Why we promote rooming-in

For mom and baby’s health

Rooming in

Not very long ago family and visitors would clamor for prime viewing spots outside the nursery window to see their newborn swaddled, beyond reach and comforting touch. No longer, as hospitals moved from open wards to private rooms,  the practice of rooming-in has become common place. At TMC for Women, rooming-in is the norm, but we’re still asked occasionally, by moms and families, about baby spending time in the nursery.

Why we promote rooming-in

The practice of taking baby to the nursery to ‘give mom a break’or a good night’s sleep might seem logical, but research studies have shown that sleep patterns and breastfeeding are often better established when baby stays with mom and mom with support learns her child’s cues. For this reason we promote 24-hour rooming-in for new moms.

Mom to near 2 year old Felix, Cindy shares her experience rooming-in at TMC for Women,

“I was going to the El Rio Birth Center and wanted to have a natural -birth experience, but that wasn’t in the cards for me. At 41 weeks, it was time to go to the hospital. I was at TMC for two days before Felix was born via C-section. He was 10.5 lbs and a bit of a celebrity for the short time I was there. There hadn’t been such a big baby born in quite a while. After the C-section, our midwife gave Felix to me right away.”

Placed on Cindy’s chest immediately, Felix stayed with mom except for testing and a short time when Cindy was attended to following the C-section.

“The nurses at TMC were very kind, supportive and respectful of my need to have Felix with me at all times. I was there after the surgery for 3 days. It was amazing to have that little guy close to me. I wouldn’t have traded that experience for anything in the world.”

What is the newborn nursery for?

Our newborn nursery is reserved for only those babies who need intensive observation or are having problems that prevent them from staying in their mother’s room.

Moms are encouraged to always keep their baby with them. Mom’s partner or a support person is welcome to stay overnight to help them with the baby, as they bond and get to know one another.

Why rooming-in is important

• Rooming-in promotes successful breastfeeding
• Keeping your baby with you at all times helps both of you sleep better and establish sleep wake cycles. There are also physiological benefits in regulating baby’s blood glucose levels, temperature, and respiratory rate.
• The safest place for the baby is with the parent
• Being together strengthens your bond – the more time you spend together,the better you will know each other
• You will learn your baby’s cues, and the baby will be calmer hearing your familiar voice and your heartbeat
• You will feel more confident in your ability to care for the baby when you go home from the hospital

Resources


Keefe, MR. Comparison of neonatal nighttime sleep-wake patterns in nursery versus rooming-in environments. Nurs Res. 1987 May-Jun;36(3):140-4. [Accessed6-6-2014]

Koskinen, KS.,  AhoAL, Hannula L, Kaunonen M, Maternity hospital practices and breast feeding self-efficacy in Finnish primiparous and multiparous women during the immediate postpartum period. .Midwifery 2014 Apr;30(4):464-70. doi: 10.1016/j.midw.2013.05.003.Epub 2013 Jun 13. [Accessed 6-6-2014]

Moms and babies saving lives one cord blood donation at a time


As an expectant parent, perhaps you’ve heard about preserving your newborn’s umbilical cord blood, and educated yourself on the pros and cons of both private banking and public donation. If you’ve decided to privately bank, you select a bank, and start working directly with that company’s representative. If you’ve decided that public donation is the way to go, it’s easy to do so if you’re delivering at TMC for Women. Tucson Medical Center is proud to be the only hospital in Southern Arizona that’s part of the Arizona Public Cord Blood Program, administered by the Arizona Biomedical Research Commission.

Donated umbilical cord blood is available on the Be The Match registry, which helps those with life-threatening diseases find potential stem cell matches for transplant.

Donating your baby’s cord blood as part of this program is free

Donating does not require you to do anything ahead of time. It’s best to discuss cord blood donation with your health care provider. If you haven’t decided before you arrive at TMC for Women in labor, you still have time to make that decision. All you have to do is tell your labor & delivery nurse that you want to participate in the program, and our dedicated cord blood team will take care of the rest.

TMC for Women’s Cord Blood Coordinator: Kristen Wilt

Kristen has been a labor and delivery nurse for 24 years, including the last eleven years here at TMC for Women and oversees the program as TMC for Women’s cord blood coordinator. “I’m so excited to be a part of this amazing program. As a labor nurse, I’ve been well aware of the powerful, life-saving benefits of cord blood stem cells for many years now. It’s been so difficult to watch the potential to save a life just go into the garbage, day after day! This is such an easy way for expectant moms to give back. Can you imagine how special it would be to one day tell your child that they saved a life on the day that they were born? I wish that I had had that opportunity.”

How does it work?

Once you tell your labor and delivery nurse that you want to donate this precious life-saving resource, one of the consenters will come visit you in your room. They’ll help educate you and answer any questions you may have.

Collecting the baby’s cord blood does not change your labor or delivery, and it does not hurt the mom or the baby. “Typically, as soon as we educate parents about publicly donating their baby’s cord blood, they’re on board with it. Sometimes families instantly say, ‘I don’t want to do that,’ but if they allow us to explain it, their reaction is, ‘Oh – that’s not what I thought it was.’ And then they decide to participate,” said Wilt.

