livingwell az- march 2013

8
HEALTHCARE News How does AGING impact pain and pain management? ANSWER: As we age, it becomes more important to treat pain quickly to prevent it from becoming chronic, said Nikesh Seth, M.D., an anesthesiologist and pain management specialist with Scottsdale Healthcare Comprehensive Pain Center. “Older people may wait weeks or months before they seek help for knee pain, for example,” he said. “Where a 22-year-old’s knee pain might resolve fairly quickly, an older person’s knee pain could be more severe and if not treated appropriately, might lead to the need for more aggressive treatment.” Tutankhamen Pappoe, M.D., a physical medicine and rehabilitation physician with East Valley Spine and Sports Medicine Center in Mesa, agreed that older patients may not report their pain to their doctor as readily as younger patients. “Sometimes patients mistakenly believe that aches or pains are a normal part of aging, so they don’t mention it,” he said. “Or they’re scared it might indicate a serious disease, so they’re reluctant to bring up the subject.” Because the liver and kidneys may not be working optimally in an older patient, Pappoe explained, medication dosages and an increased possibility of medication side effects are important considerations for a physician prescribing a pain management program for an older patient. Pain, pain, go away... Chronic pain affects millions of Americans BY DEBRA GELBART Continued on page 4 PAIN MANAGEMENT HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILY THE ARIZONA REPUBLIC A SPECIAL PUBLICATION CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING Vol. 3, No. 3 March 2013 HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILY A SPECIAL PUBLICATION CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING w e l l az - az - 50 AND FEARLESS: SCREENING COLONOSCOPIES SAVE LIVES Tory McJunkin, M.D., a double-board-certified interventional pain medicine physician, anesthesiologist and co-founder of Arizona Pain Specialists, gave Josh Filani a platelet-rich plasma treatment for Filani’s aching knees. Filani said the treatment gave him a complete turnaround in how he feels when he plays basketball and participates in other physical activities. RICK D’ELIA Does DEPRESSION cause pain or does pain cause depression? ANSWER: More than 50 percent of people who suffer from chronic pain develop clinically significant depression or anxiety, said Tory McJunkin, M.D., a double-board- certified interventional pain medicine physician, anesthesiologist and co-founder of Arizona Pain Specialists, a medical practice with locations in Scottsdale, Glendale and Chandler. In more than 50 percent of patients with diagnosed depression, said Ian Sadler, Ph.D., staff clinical psychologist at the Arizona Burn Center in Phoenix, pain of some sort is one of their most common physical complaints. Sadler, who is also a clinical assistant professor in the departments of psychiatry and surgery at the University of Arizona College of Medicine in Phoenix, also said that in some patients who have depression, the perception of pain is heightened. On the flip side, he noted that if someone has lingering pain from an injury and the person’s activity level or socialization is affected, he or she can easily become depressed. Sadler said narcotic medications for chronic pain can complicate clinical depression, because the medications by nature depress the central nervous system. When anti-depressant medications are added to pain medications, however, there are often beneficial effects, he said, “because if mood improves, the patient often experiences less pain.” Banner physician honored for Alzheimer’s research The American Academy of Neurology and the American Brain Foundation awarded the 2013 Potamkin Prize for Research in Pick’s, Alzheimer’s and Related Diseases to three physicians, including Eric M. Reiman, M.D., with Banner Alzheimer’s Institute. Reiman is being honored for his efforts to characterize some of the earliest brain changes associated with the predisposition to Alzheimer’s, accelerating the evaluation of promising prevention therapies and helping establish the Alzheimer’s Prevention Initiative. Reiman, the author of more than 250 research publications, is internationally recognized for his contributions to the fields of brain imaging, behavioral neurosciences and the study of Alzheimer’s before the onset of symptoms. More info: aan.com/patients; banneralz.org Trial of pancreatic cancer drugs show great promise An international clinical trial led by physicians from Scottsdale Healthcare’s Virginia G. Piper Cancer Center shows that a combination of cancer drugs Abraxane and gemcitabine extends survival of late-stage pancreatic cancer patients compared to standard treatment. Study results showed a 59 percent increase in one-year median survival rates and more than double the two-year survival rate for patients receiving Abraxane plus gemcitabine, compared to patients receiving only gemcitibine. Daniel Von Hoff, M.D., chief scientific officer for Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare and TGen’s physician-in- chief, served as international lead investigator for the MPACT (Metastatic Pancreatic Adenocarcinoma Clinical Trial) study. Ramesh Ramanathan, M.D., medical director of Virginia G. Piper Cancer Center Clinical Trials at Scottsdale Healthcare, was principal investigator for the clinical trial in the United States. The MPACT study is the largest phase III clinical trial completed in advanced pancreatic cancer with more than 800 patients in 11 countries. More info: 480-323-1339; 877-273- 3713; [email protected]; shc.org IN THIS ISSUE: COVER/04: PAIN AND PAIN MANAGEMENT 02: FOOT SMART, SHOE SAVVY 03: VISION SURGERY 04: SUPPORT GROUPS/EVENTS 05: SUPPORT GROUPS/DEALS 06: EARLY-ONSET PUBERTY 07: CARPAL TUNNEL SYNDROME Whether it’s fear of the prep, the procedure or potential results, fear is the top reason most 50-year-olds avoid a colonoscopy. To help ease these fears, Scottsdale Healthcare has launched its 50andFearless.org health education campaign featuring former NFL all-pro fullback Ron Wolfley. A screening colonoscopy is recommended starting at age 50, but if there is a family history, screenings should begin at age 40. The Centers for Disease Control and Prevention estimates that up to 60 percent of colorectal cancer deaths could be prevented if everyone aged 50 years and older were routinely screened. Visit 50andFearless.org for more information about screening and scheduling a colonoscopy, treatment options and more. Tutankhamen Pappoe, M.D., front, is a physical medicine and rehabilitation physician with East Valley Spine and Sports Medicine Center. Pappoe and the center’s physical therapy director, Drew Marchesi, are working with Marcia Davis of Mesa, who had a hip replacement and other procedures. S ince finding accurate information about various aspects of pain can be challenging, we asked local experts some important questions related to pain. Reiman Virginia G. Piper Cancer Center Characteristic Rehabilitation Hospital Nursing Home Frequent visits by an at- tending physician Required Not required Multidisciplinary team approach Required Not required RN oversight and availability 24 hours/day At least 8 consecutive hours/day Specialty nursing training, rehabilitation expertise 5 - 7.5 hours/day 2.5 - 4 hours/day PT, OT, and/or speech therapy level of service 3 hours/day (minimum) No minimum ©2011:HealthSouth Corporation:473726 HealthSouth East Valley Rehabilitation Hospital 5652 E. Baseline Road # Mesa, AZ 85206 480 567-0350 # Fax 480 567-0352 healthsoutheastvalley.com HealthSouth Scottsdale Rehabilitation Hospital 9630 E. Shea Blvd. # Scottsdale, AZ 85260 480 551-5400 # Fax 480 551-5401 healthsouthscottsdale.com HealthSouth Valley of the Sun Rehabilitation Hospital 13460 N. 67th Ave. # Glendale, AZ 85304 623 878-8800 # Fax 623 334-5360 healthsouthvalleyofthesun.com A Higher Level of Care Choose HealthSouth: You Deserve a Higher Level of Care +,1 /(% $)&&%-%+#% "%/1%%+ ! rehabilitation hospital !+$ ! +0-.)+’ (,*%

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Jealthcare news you can use for your whole family

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HEALTHCARENews

How does AGING impactpain and painmanagement?ANSWER: As we age, it becomes moreimportant to treat pain quickly to preventit from becoming chronic, said NikeshSeth, M.D., an anesthesiologist and painmanagement specialist with ScottsdaleHealthcare Comprehensive Pain Center.“Older people may wait weeks or

months before they seek help for kneepain, for example,” he said. “Where a22-year-old’s knee pain might resolvefairly quickly, an older person’s knee paincould be more severe and if not treatedappropriately, might lead to the needfor more aggressive treatment.”Tutankhamen Pappoe, M.D., a physical

medicine and rehabilitation physician

with East Valley Spine and SportsMedicine Center in Mesa, agreed thatolder patients may not report their painto their doctor as readily as youngerpatients. “Sometimes patients mistakenlybelieve that aches or pains are a normalpart of aging, so they don’t mentionit,” he said. “Or they’re scared it mightindicate a serious disease, so they’rereluctant to bring up the subject.”Because the liver and kidneys may

not be working optimally in an olderpatient, Pappoe explained, medicationdosages and an increased possibility ofmedication side effects are importantconsiderations for a physician prescribinga pain management program for anolder patient.

