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

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

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

Why are women placed on bed rest?

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

Primarily, we see women who:

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

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

How the TMC for Women Antepartum Program supports women

Addressing the whole person

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

Combating loneliness

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

Knowing what to expect

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

Making a home away from home

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

Conquering boredom

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

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

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

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

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

Take a FREE tour of our maternity services.

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

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

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

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

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

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

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

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

 

Is genetic testing right for you in determining cancer risk?

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

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

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

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

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

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

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

Make sure testing is appropriate for you.

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

Genetic testing isn’t just for women.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Save the date for your maternity services tour date.

 

 

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

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

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

A team approach

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

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

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

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

Specialized services

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

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

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

Meaningful support and resources

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

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

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

• familiarize them with all aspects of the treatment plan.

• share hospital and community resources.

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

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

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

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

breast cancer risk assessment

Jawna and Finn – Finding support for breastfeeding at TMC for Women

Jawna and Finn, breastfeeding and lactation consultants at TMCFor six years Jawna Stickney has helped mamas welcome their babies into the world at Tucson Medical Center. When it came to her first child she had no doubt where she was going to give birth, “I had that peace of mind and that trust that comes from working with the staff at Tucson Medical Center” … “I would never deliver at any other hospital.”

“Giving birth can be nerve wrecking for first time moms. As a labor and delivery nurse, I really enjoy being part of someone’s life-changing experience, providing them with support and comfort. When I gave birth to my son, I had the ability to look over at the monitors and see that baby was fine, and to know we were both in good hands with my coworkers.”

While Jawna’s medical education and experience provided her with an added advantage when it came to childbirth, breastfeeding was another matter.

“The lactation consultants were life savers. Finn had some trouble latching on and so I asked for some one-on-one support from the lactation experts.”

Finn was tongue-tied. The tissue that connected his tongue to his mouth didn’t allow him to move his tongue so that he could nurse. While some infants can still nurse if they are tongue-tied or others may need a simple surgical procedure called a frenotomy which can be done with or without anesthesia, Finn’s tongue-tie was more significant. Finn was referred to Dr. William LaMear of Tucson Ear, Nose and Throat. At just ten days old he went into the operating room to have corrective surgery.

“As soon as he came around after the surgery he latched on. No problems. Breastfeeding was 100 percent better than before surgery. Because Finn was so young we had to stay in the Pediatric unit overnight. The lactation consultants came over to the Pediatric unit to help Finn and me.”

What breastfeeding support is available at TMC for Women

Before baby:

In the hospital:

  • Nursing assistance during your hospital stay, offered seven days a week
  • The Desert Cradle hospital-based shop offers electric breast pump rentals and sales, nursing and newborn products

After baby:

TMC offers outpatient breastfeeding support services, whether you deliver at TMC or not.

  • Outpatient Breastfeeding Support Clinic with an IBCLC*-certified nurse (by appointment only).

For more information on any of these services, please call (520)324-5730.

*International Board Certified Lactation Consultant

“I was able to exclusively breastfeed Finn because of the support I received from the lactation consultants and the lactation support group. “

Finn continued to nurse for 19 months. Jawna’s advice to new moms: “Go to the TMC breastfeeding support group and ask for help from the lactation specialists.”

Finn was two years this month, and Jawna is due on October 28 with her second child.

“This pregnancy is so different from my first. If I was tired or nauseated before, I could rest or do whatever I wanted. In some ways, having Finn made my first trimester easier this time around, because I had no time to sulk or bask in morning sickness.”

Jawna knows if breastfeeding proves challenging with her second child she will be back at the support group. “Breastfeeding has a learning curve. I knew nothing about breastfeeding with Finn. He was learning how to nurse and I was learning how to breastfeed. This time, the baby will be learning, but I will have the knowledge gained while nursing Finn.”

Join us for Breast is Best: Breastfeeding Techniques for Success

October 4, 5:30 – 6:30 p.m. The Core at La Encantada

TMC Lactation Consultants Bev Carico, RN, IBCLC, and Asa Lader, RN, IBCLC, for a free engaging presentation and Q&A on breastfeeding resources available at TMC.  Knowing all of your options can help you have a successful breastfeeding journey! Register today.