Remember, to participate in this program, you must be at least 18 years old, at least 36 weeks along in your pregnancy, and be pregnant with only one baby.

The consenter will also go over any items that may exclude you from participating in the program. It’s similar to the questions that are asked of you when you give blood. Since cord blood is considered a blood product by the FDA, and it may be transplanted into a very sick person, you can understand why every precaution must be made to ensure the cord blood is free from disease and contamination.

After the baby is delivered, your provider clamps the umbilical cord, sterilizes a small patch where the collection will happen, and then collects the blood. They will try to get as much blood as they can, but remember – since the cord has already been clamped, the collection does not impact the baby in any way. Then, mom delivers the placenta. The entire collection process takes just a few minutes, and since it happens between when the baby and the placenta come out, it does not interfere with the birthing process. How the baby is delivered does not make a difference for this donation program.

Moms who have vaginal births and those who undergo cesarean sections can donate.

The consenter then takes the blood into a special room inside TMC for Women’s labor and delivery area where the collection is weighed, labeled and put into a container that keeps it at the proper temperature. Then a courier takes the donation to Tucson International Airport to be flown to the cord blood bank where it will be processed and stored.

Donating your baby’s cord blood as part of this program is free, safe and confidential. In the event a TMC baby’s blood is selected for transplant, TMC will receive notification with very limited information on it, including where the cord blood was shipped and the name of the disease it was used to treat.

In the few years the Arizona Public Cord Program has existed, 50 cords have been selected for transplant, which means 50 lives were saved because of this program.

For more information about the program, please click here, or contact Kristen Wilt at (520) 324-6210 or Kristen.Wilt@tmcaz.com.

Breastfeeding – 10 ways you can support the new mama in your life

10 ways dads can help with breastfeedingThere was a time when in the first fresh days and weeks of a baby’s life, a new mom would be surrounded by the women of her family and community. They would provide her support and guide her through breastfeeding and caring for her new child. Today, that is often not the case. A new mom may find herself without that sisterhood to draw upon. Breastfeeding support groups, lactation consultants and postpartum doulas provide valuable resources, but for day-to-day the support of dad or partner is critical in determining whether breastfeeding is successful.

TMC for Women Lactation Consultant, Susan Dennis IBCLC, shares these ten tips to help dads and partners help the new mom in their lives:

How to provide breastfeeding support to your partner:

  1. Before baby arrives attend a Breastfeeding Class with the expectant mom.
  2.  Tell the new Mom that she is doing a great job- encouragement is a key building block to success.
  3. Help recognize when the baby is showing feeding cues and help give mom private time to feed without distractions from other visitors.
  4. Place pillows under mom’s arms, back, legs to help support her in comfortable positions while feeding.
  5. Watch how staff at the hospital or birth center help the baby start a feeding and do the same when mom needs help.
  6. Hold baby skin to skin after feedings while mom takes a nap. This is a great bonding time for you and baby.
  7. Bring water and snacks whenever mom feels hungry.
  8. Be the mom’s sounding board when she feels frustrated. Sometimes she just needs to talk.
  9. Burp baby, change diaper and cuddle baby in between feedings so you get a chance to know the baby.
  10. Babies are only small for short time. When they cry they need to be held. This builds trust and later independence.

Know there are outside resources to help mama with breastfeeding, we provide outpatient consultations with certified lactation consultants as well as a weekly support group.

Resources

Pisacane, A., Continisio GI., Aldinucci, M., D’Amora, S., Continisio, P., A controlled trial of the father’s role in breastfeeding promotion Pediatrics. 2005 Oct;116(4):e494-8. [Accessed 6/13/2014]

Back to Work – Breastfeeding in the workplace

Making the transition back to work after your maternity leave ends can be difficult, especially switching to pumping. Our lactation consultants provide these tips for success once you’re back at work:

  • When you’re away from your baby, pump every 2-3 hours or as much as possible
  • Breastfeed just before you leave for work and as soon as you get home again
  • Help your milk expression by having pictures of your baby with you; record the sounds of your baby on your cell phone or voicemail and listen to those while pumping
  • Try to create a relaxing atmosphere in which to pump. Closing your eyes, breathing deeply and relaxing will help with expression of milk
  • Massage your breasts before and during the middle of the pumping session
  • End your pump session with hand expression to aid breast drainage
  • When home, feed your baby on demand to help maintain your supply
  • Keep talking with your employer/supervisor about what is working and what isn’t
  • Remember breastfeeding and pumping is an organic thing, be flexible
  • Dr. Jack Newman provides many resources for breastfeeding moms. This link includes techniques for expressing milk successfully when you’re away from your baby.

As a working mom, you have many responsibilities, and it may be challenging to keep up your milk supply. Food, drink and lots of cuddling with your baby, in addition to frequent breastfeeding on your days off, will help maintain your supply. Remember, you are doing a great job. Call our Breastfeeding Support Program (520) 324-5730 if you have any questions.

