Because medicine is not static: Meet Lacie – authentic obstetric simulator

obstetric simulator obgynTMC for Women is the lead provider for childbirth in Southern Arizona. Whether a mother is seeking a natural birth with no interventions or a high risk pregnancy that requires interventions and everything in between, the staff at TMC is constantly updating their knowledge to be prepared. Thanks to the support of the TMC Mega Raffle, a lifelike training simulator is giving techs, nurses and physicians realistic preparation to best address birthing complications and challenges.

During childbirth, serious health risks can arise suddenly and clinical staff must act quickly to protect mom and baby. “The better the training – the better the patient outcomes,” said Stacie Wood, clinical nurse educator at TMC for Women. “Our simulator is a bridge between classroom learning and real-life clinical experience.”

Just what is an advanced obstetric simulator and how real is it?

“The simulator is a wireless, robotic mannequin that can talk, breathe, blink, and respond,” said Wood.

The authentic simulator, which the TMC for Women staff named Lacie, is intended to be as human as possible – even her skin texture is strikingly realistic.

Yet, there is more to this mannequin than a realistic appearance. Lacie can give birth, react to medications, simulate bleeding and record metrics, such as the force of CPR compressions.

“We are able to train for all obstetrical scenarios and emergency care,” Wood explained. “Lacie offers unrivaled realism and versatility for clinicians to practice high-risk scenarios.”

TMC has taken full advantage of the unique training opportunities that Lacie offers. Lacie is housed in her own simulation suite, built to resemble TMC’s patient rooms. There is an adjacent control room with a one-way mirror, through which specially trained nurses operate Lacie using a laptop computer.

The control room also serves as a debrief room. Debriefing is the most important part of the training exercises. Participants are asked to reflect on their actions and discuss key learning points, which can then be applied to real-life situations.

Why is training with Lacie better than a standard training?

“Lacie is interactive and that makes the clinical participants more than observers,” said Wood. “The clinical staff engage the emotional and sensory components of learning that are beneficial for critical thinking, decision-making and delegation.”

TMC is the only hospital in Southern Arizona with the advanced simulator and one of very few hospitals to have the in-depth training available on campus. “Going forward, we will provide quarterly simulations using Lacie, because enhancing staff education and proficiency means enhancing patient care and safety.” Wood said.

 

 

TMC receives Dietetic internship accreditation

dietetic internship tucsonTucson Medical Center has been granted accreditation for a Dietetic Internship Program by the Accreditation Council for Education in Nutrition and Dietetics (ACEND). TMC will accept four interns per year to complete the 1,200 hours of supervised practice in order to be eligible to take the exam necessary to become a Registered Dietitian.

“For this first year what we really wanted to do is give back to TMC, so we did an internal candidate selection. We wanted either an employee or a volunteer,” says Beth Dorsey, director of food and nutrition services. The interns starting Jan. 2 are Zoe Schroeder and Lance Kokot, both Food and Nutrition Services Associates. TMC will participate in the national match program for the next round of interns.

“You have to complete an accredited supervised practice internship in order to sit for the examination to become a registered dietitian. There aren’t enough internships in the United States and of those internships, there is only a 60 percent match rate,” said Dorsey.

To be eligible for the nine-month TMC internship program, candidates must have a Bachelor’s Degree in Nutrition with a Dietetics emphasis from an accredited institution.

“While precepting interns is a time commitment, it encourages us to stay up to date on the most current research and nutritional practice. All of our clinical dietitians are qualified to precept dietetic interns because they are credentialed through CDR and maintain a current registration,” said Dorsey. “We have precepted interns in the clinical portion at TMC for years for other organizations; we’ve just never had our own baby, we’re really excited.”

The full dietetic internship program includes community, clinical, research and food service. To build the program prior to applying for accreditation, Dorsey and Patient Food Services Manager, Ruth Halter, reached out to consultant Apameh Bashar, “Her expertise was essential to the creation of this program and we are so grateful for her,” said Halter. After guiding them through the development and application process, Bashar joined the TMCOne staff as a certified diabetes educator.

Dorsey says, “Ultimately, it’s good for the Tucson community. The reason that we did this is because the University of Arizona has so many graduates in nutrition, approximately 150 a year, and there are very few spots in Tucson to get an internship … maybe ten spots for all of the graduates. And if they don’t get an internship in Tucson that means that we lose them and we want to keep them in the community of Southern Arizona.”

Mission Moments: Inspired by a 6 year old to first assume good intentions

Family of four standing in front of a bay

The call was enough to make a parent’s heart drop: Come to the school now. Your daughter may have to go to the Emergency Department.

Sanjay Timbadia, Tucson Medical Center’s Laboratory manager, rushed to school to find his first-grade daughter’s head bandaged with blood in her hair and on her dress.

A child had been throwing rocks on the playground and one of them had struck his daughter in the head while she played on the monkey bars. There wasn’t any malice: It was just an accident.

It was later, after she had been treated at the TMC Pediatric Emergency Department, that the little girl said something that was a poignant reminder for her father.

“That boy that threw the rock: I think he was just trying to get it out of the playground so that no one would trip on it,” she said.

It was a moment for pride and reflection, Timbadia said, and he shared the story with his team as they entered the holiday season.

“She has reminded us of an amazing lesson: to always assume positive intent first,” Timbadia said.

The lesson can be applied in the lab, which is a busy place that processes more than 2 million tests every year. It can also just as importantly be applied in everyday life as a balm against the divisions that can cause cultural and political divides – and it’s even stronger when peppered with gratitude, he noted.

“If I’m delayed because I’m in traffic or if I get a flat tire, I just try to remember that at least I have a car to take me places because there are many others who are waiting for a bus in the summer heat,” Timbadia said. “And if someone gets in front of me and drives slowly, you never know: Maybe that person just prevented me from getting into an accident.

“I think like anything else, assuming positive intent and being grateful is something we learn, and it’s also something that gets stronger with practice. At TMC, we are committed to being here to make things better for our patients and our community when they need us – and we approach that work with positive intent.”

Tucson Medical Center earlier this year adopted a new mission statement. To celebrate, we will share an ongoing series of “mission moments.”

What are mission moments? They aren’t necessarily dramatic stories of heroism, although our medical staff saves lives every day. These are moments that breathe life into words – moments that are profound or powerful or touching and that remind us why we do the work we do. Hundreds of these reminders happen every day. Thank you for letting us share some with you.

Do you have a TMC mission moment you’d like to share? Send it to Communications@tmcaz.com.

Heart of Hospice: The glue that holds the team together

Sherry Schneider, admissions coordinator for TMC Hospice, was honored this week as the Heart of Hospice.

Schneider, who has been with TMC Hospice for almost eight years, coordinates the assessments of patients to ensure they qualify for hospice benefits, and then begins the process of admitting patients into Hospice. She works hand and hand with admission nurses, case managers and physicians within TMC Hospice as well as all over the community. She is also usually the person one would call if they were considering hospice for themselves or a loved one.

TMC Hospice admissions coordinator holding a boquet of red and white rosesAnyone who was around for the morning celebration would have heard the superlatives flying around to describe Schneider.

“Sherry is a really incredible person to work with,” said Stephanie Carter, manager of hospice care. “She’s always willing to help out no matter how long it takes.”

According to the anonymous nomination, “Sherry is amazing! Somehow she is able to juggle so many responsibilities at once. She always does her best to get as many people seen as quickly as possible; often with not enough staff and paltry records. She navigates the murky waters of insurance companies, Medicare and the VA and case managers, all the while be politic and professional.”

But perhaps the highest praise comes by those who have had to step into her shoes when she is not around.

“I can safely say that anyone of us who has ever covered for her has likely cried at his or her desk, overwhelmed by the phone calls, requests, question and responsibilities,” the nominator said.

Her director, Kim Fore, put it succinctly, “Sherry is awesome. She’s our glue.”

The quarterly award comes with a recognition plaque on the unit, a pin and a dedicated parking space. The award allows colleagues to recognize their peers:

Everything he or she does is for our patients and families and personifies compassion, kindness, empathy, a great work ethic and knowledge. The Heart of Hospice is also someone who is calm under pressure, is respectful, is detail-oriented, is a critical thinker, and has great communication skills. This person is someone who is always there to help his or her peers and does so with grace and skill. Being able to nominate someone for this award is a gift because it means you have observed greatness, not just once, but every time you have interacted with this individual.

Has a TMC Hospice nurse made a difference in your life? Consider recognizing this extraordinary nurse with a DAISY Award nomination.

Mission Moments: Responding to the disaster in Puerto Rico

Tucson Medical Center earlier this year adopted a new mission statement. To celebrate, we will share an ongoing series of “mission moments.”

What are mission moments? They aren’t necessarily dramatic stories of heroism, although our medical staff saves lives every day. These are moments that breathe life into words – moments that are profound or powerful or touching and that remind us why we do the work we do.

Hundreds of these reminders happen every day. Thank you for letting us share some with you.

Dr. Monica Guzman Zayas

Dr. Monica Guzman Zayas watched helplessly as news reports showed her childhood home in Puerto Rico being decimated by hurricane winds and rain.

Her parents still live in her small hometown of Villalba, in a remote central area high in the mountains. For 16 days, she couldn’t reach them to find out if they were in a refugee center or if they were OK.

When the anesthesiologist at Old Pueblo Anesthesia finally was able to connect with them, she was relieved that they were OK. But she heard terrible stories of people on dialysis or in need of oxygen tanks struggling for any kind of routine medical services given the damage across the island to road networks, communication channels and power services.

“It just all seemed so desperate and I could not believe what I was seeing. I knew I had to help somehow.”

Dr. Guzman decided to ask if TMC might be able to assist with medications. The Pharmacy rapidly identified drugs that could make an immediate impact in the disaster, including those needed to treat infections and provide relief from symptoms.

“I cannot tell you how happy I was,” she said. “I asked because I feel that TMC is very involved in the community to make a difference. They don’t just say it, they do it. Their goal is to help the community to make things better, and that was true when another part of this country was in great need,” she said.

Guzman partnered with an aid group comprised of other doctors from Puerto Rico who banded together to secure desperately needed medicine, equipment and supplies. Dr. Guzman drew strength from seeing the photo (above) of the medical staff on the ground in Puerto Rico opening the boxes.

“It feels great to be able to help, especially being originally from there and seeing the destruction and knowing that what you remember is not there,” Dr. Guzman said. “You feel you are so far away and not able to reach them, so to be able to make some difference, I just don’t have the words to describe it.”

Do you have a TMC mission moment you’d like to share? Send it to Communications@tmcaz.com.

Making the most of your primary care visit

why you need a doctor before you get sickRegularly visiting a primary care provider is one of the best ways to maintain strong health – here’s what you can expect before, during and after the visit.

Knowing what to expect will put you at ease and help make the most of every visit.

Before the visit

First steps

When you schedule your appointment, ask about new patient registration forms. These forms usually request health history, medications, and insurance information.

Yes, there are forms to complete – but they serve a very important purpose and are not as long as you might anticipate.

“Providers want be your health partner and a little bit of preparation will be worth your time,” said Kathy McLeod, a family nurse-practitioner and primary care provider at the TMCOne Rincon location.

“As a provider, the more information I know about your health history, the better health partner I can be – providing information to best help you make current and future health choices,” McLeod said.

Arrive a little early

You should also take a peek at your insurance card to determine your copay, and be prepared to make your copayment when you arrive. If it’s your first visit, arriving 15 minutes early will help keep everyone on schedule.

If you have not completed the new patient forms yet – arrive about 30 minutes early to ensure you have enough time to finish them before your appointment.

Prioritize your questions and share your goals

It is recommended patients jot down a few questions a head of time, and prioritize them depending on their most immediate concerns.

“It is important to me to know what is foremost on a patient’s mind – and what their overall health goals are.”

During your visit

The PCP is here for you

If you are feeling nervous, remember that a PCP is your health partner and their purpose is to assist you. Discussions about your health care are confidential and protected by federal law.

“We want patients to feel confident sharing their health challenges and history so we can provide the best health advice and direction possible.”

Your needs are the priority

A PCP visit may include a physical exam. If you have privacy preferences, let the provider know.

“A dedicated PCP will make accommodations to ensure the patient feels comfortable, respected and valued,” explained McLeod.

Long-term health goals

The provider can do more than treat an immediate health need – they can review your health history and help make a plan to maintain good health going forward.

“A healthy lifestyle is not a one-size fits all,” said McLeod. “We think critically about each patient’s health and health challenges, discuss needs and preferences and help tailor a healthy plan just for you.”

After your visit

Schedule your next appointment before you leave

Numerous studies have shown that people who regularly visit their health care provider are healthier – so be sure to make your next appointment before you leave.

“Based on your health needs and challenges, you and your provider should decide when the next appointment should be.”

Schedule referrals, testing and blood draws right away

“It’s a good idea to make arrangements as soon as possible.” McLeod explained. “The faster you schedule, the faster you can get needed results and we can take action.”

The PCP is your health resource

Contact your PCP’s office with any health developments, because they can help facilitate treatment quickly. “Whether big or small – a PCP is your personal health resource. Please remember to call 911 immediately for emergencies and life threatening matters.”

Get all the answers

A patient’s health education and understanding are crucial – so what should a patient do if they have an additional question? “Online patient portals are becoming more commonplace and are one of the easiest and fastest ways to keep in contact with your provider,” said McLeod.

MyChart

MyChart is secure, online access to your health information at TMCOne. Your health information and your visits to TMCOne are available at your fingertips from the privacy of your home computer, smartphone or tablet at any time, day or night. All that is needed is Internet access and an email account.

With MyChart you can:

  • View your health summary, current list of medications and allergies
  • Email your provider with non-urgent medical questions (please allow 48 hours for answers)
  • Make and cancel appointments
  • e-Check In for scheduled appoints, allowing you to fill out any needed paperwork ahead of time.
  • Refill prescriptions
  • View test/lab results as released by your provider
  • Access medical information of children or dependent adults, including access to immunizations
  • Review post-visit instructions
  • Online bill pay

Provide input

Health care organizations like TMCOne often send surveys to their patients – please take a moment to share your experience.

“Your suggestions matter to the PCP,” McLeod said. “At TMCOne our mission is to provide the highest quality, compassionate care to every patient every time. We are always looking to improve patient experience and we take patient feedback very seriously.”

The TMCOne website provides patient resources, preparation information for your visit, and new patient forms.

Click here for further information about MyChart.

