they didn’t have to worry about bracing for a dentist “with attitude.” “I’m not here to conquer the world. I’m here to give the best care to patients,” he said. So even before he became only the second business in the Ahwatukee Hills Plaza in 2001, Ito’s philosophy attracted his first patient. Tess Powers had stopped to speak with him, explaining that even the thought of going to a dentist filled her with dread. As a patient of Dr. Ito’s for the past 15 years, Powers now looks forward to her visits to Sonoran Hills Dental. She says she was especially grateful to him when a temporary crown fell off on a recent weekend. Powers is a singer and the thought of performing with her tooth missing was embarrassing. So Ito met her on a Saturday and fixed her problem. “Coming here feels like family. The care is fantastic,” Powers said. Powers and her family are so pleased with their dentist that her grown daughter, who is out of state attending law school, returns to Ahwatukee for her dental cleanings. In a recent visit, Powers reminded Ito of the Brownie troop she brought to his office to learn about dentistry. Ito nodded with enthusiasm; he says he enjoys reaching out to the community. Ito’s own son, Lleyton, 14, was afraid of dental treatments. With a series of gradual, alternative approaches that Ito uses to assist any fearful patient, Lleyton lost that terror. Since the beginning of his dental practice, Ito has seen changes in the profession and in patient expectations. First, he says, everything is digital now. When he first began, patient charts were stacked high, requiring him to ﬂip back and forth to see previous care and track progress. Now, with digital X-rays, cameras and charting, there’s considerably less paperwork, and it’s easier to get the patient’s full history in one place. When he started practicing, patients were accustomed to silver fillings and were less concerned about aesthetics. Now, aesthetics are a major concern for patients, with tooth whitening, tooth-colored fillings and adult braces comprising a much larger portion of his services. Where one in 100 adult patients might have wanted braces 15 years ago, now as many as 20 percent of his adult patients requests them, Ito says. More patients also are paying out of pocket for their dental care. Companies are less likely to offer a dental plan, so Sonoran Hills Dental offers a discount plan and a new patient special for $79. While he embraces technological advances in dentistry, Ito prefers not to be an early adopter. For instance, CEREC crowns, which are constructed of non-metallic materials and inserted all in one day, are now becoming popular. “I like technology to have the bugs worked out before I use it,” Ito explained. His staff originally comprised his wife, Kristin, as office manager. But now Ito’s practice has grown to include office manager Michelle Mickus, doctor’s assistant Laura Rios, fulltime hygienist Jennifer Dahman, and part-time hygienist Jaime Brown-Roessing. Family is an important value to Ito. He says he chose dentistry because it seemed to be the only medical practice where doc-

Dr. Collin Ito and and wife Kristin

tors were able to have a normal family life. Being a dad, husband and community member was important to him. One of Ito’s favorite parts of his practice is seeing long-time families bring their own children to him. As more sole-practitioners are consolidating into group practices, Ito has bucked that trend. For his own dental care, Ito trusts his hygienists for cleaning. If he needs to go to another dentist, he has a couple he trusts. Fortunately, he said, his teeth are in good shape. n Information: 4909 E. Chandler Blvd., Ahwatukee. sonoranhillsdental.com, 480-785-9191.

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Ahwatukee couple’s healthcare practice is a ‘natural’ BY SHELLEY GILLESPIE TIMES PUBLICATIONS CONTRIBUTING WRITER

eter Pinto and Amy Puls got no respect when they moved their healthcare practice from Tempe to Ahwatukee in 1993. At least that’s how the medical community in general made the husband-wife chiropractic team feel. “My first year in practice, I literally had an orthopedic surgeon sneak in the back door for fear of being ridiculed by his peers because he was going to a chiropractor,” Pinto recalled. “The good news is now they let medical doctors marry chiropractors. So, times have changed,” Pinto joked. “Mainstream has caught up to what we were promoting 20-30 years ago.” Although they focused on chiropractic care when they first opened in Tempe in 1984, they brought a new vision to their Ahwatukee practice.º They rebranded their business as Natural Healthcare Specialties to focus on a more holistic approach to the typical complaints they received from patients. And they got a bonus moving to a building that had once been a Rural Metro fire station: it made the commute from their Ahwatukee home easier. Their move cost them most of their patients, but they built a new client base by basing a path to wellness on pain management, stress control, lifestyle adjustments and nutrition.

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Peter Pinto and Amy Puls

Many patients come to them in frustration. “They come in with shopping bags full of nutrition products, but nothing works,” Puls said. Their patients’ typical complaints are often the byproduct of today’s high-pressured life: “Stress, overwhelmed, exhaustion, just being out of sync,” Puls said. After medical doctors have ruled out active diseases as causes for those health concerns, Pinto spends considerable time talking with patients to understand their symptoms. Most of their patients are referrals. “You can’t want more for the patients than they want for themselves,” said Pinto. “The patient needs to be receptive to what is available to achieve the best success.” To help identify what might be available to address his patients’ symptoms, Pinto uses mainstream lab tests and specialized software.

“They come in with shopping bags full of nutrition products, but nothing works.” He reviews the lab work with a patient and decides the best choices for treatment. Treatments ranging from chiropractic to nutrition or lifestyle adjustments often can help him and Puls uncover the causes and learn how to apply the best pain management approach. Patients who have achieved recovery sometimes return years later when their lives change or come back for a “tuneup.” But Pinto said, “You don’t want them to be co-dependent on going to doctors.” Two-thirds of their patients are female and most are 35-60 years old. But some are professional athletes, and, through a contract with the Arizona State Fair, some have been musicians, including The Who’s lead singer Roger Daltrey and platinum record artist Kenny Loggins, who needed quick therapy after traveling and performing. n Information: 13203 S. 48th St., Ahwatukee. 480-4964949, naturalhealthcarespecialties.com

Sovereign Health of Arizona’s Chandler clinic helps women recover from trauma, addiction TIMES PUBLICATIONS STAFF

or women who have suffered physical and emotional trauma, re-assimilating to everyday life can be a challenge. Treatment is critical, especially for those who haven’t succeeded with previous therapies. That’s where Sovereign Health of Arizona comes in. Its programs in Chandler are aimed at helping women who need healing from a variety of traumatic episodes, ranging from addiction to physical abuse. “We’re able to offer women a refuge where they’re with other women,” said Dr. Susanne Drury, one of the chief doctors for Sovereign Health of Arizona. “It makes them feel safe so they can address the trauma.” Sovereign Health provides a safe and secure location in Chandler for women recovering from drug and alcohol addiction, mental health disorders and other conditions. Sovereign places special emphasis on helping clients with trauma through a range of therapies. Its treatment centers in Chandler and across the nation are governed by The Sovereign Way, “a philosophy that recognizes each patient’s unique needs and circumstances by providing them with personalized treatment plans tailored to their specific treatment needs.” It offers holistic programming to aid in the rehabilitation of brain function, but also educate patients on life skills to give them the tools they need to lead more productive lives and avoid future relapse. Besides providing a safe and supportive environment where women can focus on their recovery, Sovereign also offers therapeutic activities such as equine therapy, art therapy, yoga, meditation and exercise.

The treatment program at Sovereign Health’s Chandler facility is broken down into three phases: Stabilizing the women’s emotions, processing the trauma and putting fears to rest, and finally reconnecting them to life and helping them move forward. Its Serenity House offers three-day to seven-day programs to provide an intake experience that calms them for the therapy awaiting them. “During that time, the focus is on diagnostic evaluation. We also take them from the street into a treatment facility and in a calming, gentle way,” said Anthony Mele, the clinical director for Sovereign Health Group. After their time in Serenity House, the women continue treatment in outpatient facilities, progressing until they are able to live on their own and complete their treatment. “Most of the women we treat have been through a lot of drug and alcohol programs in their past, but those were not equipped to deal with the trauma,” Mele said. “By the time we get them, they may have been through five, six seven different programs and never had their trauma addressed.” For women seeking treatment for addiction, Sovereign Health stresses that “recovery takes commitment.” It uses a 12-step process originated by Alcoholics Anonymous. While this program is not mandatory for women in recovery, it is a dominant and effective method used by many patients, Sovereign said. Chandler Councilman Kevin Hartke said the Sovereign facility is an important one for the city. “I think Sovereign Health will be another asset for our community,” he said. “It’s also just a good organization.” n Sovereign Health of Arizona’s women’s center accepts most major health insurance plans. Information: 866–598-7261.

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Doctors developing new tools to address concussions, but some say more research needed BY NICK SHAW CRONKITE NEWS

ccelerometers. Mouthpieces that turn blue. IV dye. PET scores. Phone apps. In the escalating battle against concussions, doctors are developing more and more tools to combat head injuries. Primarily focusing on education, Dr. Javier Cardenas has seen a number of innovations in new equipment, but he has some reservations. “There’s a lot of devices and tools that are upcoming,” said Cardenas, the medical director of the Barrow Neurological Institute and one of the nation’s leading neurologists. “The problem is the cart is before the horse with most of them. It really is important to do the research first before marketing devices and objects to families.” While accelerometers may not be the best tool in determining if someone has sustained a concussion, Cardenas said the future is discovering when an athlete has suffered a brain injury and when they have completely recovered to return safely to play. The Translational Genomics Research Institute, along with Arizona State University and A.T. Still University, has targeted

just that. “(We are) looking for biomarkers, specifically micro-RNA biomarkers in the blood, urine and saliva of those who are injured but also those who have sustained the greatest number of hits and the greatest frequency of hits,” said Cardenas. Dr. Roger McCoy, head athletic trainer at Arizona State, sees it as a part of the future of concussion detection. “Instead of all of these tests on the sidelines and in the locker room, our hope would be something like a mouthpiece that would turn blue,” McCoy said. “When that protein is secreted and now you know that person is concussed, there is no question about it.” When it comes to local high school and youth sports, the Barrow Concussion Network is closely working with the community. The Arizona Interscholastic Association has partnered with Barrow to provide concussion education and baseline testing to student-athletes. Dr. Tamara McLeod, director of the athletic training program at A.T. Still University, has worked with AIA since 2009 and alongside Barrow since 2011. Together, A.T. Still and Barrow created simple tests that can be performed using your phone. Strides have been made over the years

to develop equipment and protocols regarding concussions, but there have been some drawbacks in trying to implement rules and gear, especially around the state. Cost is another issue preventing high school and younger athletes from receiving the best care. The allocation of resources plays a large role. The Barrow Concussion Network is hoping new equipment and medical testing currently being researched is available for everyone. “If it’s a blood test, a saliva test, with technology hopefully there will be an affordable way of getting it down to that level or supplying it as a district,” McCoy said. “Each individual team may not need it, but at every game the devise is there.” Cardenas and the network are hoping to change a culture and the approach teams and leagues take to tackle “hidden injuries.” McCoy said he thinks new equipment and testing will start to appear in the near future. “Many of our tests are relying on the athlete being honest about their symptoms and how they feel. I think you’ll start to see some (equipment) as early as three to five years, especially the PET scans and advanced imaging that measure the tissue and physiological function of the brain. It takes a lot of guesswork out of it.” n