Sign up for Breastfeeding Basics – A class for expectant mothers to support them on the breastfeeding journey

We’d love to hear your input. If you’ve already breastfed and made the transition back to the work place can you share a little of your experience? How did you make it work? What challenges did you face? Did you have a particularly positive experience with an employer? Give kudos to them.

Useful resources:

At TMC for Women

  • TMC for Women’s Breastfeeding Support Program – Call (520) 324-5730
  • TMC for Women’s Breastfeeding Support Group – Mondays, 10-11:30am in the Canyon Conference Room near the Southeast Entrance.
  • Tucson Medical Center has lactation rooms for its staff on the postpartum unit. Contact the Breastfeeding Support Program for more information

Online

In the Literature

The Milk Memos – At times hilarious, sometimes poignant and always insightful resource that started as a plea from one new mom sitting in a lactation room at IBM to whoever might be also using the lactation room.

 

 

Struggling with breastfeeding? We have help

breastfeeding baby carlo-navarroBreastfeeding at its best is inexpensive, easy and provides a whole host of health benefits for both mother and child. But you would not be alone if at first you struggle with breastfeeding. A trained lactation consultant, typically certified by the International Board of Lactation Consultant Examiners, can provide the insights needed to get over the stumbling blocks that prevent many women from continuing to breastfeed and reap the benefits.

Along with our weekly free breastfeeding support group, we also now offer private outpatient consultations. Supplemental funding from TMC Foundation ensures that all women can access this resource.

An outpatient breastfeeding clinic

Tucson's outpatient breastfeeding clinicThe TMC for Women Outpatient Breastfeeding Clinic was created to help women and babies with breastfeeding once they have left the hospital or birth center. Lactation consultants can help address latch problems, provide nipple shields and help with supplemental nursing systems (for those babies who are ineffective at nursing, preemies or special needs babies, or for moms who have a low milk supply or whose bodies need encouragement to lactate).

The goal of the clinic is to make sure all new mothers in our community can access trained lactation consultants and overcome hurdles to breastfeeding, no matter what their insurance or ability to pay. You can still access support via telephone on our breastfeeding warmline, (520) 324-5730. (When clients call this phone number you can leave a message either on our Outpatient Line to schedule an appointment or the main line for questions. The lactation consultants return calls in between patient care and between hours of about 8 a.m. to 6 p.m.)

In-person visits provide another level of support that is impossible to attain via a phone conversation. The appointments are typically 60 to 90 minutes long and take place in a comfortable, non-clinical setting, nestled in a quiet corner of our campus.

Call (520) 324-5730 to make an appointment for an outpatient consultation.

What you should know about our breastfeeding consultations:

  1. Services are available to anyone in the community regardless of where you deliver your baby
  2. You do not need a referral
  3. If you have insurance, it will be billed first; if the insurance company refuses to cover the consultation or if you don’t have insurance, the cost will be covered under a grant from the TMC Foundation. Our TMC community recognizes the benefits of supporting breastfeeding for the health of mom, baby and the community at large.
  4. Don’t have easy transportation? Perhaps you’ve just had a C-section and can’t drive? No worries, we can help with transportation to and from your appointment. Just ask when you schedule your appointment.
  5. You will see a registered nurse who is a certified lactation consultant
  6. Need more than one consultation? No problem, multiple appointments are available.
  7. This appointment is not in a cold hospital room. Consultations take place in a comfortable, private sitting area designed by the lactation consultants in line with what we know helps support women who are breastfeeding.

“Don’t Smile!” – A man’s guide to supporting a mom-to-be

It was total adrenaline – the night my first son was born. With 007 speed, I grabbed our overnight bags, got my wife into the car and hoped to make it to the hospital in time. I remember thinking, over and over, “this is it – I’m going to be a dad.”

Jim and his eldest child.

As I pulled into labor and delivery, nothing could rip the smile from my face. After we got to a room, my wife’s contractions became pretty intense. She started vomiting – which I hadn’t expected. Still pumped, with a silly grin from ear to ear, I handed my wife a tiny pail that was 10 times too small. Cheeks red and eyes watering, she looked at me and shouted “Don’t smile!”

Well, that did it. I stopped smiling – not because of what she said, but because in that moment I realized I had done nothing to help prepare for this day, and had only focused on how it was affecting me.

Guys, just because we don’t have a uterus doesn’t mean we have no responsibilities when it comes to our pregnant partners.

No, you don’t have to spend all day reading about how a fertilized egg implants itself into the lining of the uterine wall. There are real ways to be a rock for your partner – and it’s not just what you do, but how you do it.

Get it together

One of the most important things I learned was, no matter how you prepare, do it together. Whether you found a new book, website, anecdote or whatever – talk about it with your partner. There’s some anxiety that comes with pregnancy – a lot of “what if” scenarios. Doing things together lets your partner know you’re a team and you’ve got her back.

There’s no shortage of pregnancy info out there, and working together, you’re likely to find the planning methods and information sources that work for you both. Plus, you’ll know what you’re doing and won’t be surprised – like I was.

Tip: Go with her to every OB/GYN appointment. Also, remember this is a very personal thing for her, so don’t announce she’s pregnant without talking to her first.