Pain, pain, go away...Chronic pain affects millions of Americans BY DEBRA GELBART

Continued on page 4 PAINMANAGEMENT

HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILYTHE ARIZONA REPUBLIC A SPECIAL PUBLICATION CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING Vol. 3, No. 3 March 2013HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILYA SPECIAL PUBLICATION CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING

wellaz-az-

50 AND FEARLESS: SCREENING COLONOSCOPIES SAVE LIVES

Tory McJunkin, M.D., a double-board-certified interventional pain medicine physician, anesthesiologist and co-founder of ArizonaPain Specialists, gave Josh Filani a platelet-rich plasma treatment for Filani’s aching knees. Filani said the treatment gave hima complete turnaround in how he feels when he plays basketball and participates in other physical activities.

RICKD’ELIA

Does DEPRESSION causepain or does pain causedepression?ANSWER: More than 50 percent ofpeople who suffer from chronicpain develop clinically significantdepression or anxiety, said ToryMcJunkin, M.D., a double-board-certified interventional pain medicinephysician, anesthesiologist andco-founder of Arizona Pain Specialists,a medical practice with locations inScottsdale, Glendale and Chandler.In more than 50 percent of patients

with diagnosed depression, said IanSadler, Ph.D., staff clinical psychologistat the Arizona Burn Center in Phoenix,pain of some sort is one of theirmost common physical complaints.Sadler, who is also a clinical assistantprofessor in the departmentsof psychiatry and surgery at theUniversity of Arizona College ofMedicine in Phoenix, also said that insome patients who have depression,the perception of pain is heightened.On the flip side, he noted that ifsomeone has lingering pain from aninjury and the person’s activity level orsocialization is affected, he or she caneasily become depressed.Sadler said narcotic medications for

chronic pain can complicate clinicaldepression, because the medicationsby nature depress the central nervoussystem. When anti-depressantmedications are added to painmedications, however, there are oftenbeneficial effects, he said, “becauseif mood improves, the patient oftenexperiences less pain.”

Bannerphysicianhonored forAlzheimer’s researchThe American Academy of Neurologyand the American Brain Foundationawarded the 2013 Potamkin Prize for

Research in Pick’s,Alzheimer’s andRelated Diseases tothree physicians,including Eric M.Reiman, M.D., withBanner Alzheimer’sInstitute.

Reiman is being honored for his effortsto characterize some of the earliestbrain changes associated with thepredisposition to Alzheimer’s, acceleratingthe evaluation of promising preventiontherapies and helping establish theAlzheimer’s Prevention Initiative.Reiman, the author of more than 250

research publications, is internationallyrecognized for his contributions tothe fields of brain imaging, behavioralneurosciences and the study ofAlzheimer’s before the onset ofsymptoms.More info: aan.com/patients;

banneralz.org

Trial ofpancreaticcancerdrugs showgreatpromiseAn international clinical trial led byphysicians from Scottsdale Healthcare’sVirginia G. Piper Cancer Center showsthat a combination of cancer drugsAbraxane and gemcitabine extendssurvival of late-stage pancreaticcancer patients compared to standardtreatment.Study results showed a 59 percent

increase in one-year median survivalrates and more than double thetwo-year survival rate for patientsreceiving Abraxane plus gemcitabine,compared to patients receiving onlygemcitibine.Daniel Von Hoff, M.D., chief scientific

officer for Virginia G. Piper CancerCenter Clinical Trials at ScottsdaleHealthcare and TGen’s physician-in-chief, served as international leadinvestigator for the MPACT (MetastaticPancreatic Adenocarcinoma ClinicalTrial) study.Ramesh Ramanathan, M.D., medical

director of Virginia G. Piper CancerCenter Clinical Trials at ScottsdaleHealthcare, was principal investigatorfor the clinical trial in the United States.TheMPACT study is the largest phase IIIclinical trial completed in advancedpancreatic cancer with more than800 patients in 11 countries.More info: 480-323-1339; 877-273-

3713; [email protected]; shc.org

IN THIS ISSUE:COVER/04: PAIN AND PAINMANAGEMENT02: FOOT SMART, SHOE SAVVY03: VISION SURGERY04: SUPPORT GROUPS/EVENTS05: SUPPORT GROUPS/DEALS06: EARLY-ONSET PUBERTY07: CARPAL TUNNEL SYNDROME

Whether it’s fear of the prep, theprocedure or potential results, fearis the top reason most 50-year-oldsavoid a colonoscopy. To help easethese fears, Scottsdale Healthcare haslaunched its 50andFearless.org healtheducation campaign featuring formerNFL all-pro fullback Ron Wolfley.

A screening colonoscopy isrecommended starting at age 50, but ifthere is a family history, screenings shouldbegin at age 40. The Centers for DiseaseControl and Prevention estimates that upto 60 percent of colorectal cancer deathscould be prevented if everyone aged 50years and older were routinely screened.

Visit 50andFearless.orgfor more information aboutscreening and schedulinga colonoscopy,treatment optionsand more.

Tutankhamen Pappoe, M.D., front, is a physical medicine and rehabilitation physician with EastValley Spine and Sports Medicine Center. Pappoe and the center’s physical therapy director, DrewMarchesi, areworkingwithMarciaDavis ofMesa,whohadahip replacement andother procedures.

Since finding accurate information about various aspectsof pain can be challenging, we asked local experts some

important questions related to pain.

Reiman

Virginia G. Piper Cancer Center

Characteristic RehabilitationHospital

Nursing Home

Frequent visits by an at-tending physician

Required Not required

Multidisciplinaryteam approach

Required Not required

RN oversight andavailability

24 hours/day At least 8 consecutivehours/day

Specialty nursing training,rehabilitation expertise

5 - 7.5 hours/day 2.5 - 4 hours/day

PT, OT, and/or speechtherapy level of service

3 hours/day(minimum)

No minimum©2011:HealthSouth Corporation:473726

HealthSouth East Valley Rehabilitation Hospital5652 E. Baseline Road Mesa, AZ 85206

480 567-0350 Fax 480 567-0352

healthsoutheastvalley.com

HealthSouth Scottsdale Rehabilitation Hospital9630 E. Shea Blvd. Scottsdale, AZ 85260

480 551-5400 Fax 480 551-5401

healthsouthscottsdale.com

HealthSouth Valley of the SunRehabilitation Hospital

13460 N. 67th Ave. Glendale, AZ 85304623 878-8800 Fax 623 334-5360

healthsouthvalleyofthesun.com

A Higher Level of CareChoose HealthSouth:You Deserve a Higher Level of Care

rehabilitation hospital

Foot smart and shoe savvyTake care of your feet and they’ll likely take care of you BY ELISE RILEY

VITAL Signs

“I would say that 80 to 90 percent ofpeople are misfit in their current footwear,”Orischak said. “They buy what they alwaysbought, or they buy self-help. If you’rewide, you buy shoes that are too long. Ifyou’re narrow, they’re too short. If you’rea man, you buy the same shoe you worein college — no matter what.”

Orischak said her team takes fourdifferent measurements of each foot toensure a proper fit. Correct sizing andfitting aligns the body and maintains aproper gait; incorrect sizing or fitting canresult in bunions, inflammation, plantarfasciitis, fungal infections —and yes,football fans — turf toe.

Careful with high heelsBeing careful doesn’t mean aficionadoscan never wear their beloved catwalk-styleJimmy Choos. Just like with your diet, it’sall about moderation.

“There is a lot of compelling evidenceout there about how footwear can leadto serious orthopedic problems,” saidDenise McGinley, RN, MSNAd, directorof the Center for Orthopaedic Innovationat St. Luke’s Medical Center in Phoenix.“The real culprit is not so much the styleof shoes, it’s how much time you spend

in them. Wearing babydoll flats is just asunhealthy as wearing six-inch stilettos ifyou wear them every day. It puts a lot ofunnatural stress on your bones and joints.”

Aging a culpritAs with most of our physical attributes,as we age, our feet change. For example,the fat pockets at the bottoms of our feetshrink and our arch-support needs change.

Simply due to aging, expertsrecommend getting re-sized every yearor two. You should also toss out those oldsneakers after about a year — chances aregood they’ve worn out their welcome andyou’ve worn out support in the shoeby then.

L ieutenant Dan had plenty of pearlsof wisdom in Forrest Gump. But did

you know he offered us some sagehealth advice?

“First,” he said, “take care of your feet.”It’s true. The eyes might be the windows

to your soul, but your body’s foundationis in your soles. The health of your feetaffects the rest of your body — jointhealth, pain management, you name it.