 

Preparing for childbirth – Katie chose TMC

Katie and Goldie KeatingKatie Keating can run a marathon, 26.2 miles, in 3 hours and 3 minutes. During graduate school she investigated what the universe is made of, literally! Her studies centered on the interactions among galaxies. So, when it came to having a baby, Katie applied the same level of dedication and effort to preparation as she did to her running and academic studies.

Katie ran during the first two trimesters of her pregnancy preparing herself physically.

“After that I walked a few miles per day up until the end. Everyone’s experience is definitely different though,” she says. “I would recommend doing what feels best to you.”

Katie and her husband, Jared, toured the TMC Mom/Baby unit, and took the weekender Preparation for Childbirth, Baby Care ABC and Breastfeeding Basics classes.

”The classes definitely helped me feel more in control, since I understood a lot more of everything that was happening around me. It was also helpful that when there were choices to make during labor, I had already thought about them ahead of time and was prepared, rather than having to make decisions in the heat of the moment when I was in a lot of pain.”

 From healthy pregnancy and VBAC classes to breastfeeding and newborn care we’ve got you covered.  Sign up for a class today

On Jan. 9, 2016, Katie and Jared welcomed their daughter Goldie to the world at TMC. Six weeks after Goldie’s birth Katie was back running. “That is just what worked for me,” she says. “ I don’t think there’s anything wrong with waiting longer to exercise, you are going through so much as a new mom that I think you should only exercise if it’s helpful to you mentally and physically. Sometimes you need a nap, sometimes you need a run.”

Interested in developing or maintaining your exercise routine while pregnant?
The Core at La Encantada offers seminars including those on exercise and pregnancy.

Katie, Jared and Goldie are expecting another addition to the Keating family in 2018. Katie reports she is able to run more than she did last time. “I feel pretty lucky it’s worked out that way this time.”

See Katie, Goldie and other TMC moms and babies in our latest video!

Pregnant? What you need to know about pre-eclampsia

Pregnant? Are you making all of your prenatal visits? It can seem tiresome to go to prenatal visits when it seems like they do the same blood pressure and urine tests every single time, but those prenatal visits are critical for keeping you and baby healthy. One of the conditions your midwife or obstetrician is on the lookout for is pre-eclampsia.

Pre-eclampsia is a potentially life-threatening condition for mother and baby where an expectant mother develops high blood pressure after 20 weeks of pregnancy. Pre-eclampsia and its related conditions affect somewhere between one in 10 or one in 20 pregnant women every year making it a relatively common condition.

pregnant preeclampsia

Symptoms of pre-eclampsia and eclampsia

Pre-eclampsia is often a silent condition, the signs subtle or dismissed as just a ‘normal’ part of pregnancy – making prescribed bedrest particularly frustrating to a woman who feels fine. The subtle often silent signs of pre-eclampsia mean that those prenatal visits and checks are vital to catching and treating it.

While pre-eclampsia can be a silent condition, be on the watch for any of the following symptoms:

  • Swelling
    Yes, a little in your feet might be fine, but around your face? Hands? Get it checked.
  • Sudden weight gain
    Those repeated weighing measurements are not just some torture device; they have an important purpose. Watch for more than two pounds a week.
  • Nausea or vomiting
  • Pain
    Pain in the stomach area just beneath the ribs and/or shoulder
  • Migraine-like headache
    If it doesn’t go away with your obstetrician-approved over-the-counter medication, call your provider that day.
  • Vision changes
    From flashing lights and light sensitivity to blurry vision, if your vision changes contact your provider immediately.
  • Confused, muddled thinking, racing pulse, sense of anxiety
    More than usual? See a doctor.

Eclampsia vs. pre-eclampsia

Eclampsia is viewed as a serious complication of pre-eclampsia. It can result in seizures for the expectant or postpartum mother. During a seizure, the oxygen supply to the fetus is drastically reduced. Sudden seizures can occur before, during or (rarely) up to six weeks after delivery (postpartum). Postpartum seizures are most common during the first 48 hours after delivery.

How is pre-eclampsia diagnosed and treated?