This is her thing

When it comes to expecting, expect to get advice from everyone. Seriously. Everyone. Your parents, her parents, your friends, even that guy you met once at the company holiday mixer and can’t remember his name – yeah, him too.

There are a lot of standards, but every body and every pregnancy is unique. This is happening to your partner and her body – the choices about her diet, exercise and everything else, should be hers.

Not so fast, bro. That doesn’t mean we shouldn’t be involved. It just means if you have information to share, don’t mansplain the info like you’re dictating what she has to do. Have a real conversation, provide new info and options – and then respect her decision. “Wait, it’s my baby too.” Yes, and the best way to support your baby is to support the mom.

At one point during my wife’s first pregnancy, she was experiencing varying symptoms of high blood pressure. Some of these symptoms can be non-descript, but I wanted her to see the doctor anyway and very strongly insisted. Fail. Her blood pressure was fine, and I ended up with a stressed out and upset mom-to-be. This was not good for her or the baby.

Tip: The information and experience could get overwhelming. If it does, be cool and be constructive. Don’t make dismissive dude comments like “just relax” or “it’s fine.” To her, that sounds like “I don’t care” or “you’re just overreacting.” Think about what you’re saying and how you can help.

Help out – before she asks

Throughout the three trimesters of pregnancy, she will be experiencing different effects. Some of the fun ones include exhaustion, morning (or evening) sickness, memory loss, swollen feet, insomnia, and undulating hormones. There are many more.

Sometimes the effects get a little weird. My wife used to hum in her sleep while she was pregnant. There are a lot of physical and emotional effects she is enduring, not to mention feeling downright uncomfortable.

You know your partner – think of ways you can help out around the house. It doesn’t have to be big, and can be as simple as a menial chore here and there that gives her an extra half-hour to put her feet up and relax. BTW, these helpful acts are even more meaningful if she doesn’t have to ask.

Tip: Pregnancy can get physically demanding. If you really want extra points – offer a shoulder or foot massage every once in a while. Hey guys – I said shoulders and feet.

Pack it up

Yes, her OB/GYN has set a due date – but think of this as a general guideline, because babies are almost never born on their due date. My first son was nearly four weeks early, and my second son was two weeks early.

Take 10 minutes to sit down with your partner and make a list of what you both will need for a hospital stay of a few days. You’ll probably be in the hospital for only one night, but just in case, make the plan for a few days. About six weeks out, pack bags for you and her and keep ‘em close to the door. If you wait till the last minute to do this it will be an epic mess – for real.

Get the baby’s car seat ready around this time too. Read the instructions – at least twice – and get that sucker in the back seat. If you aren’t sure the seat is in correctly, make an appointment with one of the car seat safety stations in Pima County.

Trust me and do this ahead of time, you don’t want to try to figure this out in the hospital parking lot, while your partner and new baby are waiting for you.

Another necessity is a contact list. Discuss with her about who you both want contacted when the baby debuts. This way, you can take care of all that and she can focus on having the baby – that’s enough to handle.

Tip: Get a suitcase, backpack or travel duffel for each of you. If you pack one enormous suitcase for both of you – yeah, that big, heavy, bulky thing just isn’t going to work.

You’re up, slugger

Whatever the stereotypes of guys may be, we do want to be good husbands, partners and fathers. Even with this intent, I just wasn’t aware of some of things I could have done to be that great partner and husband during my wife’s pregnancy.

Finding your own path is going to be part of this ride, but I know it will be easier if you do this together, support her, help out and prepare. Starting a family has been my most rewarding experience, and it will be for you too.

And I know all the partners out there have other great tips, too. Please leave your own suggestions in the comment section.

Jim and family

You got this! A big thumbs up from Jim and his family on your adventure

Although family is his first priority, supporting a mom-to-be was a new responsibility for Jim Marten who works in communications at Tucson Medical Center. When he isn’t engaging press relations and community affairs for TMC, he’s spending time with his wife, Jami and their two sons, Aaron and Aiden. He hopes sharing this experience will help dads and partners get it right the first time, and won’t leave mom shouting “don’t smile!”

Breast cancer survivor spreading a message of body positivity

BethAnne King LobmillerBreastless and beautiful

When breast cancer survivor and advocate BethAnne King-Lobmiller was just 10 or 11 years old, she recalls accidentally barging in on her grandmother as she was changing her blouse. “I must have gasped or looked shocked … but she just smiled and invited me to come in and close the door. Then she explained to me why she didn’t have breasts.”

“She had a bilateral mastectomy in the 1970s, back when cancer surgery was radical and went deep, and as a result, she was completely flat.” King-Lobmiller recalls with a smile. “I had never noticed that she wore fake boobs – she even wore smaller ones in the summer to stay cooler – and none when she was in her pajamas.”

Possibly in part as a result of her grandmother’s unapologetic honesty and generosity in sharing her experience, King-Lobmiller dedicates herself to advocating for body-positivity after breast cancer. Breastless and Beautiful, the advocacy group she started, boasts more than 300 members and exists for women who have chosen not to undergo reconstruction after a mastectomy. Says King-Lobmiller, “I didn’t choose flat, it chose me … as corny as that sounds.”

