Health Care

Chronic knee pain can result from a variety of conditions from injury to arthritis, the most common cause of disability in the United States. Banner Boswell Medical Center invites the community to “Knock Out Knee Pain,” a free seminar from 9 to 11 a.m. Dec. 1 in the hospital’s Memorial Hall, 13180 N. 103^rd Drive in Sun City. Light refreshments will be served. Call 602-230-CARE (2273) to reserve a seat.

Dr. James Kort, orthopedic surgeon with Banner Arizona Medical Clinic, and Lori Ramage, PT, Joint Club coordinator at Banner Boswell, will reveal how to keep your knees healthy and what to do if the pain begins to interfere with everyday life.

“Patients shouldn’t have to live with joint pain,” Kort said. “There are a wide range of treatments and interventions available that can help ease pain and in some instances, eliminate it altogether.”

In a 2006 study conducted by the Centers for Disease Control and Prevention, 30 percent of adults surveyed reported experiencing some type of joint pain, the most prevalent being knee pain.

One of the primary causes of joint pain, arthritis, results from wear and tear of cartilage that normally provides a cushion during movement, leading to inflammation and pain. According to a 2008 study by the National Arthritis Data Workgroup, 46 million Americans suffer from arthritic disease – equivalent to more than 21 percent of the adult population. By 2030, researchers estimate that 40 percent of American adults will suffer from some form of arthritic disease.

Do you experience knee pain? You’re not alone. The good news is you can please your knees and stop suffering with the pain.

Learn what treatment options are available for your joint pain at nonprofit Banner Del E. Webb Medical Center by attending a free seminar presented by orthopedic surgeon Dr. Scott Siverhus. 

Siverhus will debunk myths about knee pain, the causes of knee pain and how to rid pain associated with these heavily used joints.

The seminar is from 11:30 a.m. to 12:30 p.m. Nov. 20, in the auditorium at the medical center, 14502 W. Meeker Blvd., in Sun City West. Refreshments will be provided.

Nearly 32 million Americans have osteoarthritis, which commonly affects weight-bearing joints such as the knee, and almost one third of adults experience joint pain. Banner Del E. Webb provides experienced surgeons and orthopedic unit nursing staff with clinical expertise and experience to help you on your way to total knee health and back to doing the things you love.

For information about this free educational seminar, visit www.BannerHealth.com/WebbJointseminar. To reserve your seat, call 602-230-CARE.

 Southwest Prostate Cancer Foundation's men’s health talk program from 10 to 11 a.m. Nov. 5 , sponsored by Southwest Oncology Centers, will focus on smoking cessation/diabetes and active surveillance of prostate cancer.          

Special guests and presenters will be Mr. Wayne Tormala, chief of the Arizona Department of Health Services Bureau of Tobacco and Chronic Disease; Dr. Phranq Tamburrie, NM.D; Dr. Raushanah Najeeullah, N.D.; and Fred Taylor, executive director of SWPCF.

The show will be broadcast in a new format on radio station KXXT 1010AM, or online at www.Familyvaluesradio.Net (click left side of menu). The call-in number is 602-296-3632

Pitluk, vice president and chief medical officer for Health Services Advisory Group, Inc., will focus on breast cancer/colon cancer.

The program will cover a variety of cancers including prostate cancer, breast cancer, and colon cancer. A major aspect is healthy living for both sexes. A major component of the show will be discussions by health care professionals on cancer.

Arizona may face one of its toughest flu seasons this year, but by arming yourself with knowledge, you have a better chance of staying healthy this winter.

Join Banner Thunderbird’s Medical Director of Infection Prevention, Dr. Mandeep Rai, to get the latest flu facts and tips on staying healthy during flu season. Non-profit Banner Thunderbird Medical Center will have a free community presentation about H1N1 and the seasonal flu, where medical experts will also answer questions from the public.

The community presentation will begin at 7 p.m. Oct. 28 in the Banner Thunderbird Conference Rooms 1, 2 and 3 on the lower level of the hospital. Light refreshments will be served.

Attendees will learn about the regular seasonal flu and the H1N1 flu – their similarities and their differences. Rai will also help attendees understand the way influenza is transmitted and what you can do to protect yourself.