Enjoying the Season While Avoiding Stress – Tips from Mary Atkinson, Director of Wellness

Tips for keeping the stress at bay this holiday season
Do you have a love-hate relationship with this time of year? You love the vision of family and friends brought together to celebrate and the fantasy shown on Pinterest or in magazines, but you hate the pressure you feel to create some idyllic experience? Our director of Wellness, Mary Atkinson, has these suggestions to reduce the stress and up your enjoyment of the season:
  1. Review your calendar
    It’s easy to fill up your calendar with events and gatherings and feel rushed at every one. Sit down with your family and discuss which events are actually truly loved and which have just become routine. Perhaps the annual potato latke cook-off is a must do for the whole family, but the bike ride around Winterhaven lights is no longer top of everyone’s list. Remember those quiet moments with loved ones where you’re not doing anything but lighting candles together and savoring the moment can be the most precious.
  2. Celebrate the season
    Don’t focus on one day. We can get hung up on creating the ‘perfect day’ pinning too many hopes on one day. Refocus on the little moments of beauty, kindness and community that you experience throughout the month.
  3. Ask for help and delegate
    Whether it’s sharing the responsibilities of a fancy meal for a horde of family and friends, sending cards to the family or wrapping gifts for all ask for help. Perhaps make the feast more potluck and the cards can be written and addressed by other members of the household? Working together can be memory-building in itself.
  4. Indulge with balance
    Tis the season of festive gatherings and indulgent eating. Nutritionally speaking, this is a tough time of year. We don’t want to give up delicious holiday dishes; however, we would rather not wreck our health through weeks of unhealthy eating. Fortunately, with a few modifications and a little moderation, we don’t have to do either. Check out registered dietitian Laurie Ledford’s suggestions here. Remember to take time to breathe and to take a walk after dinner or a hike with the family.
  5. Recognize and remember
    During holidays loss and estrangement can feel particularly hard. Terri Waldman, former director of the TMC Geropsychiatric Center, shared these wise words, “Your heart has no obligation to be jolly. Take the time to celebrate cherished memories but be open to new rituals. If you find you are having a hard time coping and can’t shake the sadness, though, don’t try to tough it out. It may be time to see a primary care physician.”
  6. Learn to say no
    Saying yes when you should say no can leave you resentful and overwhelmed. Friends and colleagues will understand if you can’t participate in every project or activity.
 
No matter whether your house will be full to the gills or quiet this holiday season, we hope the season is healthy and full of hope.
From our family to yours best wishes,
Mary Atkinson
Mary Atkinson is a registered dietitian and TMC’s Director of Wellness. You can find out more about the programs that the Wellness Department offers the Tucson Community here.

Deck the Halls Safely – with Safe Kids Coordinator Jessica Mitchell

Finally, the temperatures have cooled enough that there is the tiniest bite in the air that signals our desert winter. I love this time of year, surrounding myself with family and making memories for my children. In our house we’re putting up the tree, lighting candles and baking cookies. It smells like vanilla and pine and all things wintertime.

Of course, along with all the delights of the season there are some safety concerns:

  1. Candles
    Those pine-scented candles I love so much are a burn risk. I make sure to have them at least 12 inches from any flammable material, and because I have young children, out of their reach. When you leave a room you blow out any candles. I also have a set routine every night of checking to make sure I haven’t forgotten any candles.
  2. Decorations – Kid-friendly
    They’re shiny and glittery and just shout ‘Touch me!’ Watch out for baubles that break easily when you have young children around. Kids are curious and will want to play with the ornaments on the tree, so you might as well prepare. Move the ornaments that are breakable or have metal hooks towards the top of the tree. That makes room at the bottom for the ones that are safer for young kids.
  3. Lights – Cords
    Stringed lights mean extra cords. Make sure cords are taped down to reduce trip risks. Also, make sure that you’re not overburdening the sockets and creating a fire risk. Check that your lights are in good working condition with no frayed or exposed wires or loose bulb connections.
  4. Tree
    If your family brings a pine tree inside at this time of year there are a few things you can do to lower the risk of fire. Make sure you keep the tree watered on a daily basis so that the needles don’t dry out. Is your tree located at least several feet from any heat source, including heating vents and lights as well as candles and fireplaces? Always turn the lights off on the tree when you go to bed or leave the house. When the season is done make sure your tree is disposed off. A dried out tree on your property is a fire risk.
  5. Smoke alarms
    Make sure you have checked your smoke alarms recently and the batteries are working. If the alarms are more than 10 years old they’ve probably expired, and it’s time to replace them.

Have a happy, healthy and safe holiday season,

Jessica

Jessica and family celebrating the holidays

Jessica Mitchell is the Safe Kids Pima County program coordinator. Safe Kids Pima County is a network of organizations whose mission is to prevent accidental childhood injury, a leading killer of children aged 19 and under.

Spearheaded by Tucson Medical Center, the local coalition is part of Safe Kids Worldwide, a global network of more than 600 coalitions in 23 countries bringing together health and safety experts, educators, corporations, foundations, governments and volunteers to educate and protect families.

 For more tips on keeping your family safe all year round

check out our website

 

A snack to hike with – Brenda’s Power Bites

Brenda's power bitesNeed a portable source of fuel for a long hike or bike ride? Want a trail snack that isn’t simply candy in disguise? Brenda’s Power Bites are your solution! Recipe courtesy of Brenda Andreasen, instructor for TMC Wellness.

Ingredients

3 c oats (regular or quick cooking)
1 tsp cinnamon
1/4 c unsweetened flaked or shredded coconut (optional)
1/4 c roasted, salted sunflower seeds
2/3 c dried dates, finely chopped
2/3 c dried apricots, finely chopped
2/3 c dried cherries
1 tsp vanilla extract
1 c almond butter (or any nut butter)
1/2 c agave nectar (or honey)

Note:  Feel free to use any combination of dried fruit and nuts or seeds of your preference.

Directions

  1. In a large bowl, combine oats and cinnamon.
  2. Use a food processor to chop the sunflower seeds and coconut. Add to the dry ingredients.
  3. Combine dried fruits and vanilla extract in the bowl of the food processor. Coarsely chop the fruit. (The extract will aid the blades in the chopping process.) Add fruit to dry ingredients.
  4. Add nut butter and agave nectar to the rest of the mixture. Combine well until mixture begins to stick together.
  5. Form mixture into 1 inch balls.
  6. Place balls in an air-tight container, separating layers with wax paper.
  7. Refrigerate at least 4 hours or overnight to allow oats to absorb moisture.

Makes about 60  ½-ounce balls

Nutrition Information (per 2-bite serving)

Calories:  130
Total Fat:  6g
Saturated Fat:  1g
Protein:  3g
Potassium:  175mg
Sodium:  85mg
Carbohydrate:  16g
Fiber:  2.5g

TMC and Mobile Meals of Southern Arizona

 

Tucson Medical Center and Mobile Meals of Southern Arizona have a long-standing partnership that is delivering special friendship to isolated and homebound Arizonans.

For nearly 50 years, Mobile Meals has delivered nutritious, locally-prepared meals to elderly and disabled adults in Tucson and the greater area. The homegrown nonprofit supports the independence, health and dignity of homebound adults by providing home-delivered, special-diet meals each day.

Special effort providing special meals

“What makes Mobile Meals unique is we deliver meals that are specially prepared for each client’s specific nutritional needs,” said Tamara McKinney, executive director of Mobile Meals of Southern Arizona. “And they are delivered daily by volunteers who really care about our client’s health and well-being.”

The added challenge of delivering medically-tailored meals doesn’t discourage McKinney or the organization. “That’s when people need us most – 94 percent of our clients need a special diet,” she explained. “Our Mobile Meals dietitian works closely with each client’s medical provider to determine what specific diet is needed.”

A community working together

McKinney noted that Mobile Meals doesn’t happen without the support of local organizations. “TMC has been a key partner since Mobile Meals began in 1970, together we are helping our community’s most vulnerable adults maintain their health and independence.”

The specialized meals are prepared at TMC each day, explained Ruth Halter, TMC’s manager of food services and Mobile Meals board member. “Proper nutrition is key to maintaining health in general, but it becomes increasingly important when someone has a chronic medical condition such as heart disease, kidney disease or diabetes.”

Halter added that the meals have an indelible and positive effect. “Those receiving Mobile Meals are able to continue living at home – which is a benefit to our patients and the community as a whole.”

Volunteers make the difference

Like clockwork, a supervisor reviews the meals in the TMC Kitchen, ensuring each recipient receives the correct food. Volunteers soon arrive to pick-up and deliver.

“The delivery is the best part,” said Mobile Meals volunteer Bev Lundquist. “We sit, talk and get to know one another – I’m friends with every person I deliver to.”

The connection and friendships that are cultivated through mobile meals go a long way. “They’d be happy to see me even if I didn’t have any food,” Lundquist said. “It’s very fulfilling to know we are making a real difference in the lives of people in need – we get such a great sense of community.”

Improving health, enriching lives

McKinney explained the volunteers are very passionate, motivated by the challenges recipients are facing – including isolation.

“Many recipients live alone and really look forward to interacting with our volunteers,” she said. “The visits are more than meal delivery or social visits; for many of those isolated and medically fragile adults, the volunteers are making sure they’re safe.”

McKinney explained that a client fainted during a recent delivery visit. The volunteer was able to call 911 and get the client immediate medical attention. “Can you imagine what might have happened if our volunteer hadn’t been there? Many of our clients have outlived their friends and family, and our volunteers might be the only people they see in a week.”

Grateful for community partnership

“We are so thankful for the local support that makes our program possible and for our partnership with TMC,” said McKinney. “Our collaboration shows how we can bring together needed resources to protect our most vulnerable, and it inspires volunteerism to make a positive change for our whole community.”

To volunteer or donate to Mobile Meals of Southern Arizona, call (520) 622-1600 or email info@mobilemealsoftucson.org.

 

 

Looking to maintain not gain this holiday season? Tips from one of our wellness experts

 

Thanksgiving wellness tipsAmy Ramsey, manager of TMC Employee Wellness & Engagement, mom, marathon runner, hiker and all around fitness guru shared these tips for all those looking to enjoy this holiday season while maintaining and not gaining.

Avoid large plates

Serve reasonably sized servings on smaller, appetizer plates instead of a massive dinner plate. If you’re hosting, do everyone a favor and keep your larger plates hidden away.

We eat with our eyes before we even take the first bite of food. I don’t know about you, but two tablespoons of hummus loos a lot less depressing if served on a smaller plate filled with veggies and seedy crackers than alone on a large plate.

We are all tempted to fill the plate when serving our selves, so think smaller plates for portion control.

Slow down

Clearing your plate is not a race, so there’s no need to preload your fork for each bite. Taking breaks will extend the time it takes to eat your meal and possibly reduce the amount of food you eat.

Did you know that it takes between 15 to 20 minutes for your brain to get the signal that your stomach is full? Give your stomach a chance to catch up with your brain!

Turn off the distractions

Televisions, phones and laptops should not be near your dining table. When electronics and other distractions have our attention, the amount of food that we’re putting into our mouths does not–it’s the perfect environment for mindless eating.

Thanksgiving can be a great day to have some football on in the background, so you may let this one slide for the special day, but losing the distractions is a good, all-around general tip for everyday meal times.

Freshen your mouth

When you’re done eating, keep your mouth busy with a piece of gum, or head to the bathroom to brush. Keeping a clean mouth may be motivating enough to keep us from mindlessly grazing on food.

I couple this tactic with shutting off the kitchen lights after dinner is done, and I’m definitely less likely to go looking around after the kitchen is “closed.”

Happy Thanksgiving. I hope you can find time to relax and enjoy whatever it is that makes YOU happy!

For more tips, recipes and wellness events sign up for our monthly Live Well newsletter.

live well newsletter sign up

 

Health systems hosting enrollment event and family fun festival

health enrollment fairDo you need affordable health insurance?

Southern Arizona’s major healthcare providers have come together to make sure you have free, personal help to find the right fit!

With enrollment ending Dec. 15, the Pima County Enrollment Coalition will be offering in-person assistance with Medicare, AHCCCS/KidsCare and Marketplace coverage on Saturday, Dec. 2 from 8 a.m. to noon.

To make an appointment, call 800-377-3536 or go to coveraz.org/connector and enter zip 85713.

Walk-ins are welcome at the event, which will be at Kino Veteran’s Memorial Stadium, 2500 E. Ajo Way.

In addition to several community runs, there are lots of other activities as well:
• Check your blood pressure
• Drop off old medications
• Learn more about vision and dental assistance
• Find out about pet adoptions from Pima Animal Care Center
• Enjoy bouncy houses for the kids
• Pledge to end bullying

For more information on the event or enrollment, visit the SOAZCares website – sponsored by Tucson Medical Center, Carondelet Health Network, Banner-University Medical Center Tucson, El Rio Health, Northwest Healthcare and Pima County.

Those who miss the enrollment window may have to wait until the next enrollment period to get coverage, unless they experience a life changing event such as getting married or losing your health insurance through a job. “It’s easy to enroll and there’s plenty of help to make sure you understand the process,” said Nancy Johnson, CEO of El Rio Health.

Pregnancy and Back Pain – Tips from an Expert

pregnancy-back-pain

The waddling gait, the hands pressed into the small of her back, mama-to-be is uncomfortable.

An aching back is such a common part of pregnancy that the waddling and back clutching is a stereotype of late-term pregnancy. But backaches can start much earlier in pregnancy. The vast majority of pregnant women will experience backaches during pregnancy. For many, it persists after the birth of the baby.

Tim Evens PT of Agility Spine & Sports Physical Therapy gave us the lowdown on why back pain is an issue during pregnancy and what to do to prevent and to treat back pain.

Why do so many pregnant women experience backaches?

As the baby grows and mama’s belly grows, the increased weight, shift in center of balance, and the increased mobility of some of the joints of the pelvis (hypermobility of the sacroiliac joint) all contribute to extra strain on the lower back. This added strain and resulting distorted movements with joints locked at the end range of motion can make daily life painful.

What can you do to prevent backaches during pregnancy?

A strong core and upright posture before and during pregnancy can help prevent backaches.

  • Squats help strengthen legs, abs and pelvic floor, and require balance and can be performed during pregnancy.
  • Balancing exercises, such as through yoga, can provide core strengthening
  • Avoid over stretching
  • Limit how much sitting you do each day
  • Exercise 30 minutes every day

When to contact a physical therapist?

Evens suggests that if back or pelvic pain is limiting daily function do not wait to seek help. Often it is an issue that can be easily addressed. The first port of call is your primary care physician who can rule out other issues. If this is a second or third pregnancy and this is a familiar pain you may wish to check in with your physical therapist’s office.

How can a physical therapist help you if you experience backaches?

A physical therapist can help you return to fully functional movement, and address tissue healing and trauma of back and pelvis pain. As many of these issues can be addressed simply, Evens encourages women to seek help if the pain is limiting their daily function. Don’t let it linger for months when it is easy to fix and can help reduce stress during a time that can be fraught with stress anyway.

At your appointment the physical therapist will evaluate your flexibility, strength, balance and posture. The therapist may manipulate or move your body to address immediate tissue issues, and almost always will provide you with at-home daily exercises to increase strength, mobility and flexibility.