But the journey to her current state of body-positivity took time, reflecting back on her own diagnosis, she says, “When I first heard that I was going to have a mastectomy, I was beside myself, I couldn’t’ accept it.”

“One of the things I noticed about myself as I attended support groups was that I was really more freaked out about it than anyone I knew. But I was just processing it and grieving the finality of the loss. I wasn’t soothing myself with the idea of the breasts I would have afterward, so it felt very raw and real.”

Choices post mastectomy include going flat

Not willing to go through additional surgery beyond her mastectomy, King-Lobmiller found there was an assumption among everyone from medical professionals to support groups that reconstruction would be the obvious choice. Going flat wasn’t an overt part of the mix.

“I’m not advocating for flatness, I’m asking for there to be a conversation about the option.”

Her philosophy is that, like most things, the more people see healthy, beautiful survivors who have chosen flat and the more the community knows about it, the more comfortable women will become with making the choice that is best for them.

“Honestly, hardly anyone notices. When they do, I think to myself, “Please say something to me” because I always want the opportunity to educate someone and help them to understand,” said King-Lobmiller.

“The idea that I’m not a feminine and beautiful woman because I don’t have breasts is ridiculous,” she said.

TMC’s dedicated Oncology Nurse Navigators are here to help with resources for patients and their families and information about support groups. And don’t forget to schedule your annual mammogram today.

Ready or not: Birthing positions for the big day

Baby is coming, birthing positions and resources.As your pregnancy progresses, you are likely starting to envision the actual, physical act of labor. What will it be like? Will you need to bring anything? Will you have the opportunity to try out different positions and birthing aids until you find the right combination?

It’s important to know that even with an epidural, active positioning is necessary as you give birth to promote baby’s progress. Actively engaging your body by moving, rocking, bouncing and squatting is essential to the birthing process because it enhances your comfort and makes the birth move along.

“Patient safety is our top priority and skilled nurses, there every step of the way, to help you along your labor path are essential,” said Stacie Wood, clinical educator for TMC Women’s Services. “Safe positioning is an important tool to help maximize the birth experience.”

The most important thing is to use whatever tools are available to deliver a safe, happy and healthy baby.

If there is something that you are already comfortable using at home – your favorite stability ball for instance – by all means, bring it with you. But you don’t have to come with your own equipment – we’ve got you covered with a variety of birthing aids in different sizes.

And to make sure you have peace of mind, all the while you are out of the bed, your baby can be monitored by either a wireless monitor system or a portable wired monitor.

“Having the freedom to move around is one of the big positives that we offer our moms,” says Wood. “They can still be active and move around freely without losing the feeling of security about the baby’s safety because of the monitors we have.”

There are different tools available for a few purposes during your labor:

  • stability balls, squat bars and squat chairs help your body actively engage in the process;
  • peanut balls allow you to rest in bed while still promoting dilation and the baby’s descent;
  • labor tub and a shower because warmth might be important for your experience.

With the stability ball, your partner also can help out by sitting behind you with a warm pack and providing a massage. (Don’t worry, we’ll do a little training first.)

To register for a free Maternity Services tour, please visit our website.

 

 

Incredible reward at no cost – How cord blood donations are changing lives at TMC

Cord Blood Kristen Wilt

Cord blood donations can enhance and save lives, and do even more – providing donors and their families with the uplifting benefit of knowing their cord blood gift will have a positive impact for years to come.

“My brother-in-law passed away from a rare blood disorder when he was just 19,” said Stephanie Babcock, a mom who recently donated the cord blood from her baby Midori at TMC. “It’s so rewarding to know our donation can save someone like my brother-in-law – we know what it means to that person and their family.”

What is cord blood?

What exactly is cord blood and why is it so beneficial?

“Cord blood is the blood that is left inside the umbilical cord and placenta after a baby is born,” said Kristen Wilt, cord blood coordinator at TMC. “It is so important because it contains blood-forming stem cells that can be used in blood transfusions to heal or repair damaged cells that cause serious diseases.”

Saving and improving lives

Wilt explained cord blood stem cells are used to treat more than 80 life-threatening diseases, which include many forms of cancer, as well as immune and genetic disorders. “Acute myeloid leukemia, Hodgkin’s lymphoma and sickle cell anemia to name just a few,” Wilt said.

Cord Blood 4Blood transplants can have a significant and permanent effect for individuals facing specific debilitating and severe health challenges, she explained. “By and large, the treatments can cure many diseases or have a significant impact that dramatically improves the quality of life for the recipient.”

How donation works

Wilt said the process is quick, easy, and it is free. “At TMC the mom and family are asked if they would like to donate the cord blood immediately after birth,” explained Wilt. “There is one simple consent form to sign and a health history questionnaire to review and you’re done – you’ve just created a life-saving possibility for someone.”

Participation in the Arizona Public Cord Blood Program is growing, but currently available only in a few Arizona hospitals. “It made a great impression on us that TMC was the only hospital in Southern Arizona who offers cord blood donation,” said donor Babcock. “It can seem like a small thing but has such an incredible impact.”