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Ahwatukee pediatrician’s concierge service aimed at more personal care TIMES PUBLICATIONS STAFF

oing to see the doctor can be a pain when you have a child who’s hurting and you’re trapped in the waiting room. Ahwatukee resident Dr. Duane Wooten is looking to change that. In addition to his current pediatric practice, he has developed a concierge service. Wooten said the service, called Just For Kids (JFK), enables him to make house calls and provide the kind of personal level of care he provided when he started his medical career. “I used to do house calls all the time,” he said. “I was like the only person in town doing them for children and I always thought it was a situation where it was a convenience for my patients.” Wooten noted that wait times to see a doctor can be upwards of an hour and if the child needs to go to the emergency room, the wait can be many, many times longer. So, he thought, it would be easier to eliminate the wait altogether, especially for children with special needs. “The concept is to not only take care of those people who want the convenience of

having a physician for their children who will come to them,” Wooten said. “But also for those special needs and those niche children, it makes it extremely convenient for those families.” Ahwatukee parent Todd Heaton believes the concierge service would be a much easier process than the current routine. “The biggest challenge as a parent when it comes to doctor visits is waiting,” he said. “If it’s not an emergency, like a broken arm or something dire, you’re waiting sometimes weeks just to get in. I think (concierge medicine) would be great.” JFK is broken into two tiers. Level I customers receive home visits, 24-hour cell phone and text access to the doctor, limited or no waiting for office visits, and annual physicals. The more comprehensive Level II service includes a personal Skype account in which customers can video-conference with Wooten and get prescriptions. The cost for the JFK service begins at less than $4,000 for the year. “Just For Kids won’t have any insurance plans,” Wooten said. “Just For Kids is a premium-based company that you pay a

Dr. Duane Wooten

premium per year and you get significant services.” Wooten said he has taken care of all socio-economic levels of people, from the wealthiest to the most disadvantaged, and that he treats them all the same. “I do it because I have a passion to take care of my people,” Wooten said. “This is just an avenue where I can do it.” n

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Ahwatukee, Gilbert, Mesa, Desert Ridge, Julio Hernandez, MDJulio MD Hernandez, MD Paul E. English Paul E. MD, English FAAD Paul MD, E. English FAAD MD, FAAD Julio Hernandez,

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Ahwatukee Ahwatukee Dr. English Dr. English attended Dr. attended English attended Ahwatukee Dr. Hernandez Dr. Hernandez wasDr.born Hernandez was born was born Weber Weber State University State Weber University State University and raised and in raised Puerto and in Puerto Rico. raisedRico. in Puerto Rico. graduating graduating magnagraduating magna cum cum magna cum He studied He studied medicine He medicine studied at the at medicine the at the laude with laude a major with laude ain major with in a major in University University of Puerto of Puerto Rico Rico University of Puerto Rico Zoology Zoology and a minor and Zoology a in minor Chemistry. and in aChemistry. minor in Chemistry. School School of Medicine, of Medicine, followed by one byfollowed one School of followed Medicine, by one Dr. English Dr. English attended Dr. attended medical Englishmedical attended school school atmedical at school atof internship year of year internship in Internal in Internal Medicine Medicine year of internship in Internal Medicine the University the University of Utah the of University inUtah Salt Lake in Salt of City Utah LakeinCity Salt Lake in Pittsburgh, in City Pittsburgh, PA. in HePittsburgh, completed PA. He completed a three a three PA. He completed a three and after and graduation, after graduation, and completed after graduation, completed an completed an an Dermatology year Dermatology year residency residency at the at the year Dermatology residency at the Visit our website totoview full bios. Visit our Visit website our Visit website our view to website full view bios. full to view bios. full bios. University of Puerto of Puerto Rico in Rico 1984 inand 1984 and University of Puerto Rico in 1984 and internship internship in Pediatrics internship in Pediatrics at theinUniversity at Pediatrics the University atUniversity the University English Dermatology.com English English Dermatology.com Dermatology.com English Dermatology.com became became board certified board certified byboard the American bycertified the American became by the American of Utahofand Utah Primary and of Primary Utah Children's and Children's Primary MedicalMedical Children's Medical Board Board Dermatology of Dermatology same thatyear. same year. Boardthat of Dermatology that same year. Center. Center. Dr. English Dr. Center. English completed Dr. completed English a completed a a of Dermatolo Dermatolo ist Dermatolo Dermatolo gist gist ggist He taught He taught Dermatological Dermatological surgery as an as surgery an He taughtsurgery Dermatological as an Dermatology Dermatology residency Dermatology residency at the at residency the at the ofthe:ofthe: � � ofthe: � ofthe: � Assistant Assistant ClinicalClinical Professor Professor in the in the Assistant Clinical Professor in the University University of Texasof University Southwestern Texas Southwestern of Texas Southwestern Department Department of Dermatology of Dermatology atofthe at the Department Dermatology at the MedicalMedical School School inMedical Dallas in and Dallas School served and in Dallas served as and as served University University ofasPuerto of Puerto Rico until Rico until 1987. University of 1987. Puerto Rico until 1987. Chief Resident. Chief Resident. Chief Resident. Gregory Gregory Wing, MD Wing, Gregory MD Wing, MD

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Mary Connolly, Mary Connolly, RN, CNP Mary RN, Connolly, CNP RN, CNP Gilbert Gilbert Gilbert

Gilbert Gilbert Gilbert Mary has Mary been haswith been Marywith has been with Dr. RitaDr. Fisler RitaisFisler anDr. is Rita an Fisler is an Dr. Wing Dr.isWing a board isDr. a certi board Wing certi is a board certi experienced English English Dermatology Dermatology English Dermatology experienced dermatologist experienced dermatologist dermatologist fied dermatologist fied dermatologist fied who dermatologist who who sincePrior 2001.to since Prior EDC,2001. to EDC, Prior to EDC, and a graduate and a graduate ofand Harvard Harvardof Harvardsince 2001. aofgraduate joined English joined English dermatol joined dermatol English dermatol Mary twenty had twenty years Mary had years twenty years MedicalMedical School School inMedical 2002.in 2002. School in 2002. Mary had ogy in August ogy in August 2015. ogyDr. 2015. in August Dr. 2015. Dr. hospital of hospital experience of experience hospital as an R.N. experience as anHer R.N. as Her an R.N. Her is aShe diplomate is a diplomate of the of the American She is a American diplomate of the of American Wing isWing a Utah is anative Utah Wingand native is aearned Utah andnative earned his and hisShe earned his clinical clinical background background clinical includes, background includes, Medical Medical includes, Medical Board Dermatology a fellow and a in fellow in a fellow in Boardand of Dermatology and Bachelor's Bachelor's degreeBachelor's degree in Neuroscience in Neuroscience degreeatin Neuroscience atBoard of at of Dermatology Surgical, Surgical, ICU, OR,ICU, Surgical, Psych OR, ER, Psych ICU, NICU, OR, ER, L&D, NICU, Psych L&D, ER, NICU, L&D, the American the American Academy Academy of Dermatology. of Dermatology. the American Academy of Dermatology. Brigham Brigham Young University. Young Brigham University. Young He received University. He received He received HospitalHospital Management Management Hospital andManagement Dermatology. and Dermatology. and Dermatology. After anAfter internship an internship at Massachusetts at Massachusetts After an internship at Massachusetts his medical his medical degree his degree from medical the from University degree the University from the University Beginning Beginning her career her in career California, in California, Maryin California, Mary Beginning her career Mary General Hospital Hospital in Boston, inHospital Boston, M A, shein M A, she M A, she General Boston, of Colorado of Colorado whereofhe where Colorado was he elected was where elected to he was toGeneral elected to workedworked as a staff as nurse, a staff charge nurse, charge nurse nurse worked as a staff nurse, charge nurse the Alpha theOmega Alpha Omega the Alpha Alpha Honor Alpha Omega Society. Honor Alpha Society. Honor Society. completed completed her Dermatology her Dermatology residency residency residency completed her Dermatology and assistant and assistant clinical director; director; always always didirector; di always di andclinical assistant clinical Dr. Wing Dr.completed Wing completed Dr. his Wing Dermatology completed his Dermatology his Dermatology at the University at the University of Kansas MedicalMedical at Kansas the of University of Kansas Medical rectly involved rectly involved in patient in patient care. Even care. as Even a as a Even as a rectly involved in patient care. residency residency at the University at residency the University of at Colorado the of University Colorado of Colorado Center Center where she where wasshe chief wasresident, chief Center where sheresident, was chief resident, ClinicalClinical DirectorDirector ofClinical a Level ofDirector aIIILevel OB Depart III Depart of OB a Level III OB Depart and served and served as a chief and as aresident served chief resident asatavarious chief atresident various at various and practiced and practiced for and 10 years for 10inyears thefor Kansas in10 theyears Kansas practiced in the Kansas ment, with ment, 24with hour 24accountability, hour accountability, sheaccountability, she ment, with 24 hour she clinics including clinics including the clinics Denver the including Denver VA the VADenver VAarea City City before area before moving moving to before Scottsdale, to moving Scottsdale, City area to Scottsdale, always always remained remained hands hands in patient on in patient alwayson remained hands on in patient Hospital, Hospital, Children's Children's Hospital, Hospital, Hospital, Children's and theand Hospital, the and the Arizona.Arizona. Arizona. care and care as and a patient ascare a patient advocate. and asadvocate. a patient advocate. University University of Colorado of University Colorado Hospital. of Hospital. Colorado Hospital. Brian Brinegar, MPAS, Brian PA-C MPAS, Brinegar, PA-C MPAS, PA-C Mindy Hendrickson, Mindy Hendrickson, MMS, Mindy PA-C Hendrickson, MMS, PA-C MMS, PA-C Brian Brinegar, Gilbert Gilbert Gilbert AhwatukeeAhwatukee Ahwatukee

Cynthia Cynthia (Cindi) Franco (Cindi) Cynthia Franco (Cindi) Franco MS, PA-CMS, PA-C MS, PA-C Santan Valley Santan Valley Santan Valley