How to perform a squat

Evens provided these tips for performing an effective squat:

  1. Hold your lower lumbar spine in a neutral position. As you squat the low spine should not flex (tail should not tuck under)
  2. Make sure your knees do not move in front of your toes. This ensures that the majority of motion is coming from the hips

Remember good squats require good hip strength and flexibility.

 

This post was first shared on May 1, 2014

Are you new to hiking? Here are tips and trails to get you started.

tips for new hikersFall has finally found its way to Tucson. As we welcome the cooler weather, Laurie Ledford, part of the TMC Wellness Department suggests that it is time to toss out the old “It’s too hot to exercise” excuse, lace up our shoes and get outside.

If running isn’t your style, or if you find walking too boring, you are in luck – Tucson is home to some of the most beautiful hiking trails imaginable. Here are Laurie’s suggestions for new hikers:

Before the hike

  • Dress properly. Layered clothing on the upper body is the way to go. This allows you to peel off outer layers as you warm up. If you want to wear shorts, be aware that you risk scrapes from cacti and rocks, so be careful! If you opt for long pants, choose something that allows you to move easily – in other words, not jeans.
  • Wear comfortable hiking boots or trail shoes with good tread. You want footwear that will keep your feet on the trail while keeping out little rocks and blisters.
  • Protect yourself from the sun. Cover any exposed skin with sunscreen, preferably a broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher. Cover your head with a wide-brimmed hat to protect your face, ears and neck. Shield your eyes with UVA- and UVB-blocking sunglasses.
  • Bring water and a snack. The weather might have cooled down, but exercise can still be dehydrating. A high-carbohydrate snack will prevent hypoglycemia. Even if you think you won’t be gone long enough to get hungry, you never know when you could get lost or delayed.
The view from Blacketts Ridge, Arizona

The view from Blacketts Ridge, Arizona

During the hike

  • Stay on the trail. This is safer for you and the environment in which you are hiking; you are less likely to run into a cactus or twist an ankle, and you won’t contribute to erosion.
  • Yield the right of way to anyone bearing a burden. If you meet another hiker on a narrow trail, who has the right of way? If the other hiker is heading uphill (and needs to maintain momentum) appears to be struggling or is carrying a heavy pack, be courteous and step aside.
  • Be aware of any faster hikers behind you. Please pull over and let them pass.
  • Respect your own limitations. Be mindful of the distance or time you have hiked and how much is still ahead of you. You don’t want to reach complete exhaustion before the end of the hike.
  • Before you head up a hill, think about how you’ll make it back down (or vice versa). If your legs get too tired, you could fall. If your knees are not in great shape, they are going to scream at you all the way down the mountain. Hikers with bad joints may want to stick to flat trails or use trekking poles for additional stability and support.
  • Leave no trace. If you bring something in, take it out with you. But don’t take out more than you brought – i.e., leave bird nests, flowers and saguaro ribs where you find them

After the hike

  • It is better to enjoy happy memories of your hike the next day than to suffer aching muscles. If you are new to hiking, you will likely feel sore afterwards, no matter what. Remember to go easy on yourself during and after a hike, and your fitness level will improve over time.
  • Re-hydrate, rest and refuel as you plan your next hiking adventure.
Tucson Medical Center employees enjoy a winter hike on Douglas Spring Trail

Tucson Medical Center employees enjoy a winter hike on Douglas Spring Trail

Hikes for the new-to-town

You may hear seasoned hikers talking about some of their favorite trails: Blackett’s Ridge, Finger Rock and Agua Caliente Hill among them. However, for those who are new to hiking, it is a good idea to start with something a bit easier.

  • Nature Trail at Catalina State Park is a one-mile, relatively flat, loop trail. Once you’ve tackled that, you can take on some of the park’s more difficult trails, such as Canyon Loop Trail (2.2 miles) and Romero Canyon Trail (5.9 miles round-trip, if you go all the way to the pools).
  • Garwood Trail, on the east side of town, takes you 3.4 miles, out and back. There is a fun and interesting network of trails to explore here, including Wildhorse Trail (3.2 miles) and Douglas Spring Trail (17.2 miles, if you do the whole thing). Bring a compass, map and a good sense of direction with you, it can be easy to turn down the wrong trail.
  • Sabino Canyon Recreation Area is home to many trails of varying levels of difficulty. By walking the tram road, you can enjoy canyon views without ever leaving a paved road. As you start feeling more adventurous, branch off to try sections of Esperero Trail, Phoneline Trail, or take Bear Canyon Trail to Seven Falls (8.2 miles).

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Laurie Ledford is a registered dietitian from Atlanta, Georgia, the land of grits, collard greens and super-sweet iced tea. She now works as a registered dietitian  in the Tucson Medical Center Wellness Department. She enjoys helping people improve their health through sustainable dietary changes while still relishing occasional indulgences. In her off hours, Laurie engages in foodie pursuits such as sampling unusual flavor combinations (olive oil and basil ice cream was a good one) as well as hiking and cycling.

Is it the flu or just a cold? Advice from a family nurse practitioner

Is it the flu or just a cold?

Natalie Olendorf, family nurse practitioner with TMCOne explains the difference between the two, what you can do to prevent falling victim to them, and when you should seek medical advice.

Both the flu (or influenza) and the common cold are viral infections. However, while the common cold is usually harmless although uncomfortable, influenza has the potential to be dangerous, especially for the very young, very old or those at risk for complications.

Typically the flu affects the nose, throat, and the lungs. The common cold, meanwhile, is a viral infection of just the upper respiratory tract or nose, sinuses, and throat.

Symptoms of the flu include chills, sweats, cough, sore throat, runny nose, body aches and fever over 101.4. It can make people feel quite ill – often they don’t even want to get out of bed. Symptoms will usually last 10-14 days.

Symptoms of the common cold are similar to those of the flu, but not as severe and include a runny nose, nasal congestion, a sore throat, facial pressure, mild aches, and even a low grade fever. Most people will recover from a cold within 7-10 days.

Treatment of the flu

Most people get over the flu without prescriptions, but if you are at risk for complications, you should see your primary care provider for an anti-viral medication called oseltamivir (Tamiflu) or zanamivir (Relenza).

It’s important to note that antiviral medications don’t work like an antibiotic. They help to shorten the flu illness and to prevent complications but do not cure the flu. They need to be taken within 48 hours of the onset of symptoms or they don’t work well. Other treatments include ibuprofen or acetaminophen, rest and fluids.

Should I take antibiotics?

Since the flu, like the common cold, is a viral infection an antibiotic should not be taken. Antibiotics are only good for getting rid of bacterial infections. It is not healthy to take antibiotics when they are not needed because your body can develop resistance, meaning they won’t work when they are needed in the future. Or you may have an unnecessary side effect or allergic reaction.

When should I contact a primary care provider?

You should contact your primary care provider if you have a high fever that is not relieved by over the counter medications; have shortness of breath or trouble breathing, severe cough, are unable to take in fluids or food, or start to become dehydrated.

Who is at risk for flu complications?

Complications of the flu can be significant even life threatening. They include pneumonia, bronchitis, asthma and COPD flare ups, heart problems, and ear infections.

Generally, people who are at risk for flu complications include children, pregnant women, the elderly, people with obesity, asthma, or COPD, smokers, and those with chronic medical conditions like kidney disease or diabetes. Even if you don’t fall into one of the risk groups, someone you love might. Getting the vaccination will help protect those you care about too.

How to prevent the flu

The most important thing that can be done is to get the flu vaccine in the fall.

The vaccine helps your body to make antibodies to fight off the flu without actually getting the flu. It takes about two weeks after you receive the vaccine for the antibodies to develop and provide you with protection from those flu strains. This is why it is better if you get vaccinated early in the flu season.

You can also protect yourself against the flu include keeping your immune system healthy by getting enough sleep at night, eating a variety of foods including fruits and vegetables, getting exercise, and managing stress. Wash your hands before and after eating and using the restroom. Avoid others with flu symptoms.

If you have a severe cough or fever, please don’t go to work or school. Stop transmission of the flu by limiting exposure to others.

But I always feel sick after the flu vaccine!

The flu vaccine has a form of a dead virus and a dead virus won’t get you sick with the flu.

However, some people may feel achy or under the weather for a couple days after having a flu vaccine. This is a sign of your body’s immune system making antibodies. Although uncomfortable, this is much milder than the feeling you have if you contract influenza.

The flu vaccine also is given during cold and flu season, so you may contract a separate cold or respiratory illness after being vaccinated. This is a coincidence and was not caused by the flu vaccine.

When should I get the flu vaccine?

Now!

If you haven’t already had your flu vaccine, get vaccinated before it starts spreading through our community. Even if it is late in the flu season the vaccine can still be beneficial. You can schedule an appointment to get the flu vaccine at the TMCOne Wyatt office by calling (520) 394-6619. A brief registration keeps you on schedule, the central location makes it easy and the friendly professionals provide the quality care your family expects from TMCOne. The flu shot is covered by insurance and only $25 for out of network plans.*

 

Natalie Olendorf F.N.P. and familyAbout Natalie Olendorf, F.N.P.

I am a board certified Family Nurse Practitioner. I have worked in family medicine and urgent care for the last 8 years. Prior to joining TMCOne I worked as a nurse in a Children’s Hospital in Chicago on a solid organ transplant unit and as an emergency room nurse in a Level 1 trauma center.

I attended University of Illinois Champaign/Urbana where I received by Bachelor’s in Nursing in 2003 and then attended University of Illinois Chicago where I received my Master’s in Nursing in 2009. Currently, I am working same-day care and the Fast Pass program at the TMCOne Wyatt location.

I am married and have a young son and daughter. I enjoy being active and outdoors with my family in my free time.

 

“Diabetes doesn’t change who I am”

Brody Coomler shares his insights on living with type 1 diabetesTwelve year-old Brody Coomler refuses to let type 1 diabetes define him – he explains how a seventh grader balances a full schedule with the challenges of diabetes.  

He’s an avid basketball player, he’s a hip-hop dancer, he plays the tuba and he’s a gamer. Brody is an active and enthusiastic tween who doesn’t let diabetes keep him from doing the things he’s passionate about.

At four, Brody and his family learned his pancreas was creating little to no insulin – the hormone that regulates blood sugar. He was diagnosed with type 1 diabetes, a chronic and life-long condition that causes blood sugar to spike and fall unexpectedly.

Surging blood sugar levels are far more than a nuisance, they can lead to serious medical complications and death if not properly managed through insulin therapy.

Managing type 1 diabetes can be demanding, especially for a young person. During National Diabetes Awareness Month, Brody shares how monitoring diabetes is part of his life, but hasn’t taken it over.

What does having type 1 diabetes mean to you?

Diabetes doesn’t change who I am. But it is a disease that I have to manage on a constant basis in order to stay safe.

Do you have to check your blood sugar all the time?

Yes, I do! I have to check before meals and before bed. If I’m feeling like my blood sugar is too high or if I’m feeling like my blood sugar is too low I have to test. I am very active and so I have to test before I play any sports or any dancing. Monitoring my blood sugar is a big part of having diabetes.

Do you have a special diet?

No, I don’t have a special diet. But like anyone I have to watch what I eat. I count my carbohydrates so that I can dose my insulin based on what I’m eating.

Does diabetes ever get in the way of sports or hobbies?

It definitely does. When I have low blood sugar I have to sit out of a sport or not be able to participate. I have to make sure that my blood sugars are in good range so that not only am I safe but also so that I can perform.

What do you want people to know about having type 1 diabetes?

Don’t let type one diabetes stop you from doing anything!

How would things be different for you if there was a cure?

I don’t let diabetes hold me back, but I would definitely be more free from having to test my blood sugar, put on new insulin pump sites or wear a continuous glucose monitor – things like that. I wouldn’t get sick as much as I get sick now. My mom wouldn’t call me as much.

What would you tell a friend who just found out they have type 1 diabetes?

I would suggest that they make other friends who have type 1 diabetes so that they can help one another. My friends with diabetes are a good support to me. You can expect the unexpected. You get to have some fun times and meet people that you didn’t think that you would otherwise meet.

For more information about type 1 diabetes and how you can support research for a cure, visit the JDRF website or call (800) 533-CURE (2873).

TMCOne provides adult and pediatric endocrinology services – for more call (520) 324-4900.

 

Physicians and patients taking on the opioid crisis together

The practice of prescribing opioid drugs to patients following surgery has been the go-to standard in an environment where zero pain in recovery is the expectation. But with the fallout of opioid drug overuse painful to communities across the nation, both providers and patients are looking for alternatives.

Anesthesiologists from Old Pueblo Anesthesia, who practice at TMC, have been working to enhance their regional anesthesia program to provide additional options for patients.  If patients can keep opioid use to a minimum in those crucial first days after surgery, while reducing their pain and inflammation, the hope is that they can use fewer narcotics through their recovery period.

Opioids and Older Adults free seminar

Shoulder surgery, for example, is notoriously uncomfortable for some patients because the shoulder is engaged when a patient is standing or when laying down. Traditional anesthesia only lasts about 24 hours.

Now, in addition to direct injections to numb the area and block pain during surgery, physicians can place tiny catheters near the nerves that supply the shoulder with a local anesthetic to provide greater comfort for up to 3 days. The patient can care for the pump at home and throw it away when the anesthesia is depleted.

Dr. Robin Kloth said that Old Pueblo performed a comparison of patients with total shoulder replacement who used traditional pain relief and those who used interscalene catheter placement. “Over the course of the full 3 days, the catheter patients took less than half the narcotics that our compared group took in just a single day,” she said, adding patients also reported far less nausea.

Dr. Neesann Marietta concurred. “These techniques can really extend a patient’s pain relief, which greatly increases patient satisfaction. They can go home and sleep comfortably, which is so important for the healing process.”

And that’s just one example. For abdominal surgery, patients relied previously on epidurals that could only be used during their hospital stay. Now, anesthesiologists can do a block that provides local relief in the abdominal wall that will last up to 24 hours, and patients may be sent home the same day.

Colorectal and gyn-oncology surgeons are increasingly using a slow release local anesthetic that lasts up to 72 hours.

The colorectal program reports that between greater patient education, early ambulation and regional anesthesia, patients are seeing a decrease in patient length of stay by 1.3 days and an 88 percent decrease in morphine equivalent, given in the first 24 hours post-surgery.

“Both doctors and patients are becoming increasingly aware of the potential for the misuse of highly addictive pain medications and it’s important that we be part of this national discussion,” said surgical oncologist Michele Boyce Ley, who uses regional anesthesia as well as nonsteroidal medications such as Celebrex and gabapentin to help control pain for her patients having breast surgery.

Ley said her patients are doing so well, many are managing post-surgical pain with little more than Tylenol or ibuprofen.