Cord blood donations from TMC have gone to help patients all over the United States and as far away as Australia.

Safety and anonymity

Donating cord blood poses no risk to the baby or mom because the cord blood is collected after the birth, when the placenta and umbilical cord are no longer needed.

The hospital assigns a number to each donation so that it is received and tracked by the public cord blood bank anonymously.

“We did our research,” said Babcock. “We had no concerns about safety or privacy – TMC made it a simple, easy part of the birthing experience.”

Cord Blood 3

Where it goes and how it helps

For the past four years, TMC has worked with the Arizona Public Cord Blood Program and has provided almost 5,000 cord blood donations.

“Within 48 hours, the cord blood is delivered to the University of Colorado Cord Blood Bank (an FDA-licensed facility), where it is cryopreserved in liquid nitrogen tanks,” said Wilt. “This process conserves the stem cells in the blood for a very long time – donations have been used after 20-25 years.”

The donation becomes part of the national registry managed by NMDP/Be the Match registry. “Worldwide, patients of all ages who are in need can work with the registry to determine if they are a match,” Wilt said.

Why your donation matters, for others and for you

Some moms and families decide to save and privately store their baby’s cord blood. However, the cryopreservation process and on-going storage fees can be cost-prohibitive. “If cord blood is not donated, it is disposed of as medical waste – and it is truly a waste,” said Wilt.

Donating cord blood has such significance because finding a match can be very difficult. “About 70 percent of people in need are not able to find a match from their family,” Wilt said. “More cord blood donations means a greater chance that someone in need will find a match.”

For Babcock, making the donation was more than a fulfilling gesture. “It’s not a big sacrifice, and it changes your life just knowing that you could save an adult or child who is fighting a deadly disease.”

Cord Blood 1For more information about cord blood donations, contact Kristen Wilt at (520) 324-6210 or visit the Save the Cord Foundation website.

TMC nurse named Mrs. Arizona; heightens awareness of postpartum depression

Sarah Barrett.jpgSarah Barrett has been a nurse for more than six years, specializing in serving new mothers and babies.

And even though she helps screen new mothers for postpartum depression, it didn’t occur to her that the sadness she felt and the guilt she carried as a result were rooted in her own struggles with depression.

It wasn’t until she took the screening tool herself that it all clicked into place for the mother of three.

“My score was through the roof,” she recalled of that day in the spring of 2017. “It took seeing it in black and white to help me understand what I had been feeling.”

Barrett, who was recently crowned Mrs. Arizona and will compete in August in the Mrs. America pageant in Las Vegas, will spend a year traveling the state to bring awareness to an issue that many women are afraid to share for fear of being judged.

“I knew when I entered this that I wasn’t going to be afraid to say, ‘This happened to me,’ and to be an example,” said Barrett. “It can happen to anyone and it doesn’t mean you’re a bad person or a bad mother. It means you’re human and it’s time for the community to embrace and support these women.”

Barrett competed in pageants in college, gaining confidence and interviewing skills as she shared her platform then about pet ownership.

Then came marriage and three children. The first two, her girls, weren’t easy – she had pre-term labor with both, although she made it to term. But her son came four weeks early. “The medical side of me and the logical side of me knew it wasn’t my fault, but as a mother, I felt like I had let my family down,” she said. She cried alone in the hospital the next day, with her son in the newborn intensive care unit and missing her daughter’s fifth birthday party. Driving home from the hospital with an empty car seat was excruciating.

Sarah CrownedBarrett said she pushed down the feelings and resumed her life, only to have them all come crashing in again on his first birthday, when she saw the familiar social media posts that pull photos from a year ago. Seeing him so small and intubated sent her into a tailspin.

She got used to crying in the bedroom, wiping her eyes and putting on a smile for everyone else. Her marriage was strained. “You can’t meet other people’s needs and take care of them if you’re not taking care of yourself,” she said.

It was hearing a friend’s story that left her reaching for the screening survey. “It was so eye-opening for me. All this time, I thought I was alone and there was something wrong with me.”

It was only later she found that in many cases, postpartum depression is triggered by the unexpected: if a woman had planned for a vaginal birth but ended up with a C-section, for example, or if the baby comes early or if there was an unplanned diagnosis. “You formulate the perfect birth in your mind and then when you go home and it’s not that perfect birth, it can be really hard.”

She found healing in the pageant process. “The more I shared my story with women about what I went through, and the more they reciprocated back about what they went through, the more it helped me heal. So the bottom line is don’t be afraid to reach out to someone who you trust.”

Barrett credits TMC for screening every new mother and for its robust weekly postpartum depression group, as well as for its mandatory class for new moms before they go home that touches on everything from properly installing car seats to symptoms of depression to watch for.

Click here for more information about our postpartum and pregnancy depression support group.

She wants to ensure more health providers screen new moms and wants to bring more awareness to support partners, who need tools to share what they’re witnessing. “You want to be careful about how you open those lines of communication: How are you feeling? How are you coping with being a new mother? I know it must be hard getting sleep right now.”

