IN THIS ISSUE | 2 Donate Life Month | 3 Health camps for kids | 4-5 Seniors: falls & caregiving | 6-7 Events & support groups

APRIL 2014

Button-batteriesThe tiny batteriescan be dangerous —or even deadlyBy Meghann Finn Sepulveda

Technology today has become

more compact than in the past,

requiring smaller batteries

to operate items like remote

controls, hearing aids, car-key

fobs, toys and even somegreeting cards.

Coin-shaped lithiumbutton-batteries,

when swallowed by a young child (or

anyone else, for thatmatter…), pose a

truemedical emergency if the battery

gets lodged in the esophagus. Burning

can occur, causing severe and possibly

permanent damage.

Two-hourwindowTheNational Capital Poison

Center estimatesmore than 3,500

people swallowbutton-batteries

each year in the United States.While

themajority of these batteries pass

through the body and are harmless,

they can sometimes get stuck in the

esophagus, especially in children

age 6 and younger.

“The flat shape and size of a

button-battery, when lodged in the

esophagus or the nose, creates a

circuit between the tissue and causes

burning,” said James Reingold,M.D.,

medical director, pediatric emergency

department, Banner Children’s at

Cardon Children’sMedical Center in

Mesa. “There is a two-hourwindowof

time for treatment before permanent

damage and scarring occurs.”

Possible symptomsAmong other issues, possible symp-

toms of battery-swallowing include

nausea, chest pain and gastrointestinal

inflammation.

“If the battery is stuck high in the

esophagus, we sometimes see drooling

and vomiting,” Reingold said. “When

a child doesn’t respond to treatment

or seems to be getting progressively

worse, we order an X-ray.”

Emergency treatmentMedical attention should not be delayed

if there is even a remote possibility that

a child swallowed a button-battery.

“The clock is ticking,” said Gary Silber,

M.D., division chief, pediatric gastro-

enterology, Phoenix Children’s Hospital,

“The quickerwe can get the battery out,

the less extensive the damage.” Silber

added that childrenmay have complica-

tions forweeks ormonths after surgery

andwillmost likely require dietary

restrictions and additional procedures

to remove scar tissue.

ResourcesBannerGoodSamaritanPoisonCenter:bannerhealth.com; 800-222-1222

National Capital PoisonCenter:poison.org; 202-625-3333

New cholesterol guidelinesThe CDC says up to 40million Americans have high

cholesterol, and last November, the American College of

Cardiology and the AmericanHeart Association revised

their guidelines for cholesterolmanagement.

“We’re no longer looking only at total cholesterol levels,”

said Suzanne Sorof, M.D., a cardiologist inMesa. “We’re

taking a broader approach towho should be treated. It’s

now recommended that all peoplewith diabetes and

everyonewith any cardiovascular disease—regardless

of their cholesterol levels—be prescribed a statin

medication,” she said. She recommends that if your

total fasting cholesterol is above 199, discusswith

your doctorwhether taking a statinmedication is

right for you.

Medications andmedical devicesFor theestimated6millionAmericanswhosuffer

fromheart failure (when theheartmuscle can’t pump

enoughblood to thebody tomeet thebody’sneeds),

“threeor four common, affordableprescription

medications takendaily can letmostpatients

livewithahighqualityof life for another

20 to30years,” saidNancySweitzer,M.D.,

Ph.D., chief of cardiologyanddirector at the

SarverHeartCenter atTheUniversityof

Arizona inTucson.Themedications include

anACE inhibitor, abetablocker, analdoste-

roneblockingagent thatblocks theeffectsof

the steroidhormonealdosterone, andadiuretic

suchasLasix.

Heart failure can result fromother forms of heart

disease, Sweitzer said, including blockages of the arteries

that can cause heart attacks, valvular disease or a serious

virus that affects the heart. Symptoms of heart failuremay

include shortness of breath, fatigue andweakness, and

swelling of the legs, ankles and feet, she said.

Many heart failure patientsmay also need one of two

medical devices to alleviate their symptoms, Sweitzer said.