“We have been working on this in earnest and getting training on these techniques because of concerns about opioid usage,” Kloth said. “Opioids have been the go-to solution for many years, in part because patients had high expectations of pain relief and because a bottle of Percocet is really cheap. These techniques are more labor intensive, but we’ve demonstrated value to the patient – and it’s the right thing to do,” she said.

Many patients also feel less lucid and less awake when using narcotics, which could delay physical therapy and rehabilitation.

Physicians have several opportunities to manage the use of narcotics, particularly important as patients leave the hospital with a plan for pain management during recovery.

Marietta said the techniques are not right for every patient and every case, but patients who are concerned about the potential for opioid misuse should have a conversation with their physician about pain control – and see if a nerve block would be appropriate.

Meet with Drs. Marietta, Kloth and Lambert Wednesday, November 15 as they discuss how anesthesiologists and patients can address this in practical terms at TMC for Seniors. More details available here.

Military service shaped TMC Imaging Director

danfelix3 (002)Every day is Veteran’s Day for Air Force veteran Dan Felix. There will be no parades or fanfare for him today. Instead, he will go to work to serve, shaped by his service in the Air Force.

Felix, the director of imaging at TMC, joined right after graduating from his high school in his rural, mining community of Hayden. There were 43 students in his graduating class.

A first generation U.S. citizen, whose parents hailed from Mexico, Felix was drawn to military service. “I wanted to give back to the country that allowed my parents to raise a family in America with all the benefits we all enjoy,” Felix explained. He’d seen firsthand great poverty in Mexico. “We had health care, clothing, food, money. From a young age, I learned to appreciate the opportunities and luxuries   our great country had to offer.”

The Air Force provided structure, taught him to develop his natural qualities of perseverance and patience, and challenged him to keep growing. He appreciated the mines – his father and brothers retired from that work – but he didn’t want it for himself. He signed up for college classes, obtaining associate’s degrees in X-ray technology and later, nuclear medicine. A bachelor’s in medical and imaging technology followed. He is now one class away from a master’s degree in leadership.

The transition was a natural one. “X-ray has some parallels to the technical work I was doing in the Air Force – there’s electronics and physics and you’re working with your hands – and that’s combined with an intellectual component.”

It was nuclear medicine that stole his heart. He initially told his instructor there was no way he was going to like it. But Day One he was besotted. “Just the sound of it is intriguing, but beyond that, you’re in the physics world, talking about radiation at its origin. I was living in this cerebral realm I had aspired to my whole life.”

He ended up joining Tucson Medical Center in 1999 to train in nuclear medicine. He never left.

“As I look back and analyze the mission of the military and TMC, they dovetail,” he said, noting both exist to serve others and play a role in providing for the greater good of everybody else.

He never takes the day off for Veteran’s Day. “I am so appreciative of being able to come into work to help others – the patients we serve, the workers who make up this hospital – and to provide for my family. I take a lot of pride in those three things, so if you think about that, why wouldn’t I want to work?”

That doesn’t mean he won’t spend some time reflecting on those who serve. “Joining the military at a young age means leaving your comfort, your home, your family and everything you know that is normal, and embarking into a huge world of unknowns,” he said.

“When I think about veterans, I think about those who decided to take a risk and take a leap of faith for the sake of their country. It’s not just a job. It’s a sacrifice for others – and I don’t think that’s easily understood unless you’re the one doing the sacrificing.”

Stay in optimum health, prevent metabolic syndrome

Tips from Endocrinologist Dr. Pati on how to prevent metabolic syndrome

Are you at risk for developing metabolic syndrome?

Metabolic syndrome, which often carries no signs or symptoms, is associated with several obesity related disorders including fatty liver and cirrhosis, kidney disease, polycystic ovarian syndrome, and obstructive sleep apnea. It places those affected by the syndrome at increased risk of developing diabetes and heart disease – and they never even know they have it!

Dr. Divya Reddy Pati, endocrinologist with TMCOne, answers our questions about this metabolic syndrome.

Tell me more. What is metabolic syndrome?

Metabolic syndrome, also known as insulin resistance syndrome or syndrome x, is a group of factors that increase the risk of developing diabetes, heart disease and stroke.

Insulin is a hormone produced by the pancreas that helps move blood sugar into the cell where it is used for energy. Obesity causes insulin resistance, which leads to high blood glucose.

How is it diagnosed?

A physician who specializes in endocrinology can prescribe the medical tests that diagnose metabolic syndrome, which is determined by a presence of three of the following:

  • Abdominal obesity, defined as a waist circumference in men ≥102 cm (40 in) and in women ≥88 cm (35 in)
  • Serum triglycerides ≥150 mg/dL or drug treatment for elevated triglycerides
  • Serum HDL cholesterol <40 mg/dL in men and <50 mg/dL in women or drug treatment for low HDL cholesterol
  • Blood pressure ≥130/85 mmHg or drug treatment for elevated blood pressure
  • Fasting plasma glucose ≥100 mg/dL or drug treatment for elevated blood glucose

What is the prevalence of metabolic syndrome?

Metabolic syndrome is more common in African-Americans, Asians, Hispanics and Native Americans. Chances also increase with age, as well as with lack of physical activity.

What is the treatment?

Treatment of metabolic syndrome is aggressive lifestyle modification focused on weight loss and increase in physical activity. Weight reduction is optimally achieved by diet, exercise and pharmacological treatment if needed. Medications are used to treat risk factors such as high blood pressure, glucose and lipids.

What do you suggest we do to stay in optimum health?

It is important to visit your primary care physician regularly and address an endocrinology specialist if metabolic syndrome is encountered. Maintaining a healthy diet and an exercise plan (approved by your provider) is an excellent way of avoiding metabolic syndrome and maintaining optimum health.

pati1Dr. Divya Reddy Pati is an endocrinologist practicing with TMCOne. She diagnoses and treats diabetes, thyroid problems, calcium disorders, osteoporosis, pituitary, adrenal and other hormonal disorders.

 

A version of this interview was first posted on December 21, 2016

 

Recent breast cancer diagnosis? Advice from breast cancer survivors

Vanessa H-B.jpg

Now what? Once you move beyond your initial reaction to a breast cancer diagnosis, whether it is disbelief, fear, anger or uncertainty, what should you do? We asked three breast cancer survivors for words of wisdom to the recently diagnosed.

1. Bring a trusted friend or family member as an advocate to your doctor’s appointments

When faced with a cancer diagnosis the options can seem daunting and the information overwhelming. It can be invaluable to have an advocate in the room to be a second set of ears. A person who is confident enough to ask questions, able to take notes and willing to process the information afterward with you. Advocates should understand their role prior to going to your appointment so they can be prepared.

2. Write down your questions

Create a written list of specific questions prior to your appointments to discuss with your doctor. Let your doctor know that you have questions at the beginning of your appointment.

3. Beware of Dr. Google

Dr. Michelle Boyce Ley, board-certified breast oncology surgeon, medical director of TMC’s Breast Health Program and a breast cancer survivor herself said, “Don’t google outcomes. I’ve seen what’s out there and they don’t look like my own patients.” Tess X, a patient of Dr. Boyce Ley’s, said “I didn’t do much reading outside the basics because you can really get into the weeds and pseudo-science. I looked up my particular variant of BRCA2 and did some calculations on risk over 10 years and lifetime, but I have a biology background. Then I talked with Dr. Boyce Ley to discuss my risks and treatment options.”

4. Talk to your doctor about risk and benefits

“Don’t assume the risks and benefits are the same as a friend’s with the same form of cancer,” Tess X said. Two people can have the same form of cancer, but the treatment plan might be quite different dependent on stage, location and the individual’s aversion to risk.

5. Ask about all the options including if there are options in treatment that they don’t offer.

“It makes me so sad when I give a talk and someone comes up afterward and says, ‘Why didn’t they offer me that?’” said Dr. Michelle Boyce Ley, . It’s important that your physician be willing to discuss all options with you, so you can participate in shared decision-making. “You can’t make a good decision unless you have the information.”

6. Don’t be afraid to share your diagnosis with others

“I met many survivors that way,” said Vanessa Hough Buck. “They have been an encouragement to me. Find a support group of survivors.”

7. Don’t avoid being in photographs while you’re going through treatment

“Even when you don’t feel your best, be in the picture. When I look back now, those are my favorite photos,” Buck said.

8. Let people know what you need from them

“Your friends and family have good intentions but don’t always know what to do. It’s alright to ask for specific help. And it’s OK to say ‘no’ to visitors,” Buck said.

 

Are you a breast cancer survivor? What advice would you give to the recently diagnosed?

TMC for Women has a high risk breast clinic that provides education, treatment options, and coordination to best help high risk patients choose their next steps.

 

 

Have you talked with your primary care provider about your weight? National Obesity Care Week

TMC offers surgical and non surgical scientifically based programs to support you achieve a healthy weight. The American Medical Association in 2013 recognized obesity as a disease, and in doing so took critical steps towards supporting those affected to access science-based healthcare.

The misperceptions and stigma surrounding the causes of obesity often negatively affect an individual’s ability to access the care they need. The more than 90 million adult Americans affected by obesity are at increased risk for a variety of health conditions, including type 2 diabetes, high blood pressure, and sleep apnea.

Despite the significant health impacts of obesity, many of us struggle to talk with our primary care provider about our weight and how a science-based approach can help us to achieve a healthy weight.

Tucson Medical Center offers safe and effective weight-loss programs with both surgical and non-surgical options. We know everyone faces unique challenges to achieving a weight-loss goal. Our team of medical professionals can help you choose the path that’s right for you.

Weight-Loss Counseling Program

Our registered dietitians and exercise physiologists will work with you to create a personalized plan you can live with, so you can lose weight and keep it off. The 12-week program includes: • Nutrition, fitness and general wellness assessments • Reliable advice that you can use • Tracking of weight and estimated body composition • Development of personalized nutrition and fitness plans • Strategies to promote long-term weight-loss success

The program is individualized for you and so you can begin at any time. For more details, please contact TMC Wellness, (520) 324-4163 or Wellness@tmcaz.com.

Weight-Loss Surgery from the TMC Bariatric Center of Excellence

At the TMC Bariatric Center, we offer a comprehensive approach to help those who qualify for weight loss surgery. For most people to qualify you must:

  1. BMI ≥ 40, or more than 100 pounds overweight
  2. BMI ≥35 and at least one or more obesity-related co-morbidities such as type 2 diabetes, hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease
  3. Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts

Our program guides you every step of the way on your weight-loss journey, starting with free seminars to discover if a surgical option is right for you; to pre-surgery counseling and evaluations; post-op care that includes nutritional counseling; psychological support; instruction on incorporated exercises into your lifestyle; and discussion groups where you can build relationships with others who have had bariatric surgery at TMC to help you achieve your goals.

 

The TMC Bariatric Center of Excellence is accredited as a comprehensive center by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.

The American Society for Metabolic and Bariatric Surgery (ASMBS) Center of Excellence was started in 2004 to advance the safety and efficiency of bariatric and metabolic surgical care. Surgical Review Corporation administers the program on behalf of the ASMBS.

No matter what method you have used to lose weight, sticking to your new good habits and keeping the weight off can be a challenge. Don’t try to tackle it alone, talk to your primary care provider, talk to us, together we can take on the challenge of obesity and its complex nature and help you be a healthier you.

This week is National Obesity Care Week where the goal is to advance an evidence-based understanding of obesity and widespread access to respectful, comprehensive and appropriate care.

Drivers beware of ghouls and goblins

halloween drivingSo Halloween isn’t your thing. Your plan for Halloween evening involves turning off all the lights, disabling the front door bell and retreating to the back of the house where you can’t be bothered by an incessant stream of trick-or-treaters. Perhaps Halloween is your favorite holiday and your household is so frantic with anticipation, you’ve even taken the day off work to prepare! Whether you’re a lover of all things Halloween or not, whether you have kids or not, we have a special plea for tomorrow – Pay particular care while driving tomorrow.

Children are more than twice as likely to be hit by a car and killed on Halloween as on any other day of the year. Take particular care this Halloween with these tips from Safe Kids Pima:

  1. Slow down and be especially alert in residential neighborhoods. Children are excited on Halloween and may move in unpredictable ways.
  2. Take extra time to look for kids at intersections, on medians and on curbs.
  3. Enter and exit driveways and alleys slowly and carefully.
  4. Eliminate any distractions inside your car so you can concentrate on the road and your surroundings.
  5. Drive slowly, anticipate heavy pedestrian traffic and turn your headlights on earlier in the day to spot children from greater distances.
  6. Popular trick-or-treating hours are 5:30 p.m. to 9:30 p.m. so be especially alert for kids during those hours.

Safe Kids Pima County is a network of organizations whose mission is to prevent accidental childhood injury, a leading killer of children 19 and under. Spearheaded by Tucson Medical Center, the local coalition is part of Safe Kids Worldwide, a global network of more than 600 coalitions in 23 countries bringing together health and safety experts, educators, corporations, foundations, governments and volunteers to educate and protect families.

 

Advancements in chronic pain treatment – more than medication

chronic pain treatment, beyond medicationPain management specialist Dr. Robert J. Berens shares how advancements in chronic pain treatment are providing relief without a prescription.

What advances have a made a significant impact in chronic pain treatment?

Over the past few decades, the treatment options have been refined and improved for interventional pain medicine. We have many techniques to target specific nerves and try to reduce or eliminate their ability to generate pain signals in the brain.

Sometimes we can accomplish this with medication management and other times, minimally invasive techniques can offer more directed treatment with a more rapid resolution.

We have advanced techniques in radio frequency treatments to provide longer-term control of pain, in addition to directed nerve root therapies to establish relief.

Spinal cord stimulation is an area of significant improvement. We are now able to implant targeted stimulators into the area of the spine to control abnormal signals to the brain that are difficult to treat with other modalities.

What is interventional pain management?

Interventional pain management is a discipline in pain medicine that helps relieve patients of their pain by going beyond medication. It relies on a wide array of therapies to diagnose, reduce, and often eliminate a patient’s pain.

Minimally-invasive techniques have the ability to diagnose a problem and treat the pain accordingly – often via a procedure or treatment, such as injections or devices and managed over time if necessary.

Many interventional treatment therapies have been used to treat most aspects of spine related pain, and return a patient to their normal level of activities as soon as possible.

What are the advantages of seeing a pain management specialist?

Most patients initially receive their pain care from the primary physician. When pain control is not within reach or a more targeted treatment is available, the primary physician or others will refer to a pain specialist.

When is it time to seek a pain management specialist?

Pain can often begin as an acute problem and slowly change into a chronic problem that is difficult to treat. Chronic pain can be from a long-standing problem with or without an initial injury.

Once a problem does not appear to be improving, it is likely entering a chronic phase. Acute and chronic pain can be treated by a pain specialist and this should be considered at any time in the course of the problem.

It can often be noted that early referrals to an interventional specialist can often help to provide a more rapid reduction in pain, and at times eliminate the source.

Why have you continued to provide care at TMC?