“Your body is built around anarchitectural system, the skeleton, and thefeet are the foundation,” said Sue Orischak,a certified pedorthotist and owner of FootSolutions in Scottsdale. A pedorthotistis someone who specializes in the useof footwear and supportive devices toaddress foot conditions.

Orischak notes that anything that’s awrywith the foot is going to mirror itself allthe way up to the head. Instability in yourfeet forces your body to compensate insome capacity, meaning knee and/or hipissues are common, as is back pain, if footproblems are ignored.

Size it upWhen it comes to shoes, it starts withchoosing not only the right kinds of shoes,but also the best-fitting shoes.

5FYIsregarding feet

1 There’s really no differencebetween men’s and women’sshoes. Men’s tend to be a bitwider. Ergo, if women havetrouble finding athletic shoesthat fit, a men’s shoe might bethe solution.

2 Socks matter. The material andcompression of your socks isimportant for your foot health.Just be careful with cotton socks— they keep moisture on yourfeet and can promote fungalinfections. Instead, some expertsadvise selecting microfiber,wool or silk.

3 Buy running shoes for dailywear. There’s a differencebetween a running shoe and across-trainer. Running shoes aredesigned to help the foot springthrough a step. They tend tohave more architectural support.

4 Constantly wearing flip-flopscan be as bad as alwayswearing high heels. Walkingin flip-flops eliminates any archsupport which can result injoint issues. Similarly, high-heelwearing can shorten the Achillestendon which means walking inflats later on can be painful.

5 Pedicures are not just a vanitytreatment.A professional pedicure isactually good for your feet; itremoves dead skin, promotescirculation and can keep yournails healthy. Just make sure yougo to a nail salon that followsproper health-code procedures.

— Elise Riley

THINKS

TOCK

General Manager:CAMI KAISER, [email protected]

Manager Creative Development:ISAAC MOYA, [email protected]

Editor: PAULA HUBBS COHEN, [email protected]

Contributing Editor:JIM WILLIAMS, [email protected]

Managing Art Director:TRACEY PHALEN, [email protected]

A division of The Arizona Republic.200 E. Van Buren St., Phoenix, AZ 85004

Design: LISA QUIRIN, [email protected]

Republic Media Intern: NICK KOSTENKO

Advertising: RHONDA PRINGLE, 602-444-4929,[email protected]. For general advertisinginquiries, contact Republic Media at 602-444-8000.

Look for Livingwell a-z on the first Wednesday of each month! Each month, we bring you local health information you can use to keep you andyour family living well. From A to Z, we tackle a broad range of health issues and offer you a wealth of resources where you can find more specific information. This publication is produced byRepublic Media Custom Publishing. For questions concerning any content included in this publication please contact: Editor Paula Hubbs Cohen, [email protected] or call 602-444-8658.

ResourcesAmerican Orthopaedic Foot andAnkle Society: aofas.org/footcaremd

Center for Orthopaedic Innovationat St. Luke’s Medical Center:stlukesmedcenter.com/services/orthopedic

Foot Solutions: footsolutions.com

WebMD: webmd.com

2 | LIVING WELL A-Z | WEDNESDAY, March 6, 2013

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*Sources: Journal of the American Medical Association, American Academy of Orthopaedic Surgeons

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invasively by replacing only select layersof the cornea, a procedure that usuallyheals in about six to eight weeks.”

Elective surgeriesWhile surgical intervention is sometimesa medical necessity, less severe visiondeficiencies like nearsightedness(difficulty seeing distant objects),farsightedness (difficulty seeing closeobjects) and astigmatism (distorted orblurred vision) can be managed withcorrective eyewear. However, advancedlasers and precision blades used inrefractive or laser vision correctionsurgery present several practical andpopular options for saying goodbye toglasses.

Perkins described LASIK (laser-assisted in situ keratomileusis), PRK(photorefractive keratectomy) and ICL(implantable contact lenses) as threecommon types of refractive surgery thatare eliminating the need for correctiveeyewear. However, he cautioned thatsince fluctuations in vision continueinto early adulthood, refractive surgeryshould not be performed until visionstabilizes, typically around age 20.

ResourcesAmerican Society of Cataractand Refractive Surgery: ascrs.org

Barnet Dulaney Perkins Eye Center:goodeyes.com

Nationwide Vision:nationwidevision.com

Southwestern Eye Center: sweye.com

If you’re having trouble seeing straight,vision surgery just might help bring

things into focus.According to the National Eye Institute,

part of the National Institutes of Health,more than 150 million Americans rely oncorrective eyewear due to a refractiveerror that prevents the eye from focusingclearly. Hoping to shed glasses, contactlenses and medications as well as correctage- and health-related vision problems,more people are increasingly takingadvantage of innovations in visionsurgery.

Cataract surgery“Cataract surgery is by far the numberone vision surgery performed in thiscountry,” said Scott Perkins, M.D., anophthalmologist and medical directorat Barnet Dulaney Perkins Eye Center.“Generally an age-related condition, mostpeople undergo cataract surgery in their70s.” Cataracts develop when the lensinside the eye becomes yellow or cloudyand impairs vision.

The National Eye Institute reportsthat half of all Americans have acataract by age 80. Treatment entailssurgically removing the obscured lensand replacing it with an artificial one.Replacement lens options include thosethat enhance either distance or closevision, and while some newer lenses doboth, they are not usually covered byinsurance and may be cost-prohibitive.If you’re interested in this option, checkwith your insurance carrier for coveragedetails.

Corneal transplantationIn addition to popular procedures likecataract surgery, Daryl Pfister, M.D., anophthalmologist and cornea and cataractspecialist at Southwestern Eye Center,noted that corneal transplantation maybe necessary to treat some types ofcorneal disease or damage.

“There are new options for corneatransplants that weren’t around just a fewyears ago,” Pfister explained. “Transplantsthat once required replacing the fullthickness of the cornea [the outermostlayer of the eye] and took up to 18months to heal can now be done less

Vision surgerymay be key to staying focusedCurative benefits of eye surgery BY KRISTINE BURNETT

THINKS

TOCK

3conditions in whichvision surgerymight be helpful

1 Diabetic retinopathy(diabetic condition causing bloodvessels in the eye to leak)

2 Glaucoma (increased pressure insidethe eye that can lead to blindness)

3 Macular degeneration (chroniccondition causing central vision loss)

Correction vs. cataractsPfister said that if someone is overabout age 50 and is considering laservision correction such as LAKIK, PRK orICL, they should first be evaluated forcataract surgery. Although laser visioncorrection does not exclude someonefrom future cataract surgery, it can makethe procedure more difficult to predictrefractive results.

“If you’re at an age where you’re makinga choice between laser vision correctionand cataract surgery, go with cataractsurgery,” Pfister suggested.

Laser visioncorrectionafter age 50LASIK and PRK are the mostpopular forms of refractivesurgery, but they are not foreveryone. Due to the onset ofcataracts, those in their 50s and60s may achieve better resultsfrom a procedure called a clearlens exchange, also known asrefractive lensectomy, accordingto Mark Peller, O.D., vice presidentof professional services atNationwide Vision.

As with cataract surgery, clearlens exchange replaces the naturallens with a synthetic one. Oncedone, a cataract will never developin that eye. The procedure alsoimproves nearsightedness andfarsightedness. Jodi Mitchell,director of operations forrefractive surgery at NationwideVision Laser Center, explained thatreading glasses are typically stillneeded after LASIK and PRK, but aclear lens exchange may eliminatethe need for glasses altogether.

Several factors can precludesomeone from having refractivesurgery, including certainmedications, disease pathologiesand irregular corneal shape andthickness. Since refractive surgeryisn’t ‘one size fits all’, individualhealth and lifestyle factors mustbe considered.

WEDNESDAY, March 6, 2013 | LIVING WELL A-Z | 3

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All groups and events are believed,but not guaranteed, to be free unlessotherwise stated. Every effort has beenmade to verify accuracy, but please callbefore attending to confirm details.