One is an implantable defibrillator that restarts the heart

if it stops beating effectively; the other is a special cardiac

resynchronization pacemaker that can “correct disordered

contraction of an enlarged heart,” she said.

Subcutaneous defibrillatorsTraditional implantable defibrillators for the prevention of

cardiac death require the placement of ‘transvenous

leads’ which are softwires that carry signals from the

heart and deliver shock energy to the heart.

Emmett’s storyIn 2010, a button-battery nearly took

the life of a 1-year-old Arizona boy

namedEmmettwhen he swallowed a

button-battery that burned through

his esophagus. To help educate parents,

grandparents and others about the

danger of button-batteries, the young

boy’s family launched Emmett’s Fight

(EmmettsFight.com). Thewebsite

contains not only Emmett’s story, but

also information and resources related

to button-battery ingestion.

Updates and advances in heart-related medicationsand technology | Story by Debra Gelbart • Photos by Rick D’Elia

heartfor

help ngyour

Newhopeh i

Here’s a startling statistic: an estimated 80million Americans (one in three adults) have one ormore types

of heart disease, according to the Centers for Disease Control and Prevention (CDC). To find outwhat’s new in heart

disease-relatedmedications and technology, we spokewith several local experts; here’swhat they had to say.

"The leadsmay allow the introduction of infection into

the heart, settling on and destroying the heart valves,”

said AndrewKaplan,M.D., a cardiac electrophysiologist

with BannerHeart Hospital inMesa, adding that the leads

may break, requiring replacement or removal.

Anewsubcutaneous (belowthe skin) implantabledefibril-

lator system isnowavailable. TheS-ICD™Systemeliminates

transvenous leads (those that go throughabloodvessel

into theheart), “sowecanavoidpotential complications,”

Kaplan said.

MRI-compatible pacemakersKaplan is alsoaprincipal investigator ina clinical trial

evaluating the safety andefficacyof anewMRI-compatible

pacemaker. Conventionalpacemakersaren’t compatiblewith

MRI scannersbecause they’remadeoutofmetal that inter-

fereswith thewaymagnetic resonance imagingoperates.

“Elderly patients are twice as likely to needMRIs as

younger patients. This is also the populationmost likely to

have a condition requiring pacemaker implantation,” he

said. Data from the clinical trial is expected to be submit-

ted to the Food andDrug Administration for consideration

within a year. “We hope tomove toward replacing

traditional pacemakerswith this one if it receives FDA

approval,” he said.

� continues on page 8

AcardiacelectrophysiologistwithBannerHeartHospital inMesa,Dr.AndrewKaplanrecently implantedanewMRI-compatiblepacemaker inpatientShirleyFleet.Here,heshowsherwhat thepacemaker looks like.Kaplan isaprincipal investigator inaclinical trialevaluatingthepacemaker.

Banner MD Andersonopens outpatient additionBannerMDAnderson Cancer Center

recently opened the second phase of its

outpatient facility, amajor addition that

expands specialty cancer treatment

services and prevention programs in

Arizona.

The three-story addition includes

The JamesM. Cox Center for Cancer

Prevention and Integrative Oncology,

additional clinic and infusion space,

a separate hematology/stem cell trans-

plant clinic and expanded radiation

oncology space.

More info: BannerMDAnderson.com

Chandler Regional namedLevel 1Trauma CenterChandler RegionalMedical Center

has been designated as a provisional

Level I TraumaCenter by the Arizona

Department of Health Services, Bureau

of EmergencyMedical Services and

Trauma System. Previously, critically

injured patients in the East Valleywere

transported to Phoenix or Scottsdale for

treatment. The trauma team includes

specialists such as anesthesiologists,

emergency physicians, hand surgeons,

neurosurgeons, orthopedic surgeons,

plastic surgeons, trauma critical care

surgeons, nurses and ancillary services.