Information will also be presented about the latest flu vaccines for seasonal and H1N1 flu including details about the nasal mist vaccine and injectable vaccination. You can also hear about visitor restriction policies that Banner facilities are following to protect patients and visitors from getting sick.

Banner Thunderbird is at 5555 W. Thunderbird Road in Glendale. To attend you must register. To do so, call 602-230-CARE (2273).

Mike O’Leary of Surprise was just 43 when he was diagnosed with early onset Parkinson’s disease.

He had to quit his job at the Palo Verde Nuclear Power Plant, and begin treatment for the disease.

But standard medical treatment began causing such severe side-effects he experienced paranoia and hallucinations, mostly directed at his wife, Linda, who has been diagnosed with familial Parkinson’s.

O’Leary was continually accusing Linda of infidelity until it became too much for her to take.

“She left me for six months,” O’Leary, now 51, said.

In July, O’Leary became the first person in Arizona to receive a rechargeable, deep brain stimulation implant, a device that works similar to a pacemaker that stimulates a precise area of the brain to address symptoms of Parkinson’s disease and essential tremors, stopping the tremors.

Qualified patients who opt for deep-brain stimulation have motor-skill challenges that significantly interfere with their quality of life and cannot be controlled by medication.

O’Leary said everything has improved for him, he’s on less medication, and Linda is back home.

His surgeon, David Pootrakul, discussed deep brain stimulation at Banner Boswell Medical Center Monday, and will repeat the lecture at a Parkinson’s event Oct. 31 at Rio Vista Recreation Center in Peoria.

Pootrakul said deep brain stimulation is being used for treatment of those with movement disorders such as Parkinson’s (tremors while not moving), essential tremors (tremors that exhibit when a patient moves) and dystonia (a neurological movement disorder), but may also be used for obsessive compulsive disorder, and in the future obesity and satiety.

Pootrakul said he has performed the procedure on more than 70 patients who have overwhelmingly experienced improvement in tremors and other symptoms including stiffness, rigidity, balance and walking.

Getting the precise placement of the electrical probes takes an merger of CT scan and MRI reports and an hour and a half of calculations just prior to surgery.

Pootrakul said he has performed the surgery on patients as young as their 30s to those in their 80s, and bases it on overall health and desired outcome.

“For some of the young (inplant recipients) after the procedure, you can’t tell they have Parkinson’s now,” Pootrakul said.

Doctors advised a Sun City West audience Thursday to learn more about the flu and its symptoms and not to panic when the H1N1 virus hits full force in the coming months.

"We encourage that you get the vaccine if it becomes available to you," Cindy Hammond, a registered nurse for infection prevention. "Education is the key to it all," she said.

Hammond was on a panel of four Banner Health health professionals at Banner Del E. Webb Medical Center to provide the latest information about the H1N1 flu virus. Also on the panel were Dr. Charlie Agee, chief medical officer; Dr. William Mostow, director of the emergency department; and Tina Ladowski, emergency management director.

"There are so many people confused about the virus and vaccinations that it’s important for us to get the right information out there," Ladowski said.

Agee said the H1N1 virus headed to the forefront of national attention last year. The flu is similar in makeup, he said, to the virus found in pigs in North America.

The swine flu, Mostow said, has a greater effect on people age 25 and younger, along those who have major health problems.

Mostow said many of the symptoms are the same as the regular flu, but swine flu victims may experience more nausea, vomiting and diarrhea.

Hammond said there are warning signs as well, and they include heavy breathing and pressure in the chest.

Ladowski said it’s important to stay healthy and watchful during this time. She suggests people stay away from others who are sick.

If they must be around anyone, Ladowski said it’s important to remain clean and use hand sanitizers whenever anything has been touched.

In addition, Hammond said she also suggest people receive a regular flu shot.

The Centers for Disease Control is expected to deliver a batch of H1N1 vaccine, which will be given to high-risks groups, including children, first.

Mitchell Vantrease may be reached at 623-876-2526 or mvamtrease@yourwestvalley.com.

Southwest Prostate Cancer Foundation will have a men’s health talk radio show sponsored by Southwest Oncology Centers at 10:30 a.m. Thursday.

The show will be broadcast on KXXT 1010 AM, or online at www.familyvaluesradio.net (click left side of menu). The call-in number is 602-296-3632.