Brian Brinegar has Brian been has Brinegar been has been Mindy Mindy has been has Mindy with beenhas withbeen with Brian Brinegar Cindi is Cindi a native is aFloridian native CindiFloridian is a native Floridian with English with English Dermatology with Dermatology English Dermatology English English Dermatology Dermatology English Dermatology who graduated who graduated valedicto who valedicto graduated valedicto since 2010. sinceHe 2010. is certified since He is2010. certified He is certified rian of her rianhigh of her school high rian of school her high school since October since October of 2007. sinceofOctober 2007. of 2007. by the NCCPA by the NCCPA andby is the andNCCPA is and is class. Cindi class.completed Cindi class. completed Cindi completed She completed She completed her She completed her her license license to practice to license practice in the state to in the practice ofstate Arizona. in ofthe Arizona. state of Arizona. her B.S. her degree B.S. degree at her Florida B.S. at State Florida degree University State at Florida University State University Bachelor Bachelor of Science ofBachelor Science degreeof degree atScience Arizona at Arizona degree at Arizona Brian completed Brian completed his Brian Bachelor completed his Bachelor of Science his ofBachelor Science of Science where she where received she received where the prestigious she thereceived prestigious Florida the prestigious Florida Florida State University. State University. She State then University. She entered then entered She thendegree entered degree at Brigham at Brigham degree Young at University Young Brigham University inYounginUniversity inand Presidential Academic Academic and Academic Presidential Scholarship and Presidential ScholarshipScholarship the Physician the Physician Assistant the Assistant Physician program program Assistant at atprogram at InUtah. Provo, Utah. Provo, 2003 Provo, In he2003 received Utah. he In received his 2003 he hisreceived Award.hisAfter Award. earning AfterAward. earning her undergraduate After herearning undergraduate her undergraduate degree, Cindi attended Cindi degree, attended theCindi United the attended States United States the United States Midwestern Midwestern University Midwestern University in Glendale, in University Glendale, in Glendale, master'smaster's degree degree in master's Physician in Physician degree Assistant inAssistant Physiciandegree, Assistant SportsofAcademy Sports where Sportsshe where Academy attained she attained where her she herattained her Studies from Western from Studies Western University from University Western of Health of University Health Health Academy AZ where AZ she where completed she AZ where completed a Master's she completed a Master's Studies a Master's Master's Master's DegreeDegree inMaster's Sports in Medicine Sports DegreeMedicine inwith Sports a with Medicine a with a Sciences Sciences in Pomona, in Sciences Pomona, California. in California. Pomona, He special He California. special He special portfolio portfolio and practicum and portfolio practicum in dermatology. and practicum in dermatology. in dermatology. 4.0 GPA.4.0 After GPA. a seven After 4.0 aGPA. year seven engagement After year a seven engagement year engagement izes in dermatologic izes in dermatologic izes skin in conditions, dermatologic skin conditions, in skin conditions, in in She graduated She graduated from SheMidwestern graduated from Midwestern from Midwestern working working in sportsinmedicine, working sports medicine, inUnited sportsStates United medicine, States United States cludingcluding skin cancer. skincluding Brian cancer.also skin Brian has cancer. also exper has Brian exper also has exper University University in 2007in University with 2007 a Master with in a2007 Master of withofa Master of Air ForceAirCivil Force Service, Civil Air Service, Force and asCivil an andAdjunct Service, as an Adjunct and as an Adjunct tise in cosmetic tise in cosmetic dermatology tise indermatology cosmetic including dermatology including including Professor; Professor; Cindi entered Cindi Professor; entered the celebrated Cindi theentered celebrated the celebrated MedicalMedical ScienceScience degree. Medical degree. Science degree. laser procedures, laser procedures, injectable laser procedures, injectable fillers, and fillers, injectable and MCP fillers,Hahnemann and MCP Hahnemann Physician MCP Hahnemann Physician Assistant Assistant Physician Assistant sclerotherapy sclerotherapy for vein sclerotherapy for reduction. vein reduction. for vein reduction. ProgramProgram at Drexel atProgram University. Drexel University. at Drexel University.

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AHWATUKEE MEDICAL 2016-2017

Casa Grande, Arcadia and Central Phoenix Annie MMS, Sullivan, PA-C Annie MMS, Sullivan, PA-C MMS, PA-C Melanie Childs, Melanie LE CLT Childs, Melanie LE CLT Childs, LE CLT Megan Shoen, Megan MPAS, Shoen, PA-C Megan MPAS, Shoen, PA-CMPAS, PA-C Annie Sullivan, Ahwatukee Ahwatukee Ahwatukee Aesthetician Aesthetician Aesthetician Ahwatukee Ahwatukee Ahwatukee Ahwatukee Ahwatukee Ahwatukee

Megan, anMegan, Arizonaan native, Megan, Arizonaannative, Arizona native, Annie has Annie been with has Annie been with has been with Melanie is Melanie a licensed isMelanie a licensed is a licensed joined English joined Dermatol English joined Dermatol English Dermatol Enlish Dermatology Enlish Dermatology since Enlish Dermatology since since medical aesthetician medical aesthetician medical and aesthetician and and ogy in 2013. ogyShe in 2013. gradu ogyShe in 2013. graduShe gradu 2014. She 2014. has been She 2014. has been She has been field laser technician. field laser field technician. Shelaser technician. She She ated with her atedMaster with ated her of Master with her of Master of practicing practicing as a physician practicing as a physician as a physician received her received training her received attraining Southwest herattraining Southwest at Southwest Physician Assistant PhysicianStudies Assistant Physician at A.T. Studies Assistant Still at Studies A.T. Stillat A.T. Still assistant for assistant the past for assistant 6 the years past in forderma 6the years past in 6derma years in derma Aesthetics. Prior to Aesthetics. Institute ofInstitute Natural of Institute Naturalof Aesthetics. Natural Prior to Prior to University. University. Prior to receiving University. Prior toher receiving Prior to her receiving her tology and tology 6 years and in tology family 6 years and practice in 6 family years practice in family practice becoming an aesthetician, Melanie becoming becoming an aesthetician, an aesthetician, Melanie Melanie master's, Megan master's, hadMegan master's, the prestigious had Megan the prestigious had the prestigious prior to that. prior She toattended that. prior She tocollege attended that. She oncollege attended oncollege on in10 spent 10 years the Education field. spent years spent in10the years Education in the Education field. field. honor to sign honor with toThe sign honor University with toThe signof University with The University of of Along withAlong her passion forpassion helping a was full Division I athletic Division a full scholarship I athletic Divisionscholarship I athletic scholarship withAlong her with herforpassion helpingfor helping Texas at Austin Texaswhere at Austin Texas she was where at Austin a she where was a she a a full shepeople has always been interested shepeople has always she has been always interested been interested graduated and graduated fromand the graduated University from the University of from thepeople University of of scholarshipscholarship athlete and scholarship athlete a member and athlete aofmember theand and aofmember the of the Medical and the beauty in beauty in the Medical in the field Medical and the field and the inbeauty in Texas Longhorn's Texas Longhorn's Division TexasILonghorn's Women's Division I Women's Division I Women's Wisconsin-Madison Wisconsin-Madison Wisconsin-Madison with a Bachelor with aofBachelor withinathe of Bachelor of field dustry. transition to aesthetics was a to aesthetics dustry. transition The transition to aesthetics was a was a Rowing program. RowingWhile program. Rowing attending While program. UT attending While Science attending UT UT in Nutrition. degree Science degree Science in In degree Nutrition. 2002 in she Nutrition. In 2002 she In The 2002 she Thedustry. natural step for her but more impor natural step natural for her step butfor more her impor but more impor Austin, Megan Austin, balanced Megan Austin, her balanced Megan academics her balanced academics her academics received her received Masterher received of Medical Masterher ofScience Master MedicalofScience Medical Science tantly, her tantly, patients the ben appreciate herappreciate tantly, patients herappreciate patients the ben the ben with her athletics with herand athletics with graduated, herand athletics graduated, earning and graduated, earning earning degree in Physician degree in Assistant degree Physician inStudies Assistant Physician Studies Assistant Studies efit from the unique blending of skills efit from the efit unique from the blending unique of blending skills of skills her Bachelor herofBachelor Science herof inBachelor Science Kinesiology: of in Science Kinesiology: in Kinesiology: from Midwestern from Midwestern University-Glendale. from Midwestern University-Glendale. University-Glendale. she derivesshe from thisshe background. derives from derives this background. from this background. Health Promotion Health Promotion and Health Fitness. Promotion and Fitness. and Fitness. Kenan Arkawi, Kenan PA-CArkawi, Kenan PA-CArkawi, PA-C

Alvin R.MD Fulkerson, Alvin R.MD Fulkerson, MD Kelly DonaldKelly Chavez, Donald PA-C Kelly Chavez, Donald PA-C Chavez, PA-C Alvin R. Fulkerson, Board Certified Board Dermatologist Certified Board Dermatologist Certified Dermatologist Mesa Mesa Mesa

Nationally Certified Nationally Physician Certified Assistant Nationally Physician Certified Assistant Physician Assistant Casa GrandeCasa GrandeCasa Grande

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In the course In the of receivcourse In the of receivcourse of receivKenan Arkawi, Kenan PA-C Arkawi, began Kenan PA-C Arkawi, began PA-C began While dermatology While dermatology isWhile bothdermatology is both is both ing his Masters ing his ofMasters ing hisofMasters of his career in histhe career U.s. his in Navy the career U.s. in Navy the U.s. Navy Physician Assistant exciting and exciting challenging and exciting challenging for and challenging for for Physician Assistant Physician Assistant as a Hospital as aCorpsman. Hospital as aCorpsman. Hospital Corpsman. Studies from Dr. Fulkerson, Dr. Fulkerson, the most Dr. Fulkerson, the most the most Studies The Univer from Studies The Univer from The Univer rewarding rewarding aspect of rewarding his aspect profession of his aspect profession is of his profession is is As a Hospital As aCorpsman Hospital As aCorpsman he Hospital was intro Corpsman he was intro heof was intro sity Nebraska sity of Medical Nebraska sity ofSchool, Nebraska Medical Kelly School, Medical Kelly School, Kelly the relationship the relationship formed the relationship between formed between formed between realized Chavez hisrealized unique Chavezhis treatment realized uniquehis treatment unique treatment duced to aduced wide variety to aduced wide of medical variety to a wide of medical varietyChavez of medical physician and physician patient. and physician The patient. friendships and The patient. friendships The friendships "I like to get "I like tostyle, know to get "Ithe like to patient know to getthe to patient know the patient specialtiesspecialties and gained specialties and a desire gained and toalearn desire gainedtoastyle, learn desire tostyle, learn he has developed he has developed over he the has past developed over29the past over29 the past 29 by name and by name build aand by personal name build and arelation personal build arelation personal relation more about more the about vastmore medical the about vast field. medical the vastfield. medical field. yearstohave years enriched haveyears his enriched lifehave andhis enriched life andhis life and ship." It's common ship." It'sfor common ship." KellyIt's tofor common laugh Kelly tofor laugh Kelly laugh After receiving Aftertraining receiving After astraining receiving a PACU astraining a PACUwith as a his PACU continue to continue inspire to continue inspire During to him. medical inspire During him. medical During medical patients with hisand patients with the his trust and patients they the build trust andthey the trust buildthey build him. ( post-anesthesia ( post-anesthesia care ( post-anesthesia unit) corpsman, care unit) care corpsman, unit) corpsman, school, to Dr.present school, Fulkerson Dr.school, Fulkerson was influenced Dr. Fulkerson was influenced to was influenced to to offers a comfortable offers a comfortable offers platform a comfortable toplatform presentto platform present specialize in specialize dermatology specialize in dermatology by an in dermatology by an by an Kenan wasKenan stationed wasKenan at stationed Navy was Medical stationed at Navy Medical at any Navy Medical new concerns. any new Four concerns. any years new concerns. Four of services yearsFour of services years of services encouraging encouraging dermatologist, encouraging dermatologist, Louisdermatologist, Kellar. Louis Kellar. Louis Kellar. United in States United in Navy, the States where United Navy, he States where Navy, he where he Hospital inHospital San Diego, inHospital San CADiego, where in San he CADiego, where in CA hethe where hethe Since that time that has Since time devoted he that has time his devoted time he hashis devoted time his time provided for a crew care provided for of 400 a care crew on for aof 400 a crew on of a 400 onSince a he provided medical provided support medical provided tosupport all medicaltosupport all provided to all care and energy field and toofenergy the dermatology fieldtoofthe dermatology field of dermatology daily basis-gave daily basis-gave himdaily exposure basis-gave him to exposure a him to exposure a energy to and a to the branches of branches the military. of branches the military. of the military. and extraordinary patient and extraordinary care. patient care. patient care. diverse and diverse complex and diverse patient complex and base. patient complex base. patient base.and extraordinary Kathlynn Hurt, Kathlynn PA-C Hurt, Kathlynn PA-C Hurt, PA-C