I have been associated with TMC since 1990 because TMC has been a leader in our community and has consistently provided patient-centered care.

We have been fortunate to have a fabulous staff to support our services and provide compassionate care to our patients.

TMC has established itself through its commitment to excellence and its focus on creating the best team approach in Southern Arizona.

Dr. Berens

Dr. Robert J. Berens is board certified in pain management and anesthesiology. He has been in practice since 1990 and has served as the medical director of the TMC Integrative Pain Center since 2004.

For further information or to schedule an appointment, please call (520) 324-2080.

The Integrative Pain Center is located at 5355 E. Erickson Dr.

 

Powerlifting helped channel despair, helplessness after loss to domestic violence

When Rachel Tineo’s 24-year-old niece was murdered in a domestic violence incident by the father of her three children, Tineo didn’t know how to fathom the depth of her loss.

Tina Soto had been like a daughter to her – and that someone intentionally and senselessly took her life in front of her young children in June 2013 left Tineo full of rage.

“It’s not something you have a coping mechanism for,” said Tineo, a senior business systems analyst at Tucson Medical Center. “I would go home, talk to my husband, play with the dogs and get up and go to work again the next day – but it wasn’t enough. I had all these built-up feelings, including sadness, anger and depression.”

Something had to change.

Tineo had already been health-conscious. She was a runner. She ate clean.

A part of her thought she should just stick to her kettlebells and running routine. Another part felt it was time to jolt herself out of her comfort zone. She went to her trainer and explained, “I want to bring more to the table because I need it to get through every day.”

“It wasn’t until I started powerlifting that I was able to control the feelings I had. Whether I was deadlifting or bench pressing or squatting, I was taking all those feelings and putting them into buckets in my brain. And I would fill those buckets up with positive energy and that energy would eat up all of those negative thoughts. When I lift, I pick up that bar and I let it take everything away from me.”

Over the course of 6-8 months, she started feeling better.

By November 2014, she had enrolled in her first competition. In that first competition, she bench pressed 110 pounds, did 245 pounds on a deadlift and squatted 120 pounds.

“Powerlifting made me a stronger person physically, emotionally, mentally and intellectually.” It also gave her a ready-made support group, ready to cheer her on to challenge herself to bigger and better accomplishments.

After she started lifting, she started sharing her story publicly, hoping to raise awareness about domestic violence and help erase stigma. Tina had been too ashamed to tell anyone about what had been happening to her for the previous three years.

Serving as an advocate helps give her purpose, even though it is emotionally exhausting each time she relives the story. “I felt I really needed to do this for Tina.”

She will have her seventh competition on Saturday. She’s set a goal of squatting 231 pounds, bench pressing 145 and deadlifting 308.

To this day, Tineo still relies on powerlifting as a form of therapy to get through life’s everyday stresses, as well as the knowledge that Tina is gone.

She’s also kicked up her running program, signing up for a half marathon in March 2018.

Tineo said she’d love to eventually lift with her grandchildren. In the interim, she’s teaching them about respecting themselves – from what they put in their mouths to the activities they do and the way they treat others.

“It’s important to be nice to each other and not say mean things to hurt each other. It’s important to respect boundaries. Ultimately, domestic violence is a learned behavior. If it’s learned, it can be unlearned.”

 

 

 

 

Bust that sugar habit in four easy steps

Tucson Medical Center is part of the Mayo Clinic Care Network.

Is hidden sugar adding inches to your waistline? Laurie Ledford, Registered Dietitian, follows this video from the Mayo Clinic with four easy steps for reducing the sugar in your diet:

Step 1 – Know Where the Sugar Is

Major Sources:

  • sugar-sweetened soda, energy drinks, sports drinks, sweet iced tea
  • fruit drinks
  • grain-based desserts (e.g., cakes, cookies, doughnuts, pies and granola bars)
  • dairy desserts (e.g., ice cream custard)
  • candy
  • ready-to-eat cereals
  • breads

Sugar can also be found lurking in salsas and sauces, such as ketchup. You have to read the ingredients label to find it. You may see sugar called by many different names on food labels. Some of its aliases are dextrose, confectioner’s powdered sugar, corn syrup solids, fructose, glucose, high-fructose corn syrup (HFCS), invert sugar, lactose, malt syrup, maltose, molasses, nectars (e.g., peach nectar, pear nectar), syrups (corn, maple) or sucrose. If you add brown sugar, raw sugar, honey or agave syrup to your food or drink, you are still adding sugar.

But what about the sugar in fruit?

Yes, there are naturally occurring sugars in fruit (also in other minimally processed foods, such as milk), but these are accompanied by essential nutrients. Processed foods with added sugars are usually nutrient-poor. Said another way, they are just empty calories… until you see them sitting on the back of your thighs.

Step 2 – Know Your Limit

The American Heart Association recommends limiting the calories you consume from added sugars. For most women, the limit is 100 calories or 25 grams per day. For most men, the limit is 150 calories or 37 grams. You know your limit, now how to figure out how much you’re eating.

Step 3 – Know How Much You Are Eating

Read the Nutrition Facts panels on packaged foods, and remember to pay attention to the number of servings you are actually eating. If you have a smartphone try an online nutrition app like MyFitnessPal for tracking.

If you are adding sweeteners yourself be familiar with what the caloric intake is

  • 1 tsp sugar = 16 calories
  • 1 tsp maple syrup = 17 calories
  • 1 tsp molasses = 19 calories
  • 1 tsp honey = 21 calories
  • 1 tsp agave syrup = 21 calories

And if you add more than 1 teaspoon multiply the calories accordingly.

Step 4 – Cut Back Where You Can

Here are some suggestions from the Center for Science in the Public Interest, publisher of the Nutrition Action Health letter:

  • Cut back on soft drinks (which they call “liquid candy”) and sweet tea. Instead, try club soda, seltzer, unsweetened tea, low-fat or non-fat milk. Better yet, drink water.
  • Avoid fruit drinks, -ades and cocktails. These are essentially non-carbonated soda pop. Sunny Delight, Fruitopia, and others are only 5-10 percent juice. If you want juice, choose 100 percent juice and watch your portion size.
  • Limit candy, cookies, cakes, pies, doughnuts, granola bars, pastries and other sweet baked goods. Eat fruit, veggies or nuts instead.
  • Fat-free cakes, cookies and ice cream may have as much added sugar as their fatty counterparts, and they’re often high in calories. “Fat-free” on the package doesn’t mean fat-free on your waist or thighs.
  • Look for breakfast cereals that have no more than 8 grams of sugar per serving.

We all have some special sweets we don’t want to give up forever. You don’t have to. Instead, treat them as indulgences and eat them less often or in smaller portions. You can also prepare them yourself, so that you can control the amount of added sugar that goes into them. As a challenge, try gradually reducing the amount of sugar in your recipes to see how little you can get away with.

Another option you might want to try is using artificially sweetened beverages and desserts. Not everyone likes artificial sweeteners, but they can help some people satisfy their sweet tooth without the extra calories or rise in blood sugar.

Start today! Break your sugar addiction.

Challenge yourself to try one or more of these easy strategies for cutting back on wasted calories:

  • I will replace one sugar-sweetened beverage with an equivalent amount of water on at least three days during the next week.
  • I will try a breakfast cereal that contains less than 8 grams (2 teaspoons) of sugar per serving.
  • The next time I eat yogurt, I will replace half of the sweetened yogurt with plain yogurt. (Then I can save the other half of that sweetened yogurt for the next day.)
  • The next time I bake, I will reduce the amount of sugar in the recipe by 25 percent. (For example, use 3/4 cup instead of 1 cup of sugar.)
  • The next time I order dessert in a restaurant, I will share half (or more) of it with someone else.

Need support in making healthy changes to your diet?

Tucson Medical Center offers personalized nutritional assessments by registered dietitians to help you reach your goals.

Laurie Ledford MS RD aka The Nutritionista
Laurie is a Registered Dietitian from Atlanta, Georgia, the land of grits, collard greens and super-sweet iced tea. She works as a Registered Dietitian at Tucson Medical Center. She enjoys helping people improve their health through sustainable dietary changes while still relishing occasional indulgences. In her off hours, Laurie engages in foodie pursuits such as sampling unusual flavor combinations (olive oil and basil ice cream was a good one) and discovering delicious food and beverage pairings. She is still trying to find the perfect wine to serve with Brussel sprouts.

 

 

Join the conversation: Reviving trust, civility in a time of political and social divides

It too often seems we are more divided than ever, from political ideology to social issues.

The National Institute for Civil Discourse will share actions we can take individually and locally that can serve as a balm to the friction around us.

The one-hour discussion will take place at Tucson Medical Center’s The Core at La Encantada at 5:30 p.m. on Nov. 2.

Rounding out the Downtown Lecture Series on “Truth and Trust in the Global Scene,” the discussion is open to all participants who want to learn and practice tools and skills to restore civility in their everyday lives.

Earlier this year, The Institute launched an initiative to revive civility through small groups and texting platforms to help members of the community build trust and invite open, respectful dialogue.

“Engaging in constructive dialogue is something we have to consciously work at – and particularly when our political discourse is often peppered with personal attacks and when we are so often exposed to hateful rhetoric and polarization,” said Basant Virdee, who works on the Institute’s Revive Civility Initiative.

“The good news is that we can get better at cultivating a respectful environment and we are looking forward to connecting with people about how to foster civil, civic discourse.”

Kindness, trust and respect are foundations not just for healthy dialogue, but for healthy communities, said Tara Bruce, assistant manager of The Core. “As a nonprofit community hospital that is committed to building health, we are pleased to support the work of the National Institute as our society continues to grapple with conflict and how we can best respond to it,” Bruce said.

The event is free but registration is requested at https://www.tmcaz.com/body.cfm?id=324&registration=true&action=detail&ref=5092

For more information about other health lectures, wellness events and fitness classes at The Core, please visit www.thecoretmc.com

 

TMC resale boutique holds big sale to celebrate five years of helping patients

resale, tucson, thrift, sale,What’s better than a great sale on quality clothing and household items?

A great sale, combined with the knowledge that all proceeds go to help patients and families in need.

The Teal Saguaro, Tucson Medical Center’s resale boutique across from the hospital, is holding a fifth anniversary sale on Saturday, Oct. 28 from 10 a.m. – 2 p.m., with a whopping 50 percent off most items!

When TMC opened the Teal Saguaro, it was envisioned as another way to raise revenues to serve the community, with all proceeds directly support TMC and its services.

The retail space also serves as a family resource center, where families can pick up free booster seats and bicycle helmets for children. And because families can’t plan for emergencies, the shop accepts vouchers from the hospital so that families who dropped everything to come to a loved ones’ side, can pick out clothing or other necessities to help during their stay, which can sometimes be days, depending on a patient’s condition.

“The Teal Saguaro vouchers bring a lot of comfort – providing a fresh pair of clothes for child patients and parents who have had an unexpected hospital stay,” explained Jamie Antrim, a child life assistant at TMC for Children.

Director of Community Programs Hope Thomas, who opened the shop five years ago, applauded it as a great example of a volunteer-run business. “I think it’s been such a success because it really combines creativity, a clean shopping environment and a fabulous group of dedicated volunteers working to support those in need,” she said. “We are thrilled to be celebrating this milestone with our community.”

 

 

 

One foot at a time – Newborn screening

Electine Orido RN and Baby Cash

A quick pin prick to the heel of the foot, a small cry, a few drops of blood on card and you and your baby have taken an important step in keeping your child healthy – newborn screening.

Here in Arizona the newborn screening looks for 31 core disorders. In addition, we conduct a screening for hearing loss , for critical congenital heart defects and for jaundice. The list continues to expand as medical understanding grows.

Find out more about the Arizona Newborn Screening Panel

In July 2017, the State of Arizona Health Department added severe combined immunodeficiency, or SCID, to the list of conditions screened. While you may never have heard of SCID, a rare disorder affecting about one in 50,000 to 100,000 babies in the United States, you may have heard of the “Boy in the Bubble.” A young boy, David Vetter, brought this disease to notice when he survived for 12 years living in a plastic enclosure that excluded the everyday germs that generally kill affected infants in the first year of life. Generally, infants appear healthy at birth, but the lack of a functioning immune system makes them vulnerable to even everyday germs. Today, survival rates for children affected by SCID are much higher due to improved screening and treatment. If an infant receives a bone or cord blood transplant in the first three and half months of life prior to active infections, the survival rate can be as high as 94 percent.

But my baby looks healthy … Why every newborn needs newborn screening

We screen all babies because ALL babies are at risk, even if they look healthy. Most babies who are identified through screening have no family history of a disorder. The sooner a disorder is identified the quicker treatment can begin, which can prevent disability and even death.

What is involved in newborn screening?

Kassandra and baby Cash

1. Blood Test

At about 24 hours after birth, we start newborn screening with what is often called the heel-stick test.

Your baby’s heel will be cleaned and warmed. A quick pin prick allows five drops, yes just five drops, from your baby’s heel to be dropped onto a card with special filter paper to absorb the blood.

Once your baby’s details and your contact information are collected on the card it is sent off to the Arizona State Laboratory for testing.

Your child’s healthcare provider will be informed of normal or abnormal results. Be sure to ask your child’s provider for the test results if they do not volunteer them.

2. Pulse Oximetry

By using a sensor to detect low oxygen levels in the blood, we can identify babies who may have severe heart defects known as critical congenital heart disease. The pulse oximetry test is quick, easy and painless. We usually perform this screening test about 24 hours after birth. If a newborn’s oxygen level is below normal, your baby may need to have an ultrasound of the heart (echocardiogram). Unfortunately, the pulse oximetry screening is limited in that it won’t find all heart conditions.

3. Bilirubinometer

We assess all babies for jaundice using a special light meter, which calculates the level of bilirubin by analyzing how the light reflects off the skin. Because bilirubin levels, which cause the yellowing of the skin, peak between the second and fourth day after birth, your newborn’s health care provider should check for jaundice after release from the hospital. If jaundice is suspected, the level of bilirubin in the blood will be assessed too.

4. Newborn hearing screening

This is a simple, non-invasive hearing screening. If your baby appears to have a hearing issue during the initial screening the baby will be referred for auditory brainstem response and otoacoustic emissions testing. Your baby will be asleep during the ABR testing, and if the infant sleeps well, we usually give the results of the testing immediately following the test.

Whether you deliver with a midwife or obstetrician at TMC for Women we will take care of these critical newborn screenings. To find out more about our maternity services check out the free maternity services tour.

Find out more: FREE maternity services tour.

When bed rest is required- Tucson Medical Center’s Antepartum Program

Bed rest at TMC for Women - a specialized antepartum program TucsonIn theory bed rest sounds glorious! Hours to read and to watch your favorite movies, without disruption! In reality, bed rest can be far from heavenly. The extra time to focus on concerns about your baby’s health as well as worries about disruptions to your family, your work and your relationships can make bed rest particularly difficult.

