Six reasons why your family needs a primary care physician

Six reasons why your family  needs a primary care physician

Why do you need a primary care physician?

You feel fine. No major illnesses, the occasional sniffle, and that niggling headache of course, and your mom just got diagnosed with high cholesterol, but you? You feel fine. You haven’t seen a doctor since you had to rush into urgent care that weekend two years ago.

The time to go to the doctor is when you’re sick right? You don’t have time right now.


Establishing a relationship with your primary care physician has all kind of benefits:

  1. Saving time and money
  2. Try getting in to see a doctor quickly if you don’t have a primary care physician.
    They’ll want you to have had a new patient appointment to get a history and baseline information first. Those long appointments are usually at set times and not as flexible as regular appointments. Having a primary care physician established means the office is more able to squeeze you in for a quick appointment or call you back to discuss an issue and get you back on your feet and maybe back to work quickly.
  3. Back on the road to recovery
    A primary care physician can follow-up and make sure you’re on the way to recovery following a visit to an emergency room.
  4. Keep you up to date
    Whether it’s a new flu strain, or new screening wellness guides your primary care physician can help you stay current on vaccinations and preventative screenings maintaining your good health.
  5. A doctor who looks at the whole you
    Your cardiologist is worrying about your heart rate, your neurologist your seizures, but who is looking at the big picture? Your primary care physician can oversee management of your overall health – they’re able to see results from all specialists and able to get the big picture. And because they have a relationship with you they can help come up with a plan if you have complex medical needs. Which leads us to,
  6. Someone you can talk frankly with about your health concerns
    With a relationship that develops over time, a primary care physician can better understand what matters to the patient regarding lifestyle choices, health goals, etc. Building trust and a connection is an important piece of the relationship between a patient and a primary care physician. If you have a good relationship it is easier to share those pertinent factors that you  might be shy about otherwise.

Don’t have a primary care physician? Let us help you find one today! Call toll-free 1-844-TMC-CARE for assistance.

Gary Brauchla’s great race

Gary & Kathie Brauchla

Gary & Kathie Brauchla

Before he died, Gary Brauchla always had it in the back of his mind that he wanted to run a 5k.

It took his death to make it happen.

His remarkable journey from death to the completion of his first 3.1-mile run began sometime around 3 a.m in the early morning of Sept. 29, 2012, when the home builder went into cardiac arrest as he slept in his rural home about 90 miles from Tucson.

Earlier that evening, he had complained of pain in his right shoulder, but shrugged it off since he had had chili for dinner and thought he might be experiencing indigestion.

Later, his wife, Kathie, was awoken by a loud snort, which she assumed then was snoring. In retrospect, it was probably her husband’s last gasp. She nudged him. Nothing. Nudged him again. Nothing. Pushed harder a third time. No response. “Then it all clicked together what was going on,” she recalled. “I flipped the light on and he was not breathing.”

A former surgical technician for 15 years, Kathie immediately started CPR, called 911 and sustained the chest compressions until help arrived. The wait was excruciating. The sound of the diesel engines of emergency vehicles never sounded so good. A defibrillator restored his heart rhythm.

Brauchla was flown by helicopter to Tucson Medical Center, where doctors induced a coma, put in some coronary stents to reopen blocked arteries and cooled his body temperature through therapeutic hypothermia in order to reduce the brain’s oxygen requirements and reduce the chance of brain injury.

He would remain in a coma for 2.5 weeks, while loved ones wondered about the degree of brain damage he may have sustained.

He was already unspeakably fortunate. According to the Centers for Disease Control and Prevention, approximately 300,000 people in the U.S. experience a cardiac arrest outside of a hospital setting. More than 92 percent of them die. But he would be more fortunate still. He fully recovered.AP2A0615

“By doing everything TMC did, I am still here physically and mentally,” Brauchla said.

Once he was strong enough, his cardiologist wrote a prescription for him to attend the cardiac rehabilitation program at Tucson Medical Center to rebuild his strength and heart. Even though it is a 90-mile drive from his home in Pearce, Arizona, he attends three days a week.

He’s taking advantage of the program’s nutritional training, watching his diet and making conscious choices about the fuel he gives his body. And he appreciates that experienced staff is monitoring his heartbeat, making sure he is exercising safely but also challenging his heart, under proper supervision.

And on June 1, at 68 years old, he ran his 5k, at the TMC-sponsored Meet Me Downtown 5k Night Run/Walk.

He finished middle of the pack. But he figures that’s pretty good for a guy who faced down death.

“I was given a gift of life,” Brauchla said, adding he has become an advocate of making sure rural areas have access to automatic electronic defibrillators and promoting CPR. “My wife, God bless her, saved my life.”

Brauchla also volunteers at TMC’s cardiac ward four times a month, calming the fears of new patients about what the future holds. “I have a pretty good story I can tell,” he says. “Heart attacks are not necessarily a death knell. You can heal yourself, but you have to take steps to do it.”

Marcy Tigerman: Thankful to finally be pain free after getting both hips replaced at TMC

Marci_TigermannAll Marcy Tigerman wanted was to be able to ride her horse, Mex, once again.  Debilitating bone-on-bone arthritis in both hips prevented her from riding him, or doing much else for that matter.  She’d been active all her life, swimming, biking and weight lifting, until the pain became non-stop and forced her to a standstill.  After work, she’d lay on the couch because it hurt too much to do anything else.

“I remember seeing a commercial on television for TMC featuring a triathlete.  As she described the horrible pain she experienced with bone-on-bone arthritis, it brought me to tears.  I thought to myself, ‘If she can do this, I can do this.  If she can get back on her bike, swim, and run, then I can do this.’”

Finally, Tigerman had enough of the pain.  In March, she underwent her first hip replacement surgery at TMC.  “The physical therapist came to my house.  She taught me how to get out of bed, and walk around.  I remember her telling me, ‘You’re going to want to get that second hip done pretty soon.’  And I said, ‘No, I am not.  I can’t do this again.  It’s just too much.’”

Fast forward six weeks.

Tigerman was recovering well with her new joint… but the other side was causing big problems.  “I was uneven because on the side where I had my replacement, I had normal joint space.  On the other side, I was still bone-on-bone.  I had a leg length discrepancy, and I was limping as a result.”

Tigerman called her surgeon.  “I told him – let’s schedule the second one.  Let’s move this surgery up.  I need to feel better.”

Three months later, she was in the new TMC Orthopaedic & Surgical Tower for the other hip.

“The second one was almost easier because I knew what to expect.  The fear factor that was present for my first surgery was gone for my second.”  Tigerman’s recovery process moved right on schedule.

“I remember the day of my surgery.  After the operation, they got me up and out of bed.  I couldn’t believe I was standing up.  I put my foot down on that new hip, and thought, ‘wow – it doesn’t hurt.’”

At home, what started as a few steps turned into a short walk to get the mail, and eventually a walk down the street.

“My new hips make me feel like I’m 40 years old again.  I have no pain, and I now have two even legs.  It doesn’t hurt just to function anymore.  Getting out of bed doesn’t hurt.  Getting in my truck doesn’t hurt.  Sitting and working doesn’t hurt.  Walking my dog doesn’t hurt.  I can finally get back to my life.  When you’re in pain 24 hours a day, you can’t imagine what it’s like to be out of pain.  Now that I’ve had both hips replaced, and I’m pain free, I wonder why I wanted so long to get them done.  The great care I got at TMC helped me get back to what I love to do in life.”

And that includes riding her horse.

“Before my surgeries, I asked my doctor if I’d ever be able to ride Mex again.  He said yes, once I was up there I’d be fine, but getting on and off could be a challenge.  He was right.”

Tigerman started by grooming Mex.  Then she felt strong enough to lead him around.  “At the end of September, I put my food in a stirrup, and tried to get my leg over.  I couldn’t.  I continued my exercises at home, and received more physical therapy.  Three weeks later, I put my foot in the stirrup, and the other leg went over no problem.  I sat down in the saddle and put both feet in the stirrups and I immediately started crying.  I was so happy.  I haven’t been able to ride my horse in about a year.  Now I can, and nothing hurts.  It’s incredible.  I didn’t know if I would ever be able to ride again, and now I can finally say I feel like I have my life back.”

Unlucky genes: When “pretty healthy” isn’t good enough

Peter Riveri 5522Peter Riveri had always done everything right.

An avid runner and exercise fanatic, he appeared to be the picture of health.

Unfortunately, his genes were leading him on a deadly path.

About five years ago, he grew concerned that he wasn’t tolerating his workouts to the same degree. He felt sluggish.

After going to Tucson Medical Center for tests, he ended up needing a stent.

He admits to being depressed. Maybe even a bit angry afterward. “I lived what I thought was a healthy lifestyle,” he said.

Riveri initially resisted going to the cardiac rehabilitation program. He hadn’t gone through open heart surgery. He had his own home gym. He didn’t think he needed a structured program.

But after giving it a try, he found it helped him psychologically to see how others, with more significant physical issues, chose to respond to their own challenges. A competitive person, he finds motivation in the drive of others. He has also made good friends over the years, including Rick Randels. 

“The fact is, I don’t need to come here,” Riveri said. “I choose to come here, because I really enjoy working out here.”

In addition to his workouts, he also has switched to a vegan diet. His cholesterol is now below 100 mg, without medication.

“I don’t want to preach, but you make decisions in life that put you in a position for bad things to happen later on down the road,” he said.

He shares that message with cardiac patients at Tucson Medical Center, where he assists as a volunteer. “We talk to people in the hospital who have had surgery or have gotten a stent and we let them know there’s a path to keep them out of hospital if they choose to go down it.”

“In time, they can be back, healthy, and having an active lifestyle. Whether they choose to do it or not is up to them,” he said.

And when he runs into them later at the rehabilitation facility, Riveri added, “It kind of makes you feel good because you’ve had some impact on their health and a positive impact on their lives.”