Topics will be the impact of diet on cancer and impact of problems with the state budget on health-related issues. The program also will cover breast cancer and colon cancer and the importance of healthy living for both sexes. A major component of the show will be discussions by health care professionals on cancer.

Special guests and presenters will be Corporation Commissioner Kris Mayes; Dr. Phranq Tamburrie, NM.D.; Dr. Raushanah Najeeullah, N.D., and Fred Taylor, executive director of the Southwest Prostate Cancer Foundation.

The public is invited to join Banner Health experts for the Power Over Parkinson’s 2009 Educational Conferencefrom 8:30 a.m. to 2:15 p.m. Oct. 31 at Peoria’s Rio Vista Recreation Center, 8866-A W. Thunderbird Road.

The event, which is hosted by the Arizona chapter of the American Parkinson’s Disease Association, costs $10 per person for members and $15 per person for non-members. A continental breakfast and lunch are included in the registration fee. Call 800-541-4960 to reserve a seat.

Banner Health experts scheduled to speak and participate in a question and answer session include:

• Neurologist Dr. Holly Shill, Banner Sun Health Research Institute – Parkinson’s disease clinical studies
• Neurologist Dr. M. Cristina Ospina, Banner Good Samaritan Medical Center – Drugs and non-motor symptoms of Parkinson’s disease
• Neurosurgeon Dr. David Pootrakul, Banner Boswell Medical Center – Deep brain stimulation surgery for Parkinson’s disease

The program also includes information on Banner Good Samaritan’s PD Meds Connection program and an interactive session on drumming for fun and exercise.

“Affording the people with Parkinson’s disease in the Phoenix area the opportunity to learn about the latest updates in research, medical treatments and surgical options from nationally known medical experts is the first goal of the Power Over Parkinson’s conference,” said Tom Viviano, APDA state director and coordinator of the APDA Information and Referral Center at Banner Good Samaritan. “When attendees see a gathering of 300 people affected by Parkinson's disease, they don’t feel so alone in their disease. Parkinson's is the second most prevalent chronic neurological disorder after Alzheimer’s, and affects more than 1.5 million Americans. It is estimated that over 20,000 Arizona residents live with Parkinson's, and the goal of the American Parkinson Disease Association is to ease their burden and find the cure.”

There may be a variety of reasons why women may not be able to keep or care for their baby.

But Banner Thunderbird Medical Center wants to remind people about an Arizona law allowing people to voluntarily leave an infant with a “Safe Haven Provider.” Non-profit Banner Thunderbird is a Safe Haven Provider.

In addition to the Glendale hospital which has a safe haven drop off drawer, other Safe Haven Providers are: medical staff at any hospital, fire stations and firefighters, EMTs and paramedics, adoption agencies, private welfare agencies and churches that have a sign indicating they are a Safe Haven Provider.

According to the law, you can give your baby to a Safe Haven Provider without fear of being arrested or anyone trying to identify or find you as long as:

• The baby is 3 days old or younger. (72 hours)
• The baby has not been physically harmed; and
• There are no plans to return for the baby at a later time.

“In addition to the Safe Haven Drawer, which sounds an internal signal when a newborn has been dropped off, the woman, her friends or family can hand over the newborn to any medical staff member here at Banner Thunderbird – no questions asked,” said Kimberly Marshall, clinical manager of Banner Thunderbird’s Pediatric Emergency Department and co-founder of Arizona Safe Baby Haven. “There are options available.”

Women are encouraged to call 1-866-707-BABY(2229) or visit www.ArizonaSafeBabyHaven.com. Services are free and confidential.

According to local health experts, seniors should receive the H1N1 vaccine, in spite of the Centers for Disease Control ranking them as a low priority when vaccines become available.

"The elderly with different conditions and co-morbidities are the ones more likely to die, which has traditionally been the case with every flu," said Hamid Rayani, lead hospitalist with Banner Boswell Medical Center in Sun City. "Right now if you look at the mortality rates (of H1N1), those who have died have not been elderly, which is why some say the elderly should not be worried.

"But I’m very skeptical about this because once it spreads to elderly people, I have a feeling we’ll see mortalities because they don’t have enough resistance. We need to prioritize for the elderly with co-morbid conditions and then those (elderly) without co-morbid conditions."