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WALKING GROUPVarious dates & timesBy Humana Guidance Centerat RedMountain Park7745 E. Brown Rd., MesaRegister: 480-325-4707

WEIGHT LOSS SURGERY SEMINARSVarious dates, times & locationsBy Scottsdale HealthcareRegister: bariatricsurgeryaz.com;480-882-4636

WEIGHT LOSS SURGERY SEMINARSVarious dates, times & locationsBy St. Luke’s Medical CenterRegister: 800-248-5553

LIVINGWITH ARTHRITISMarch 6, 7–8 p.m.By Scottsdale Healthcareat Barnes & Noble10500 N. 90 St., ScottsdaleRegister: shc.org/events; 480-882-4636

BACK PAIN 101March 7, noon–1 p.m.Mountain VistaMedical Center1301 S. Crismon Rd., MesaRegister: 877-924-9355

ADVANCE CARE PLANNINGMarch 8, 10–11:30 a.m.By Sun Health at First Baptist Church11019W. Peoria Ave., Sun CityRegister: 623-455-5633; sunhealth.org

TOTAL JOINT REPLACEMENTMarch 13, 20 & 27, 9 a.m.Banner Gateway1900 N. Higley Rd., Gilbert602-239-2273

EXERCISE FOR LOW BACK PAINMarch 13, 1–2 p.m.By Scottsdale Healthcareat Appaloosa Library7377 E. Silverstone Dr., ScottsdaleRegister: shc.org/events; 480-882-4636

CHOLESTEROL & YOUMarch 18, noon–1 p.m.Mountain VistaMedical Center1301 S. Crismon Rd., MesaRegister: 877-924-9355

BLOOD PRESSURE CLINICSMarch 19, 9 –11 a.m.By Sun Health at Grandview Care Center14505W. Granite Valley Dr.,Sun CityWest (walk-ins welcome)

ALLERGIES & SINUSPLASTYMarch 20, 6:30 p.m.By John C. Lincoln at Cowden Center9202 N. Second St., Phoenix623-434-6265

HEALTHY VISION FOR LIFEMarch 20, 7–8 p.m.By Scottsdale Healthcareat Barnes & Noble10500 N. 90 St., ScottsdaleRegister: shc.org/events; 480-882-4636

MAKOPLASTY SEMINARMarch 21, 6–7 p.m.Arrowhead Hospital18701 N. 67 Ave., GlendaleRegister: 855-292-9355;azhealthyhours.com

TOBACCO CESSATION PROGRAMMarch 21, 6–7 p.m.Scottsdale Healthcare Osborn7301 E. Fourth St., ScottsdaleRegister: shc.org/events; 480-882-5761

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CONGESTIVE HEART FAILUREMarch 6, 13, 20 & 27, 6:30–7:30 p.m.Chandler Regional1955W. Frye Rd., Chandler480-728-5414

STROKEMarch 7, 1:30–2:30 p.m.Banner Boswell Rehab10601W. Santa Fe Dr., Sun City623-832-7000

STROKE SUPPORTMarch 14, 10 a.m.Banner Thunderbird5555W. Thunderbird Rd., Glendale602-230-2273

STROKE SUPPORT GROUPMarch 14, 1:30–3 p.m.Banner Baywood6644 E. Baywood Ave., Mesa480-321-4790

STROKE SURVIVORMarch 14, 2:30–4 p.m.Chandler Regional1875W. Frye Rd., Chandler480-728-5414

HEART-HEALTHY EATINGMarch 19, 11 a.m.Banner Heart Hospital6750 E. Baywood Ave., Mesa480-854-5401

STROKE SUPPORT GROUPMarch 19, 3–4 p.m.Mountain VistaMedical Center1301 S. Crismon Rd., MesaRegister: 877-924-9355

WOMEN’S CARDIAC HEALTHMarch 26, 9:30–10:30 a.m.By Sun Health and Banner Healthat Banner Boswell13180 N. 103 Dr., Sun CityRegister: 623-455-5633; sunhealth.org

STROKE CAREGIVERMarch 28, 2:30–3:30 p.m.Mercy Gilbert3420 S. Mercy Rd., Gilbert480-728-5414

CARDIAC REHAB SUPPORTApril 1, 5 p.m.Banner Desert1530 S. Dobson Rd., Mesa480-412-3785

DIABETES

DIABETES SUPPORT GROUPCardon Children’s Medical Center1400 S. Dobson Rd., MesaCall for dates & times: 480-412-4557

TAKING CONTROL OF DIABETESVarious dates, 6–7 p.m.By Abrazo Healthat Pastoral Care Associates2040W. Bethany Home Rd., PhoenixRegister: 855-292-9355;azhealthyhours.com

TAKING CONTROL (3-CLASS SERIES)Various dates & timesParadise Valley Hospital3815 E. Bell Rd., PhoenixRegister: 602-923-5813;[email protected]

DIABETES SUPPORT GROUPMarch 11, 3–4 p.m.Mountain VistaMedical Center1301 S. Crismon Rd., MesaRegister: 877-924-9355

DIABETES SUPPORT GROUPMarch 14, 1–2 p.m.St. Luke’s Medical Center1800 E. Van Buren St., PhoenixRegister: 877-351-9355

DIABETES SUPPORTMarch 19, 3–4 p.m.Banner Baywood6644 E. Baywood Ave., Mesa480-321-4578

DIABETES PUMPERS GROUPMarch 19, 7–8 p.m.ByMercy Gilbert at Rome Towers1760 E. Pecos Rd., Gilbert; 480-728-3535

ALZHEIMER’S/DEMENTIA

ALZHEIMER’S &MEMORY SUPPORTVarious dates, times & locationsBy Benevilla; 623-584-4999

COMPASS FOR CAREGIVERSVarious dates & timesBanner Alzheimer’s Institute901 E.Willetta St., PhoenixRegister: [email protected];602-839-6850

SUPPORT GROUPMarch 8, 12:30–2 p.m.Banner Alzheimer’s Institute901 E.Willetta St., PhoenixRegister: [email protected];602-839-4617

MEMORY SCREENINGMarch 15, 9 a.m.–1 p.m.By Banner Alzheimer’s Instituteat Pecos Community Center17010 S. 48 St., PhoenixRegister: 602-230-2273

SUPPORT GROUPLunch providedMarch 17, 11 a.m.–12:30 p.m.St. Joseph’s Huger Mercy2345W. Orangewood Ave., Phoenix623-406-5600

CAREGIVER SUPPORTMarch 18, 1:30–3 p.m.By St. Luke’s at Pyle Adult Rec. Center655 E. Southern Ave., TempeRegister: 877-351-9355

CAREGIVER SUPPORT (DUET)March 19, 12:30–2 p.m.Church of the Beatitudes555W. Glendale Ave., Phoenix602-274-5022

CAREGIVERS SUPPORT GROUPMarch 25, 1:30–3:30 p.m.Banner Sun Health Research10515W. Santa Fe Dr., Sun City623-832-5328

CAREGIVERS SUPPORTApril 1, 3–4:30 p.m.Banner Estrella9201W. Thomas Rd., Phoenix602-528-0545

SENIORS

MEDICATION CHECKSMarch 6, 11 a.m.–noonSt. Luke’s Medical Center1800 E. Van Buren St., PhoenixRegister: 877-351-9355

HEARING SCREENINGMarch 8, 1–4 p.m.Tempe St. Luke’s1500 S. Mill Ave., TempeRegister: 877-924-9355

DEPRESSION IN SENIORSMarch 19, noon–1 p.m.St. Luke’s Medical Center1800 E. Van Buren St., PhoenixRegister: 877-351-9355

DEMENTIA/DELIRIUM/DEPRESSIONMarch 19, 1-5 p.m.ByAZGeriatrics Society at Foundationfor Senior Living Caregiver House1201 E. Thomas Rd., PhoenixRegister: 602-265-0211

WOMEN&CANCER

GYNECOLOGICMarch 12, 5–6:15 p.m.Banner Desert1400 S. DobsonRd.,Mesa; 480-412-4673

YOUNGWOMEN’S SUPPORTMarch 12, 6:30 p.m.Banner Thunderbird5555W. Thunderbird Rd., Glendale602-865-5450

FACING FORWARDMarch 13, 1–3 p.m.Virginia G. Piper Cancer Center10460 N. 92 St., ScottsdaleRegister: shc.org/events; 480-882-4636

CANCERSUPPORT

LOOK GOOD, FEEL BETTERVarious dates, times & locationsIronwood Cancer & ResearchRegister: 480-855-2224

YOGA FOR CANCER PATIENTSVarious dates & timesBanner MD Anderson2946 E. Banner Gateway Dr., Gilbert480-256-4141

YOGA/MEDITATIONMarch 7 & 21, 6–8 p.m.By John C. Lincoln andTheWellness Community19841 N. 27 Ave., Phoenix602-712-1006

LARYNGECTOMEEMarch 21, 1 p.m.Banner MD Anderson2946 E. Banner Gateway Dr., Gilbert480-256-4141

COLORECTALMarch 21, 6 p.m.Banner Thunderbird5555W. Thunderbird Rd., Glendale602-865-5450

ESOPHAGEALMarch 21, 6–7:30 p.m.Banner Good Samaritan1111 E. McDowell Rd., Phoenix602-839-4970

ORAL, HEAD & NECKMarch 21, 6:30–8 p.m.Virginia G. Piper Cancer Center10460 N. 92 St., Scottsdale602-439-1192

I CAN COPEMarch 25, 6 p.m.Banner Thunderbird5555W. Thunderbird Rd., Glendale602-865-5450

LYMPHEDEMAMarch 25, 6:30–8:30 p.m.Virginia G. Piper Cancer Center10460 N. 92 St., ScottsdaleRegister: 480-882-4636; shc.org/events

PANCREATICMarch 27, 9–11 a.m.By Sun Health at Grandview Care Center14505W. Granite Valley Dr.,Sun CityWestRegister: 623-455-5633; sunhealth.org

LIVING & COPINGMarch 28, 4:30 p.m.Banner MD Anderson2946 E. Banner Gateway Dr., Gilbert480-256-4141

Take advantage of more than 100 opportunities foryou to meet others with similar issues and learn moreabout various aspects of your health – from A to Z.