24 Hours in the Old Pueblo registration is one hot ticket!

Press-Release-Sunset-RiderIn a world where it’s common for 24 hour mountain bike races to experience year-on-year decreases in participation, Epic Rides’ 24 Hours in the Old Pueblo presented by Tucson Medical Center (TMC) is doing the exact opposite.

Registration for America’s largest 24 hour mountain bike event, which is scheduled for February 14-16, 2014, opened on October 1st, and the Men’s Solo Category sold out in less than 12 hours (a new record).  During the previous six years the #24HOP reached maximum capacity two months before event weekend. Rolling strong into its 15th year, the highly anticipated event is close to selling out over four months in advance.

With tremendous cooperation from Willow Springs Ranch and the Arizona State Land Department,  24 Hour Town will welcome over 4,000 riders and support crew members anxious to enjoy a weekend of unparalleled camaraderie while raising funds for local and national non-profits including Tucson’s Bag It! (a cancer survivors resource organization). This year’s event will also mark Tucson Medical Center’s third year as the presenting sponsor.

“TMC is excited to continue the support of the mountain biking community in Tucson as part of a wider effort to promote healthy lifestyle choices across the region. Epic Ride’s 24 Hours in the Old Pueblo never fails to be one of the most challenging and fun events in Tucson for everyone involved,” said Tucson Medical Center’s Vice President of Community Benefit, Julia Strange.

Participants will be arriving from near and far with more than 37% of the field traveling from outside of Arizona to enjoy the government issued three-day holiday, President’s weekend, while riding pristine singletrack under the warm Sonoran Desert sun.

For those still in contemplation Epic Rides has a simple, yet concise message.

Procrastinators beware; at the current rate, registration will be completely full by early November.

Click here for complete event information and registration.

Rick Randels- In good company

cardiacrehabLast week, readers learned about Rick Randel’s incredible path to cardiac health. Despite multiple bypasses, surgeries and close calls, through hard work, and help from the folks at TMC’s Cardiac Rehab, he has been able to get and stay healthy.

These days, you can often find Randels over at El Dorado hospital or visiting cardiac patients at TMC.

And he’s in good company.

Randels is joined by a group of other volunteers participating in the cardiac rehabilitation program at Tucson Medical Center can often be found visiting new heart patients, sharing their stories, showing off old scars and letting them know that a full and active life awaits.

“I love going to the ward and talking to the people there,” said Gary Brauchla, a colleague of Randel’s who survived a cardiac arrest in late 2012, only to go on to run in his first 5k race in spring 2013. “It’s amazing to see their faces brighten up when they realize it’s not all gloom and doom,” he said.

Volunteers like Randels and Brauchla are just one piece of the quilt that is the TMC volunteer force.

In fact, on any given day, an average of 87 volunteers are playing important roles throughout the hospital.

In addition to 360 adult volunteers, some of whom are “empty nesters” looking for fulfilling ways to spend their time, the volunteer program also includes as many as 175 student volunteers. Those students are able to bring energy and new insight to their college careers, while building their resumes and professional skills.

Some of the volunteers even have fur and four legs, and can be found comforting patients in the hospital’s pet therapy program.Pet%20Therapy

Among some of the roles volunteers may serve:

  • Greeting guests at the entrances, to help steer them in the right direction and begin the check-in process;
  • Visiting overnight patients to ensure their immediate needs have been met;
  • Sewing pillows and blankets for patients to provide additional comfort;
  • Staffing TMC’s resale boutique (Teal Saguaro), infant/breastfeeding support store (Desert Cradle) or the main hospital Gift Shop, with 100 percent of the proceeds supporting hospital programs;
  • Assisting nursing staff in the newborn intensive care unit with the smallest, most vulnerable babies, as well as serving new moms and babies in the Mom/Baby unit;
  • Ensuring that even though the hospital is a big place, patients can easily get from one area to the next by hopping on volunteer-driven courtesy cars.

Hope Thomas, the director of volunteer services and community programs at Tucson Medical Center, credits the volunteers with making TMC the high-quality hospital that it is. Their efforts translate into more than 86,000 hours annually – or the equivalent of 42 staff positions every year.

IPU%20VolunteersAnd volunteers gain a great deal from the experience as well. Aside from knowing they’re helping others, since they frequently work in pairs, they also develop lasting friendships. That camaraderie is a social outlet that prevents isolation and encourages community engagement.

“If TMC staff is the heart of our hospital, then the volunteers are the soul,” Thomas said. “They’ve earned our trust. We value their efforts because they bring their experiences and their compassion to the patients who need it most.”

Tucson Medical Center tries to find placements for all qualified applicants, asking for a six-month commitment. One word of caution: It can be addicting. Volunteer Norma Fletcher has spent more than 44 years at TMC.

“I think if anyone is interested in volunteering, I’d encourage them to do it, because it helps the community,” she said. “And what they’ll find is they get more out of it than they put into it.”

Those interested in learning more about the volunteer program are encouraged to call 324-5355.

Rachel Tineo- Just a walk a day can keep the doctor away

rachel1This month readers learned about the incredible wellness journey of Rachel Tineo, a senior systems analyst at TMC. Over the last couple years Tineo has transformed from being overweight and and at risk for diabetes, high cholesterol and hypertension to an enthusiastic proponent and example of healthy living.

These days, it only takes one look at Tineo to see that she has made some very big changes to her lifestyle. As a matter of fact, she has changed practically everything about her lifestyle and that of her family as well.

Tineo now spends up to 6 days per week in the gym—and lifts loads well into the triple digits under the direction of her personal trainer. She has also made sweeping improvements to the foods she eats, controlling her portions and her calories.

At TMC, this is becoming a much more common story among employees, thanks to an expanding wellness program that incentivizes, encourages and provides opportunities for better, healthier choices. And while Tineo’s choice of workouts is charged with heavy weights in a gym setting, it is certainly not the only way to hit fitness targets.

Even something as simple as walking can do the trick.

DorothyAs a matter of fact, the U.S. Surgeon General recommends 30 minutes of walking (or other physical activity) each day. And as another TMC employee, Dorothy Larson, found out, regular exercise, including walking, decreases your risk of heart attack, stroke, high blood pressure, some cancers, osteoporosis, depression, anxiety and obesity. It also improves overall health, helps osteoarthritis and diabetes, boosts HDL cholesterol (that’s the good kind) and can improve your mood.

Larson, a financial analyst, would have the Surgeon General’s stamp of approval since she has been walking the TMC campus for much of the 26 years she has worked for the hospital.

She had a scare about 20 years ago when doctors suspected she might have cancer in her leg. After surgery gave her a clean bill of health, the once-occasional walker became an avid fan.

Larson tries to walk every day, with her lunch periods providing some downtime from crunching numbers.

“I feel more energized when I come back, Larson said.

When it’s hot, she can walk the halls, which also gives her an opportunity to interact with folks in the hospital, since she works in an outlying building. And in pleasant weather, she can walk the trail system that largely encircles the hospital grounds and enjoy nature.

Larson said walking has helped her stave off weight gain, but said remaining active has also helped her maintain strength and agility.

She also likes the variety. She can walk briskly, to get her heart rate up. She can walk at a lower speed for relaxation. And she can walk with colleagues and reconnect with their lives.

“It’s fun and it’s enjoyable and you don’t need any equipment – just a good pair of walking shoes,” she said.

“What you do for exercise doesn’t have to be crazy. The main thing is, you need to find some way to move your body. It doesn’t matter how. Just find something that you can sustain and incorporate into your day. Even that one change can make a big difference,” said Tineo.

Mindfulness is an important factor in our health

It is well documented that mindfulness can positively affect our health….Why? How do we become more mindful?

If you were to Google the term ‘Mindfulness’ you would see many references to meditation. While meditation is a very effective way of becoming more mindful, it is just a tool. Mindfulness is a focusing of one’s attention, and how you achieve that may be very different from one person to the next.

Mindfulness as defined by modern psychology means to “bring one’s complete attention to the present experience on a moment-to-moment basis.” Why is that so important to our health? Nine out of 10 adults suffer from at least one chronic disease, and most chronic diseases can be improved with positive behavior changes. Now think about mindfulness as having an acute awareness of the present, and it is a bit easier to see how it can be used to treat stress, anxiety, and disordered eating. For example, if we all paid closer attention to what we were putting in our mouth as we sit in front of a computer typing (I promise I’m only drinking water while writing this!) think of the number of calories and thereby pounds we would save ourselves. Or, if rather than letting our mind race all night about the things we failed to accomplish, we performed a five-minute breathing activity to clear our heads, just think of the sleep you could have!

So how do we become more mindful? As I said before, there are many tools and techniques that can help you to start to become more mindful or aware. Everyone is different, so you may need to try different things to see what works for you.

Here are a few suggested activities you may want to try:

• Breathing
• Meditation
• Yoga or Stretching
• Time Outs before new activities
• Spend time in nature
• Listening to quiet instrumental music
• Journaling
• Don’t do other things while you are eating

Ultimately, being mindful comes back to being purposeful about everything you do. Don’t let your autopilot direct your actions. Be present in your life at every moment and notice the beauty, joy and extraordinary things that are all around you.

About the author:


Mary Atkinson, RD
Director of Wellness
Tucson Medical Center

A Lifestyle Change Success Story

Monica Martinez  before

Monica Martinez before

Eat well.  Exercise.

We hear it all the time. The reality is, most of us don’t do it.  Or, don’t do it consistently.

Although people may not always make the best diet and fitness choices, they still intrinsically want to be healthy and fit. In other words, people don’t feel like they’re consciously making poor decisions when indulging in fattening foods or not exercising regularly. An unhealthy lifestyle unknowingly becomes a habit that eventually manifests itself in a person being overweight or developing chronic health problems.