According to the CDC Web site, emergency workers and health-care workers, caregivers, pregnant women, infants and those aged 6 months to 24 years would receive first priority should limited quantities of the vaccines be available when the vaccines are released.

Those 25 to 64 who have health conditions that put them at a higher risk for medical complications should they contract the flu would also be among the priority cases.

Once those demands have been met, healthy individuals age 25 through 64 years could then receive vaccinations, followed by those 65 and older.

The CDC says studies indicate that the risk for infection among persons age 65 or older is less than the risk for younger age groups.

But health experts stress seniors should still receive the vaccine.

"Seniors should get both the vaccines, even if they think they had a flu sickness," said Mandy Rai, chairman of infectious diseases at Arrowhead Hospital in Glendale. "Over the past few months (H1N1) has shown really bad outcomes from groups in the high priority, such as younger kids and pregnant women, (and not seniors) because it was felt that seniors had some leftover immunity from previous, similar flus."

Rai said many of those experiencing flu-like symptoms now actually have H1N1, and not seasonal influenza.

"Ninety-nine percent of the illness now is H1N1; that is what the county is seeing, but they aren’t even testing or confirming anymore they are being so inundated," Rai said. "We don’t even know how bad the flu season will be, which typically starts around Christmas."

Rai said she wants seniors to not panic and be reassured there are enough vaccines to go around.

"I would also reassure them in the spectrum of the illness, it has been on the mild side," she said. "But having said that, we don’t know what the next few weeks will bring so we need to be very vigilant."

Receiving influenza and H1N1 vaccinations and practicing common-sense techniques for those most at-risk for contracting H1N1 is needed.

"Don’t go into crowded areas, to the cinemas, kids events or football games," Rai said. "And if somebody is sick, try to avoid exposing it to others."

Joy Slagowski may be reached at 623-876-2514, or jslagowski@yourwestvalley.com.

EDITOR’S NOTE: In response to comments made by AARP Arizona President Len Kirschner in the Sept. 18-19 editions of the Daily News-Sun, Dr. Robert Fitzgerald, a Sun City physician, discussed health-care reform Tuesday with the Daily News-Sun editorial board.

A Sun City physician said Tuesday proposed legislation to overhaul the nation’s health system would lead to rationed care and slowly bankrupt the Medicare system as more and more Baby Boomers apply for coverage.

Dr. Robert Fitzgerald, who specializes in emergency room care with a focus on seniors, told the Daily News-Sun editorial board he believes proposals for the overhaul of health care don’t address the primary problem.

"The bottom line is that I believe those bills need to be scrapped and started over again," Fitzgerald said.

His comments came on the same day that liberal Democrats failed in two efforts to include a government-run insurance option in the legislation before the Senate Finance Committee.

Fitzgerald said the proposed legislation, including the bill proposed by Sen. Max Baucus, D-Mont., the finance committee chairman, are based more on financial changes rather than the systemic overhaul the health-care system requires.

And a main problem, he said, is the flood of Medicare-eligible Baby Boomers who soon will be tapping into the funding pipeline.

The doctor said 12,000 Boomers a day will be added to the rolls beginning in 2012 and that will continue for more than a decade.

"Getting everybody an insurance card doesn’t really necessarily mean you’re going to have the right level of care," he said. And since 30 percent of Medicare dollars are spent during the last year of a person’s life, that would mean rationed care, something proponents of the current reform plans dismiss.

"Can all of these patients be admitted to the hospital or can they be sent to skilled nursing facilities which would cut down on the costs?" he said, adding that decisions would have to be made about who would receive what type of care and when.

Fitzgerald said the government should have prepared for some type of reform at least 25 years ago, but there was no political advantage for elected officials to do so.

Now, he said, Congress and the president are talking more about "health-care payment reform" than they are overhauling a system that needs to be fixed from top to bottom.

According to Fitzgerald, there is a need for some public involvement — "it’s important to have a safety net somewhere" — but the private sector needs to be a primary player in any reform.

"To be honest, there isn’t one individual solution to solve all of these problems," Fitzgerald said.

Some of the options to improving health care, Fitzgerald said, include opening up insurance from state-to-state for competitive rates and making the risk pool larger.