Please call to confirmreservations and cost (if any).

March 9BreastCancerCopingCampWHAT: Seminars for survivors,spouses, caregivers, children.Includes communicationstrategies, coping skills.WHERE: Country Inn and SuitesDeer Valley, 20221 N. 29 Ave.,PhoenixPRESENTED BY: John C. LincolnDeer Valley Hospital; ArizonaYoung Breast Cancer SurvivorSupport Initiative; Men AgainstBreast CancerTIME: 9 a.m.–2:30 p.m.COST: FreeREGISTER: [email protected] 623-434-2784

March 16Arizona Sjögren’sAutoimmune DiseaseAwareness Health FairWHAT:Advice, information, healthscreenings. Silent auction, snacks,prizes, music.WHERE: Inside Paradise ValleyMall, 4568 E. Cactus Rd., PhoenixPRESENTED BY: Arizona Sjögren’sSyndrome Support GroupTIME: 9–11 a.m.COST: FreeINFO: [email protected] 480-391-2522

MarchTOP Events

March 17Ostomy Products FairWHAT:Ostomyproducts,medicalaccessories, demonstrations. Privateconsultations, tips on how to travel.WHERE: Banner Desert MedicalCenter, 1400 S. Dobson Rd., MesaPRESENTED BY: East Valley OstomySupport GroupTIME: 11 a.m.–3 p.m.COST: FreeINFO: 480-451-3815

March 19 & 26FiveWishes WorkshopWHAT:How to discusswith doctors/familymembersmedical treatmentrelated to serious illness anddeath.WHERE: Church of the Beatitudes,555W. Glendale Ave., PhoenixPRESENTED BY: DuetTIME:March 19, 9–11:30 a.m.or March 26, 6:30–8 p.m.COST: FreeREGISTER: 602-274-5022

March 20Colon Cancer AwarenessWHAT: Presentations on preventingcolon cancer, health vendors, more.WHERE: Virginia G. Piper CancerCenter, 10460 N. 92 St., ScottsdalePRESENTED BY: Virginia G. PiperCancer CenterTIME: 6–8:30 p.m.COST: FreeREGISTER: shc.org/eventsor 480-882-4636

March 23Third AnnualCancer Survivors DayCelebrationWHAT: Pancake breakfast,head and neck screening,face-painting, children’s crafts,info and resources.WHERE: 695 S. Dobson Rd.,ChandlerPRESENTEDBY: IronwoodCancer& Research Centers; ChandlerRegional andMercy GilbertMedical CentersTIME: 8–11 a.m.COST: FreeINFO: ironwoodcrc.comor 480-855-2224

March 23Easter Egg Hunt &Family Health FairWHAT: 40th annual egg huntand health fair. Bounce house,games, prizes. Health screenings,info on community resources.WHERE: St. Luke’s MedicalCenter, 1800 E. Van Buren St.,PhoenixPRESENTED BY: St. Luke’sMedical CenterTIME: 9–11:30 a.m.COST: FreeINFO: 877-351-9355

Continued from cover

PAINMANAGEMENT

ResourcesChronic Pain Association (ACPA):theacpa.org; [email protected]

Chronic Pain Anonymous:chronicpainanonymous.org

Pain-related support groups:(See Calendar listings page 5)

What is FIBROMYALGIAand why is it often so hardto diagnose and treat?ANSWER: Fibromyalgia is a chronicmedical condition characterized by painin the soft tissues in all quadrants of thebody; it is diagnosed through exclusion,meaning that other conditions must beruled out first. There is no initial testfor fibromyalgia.Possibly caused by chemical imbalances,

fibromyalgia overwhelmingly affectswomen, but doctors don’t knowwhy,said Sandra Miller, M.D., a family medicinephysician with the Family Medicine Centerat Banner Good SamaritanMedical Centerin Phoenix. “Fibromyalgia is stronglyassociated with sleep disorders,” she said.“If sleep apnea is managed, a fibromyalgiapatient’s pain can be greatly diminished.”Once other conditions are ruled

out, fibromyalgia may be diagnosed ifa patient has at least 11 of 18 ‘tenderpoints’ above and below the waist andon both sides of the body (the back ofthe neck, elbows and hips are three ofthe 18). The criterion for diagnosis maysoon be revised, Miller said, to simply bepain in all quadrants of the body.

s,ow

Fairs,medicalons. Privatew to travel.

THINKSTO

CK

Why isBACKPAIN soprevalent?ANSWER: “One of themost commonreasons is age,” saidMichael Perry, M.D.,medical director of the Laser Spine Institute,a national organizationwith a location inScottsdale. “As we get older, conditions ofthe spine deteriorate and therefore lead toback pain symptoms. Another issue is beingoverweight. When you increase the loadon your spine, it increases the risk of injuryor trauma.”Perry added that people with labor-

intensive jobs need to be cognizant ofthe wear and tear they may be causing ontheir spine. “And everyone should practiceproper mechanics while moving, bending,lifting and twisting,” he said.Seth, of Scottsdale Healthcare

Comprehensive Pain Center, saidconservative treatment includes backbraces, yoga, medications and injections.When conservative treatment fails, surgerymay be an option.

What are the benefits of anINTEGRATED APPROACH topain management?ANSWER: “We know pain is multifacetedand that if you don’t take an integratedapproach to alleviating it, the pain oftendoesn’t get better,” said Shannon Scott, D.O.,clinical assistant professor at the ArizonaCollege of Osteopathic Medicine and afamily medicine physician at theMidwesternUniversity Multispecialty Clinic in Glendale.“It’s important to integrate multiple

modalities into the treatment plan,” she said.“This includes psychological evaluation andbehavioral therapy, physical therapy, manualmedicine (osteopathic manipulation),exercise and oral or injectedmedications.”Often a [pain] patient in a family medicine

practice is also being seen by specialistssuch as a surgeon, a physical medicinedoctor, a rehabilitation doctor and/or ananesthesiologist who also specializes in painmanagement, Scott added.

How is CANCER RELATEDpain treated?ANSWER: “Long- and short-actingnarcotics or combinations of them arethe most often-used remedies for painassociated with cancer,” said John Bibb,M.D., a medical oncologist with ArizonaOncology, a medical practice withmultiple locations in the Valley.For patients with throat cancer pain

that prevents them from swallowing[and patients with other types of pain],narcotic analgesics such as Fentanyl canbe administered through a patch appliedto the skin, allowing the medication tobe absorbed into the bloodstream.

What are some COMMON TREATMENTS for chronic pain?ANSWER: McJunkin, of Arizona Pain Specialists, said that commonly used treatmentsinclude physical therapy, anti-inflammatory medications, non-narcotic pain medications,muscle relaxers and epidural steroid injections.Additional treatments include facet injections (steroid injections into the small joints

at each segment of the spine); radio frequency ablation that destroys the nerves causingthe pain; a spinal cord stimulator (McJunkin calls it a “pacemaker for pain relief”);and vertebroplasty (bone cement is injected through a small hole in the skin into afractured vertebra with the goal of relieving back pain).McJunkin noted that treatments soon to become routine include injections of

platelet-rich plasma and stem cells directly into painful areas.

What should you do if yourdoctor CAN’T FIND THECAUSE of your chronic pain?ANSWER: Consider seeking a second (orthird...) opinion and discuss with yourdoctor the most effective ways to treatand manage your pain.