This is exactly what happened to Monica Martinez, patient services representative in Emergency Registration at Tucson Medical Center.

“All of a sudden I realized that I was gaining 3-5 pounds every time I visited the doctor, and eventually developed high blood pressure and a cholesterol problem, requiring that I take medication,” says Martinez

Monica admits that she was always the chunky one in the family, and although she tried on many occasions to lose weight, she struggled to stay consistent and would not follow through with her diet and fitness plans.

This happens far too often to people whose intentions are in the right place.

The struggle to stay on the fitness path become increasing difficult because for some people, even when making the “right” decisions and adopting healthy behaviors, the road to seeing results is long and may come to others quicker than it comes to them.

However, comparing yourself to others is not the mindset you want to get into because it can make you your own worst critic. Monica explains how she felt trying to fit in and comparing herself to some of her friends, hoping that no one would notice her weight.

“I recall not being able to look at myself in a full length mirror. Just going to the store to try on clothes pushed me to tears. I didn’t even recognize myself anymore,” said Martinez.

Managing the busy routine of life, Monica worked nights and began to notice her lack of motivation and not having the energy to play or do things with her children with the little free time she did have. But it was painfully apparent that she needed to make a healthy lifestyle change when one of her young sons suggested that she take a ‘pill that makes you skinny’ that he had seen on an infomercial.

“That was the breaking point.”

For some people, a drastic event or realization is necessary in order to employ consistent and meaningful change. Change for Monica was slow but always increasingly progressive, and she made a commitment to focusing on her health, one day at a time.

“I stopped eating processed high carb foods and adopted a cleaner and simpler diet. I cut out fast food and soda and began drinking protein shakes and eating vegetables and preparing my own healthier meals.”

Educating yourself is an important part in the process of doing the right things for your body and overall health. Monica found out what foods were actually packed with the nutrients she needed.

She also learned that the road to better health and losing weight is not reached solely through improved diet, but all through regular exercise.

Program such as Live Well, a Tucson Medical Center employee program that provides healthcare premium incentives for active employees, provided a way for Monica to begin exercising on a regular basis.

Monica Martinez today

Monica Martinez today

“Through Live Well, I joined an employee fitness team and began brisk walking on my lunch break. I started off only walking a half a mile, but have worked my way up to 4 miles a day.”

In addition, Monica joined a Zumba class and many other fitness activities.

“Finding fun exercises was key to my fitness success. I mix my workouts up and find ways to include my kids or friends.”

Monica went through a lifestyle change transformation, and in doing so, gained self confidence and the motivation needed to keep working towards her health and fitness goals.

Since she made a commitment to change, Monica has lost over 60 pounds and no longer needs to take medication to regulate her blood pressure or cholesterol!

“Throughout this journey it hasn’t been easy, but I’ve realized that what I’m doing is important. Along the way I take the time to celebrate my fitness successes. These are worth celebrating, because when it comes to my health, no success is too small to share or be proud of.”

Nutrition tips to get you ‘race ready’

imagesThe Epic Rides 24 Hours in the Old Pueblo Race is under a week away. TMC is the proud feature sponsor of the race and also has quite a few employees and brave cyclists participating in this exciting affair.

So the question is, are you ‘race ready’?

There are a number of things that can happen during an endurance activity such as a 24 hour race. Whether it is an environmental challenge, the mistake of a fellow participant or teammate, or an equipment malfunction, let’s face it, accidents happen.

However, there are things we can control like our physical and mental health when preparing for rigorous activity. In addition to one’s training regimen, making the appropriate nutritional choices leading up to recreational or competitive activity is one important way to be sharp and ready to take on unexpected challenges.

“Putting the right foods in your body is one of the many important nutritional choices you can make before a high performance activity,” says Mary Atkinson, Director of Wellness at Tucson Medical Center.

“The energy needs of people that participate in endurance activities are high. Every person’s nutritional needs will vary dependent upon age, gender, and daily activity. One should be sure they consume a sufficient amount of calories, and that these calories come from a variety of healthy sources.”

The following are tips to consider to get you ‘race ready’:

Carbohydrate Needs – Carbohydrates, the primary fuel during exercise, are easily digested and quickly used by the body. It is recommended to ingest 3 – 4 gram per pound of body weight daily for persons participating in heavy and high intensity endurance activities.

Fat – Moderate consumption from healthy fat sources such as fish, avocados, and nuts are a vital source of energy for lengthy exercise and sports training. However, avoid the intake of saturated and trans fats.

Protein – Protein is extremely important in the building and repair of muscles. Although it is not a primary source of energy during endurance exercise, it is recommended that athletes take .5 – 1 gram per pound of body weight daily for persons participating in heavy and high intensity endurance activities.

Atkinson suggests, “Maintain a balanced diet during the days before a race or competition, and make sure you’ve consumed adequate amounts of fluids, carbohydrates, healthy fats, and protein. This should ensure that your nutritional needs will be met for optimum performance on race day.”

The Epic Rides 14th annual 24 Hours in the Old Pueblo race is one of the largest 24-hour mountain bike events in the world. TMC partnered with Moots, the Official Bike Sponsor, to give away over $4000 in Moots titanium bike parts, raising awareness of the new Tucson Medical Center Orthopaedic and Surgical Tower scheduled to open in April.

To register for the giveaway and get more information about the Orthopaedic and Surgical Tower, click here. 

Positively Sexy: Healthy Aging and Sexuality event this Friday

TMC Senior Services will host its 6th annual Healthy Aging and Sexuality Event: Positively Sexy this Friday, Feb. 15, from 2 – 5 p.m. at TMC’s Marshall Conference Center.

The workshop will provide a comfortable setting for older adults to come together and learn about sexuality, sensuality and the clinical aspects of aging.  “This event will be an opportunity for people to learn about how our bodies change as we age, and how that may affect our sexual well-being,” explains L’Don Sawyer, TMC Senior Services Director.

“We will address the questions many people may not be comfortable discussing with their health care provider.  Is it okay to have sex after a heart attack?  What medications may affect my sex life?  What can I do about erectile dysfunction?  This is a chance for people to get their questions answered,” says Sawyer.

Dr. Pal Evans is a retired OB/GYN, the current chairman of the Pima Council on Aging, and works with TMC’s Senior Services programs.  In the video below, he tells us why he thinks seniors’ sexuality is such a taboo topic in our society, and why it’s such a difficult conversation for health care professionals to have with their patients.  Also, find out what he thinks is the biggest misconception people have about this topic!

For information about the event, including how to RSVP, please click here.

UnitedHealthcare patients in southern Arizona to benefit from improved care coordination and enhanced health services through AzCC

People enrolled in UnitedHealthcare employer-sponsored benefit plans now have access to Arizona Connected Care (AzCC), a physician-led, patient-centric accountable care organization (ACO) that manages all aspects of patient health care, ensuring that the proper course of treatment and preventive health measures are being followed. The AzCC ACO combines advanced analytics to measure and improve quality outcomes for patients with innovative, value-based performance incentives.

During the past year, AzCC has been providing its prevention- and wellness-focused health care to seniors enrolled in UnitedHealthcare’s Medicare Advantage plans. This new, expanded collaboration will give more than 180,000 people enrolled in UnitedHealthcare’s employer-sponsored health benefit plans throughout southern Arizona the opportunity to benefit from access to quality care from approximately 200 AzCC care providers and health professionals through this distinctive care model.

AzCC, composed of primary care physicians, specialists, Tucson Medical Center, and other health care providers, in 2012 became the first ACO qualified by the Centers for Medicare and Medicaid Services (CMS) in southern Arizona. Since then AzCC has provided care to thousands of patients while practicing the Institute for Healthcare Improvement’s (IHI’s) “Triple Aim” objective: increase patient satisfaction, improve the health of the population and reduce the cost of health care.

“We are delighted to expand our partnership with UnitedHealthcare so that thousands of additional UnitedHealthcare patients in Southern Arizona can receive the distinctive care that an ACO can provide,” said John Friend, executive director, Arizona Connected Care. “We believe this program will clearly demonstrate that proactive care focused on wellness and chronic disease management actually reduces health care costs.”

UnitedHealthcare plan participants who use an AzCC care provider do not have to do anything differently in order to receive the benefits of the ACO. Participating primary care physicians will receive monthly updates on their patients, enabling them to monitor all of the care each patient is receiving and access the patient’s care in one record.

For example, if a patient is being treated for heart disease, all the tests, screenings and medications the patient is receiving will be collected into one record to ensure that the appropriate course of care is occurring, the care is coordinated, and the patient is receiving any and all necessary services. This model will help manage services for patients with chronic conditions, such as diabetes and heart disease, while keeping the focus on health and well-being, increased patient safety and care delivery well supported by science.

“Arizona Connected Care is an important provider of health care services in southern Arizona, and we are pleased that more of our health plan customers now have access to AzCC’s innovative ACO care model that improves quality, streamlines care and reduces costs,” said Jeri Jones, CEO, UnitedHealthcare Employer & Individual of Arizona.

UnitedHealthcare is working with physician groups, hospitals and medical centers, and other health care delivery organizations across the country to achieve IHI’s “Triple Aim” objective. UnitedHealthcare’s value-based payment capabilities are designed to support this transformation of care delivery. Today, more than $20 billion of UnitedHealthcare’s annual physician and hospital reimbursements is tied to accountable care programs, centers of excellence and performance-based programs.

Participating AzCC physicians are already using advanced tools and software applications from UnitedHealth Group’s Optum business, a partnership announced in 2011. These capabilities provide health information on patients, enabling their care providers to more easily collaborate with each other on health care decisions. This information will also help AzCC care providers better understand and identify best practices for overall patient wellness and disease management, leading to meaningful health improvements over time.

To read more on this topic, check out the recent article in the Arizona Daily Star.