Barrett said her marriage of 11 years is stronger than ever, and she’s found joy in being with her family. She’s also proud of her new role. “This is something we decided to do as a family, so I got the OK from all of them that we would do this. It’s been an amazing experience to be surrounded by these women who are passionate about a cause and involved in making a difference in their communities.”

Need more information about our Postpartum and Pregnancy Depression Support Group? Click here. 

Pregnant? Set the stage for breastfeeding before your due date

You work.
You’re about to have a baby.
You plan to breastfeed.
You plan to continue to breastfeed when you go back to work.
Now, just how is that going to work?

Despite all the known benefits of breastfeeding for the health and well-being of our children, many of us face barriers and challenges when we return to work that derail our efforts to continue to breastfeed. Here are some tips from our lactation consultants about actions you can take while you’re pregnant and still working to make things easier upon your return to the workplace.

 

Set the Stage-Before Your Due Date

Before your due date talk to your employer or supervisor about your plans to breastfeed and the positive implications for your workplace if you’re able to continue to breastfeed and to express milk when you return to work:

  • Lower health care costs for both mother and child. Breastfed babies have lower rates of infection and illness and breastfeeding has positive implications for mothers too, including lower rates of breast cancer, ovarian cancer, diabetes and osteoporosis.
  • Lower absentee rates
  • Higher employee morale (and so productivity) and positive view of a “family-friendly” employer.
  • Retention of experienced employee

It is also useful to know the legal requirement of employers to be supportive. The Healthcare Reform Act (Patient Protection and Affordable Care Act) made clear the responsibility of all employers to provide suitable (private, not a bathroom) space and reasonable time for mothers to express their milk multiple times a day without interruption. You can find more information about the federal law here.

Make a plan

Before your due date, come up with a plan with your employer or supervisor to make pumping successful. Your plan should include:

  • The location of a private, non-bathroom space, where you will not be disturbed or viewed while you express milk.
  • How your work schedule will allow you two to three approximately 15 minute (plus travel time) breaks every work day.
  • Where you will be able to store your breast milk. Susan suggests a cooler that you can take to and from work.
  • Where you will be able to store and clean your breast pumping equipment.
  • How you might modify your schedule at the beginning to ease into being away from your baby. If possible, see if you can return to work for reduced hours the first few weeks or starting in the middle of your work week so that you have less time away from baby the first week back.

Once you have agreed upon a plan, write it down and share a copy with your employer and supervisor.

Don’t forget to tap into a powerful resource, your colleagues. Is there someone in your workplace who breastfed their children? Or whose partner breastfed? Can this person be a champion for you?

Sign up for Breastfeeding Basics – A class for expectant mothers to support them on the breastfeeding journey

Until we have a child and start to breastfeed, we may be oblivious to those in our workplace who were forging the way with regard to breastfeeding and working. These colleagues may be able to offer support and practical solutions for your specific workplace.

If you work at a site with a human resources office you may wish to check in with the folks there, first, as there may be a site-based program to support you. The Business Case for Breastfeeding from Womenshealth.gov provides a wealth of information your human resources or employer can use. Among other items this document includes a list of myths and facts that you may wish to arm yourself with in case your employer or supervisor has concerns.

Pregnant? Finding sleep elusive? Try a body pillow!

The ever-changing state of your body during pregnancy inevitably makes getting comfortable enough to beat those fits of insomnia feel impossible. Your body is working to create a new life and an important part of that process is rest.

You know that sleeping on your back again will have to wait and the best position for you and your baby is with you on your side, but that doesn’t make it any easier. With a little help from the right pillow, you’ll ease the strain on your body and get a restful night’s sleep.

As with anything, the best option for you won’t necessarily be the best for someone else. There are a variety of options out there to fit your particular needs.

The pregnancy body pillow – designed in the curved shape and length of your body, this option is like snuggling your partner all night.

The u-shaped pregnancy pillow – the name says it all, this versatile pillow is constructed to wrap around your body from front to back, allowing you to turn from your right to left sides and prop your head up when on your back.

The inflatable pregnancy pillow – shaped like a pool float, this option has a belly-shaped hole that allows you to rest comfortably on your stomach.

The wedge – small and intended for targeted areas, this pillow can be shaped to fit between knees, under the lower back or anywhere else that needs a little help.

“Getting enough rest is vitally important for your body and the development of your baby,” said Stacie Wood, clinical educator for Women’s and Children’s Services and Tucson Medical Center.

Now that you know your options, if you’ve got the DIY spirit and the reluctance to spend extra money, get creative! Hop onto Pinterest and get those creative juices flowing. Check out these pins we’ve saved for you on DIY Pregnancy Pillows.

Pregnancy and the flu vaccine – Protection for you and your baby

Why you should get the flu shot if you're pregnant

Photo by Alex Pasarelu

“Babies can’t be given the flu vaccine until they are six months old, so the vaccine that you receive is for both of you,” explained Erin Sperry Schlueter, M.D. F.A.C.O.G., department chair of TMC OB/GYN.

With pregnant women on the short list of people with an increased risk of developing flu complications, understanding the facts about the flu vaccine is a top priority. According to the American College of Obstetrics and Gynecologists (ACOG), pregnant women can get the flu vaccination at any time in their pregnancy, but it is best to get one early in the flu season, October through May.