4 | LIVING WELL A-Z | WEDNESDAY, March 6, 2013

COLON CANCERApril 2, 5–6:15 p.m.Banner Desert1400 S. Dobson Rd., Mesa480-412–4673

COLORECTAL CANCERApril 2, 6 p.m.Banner Good Samaritan1111 E. McDowell Rd., Phoenix602-839-4970

BREAST CANCER

BOSOM BUDDIESSUPPORT GROUPSVarious dates, times & locationsAhwatukee/Chandler: 480-893-8900East Valley: 480-969-4119Scottsdale: 623-236-6616West Valley: 623-979-4279

LOOK GOOD, FEEL BETTERMarch 12, 4:30–6:30 p.m.By John C. Lincoln &American Cancer SocietyJohn C. Lincoln Breast Center19646 N. 27 Ave., Phoenix623-434-2784

YOUNG SURVIVOR GROUPMarch 12, 6–8 p.m.By John C. Lincoln, TheWellnessCommunity & Southwest AmbulanceJohn C. Lincoln Breast Center19646 N. 27 Ave., Phoenix602-712-1006

LEARN & SUPPORTMarch 13, 5:30 p.m.Banner Good Samaritan1111 E. McDowell Rd., PhoenixRegister: 602-712-1006

LEARN & SUPPORTMarch 14 & 28, 6–8 p.m.John C. Lincoln Breast Center19646 N. 27 Ave, Phoenix602-712-1006

SUPPORT GROUPMarch 26, 5–6:15 p.m.Banner Desert1400 S. Dobson Rd., Mesa480-412-4673

SUPPORT GROUPMarch 26, 5:30 p.m.Banner MD Anderson2946 E. Banner Gateway Dr., Gilbert480-256-4141

TRIPLE NEGATIVEMarch 27, 5:30 p.m.Banner Good Samaritan1111 E. McDowell Rd., PhoenixRegister: 602-712-1006

CIRCLE OF HELPMarch 28, 6–8 p.m.By Bosom Buddies at John C. Lincoln19646 N. 27 Ave., Phoenix602-236-6616;[email protected]

METASTATIC SUPPORTApril 3, 11:30 a.m.–1 p.m.Banner Desert1400 S. Dobson Rd., Mesa.480-412-4673

PARKINSON’S

CAREGIVERS’ SUPPORTGROUPS (DUET)Various dates, times & locations602-274-5022

DANCE, EXERCISE, YOGA,ART & TAI CHIVarious dates, times & locationsByMuhammad Ali Parkinson CenterRegister: 602-406-6903

PD 202: PARKINSON’S INFOMarch 8, 15 & 22, 10 a.m.–noonByMuhammad Ali Parkinson Centerat Legacy Retirement Residence5625 E. McKellips Rd., MesaRegister: 800-227-7691

DEEP BRAIN STIMULATIONMarch 8, 10:30 a.m.Banner Sun Health Research10515W. Santa Fe Dr., Sun City623-832-5328

PARKINSON’SMarch 11, 10–11:30 a.m.Banner Sun Health Research10515W. Santa Fe Dr., Sun City602-942-9008

PARKINSON’S SUPPORT GROUPMarch 12, 1–2 p.m.HealthSouth Valley of the Sun13460 N. 67 Ave., Glendale623-878-8800

PARKINSON’S SUPPORT GROUPMarch 19, 3 p.m.By Benevilla at Shepherd of the HillsMethodist Church13658W.Meeker Blvd., Sun CityWest623-584-4999

PARKINSON’S & PARTNERSMarch 25, 10–11:30 a.m.Banner Sun Health Research10515W. Santa Fe Dr., Sun City602-942-9008

PARKINSON’S FORUMMarch 26, noon–3 p.m.By Benevilla at Shepherd of the HillsMethodist Church13658W.Meeker Blvd., Sun CityWestRegister: 623-584-4999

BREAST-FEEDING

NURSINGMOMS SUPPORTVarious dates & timesBanner Del E. Webb14502W.Meeker Blvd., Sun CityWest602-230-2273

BREASTFEEDINGMarch 6, 13, 20 & 27, 11 a.m.Chandler Regional1875W. Frye Rd., Chandler480-728-5414

BREASTFEEDINGMarch 7, 14, 21 & 28, 1–2:30 p.m.Banner Desert1400 S. Dobson Rd., Mesa480-412-3035

BREASTFEEDINGMarch 8, 15, 22, 29, 10 a.m.Mercy Gilbert3555 S. Val Vista Dr., Gilbert480-728-5414

BREASTFEEDINGMarch 11, 18 & 25, 10–11:30 a.m.St. Joseph’s350W. Thomas, Phoenix602-406-4954

LACTATION SUPPORTMarch 11, 18 & 25, 1–2 p.m.Banner Estrella9201W. Thomas Rd., Phoenix623-327-8001

BREASTFEEDINGMarch 12 & 26, 10 a.m.Banner Ironwood37000 N. Gantzel Rd., San Tan Valley480-394-4000

BREASTFEEDING SUPPORTMarch 18, 6–7:30 p.m.Banner Good Samaritan1111 E. McDowell Rd., Phoenix602-839-3502

PARENTING

GRANDPARENTS RAISINGGRANDCHILDREN (DUET)Various dates, times & locations602-274-5022

POSTPARTUM DEPRESSIONMarch 6, 13, 20 & 27, 1–2:30 p.m.Chandler Regional1875W. Frye Rd., Chandler480-728-5414

PREGNANCY, PARENTING & PLAYMarch 7, 14, 21 & 28, 7–9 p.m.Banner Baywood6644 E. Baywood Ave., Mesa480-321-4455

SUPPORT THROUGH OTHERPARENTS (STOP)March 7, 14, 21 & 28, 7–9 p.m.First Presbyterian Church161 N. Mesa Dr., Mesa623-846-5464

PREGNANCY & POSTPARTUMMarch 12, 19 & 26, 10–11:30 a.m.Banner Desert1400 S. Dobson Rd., Mesa480-412-5292

POSTPARTUM SUPPORTMarch 12 & 26, 11 a.m.Banner Thunderbird5555W. Thunderbird Rd., Glendale602-865-5908

NEWBORN PARENTINGMarch 12, 2–3:30 p.m.Banner Baywood6644 E. Baywood Ave., Mesa480-321-4455

SUPPORT THROUGH OTHERPARENTS (STOP)March 12, 19 & 26, 7–9 p.m.Larkspur Christian Church3302W. Larkspur Dr., Phoenix623-846-5464

BIRTH PARENT SUPPORTMarch 26, 6–8 p.m.St. Joseph’s350W. Thomas Rd., Phoenix888-818-4445

PREGNANCY & INFANT LOSSApril 1, 7 p.m.Banner Desert1400 S. Dobson Rd., Mesa480-412–3595

GASTRO-INTESTINAL

CELIAC DISEASEMarch 6, 7–8:30 p.m.Paradise Valley Retirement Center11645 N. 25 Pl., Phoenix623-587-8885

OSTOMYMarch 7, 2–4 p.m.Banner Boswell13180 N. 103 Dr., Sun City623-935-7514

RESPIRATORY

ASTHMA SUPPORT GROUPCardon Children’s Medical Center1400 S. Dobson Rd., MesaCall for dates & times: 480-412-7902

BETTER BREATHERSMarch 11, 2–4 p.m.By Sun Health at The ColonnadeRecreation Village19116 ColonnadeWay, SurpriseRegister: 623-455-5633; sunhealth.org

RESPIRATORYMarch 14, 1:30 p.m.Banner Boswell13180 N. 103 Dr., Sun City623-832-5708

Save $1,000 on bilateral Lasik or ICLTHE DEAL:Use your tax refund at Barnet Dulaney Perkins Eye Centerand receive $1,000 savings. Restrictions apply.DATES VALID: Through June 30, 2013HOW TO GET THE DEAL: 602-955-1000WHERE: Visit goodeyes.com for locations and details

$199 lung cancer screening programTHE DEAL: Comprehensive screening: CT scan of the chest cavity,coronary calcium scoring, review of results, consultationwith physician.DATES VALID: OngoingHOW TO GET THE DEAL: Call 855-586-4727WHERE: St. Joseph’s Hospital, 350W. Thomas Rd., Phoenix

2-week trial at Mountainside FitnessTHE DEAL: Free 2-week trial plus sign-up formembershipwithin the trial period and receive half-off enrollment.DATES VALID: ThroughMarch 31, 3013HOW TO GET THE DEAL: Visit anyMountainside Fitness in the ValleyWHERE: Locations listed onmountainsidefitness.com