Mark Rosenberg, MarkDO, Rosenberg, FAOCD Mark DO, Rosenberg, FAOCD DO, FAOCD Rebecca Morrow, Rebecca PA-C Morrow, Nationally Rebecca PA-C Morrow, Nationally PA-C Nationally Nationally Certified Nationally Physician Certified Assistant Nationally Physician Certified Assistant Physician Assistant Board Certified Board Dermatologist CertifiedBoard Dermatologist Certified Dermatologist Certified Physician Certified Assistant Physician Certified Assistant Physician Assistant Desert Ridge Desert Ridge Desert Ridge

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Chip in the gut may become a future guide to personalized medicine BY EDDIE KELLER CRONKITE NEWS

eet HuMiX, the “gut on a chip” that may lead one day to personalized medical treatments. Arizona researchers in Chandler are able to map, isolate and study the interactions between the microbes in your body and your tissues and organs—like the stomach—by using a chip half the size of an iPhone 6 Plus. Multiple tubes are hooked to a HuMix chip to test how various compounds interact in the simulated gastrointestinal environment. Scientists use the swirl-shaped chips to study the interactions between your body and the things that affect it, such as food, medicine and germs. “We can look at the effect of drugs. We can look at the effect of nutrition,” said Frederick Zenhausern, lead researcher for

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HuMiX at the University of Arizona’s lab in Chandler. “If you eat too much chocolate, maybe that will have an impact.” Researchers connect a chip to multiple tubes that feed in compounds, microbes, and tissue samples from the gastrointestinal tract. Then, scientists study the interactions among all the substances, trying to determine the impact on an array of health issues. The chips may offer answers as simple as figuring out what makes a person have a stomach ache, or as complex as determining whether brain disease, Parkinson’s disease or Alzheimer’s are connected to microbes in the gut. “In the gut, you have a lot of neurons and nerves that connect with your brain. So maybe that communication between those cells can generate a neurotoxin” that inﬂuences the brain, said Zenhausern, director of the university’s Center for Applied NanoBioscience and Medicine.

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The potential medical breakthrough could mean individualized medical treatments could replace an all-purpose, onesize-fits all approach to a health issue, researchers said. “Your body is completely different from my body. So, the probiotics that might improve your digestion might not be so good for me. That’s one potential application,” said Marc Macgiollaeain, a visiting scientist from Luxembourg. n

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AHWATUKEE MEDICAL 2016-2017

Flanked by two high school athletes, Dr. Javier Cárdenas, a sports neurologist at Barrow’s Concussion and Brain Injury Center and a national leader in concussion research, discusses the survey results.

Barrow Institute concussion survey called ‘encouraging and troubling’ TIMES PUBLICATIONS STAFF

lmost one-third of Arizona high school senior athletes report they have sustained a concussion, according to the first statewide concussion-related study of teenagers conducted for Barrow Neurological Institute. Brain experts at Barrow released called the study’s conclusions were both encouraging and troubling. “While the number of teens who have suffered a concussion is disturbing, we are pleased that the survey also shows that Arizona youth are becoming informed about concussions and the dangers of not being treated,” said Dr. Javier Cárdenas, a sports neurologist at Barrow’s Concussion and Brain Injury Center and a national leader in concussion research. Barrow is part of Dignity Health’s St. Joseph’s Hospital and Medical Center. The survey also revealed that concussions are having a direct impact on sports participation, with one in four boys deciding not to play football because of concussion concerns and one in 10 girls declining to play soccer for the same reason. The study was conducted by WestGroup in June 2016 with a sample of 304

males and females, ages 14 to 18, living in Arizona. Of these, 169 reported playing school and / or club sports. While the issue of concussion in football has been widely discussed, the high rate of brain injury in girls’ soccer is less well known. Cárdenas said he was encouraged by the report’s finding that 79 percent of student-athletes said they would tell their coach if they thought they had suffered a concussion. The web poll of teens in June 2016 is the latest in a series of Barrow surveys aimed at gauging public understanding of concussion. Previous surveys polled parents and other adults. This survey was conducted to determine concussion awareness among Arizona teens and to understand behavior based on personal experience or potential future experience. It sampled those who play sports and those who do not and broke down responses by age and gender. “With each survey, we’re seeing more sophisticated opinions,” said Cárdenas. “Keeping a pulse on the public’s view of concussion is incredibly important in Arizona, where we have taken a national lead in creating a safe environment for all

students.” Cárdenas credited the increased concussion awareness among teens to Barrow Brainbook, the pioneering concussion education program launched by Barrow in August 2011. All Arizona high school student-athletes are required to take it before participating in sports. Arizona State University athletes will also be required to complete the Barrow Brainbook module before play. ASU is the first NCAA-affiliated university to introduce the education to its student athletes. Still, even with the education, about a quarter of student-athletes polled say they did not receive information about the signs and symptoms of concussion. “One hundred percent awareness and education is the goal,” Cárdenas said. As teen athletes learn more about concussions, they appear less likely to try to play through them. Asked what they would do if they suffered a concussion, 79 percent said they would immediately tell their coach, while 30 percent would tell their parents. Only 13 percent said they would wait for a stop in game action and four percent said they would not tell anyone. “What’s really encouraging is that they’re reporting concussions to their coach,” Cárdenas said. n 2016-2017 AHWATUKEE MEDICAL

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New heart procedure reduces patient recovery time

BY ISABEL MENZEL CRONKITE NEWS

The team of cardiac surgeons and cardiologists demonstrated the procedure on two patients at Abrazo Arizona Heart Hospital. The hospital was one of 80 sites participating in the trials that aim to demonstrate the effectiveness and durability of the procedure known as a transcatheter aortic valve replacement, or TAVR. In one Arizona demonstration, doctors from around the country watched on video monitors as a team of surgeons inserted a catheter into a patient’s groin, thread it into an artery and into the heart, where an artificial valve is placed. The surgery is described as minimally invasive compared to open heart surgery that involves cracking open a patient’s sternum. Early results are promising, said Dr. Timothy Byrne, a cardiologist and lead surgeon for the Arizona demonstration. “Is the transcatheter valve going to replace traditional surgery? Well, the data will tell us,” Byrne said. “We believe that all the way down the road that the answer is ‘yes.’” The surgery is for patients suffering 22

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AHWATUKEE MEDICAL 2016-2017

Brian Thorsen/Abrazo Arizona Heart Hospital

relatively new heart surgery procedure radically lowers the recovery time for patients and may help save lives, according to medical experts who are training physicians in Arizona on the method. Clinical trials show patients undergoing heart-valve replacement surgery spend an average of two to three days in a hospital, compared to a minimum of one to two weeks for patients undergoing open-heart surgery.

Cardiologist Timothy Byrne and his team look into the monitor while feeding a catheter into the heart chamber.

from a blockage or narrowing of an aortic valve leading to aortic stenosis, which restricts blood ﬂow to the brain. An estimated 1.5 million Americans have the progressive, life-threatening condition. Clinical trials for the surgery, have involved high-risk heart patients who are in a frail state and aren’t good candidates for open heart surgery, but trails are being conducted to determine if the surgery is a better option for low-risk patients as well. Not all patients are good candidates for the procedure. The surgery is less likely to be performed on people with severe or advanced dementia and severe lung disease. The durability of the replacement valve is still unknown, said Tammy Querrey, a director of cardiovascular care at Abrazo. The first patient who received an aortic valve in 2005 in Venezuela is alive and healthy, Byrne said. The recovery time is shorter and less stressful for patients than traditional open heart surgery. According to medical experts, heart-

valve patients typically spend an average of two to three days in the hospital with an overall recovery of only a few days. In comparison, open-heart surgery patients spend one to two weeks or longer in the hospital, with a total recovery time of six weeks. Less than 30 percent of patients continue to use their pacemakers six months after the heart-valve surgery. Byrne said valve-replacement patients had a lower mortality rate and less strokes than open-heart surgery patients. Surgeons believe the procedure will ultimately prove to be more efficient and less risky than traditional surgery. And, it will return quality of life. So far, the procedure has had excellent outcomes and changed the lives of thousands, including a 95- year old patient. “It’s very inspiring when they say, ‘Well, I want to get back on the golf course, or I want to get back to walking around this pond,’” Querrey said. “‘I just want to be able to walk a couple times a day around the pond that I like to see the ducks, the birds the nature, just experience that simple thing again.’” n

bios

medical ahwatukee/chandler

2016-17

Rashmi Bhatnagar, DMD, MPH Dentistry

BellaVista DentalCare 15715 S. 46th St., #104 Phoenix, AZ 85048 480-598-5900 www.BellaVistaDentalCare.com Dr. Bhatnagar, the founder of Ahwatukee’s BellaVista DentalCare, began her successful practice with a vision. She said, “I was determined to provide exceptional dental care with state-of-the art procedures and highly skilled, gentle, caring providers.” In order to fulfil her vision, Dr. Bhatnagar understands that advances in techniques require life-long learning. She continues to take over 200 hours of advanced dental education a year to share and implement in her teams’ care of her precious patients. She states, “Dentistry is ever-evolving. The practice, procedures, equipment, and materials we use should follow that upward trend to create dental success for our patients long-term.” Recently, Dr. Bhatnagar completed course work required for fellowship and mastership degrees with the Academy of General Dentistry which involved being evaluated by a board of her peers. These degrees are achieved by only the top dedicated dentists in the country. Dr. Bhatnagar obtained her Doctorate in Dental Medicine and Masters in Public Health from the University of Pittsburgh, and completed an advanced residency program at Albert Einstein Medical Center in Philadelphia.

Bethany Cheatham, MSN, FNP-C Dermatology

Ahwatukee Skin & Laser 4425 E. Agave Rd., Suite 148 Phoenix, AZ 85044 480-704-SKIN (7546) www.ahwatukeeskincare.com

Bethany is a board certified Family Nurse Practitioner. Originally from a small town in Iowa, Bethany grew up in Chandler, AZ. She earned her Bachelor’s of Science in Nursing from Arizona State University in 2007. While working as a labor and delivery nurse, she returned to school at University of Phoenix to become a Family Nurse Practitioner to purse her long-term goal of working in dermatology. With a family of severe acne and psoriasis, her interest in the skin began in high school and grew. Bethany loves that in treating the health of the skin, the self image of the patient may be improved, as well. She provides care focused on compassion and respect for the individual needs of the patient.