Expectant mothers on bed rest have always had a place at TMC for Women, and efforts are made to provide stimulation and support during this sometimes stressful time. After seeing how bed rest affects expectant mothers, talking with women who had experienced bed rest and reviewing the peer-reviewed research, Women’s and Children’s Services has formalized the TMC for Women Antepartum Program to better support women during this time.

Why are women placed on bed rest?

There are a myriad of reasons that you might be placed on bed rest.

Primarily, we see women who:

  • Are in preterm labor
  • Have problems with the placenta, such as placental previa or partial abruption (the placenta is near the cervix or a small section has separated from the inner wall of the uterus before delivery)
  • Have pre-eclampsia (a dangerous condition for mom and baby characterized by high blood pressure)
  • Have uncontrolled diabetes during pregnancy
  • Have a baby who is not growing sufficiently (intrauterine growth restriction)
  • Have a premature rupture of the membranes (the bag of water has broken)

While you may be able to restrict your activity sufficiently and stay at home on bed rest, it is dependent on how serious your condition, your proximity to the hospital, what support and demands you have at home, many women need to be at the hospital.

How the TMC for Women Antepartum Program supports women

Addressing the whole person

You and your baby’s health is our priority, and that includes your mental health. Finding out that your pregnancy and baby may be at risk would be enough, during the hormonal rollercoaster that is pregnancy, to depress any woman, but the other aspects also make it difficult for mom. In our antepartum program we monitor mom’s physical and mental health throughout, initiating counselling to support mom if need be. Rather than waiting until baby is here, our program recognizes the mental strains that accompany bed rest during the antepartum period.

Combating loneliness

Bed rest can be isolating. In the antepartum program you can have visitors throughout the day, 24/7, and a pull-out sofa is available for your support person. We also have opportunities to socialize with other women who are on bed rest. Knowing you are not alone can bring comfort.

Knowing what to expect

If we expect your newborn to stay in our Neonatal Intensive Care Unit (NICU), a neonatologist (specialist in newborns) will meet with you during your stay. We also have a weekly tour of the Neonatal Intensive Care Unit. Knowing what to expect, and the expert care that our Level III Nursery provides, helps lessen the fear of the unknown.

Making a home away from home

While we know that our hospital breaks the mold when it comes to providing yummy and nutritious food, we also know that sometimes you just want your grandma’s chili or a favorite snack. Each of the private rooms has a refrigerator, and you have access to a kitchen so you can enjoy a little bit of home. You can also decorate your room to make it homier, and as a unit we can help you celebrate festivities and your milestones.

Conquering boredom

We’re building a library of both fiction and baby-related books to share with you, as well as a growing DVD library when what you can find online (Hello, free Wi-Fi!) is no longer enough of a diversion.

Our pet therapy dogs love to visit, and those wagging tails and gentle dispositions are guaranteed to bring a smile to your face.

If your condition allows, wheelchair excursions to one of TMC’s beautiful courtyards can bring a little beauty into your day.

We have crafts to occupy your time and volunteers who can teach you to knit and introduce you to the world of fiber arts.

By recognizing the unique challenges of antepartum bed rest, we aim to make your journey a little easier.

Take a FREE tour of our maternity services.

Hidden Scar technology allows surgeons to minimize scarring without compromising breast cancer treatment

Hidden Scar breast cancer surgery centerBreast cancer surgery can save a woman’s life. And with new advances, surgery doesn’t necessarily mean leaving scars behind that serve as a visible reminder of cancer.

Tucson Medical Center is a Hidden Scar Center, with demonstrated expertise in surgical techniques that minimize scarring while retaining effective oncologic results.

Through Hidden Scar, surgeons make incisions in a location that’s harder to see so the scar is less visible. Advanced tools and technology make it easier for surgeons to make small incisions and reduce the risk of complications, all while keeping as much healthy breast tissue as possible.

“It’s important to me to individualize the care my patients receive,” said breast surgical oncologist Michele Boyce Ley. “For many women, scars do matter.  They can impact clothing choices, self-confidence, self-esteem, intimacy, and other important factors of daily life. Through Hidden Scar techniques, women can have surgical treatment that not only offers the best clinical outcomes, but provides the best aesthetic outcome as well.”

One option to consider is whether a nipple sparing mastectomy might be appropriate. “This technology facilitates preservation of the nipple for a more natural appearance after mastectomy,” said Boyce Ley, a fellow-ship trained surgeon.

Because every cancer is different, it’s important to discuss options with your physician and surgeon, based on the size and location of the tumor.

“Sometimes, we need a creative solution; I take a lot of pride in finding the solution that best matches the needs of each patient,” said Boyce Ley.

 

Bean spread – Packing a protein punch in an inexpensive and quick way

not hummus, cheap, quick bean dips for a protein punchHummus is available in almost any grocery store, and you can find it in a variety of flavors. However, not everyone is a fan of garbanzo beans or tahini or some of the other common hummus ingredients. Making your own bean spread allows you to customize it to your preferences, and it saves a little money.
You can spread it on pita triangles as a snack; use it in a sandwich for additional protein and flavor; or use it as a dip with raw veggies or tortilla chips.
If you don’t have a food processor, you can do this in a blender by adding more water to the recipe. The result will be a little runnier, which makes for a better dip than a spread.

Basic Ingredients

1 can of beans (such as pinto, kidney, cannellini, black or garbanzo)

1 Tbsp lemon juice

2 Tbsp good quality olive oil water, as needed

Variations

Choose one or more of the following ingredients to personalize your bean spread:

  • garlic
  • fresh basil, parsley or cilantro
  • spices, such as cumin, paprika or cayenne pepper
  • baby spinach
  • artichoke hearts
  • sundried tomatoes, soaked in warm water for about 20 minutes and drained
  • roasted red peppers
  • jalapeño  or other hot pepper

Directions

1. Rinse and drain beans thoroughly.

2. If using fresh garlic, peel it and process in the food processor until finely chopped.

3. Add beans and lemon juice to the food processor. Drizzle olive oil over the beans.

4. Process until beans are coarsely chopped; then add your special ingredients.

5. Continue processing until the mixture reaches your preferred consistency. You may need to add a few tablespoons of water to make it smoother.

6. Serve or chill immediately.

For more healthy recipes, wellness tips and events sign up for our monthly Live Well newsletter.

Halloween Safety Tips from Jessica Mitchell, Safe Kids Pima County

I love celebrating Halloween with my family, but I must admit I feel like I’m holding my breath all evening. Like many Tucson neighborhoods, ours has few street lights and on Oct. 31, kids are EVERYWHERE, often in dark costumes, often zigzagging across the roads to trick or treat. It’s a safety nightmare! Did you know that children are more than twice as likely to be hit by a car and killed on Halloween than on any other day of the year?

We try to watch where we are going, watch where our little ones are and watch for cars all at the same time. It can be really tough. I give my kids glow sticks to help them be seen by others, including drivers of cars. An added bonus, they think glow sticks are the coolest things ever!

What can you do to make Halloween safer this year for your children?

  1. When selecting a costume make sure it is the right size to prevent trips and falls.
  2. Decorate costumes and bags with reflective tape or stickers and, if possible, choose light colors.
  3. Since masks can sometimes obstruct a child’s vision, try nontoxic face paint and makeup whenever possible.
  4. Have kids use glow sticks or flashlights to help them see and be seen by drivers.
  5. Children under the age of 12 should not be alone at night without adult supervision. If kids are mature enough to be out without supervision, remind them to stick to familiar areas that are well lit and trick-or-treat in groups.
  6. Popular trick-or-treating hours are 5:30 p.m. to 9:30 p.m. so be especially alert for kids during those hours.

Plan ahead and keep your little ghouls and goblins safe and sound this Halloween,

Jessica

Jessica Mitchell is the Safe Kids Pima County program coordinator. Safe Kids Pima County is a network of organizations whose mission is to prevent accidental childhood injury, a leading killer of children aged 19 and under. Spearheaded by Tucson Medical Center, the local coalition is part of Safe Kids Worldwide, a global network of more than 600 coalitions in 23 countries bringing together health and safety experts, educators, corporations, foundations, governments and volunteers to educate and protect families.

These halloween revelers need a few glow sticks and then theyll really be shining.

Five-part series helps inform transformation agenda for health care, business

TransformationReportHealth care industry leaders face incredible challenges in shifting from traditional, volume-driven fee-for-service to value-based care.

As a member of the national Health Care Transformation Task Force, an industry consortium, and as the hospital member of two accountable care organizations, Tucson Medical Center is at the forefront of innovative work to provide higher quality, more efficient health care.

“The Transformation to Value: A Leadership Guide” from the Health Care Transformation Task Force shares the collective experience and wisdom from organizations at the vanguard of value-based payment and care delivery.

The Health Care Transformation Task Force created the “The Transformation to Value: A Leadership Guide” to assist health care leaders as they design and implement their transition to value based delivery and payment. This series of captures the transformation journeys of individual organizations, including both successes and lessons learned, and allow decision makers to benchmark themselves against similar organizations that are actively moving toward value-based care.

“The Transformation to Value: A Leadership Guide” is one more reason we’re proud to be part of the Health Care Transformation Task Force,” said Julia Strange, vice president of community benefit for TMC. “This new series offers proven advice to health care leaders as they design and implement their own transition to value based delivery and payment. This initiative reflects our and other task force members’ common commitment to facilitate transformation, both for members and others.

The Transformation to Value: A Leadership Guide” from the Health Care Transformation Task Force is practical freeware that can save organizations at any stage of the transformation journey countless hours, while avoiding the pitfalls uncovered by early adopters. Others are encouraged to use and share this work. http://bit.ly/2ylIwEK

Dispose of unneeded medications Oct. 23 at TMC Senior Services

Meds.jpgHaving old medications lying around puts children, teens and even pets at risk from inappropriately ingesting them.

It also increases the risk of mix-ups with any of your existing prescriptions.

If you have any medications you don’t need any longer, dispose of them safely and securely at a free Dispose-A-Med event at 1400 N. Wilmot in the El Dorado Health Campus.

Tucson Police Department will be on hand from 10 a.m. to noon to accept prescriptions or over-the-counter medications and vitamins. Sorry but sharps aren’t accepted, and we have to decline medication in liquid, creme or inhalation/aerosol form.

Come early for a free 9 a.m  presentation that morning on medication safety – and make sure to bring your current bottles for free one-on-one pharmacist consultations from 10:30 am. – noon.

To RSVP for the presentation, please visit the event registration page at TMC Senior Services.

For more information, please call 324-1960.

 

Ballots are in the mail for Nov. 7 election

Engaged voters are fundamental to a healthy community and a healthy democracy.

If you’re registered to vote, watch for a ballot coming soon to your mailbox for Nov. 7’s consolidated election.

Depending on where you live, you’ll have a say in:

  • ward races for the Tucson City Council
  • ballot propositions that would raise the salary of Tucson’s mayor and council as well as to increase the sales tax to fund zoo improvements and early childhood education
  • bond or override elections in several school districts, including the Tucson, Sunnyside, Flowing Wells and Marana unified school districts
  • funding and other issues in several fire districts

Oro Valley, where voters will decide on a park improvements package, will have polling sites open on Election Day, but the other jurisdictions are holding mail elections.

Please mail your ballot by Thursday, Nov. 2 to ensure your ballot is ready for counting on Election Day.

You may also track the status of your Vote-by-Mail ballot online. Simply visit: www.recorder.pima.gov and click on “Early Ballot Status” to ensure your ballot was received and processed.

For more information, please direct questions to the Pima County Recorder’s Office at (520)724-4330

Is genetic testing right for you in determining cancer risk?

should i get genetic testing to determine my risk for breast cancer?Medical advances have now allowed us to identify whether patients with certain inherited gene mutations have an increased risk of breast cancer.

Awareness is growing among patients that there are genes related to breast cancer and steps they can take to reduce future risk – but that doesn’t necessarily mean we should all get tested.

Here are some things to consider when deciding whether testing is appropriate for you:

Genetic testing will only provide insight into one area of risk.

You might still be high risk, even if the test shows no gene mutation. Maybe you have dense breasts, maybe you’ve never had kids, maybe you smoke, or you drink alcohol daily. Genetic abnormalities are associated with about 10 percent of cancer cases. That means no matter your test result, if you have factors that place you at higher risk, it is still important to have regular screenings.

If you were tested 5 years ago or more, you may consider retesting.

Back then, tests were only looking for mutations in BRCA 1 and 2. Now, tests routinely look at more than 25 genes that have a connection to increased risk for cancer development.

Make sure testing is appropriate for you.

Testing is most appropriate for those with a family history across multiple generations. Some special populations, such as Ashkenazi Jews, also have a higher tendency toward mutation and would be good candidates for testing.

Genetic testing isn’t just for women.

Gene mutations don’t discriminate and men get breast cancer as well. Testing, however, is not recommended on minors since the mutations inform lifetime cancer risk and children are too young to consider potential interventions.

You’ll want someone with expertise to help with the results.

There are interventions that may reduce the risk of cancer, from more frequently screenings to medication and surgery. Your primary care physician may be a good place to start the conversation, but often a specialist in breast cancer risk is best equipped to partner with patients to help them identify the next steps that are right for them. TMC offers a High-Risk Breast Clinic . Please call 324-2778 for more information.

Dr. Michele Boyce Ley, a board-certified breast oncology surgeon, serves as medical director of TMC’s Breast Health Program. She is accepting new patients and is located at 2625 N. Craycroft Road.

Help celebrate Physical Therapy month throughout October

EmilyBurdettePhysical therapists work hard to help patients improve their range of motion, strength and flexibility so they can lead their most active lives and obtain better outcomes.

National Physical Therapy month is held each October and Tucson Medical Center would like to take this time to recognize the impact of our therapists. A big thank you is in order for the 14 physical therapists and six physical therapy assistants in adult acute therapies, as well as the 11 therapists in pediatric therapies.

It’s also an opportunity to highlight the achievement of those therapists that have worked towards their advanced certifications.

According to the American Board of Physical Therapy Specialists, certification was established to:

  • recognize physical therapists with advanced clinical knowledge, experience, and skills in a special area of practice
  • assist consumers and health care community in identifying physical therapists who have advanced skills
  • address a specific area of patient need

Certification takes a great deal of work: Therapists must have extensive background in their specialty area including direct clinical hours and passing a board exam.  In order to maintain the certification, therapists must retake the exam and participate in professional development activities including service to the profession, teaching, and participation in research studies.

We caught up with Emily Burdette, who recently earned her certification, to learn more about the effort.

Why did you pursue this certification?

I wanted to pursue the designation of board-certified clinical specialist in pediatric physical therapy in order to demonstrate my commitment to the profession of pediatric physical therapy as well as my patients. I wanted to set myself apart as a clinician who is considered to have advanced clinical skills in pediatric physical therapy.