HEALTHCARE Deals

IRONWOOD CANCER ANDRESEARCH CENTERS:ironwoodcrc.com

JOHN C. LINCOLN HOSPITAL:jcl.com

LASER SPINE INSTITUTE:laserspineinstitute.com

MAYO CLINIC:mayoclinic.com

MERCY GILBERT MEDICALCENTER:mercygilbert.org

MOUNTAIN VISTA MEDICALCENTER:mvmedicalcenter.com

PHOENIXCHILDREN’SHOSPITAL:phoenixchildrens.com

SCOTTSDALE HEALTHCARE:shc.org

ST. JOSEPH’S HOSPITALAND MEDICAL CENTER:stjosephs-phx.org

ST. LUKE’S MEDICAL CENTER,PHOENIX: stlukesmedcenter.com

TEMPE ST. LUKE’S HOSPITAL:tempestlukeshospital.com

ABRAZO HEALTH CARE(AZ Heart Institute andAZ Heart, Arrowhead, Maryvale,Paradise Valley, Phoenix BaptistandWest Valley hospitals):abrazohealth.com

BANNER HEALTH:bannerhealth.com

BARNET DULANEYPERKINS EYE CENTER:goodeyes.com

BARROWNEUROLOGICALINSTITUTE: thebarrow.org

CARDON CHILDREN’S MEDICALCENTER: bannerhealth.com

CHANDLERREGIONALMEDICALCENTER: chandlerregional.org

DUET: duetaz.org

FOOT SOLUTIONS:footsolutions.com

HEALTHSOUTHREHABILITATION:healthsouth.com

INFOOnline

BETTER BREATHERSMarch 20, 2–3 p.m.Chandler Regional1875W. Frye Rd., Chandler480-728-5414

BETTER BREATHERSMarch 28, 1:30 p.m.John C. Lincoln250 E. Dunlap Ave., Phoenix602-870-6060

BRAIN

BRAIN INJURY & CAREGIVERMarch 7, 6:30–7:30 p.m.HealthSouth Valley of the Sun13460 N. 67 Ave., Glendale602-508-8024

BRAIN INJURY SURVIVORSMarch 11, 7–8:15 p.m.St. Joseph’s350W. Thomas Rd., Phoenix602-406-3333

APHASIAMarch 12 & 26, 10–11 a.m.Banner Boswell13180 N. 103 Dr., Sun City623-972-4263

SYRINGO & CHIARIMarch 21, 11 a.m.–1 p.m.St. Joseph’s Outpatient Rehab114W. Thomas Rd., Phoenix623-561-9606

BRAIN TUMORMarch 26, 6–8 p.m.St. Joseph’s350W. Thomas Rd., Phoenix623-205-6446

BRAIN HEALTHMarch 28, 1–2 p.m.By Scottsdale Healthcareat Granite Reef Senior Center1700 N. Granite Reef Rd., ScottsdaleRegister: shc.org/events; 480-882-4636

PAIN

CHRONIC PAINMarch 8 & 22, 6–8 p.m.By American Chronic Pain Assoc. atCatholic Outreach Center12301W. Bell Rd., Surprise602-532-2981

CHRONIC PAINMarch 13 & 27, 6:30–8 p.m.By American Chronic Pain Assoc.at Via Linda Senior Center10440 E. Via Linda, Scottsdale480-314-2330

PAIN SUPPORT GROUPMarch 14 & 28, 6–8 p.m.HealthSouth Valley of the Sun13460 N. 67 Ave., Glendale623-334-5437

ADDITIONALSUPPORTGROUPS

SPASTICITY CLINICMarch 7, 1–4 p.m.HealthSouth Valley of the Sun13460 N. 67 Ave., Glendale623-878-8800

AMPUTEEMarch 12, 6–7 p.m.HealthSouth Valley of the Sun13460 N. 67 Ave., Glendale623-334-5358

LARYNGECTOMYMarch 19, 4–5 p.m.Banner Boswell13180 N. 103 Dr., Sun City623-832-5349

RENAL FAILUREMarch 21, 9:30–11:30 a.m.By Sun Health at La Loma Village14154 Denny Blvd., Litchfield ParkRegister: 623-455-5633; sunhealth.org

VESTIBULARMarch 21, noonBanner Good Samaritan1111 E. McDowell Rd., Phoenix602-839-2317

MEN’S DISABILITY ISSUESMarch 21, 5:30–7 p.m.Disability Empowerment Center5025 E.Washington St., Phoenix602-980-3232; [email protected]

LIVINGWITH KIDNEY DISEASEMarch 26, 9:30–11:30 a.m.By Sun Health at La Loma Village14154 Denny Blvd., Litchfield ParkRegister: 623-455-5633; sunhealth.org

GRIEF BEFORE LOSSMarch 27, 10 a.m.By Benevilla at Birt’s Bistro & Bookstore16752 N. Greasewood St., Surprise623-584-4999

MULTIPLE SCLEROSIS (WOMEN)March 30, 10 a.m.St. Joseph’s350W. Thomas Rd., Phoenix480-829-6563

CAREGIVERS

SUPPORT GROUPSINCLUDING LGBT (DUET)Various dates, times & locations602-274-5022

CAREGIVER SUPPORTMarch 6, 10:30 a.m.By John C. Lincoln at Cowden Center9202 N. Second St., Phoenix602-870-6374

SUPPORT GROUPMarch 8, 2:30–4 p.m.Mountain VistaMedical Center1301 S. Crismon Rd., MesaRegister: 877-351-9355

ONLINE NETWORKING (DUET)March 9 & 26, 9–11 a.m.Register: DuetAZ.org (Events tab)602-274-5022

SUPPORT GROUPMarch 11St. Joseph’s Outpatient Rehab114W. Thomas Rd., PhoenixCall for time: 602-406-6688

CAREGIVER SUPPORT GROUPMarch 15, 9 a.m.By Benevilla at Birt’s Bistro & Bookstore16752 N. Greasewood St., Surprise623-584-4999

CAREGIVER SUPPORTMarch 27, 2:30–3:30 p.m.St. Luke’s Medical Center1800 E. Van Buren St., PhoenixRegister: 877-351-9355

WEDNESDAY, March 6, 2013 | LIVING WELL A-Z | 5

I taught my children to nevergive up. After my breast cancerdiagnosis, I followed my ownadvice and got a second opinion.My answer was Mayo Clinic.

Kim Loving

Kim had an entire team of world-renowned Mayo Clinic Cancer Center experts focused on herrecovery. If you are diagnosed with breast cancer, you deserve the best as well. Mayo Clinicpatients with breast cancer have substantially higher five-year survival rates compared to theU.S. National Cancer Database. We are an in-network provider for most people and a physicianreferral is rarely required. To schedule an appointment, call (480) 301-8000 or call our BreastClinic directly at (480) 301-4000.

Visit mayoclinic.org/breastcancer

BARIATRIC PROGRAMHear aboutmedical& surgical

treatments for obesity.

THURS., MAR 7:6-6:45PM

TUES., MAR 19:6-6:45PM

(480) 342-2869MayoClinic.org/Arizona

Taking Care of Your HeartLearn about Women’s

Cardiac Health

Tuesday, March 269:30 - 10:30 a.m.

RSVP: (602) 230-CARE (2273)www.BannerHealth.com/events

My health. Online and onmy schedule. JCLMyChart.Enjoy the benefits of JCLMyChart, your personal electronichealth record. It lets you manage your health informationeasily from your computer, digital tablet or iPhone orAndroid phone.

4 Receive test and lab results online.4 Request an appointment.4 Request a prescription refill.4 Review post-visit instructions from your provider.

Call 623-580-5800 for more information or visit JCLMyChart.com

EXPERTS

Scott A. Perkins, MDAs a nationally recognized ophthalmologist with Barnet DulaneyPerkins Eye Center,Dr.Perkins has performed more than 50,000cataract surgeries and more than 10,000 vision correction proceduressuch as LASIK and Implantable Contact Lenses (ICLs).As an innovatorin the field of ophthalmology,he has participated in over 25 clinical trialsfor both pharmaceutical and ophthalmic devices.

In addition,Dr.Perkins serves on the Board of Directors forArizonaVisionaries, a donor driven non-profit organization providing cataractsurgery and eyeglass fittings in third world countries.He is not onlytrusted for his surgical talents and modest nature,but is also well knownfor his compassion and ability to connect with and comfort patients.

Board Certified by theAmerican Board of Ophthalmology.Member of theAmerican Society of Cataract and Refractive Surgery.Fellow of theAmericanAcademy of Opthalmology.