2016-2017 AHWATUKEE MEDICAL

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medical bios

2016-17

Angela Christopher, DC, ART, MUAC

Janet Euzarraga, DDS

Chiropractic Physician & Physiotherapist

Dentist

AZ Spine Disc & Sport

Dr E’s Cosmetic & Family Dentistry

4530 E. Ray Rd #110 Phoenix, Arizona 85044 480.759.1668 www.azspinediscandsport.com Dr. Christopher has been a practicing chiropractic physician and physiotherapist in the Ahwatukee area since 2005 after graduation from Logan University, in St. Louis, as a Doctor of Chiropractic. Dr. Christopher was previously the owner of “Ahwatukee Spine and Disc Center” until 2014 when she teamed up w/ her husband, Dr. David Stone, M.D., to open “AZ Spine Disc and Sport.” Both Dr. Christopher and Dr. Stone noticed holes in the medical system that stemmed from communication. The doctors decided to bring together Primary care, Sports Medicine, Pain Management, Chiropractic, Physical Therapy, Acupuncture, Personal Training, Weight loss and nutrition. Having all of these specialties in one facility allowed them to treat the patient rather than the condition and to combine eastern and western medicine. They have found that increased communication between provider types has helped to find diagnoses and treatment solutions much more quickly and helped to decrease both time and money spent for their patients. Dr. Christopher is well respected in the community and was voted “Best Phoenix Chiropractor” in 2010 by Phoenix Health and Wellness Magazine and a “Best of Ahwatukee” chiropractor by the Ahwatukee Republic in 2011, 2012, 2013, 2014, and 2015. AZ Spine Disc and Sport was voted on of the top 20 Chiropractic offices in 2016 by Expertise. Dr. Christopher uses many types of adjustment techniques and therapy techniques to create a unique plan for each of her patients. She is currently certified in Active Release Technique, Manipulation under Anesthesia, and Kinesio Tape. She has an advanced Active Release Biomechanics Certification and is proficient in biomechanics analysis and active exercise training. She recently became certified in FAKTR technique and performs myofascial release techniques both hands on and with tools. She has also dedicated continuing education hours to understanding diagnostics and the treatment of specific injuries relating to work related accidents and automobile collisions.

Lisa Cockrell, RN Cosmetic Injectables

Ahwatukee Skin & Laser 4425 E. Agave Rd., Suite 148 Phoenix, AZ 85044 480-704-SKIN (7546) www.ahwatukeeskincare.com Lisa Cockrell is Certified as a Registered Nurse Injector by the American Society for Aesthetic Plastic Surgery, and has been performing cosmetic injectables since 1999. She is also a National Trainer for Galderma®, and travels across the country training doctors and nurses in injection techniques. Lisa offers Dysport® or Botox® to minimize wrinkles of the forehead and around the eyes. She also offers Restylane® Lyft, Voluma®, and Juvederm® to restore volume in the cheeks and lower face, and Restylane® and Restylane® Silk to restore and enhance the lips. Her goal is to provide a refreshed and more youthful look, while maintaining a natural appearance, and she encourages her patients to return for a visit in 2 weeks to ensure that she has met her goal and her patient’s expectations.

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AHWATUKEE MEDICAL 2016-2017

4206 E Chandler Blvd #20 Phoenix, AZ 85048 480-494-2435 www.drEfamilydental.com Janet Euzarraga, DDS, “Dr. E,” a rare gem in the world of dentistry, focuses on quality, personalized care. Inspired by reconstructive dental work she received as a child, she has dedicated her life to perfecting her craft. Dr. E majored in Biology at Loyola University of Chicago, received her Dental degree from Loyola University School of Dentistry and advanced her skills with studies in cosmetic and restorative dentistry. After 14 years in northern IL, she came to Arizona and in 2001 the Ahwatukee community, where she lives with her husband and two sons. She said, “In my practice I use the most modern, high-tech dental equipment available to give others the self-confidence that comes with a healthy and beautiful smile. Above all, my team and I share a strong passion to treat our patients as we would like to be treated—like family.”

Kelly Fields, LPN, LE, CLT, LSO, ARRA Certified Laser Instructor Ahwatukee Skin & Laser 4425 E. Agave Rd., Suite 148 Phoenix, AZ 85044 480-704-SKIN (7546) www.ahwatukeeskincare.com

Kelly Fields has been in the Medical Aesthetic industry for 15 years. She started her career and training under world renowned Dr. Stephen W. Perkins, MD (past president of the American Academy of Facial Plastic and Reconstructive Surgery). Throughout her career, she has worked with multiple respected Plastic Surgeons, Dermatologists, and top laser companies providing, high end medical aesthetic services and clinical education. As a Licensed Practicing Nurse (LPN) and a Licensed Aesthetician (LE) she focuses on anti-aging procedures and a variety of cutting edge laser treatments. The treatments Kelly offers include Ultherapy, Cosmetic injections, Micro Needling, IPL, miraDry, Chemical peels, and a variety of laser treatments. Kelly is a past West Coast Clinical Educator for Ulthera, Inc. (Ultherapy) and Alma Lasers. This allows her to be a part of the most current technology. Her focus is to keep you feeling youthful and enjoying every step of the way!

Jeff Foucrier, PT, DPT, OCS

Ziad El Khoury, MD

Spooner Physical Therapy

Premier Cardiovascular Center

16611 S. 40th St., #130 Phoenix, AZ 85048 480-706-1199 www.spoonerpt.com

77 S. Dobson Rd. Phoenix, AZ 85224 480-814-0266 pcvc.md

Physical Therapy

Jeffrey Foucrier, Doctor of Physical Therapy, graduated from Regis University in 2011 and is a Board Certified Orthopedic Specialist (OCS). His mission is to strive to be resource for quality rehabilitative and evidence-based medicine for his patients and other medical professionals. He has pursued additional qualifications as a Certified Myofascial Trigger Point Therapist (CMTPT) and has undergone extensive continuing education in the management of chronic pain syndromes, vertigo, headaches and migraines, as well as neck and jaw pain. In an effort to practice professional excellence while promoting inter-professional best practices, Jeff is an adjunct professor at A.T. Still University’s Doctor of Physical Therapy Program. He is a clinician at Spooner Physical Therapy in Ahwatukee.

Electrophysiologist

Dr. El Khoury grew up in Lebanon where he attended medical school at the American University of Beirut, and moved to the US in 2006 for his medical training. He completed a residency in Internal Medicine at Emory University in Atlanta and fellowships in Cardiology and Cardiac Electrophysiology at Indiana University in Indianapolis. Dr. El Khoury joined Premier Cardiovascular Center in 2013. Dr. El Khoury sees patients at both Casa Grande and Chandler locations and is board certified in Cardiovascular Diseases and Clinical Cardiac Electrophysiology. Practicing cardiology is one of his passions, and being able to have a positive impact on his patients’ lives always brings him the greatest satisfaction. He strives daily to achieve that, whether it is through counseling, patiently listening to their concerns or through safe and effective delivery of therapeutic interventions. In his leisure time, Dr. El Khoury enjoys hiking in the mountains, listening to music and spending time with friends.

Janet Jordan, DDS

Romas Kirvatis, MD

Ahwatukee Orthodontics

Premier Cardiovascular Center

12010 S. Warner-Elliot Loop #2 Phoenix, AZ 85044 480-598-3659 www.ahwatukeeorthodontics.com

77 S. Dobson Rd. Phoenix, AZ 85224 480-814-0266 pcvc.md

Orthodontics

Dr. Janet Jordan established Ahwatukee Orthodontics 20 years ago with a mission statement of providing each patient and family a comprehensively exceptional experience. Dr. Jordan is committed to catering to each patient’s individual needs in a gentle, professional and respectful manner in all aspects of their experience with Ahwatukee Orthodontics, from the front office to the dental chair. She and her staff are experienced and caring. Dr. Jordan is a specialist provider for Invisalign® and is a specialist in Dento-facial Orthodontics. She received her Doctorate and Specialty in Orthodontics from NYU where she graduated in the top of her class earning awards and honors. Subsequently, she worked as an associate professor at NYU and later at UOP in California before returning to Arizona where she now lives with her husband and family.

Interventional Cardiology

Dr. Romas Kirvaitis received his Bachelors of Science degree from Marquette University in 1988. He completed his Doctor of Medicine at the Medical College of Wisconsin in 1992 and began his general surgical residency at the University of Illinois Hospitals in Chicago, Illinois. He moved to Boston, Massachusetts to complete a research fellowship in cardiac surgery at the New England Deaconess Hospital, an affiliate of Harvard Medical School. Dr. Kirvaitis completed internal medicine residency at St. Joseph’s Hospital in Phoenix, Arizona in 2005 and completed his cardiology fellowship at Aurora/Mount Sinai/St. Luke’s Medical Center in Milwaukee, Wisconsin in 2009 followed by an interventional cardiology fellowship in 2010. In 2010 Dr. Kirvaitis returned to Arizona to practice cardiology. He is an interventional board certified cardiologist and able to perform percutaneous structural heart, peripheral vascular, and endovascular procedures.

2016-2017 AHWATUKEE MEDICAL

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medical bios

2016-17

Mary Jo Kutler, DO

Sarah Neumann, MMS, PA-C

Pediatric Medicine

Dermatology

Ahwatukee Pediatrics

Ahwatukee Skin & Laser

15715 S. 46th St., #102 Phoenix, AZ 85048 480-496-6444 www.ahwatukeepeds.com

4425 E. Agave Rd., Suite 148 Phoenix, AZ 85044 480-704-SKIN (7546) www.ahwatukeeskincare.com

Dr. Kutler founded Ahwatukee Pediatrics in 1993 and has been serving the East Valley’s pediatric population since then. She was born and raised on Long Island, New York. She completed a pediatric residency at Phoenix Children’s Hospital and Maricopa Medical Center. She is Certified by the American Board of Osteopathic Pediatricians and the American Board of Pediatrics. Dr. Kutler is married for 32 years and has two children and one grandchild. Dr. Kutler is passionate about pediatric medical care, prevention, and wellness and has an emphasis on allergy testing and treatment, as well as, weight loss for adults and children in her practice. “Weight loss discussions revolve around a multifaceted approach and lifestyle changes. I think we offer that opportunity for patients if they are willing to accept the challenge.”

Jody Murray, L.Ac, ATC

Georges Y. Nseir, MD

AZ Spine Disc & Sport

Premier Cardiovascular Center

4530 E. Ray Rd #110 Phoenix, Arizona 85044 480.759.1668 www.azspinediscandsport.com

77 S. Dobson Rd. Phoenix, AZ 85224 480-814-0266 pcvc.md

Acupuncturist & Athletic Trainer

Dr. Georges Y. Nseir, a founding member of Premier Cardiovascular Center (PCC) is an Invasive Cardiologist with over 15 years of experience in cardiovascular medicine. He is board certified in Cardiovascular Medicine and Interventional Cardiology and Vascular and Endovascular Medicine. Previously, Dr. Nseir practiced at the Arizona Heart Institute (AHI) – East Valley in Phoenix, Chandler and Casa Grande from 2000 to 2009. He joined AHI after completing his fellowship in interventional cardiology at Charleston, West Virginia.

For the past 18 years, Jody has taken an integrative Eastern and Western approach to orthopedic injuries, pain management and sports medicine. She has successfully treated professional, Olympic and other elite athletes, as well as recreational participants and armchair quarterbacks. Jody is particularly proficient at evaluating and treating difficult to manage injuries and returning patients safely back to activity. Jody really enjoys helping everyone find their inner athlete, regardless of their level of competition!

Dr. Nseir received his medical degree from the Lebanese University School of Medical Sciences in Beirut, Lebanon and completed his residency at Staten Island University Hospital in Staten Island, New York. In addition to his fellowship at Charleston Area Medical Center, Dr. Nseir is a past fellow in cardiovascular disease at State University of New York in Brooklyn and Cardiovascular Interventions at Arizona Heart Institute, Phoenix, AZ.

In her free time, Jody has been volunteering on the Sports Medicine Team with the Grand Canyon Pro Rodeo and has been to Mexico with the Flying Samaritans. She believes strongly in volunteerism and looks forward to opportunities in the Ahwatukee community.