I pursued this certification as a commitment to further the profession of pediatric physical therapy. In order to become re-certified as a pediatric certified specialist, I must be active in the profession of pediatric physical therapy by attending continuing education courses, teaching physical therapy students during their clinical internships, participating in research projects, and becoming a mentor to other pediatric physical therapists.

Lastly, I wanted to pursue this certification to continue my commitment for life-long learning as a pediatric physical therapist. It is a personal commitment of mine as well as the other therapists working at Tucson Medical Center Pediatric Therapies to stay as up-to-date as possible on all research regarding the treatment of children. We all pride ourselves on the emphasis Tucson Medical Center Pediatric Therapies has on evidence-based practice.

How rigorous was the process? 

I studied every day for nine months for about 2-3 hours per day. I was busy reviewing various diagnoses that are seen by pediatric physical therapists in different areas of practice. I also reviewed research papers from the Pediatric Physical Therapy Journal and Physical Therapy Journal and took continuing education courses for diagnoses that I am not as familiar with. The actual test for certification was 6 hours long and 200 questions.

Was it worth it? 

It was worth the sacrifice so that I could provide the best evidence-based care to my patients. It helped me to review treatment of pediatric diagnoses I am familiar with as well as learn about the treatment of diagnoses I am not as familiar with. I believe that all of the studying and reviewing of research articles has made me a better, more knowledgeable pediatric physical therapist!​

Optimize your fruit and vegetable choices with tips from our wellness experts

eating well doesn't have to break the bankIt should come as no surprise that eating plenty of fruits and vegetables is part of a healthy diet. The more vegetables and fruit you eat, the less likely you are to develop cardiovascular disease, age-related eye diseases, osteoporosis and some types of cancer. What does seem to be surprising to many is how easy it is to incorporate vegetables and fruit into our diets. We often hear one of these comments as the reason someone is not eating enough vegetables and fruit:

     “Fresh produce is so expensive.”

     “Fresh produce goes bad before I use it.”

     “I don’t know what I should buy, and I don’t know what to do with the stuff I do buy.”

These are legitimate questions and concerns. Here are some things to consider that will hopefully help to address how to incorporate produce more easily into your diet.

Add More Variety

We eat with our eyes. Lots of color and variety is key. We eat with our eyes – color and variety make a plate of food look more enticing. Keep this in mind when you are trying to persuade yourself or your family to eat more vegetables and fruit. Not only does variety prevent boredom, it also ensures that your body gets a full spectrum of nutrients. Different types and colors of foods provide different vitamins, minerals and other plant compounds that enable your body to perform its everyday functions and prevent disease. Add produce that is in season or locally grown is likely to be fresher and more flavorful, and generally it is more cost effective.

TIP: Purchase produce in season, cut it up into smaller pieces and freeze for use throughout the year.

Fresh vs. Frozen vs. Canned

While fresh is always best, it may not always be possible to have fresh produce. Frozen fruits and vegetables are convenient, nutritious, and often less expensive, so they are your next best option. Avoid items with added sugar, butter or sauces, as this adds extra calories and fat. In the case of beans and tomato products, canned versions are far more convenient and can still be relatively healthy. When buying canned vegetables, choose low-sodium or no-salt-added options; otherwise, drain and rinse thoroughly to reduce the sodium.

TIP: Keep some frozen vegetables on hand for a quick and easy addition to soups, pastas or rice dishes.

Think About Organic

Should you buy organic produce? That’s something you have to decide for yourself.

If you would like to eat organic foods to reduce the amount of synthetic chemicals you ingest, but you can’t buy organic every time, here are a few suggestions for prioritizing your purchases:

  • If you frequently eat a lot of certain types of fruits or vegetables, buy organic versions of them to reduce your intake of the particular pesticides commonly used on those crops.
  • Check out “The Dirty Dozen.” It is a list of conventional produce that, according the Environmental Working Group, carries a high pesticide load. Buying organic versions of these foods can reduce your consumption of toxic chemicals.
  • Most pesticide residue exists on the outer surface of produce, so you may want to buy organic if you are planning to eat the skin.

Organic foods are not necessarily more nutritious, and there is no good evidence to show that eating organic produce reduces your risk of cancer. The important thing is that you eat more fruits and veggies, however you manage to do it.

For more tips on making the most of your produce see this TMC for Women post.

Design your personalized nutrition plan or tour the grocery store with help from our registered dietitians

Is your family ready for flu season?

Are you ready for flu seasonFrom cooler temperatures to pumpkin pie, we welcome many things that come with the fall season, but the flu is not one of them. Dr. Katherine Leitner, a TMCOne provider at TMC Rincon Health Campus, provides some important pointers to best prepare families for flu season.

How should a family prepare for flu season?

The most effective preventative measure is a flu vaccination. Everyone in the family should get a flu shot.

If experiencing flu-like symptoms:

  • cover your mouth when coughing
  • avoid touching your face
  • wash your hands with soap and water frequently
  • disinfect surfaces you come in contact with
  • and stay at home for at least 24 hours

When should you get a flu shot?

The Centers for Disease Control recommends receiving a flu vaccine in October. Even if you did not receive the flu shot in October, it is still beneficial to obtain one throughout the flu season which can run through January or later. It is also important that everyone get the flu shot yearly, because the flu strain changes from year to year.

What about vitamin C and a healthy diet?

Studies have shown that supplementing with vitamin C during a cold does not actually improve the outcome or decrease the duration of illness. However, it is always important to stick to a healthy diet so you can build a good immune system for when you do get sick. During an illness, drinking lots of fluids and staying hydrated is very important.

What should you do if a child is showing flu symptoms?

Make an appointment with your child’s health care provider right away. The provider can test for the flu and treat it with a medication if caught early. To prevent the spread of illness, keep your child out of school until he or she is feeling better.

Who should get the flu shot?

Dr. Robert Jacobson, a pediatrician with Mayo Clinic, says, “The latest recommendations from the CDC reaffirm that all of us are at risk for catching and spreading the flu, and all of us should get our flu shot this fall. Very few of us cannot get the vaccine. Our getting the vaccines protects them, too.”

Influenza vaccine recommendations for the 2017-18 season include these updates and changes:

  • Afluria Quadrivalent and Flublok Quadrivalent are now available for patients 18 and older.

  • FluLaval Quadrivalent may be given to children as young as 6 months. Previously, administration was limited to children 3 and older.

  • Pregnant women may receive any age-appropriate flu vaccine that is approved and recommended by the U.S. Food and Drug Administration.

  • FluMist Quadrivalent should be not should not be used during the 2017–2018 season due to concerns about its effectiveness against influenza A(H1N1)pdm09 viruses in the U.S. during the 2013–2014 and 2015–2016 influenza seasons.

The CDC continues to recommend vaccination for all people aged 6 months and older without contraindications, preferably by the end of October. For those aged 65 and older, the CDC says standard-dose or high-dose vaccine is acceptable.
As a member of the Mayo Clinic Care Network, Tucson Medical Center works directly with Mayo Clinic, the nation’s No.1 hospital according to U.S. News & World Report. Our doctors get access to Mayo Clinic knowledge and resources, and you get the best care, close to home.

For information on how to protect infants under 6 months from the flu see this TMC for Children post.

Dr. Leitner is a TMCOne provider at the TMC Rincon Health Campus, near Drexel and Houghton.

 

DACA participant faces uncertainty with resolve, optimism

YesikaMartinezYesika Martinez looks into her future and dreams that she will someday serve others as a nurse or a counselor.

But her future possible self is on hold while she waits to see what comes next after the Trump administration’s recent directive to end the Deferred Action for Childhood Arrivals, or DACA, program in six months unless Congress comes up with a legislative solution.

Martinez, 25, has been in this country since she was 9 months old. She was born with spinal bifida, a birth defect in which the spinal canal doesn’t close before birth. Fearful her complex needs would not be met in their small community in Mexico, her parents moved to Tucson.

Growing up meant a lot of time in hospitals, with many surgeries, as well as extended physical and orthopedic therapy, and neurology and urology care. With the assistance of leg braces, she can walk, ride a bike and drive a car and is successfully working toward her career path.

Martinez watched her other friends in high school celebrate things like driver’s licenses and first jobs that were out of reach for someone with undocumented status.  Her parents instilled in her to believe that all things are possible and encouraged her growth.

When she turned 18, waiting to see if DACA participants would be eligible for in-state college tuition, she began volunteering at the Children’s Clinics, where she had received much of her care, in order to help other young patients going through other health care challenges.

In the afternoons, Martinez volunteered to teach violin to the afterschool mariachi group at her previous elementary school. “I couldn’t work, but I didn’t want to sit home. I wanted to do something with my life and contribute,” she said.

When DACA was passed, she was hired on at the Children’s Clinics as a clinical associate.

President Trump’s announcement, she said, “was a rough day for me because I know there are so many people in my same situation who don’t know what’s coming next.” Thanks to a recent renewal, her status is OK until early 2019, but she hopes a resolution will come long before then.

“What I think people don’t understand is that we go through a lengthy process to get permits,” she said. “We aren’t bad people. We’re working hard to go to school to try to contribute. I would ask this community to help fight for us and support us.”

TMC President and CEO Judy Rich recently wrote an opinion piece for the Arizona Daily Star, urging Congressional leaders to resolve DACA. Click here to read it. http://tucson.com/opinion/local/judy-rich-dreamers-make-our-workforce-stronger/article_7cdc96c8-9fb9-5435-957a-1893de6d62ce.html

 

When pregnancy leads to bed rest: a mom’s tips

Early labor story, bedrest, bed restBed rest can be a stressful time for parents while they wait days and weeks to see if their little one will arrive before term.

For Alyssa Hoyt, restricted activity started at 20 weeks, with bed rest starting at 27 weeks.

At 31 weeks, Baby Teagan tried to come early, so Alyssa spent 10 days in TMC having labor stopped twice. Alyssa went home on bed rest until Teagan – now a healthy, bubbly toddler – arrived at 37 weeks.

“I really loved all of the nurses and doctors and got to know them throughout this time, which really helped me to stay positive and compliant too,” Alyssa said.

Precisely because bed rest can be a difficult time, Alyssa shared the top five things that helped her get through:

  1. Family and friend support. Alyssa’s husband spent every night with her and took her four-wheeling in her wheelchair. Her mother brought special treats like homemade lasagna. Just taking a break from the monotony of the everyday and being able to laugh and seek comfort in love and friendship made all the difference.
  2. Remember: This is all temporary. Don’t dwell. There is an end to it and you can get through it.
  3. Comply with your doctor’s orders. The goal is to have a better outcome and a healthy, safe birth.
  4. Look to the future. Alyssa researched toys and car seats and things she would need when she brought her baby home. Being actively engaged instead of just waiting helped her feel like she had more control.
  5. Being engaged and active. Having an endurance mindset as a runner and a running coach, helped her keep in mind that this was a different kind of endurance, but it still required mental toughness and grit. Alyssa did a lot of research about what to expect, and met with physicians to understand the possible outcomes so she would feel more prepared.

Alyssa had a unique inspiration, too, in that she herself was a premature baby. Thirty years earlier, her mother, Beth Day, was at Tucson Medical Center, standing by anxiously while her baby recovered in the newborn intensive care unit.

Alyssa would spend 9 days there, until she was strong enough to go home. While Alyssa was at TMC on bed rest, staff found the handwritten log book, capturing her own time in the unit.

She and Teagan were both 5 pounds, 4 ounces, separated by 30 years.

“It was amazing to be here, with my mom, while potentially having an early baby,” Alyssa said. “Knowing my mom went through it with me I just knew it was going to be ok: we got this.”

Save the date for your maternity services tour date.

 

 

TMC wraps up summer challenge asking employees for their best ideas

Tucson Medical Center five years ago embraced the Lean management process, which works to eliminate waste and tap the knowledge of employees to make steady improvement every day.

The Summer of Ideas challenged employees to channel their creativity and share their suggestions across the hospital.

More than 250 ideas were submitted since the July kickoff. Awards were given for the team and the individual with the most ideas, as well as the best “out of the park” idea.

Some of the ideas included a TMC-specific rideshare program, new software for clinicians and an app to help patients and visitors navigate the campus.

LeanAmyThree of the four finalists – and the winner of the category – for the most ambitious idea generators work in Unit 750, an adult medical unit. Unit clerk Amy Hill, who came to TMC six years ago, won a reserved parking space for a month.

“What I really appreciate about TMC is that there is an acknowledgment that those who are closest to the work often have the best solutions to improve a process,” Hill said. “I appreciate that whether it’s finding root causes of a problem or finding the where efficiencies are, we can all have some ownership of making things better.”

Janet Heckman, the manager of Unit 750, applauded the efforts of her staff. “Taking ideas from the front line staff who actually do the work is very important as I may not realize there is an issue,” Heckman said. “I also believe being heard is a huge employee satisfaction point as they feel empowered and heard.”

Ideas were logged on a Lean tool known as an “idea board.” There are 120 idea boards throughout TMC as well as at TMCOne locations and TMC Hospice.

It’s different from a suggestion box in that ideas – as well as any outcomes or solutions – are visible to the entire team, who can contribute to the idea as it matures, said Pat Ledin, the manager of Lean and quality efforts at TMC. “We hoped the Summer of Ideas would serve as a fun catalyst to continue driving engagement and we were really pleased with the participation across so many of our departments, from environmental services to information technology to clinical staff.”

lean ideas

Medical librarian Marni Dittmar, who picked up an extra day off as an award for her most “out of the park” idea, is an example of how the process worked. She not only came up with her idea for new clinical software, but then researched it to determine the benefits and feasibility.

Click here to see a short video about how idea boards are igniting creativity and empowering staff at TMC.

TMC High Risk Breast Clinic – Personalized care, options and support

Are you at an increased risk for breast cancer? One in eight women will be diagnosed with breast cancer in their lifetime. How do you know if you are high risk? If you are at high risk – what’s next?

Tucson Medical Center has designed a clinic just for women who have these questions about developing breast cancer. The TMC High Risk Breast Clinic is focused on providing in-depth education, advanced diagnostics and compassionate support to best help high risk patients choose their next steps. TMC’s experienced high-risk team recognizes that every woman’s risk factors are different and will assess risk, and then tailor a personalized care plan based on each patient’s individual needs.

A team approach

michele boyce ley md breast cancer surgeonPatients will work with a team of breast-health professionals –who have decades of diagnostic and treatment experience. The team includes a women’s health nurse practitioner, a certified nurse navigator, and a breast surgical oncologist. In addition, patients have access to imaging specialists and genetic counseling.

“The multidisciplinary approach is central to an effective high risk program,” said Medical Director Dr. Michele Boyce Ley, a board-certified, fellowship-trained breast surgical oncologist and a fellow of the American College of Surgeons.