CATARACT & REFRACTIVE SURGERY

Locations throughout Arizona800.966.7000 • www.GoodEyes.com

Pooja Shah, MD

Dr. Shah specializes in low and high risk pregnancies,contraceptive options, in-office procedures and reproductivecare. She enjoys providing education, treatment and continuityof care to both adult and adolescent women and believes inworking in cooperation with them to provide compassionatehealth care. She completed her medical education and residencyat the University of Illinois School of Medicine in Chicago and isa member of American College of Obstetrics and Gynecology.Dr. Shah has been in practice since 2009.

GYNECOLOGY/OBSTETRICS

Banner Health ClinicSpecializing in Obstetrics and Gynecology6553 E. Baywood Ave. Suite 210 • Mesa480.543.6754 • www.BannerHealth.com/BMG-BaywoodOBGYN

Kelly V. Dale, MD

Dr. Dale is an obstetrician/gynecologist who is dedicated toall aspects of women’s health. She specializes in menstrualdisorders, contraception and minimally invasive and vaginalsurgery. Dr. Dale received her medical degree from theUniversity of Arizona College of Medicine and completed herresidency at the University of California Medical Center inLos Angeles where she received the Outstanding ResearchPresentation Award. Her care philosophy is to give her patientsboth education and care in a way that provides understandingand comfort to women through all stages of their lives.

GYNECOLOGY/OBSTETRICS

Banner Health ClinicSpecializing in Obstetrics and Gynecology6553 E. Baywood Ave. Suite 210, Mesa480.543.6754 • www.BannerHealth.com/BMG-BaywoodOBGYN

and household cleaners that may havedevelopmental, reproductive, neurologicaland immune effects,” she said. “But moreresearch needs to be done to understandthese consequences and the causes ofthese effects.”

When to be concernedEven if doctors are seeing puberty atyounger ages, Chin cautioned, this doesnot necessarily mean the phenomenonis normal.

“As pediatric endocrinologists, we arestill concerned if a girl starts pubertybefore 8 years old or if a boy startsbefore 9 years old,” she said. “If a familyis concerned that their child is showingsigns of puberty too early or is progressingthrough puberty too rapidly, I wouldrecommend that the child be evaluatedto assess whether his/her pubertaldevelopment is pathological.”

Early-onset puberty: myth or reality?Is puberty starting earlier than it used to? If so, why? BY ALISON STANTON

KIDS Korner

How is it determined?Interestingly, the bones of the handsprovide doctors with an excellentindication of early-onset puberty.

“There are a lot of growth plates in thehands and it can help me determine thecurrent bone age of the child,” McClellansaid. “In one case, I treated a little girl

who was four yearsand nine months,and she was foundto have a boneage of nine, whichwas remarkablyadvanced.”

Since girls witha bone age of14 and boys with

a bone age of 16 or so will typically bedone growing, the information McClellanobtains from X-rays will help determinehis approach.

“So if the child’s growing is done by theage of seven, she will be profoundly short,and we would want to do somethingabout it in terms of treatment. Whereas, agirl who is seven with a bone age of nine,she would still have a long time to grow.”

Should it be delayed?“Pathological central precocious pubertycan be delayed with treatments suchas gonadrotropin-releasing hormone(GnRH) agonists,” Chin said, adding thatthe decision to treat is very individualized

and should be discussed with the patient’sendocrinologist.

McClellan also uses a case-by-casemethod to treat his patients.

“Some parents say ‘she is only eight —I want the signs of early puberty to stop,’”he said. “But it usually takes about twoand a half years after the first signs ofpuberty to have the first menstrual cycle.The average age of the first menstrualcycle is 12 years and four months, and thestandard deviation is two years aboveand two years below that. So a girl whois showing signs of early puberty at eightmight get her first period at the age of 10,which is still perfectly normal.”

In general, McClellan said that for girlswho are age six or younger, it’s likely thatthe benefits of treatment will outweighthe risks.

Hormones in food?In the 1980s, McClellan said therewas an outbreak of precocious pubertyin Puerto Rico.

“It was found to be tied to chickenfarmers that were pumping estrogen intotheir chickens and the kids were eating thechicken,” he recalled. “Farmers stopped thepractice and the problem was resolved.”

Chin said she is not aware of anysimilar situations in the U.S., but she doesunderstand parents’ concern. “There isconcern that children are exposed tochemicals in food, personal care products

ResourcesKidsHealth: kidshealth.org

Mayo Clinic:mayoclinic.com

Phoenix Children’s Hospital:phoenixchildrens.com

University of Arizona Departmentof Pediatrics: peds.arizona.edu

In the late 1800s, the average age ofthe first menstrual period was 15, said

Don McClellan, M.D., chief of the divisionof pediatric endocrinology at PhoenixChildren’s Hospital.

Currently, he noted, it is 12 and a half.While early-onset puberty can affect

both boys and girls, McClellan said herarely sees male new patients who areshowing signs ofearly puberty. “Onthe other hand, afew times a monthI will see girls whoseparents suspectthey are in earlypuberty,” he said.

Why is this happening?Cindy Chin, M.D., an assistant professor inthe University of Arizona’s department ofpediatrics and a pediatric endocrinologistat the University of Arizona HealthNetwork, said that one of the major factorsfor early puberty in girls is the prevalenceof obesity in the pediatric population.

“Higher body mass index has beencorrelated with younger age at onset ofpuberty in girls as well as earlier menarche[menstruation],” she said. “In boys, it seemsthat a higher BMI is associated with laterpuberty. We don’t yet understand why thesedifferences exist. Additionally, there may beenvironmental factors that play an as-yet-unknown role in affecting pubertal onset.”

THINKS

TOCK

“We are concerned if agirl starts puberty before8 years old or if a boystarts before 9 years old.”

— Cindy Chin, M.D.

6 | LIVING WELL A-Z | WEDNESDAY, March 6, 2013

Carpal tunnelsyndromeCauses and treatments BY DOLORES TROPIANO

ResourcesArizona Hand andWrist Specialists:azhandwristspecialists.com

Arizona Prolotherapy:arizonaprolotherapy.com

PubMed Health, U.S.National Library of Medicine:ncbi.nlm.nih.gov/pubmedhealth

The carpal tunnel is a narrow, rigidpassageway of ligament and bones

at the base of the hand that housesthe median nerve andtendons. Located on thepalm side of the wrist, itprotects the main mediannerve which runs from theforearm to the hand. Carpaltunnel syndrome takes placewhen a nerve within thecarpal tunnel becomespinched or compressed.

CausesCarpal tunnel syndrome can be caused byinjuries to the wrist, certain health issuessuch as arthritis, and possibly repetitivepatterns of hand use. Indeed, David Tallman,a licensed naturopathic medical doctorspecializing in prolotherapy, said thatcarpal tunnel is an occupational problemcaused by the excessive use or misuse of thewrist. “It’s a blanket term denoting certainmedian nerve symptom patterns causedby increased pressure in the carpal tunnel,”he added.

According to John Shaff, a physicianassistant with OrthoArizona, Arizona Handand Wrist Specialists, there isn’t really onetype of activity that specifically causescarpal tunnel syndrome, which he saidaffects five percent of the population.

“It can range from repetitive activities,to accidents, to medical conditions suchas diabetes, thyroid dysfunction and evenpregnancy,” Shaff said.

TreatmentsFor those suffering from carpal tunnelsyndrome, nonsurgical treatments mayinclude exercise (such as stretching outthe fingers), frequent breaks and ice packs.Conservative treatments could also includea wrist splint or an injection of cortisone.

Shaff said that when symptoms last formore than seven weeks and conservativetreatments fail, surgery may be necessary.

“Regardless of the technique utilized, thegoal is to increase the space in the carpalcanal thus decompressing the mediannerve,” he said.

There are two types ofsurgery used to treatcarpal tunnel syndrome.One is endoscopicsurgery in which atelevision camera-like device enablesthe doctor to see intothe carpal tunnel andperform surgery withsmall incisions to thehand or wrist. Opensurgery is also an optioninvolving a largerincision in the palmof the hand over thecarpal tunnel.Source: John Shaff, OrthoArizona,Arizona Hand andWrist Specialists

THINKS

TOCK

Bring your life into focus.

With LASIK and the Implantable Contact Lens (ICL), glasses or

contacts will no longer stand between you and the rest of the

world. For over 35 years, more people have trusted their eye

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Barnet Dulaney Perkins Eye Center does not discriminate against any person on the basis of race, color, national origin,disability, or age in admission, treatment, or participation in its programs, services and activities, or in employment.

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