Today, the number of women who die as a result of eclampsia, or suffer complications from pre-eclampsia, is much lower than it was a century ago thanks to prenatal blood pressure monitoring, urine tests, and the use of magnesium sulfate and other anticonvulsants to treat seizures in women with eclampsia and prevent seizures in women who have pre-eclampsia. But the precise cause of pre-eclampsia and eclampsia is not known. This is why it is critical that all pregnant women get regular monitoring from their obstetrician or midwife.

During these visits, your blood pressure is measured with a blood pressure cuff. A sudden increase in blood pressure often is the first sign of a problem. You also will have a urine test to look for protein, another symptom of pre-eclampsia. If you have high blood pressure, tell your doctor right away if you also have a headache or belly pain. These symptoms of pre-eclampsia can occur before protein shows up in your urine.

Treatment of pre-eclampsia and eclampsia

The only cure for eclampsia and pre-eclampsia? The end of pregnancy! Even then, the impacts of pre-eclampsia and eclampsia can be seen up to six weeks postpartum.

If diagnosed your doctor may suggest:

  • Magnesium sulfate or another anticonvulsant if you have severe pre-eclampsia to prevent seizures
  • Blood pressure medication to lower your blood pressure until postpartum
  • Corticosteroids if you have severe pre-eclampsia or HELLP
  • Bed rest or reduced activity. Depending on the severity of the pre-eclampsia, this reduced activity might be to keep off your feet for a certain amount of time each day, bed rest at home or bed rest in the hospital.
  • Toward the end of pregnancy or if the pre-eclampsia is particularly severe, it may be suggested to induce labor or to perform a Cesarean section.

There is no cure for pre-eclampsia and eclampsia, and both are very serious medical conditions, but we do have treatment and management plans. For the healthiest pregnancy, we encourage you to keep up with your prenatal appointments with an obstetrician or midwife throughout your pregnancy.

 

Osteoporosis: “The most important factor is prevention”

May is Women’s Health Month, a great time to celebrate and promote stronger health and a perfect time to discuss the latest information about preventing and treating health challenges like osteoporosis.

More than 44 million American women experience the debilitating effects of the bone disease, and many women fear aching joints and brittle bones are an inevitable part of aging. It is important to know the risks, and engage opportunities to maintain optimum bone-health.

Dr. Lawrence R. Housman is an orthopaedic surgeon who specializes in musculoskeletal disease at Tucson Orthopaedic Institute. He sat down with us to discuss the best ways to prevent and treat osteoporosis.

OsteoporosisWhy are women at greater risk for osteoporosis?  

Women start with a lower bone density than men. They also lose bone mass more quickly as they age. Between ages 20-80, women will lose about 1/3 of her bone density compared to men who lose only 1/4 of their bone density in that time frame. Estrogen levels also affect bone density, and women lose bone mass more quickly in the years immediately following menopause than at any other time of their lives.

What can accentuate this risk?

Alcohol in moderation is not a risk factor, however more than four drinks per day results in a twice the risk of hip fracture. Steroids can also increase this risk. Long term use of steroids will double the risk of fracture in women.

It should be noted that proton pump inhibitors (e.g. Nexium/Protonix used for stomach disorders such as acid reflux) decrease the absorption of calcium from the stomach.

While increasing fiber, phylates (beans, wheat bran), oxalates (spinach, beet greens, rhubarb) and phosphorus (colas) can provide other health benefits they can also interfere with calcium metabolism.

What are the most effective means of preventing osteoporosis?

Regular exercise is one of the most effective means of preventing osteoporosis. Thirty minutes per day – walking is excellent, and Tai Chi reportedly decreases falls by 47 percent and hip fracture by 25 percent.

Nutrition is another import part of maintaining healthy bones. Fruits and vegetables are important. Women ages 19-50 should take in 1000 mg of calcium daily and women older than 50 should get 1200 mg per day.

Vitamin D is another vital nutrient the body needs to prevent osteoporosis. An individual can get their vitamin D through measured exposure to sunlight or through supplements. A diet with dairy, protein or calcium fortified foods (e.g. orange juice), fish (salmon/sardines) and yogurt (6 ounces has 300 mg of calcium) will go a long way in getting vitamin d to the bones.