The vaccine can be given in two ways, a shot or a nasal mist. The mist is not recommended for pregnant women, although it’s safe for women who have just given birth and are breastfeeding.

Protecting yourself from the flu is only half of the benefit; the other half is the protection it gives your baby. The vaccine decreases your risk of getting the flu while you’re pregnant and then keeps your baby protected for the first six months of life. If you do happen to catch the flu after getting the flu shot, it is usually a much more mild sickness.

“The flu shot is critically important for pregnant women because they are at a much higher risk of life-threatening complications from the flu. We also recommend that all immediate caregivers such as partners and grandparents get themselves protected with a flu shot to provide a ‘cocoon’ of immunity around the new baby”, said Dr. Sperry Schlueter.

Don’t get caught by the flu, get your vaccination early. Mild side effects like a sore arm and a low fever for a few days are a minor annoyance when compared to the flu virus.

The Centers for Disease Control and Prevention has information on their website about the vaccination and pregnancy. https://www.cdc.gov/flu/protect/vaccine/qa_vacpregnant.htm.

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

 

Pregnant? Stop before you put that cheesy snack in your mouth

The 411 on cheese you can eat when pregnantFor those of us with a deep love of cheese including those fancy stinky foreign cheeses pregnancy can put a bit of a dampener on our cheese adoration.  Don’t worry, that slice of pizza is probably just fine, but the slice of apple with brie or the salad with Roquefort cheese is out. Confused as to whether you can chow down on mozzarella or inhale camembert? Read on.

What cheeses should I avoid during pregnancy?

Generally you can divide the cheeses you shouldn’t eat into two groups, those soft crumbly blue veined cheeses like Danish blue and gorgonzola and soft cheeses like brie and camembert.
  • Brie
  • Camembert
  • Chevre (a soft goats cheese that often comes in a log like form)
  • Danish blue
  • Gorgonzola
  • Roquefort
  • Queso fresco

But I have an undeniable craving for brie or a blue cheese salad! What should I do?

A baked brie and a pastry crust is a little bit of heaven and it’s a treat you can still enjoy when pregnant! Cooking to 165F should kill any bacteria and make it safe to eat. Can’t live without your gorgonzola sprinkles on your salad, you like cheese with some flavor after all? Try a hard stilton cheese instead.

Just why are some cheeses a no-no during pregnancy?

Soft cheeses tend to contain more listeria bacteria than those that might be present in hard cheeses. Listeria bacteria can cause an infection called listeriosis which pregnant women are at a great risk of getting due to hormonal changes- 13 times more likely. While it might cause merely mild flu-like symptoms in the woman or even no symptoms the impact on the fetus can be significant. If a pregnant woman develops listeriosis it can cause premature delivery, miscarriages and still births. Early treatment with antibiotics may prevent fetal infection. Listeria bacteria is present in other foods.  Alicia Arino, clinical dietitian at TMC, adds “Unpasteurized cheese and milk can also cause Brucellosis (a food borne illness caused by ingestion of raw milk, unpasteurized cheeses, or raw meat) which can have particularly harmful effects during pregnancy.

So what cheeses can I eat?

It’s safe to eat hard cheeses ex.  Gouda, gruyere, parmesan and cheddar and the following soft cheeses are safe as long as they’re made from pasteurized milk: ricotta, cream cheese, cottage cheese, mozzarella, feta and some goat cheeses.
Alicia Arino is a clinical dietitian, board certified lactation consultant and Assistant Manager of Clinical Nutrition at Tucson Medical Center.
 

Pregnancy and Back Pain – Tips from an Expert

pregnancy-back-pain

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

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

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

Why do so many pregnant women experience backaches?

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

What can you do to prevent backaches during pregnancy?

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

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

When to contact a physical therapist?

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

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

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

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

How to perform a squat

Evens provided these tips for performing an effective squat:

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

Remember good squats require good hip strength and flexibility.

 

This post was first shared on May 1, 2014

Recent breast cancer diagnosis? Advice from breast cancer survivors

Vanessa H-B.jpg

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

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

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

2. Write down your questions

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

3. Beware of Dr. Google

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

4. Talk to your doctor about risk and benefits

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

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

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

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

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

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

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

8. Let people know what you need from them

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

 

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

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

 

 

One foot at a time – Newborn screening

Electine Orido RN and Baby Cash

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

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

Find out more about the Arizona Newborn Screening Panel

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

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

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

What is involved in newborn screening?

Kassandra and baby Cash

1. Blood Test

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

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

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

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

2. Pulse Oximetry

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

3. Bilirubinometer

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

4. Newborn hearing screening

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

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

Find out more: FREE maternity services tour.

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

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

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

Why are women placed on bed rest?

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

Primarily, we see women who:

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

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

How the TMC for Women Antepartum Program supports women

Addressing the whole person

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

Combating loneliness

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

Knowing what to expect

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

Making a home away from home

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

Conquering boredom

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

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

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

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

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

Take a FREE tour of our maternity services.

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

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

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

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

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

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

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

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

 

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