Milestone: Monday’s ‘Meet Me at Maynards’ will be MMM #200

Meet Me at Maynards, the weekly free social walk/run in downtown Tucson (with support from TMC!) , will celebrate its 200th consecutive Monday on Feb. 4, 2013. Here’s the full story from the MMM press release:

Meet Me at MaynardsMeet Me at Maynards (MMM) began on April 13, 2009, with a small group of volunteers. The event ‘stuck,’ growing each week and quickly becoming a fixture in downtown Tucson.  After outgrowing the patio space at Maynards Market and Kitchen, 400 to 600 “MMM Athletes” gather across the street at Hotel Congress each Monday (rain, shine and holidays) between 5:15 and 6:00 pm…They walk or run a route designed to show-off Tucson’s downtown and 4th Avenue. The MMM cheer of “GET OUT” expresses the goals to get out and exercise, get out and make friends and get out and support our community.  More than 18 local eateries welcome the participants with MMM discounts and provide gift certificates for the free raffle at the conclusion of each evening. Perhaps it is just a coincidence that downtown Tucson has come alive and vibrant in the past three years, but total attendance of 80,000 at MMM may have something to do with it.

MMM has partnered with six downtown fitness venues, including O2 Modern Fitness, Yoga Oasis and Armory Park Center and the Y, to offer discounted prices for alternative exercise opportunities, such as indoor cycling, yoga, Zumba, Pilates, gym workouts, etc. Classes correspond with the MMM schedule so that people can check in, do their chosen exercise and be back at Hotel Congress for the live band, awards and drawing.

MMM offers incentive prizes to those meeting milestone attendance – eight times earns a free MMM T-shirt, 15 a MMM running cap, 50 a MMM pin and 100 earns a much coveted royal purple Century Shirt. Several athletes and volunteers have attended more than 165 times:

  1. Doug Kluge                 191 visits
  2. Julie Kluge                   186
  3. James Passannanti       182
  4. Denise Leahy               179
  5. Marjorie Becklund       169
  6. Gary Carstensen          169
  7. Roma Krebs                 165

These athletes and volunteers proudly refer to MMM as “family,” creating a feeling of community and a sense of pride where they live and play. Although many may not have known much about downtown before, they now know where to see historic and beautiful sites, and where to park, eat and drink and be entertained. One example of their sense of pride is Trash Night on the third Monday of each month. Since its inception three years ago, at the suggestion of MMM Athlete Julie Kluge, more than 850 bags of unsightly trash have been collected. In fact, a frequent refrain is there is no longer enough trash to fill their bags

MMM is sponsored by:

  • Tucson Electric Power
  • Tucson Medical Center
  • The Running Shop
  • Arizona Daily Star
  • Blue Cross Blue Shield of Arizona
  • Providence Service Corp.
  • Jim Click Automotive
  • BBVA Compass Bank
  • Tucson Orthopaedic Institute

Meet Me at Maynards was developed and is hosted by Meet Me Concepts, owned by Jannie Cox, her husband David Syverson and Randy and Tia Accetta.  Expanding the idea of healthy communities is a goal shared by the founders and volunteers.  Meet Me at Maynards will celebrate its fourth birthday on April 1, Meet Me at La Encantada will celebrate its first birthday on Wednesday, March 6th, and in Boise, Idaho Meet Me Monday is celebrating six months.



Did You Know? Zumba!

Correct technique is important in any workout for the prevention of injury and to maximize results.

Group exercise led by a certified instructor can be a great way to introduce new moves and equipment. Typically delivered in one-hour blocks that include a proper warm-up and cool down, group exercise offers social opportunities with others who share the same fitness goals, while providing psychological support and physical benefits.

Estella Van Cleve, a patient care technician in TMC’s emergency department, is the first to acknowledge she wasn’t big on gyms when a friend introduced her to Zumba, a fitness class with roots in Latin and international music and dance. She’d heard of Rumba, but Zumba was new to her.

But when she tried it, she found the hour flew by and she was disappointed that they had to stop.

A certified instructor since 2010, Van Cleve hails from Colombia and has been dancing since she was a toddler. “It’s part of my culture,” she said.

Still, she noted, participants shouldn’t steer clear of a class because they fear they don’t have rhythm.

“If you can walk, you can do Zumba,” said Van Cleve, who cautions that it can be addictive. Zumba music is always playing on her car stereo and her license plate says ZUMBAQN.

The group dynamic is also important, she said. “Everybody has a story to tell and in a group, it’s better because we can share things with other people and learn from their experiences.”

Classes are $5. Classes are currently held at HealthSouth, 2650 N. Wyatt Drive, on Tuesdays from 5 p.m. until 6 p.m. and on Thursdays from 6:45 p.m. until 7:45 p.m. Please confirm class times on the community calendar at

Spreading the news about the flu to senior citizens

Are you flu-aware?

For older adults, it’s more than a casual question.  Patients aged 65 and older account for nine out of 10 influenza-related deaths, so it’s important for seniors to know about the dangers of flu, the importance of annual vaccinations, and available vaccination options.

The National Council on Aging (NCOA) is leading the charge to educate older adults about the threat of influenza and the importance of immunization through a new awareness initiative called Flu + You.

The NCOA is collaborating with Sanofi Pasteur to encourage early immunizations, as soon as the vaccine becomes available each year. Despite years of recommending flu shots for older adults, the government says immunization rates are still far below public health goals.

The body’s immune system and its ability to fight illness decrease with age, which means that older adults are more vulnerable to influenza and its related complications. As we age, the likelihood of developing other chronic medical conditions, such as heart disease, COPD, and diabetes, also increases, and having one or more underlying chronic conditions further increases the risk of influenza-related deaths in older patients.

For older adults, especially people aged 65 and older, an annual flu shot is critical and might even be life-saving.

Tackling Infection Prevention with the Cleaner!

Who leaps a mop and pail in a single bound?

Who hears the squeak of a squeegee across a crystal clear window from a mile away?

Who’s ultraviolet vision sees germs lurking in high touch nooks and crannies?

The Cleaner of course!

This week, me and the other members of the Infection Prevention League have been highlighting the many important things we all can do to prevent the spread of germs and keep our patients and community infection free.

As the Cleaner, my mission is to rid the environment of all harmful germs and help stop the spread of infection.

At TMC, we’ve made cleaning a science by using CDC guidelines and monitoring tools.

  • We have identified the surfaces that are frequently touched by hands (we call these high touch items) and made sure that these are a major focus of our cleaning efforts
  • Our Environmental Services Department has training programs that certify the staff to clean in a hospital environment
  • We monitor cleaning using direct observations and fluorescent oil and ultraviolet lights to check on thoroughness of cleaning
  • We clean all of our bathrooms with dilute bleach to stop the spread of fecal germs

Every employee has the power to rid the hospital of germs….whether it be to wipe down that phone in the hall or to disinfect a piece of equipment used for patient care…cleaning is a big part of protecting all who come to TMC.

To find out more about infection control at TMC, you can reach out to our specialists with your questions at  If you haven’t already, read the previous TMC Infection Prevention League posts from this week and meet all of our members.

Seniors can choose a stronger flu shot

Experts have agreed for years that getting a flu shot is the best way to protect yourself from influenza – especially for those in vulnerable populations, such as senior citizens.

Reinforcing the message is the National Council on Aging (NCOA), educating older adults about the importance of immunization through a new awareness initiative called Flu + You.  It’s a vital message because aging decreases the body’s ability to fight illness.

But with the decision to immunize comes a choice – which vaccine to take?

Your body’s response to vaccinations may be affected by the age-related decline in the immune system. Recent studies have shown that the traditional flu vaccine might not work as well for people 65 years of age and older. As the immune system weakens, fewer antibodies are produced following vaccination to help protect the body against infection.

Now, adults aged 65 and older have two vaccine options available – the traditional flu shot, as well as a widely available higher dose flu vaccine designed specifically for this population to address the age-related decline of the immune system. The higher dose flu shot triggers the body to produce more antibodies against the flu virus than would be produced by the traditional flu shot.

Both the traditional and higher dose flu shot options are among the vaccines recommended by the Centers for Disease Control for adults 65 years of age and older. Medicare Part B covers all influenza vaccine options recommended for this age group with no co-pay, including the higher dose option.

Remember, a flu shot protects you and also helps prevent the spread of the flu to others you care about, including family members and friends who may not have gotten their flu shot.

TMC Infection Prevention League

Hello! I am The Specialist.

Oct 14-20 is International Infection Prevention Week, which highlights efforts in educating healthcare workers, healthcare administrators, and the community about the importance steps in reducing and preventing infections.

I am part of the Infection Prevention League, which is an internal Tucson Medical Center initiative that we now want to share with our valued community. The League is a group of powerful characters who embody all of the important steps in keeping ourselves healthy.

As the “Specialist”, my job is to support the League in ensuring that every infection prevention activity happens all the time, without error.  We are only as effective as our commitment to each infection prevention step.

I make sure that infection prevention at TMC and in the community is based on well established evidence and recommendations.  I identify infection threats and create a plan of attack….I guess that what makes me the brains behind the League!

At TMC, we are committed to protecting our patients, visitors and healthcare staff from infection and we demonstrate this by:

  • Cleaning hands and hospital environment regularly
  • Using CDC Isolation Precautions to keep germs contained
  • Educating our staff about the latest infection prevention activities and the germs that put our patients at risk
  • Monitoring for certain hospital acquired infections and reporting to our staff so they all know where we stand in our mission
  • Continuous review of our infection control program to make it better and more effective
  • And most importantly, never forgetting that it is people’s lives we are affecting and protecting!

I am associated with a dedicated group of real specialists at TMC that are available to the health care staff and patients to explain infection prevention and provide every day support in our mission to keep TMC free of hospital acquired infections.