What are the warning signs of the disease – and when is it time to see a doctor?

There are usually no warning signs before a fracture occurs; therefore, the most important factor is prevention.

A primary care provider (PCP) is the best person to monitor bone health. Most physicians recommend a DEXA (bone density test) after the age of 50.

The DEXA scan is the bone density test done most frequently and is predictive of fracture risk. The scan will also show whether you have normal bone density, osteopenia (bone is becoming weaker) or osteoporosis (bone is at high risk for fracture).

If a fracture occurs, then an orthopaedist would enter the picture to advise on treatment concerning the spine or extremity fracture.

If diagnosed with osteopenia or osteoporosis – what’s next?

With treatment patients can live normal, active and happy lives.

There are many types of medications that are now available – which work to reverse and then rebuild the bone loss. With treatment, the risk of a vertebral fracture drops from between 30-70 percent and the risk of a hip fracture drops by up to 40 percent.

Housman OsteoporosisDr. Housman is an orthopaedic surgeon who practices at the Tucson Orthopaedic Institute. He earned a medical degree from the University of Alberta in Edmonton, Canada and completed an orthopaedic surgery residency at the Montreal General Hospital and McGill University. Dr. Housman is fellowship trained in several orthopaedic pursuits and is a past chief of staff at Tucson Medical Center. He has also served as president of the Western Orthopaedic Association and Arizona Orthopaedic Society.

 

 

March forth into Spring at the Women’s Wellness Camp

join-tmc-at-the-womens-wellness-camp-march-4Spring means the start of longer days and the rebirth of motivation.

What better way to revitalize your body and mind – and rejuvenate your spirit – than joining women of all ages and fitness levels at a half-day wellness camp?

The event, which takes place Saturday, March 4 on the campus of Tucson Medical Center, is designed to be fun, challenging and motivating and will help you to stay on track with your health goals.

Wellness experts will lead you through a schedule of activities that include:

  • 8:30 a.m. – 9:30 a.m. Finding Your Center, discussion
  • 9:30 a.m. – 10:15 a.m. Cardio + strength, exercise session
  • 10:15 a.m. – 11 a.m. Core strength, exercise session
  • 11 a.m. – noon Eat Purposefully discussion, with lunch
  • Noon – 12:45 p.m. Flexibility of Mind and Body, discussion
  • 1 p.m. – 1:45 p.m. Yoga

The $40 price of the program includes lunch, a T-shirt and a wellness manual, complete with goal-setting tools and useful health information.

Register online at http://bit.ly/TMCWomensWellnessCamp

Call 324-4163 for more information or email wellness@tmcaz.com

Second opinions, survival rates and treatment options: TMC One’s breast oncology surgeon weighs in on cancer diagnoses

Throughout the month of October, Breast Cancer Awareness Month, we tapped into the expertise of Dr. Michele Boyce Ley, TMC One’s new board-certified breast oncology surgeon and medical director of TMC’s Breast Health Program. We’ve shared information with you including how to assess your breast cancer risk, asked her to weigh in on myths about breast screening including mammography and self-breast exams and had her tell us what to do – and consider – if you find a lump in your breast.

To round out this blog series, we asked her opinion on a story that was recently released by the Susan G. Komen organization titled: Debunking Five Common Myths About Breast Cancer Treatment.

We decided to focus on the three Dr. Boyce Ley thought would be the most meaningful.

Myth #1: I don’t have time to get a second opinion because I must begin treatment as soon as possible.

BDP36480First – that second opinion issue. “Second opinions are important for a couple of reasons,” said Dr. Boyce Ley. “Maybe the physician you initially went to isn’t a breast specialist. Or maybe they’re just not a good fit for you. Women need to know that it’s OK to find another doctor! Don’t worry about offending your current doctor or the person who referred you to them. It’s your health. People need to feel empowered to get multiple opinions.” Dr. Boyce Ley added that second opinions are also great because perhaps the first time around, you didn’t quite understand all of the information. Or maybe one physician has a treatment option that another doctor didn’t offer you.