As a breast cancer survivor, Dr. Boyce Ley brings a unique perspective to the clinic, empathizing with patients on their journey.

“Our team meets weekly to discuss the unique aspects of each patient’s care and challenges,” Boyce Ley explained. “We leave no stone unturned, and focus on making the best care recommendations to the most important member of the care team – the patient.”

Specialized services

The TMC High Risk Breast Clinic features state-of-the-art imaging diagnostics to facilitate early and accurate detection. The dedicated breast imaging center houses the latest equipment to provide the care team with clearer images, even for patients with dense breast tissue. On-site breast biopsies by experienced physicians offers convenience and timely results.

“Our next-level diagnostics provides clearer, overall images that help identify abnormalities earlier,” said Karen Narum, WHNP-BC, the board certified, women’s health nurse practitioner at the TMC High Risk Breast Clinic. “We use an advanced breast tomosynthesis, which combines enhanced mammography with modern computer software to create three-dimensional images of the breasts.”

A genetic-testing panel can be performed to further identify risk factors and provide additional information to help guide patients through the decisions and options that are available. If surgery is determined to be the best option, patients can rely on advanced surgical techniques, including nipple sparing mastectomy and Hidden Scar techniques, which are both effective and respectful of appearance.

Meaningful support and resources

The TMC breast-health nurse navigator will be by the patient’s side every step of the way, functioning as a personal advocate, answering questions, arranging visits with specialists, lining up tests and coordinating care.

“A high-risk diagnosis can be overwhelming,” says Mary Verplank, BSN, RN, breast-health nurse navigator. “We’re here to help with anything and everything – from scheduling appointments to connecting patients with community resources.”

The nurse navigators work one-on-one with patients and family members to:

• familiarize them with all aspects of the treatment plan.

• share hospital and community resources.

• coordinate support services that may address specific needs during treatment.

• help resolve any issues that may arise, from financial questions to transportation.

For further information or to schedule an appointment call the TMC breast health nurse navigator at (520) 324-4848 or Breast.Navigator@tmcaz.com.

Are you at high risk for breast cancer? Not sure? Take our Breast Cancer Health Risk Assessment. Following completion we send the report to your email address so that you may take it to your primary care provider. Have questions? Our certified nurse navigator will reach out to those at high risk.

breast cancer risk assessment

Take a hike Tucson – 5 of our favorite trails

Hiking in Tucson with TMC's employee FEAT groupAmy Ramsey, TMC’s employee wellness and engagement manager shares some favorite Tucson hikes.

Tucson is known for its outdoor activities, and hiking is one of the top things to do in and around our breathtaking city. Below is a list of our Top 5 places to hike in Tucson.

Sanctuary Cove: If you’re in search of some solitude, it’s worth finding! Our employee group used this location on Tucson’s west side to host outdoor yoga and labyrinth walking after our hike.

Santa Catalina Mountains: Visiting the sky island to the north is a must on your list of to-dos in Tucson. TMC has hosted a number of hikes beginning at Marshal Gulch, a beautifully wooded picnic area near Summerhaven and Mount Lemmon.

Pima Canyon: Gorgeous city and canyon views on this trail, with an easy-to-reach trailhead.

Sabino Canyon: Take the tram road up and choose which way you’ll go back. For a real challenge, try Blackette’s Ridge-one of the best views from the top!

Romero Pools: Located in Oro Valley’s Catalina State Park, it’s just one of the awesome trails available, and a favorite for TMC’s hiking group.

*Bonus! Tumamoc Hill: We just couldn’t leave this one off the list. A challenging yet doable paved hike on the west side of town, Tumamoc is one of our employees’ favorites. It offers great views of downtown at the top. While you’re there, make your way over to “A” Mountain, which is just next door!

Please visit hiking in Tucson for more detailed info on all the hiking adventures that your new city has to offer.

Walk this way – Walk to School

Safe Kids Pima County and FedEx volunteers will join students from Whitmore Elementary and around the county to celebrate International Walk to School Day on October 4. International Walk to School Day raises community awareness about walking safety and promoting healthy behavior.

Did you know unintentional pedestrian injuries are the fifth leading cause of injury-related death in the United States for children ages 5 to 19? Teenagers are now at greatest risk with a death rate twice that of younger children and account for half of all child pedestrian deaths.

Whether or not your child’s school is participating, Jessica Mitchell, Safe Kids Pima County program coordinator, provides these suggestions for parents:

Teaching kids how to walk safely:

  1. Teach kids at an early age to look left, right and left again before crossing the street. Then remind them to continue looking until safely across. Teach them to never run or dart out into the street or cross between parked cars.
  2. Teach kids to put phones, headphones and devices down when crossing the street. It is particularly important to reinforce this message with teenagers. Parents, let your actions speak as loudly as your words.
  3. Encourage your children to be aware of others who may be distracted and speak up when they see someone who is in danger.
  4. It’s always best to walk on sidewalks or paths and cross at street corners, using traffic signals and crosswalks. If there are no sidewalks, walk facing traffic as far to the left as possible.
  5. Children under 10 need to cross the street with an adult. Every child is different, but developmentally, most kids are unable to judge the speed and distance of oncoming cars until age 10.
  6. Remind kids to make eye contact with drivers before crossing in front of them and to watch out for cars that are turning or backing up.
  7. It’s always best to walk on sidewalks or paths. If there are no sidewalks, walk facing traffic as far to the left as possible.
  8. Cross streets at corners, using traffic signals and crosswalks. Most injuries happen mid-block or someplace other than intersections.

As kids get older, they’re anxious for a little more freedom when walking to school or playing outside. But this is also a time when parents need to stress the importance of the little things big kids should do to stay safe.

Remember you are your child’s first role model. Lead by example:

  1. Be a good role model. Set a good example by putting your phone, headphones and devices down when walking around cars.
  2. When driving, put cell phones and other distractions in the back seat or out of sight until your final destination.
  3. Be especially alert and slow down when driving in residential neighborhoods and school zones. Be on the lookout for bikers, walkers or runners who may be distracted or may step into the street unexpectedly.
  4. Give pedestrians the right of way and look both ways when making a turn to spot any bikers, walkers or runners who may not be immediately visible.

For more resources to help keep your family safe
visit our website.

 

TMC receives prestigious national procurement recognition

procurement team

Tucson Medical Center was one of only 242 hospitals and health systems nationwide that were recognized for significant supply chain savings through efficiencies in procurement.

“As a community hospital, Tucson Medical Center knows the importance of efficiency in managing health care costs, even while never compromising on the ability to deliver high quality care,” said Kim Moon, TMC’s supply chain director.

The recognition is particularly special, Moon said, because of the 3,000 members participating in Vizient Inc’s group purchasing organizations, only 500 are even eligible for the award by participating in Vizient’s Impact Standardization Program, which helps drive down costs through group buys.

Only hospitals that earn at least $250,000 in rebates on an annual basis are eligible for an award. TMC, which has received this recognition annually since 2010, reduced its costs by achieving nearly $400,000 in rebates in 2016.

The program works through capturing rebates and reducing variation through standardization – which helps with bulk purchasing prices, but as an added benefit, improves inventory management and provides greater consistency across the hospital.

“This is not an easy bar to meet, which is why we’re so proud to receive this award,” Moon said. “Through thoughtful sourcing and standardization, we’re able to drive quality patient care, while getting the best value at the same time.”

The effort dovetails with TMC’s other work around building efficiencies throughout the hospital. The hospital introduced Lean management practices in 2013 to help root out waste and streamline processes. And TMC participates in two accountable care organizations that reward value – not volume – in health care.

“As a community hospital, TMC is responsible for the health of the people who live in this community, but we must also maintain the financial viability of our organization and keep healthcare costs under control,” said Steve Bush, TMC’s chief financial officer. “Leveraging our purchasing power is just one of the strategies we are using to do that.”

vizient award

 

TMC recognized as a Weather Ready Nation Ambassador of Excellence

BDP33616Tucson Medical Center is honored to be recognized by the National Weather Service (NWS) in Tucson as the 2017 Southeast Arizona Weather-Ready Nation Ambassador of Excellence, for going above and beyond the call of duty to help the NWS build a Weather Ready Nation.

This year,  NWS Tucson nominated TMC for its work in hosting its annual Be Safe Saturday event. For 13 years, TMC has conducted car seat checks, distributed bike helmets and booster seats and invited community partners to staff more than 100 interactive booths committed to the safety and wellness of children throughout Southern Arizona.

The National Weather Service is one of those Be Safe Saturday participants, speaking about weather safety to hundreds of families, said Ken Drozd, the Warning Coordination Meteorologist for the NWS Tucson office. “Dozens of other organizations also help educate the public about how to stay safe and we appreciate TMC’s  dedication to community safety,” he added.

BDP33551The ambassador initiative recognizes leaders in the community that help build community resilience in the face of extreme weather events – from promoting safety messages in outreach activities, to being a “weather-ready” role model.

Safety Manager Steven Barnes said TMC monitors weather conditions to ensure the safety of its HazMat team when wearing gear in the heat of the summer. The TMC Safety Department presents heat stress prevention classes to facilities personnel each June, followed by lightning safety in July and West Nile disease prevention training every August.

TMC is prepared for electrical outages during the monsoon storms with very extensive backup generator equipment for patient safety, Barnes noted, adding the hospital also has a fully equipped disaster command center and participates in local and statewide exercises every year.

“As you can imagine we are very dependent on accurate weather forecasts and prepare on a regular basis for all weather threats and situations,” Barnes said, adding he was pleased with the recognition.

Any organization can  become a Weather Ready Nation Ambassador. Schools, government agencies, private businesses, civic organizations, home owner associations and others can apply online at https://www.weather.gov/wrn/amb-tou

 

Tucson Medical Center honored with five top Readers’ Choice awards

2017 Readers' Choice Win OutLNTucson Medical Center has been named “Best Hospital” in the Arizona Daily Star’s 2017 Readers’ choice awards.

TMC also was recognized for having the best women’s center, best emergency department, best pediatric emergency department and best surgical weight loss center.

“TMC has had the privilege of serving as this region’s nonprofit, locally governed community hospital for more than 70 years,” said Judy Rich, president and CEO. “This recognition is an honor – not only because it comes from the community, but because it recognizes the work that our staff and volunteers do every day to care for those who need us.”

The Readers’ Choice awards, which launched in 2015, give the Tucson community an opportunity to vote for their favorite organizations across a variety of categories, from restaurants to shopping and home service.

Click here to see the complete list of health care winners. Search “Readers’ Choice” for other categories.

TMC salutes Walker Elementary teacher on Legendary Teachers Day for infusing wellness into her school

LegendaryTeacherMonicaBermudez.jpgA few years ago, elementary school teacher Monica Bermudez had seen one too many students pull out tortilla chips or candy for their snacks – or worse, lunch.

So she started a “Fitness Fanatics” group at her school, volunteering after school to teach as many as 95 students at a time about wellness. It’s become something of the go-to club ever since.

On Legendary Teacher Day – a day set aside to honor special teachers who make a difference – TMC celebrates Bermudez, who has been teaching for 33 years and is currently teaching second grade.

Fitness Fanatics was her own brainchild. The students earn charms for every mile they run, participate in stretching exercises and play games that keep them active. The program is open to parents and teachers, too, to broaden relationships and opportunities for wellness at the same time.

There is also a nutrition component when funding allows, teaching students how to make nutritious snacks at home – from trail mix using cereal, raisins and nuts, to a fruit salad or banana sushi, which is essentially a banana rolled in Nutella and sliced. “I wanted to use things that they can find in their cabinets at home so they can make better choices,” said the 55-year-old Bermudez.

Bermudez doesn’t stop there.

MonicaGOTR.jpgShe coaches Girls on the Run, a youth development program that teaches life skills and culminates in a 5k run to build confidence and a sense of accomplishment.

She also volunteers with Fit Kidz, a program of the Southern Arizona Roadrunners that offers free one mile races for elementary school children.

In part, Bermudez does it because she’s become a disciple herself. Although she ran in middle school, she didn’t start running again until about seven years ago, trying to find more balance and take better care of herself. “It was my release,” she said of those early forays into running.

The next thing she knew, she was running with her daughters, and then signing up for races, and then joining a running group. She’s since started triathlons and offroad running, and is doing a half Ironman next month.

“It just took on a life of its own,” she said, noting she’s noticed a significant difference in her own health. “I used to be sick year-round, starting the second week of school and I wouldn’t be well again until the week after school was out. I wasn’t sick one time last year.”

But what keeps her going is what she sees from the kids. Inevitably, the shy girls start running and by the end of the semester they’re raising their hand in class and contributing with confidence. Several of her students have made a pact not to sit during recess, but instead, will either walk or run around the playground.

“And parents come and say, ‘Please keep doing what you’re doing because my child used to go to snack aisle at the grocery store first thing, and now they’re actually picking out fruits and vegetables from the outside aisles first.’ “

Nicholas Clement, the former Flowing Wells Superintendent and founder of Legendary Teacher Day, applauded Bermudez’ work. “Monica earned her Legendary Teacher stripes by energizing, engaging and enlightening every student every day.”

TMC encourages the entire business community to take time today to celebrate a Legendary Teacher who is making a difference in our future.

For more information about Legendary Teacher Day, which is always commemorated on the fourth Thursday of September, please visit  www.legendaryteacher.com. You may also share tributes of your own Legendary Teachers on Facebook as well.

 

Eat Well- We’re going to the dogs with dog treats

It’s National Dog Week! Did you know that according to the U.S. Centers for Disease Control and Prevention, owning a pet is linked to a decrease in blood pressure, total cholesterol and triglycerides? What better way to thank your dog for all the companionship and health benefits they bring with some homemade snacks?

Puppy Pops

Pup pops

Perfect for beating the heat!

Ingredients:
Set 1:
1 cup plain yogurt
1 1/2 tbsp. honey
1 apple
Mini dog biscuits

Set 2:
2 cups watermelon
blueberries
mini dog biscuits

Set 3:
1 1/2 cup unsalted chicken broth
1/2 cup diced sweet potatoes
1/3 cup chopped carrots

Directions:
Blend/mix ingredients together
Pour in ice cube tray
Add mini dog biscuit to each cube for a handle
Freeze
Give to your pup to enjoy! Woof!

Chunky Peanut Butter Molasses Dog Biscuits

dog-biscuits.jpg

Ingredients
4 cups whole wheat flour
2 cups oatmeal
½ – ¾ cup chunky peanut butter
2 ½ cups hot water
2 Tbsp. molasses

Directions
Mix all together adding more water if too stiff, but not too sticky. Knead well. Roll out to  ¾ inch thickness and cut into shapes. Bake on greased cookie sheet for 40 min at 350 degrees Fahrenheit. Turn off heat and leave in oven overnight. (you can place them close together on cookie sheet as they do not raise.) Makes about 6 dozen

For more information on the health benefits of sharing your life with a pet check out this post.
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Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461