You can reach out to the Specialists with your questions at,
and follow the TMC Infection Prevention League posts this week and meet all of our members.

Did You Know? – Don’t Let Stress Get You Down

Did you know? That stress could be affecting your health, even if you don’t recognize it? The “fight or flight” reaction that stress often triggers keeps your body’s natural alarm system in full gear, releasing a surge of hormones, including adrenaline.

Left unchecked, stress could trigger high blood pressure, muscle tension, and depression, heart disease, obesity and diabetes.

“Stress worsens your immune system, increases your blood pressure and makes you have a more rapid heart rate,” explained Dr. Matt Heinz, a hospitalist at Tucson Medical Center. “Anything that reduces stress is generally going to make you healthier.”

Some of the patios were designed with children in mind, from a train garden to sculpture. “Play is such an important part of healing,” said Melissa Weisphal, the manager of patient services in the pediatrics department. Designed to reflect the belief that the natural environment plays an important role in healing and reducing stress, Tucson Medical Center has 28 beautifully landscaped patios throughout the campus. Every patient room looks out upon a patio, and many of the spaces are themed to invite wildlife such as butterflies or hummingbirds.

It’s also a nice respite for employees.

World Alzheimer’s Day highlights the need for sufferers to be included

Today is World Alzheimer’s Day–a time to honor both people with dementia and their caregivers. Currently, 38 million people globally are affected by dementia. That number is expected to rise to 115 million by the year 2050.

Today is a good day to take a look at The World Alzheimer Report 2012: Overcoming the stigma of dementia. The report, released today, shares results from a worldwide survey conducted with people with dementia and carers on their personal experiences of stigma. The report provides information on stigma and dementia, highlights best practices in the field of dementia, and makes recommendations which could help reduce stigma.

Nicole Batsch, a former member of the TMC Senior Services team and one of the authors of the report, says,”I want you to take a moment to think about the people you know with dementia – whether in your family, or someone else’s family and think about how you can help them stay connected in everyday life perhaps with a smile, a conversation (being patient to wait for the answer) and activities you can enjoy together like visiting a park.”

According to Batsch, the message in the report is one of social exclusion by society. She insists that it is up to everyone to include people with dementia.

“Don’t be uncomfortable talking to a person with dementia or their carer. They need your help. Ask them how you can help,” she says.

The report and accompanying video can be found at:


TMC Supports Fitness and Healthy Living with the Live Well Team Fitness Challenge

TMC’s Live Well initiative supports employees in living a healthier lifestyle through various fitness activities, programs and incentives.  Last month, Live Well launched the Team Fitness Challenge, a 12-week team activity that encourages TMC employees of all fitness levels to form teams and hold workout sessions one to three times a week. The challenge started on Aug. 15.There are currently 15 teams and over 200 participants.

The team activities cover a wide variety consisting of everything from Zumba and yoga (which we offer here on campus,) to weight training, cycling and P90X.

Kathleen Ball, co-captain of “Team Success,” has provided their team with a calendar of events so that members can choose from activities that best fit their ability and time schedules. Knowing that time is often a factor that keeps people from exercising regularly and achieving their fitness goals, Kathleen says, “I try to keep the team very flexible because sometimes life get very busy and it becomes difficult to put yourself first.”

In addition to the wide variety of fitness activities available to the team, they are also educating themselves on nutrition and how to prepare and eat more healthy meals. They recently had a grocery store experience that included a consultation with a nutritionist. This month they are having a team potluck, during which there is a contest as to who can prepare the healthiest dish that is less than 300 calories per serving.

Using Facebook, Skype, YouTube and other media, allows the team to schedule meetings and exchange workouts and other fitness and health related information.  Team Success also has upcoming events including meetings with a chef, personal trainer, and acupuncturist. The group is on its way to making 1,000,000 steps by Nov.15, and many of the group members are losing weight and reaching their fitness goals.

“Overall this team involves participation and reaching goals in fitness, weight loss, stress management, support, and flexibility – nurturing an overall feeling of accomplishment as we go. I love team success!” says Kathleen.

Did You Know? Improve Cardiovascular Health with Aerobic Exercise

Did you know….that in order to reap the most health benefits from exercise, your intensity should generally be at a low to moderate level, focusing on aerobic exercise?

Aerobic exercise is a continuous activity that utilizes large muscle groups over an extended period of time. The primary energy sources to complete such a task are oxygen and fat stores, so you lose weight by burning the most calories.

Balance, however, is important. Overdoing it can increase your risk of injury and burnout.

If you’re new to regular exercise and physical activity, you may need to start at a low intensity and gradually ramp up.

Tucson Medical Center’s cardiac rehabilitation center has an exercise program available, with a doctor’s referral, to employees and the community at large for a nominal $25 a month. To qualify for the program, which is designed to help people head off coronary artery disease, participants must have a risk factor for heart disease, whether that be obesity, smoking, stress, diabetes, high cholesterol , high blood pressure or a family history of heart disease.

Participants may use a variety of equipment, from treadmills to recumbent bicycles and weight training machines. Time slots for workouts are during the clinic’s regular hours of operation.

While gyms are a fine option for many people, the cardiac rehabilitation center offers another level of expertise, said supervisor Mark Gaxiola.

Clinical staff, including registered nurses and physical therapists, are on hand to not only help prescribe an effective and safe exercise prescription, but to be there in case anyone becomes symptomatic. Because the facility is in a clinic, staff can check blood pressures and blood sugars and then decide whether further treatment is needed at an urgent care or the emergency room dictated on the symptoms at hand.

“Peace of mind is important,” Gaxiola said. “You won’t find the same commitment or experience and licensures that we carry in a regular gym environment.”

TMC Athletes: Peak Bagging with Amy

Peak BaggerHow did you get started?

In 2003, I joined a team of 15, including Dave Mahre and Michael Murphy, both well known mountaineers, to climb Mt. Rainer in Washington. At 14,410ft tall, it is the toughest endurance climb and most heavily glaciated peak in the lower 49 states.  Only 11 of my team made it to base camp, Camp Muir at 10,410ft.  After spending a night and day in “snow school”; only 3 of us were chosen to climb to the summit. At 1am, the three of us and two guides roped together started our ascent to the summit.

On the nose of Disappointment Cleaver, I unexpectedly plummeted 10ft head first into a narrow moat. I was unconscious for one minute until I heard my name being called and realized I was hanging upside down. I was able to twist myself out of the moat, but a guide had to rescue my ice axe and water bottle that had fallen an additional 10ft.  My head was bleeding but due to the adrenalin rush, I couldn’t sense how badly I was hurt and was determined to keep going. The guides hesitated but agreed to let me continue.

At about 11,500ft, on Disappointment Cleaver, I lost my footing on the ice a couple more times. Although I did not fall, the guide finally said to me, “I can’t take it anymore. We are going to ‘bag you.'” It is the worst thing to hear as a climber because it means you are being left behind. I was still determined and eager to keep going but had agreed before leaving Camp Muir that the guides made the decisions.

From 4am until 7am, when help arrived, I attempted to keep warm while my head pounded and bleed and my jaw ached.  During that time, I lay alone feeling the most depressed, disappointed and discouraged I had ever felt in my life as I wanted so badly to climb Mt. Rainer. Truly, I knew my ego was hurt more than my body.

After this disappointing event, I decided I’d never climb a peak again. However, after talking with Dave, Michael and several other mountaineers, I learned that climbing mountains gets in one’s blood and I may not want to climb now but just wait…

It took several years, but they were right. I aquired a strong desire to climb to the tallest point wherever I was. My current goal is to climb all the tallest peaks in the Southwest. And that’s exactly what I’ve been pursuing.

  • In 2006, I hiked Wheeler Peak, the tallest mountain completely within Nevada.  In 2007, I ascended Arizona’s tallest peak Mt. Humphrey at 12,633ft.
  • In 2008, I climbed Boundary Peak, the tallest peak in Nevada, at 13,141ft. In 2009, during the night, I conquered Mt. Whitney; at 14,505ft it isthe tallest peak in the lower 49 states. On that same trip we walked to the lowest spot in the lower 49 states Bad Water Basin, which sits at 282ft below sea level.
  • In 2010, I walked to the tallest peak in Texas Guadalupe Peak, at 8,751ft.
  • Later that summer, I concurred Wheeler Peak at 13,161ft and Mt Walter at13,141ft; the two tallest peaks in New Mexico in the same day.
  • In 2011, I strolled up to the highest point in Oklahoma, the summit of Black Mesa at 4973ft.
  • In Black Mesa State Park I trekked up Mt. Wrightson; at 9453ft, it is the tallest peak in Tucson.

This year I plan to climb Mt. Elbert, the tallest peak in Colorado and second tallest in the lower 49 states.

What lessons did you learn?

I realized that, yes, I can do it. I didn’t let one hiking failure prevent me from doing more. In fact, my goal is to climb as many high mountains as I can.

I also learned that not all high points are created equally. Oklahoma and Texas were easy walks whereas Mt. Whitney, the tallest peak I’ve bagged, was a lot easier than Mt. Rainer as no specialized mountaineering equipment was necessary.

You may not be able to predict exactly the challenge a hike may present and as a result, it’s important to maintain a baseline fitness level and hike year round.

Why peak bagging?

When you reach the top you can see 360 degrees.  It’s a way to earn “bragging rights”.  I’ve always enjoyed hiking and am very destination orientated. Peak bagging has given me a destination goals for my “bucket list”.  To me, it’s a healthy, challenging, and adventurous addiction.

Were there any obstacles that you have overcome?

I had to overcome the feeling that I was a failure when I didn’t complete Mt. Rainer. I also overcame quitting and realized that when I’m exhausted, I must keep going.

I must live near mountains to train to climb higher peaks, and there is a lot of heavy training involved. I add additional hikes carrying rocks and extra water bottles to build my strength and endurance, and I make my regular exercise routine more intense.