Second – how soon after diagnosis should treatment start? The National Breast and Cervical Center Early Detection Program guidelines recommend starting treatment within 60 days of being diagnosed. Dr. Boyce Ley said that timeframe is readily accepted by most people – that two months is the maximum amount of time a patient should wait before starting therapy. She added that most patients in Southern Arizona begin therapy within a month of being diagnosed. “I think this is really hard for patients,” she said. “They feel like it’s an emergency, but realistically, it takes years for the cancer to grow. A couple of weeks in the life of breast cancer doesn’t change the outcome. Even a patient with an aggressive cancer will usually start therapy within a week or two.”

Myth #2: Everyone diagnosed with breast cancer dies from breast cancer or everyone diagnosed with breast cancer survives.

Dr. Boyce Ley stressed that breast cancer is not a death sentence. With modern treatment, an estimated 90 percent of women with early-stage breast cancer will go on to live five or more years after diagnosis without it recurring. Of course survival rates vary based on what stage the cancer is in and what kind of behavior the breast cancer has. According to the National Cancer Institute, there are about three million breast cancer survivors in the United States. However, more than 40,000 women and more than 400 men still die from breast cancer every year. The reality is that while most people will survive breast cancer, unfortunately some patients will not.

Myth #3: Chemotherapy and radiation therapy are more harmful than helpful.

Decades of breast cancer research have proven that chemotherapy and radiation therapy saves lives. “We know that these are two things that contribute to better survival,” said Dr. Boyce Ley. “Historically, doctors have gone from giving no chemotherapy to giving too much chemotherapy and now we’re working hard to give patients just the right amount.”

She added that doctors these days have lots of ways to analyze a patient’s cancer to identify more clearly what treatment would benefit the patient. This allows a treatment plan to be tailored to that specific patient. “We have ways to identify which patients are going to benefit from which targeted therapies,” said Dr. Boyce Ley. “The same can be said for targeted radiation. We have the ability to target one part of the breast where the cancer is and avoid radiation damage to the heart and lungs. Those are things we didn’t have available to us 15 years ago.”

Dr. Boyce Ley is accepting new patients! She is located at 2625 N. Craycroft Rd #201. Call (520) 324-BRST (2778) to make an appointment.

To schedule a mammogram, call (520) 324-2075. For more information about our free mammogram program for uninsured women, call the TMC for Women Breast Center at
(520) 324-1286 to review qualifications and schedule an appointment.

Screening and mammography myths – what’s your “normal?”

BDP36471We are continuing our weekly blog series with Dr. Michele Boyce Ley, TMC One’s new board-certified breast oncology surgeon and medical director of TMC’s Breast Health Program. Last week she shared with us highly valuable information about how to figure out if you’re really at high risk for breast cancer or not.

This week we’re focusing on how to sort out truths vs. myths when it comes to screening and mammography.

As women, we’re told to do our self-breast exam “when we pay our rent.” Or “on the same day every month as our birthday.” There are even apps to remind you. Most of us know we should do them. But the reality is, we don’t.

Are self-exams encouraged? And should you really be doing them? “Absolutely,” said Dr. Boyce Ley. “We want women to become really self-aware when it comes to their breast health. We want them to do monthly self-exams so that they become familiar with what their normal is. If they do regular checks and know what their breasts feel like, it’s easier to discover when something feels out of the ordinary. If you’re aware of it, you can monitor it and get in to see a breast specialist if necessary. When it comes to self-exams, it’s best to do it the first week after your menstrual cycle.”

Dr. Michele Boyce Ley Board-Certified, Breast Surgical Oncology Medical Director, TMC Breast Health Program

Dr. Michele Boyce Ley
Board-Certified, Breast Surgical Oncology
Medical Director, TMC Breast Health Program

Dr. Boyce Ley explained that there is chatter in the medical world that monthly self-exams may cause unnecessary imaging and biopsies. One of the many challenges, she explained, is that while there are a lot of risk factors we know about, there are also a lot of risk factors we don’t know about. It can be difficult to definitively decide that a 35-year-old, for example, should have a mammogram. “That’s when it’s appropriate for that patient to see a breast specialist,” she said. “If you’ve tried to figure out if you’re considered high risk or not, and you’re still unsure, or if you just need guidance to sort it all out, have a breast specialist help you,” she said. If a woman is identified as high risk, then imaging starts earlier.