More info:ChandlerRegional.org

a-za-z HEALTHC ARE NEWS BR I E FS

Banner MD Anderson Cancer Center

Chandler Regional Medical Center

Thinkstock

New hopefor childrenwith heartfailure | 8

If a child swallows abutton-battery, “the clockis ticking. Thequickerwecanget thebattery out,the less extensive thedamage.”—Gary Silber, M.D., division chief,pediatric gastroenterology, Phoenix Children’s Hospital

LivingwellHEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILY

A SPECIAL PUBLICATION CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING

a-za-z

Newhope for childrenwith heart failure

Heart

Dr. JohnNigrodiscusestheHeartmate II, a leftventricular assist device,implantedonBrettWallick, 16,with theteenandhis dad, Scott,at Phoenix ChildrensHospital. Thedeviceallows thepatient to gohome rather than stayingin thehospital attachedto anartificial heartpumpwhilewaiting foranewheart. Using thedevice on so youngapatient is a relatively newand rare practice.

| PhotoRickD'Elia

When a child or teen is suffering

fromheart failure so severe that he

or she requires a heart transplant,

a new left ventricular assist device

calledHeartmate II is improving the

patient’s quality of lifewhile he or she

awaits a transplant. JohnNigro,M.D.,

heart transplant programdirector at

Phoenix Children’s Hospital, recently

implanted theHeartmate II for the

first time in a teen.

“Thisdevicehasgenerallybeenused

only inadults,” heexplained, “butby

implanting it in a16-year-oldpatient,

wewereable todischargehimhome to

wait for anewheartwithouthisbeing

required tobehookedupcontinuously

toanartificial heartpump.”

� continued from the cover

Treatments for valve diseaseThe American Heart Association reports

thatmore than 5million Americans are

diagnosedwith heart valve disease each

year. “This has been historically treated

with open-heart surgery,” Sweitzer said.

“Butmore recently, we’ve been able to

performwhat’s called a ‘transcatheter

aortic valve replacement’ (TAVR) through

the groin arterywithout open heart

surgery. It’s a terrific procedure that can

restore life expectancy towhat it was

before the patient developed

valve disease.”

Stress testsManypeopleassumebecause theydon’t

have classic symptomsofheartdisease

(chestpain, shortnessofbreath, fatigue,

etc.) that theydon’t haveanything toworry

about. But Sorofworries for them if they

haveany familyhistoryofheartdisease,

they’repost-menopausal, they’veever

smokedat least100cigarettes in their life-

time, theyare clinicallyobese, theirblood

pressure ishigher than120/80, anynormal

activity for thematanyage is suddenly

moredifficult, or theyare sedentary. “If any

of those factors arepresent, they should

talk to theirdoctor aboutpossibly gettinga

stress test,” she said.

A stress testmonitors howoxygenated

bloodwill travel to the heartmuscle

through the arteries before, during and

after exertion. If someone is unable to

walk on a treadmill, they can undergo

what’s known as a ‘nuclear stress test’

that uses contrast agents tomimic

exertion. If they don’t want that kind of

test, Sorof said, they can have only an

ultrasound of the heart, known as an

echocardiogram. “We’ve figured out

how to administer a stress test to almost

everyone, nomatterwhat their individual

circumstances are,” she said.

ResourcesAmericanHeart Association:heart.org;800-AHA-USA-1 (800-242-8721);

Spanish 888-474-VIVE (8483)

Centers forDiseaseControl andPrevention:cdc.gov; 800-CDC-INFO (800-232-4636);

TTY 888-232-6348

National Library ofMedicine/National Institutes ofHealth:nlm.nih.gov/medlineplus

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Shalini Singh-Karnik, MDA graduate of Ross University School of Medicine, Dr.

Shalini Singh-Karnik completed her residency internship

at Medical Center of Central Georgia affiliated with Mercer

University. Dr. Singh-Karnik specializes in women’s health,

adolescent health and geriatric medicine.