It was difficult to have to ask and get time off from work to travel to other states to bag the peaks. To add to the challenge of planning, some of the mountains require permits months in advance.

Lastly, was finding someone crazy enough to join me and keep up – my husband.

TMC Athletes: Marathon Runner Raises Money for Charity

Lisa Aloyse, outpatient coder

Marathon runner

A snapshot:

I have been with Team in Training, a fundraising program for the Leukemia & Lymphoma Society, for the past three years. I’m presently training for Goofy’s Challenge, which is a two-day event at Disney World in January. On the first day, runners complete a half-marathon, or 13.1 miles, and then the next day, will complete a full marathon, or 26.2 miles.

What served as your inspiration to start?

It was that big monumental birthday. I was creeping up on 40 and it had always been my goal to run at least one marathon before I turned 40. I didn’t know how to train for one, but I remembered that the Leukemia & Lymphoma Society had a program that assisted with endurance sports fundraising so I got in touch with them. Now, I’m 42 and I’ve done three full marathons and eight half marathons.

Twenty six miles is a long way. How do you keep going?

We all have an honored hero that we’re matched up with. When it gets tough, you think about your hero. In my case, she’s 7 and she’s very brave. Ella has had cancer twice in her life.  The first time, she had leukemia.  Over a year ago, she was diagnosed with cancer of her kidney.  She is now cancer free but is having terrible side effects from the chemotherapy.  When I have doubts about why I’m doing this, I think of her and know that she didn’t give up and that what I am going through is minor to all that she has had to endure.

Any tips on how to get started?

Just start. Even if you can only walk 20 minutes, just do that. If I can do it, a lot of people can do it. I’m not a fast runner and I’m not particularly athletic.Also, people should know that you don’t have to run the entire way of a marathon.  There are speed walkers and other people who do a run/walk combination throughout the marathon, like they run for 4 minutes and walk for 1 minute.  So if you have the determination, you can find a way.

How about tips on the fundraising?

That can be the hardest part for people, but it really helps build self-esteem and you find ways to do it. I’ve done silent auctions and raffles at parties, and last year, a friend got a band and a DJ for a Labor Day party and we charged $10 a head.  I’m trying to raise $100 per mile for the 39.3 mile Goofy Challenge. Anyone who wants to sponsor me can donate on my fundraising site:

Or if they just want to learn more about Team in Training, more information can be found at

TMC Athletes: Mountain Climbing A Physical and Mental Challenge

Frank Marini, Chief Information Officer


Frank has made it to the summits of three of the seven summits, the highest peaks on each continent – Mount Kilimanjaro in east Africa, Aconcagua in Argentina and Mount McKinley. Mount Elbrus in Russia is tentatively on the calendar for 2013.

What do you like best about it?

You travel to interesting places and you see interesting things, but what I most appreciate is that it’s both a physical and mental challenge.

What’s the hardest part?

There are all kinds of challenges. Part of it is just maintaining focus and maintaining positive momentum as you’re working your way up a mountain. You’re loaded down with a lot of gear and equipment and pushing up a steep hill and dealing with lots of adverse factors, including the altitude, the cold, wind, precipitation, challenging terrain. There’s avalanche risk and crevasse risks and fall risks, so you have to be constantly gauging the environment that you’re in.

What are people most intrigued by?

They want to know why I do it, but a question I get quite often is, “Did you summit?” It’s nice to land a summit, but mountains are fickle and you’re at the mercy of other factors you can’t control. I was on Mount Rainier last week and we didn’t summit because of weather and adverse conditions. We got to a point on the mountain that we determined the risks outweighed the benefits so we turned around. You can always go back. As they say, getting to the top is optional, but getting down is mandatory.

How do you train, given that you really can’t emulate the conditions in this environment?

It’s really not realistic to train for altitude, but what you can do is train for endurance and physical strength. I run, I lift weights. I’ll climb hills with packs. Last year for McKinley, I would hike for about 4 hours with 70 pounds on my back.

How do you keep your head in the right place when it gets hard?

Partly, you just have to get through it because you’re in a situation where there really is no option. I find myself literally in situations where I think something is going to break or give out at any moment. But I really believe human beings can do a lot more than they think they can. The mind is the biggest limiting factor. When my mind starts to work against me, I acknowledge it. I even call it my internal whining, but you learn to contain it and push through the physical strain and you get to the other side. And inevitably, after you get through the tough slogs, you’re in a beautiful wilderness environment, with good friends with you. You’ve accomplished something and functioned as a team, and those steps become milestones that you can really appreciate.

Kids have their shots for school; now what about you?

You’ve picked up the school supplies, bought the new clothes and made sure your children are up to date on their vaccinations.

Now, what about you? Many adults aren’t current on their vaccinations, thinking that the shots they received in childhood still offer immunity from disease. This lack of knowledge, while understandable, can be lethal – not only for you, but for those around you.

Neonatologist Dr. Moira Richards, medical director of TMC for Children, notes that “we’re in the midst of a whooping cough outbreak in children. The source of infection for these young children is usually adults whose immunity has waned from their earlier vaccines or disease.”

We are reminded of a death just this past spring of an infant in Maricopa County who was too young to be vaccinated, yet contracted and died from whooping cough, also know as pertussis. The saddest part of this story is that this death was preventable. We count on the herd effect to protect those who cannot be immunized. This herd immunity is in decline as parents decide not to vaccinate their children and as we forget how these diseases ravished our communities.

One physician, Dr. Sterling Simpson, pediatric pulmonary specialist with Children’s Pulmonary Specialists, doesn’t mince his words when it comes to the disease:  “Whooping cough can be a lethal disease, especially to infants.”

Our blog last spring at TMC For Children,  Take Action – Stopping Whooping Cough in its Tracks, speaks to the dangers of adults not keeping up on their immunizations. Those around infants are especially urged  to be current on TDaP, the vaccination for tetanus, diphtheria and pertussis.

And what about those other two bacterial diseases that the vaccine prevents: tetanus and diphtheria?

From the U.S. Centers for Disease Control:

Tetanus (lockjaw) is a serious disease that causes painful tightening of the muscles, usually all over the body. It can lead to “locking” of the jaw so the victim cannot open his mouth or swallow. Tetanus leads to death in about 1 in 10 cases.

The herd immunity doesn’t apply to tetanus. The organism can be found in the  soil, dust and environment of most places around the world. And a small cut or puncture can lead to infection. A person who contracts tetanus is in serious trouble.

Diphtheria, which causes a thick covering in the back of the throat, can lead to breathing problems, paralysis, heart failure and even death. Before widespread use of the diphtheria vaccine, it was a leading cause of death among children. Though well controlled in the United States, diphtheria is still endemic in many parts of the world. It is spread from person to person, and about 1 out of 10 adults will die from the disease, but for children, the rate is 1 out of 5.

With school back in session, is it time to get up to date on your shots? Speak with your healthcare provider to see what boosters you may be in need of to keep yourself and those around you safe.

TMC Athletes: The Juice is Always Worth the Squeeze

Bryan Richter, lead behavioral health tech


I have been practicing Brazilian Jiu Jitsu for almost six years and have attained the rank of purple belt. I compete three or more times yearly and won the state championship in 2009, placed second in 2010 and third in 2011. I am currently training for October’s Masters and Seniors World Championships in Long Beach, Calif.

How did you get started?

I started training jiu jitsu after developing an interest in the discipline through Ultimate Fighting Championship and at the suggestion of my wife. Thank goodness that I did because it has sparked a passion and a purpose in me that I would’ve never had otherwise.

What is jiu jitsu?

It is a grappling art – with roots in Judo – a system of take downs and ground fighting based on position and leverage, as well as submission techniques that enable smaller opponents to defeat much bigger ones without any strikes. Jiu jitsu employs a variety of chokes, and attacks to the joints: wrists, elbows, shoulders, knees and ankles to gain submissions from your opponents via a “tap out.”

What are the challenges?

Conditioning is an extremely important factor as well. I am in the best shape of my life at 41. It takes a long time to earn belts; most people quit before ever receiving their first promotion. It took me longer to get my purple belt in jiu jitsu than to earn two previous black belts. The ranking system is as follows; white belt, blue belt, purple belt, brown belt and black belt. It generally takes over a decade to earn a black belt, often longer.

Training sessions are grueling, and unlike other disciplines, you have to fight every day at the end of class. This is how you “prove” your skill set and earn your promotions. Jiu jitsu is the only martial arts discipline that affords its practitioners the ability to win fights off of their backs as well as from dominant positions and is therefore an extremely effective self-defense system, particularly for women. It is also the only discipline that allows you, according to your skill set, to determine the amount of suffering you impose on your opponent.

Bryan Richter, left, after jumping guard sets up a take down of his opponent during a Brazilian Jiu Jitsu match.

Why do you do it?

My training has led me to a better understanding of myself and life in general. Jiu jitsu is not a hobby. It is a lifestyle, a way of being that encompasses diet, fitness and mindset. It shapes or reshapes your life and molds you into a better person. It transcends the mats and permeates everything in your life, always for the better.

It has changed my life immensely in almost every way. I do not think I would have been complete without it. It has simultaneously been the most difficult and most rewarding thing I have ever done, and it continues to inspire and amaze me with its vastness and potential.

There are infinite mysteries within what the Brazilians call arte suave, or the gentle way. I fear one lifetime isn’t enough to properly explore it. The grandmaster and developer of Brazilian Jiu Jitsu, Helio Gracie, when asked at age 90 what he had left to accomplish in life replied “I still need to perfect my Jiu Jitsu technique.” I think that says it all. Though I have often been injured (training with three broken toes right now) and have had to come back from three surgeries during my six years, the juice is always worth the squeeze. Everyone should do this.