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Invasive Cardiologist

Jody comes to AZSDS from Connecticut, with 30 years of healthcare experience. She is one of only a handful of practitioners nationwide to possess dual credentials in Acupuncture and Athletic Training, making her the premier Sports Medicine Acupuncturist in the area. Jody has a BS in Athletic Training from Springfield College, an MA in Exercise Physiology from UNC-Chapel Hill and graduated first in her class from the New York College of Health Professions.

Jody is trained in Traditional Chinese Medicine, Trigger Point Needling, Cupping, GuaSha, as well as other traditional therapeutic techniques.

Sarah has been a practicing dermatology PA since 2001. She grew up in Wisconsin where she received her Registered Dieticians (RD) license after completing her undergraduate degree in Community and Medical Dietetics and Psychology. She went on to travel and find her true passion for medicine. While completing a medical mission in Central America, she found herself wanting more advanced training to better serve the people. After returning to Arizona, she received her Master’s of Medical Science in Physician Assistant Studies from Midwestern University. Sarah’s passion for skin started as a teenager who battled severe acne for years. After she was successfully treated, she committed her life to helping others achieve self esteem about their appearance. Her practice style is one of compassion, understanding and commitment to quality care. Sarah takes pride in developing meaningful relationships with clients and strives to create a positive welcoming environment in her office.

AHWATUKEE MEDICAL 2016-2017

He specializes in interventional cardiology, peripheral vascular interventions; including atherectomy, intravascular stenting, balloon angioplasty, thrombolysis, and carotid artery stenting. He is a fellow of the American College of Cardiology, and professional memberships include: American College of Cardiology; Society of Catheterization and Cardiovascular Interventions and the American Heart Association. Dr. Nseir provides outpatient cardiovascular services at the PCC Chandler and Casa Grande office locations and inpatient cardiology, peripheral and interventional services at all participating area hospitals, including Banner Casa Grande, Chandler Regional Hospital, and Mercy Gilbert Medical Center.

Agnes Oblas ANP-C

Bradley Rasmussen, MD

Certified Nurse Practitioner

Dermatology

New Paths to Healthcare, LLC

Ahwatukee Skin & Laser

13838 S. 46th Place, Suite #340 Phoenix, Arizona 85044 602-405-6320 www.newpathshealth.com Agnes Oblas, as a Nurse Practitioner, my aim is to keep you healthy and to care for you during illness. The Arizona State Board of Nursing recognizes Nurse Practitioners as licensed providers of high quality health care without the need for physician supervision. I have two Graduate degrees in Nursing; sat for the National board Certification in 1980 and have maintained certification ever since. In 2004, I was awarded the American Academy of Nurse Practitioners Arizona Award for Excellence in Nursing. I was voted Ahwatukee’s Best Nurse Practitioner in 2010. I am an active member of the Nurse Practitioner Chapter of the Arizona Nurse’s Association. Come to New Paths to Healthcare, LLC where you get “Medical Care with a Nurse’s Touch”. • Contracted with Medicare and major commercial health plans • Competitive, reasonable cash-pay fee schedule • 30-60 minute office visits • Same day appointments • Phone calls answered/returned personally and promptly

Murray S. Pratt, OD Optometry

4425 E. Agave Rd., Suite 148 Phoenix, AZ 85044 480-704-SKIN (7546) www.ahwatukeeskincare.com Dr. Rasmussen is a Board Certified Dermatologist, and has been in the field for the past 18 years. He currently splits his time between Department Chair at IHC in Salt Lake City and Ahwatukee Skin and Laser focusing on skin cancer surveillance, education and surgical intervention. Dr. Rasmussen graduated from George Washington University and completed his residency at Mayo Clinic in Rochester, MN. He remains an active member of the American Academy of Dermatology (AAD). Dr Rasmussen enjoys spending his free time with his three children, golfing and enjoying the outdoors. He looks forward to meeting you.

John M. Rowley M.D. Plastic Surgery

Lifetime Eye Care 3961 E. Chandler Blvd., #106 Phoenix, Arizona 85048 480-706-3060 www.azlifetime.com Dr. Murray Pratt, and his team at Lifetime Eye Care provide comprehensive eye care and optical services to patients of all ages. They are proud to give friendly and personalized service, using cutting-edge technology in a comfortable atmosphere. Dr. Pratt graduated summa cum laude from Southern College of Optometry and continues to stay abreast of the latest research in eye care. He is a member of many local and national societies. He is experienced in fitting specialty and gas permeable contacts, treating glaucoma, diagnosing diabetic eye disease, treating all types of pink eye, as well as routine glasses and contact lens services. Outside the office, Dr. Pratt is an active member of the Ahwatukee community with his wife and best friend, Margaret, and their three wonderful daughters.

15810 S. 45th St. Ste. 140 Phoenix/Ahwatukee, AZ 85048 480-759-3001 www.drjrowley.com Dr. Rowley is certified by the American Board of Plastic Surgery, and is a member of the American Society of Plastic Surgeons as well as the American Society for Aesthetic Plastic Surgery. Attending continuing medical education courses and aesthetic meetings to provide his patients with the highest quality of care. He has been practicing in Ahwatukee for the past 14 years, and is committed to providing patients with a pleasant and rewarding experience. Dr. Rowley has been voted one of the top doctors in the valley by his peers in Phoenix Magazine for the last several years. Performing both cosmetic and reconstructive surgery, he is contracted with most insurance plans. His staff is welcoming and professional, and strives to make each office visit a personal and comfortable experience. Dr. Rowley, his wife and two daughters reside in Ahwatukee, and he is a member of the Ahwatukee Chamber of Commerce.

2016-2017 AHWATUKEE MEDICAL

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medical bios

2016-17

Ashok C. Solsi, MD

John Tretter, MD

Premier Cardiovascular Center

77 S. Dobson Rd. Phoenix, AZ 85224 480-814-0266 pcvc.md

Dr. Ashok Solsi is the President and Founder of Premier Cardiovascular Center (PCC), established in 2010. He has been practicing in the valley for past 20 years. His prior practice includes service at Arizona Heart Institute – East Valley in Mesa, Sacaton, Phoenix, Chandler and Casa Grande from 1997 to 2009 as an invasive cardiologist.

Dr. John R. Tretter is board certified in Cardiovascular Medicine, Internal Medicine, Echocardiography and level 2 CT Angiography. Dr. Tretter received his medical degree from Autonomous University of Guadalajara, Guadalajara, México. He completed his internal medicine residency at Harbor Hospital, Baltimore, Maryland in 1989 and completed his cardiology fellowship at the Mount Sinai Medical Center in Cleveland, Ohio. Dr. Tretter is a member of the American College of Cardiology and the American Society of Echocardiography. He practiced with the Slocum-Dickson Medical group in upstate New York for nearly 20 years.

Invasive Cardiologist

Dr Solsi received his medical degree from Mysore Medical College in Mysore, India and he completed his internal medicine residency at Brooklyn Hospital Medical Center where he was chief resident during his final year. Dr. Solsi is Board certified in Cardiovascular Medicine, Internal Medicine and Nuclear Medicine. He completed his Cardiology fellowship at Brooklyn Hospital Medical Center at New York University in New York (1997). He is member and fellow of the American College of Cardiology and has published several articles on various cardiovascular topics. Currently he provides services at Chandler, Maricopa and Casa Grande.

Tina Tretter, MA, NP-C

AZ Spine Disc & Sport

4530 E. Ray Rd #110 Phoenix, Arizona 85044 480.759.1668 www.azspinediscandsport.com

Dr. Stone is a board certified Physical Medicine & Rehabilitation doctor specializing in sports medicine, interventional spine procedures and general pain management. He graduated from medical school at the University of Virginia in 2009, where he was honored as the Bowman Scholar (given to the top medical student during clinical rotations, voted on by school faculty and attending physicians). After completion of his intern medical year, he moved to Denver, Colorado where he completed his residency training in Physical Medicine & Rehabilitation. After his time in Colorado, he moved once again to Arizona in the summer of 2013 to train under the supervision of the physicians at Southwest Spine & Sports for a one year fellowship position. He joined the group at AZ Spine Disc and Sport in September 2014 as the medical director for the facility. During his undergraduate years at the University of Virginia, Dr. Stone was a 4 year starter for the varsity baseball team (UVA was 2014 College World Series runner up). He still owns multiple career records at UVA including most games played (2nd all time), at bats (4th all time), runs scored (6th all time), hits (2nd all time), stolen bases (1st all time) and walks (1st all time). He was drafted in the 2002 Major League Baseball draft by the San Francisco Giants. His professional career was cut short by a series of arm injuries, from which he was unable to successfully rehab. Due to repeated injury, he decided to retire from his baseball career and started the process of applying to medical school. Dr. Stone’s mission in the office is to help his patient’s restore function and reduce pain through the most conservative means possible. He is excited to work with an excellent team of Medical Doctors, Chiropractors, Massage therapists Physical Therapists, Acupuncturists and Athletic Trainers who all have similar goals to him. Voted Best Chiropractor and Best Medical Specialist of 2015 by Ahwatukee Foothills News!

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In 2009 he traded snowboarding on the slopes of upstate New York for mountain biking in the beautiful Arizona desert terrain to join Premier Cardiovascular Center (PCC). He has extensive experience in various cardiovascular diseases and provides services at our Casa Grande location and Banner Casa Grande Medical Center, where he serves as the Chief of Cardiology.

David Stone, MD

Physical Medicine & Rehabilitation

Non-Invasive Cardiologist

AHWATUKEE MEDICAL 2016-2017

Primary Care / Internal Medicine

Christina (Tina) Tretter brings more than 18 years of diverse healthcare experience to AZ Spine Disc and Sport. With advanced certifications in medical weight loss and esthetics she is also a member of Sigma Theta Tau, (Honor Society of Nursing) as well as the National Association of Nutritional Professionals. She is the owner of Hiker Chicks of Arizona meet-up, (fostering active lifestyles for women) and is active with the American Heart Association. Tina has worked in many areas of nursing from critical care to oncology. During this time she continued to maintain her passion for sports, health and wellness. As a certified athletic trainer she volunteered for high school track & field and cross country as a trainer and coach. Simultaneously she counseled and trained vegan and vegetarian endurance athletes and worked to bring healthy meals into the school system. Tina also has experience working with overweight and obese patients and helping manage their weight. She strives to inform, educate and guide patients into healthy livable lifestyle choices. Just as she educates all her patients, Tina continues to broaden her professional horizons on a regular basis. She has pursued additional certifications in coronary care and ACLS, HCG weight loss, and trigger point and joint injections. Tina’s personal philosophy incorporates holistic and complementary alternatives to traditional medicine and feels that “as every patient is an individual—so is their treatment plan.” In her spare time Tina enjoys trail running, hiking, mountain biking, weight training and almost anything active. Her mellow side relishes in gardening and cooking. She lives here in Ahwatukee with her husband John and son Peter. She has 3 grown children, Ed, Chiane and Joe.