FAMILY MEDICINE, GERIATRICS

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Banner Health Center

144416 W. Meeker Blvd., Building C, Suite 200, Sun City West

623-876-3980 www.bannerdelewebb.org

Crista Johnson-Agbakwu, M.D.Dr. Johnson-Agbakwu is an Obstetrician/Gynecologist at Maricopa

Integrated Health System & Founding Director of the Refugee Women’s

Health Clinic (refugeewomensclinic.org). Dr. Johnson received her

undergraduate degree from Johns Hopkins University, medical degree

from Cornell University and completed her Obstetrics and Gynecology

residency at the George Washington University Medical Center.

MARICOPA INTEGRATED HEALTH SYSTEM

2601 E. Roosevelt St.

Phoenix, Arizona 85008

602-344-5011 www.MIHS.org

GYNECOLOCY, OBSTETRICS

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Teresa Malcolm, MDWith a sincere belief that each woman has unique needs

and deserves compassion and respect, Dr. Malcolm works

to provide clear explanations of tests, diagnoses and

therapies. She specializes in gynecology and obstetrics and

is a graduate of the Tulane University School of Medicine.

Banner Health Clinic

13995 West Statler Blvd., Surprise

623-478-3100 www.BannerHealth.com/HealthCenterSurprise

GYNECOLOGY, OBSTETRICS

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John C. Lincoln Physician NetworkJohn C. Lincoln Physician Network and Scottsdale Healthcare

have five locations for immediate and urgent care.

Designed with convenience in mind, our walk-in centers treat

illnesses and injuries that are urgent, but not life threatening.

Our board-certified physicians help you get back to your best

quickly. More information at JCL.com/minoremergencies.

JOHN C. LINCOLN HEALTH NETWORK

Health Care Provider

2500 West Utopia Rd. Suite 100, Phoenix

623-580-5800 JCL.COM

HOSPITALS

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An affiliate of Scottsdale Lincoln Health Network

Ben Muscha, MDDr. Muscha earned his medical degree from the University

of North Dakota School of Medicine in Grand Forks. He then

completed his residency at the University of North Dakota

Family Practice Center in Bismark. A board certified family

medicine physician, Dr. Muscha is committed to disease

prevention, health maintenance and patient education.

Banner Health Center

1917 South Crismon Road, Mesa

480-610-7100 www.BannerHealth.com/HealthCenterEastMesa

INTERNAL MEDICINE

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Dr. Erlinda RodriquezDr. Erlinda Rodriquez is a family physician, specializing inDiabetes care. Dr. Rodriquez is board certified in FamilyMedicine and Urgent Care and has been recognized bythe NCQA for her care in Diabetes and Heart/Stroke. Dr.Rodriquez is a graduate of the University of Arizona andmember of the American Board of Family Medicine as wellas the American Academy of Family Practice.

CIGNA MEDICAL GROUP

1717 W. Chandler Blvd. | Chandler

480.821.7565

PAIN RELIEF

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Dr. Bernadette ArneckeDr. Bernadette Arnecke is a family physician, specializing in

Internal Medicine. She provides comprehensive primary care

to patients ages 18 and over. Dr. Arnecke is a graduate of the

University of Texas, Galveston Texas and Fellow of the American

College of Physicians.

CIGNA MEDICAL GROUP

10900 North Scottsdale Road, Suite #606 | Scottsdale

480.368.2500

PRIMARY CARE

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Stay healthy and live well!Make an appointment today to

visit any one of these quality health experts.

Welcome to independent living – the freedom to pursuethe life you want, and freedom from the things you don’t.Take up a hobby, stay active and form new friendships.Enjoy each day to its fullest in a community that sharesyour values – at Fellowship Square.

Call us at (602) 943-1800 or visitFellowshipSquarePhoenix.org.2002 W Sunnyside Dr, Phoenix, AZ 85029

ENJOY A CAREFREE LIFESTYLE

• Park-like grounds & paths• Healthy gourmet meals• Fitness & therapy programs

• Heated pool & spa• SeniorFIT™ wellness programs…and much more

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“My third floorbalcony offers amajestic view ofour courtyard.”

-Gordon Wahlberg,Fellowship Square resident

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