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
AR-0008182913-01
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.
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