Nathan Uebelhoer, DO

Dermatologic Surgery/Mohs Surgeon Ahwatukee Skin & Laser 4425 E. Agave Rd., Suite 148 Phoenix, AZ 85044 480-704-SKIN (7546) www.ahwatukeeskincare.com Dr. Nathan S. Uebelhoer, began practicing dermatologic and laser surgery 19 years ago. As an expert in his field, he has since lectured across the United States and throughout the world, authored numerous peer-reviewed articles and book chapters on the subject, and won awards for his teaching and military service. He grew up in Massachusetts and after completing medical school at the University of New England, he went to the Naval Medical Center in San Diego for internship and dermatology residency. Following Board Certification by the American Board of Dermatology, he obtained sub-specialty training in cancer surgery and facial cutaneous reconstruction through a one-year fellowship in Cosmetic and Laser Surgery at SkinCare Physicians of Chestnut Hill in Boston, Massachusetts. Since then, he has served as the division head of Mohs and Laser Surgery with the Navy in San Diego until retiring as a Commander in 2013. Dr. Uebelhoer was also trained as a Naval Flight surgeon and private pilot and proudly served in this capacity for over 3 years with the U.S. Marine Corps. In addition to Procedural Dermatology, he has been heavily involved in rural and tropical medicine, and he continues to lecture throughout the world on his pioneering work with scar rehabilitation in wounded warriors. When not in the operating room, Nathan is with his two daughters and occasionally takes the time to play golf and the piano.

Mark Weaver, MPAS, PA-C Physician Assistant

Ahwatukee Skin & Laser 4425 E. Agave Rd., Suite 148 Phoenix, AZ 85044 480-704-SKIN (7546) www.ahwatukeeskincare.com

Lindsay Whipple, PT, DPT Lead Physical Therapist AZ Spine Disc & Sport 4530 E. Ray Rd #110 Phoenix, Arizona 85044 480.759.1668 www.azspinediscandsport.com

Lindsay has been practicing Orthopedic and Sports Physical Therapy in the East Valley since 2011. She earned her undergraduate degree in Exercise Science from the University of Tampa in 2006 where she was awarded Graduate of the Year for academic achievement and community involvement. She then returned to her home state of Vermont to complete her Doctor of Physical Therapy degree at the University of Vermont where she served as a teaching assistant for DPT students in areas of musculoskeletal diagnosis and treatment. Lindsay is certified in Integrative Dry Needling and utilizes detailed biomechanical assessment, a variety of soft tissue and myofascial release techniques, and specific corrective exercise to create an individualized plan of care for each patient to alleviate pain and assist them in achieving their rehabilitation goals. Through her career Lindsay has enjoyed working with patients of all levels including MLB, NFL and Olympic athletes and strives to help her patients achieve their highest level of performance. She is thrilled to be part of the team at AZSDS as she believes strongly in a multifaceted and holistic approach to rehabilitation. Lindsay and the Physical Therapy team at AZSDS offer Dry Needling, Myofascial Release, Cupping Therapy, IASTM/FAKTR, Postural Restoration, Craniosacral Therapy, Sports Performance Training, Post-Operative Rehab, Vestibular Rehab, Gait Analysis, and Aquatic Therapy utilizing the Hydroworx300, the only aquatic treadmill of its kind in the state.

Mark Weaver is a board certified Physician Assistant with a deep passion for dermatology. He grew up in northern Utah and worked as a phlebotomist during his undergraduate college years, planning on a career in medicine. Unexpected opportunities came his way, however, and led him to earn his MBA degree and launch into a successful business career. After a few years, Mark knew his desire for a life in medicine wasn’t going away. With his young family on board for the adventure, he made the career switch. Mark has always been fascinated by the skin and how its health can deeply impact a person’s daily life. From the first day of his dermatology rotation, he knew he wanted to spend the rest of his career in the field. Mark met and married his wife in Phoenix and is excited to be able to return and practice in the Valley of the Sun. In his free time, he and his wife love traveling with their three young daughters.

2016-2017 AHWATUKEE MEDICAL

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New program offers hope for parents seeking earlier treatment for autism BY DR. JUDY PENDLETON TIMES PUBLICATIONS GUEST WRITER

rizona has one of the highest rates of autism in the United States. According to the Centers for Disease Control, one in 66 children living in the state has autism spectrum disorder. In addition, in order for children with autism to receive medically necessarily services and interventions, Arizona’s Division of Developmental Disabilities of the Department of Economic Security (DDD) stipulates that only a developmental pediatrician, licensed clinical psychologist or psychiatrist can diagnose autism. Meanwhile, there are few developmental pediatricians in Arizona, and most are located within Maricopa County, forcing children around the state to compete for appointments. In my pediatric practice in Chandler, I have witnessed firsthand the frustration of parents who must wait months to see a doctor and access the resources their children need. But thanks to grant funding and a vision created by Dr. Robin Blitz, director of developmental pediatrics at Barrow Neurological Institute at Phoenix Children’s Hospital, Early Access to Care – AZ (EAC-AZ) is removing these roadblocks. It is training physicians across the state in assessing children for autism and providing them with a medical home. In fact, I completed the EAC-AZ training program earlier this year in order to provide my patients with a highly needed and sought-after service. Created in 2015, EAC-AZ trains medical providers around the state to diagnose and treat children with autism. After a provider completes the program, Dr. Blitz works with DDD to get the pediatricians’ diagnoses approved for DDD ser-

Caring for her patients’ teeth for 29 years!

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AHWATUKEE MEDICAL 2016-2017

Dr. Judy Pendleton

vices, thus providing much-needed early access to medical intervention, therapies and school services to children living in the Phoenix area and across Arizona. The Board of Visitors, a charitable organization in Phoenix that supports the health care needs of women, children and the elderly, has been supportive because of the impact of Blitz and her team on educating those working with these children daily. Their work is allowing for improved diagnosis and access that did not exist before. The long-term goal of EAC-AZ is to change the landscape for children with autism and their families in Arizona by providing earlier diagnosis and earlier access to interventions and medical homes, resulting in better outcomes for children and support for their families.

The long-term goal of EAC-AZ is to change the landscape for children with autism and their families in Arizona by providing earlier diagnosis and earlier access to interventions and medical homes, resulting in better outcomes for children and support for their families. The first teams began training in August 2015. I am a member of the second cohort of pediatricians who completed their training in June 2016. We are now working toward final certification, which will allow us to diagnose patients, a crucial step that opens the door for children and their families to access the services and interventions they require. So far, EAC-AZ has trained 12 providers in the regions of Casa Grande, Flagstaff, Lake Havasu, Pinetop-Lakeside, Prescott Valley, Tucson, Yuma and Maricopa as well as 11 pediatricians in Maricopa County and one in Cottonwood. EAC-AZ is open to board-certified pediatricians across Arizona. The six-month training course for primary care providers consists of learning modules, independent readings, webinars, online case discussions and two, in-person trainings at Phoenix Children’s Hospital. Providers interested in participating in EAC-AZ may contact earlyaccesstocareaz@phoenixchildrens.com. Parents who would like more information can visit barrow.phoenixchildrens.org. n Pendelton Pediatrics, 1445 West Chandler Blvd., Building B, Chandler, is part of Phoenix Children’s Care Network, Arizona’s only pediatric network. Contact: pendletonpeds.com, 480-3855055.

Gynecologic oncologists may be a woman’s best friend in fighting cancer BY DR. SNEHAL BHOOLA TIMES PUBLICATIONS GUEST WRITER

utcomes studies show that women with gynecologic cancer who are treated by a gynecologic oncologist have a greater likelihood of prolonged survival compared to care rendered by non-specialists. Gynecologic oncologists are specialists trained in the entire treatment of patients with gynecologic cancers, including advanced surgery and chemotherapy. This allows for expert, comprehensive care directed by one physician. Arizona Oncology has the largest group of gynecologic oncologists in this region who specialize in: They specialize in the treatment of ovarian, uterine, cervical, vulvar and endometrial cancers, trophoblastic disease, and complex pelvic surgery; genetic counseling and testing; colposcopy evaluation of the cervix, vulva and vagina; and ovarian cancer screening for women at high risk. Arizona Oncology is the first in the state to utilize the DYSIS Advanced Cervical Imaging System, the latest technology and advancement in the early detection of cervical cancer and pre-cancers. At Arizona Oncology, we understand that a new diagnosis of cancer can be overwhelming and frightening. Our team of experts arrange consultations quickly so patients can get needed information in a compassionate, patient-focused approach. We help patients and their families navigate through the diagnosis and treatment planning as easDr. Snehal Bhoola

How women can prevent, fight cancer Arizona Oncology advises women to follow these tips to prevent gynecologic cancer or catch it early. • Breast cancer screening and mammograms are recommended to find breast cancer early. • Get cervical cancer screening. The Pap and/or HPV test can find abnormal cells in the cervix that may turn into cancer. Pap tests also can help detect cervical cancer early, when the chance of being cured is very high. • Colon cancer screening can find precancerous polyps, so they can be removed before they turn into cancer. Screening tests also can find colorectal cancer early, when treatment works best. • Lung screening annually with low-dose computed tomography (LDCT) is recommended for people who have a history of heavy smoking, smoke now or have quit within the past 15 years, and are between 55 and 80 years old. • Skin cancer screening and wearing sun screen are the best defenses against this disease. • Maintain a healthy diet. • Get a regular women’s health exam with a primary care physician.

ily as possible so that they are not overwhelmed. Women diagnosed with cancer of the female reproductive tract want advanced care from physicians who will provide the best chance for long-term survival – no matter how complex their disease. At Arizona Oncology, we provide advanced surgical skills by board-certified gynecologic oncologists coupled with targeted and personalized chemotherapy, radiation treatment, aggressive surgery, and access to clinical trials. Arizona Oncology physicians are up-to-date on genetics and molecular profiling of tumors to direct individualized treatment in an evidence-based approach. We also focus on prevention and predisposition to cancers through genetic testing. Our strong cancer genetics program includes genetic counseling and experts in the field of genetics. Early diagnosis of cancer is extremely important, women should be aware of the risk factors and symptoms and consult their healthcare provider if they are at risk or notice any changes that may be signs. Factors that may increase the likelihood of developing women’s cancers include: • Age. Most ovarian cancers develop after menopause, and half of all ovarian cancers are found in women over the age of 63 • Obesity. A study by the American Cancer Society found a higher rate of death from ovarian cancer in obese women. Obesity is a significant risk factor for endometrial cancer. • Fertility drugs. _Prolonged use of the fertility drug clomiphene citrate, especially without achieving pregnancy may increase the risk for developing ovarian tumors. • Family history. A woman’s chance of developing ovarian cancer is increased if her mother, sister or daughter had ovarian, breast or colorectal cancer. • Breast cancer. Women with BRCA mutation have an increased risk of ovarian cancer. • Estrogen or hormone replacement therapy. Some studies suggest using unopposed estrogen replacement therapy may increase a woman’s risk of developing the certain gynecologic cancers. • Smoking and alcohol use. Some studies have found an increased risk for one type of ovarian cancer (mucinous). n Dr. Snehal Bhoola is a gynecologic oncologist with Arizona Oncology, a practice in the US Oncology Network. Information: 888-972-CURE or ArizonaOncology.com. 2016-2017 AHWATUKEE MEDICAL