TMC Athletes: Fitness is an investment in yourself

Brooklyn Sturgill, monitor technician and bodybuilder


I was trying to do a competition last year, but between going to school to be a nurse and working, I had to put it off. I’m trying not to get too far from my target, though, especially since someday I really want to go on the stage and see what that’s like.

How did this begin?

When I first met my husband eight years ago, I was doing a lot of cardio and he kept saying I should try weights. I didn’t want to at first, because I didn’t want to bulk up, which is what you hear a lot of women say. But you can see dramatic results if you just try it. Now it’s harder to get me to do cardio!

Bodybuilding is as much about diet as it is exercise. What are you meals like?

I try to eat five or six meals a day, even if they are small. When I am dieting for competition weight, my daily plan might include six egg whites with a quarter cup of steel oats for breakfast. Lunch might be six ounces of chicken with a cup of green veggies and a quarter cup of brown rice. Dinner will be up to six ounces of chicken or fish with a bag salad or a cup of green veggies. In between each meal, I usually have a shake with either a quarter cup of almonds or a shake with a quarter of an apple. I drink at least a gallon of water every day. You can go to the gym seven days a week but if you’re eating fast food all the time, you’re not going to see results.

What was the hardest part for you?

It was hard to eat more often. I was used to not eating breakfast. I laughed when I saw the diet because it seemed like so much food. Now, I can never imagine not eating breakfast. People ask what to change and the first thing I ask them is what they have for breakfast. If they say they don’t eat it, I tell them that’s their first mistake.

How do you maintain discipline?

On Sundays, I don’t train and our family treats ourselves to ice cream after dinner for dessert. I also know how I feel when I don’t eat healthy foods. Fitness is an investment in yourself. Start small and build up, and you’ll find you’ll begin to feel better and sleep better. Your clothes will fit better and you’ll have more energy to have fun with your kids.

What do you say to people who think they don’t have time to eat well or exercise?

The question they have to ask themselves is how bad do they want to be healthy? It has the potential to change their lives, but they have to want it for themselves.

Did You Know? Walking Can Meet Physical Activity Requirements

Did you know that the U.S. Surgeon General recommends 30 minutes of walking or other physical activities on most days?

Regular exercise, including walking, decreases your risk of heart attack, stroke, high blood pressure, some cancers, osteoporosis, depression, anxiety and obesity. It also improves overall health, helps osteoarthritis and diabetes, boosts HDL cholesterol (that’s the good kind) and can improve your mood.

TMC employees like to make reference to our miles of hallway, as the nation’s largest single-story hospital. Combined with the trail system that meanders around the perimeter of the campus, there are plenty of opportunities to stay strong and fit.

Dorothy Larson, a financial analyst, would have the Surgeon General’s stamp of approval since she has been walking the TMC campus for much of the 26 years she has worked for the hospital.

She had a scare about 20 years ago when doctors suspected she might have cancer in her leg. After surgery gave her a clean bill of health, the once-occasional walker became an avid fan.

Larson tries to walk every day, with her lunch periods providing some downtime from crunching numbers.

“I feel more energized when I come back, Larson said.

When it’s hot, she can walk the halls, which also gives her an opportunity to interact with folks in the hospital, since she works in an outlying building. And in pleasant weather, she can walk the trail system that largely encircles the hospital grounds and enjoy nature.

Larson said walking has helped her stave off weight gain, but said remaining active has also helped her maintain strength and agility.

She also likes the variety. She can walk briskly, to get her heart rate up. She can walk at a lower speed for relaxation. And she can walk with colleagues and reconnect with their lives.

“It’s fun and it’s enjoyable and you don’t need any equipment – just a good pair of walking shoes,” she said.

TMC Athletes: Swimmer Says It’s Never Too Late to Start

Kurt Luedtke, case manager



I am currently finishing up the Tucson Aquathon Series and training for the La Jolla Rough Water Swim in September, as well as for several late season triathlons.

How did you get started?

I got involved in swimming when I was taking my daughter to swim practice when she was about 10. I got tired of sitting there watching her and trying to coach her, so I decided to learn how hard it was. I started swimming when she was at practice. I was in my early 40s at the time and now I’m 53, so I guess the message is: It’s never too late.

What is the Aquathon?

Every Wednesday night, you swim 800 yards, which is 32 lengths of the pool, and then run a 5k, which is 3.1 miles. I keep trying to encourage other TMC employees to do it, but it seems some people think they’ll sink. The best cure for that is to take a quick lesson and then get in the pool and test yourself.  I guarantee you won’t sink.

Why the Rough Water Swim?

It’s one mile in the open ocean. My daughter and I have done it the past five years and now it’s a family tradition. I really love the freedom of being out there.

What inspires you to persist when it gets hard?

My dad was a Marine and he always used to say that pain is weakness leaving your body. I think about what our patients go through and remind myself my pain is voluntary and it will stop at the end of the triathlon. You just learn to deal with it.

TMC Athletes:Soccer Reinforces Importance of Group Effort

Stephanie Chhorn, revenue cycle representative


I have played soccer for 26 years and still play to this day. I’m a halfback. You don’t have to be very fast in that position, but you have to be able to run for a long period of time. Our weekends often consist of playing on Friday nights, Saturday and Sunday. I don’t think I’ll ever give it up.

How did you get started:

I started when I was 6. Other kids at school were playing so I wanted to play. It wasn’t until I was 10 or 11 that I really wanted to be good at it and decided I wanted to be on the All-Star team. I played into high school and then stopped playing until I was about 21, when I was hired on at TMC and a woman who worked here said there was a need for girls for a coed team.

What life lessons has it taught you?

Soccer is a team sport, so it teaches you to share. It teaches you that sometimes, in order to succeed, it takes a group effort.  One person doesn’t score all the goals or save all the goals.

Why soccer?

Partly it’s because it’s become our social circle now, so while it’s good exercise, I don’t think of it as exercise. But I do appreciate the health benefits. You have to train hard to stay fit, since the people you play with are fast and you have to be able to stay at that speed. Plus, I don’t like diets.

Were there any obstacles you overcame?

In high school, I didn’t play my junior and senior year because the coach said you had to be the fastest and the strongest or you couldn’t play. My strength is that I have good ball control skills and I can analyze the field and anticipate what will happen next. So I guess I learned over time not to be inhibited by your weaknesses. We all have weaknesses and we all have strengths and that’s an important life lesson as well.

TMC Athletes: Employee Loses Nearly Half Her Body Weight: “This is the best thing I’ve ever done.”

For Barbara Philipp, obesity was nearly a lifelong struggle.

Various weight loss support programs didn’t work, and the weight piled on even faster during the grief-filled time after her mother died.

Topping out at 385 pounds on a 5’10” frame, the 54-year-old medical transcriptionist at Tucson Medical Center faced many painful moments: needing an extra seat belt when flying, having strangers evaluate what was in her shopping cart, dealing with stares.

The final straw, though, was when she realized she could barely walk from her car in the parking lot to the front door of her apartment without needing oxygen.

Philipp’s story, however, is one of victory, continuing a series that features TMC athletes in a nod to the Olympics season and demonstrates the multitude of ways to embrace an active lifestyle.

Two years ago, Philipp decided she’d had it. After consulting with her doctor, it was determined she would be a good candidate for bariatric surgery, which limits the amount people can eat and reduces the absorption of nutrients.

It wasn’t a simple decision. It also required a major diet overhaul. Carbonation is frowned upon, so soft drinks are a no-no for the woman who used to be able to drink a case of soda in a day. She can no longer tolerate greasy food, yeast bread, peanut butter and pizza, but instead focused on fruits, vegetables and proteins. She has to eat slowly and chew well to aid digestion. She surprised herself by learning to like cauliflower and Brussels sprouts.

But boy, did the weight come off. She was losing 18 pounds a month for the first 5 months. And she’s still losing about three pounds a month. Now at 199 pounds, she’s well on her way to her target goal of 175.

“Talk about a confidence boost,” she said. And the more confidence she gained, the more active she became.

To get in shape for her surgery, she had started walking with a friend around the block. “I got hooked. I could not get enough of it,” she said. “It was amazing how far I could go once I got some of the weight off me.” Every other day, she now walks 4.5 miles.

In March, she took a class to learn how to run. “I was sore and achy at first. Even my eyelashes would hurt,” she said. She started running for one minute and walking for three, working up to running 4 minutes and walking for one. “Pretty soon, you realize you’re running more than you’re walking. And when they talk about runners getting an endorphin rush, I can now say that’s a fact.”

She said she might be slow – running a 13-minute mile – but she’s doing it, and she’s up to 5 miles every other day. She even did the TMC Meet Me Downtown 5k in early June.

She’s off blood pressure medication. She’s no longer borderline diabetic. She’s become more outgoing with strangers.

“This is one of the best things I’ve ever done and I did it for me, and not for anybody else,” she said. “I didn’t want to sit on the sidelines of life anymore. I needed to be a participant.”

TMC Athletes: Systems Analyst and Marathon Runner Suggests Trying Variety of Activities

Kimberly Huffman, business systems analyst

A snapshot:

I’ve been running for almost 10 years now and I participate in as many of the TMC sponsored races as I can throughout the year. I’ve done one full marathon, and 12 half-marathons and two sprint triathlons. I also did my first 42-mile El Tour last year.

Why do you do it?

Running is definitely my fitness choice. I like to eat – I would say chocolate is my downfall – so it’s important to get out there and burn some calories. I love to go on bike rides and I love to swim, but running is still my favorite. I just like being outdoors and enjoying the fresh air and scenery. And it just makes you feel better and more energized to have a healthy lifestyle.

What has been your biggest obstacle?