▪ What about the risk of being exposed to so much radiation during a mammogram?

It may be recommended that younger people who are identified as high risk get mammograms every other year instead of annually at first. Or perhaps your doctor wants to combine a mammogram with an MRI. “Generally, radiation risks aren’t any higher than they were with regular film screen mammograms from 15 years ago,” said Dr. Boyce Ley. “MRI is a test without any radiation.”

▪ There are 2D and 3D mammograms. How do I figure out which kind I need?

Film screen mammography is a thing of the past. These days, all mammography is done digitally. A 2D, or standard mammogram, captures all of the layers of the breast tissue stacked on top of each other. During a 3D mammogram, the x-ray camera rotates around the breast, getting a picture of multiple layers of the breast. Those layers can then be separated out for an even more precise view. For a majority of patients, standard digital mammography is still very good. Doctors have found, however, that for all patients, especially those with dense breasts, 3D mammography allows them to do fewer call backs. That means that there is a smaller chance that you’d have to be called back in for a follow-up mammogram or ultrasound. “The detection rate for cancer is higher with 3D mammography, as it allows us to find more small cancers,” explained Dr. Boyce Ley. “The downside is it can cost more.”

At TMC’s Breast Center, both 2D and 3D mammography is performed. If you’re considering a 3D mammogram, be sure to check with your insurance first to see what it covers.

▪ I have breast implants. Do I have to do anything differently?

No. The screening recommendations are the same. Dr. Boyce Ley said that implants can distort the breast tissue. In some cases, implants can make it easier to find a lump by feeling the breast tissue during a monthly self-exam. On the flipside, in some cases, it may make it harder to find a lump by imaging since the breast tissue is being pushed around by the implant. It can be difficult to visualize all the breast tissue since the implant often distorts it.

▪ Does where I get screened matter?

Yes, according to Dr. Boyce Ley. Before you schedule your mammogram, do your research. Ask if your scan is going to be reviewed by a breast imaging specialist or radiologist with a specific focus who is able to give you an accurate interpretation. “You want to have your breast imaging read by someone who almost exclusively does mammographic imaging,” said Dr. Boyce Ley. “There are so many changes in technology and what we learn about the breast. It’s important to have someone who is highly experienced.”

Dr. Boyce Ley recommends asking a few questions when you call to schedule your appointment. Ask things like, “Can you tell me about your radiologist? Can I look them up online? Are they fellowship trained in breast imaging or are they a general radiologist? What percentage of their time do they read mammograms?”

At TMC’s Breast Center, all of our radiologists are trained as general radiologists and then receive specialized training in breast imaging. Additionally, our lead radiologist, Dr. Matthew Bell, as well as Dr. Shayna Klein are both fellowship trained in breast imaging. All of our radiologists must keep their training current, so you can be confident that if you get a mammogram at TMC, it’s being read by clinicians who are specially trained in reading mammograms.

Dr. Boyce Ley is accepting new patients!
She is located at 2625 N. Craycroft Rd #201.
Call (520) 324-BRST (2778) to make an appointment.

To schedule a mammogram, call (520) 324-2075.

Spread the word about when to have your first screening mammogram and the FREE screening mammograms for uninsured women by entering our TMC for Women photo contest. Snap a picture of you and your BFF and enter for a chance at a fabulous prize.   http://woobox.com/chcztiPhotoContestBFF

Moms Have Delivery Options – Even After Cesarean

Great post over on TMC for Women. Here is a teaser: “Once a cesarean, always a cesarean” – That was the 1916 version of modern medicine, when women were told if they had a baby by cesarean section, they’d have any future babies that way as well.

Times have changed, but word has been slow to get out to women that the prior surgery shouldn’t deny women the chance to deliver a baby vaginally.

In fact, researchers say even women carrying twins can still be candidates, as can women with two previous c-sections, said Marjorie Letson, a childbirth educator who regularly hosts classes at Tucson Medical Center designed to introduce prospective moms to the full range of opportunities. For the full story here.


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