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Hysterectomies can be less invasive, Chandler surgeon says BY MICHELLE TALSMA EVERSON TIMES PUBLICATIONS CONTRIBUTOR

hysterectomy can be recommended to women of any age for various health reasons, but that means the patient faces an often overwhelming task in accepting the diagnosis and navigating through various alternatives. One option for patients is a minimally invasive hysterectomy, a procedure that often involves less post-operative pain, minimal scarring and a quicker return to normal life, according to Dr. Richard Haines Demir, a nationally recognized pelvic surgeon at Desert Women’s Care in Chandler. “For someone who has been told they need an abdominal hysterectomy in a hospital, the greatest thing I can do for them is do the surgery with little holes and get them back to their life as soon as possible,” Demir said. “We’ve implemented numeral strategies to accelerate the recovery.” Demir has performed more than 1,450 minimally invasive hysterectomy procedures. “We now have it to the point where we do the hysterectomy in the surgery center, the woman goes home, treats it with home nursing and, in three to four days, she’s back up and about,” he explained. “Twenty-five years ago, women would have a hysterectomy and lay up in the hospital for four days and then they would lay around more at home,” he added. Demir uses the latest technology and years’ worth of research and hands-on experience with minimally invasive surgery. It’s not only hysterectomies that he performs. “The other procedure that I do that really attracts people from other places is laparoscopic transabdominal cerclage,” he says. “We do it as an out patient and it’s for women who have had a repetitive miscarriage in the third trimester with a diagnosis of cervical insufficiency. These are people who have lost some pregnancies in the 18- to 28-week range. “We put a band around the cervix with the laparoscope,” he continued. “It feels good to help a couple have a baby when they’ve had some pretty sad outcomes.” “I’m not aware of anyone else who offers outpatient minimally invasive procedures; I believe I am the only one who offers this in the state of Arizona,” he said. In addition to his successful surgeries—which number in the thousands—Demir has won multiple industry awards, has been published in more than 40 papers, and has given presentations on the topic of minimally invasive procedures nationwide. At Desert Women’s Care, which he helped to found in 2010, he is the director of gynecology, obstetrics, and ultrasound. He’s been practicing medicine in both the Valley and Chicago for more than 25 years. “If you’ve been told you need a hysterectomy—specifically if you’ve been told you need a hysterectomy with your tummy cut open—those are the ideal candidates to give us a call and evaluate their alternatives to keep them out of the hospital and costs low,” Demir said, adding: “It’s a lifestyle enhancement; there are a lot of ways to reduce periods and control fertility. Again, if a woman has been told she needs it in a bad way with her tummy cut open, we are an ideal source of second opinions.” n Information: Desert Women’s Care, 80 N. McClintock Drive, Tempe, desertwomenscare.com.

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AHWATUKEE MEDICAL 2016-2017

Valley Fever guidelines, treatment changing BY NATALIE TARANGIOLI CRONKITE NEWS

octors are recommending new detection and treatment guidelines for Valley Fever, a deadly and debilitating fungal infection that mimics the ﬂu.

More than 4,000 cases emerged in the first eight months of 2016 alone, according to the Arizona Department of Health Services. People inhale fungus in soil, causing a bacterial infection that can leave patients exhausted and with muscle aches, a fever, cough, headaches and night sweats. It can last for weeks, even months. The illness is often misdiagnosed as a cold, ﬂu or pneumonia, leaving people to suffer and leading to costly medical tests and hospitalizations. Dr. John Galgiani, director of the Valley Fever Center for Excellence in Tucson, said early diagnosis is key to combating Valley Fever. Galgiani led a panel of 15 other medical experts, who developed new guidelines that make it much easier for doctors to pinpoint a patient’s symptoms with the corresponding illness. For example, different procedures are recommended based on factors including the presence of an immunosuppressing condition like HIV, if the patient was recently diagnosed with Valley Fever or if the medication should be taken orally or intravenously. There also are new protocols for treating pregnant women and people who have traveled to an area where Valley Fever is prevalent. Knowing someone’s travel history can make a difference in a proper diagnosis. “If it were done better and earlier diagnoses were made, a lot of care would be considered unnecessary and you wouldn’t have to do it,” Galgiani said. “Many procedural imaging like CAT scans and things may not be necessary.” Registered nurse Carla Gargiulo said she went through several urgent-care and hospital visits before a 2 1/2-centimeter nodule on her right lung confirmed she had Valley Fever. “I kind of went back and thought, ‘Oh my gosh, maybe I should have pushed this a little further, maybe I should’ve been a little more aggressive with my own care,’” said Gargiulo, who was diagnosed in December 2014. Her mild asthma became so severe after her illness she now relies on three inhalers a day and uses a small-volume nebulizer

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when she feels short of breath. She sleeps on a couch on the first ﬂoor of her home because it’s difficult to make it up the stairs. “Right now I’m in a vicious cycle,” Gargiulo said. Galgiani said patients and their health-care professionals should seek Valley Fever tests if the patient experiences Valley Fever symptoms. “These guidelines in many respects reinforced what we said before,” said Galgiani, whose center is based at the University of Arizona College of Medicine. “They specifically ask questions; if you have a patient with a certain set of symptoms, do you start an anti-fungal drug or not? And then there’s a basis for why that answer is our recommendation.” Another change in the guidelines is certain drugs previously thought to be unsafe to use during pregnancy are now known to be safe, according to Galgiani. He said a vaccine would protect those in high-risk areas such as Arizona and the Central Valley of California, where the most cases of Valley Fever occur. He thinks one for dogs, who are three times more likely than humans to become infected, could be available in five years. “The University of Arizona actually is working on a drug which might potentially cure this disease,” Galgiani said. n

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Specialty pharmacy helps patients with difficult conditions BY MIKE BUTLER TIMES PUBLICATIONS

here’s a new pharmacy in Chandler. But DaVita Rx isn’t the typical corner drugstore doling out monthly supplies of statin pills and tubes of toothpaste. DaVita Rx specializes in dispensing medications for patients with kidney disease, hepatitis C, multiple sclerosis and other complex conditions. Housed in a 76,000-square-foot office

building off the city’s 101 Science & Technology Corridor, DaVita Rx really provides intensive patient counseling and improved outcomes, said Mark Carlson, vice president of specialty operations for DaVita Rx. “We’re not just sending prescriptions out the door,” Carlson said. “We’re managing care.” Carlson said that unlike retail pharmacists, DaVita Rx pharmacists devote about 90 percent of their time to patient care, and about 10 percent to filling prescriptions. When a new patient calls with a medication program, Carlson explained, a pharmacist will ask the client what his or her goals are. They take time to answer patient questions. They discuss side effects and how to administer the medicine, especially if it requires a specialized injector. Technicians also ensure that patients aren’t taking prescriptions they might be allergic to or that shouldn’t be taken together. Support staff answer questions about insurance, co-payments and investigate whether the patient qualifies for financial assistance from the drug maker or a particular foundation. Patients get a follow-up call every 30 days to see how

they’re doing and to make sure they’re sticking with the plan. Many medications are highly perishable and need to be kept cold. They are shipped overnight for morning delivery. DaVita Rx’s 10,000-square-foot, secure dispensing room includes access to 2,400 square feet of walk-in cooler/freezer space. Cool storage is independently powered and backed up by generators. Carlson, a registered pharmacist himself, said DaVita Rx expanded to Chandler because of its educated and skilled workforce. “It’s a good culture fit for us. We’re really excited to be here,” he said. The Chandler facility has about 100 employees so far, who are providing business continuity for pharmacies in Florida, Texas and California. At full capacity, DaVita Rx Chandler, which employees have nicknamed Canyons, will have 550-600 staff members. Sister company DaVita Kidney Care operates nearly 2,300 outpatient dialysis centers with about 185,000 patients in the United States. About a half-dozen of those centers are located in Chandler, Tempe, Mesa and Gilbert. n Information: 485 N. Juniper Drive, Chandler; 480-665-5100.

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Sleep affects more than a child’s mood, so make sure routines are in place TIMES PUBLICATIONS STAFF

t’s a nightly ritual that many children dread: bedtime. The parents of sleep-averse kids share in the misery, too. Getting a child to go to sleep is sometimes a battle of wills, and mom and dad are often on the losing end of that battle, so they tend to concede another 30 minutes of screen time or cuddling to extinguish a tantrum. But it’s important for parents to know a good night’s rest isn’t the only thing at stake. Dr. Mary Jo Kutler, D.O., a pediatrician at Ahwatukee Pediatrics, said the benefits go far beyond waking up on the right side of the bed. “Sleep affects much more than your mood,” Kutler said. “When children get enough of it, a good night’s rest can fight infection, promote adequate growth, and even fend off obesity.” The key is setting healthy sleeping habits, she explained. Establishing them may take time, but it’s important for parents to introduce and maintain a bedtime routine, the elements of which are consistent and non-negotiable. Kutler recommends the following tips for better sleep: • Be consistent. Go to sleep and wake up at the same time, even on weekends. • Limit screen time. Activities such as watching television or playing on the computer should be avoided as bedtime draws near.

• Ritualize relaxation. Have your child take a warm bath or read a book before lying down for the night. • Mind environment. Be sure to keep your child’s bedroom dark, quiet, and cool. • Ban soda and physical activity. Avoid caffeine and exercise before bedtime. While adherence to a routine helps most kids, it may not solve all sleep problems, Kutler warned. “Disorders like sleep apnea, restless leg syndrome, night terrors, and narcolepsy are very real and compromise healthy sleep of thousands of children,” she said. “These types of disorders require the help of specially trained sleep medicine physicians who work with children and their families to diagnose and treat the problem.” Kutler says symptoms that warrant evaluation by a sleep medicine physician include: excessive snoring, lapses in breathing, gasping for air, bed wetting in children older than 6, multiple nighttime awakenings, difficulty initiating or maintaining sleep, restless sleep, hyperactivity, a decline in school performance, excessive drowsiness, sleep walking and night terrors. “If I suspect a sleep disorder that cannot be managed by the implementation of a consistent sleep routine, I’ll refer patients to a sleep medicine specialist like the ones at Phoenix Children’s Hospital,” Kutler said. “Children will undergo a comprehen-

Hours of sleep recommended for young children Age

Nighttime Sleep

Daytime Sleep*

Total Sleep

1 month

7(3)

15 1/2

3 months

5(3)

6 months

31/4(2)

14 1/4

9 months

3(2)

12 months

11 1/4

21/2(2)

13 3/4

18 months

11 1/4

21/4(1)

13 1/2

2 years

2(1)

3 years

10 1/2

11/2(1)

Dr. Mary Jo Kutler, D.O.

sive exam and consultation process, and if necessary, an overnight sleep study will be conducted, during which oxygenation, sleep quality, staging of sleep, leg movements, and heart rate are closely monitored and evaluated,” she explained. Sleep quantity–not just quality–is also important, and it varies by age. “A 1-month-old infant requires as much as 16 hours of sleep every day, whereas a 17-year-old will do fine with eight or nine hours,” Kutler said. Ensuring that children get enough sleep can be difficult, and sports activities, long work hours for mom and dad, and an ever-growing list of cool digital distractions only complicate things. But a good night’s rest must be a priority, Kutler stressed. “A restful and adequate night of sleep is a key to a healthy lifestyle,” she said. “You’re not just saving yourself from dealing with a grumpy little one in the morning, you’re protecting your child from serious health problems.” n Dr. Mary Jo Kutler is a pediatrician at Ahwatukee Pediatrics, which is part of Phoenix Children’s Care Network, Arizona’s only pediatric network that includes half of all independent pediatricians, 80 percent of pediatric subspecialists in greater Phoenix. Reach her at Ahwatukee Pediatrics, 15715 S. 46th St., Suite 102, Ahwatukee. 480-496-6444.

* number of naps in parentheses 2016-2017 AHWATUKEE MEDICAL

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