I recently read a book that inspired me about running, but I also felt after reading it that I needed to change my running style. After running the same way for nine years, I guess my feet were happy with the way I was running, so when I changed it up, I ended up spending six weeks with plantar fasciitis and then followed that with a stress fracture. I’m fine now, but my motto now is: Don’t fix it if it isn’t broken.

What is your best tip to others interested in becoming more active?

Try a variety of activities. Something will just click if it’s the right thing for you. And then when you find it, start out slow so you don’t risk injury.

Did You Know? Stretching Works to Prevent Injury, Improve Athletic Performance

Did you know that stretching can help improve flexibility? Better flexibility may improve your performance in physical activities and decrease your risk of injuries by helping your joints retain fluidity in their full range of motion.

A regular stretching program can help lengthen your muscles and make daily living activities easier – whether that be doing simple exercises at your desk to reduce the risk of work-related repetitive stress injuries or taking part in an organized yoga class.

“Flexibility is just one component of yoga, along with balance, strength, precision, alignment and endurance,” said Terese Ireland, a nurse at TMC who also teaches weekly yoga classes for employees on campus.

Even so, she said, flexibility is key in helping to prevent injury by keeping the body more supple and nimble. A flexible spine also helps in preserving posture, since slumping forward and downward can lead to neck and shoulder pain and an eventual rounding of the spine.

Her students have reported less pain in their lower back or hips with regular practice. One of her students, who lifts heavy loads throughout the day, has reported having to take less ibuprofen.

Dr. Matt Heinz, a hospitalist at TMC, said as we age, our connective tissues change and we become less limber. “If you have maintained those soft tissues and connective tissues and joints, you’re going to not only better tolerate a workout regimen, but you’re also more able to respond to a sudden change in position, like a fall,” he said.

It also helps with stress reduction, Dr. Heinz added. “Stress worsens your immune system, increases your blood pressure and makes you have a more rapid heart rate,” he explained. “Anything that reduces stress is generally going to make you healthier.”

Diana Streitfeld, a volunteer who works in the nursery at TMC for Children, reported she’s noticed a big improvement in her alignment and posture since she began practicing yoga, adding she also feels more in tune with her body.

Her flexibility has improved as well. “I had lost some of that flexibility over the years and now I’ve noticed that it’s coming back and I’ve gotten a lot more flexible,” Streitfeld said.

Aside from the physical aspects, Ireland noted yoga is also good for the mind and spirit. “It’s an absolute stress reliever and energy builder. You can walk into class, exhausted, and walk out feeling two inches taller and energized.”

As a clinical nurse leader, Ireland said yoga has helped her find another kind of flexibility: “I’ve always loved what I do as a nurse, but it’s really helped me find even more compassion and flexibility with patients, nurses and doctors.”

Ireland said the No. 1 reason people are reluctant to try yoga? They fear they aren’t flexible enough. Her response?  “Then yoga is perfect for you. It will take time, but if you consistently stick with it, you will gain that flexibility,” she said, cautioning not to let ego reign over patience, since improvements take time.

The other misconception, fueled in part by media images of lithe yogis, is that a person has to be thin to participate. “The intention of those who brought yoga to America was to help all people. Yes, it’s an art form, but it’s also for overall health, and one of the great things about yoga is that it helps people find their way to a healthier lifestyle over time. It’s not about walking in and starting a diet.”

Pets, TV and Chocolate: Potential Sleep Scuttlers

Photo courtesy of N.C. Industrial Commission

You simply are not going to be able to reverse lost sleep by trying to cram it in on the weekends.

“It takes the average person three days to rebound from one night of sleep deprivation,” explained David Sholes, manager of Neurodiagnostics at Tucson Medical Center, which oversees the Sleep Laboratory.

Memorial Day weekend aside, he said, “There are not three days in a weekend, so you’re never going to recover at that rate. You’re better off just keeping a reasonable schedule so your sleep is more consistent.”

With May designated “Better Sleep Month,” Sholes shared some tips on how to get the restorative Zzzzzz’s you need.

Sholes said the brain is built on a circadian rhythm – think of it as your internal body clock. By keeping a regular routine, it knows what time to go to sleep and what time to wake up, and is more likely to transition through the necessary four stages of sleep without interruption. Furthermore, obtaining adequate levels of each stage of sleep is important for restorative sleep.

Other tips include avoiding alcohol and caffeine, including choclate, within five hours of bedtime. Avoid going to bed on an empty stomach and finish exercising at least three hours before bedtime.

A cooler room often improves sleep. And if you can’t fall asleep after 15 to 20 minutes, get up and do some other relaxing activity instead of stewing over your inability to sleep.

Sholes said among his least popular tips: Make sure that your television stays off during sleep time. At the very least, he suggested, set the sleep timer so that it turns off within 20 minutes instead of letting it stay on the entire night. Televisions have fluctuating volumes and lighting, which can cause microarousals without the patient completely waking up. This can make it difficult for patients to transition to deeper stages of sleep or get back to sleep all together.

Also, don’t think sharing the bedroom with your pet will necessarily help with quality sleep. Although many are convinced their pets bring them comfort, Sholes said if the animal is moving around every few hours, it could interrupt the cycle of sleep stages and may do more harm than good.

Sholes suggests keeping a sleep diary for two weeks with the pet, then starting a new diary cycle without the pet to see if any difference is evident. By noting your energy level and the way you feel at wake time and half way through the next day, it will soon become apparent if the pet is significantly disturbing your sleep, he said.

As anyone pulling an all-nighter can attest, bad sleep can impede on quality of life. “It can cause an inability to stay awake during the day, which decreases productivity and can interfere with the lifestyle you want to live. Maybe your friends are going on a hike, but you’re just too tired. Maybe you have some personal goals you want to accomplish, but you can’t seem to motivate yourself,” Sholes said.

Sleep disorders, such as sleep apnea, can also have significant health impacts, he said, from high blood pressure to diabetes and heart problems.

Tucson Medical Center offers a diagnostic sleep lab with spacious, overnight accommodations to help patients get to the root of their sleeping problems.

Sholes said people tend to diminish the importance of sleep. “It’s entirely under-rated. People think it’s more of an inconvenience than a true health concern, which is alarming,” he said. “Here at TMC, we are trying to educate the community that it can really put your health at risk and prevent you from getting out of life all that you want to get out of it.”

For more information about the Sleep Diagnostic program at TMC, call 324-3318.

Laughter Might Indeed Be the Best Medicine

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Although children laugh unabashedly all day long, adults might be lucky to laugh a dozen times a day.

But those belly laughs might be just what the doctor ordered to relieve the stress of a demanding profession such as nursing.

Cardiothoracic surgeon Gulshan Sethi led an early morning round of laughter therapy Tuesday in honor of National Nurses Week.

While nurses are vital to patient care, Dr. Sethi said, they do face a number of challenges, from dealing with the emotional needs of patients and families to juggling so many tasks that they almost need an extra set of arms.

Noting prolonged exposure to stress can lead to a state of mental and physical exhaustion, the doctor warned that too many nurses opt to leave the profession.

Armed with the knowledge they are in a profession at high-risk for burnout, Dr. Sethi urged the standing-room-only group to learn self-calming techniques. “You need to give yourself time to relax,” he said.

Those techniques can take many forms, from meditation to guided imagery, progressive muscle relaxation and reciting mantras.

It might include making a conscious effort to breathe. “Most of us don’t know how to breathe right. We do not pay attention to our breath and we take it for granted,” Sethi said, adding most people tend to breathe shallow and fast when they should breathe deeply and quietly.

Meanwhile, he noted, laughing boosts the immune system, relieves tension and helps relax the body. Even faking laughter has therapeutic benefits, since it often prompts the real thing.

“As we get older, there’s so much going on in our brains that we stop laughing,” Dr. Sethi said. “I believe we have to do something to help us laugh again like children.”

Maybe one more reason to dig out those old family photo albums.

Peripheral arterial disease is no walk in the park

Between 8 million and 12 million people in the United States, especially those over age 50, suffer from peripheral arterial disease, or PAD, but many people are unaware of it because the disease, which raises a person’s risk of stroke or heart attack, doesn’t always have symptoms.

September is Peripheral Arterial Disease Awareness Month and we encourage you to learn more about this condition. According to Healthwise Knowledgebase “PAD is narrowing or blockage of arteries that results in poor blood flow to your arms and legs. When you walk or exercise, your leg muscles do not get enough blood and you can get painful cramps. PAD, also caused peripheral vascular disease, is a common yet serious disease that raises the risk of heart attack and stroke.”

PAD does not always cause symptoms, so many people may have PAD and not know it. People who do experience symptoms, such as pain or cramping in the legs, often do not report them, believing they are a natural part of aging or due to another cause.

“If you have any risk factors for PAD or have any unexplained pain or cramping in your legs, you really should discuss this with your healthcare provider,” says Karen Reinhard, N.P., vascular surgery nurse practitioner. “PAD can not only affect your quality of life but can lead to more serious complications and there are a number of lifestyle changes, treatments, and interventions that can really make a difference.”

Food and Mood: 6 Ways Your Diet Affects How You Feel – US News and World Report

Eating right is an essential component of healthy living. But sometimes figuring out the rights and wrongs can be difficult.

We all know a little chocolate might make us happy, but too much chocolate will leave us with the sugar blues.

In fact,  “[d]ietary changes can trigger chemical and physiological changes within the brain that alter our behavior and emotions.”

Find out more at Food and Mood: 6 Ways Your Diet Affects How You Feel – US News and World Report.

TMC hosts Southern Arizona Roadrunners’ Labor Day event

A perfect way to spend Labor Day: a morning run on a rolling 8-mile and 5K course looping through a cactus forest in the foothills of the scenic Rincon Mountains at Saguaro National Park East. The TMC Saguaro National Park Labor Day 8-Miler and 5K Walk/Run will take place Monday, Sept. 5, at 6:30 a.m., in Saguaro National Park East. More information is available at

Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461