In proposed legislation, insurance policies could not be canceled if people get sick. Insurers would not be able to deny coverage for pre-existing conditions for the millions who lack insurance — or have trouble getting it after being laid off or deciding to start a business.

Government subsidies would be available to make premiums more affordable, but individuals would be required to get coverage, and employers would have to contribute.

Ultimately, Fitzgerald said, decisions will have to be made on what type of care Americans want and need.

While the health systems in England and Canada provide acceptable basic care, they are slow to administer more specific treatments, he said. While it could take three weeks for a woman with a lump on a breast to be X-rayed and, if needed, see a surgeon, a similar process in Canada could take months, Fitzgerald estimated.

 

The Sun Health Auxiliary has unanimously elected a new slate of 12 officers and directors to serve on its board for 2009-10.

The new board members were installed at the auxiliary’s annual meeting Sept. 25 in Memorial Hall at Banner Boswell Medical Center in Sun City.

New officers for the 2009-10 term include chairwoman Sandra Gialinas of Surprise; vice chair Carolyn Booy and secretary Marge Loeffler, both of Sun City West; treasurer Clara Ciuffo of Surprise; assistant treasurer Elsie McAvoy of Sun City West; and past chairwoman Barbara Ryan, also a Surprise resident.

The board’s new directors include Surprise resident Shirley Prough (resale operations) and Sun City West residents Sharon Bach (communications/ membership) and Ed Stroming (retail operations). Directors-at-large include Bobbie Buhl and Nancy Gossard, both of Surprise, as well as Sun City resident Dottie Stutzman.

“Leadership is important to every organization,” said Pamela Meyerhoffer, Sun Health Foundation president/CEO. “However, great leadership – which we certainly are fortunate to have – is even more significant when it comes from those who volunteer their time to benefit others.

“Our auxiliary works year-round to raise funds that will provide new medical equipment and augment services for Banner Boswell and Banner Del E. Webb medical centers and their ancillary facilities as well as the Banner Sun Health Research Institute,” Meyerhoffer said. “With this new board’s enthusiasm and dynamic guidance, I have no doubt the Sun Health Auxiliary will continue its fine tradition of caring for our community.”

The technology to detect breast cancer early just got better at the Louisa Kellam Center for Women’s Health at Banner Del E. Webb Medical Center, 14502 W. Meeker Blvd., in Sun City West.

State-of-the-art digital mammography, also called full-field digital mammography, is available at the nonprofit hospital, thanks to a contribution from Sun Health Services.

Digital mammography produces images of better clarity and accuracy than traditional screen-film mammography, resulting in the detection of significantly more cancers (up to 28 percent more), particularly in women under age 50, women with dense breast tissue, and pre-or peri-menopausal women. Notably, digital mammography administers lower doses of radiation to patients and it detects cancers in their early stages, when they are most treatable.

“Early detection is key to survival, which is one reason we are particularly excited about this new imaging capability,” said Larry Bonno, medical imaging director at Banner Del E. Webb.

Another key benefit is the fact that digital images can also be stored and accessed electronically versus having to physically transport the films. This allows radiologists easier access to the images and, ultimately, faster results to patients.

Similar to traditional mammography, the breast is positioned on the machine’s special platform and then compressed as the X-ray is taken.

Digital mammography is the first of two new pieces of advanced imaging equipment to arrive at Banner Del E. Webb. Next month, the hospital will become the first hospital in the West Valley to offer Breast Specific Gamma Imaging, which is for women who have questionable mammograms and need further evaluation.

This piece of equipment is being paid for through an ongoing fund-raising drive led by the Sun Health Foundation.

October is Breast Cancer Awareness Month. According to the American Cancer Society, more than 192,000 cases of breast cancer will be diagnosed in the US this year and 40,170 women are expected to die from the disease. The good news is that, currently, more than 2.5 million breast cancer survivors are living in the United States. 

Banner Del E. Webb is part of Banner Health, a nonprofit health care system with 22 hospitals throughout the West.  To learn more, visit www.bannerhealth.com/Webb.

Banner Boswell Medical Center features a variety of ongoing community health offerings on and near the hospital's campus.

Blood pressure readings are conducted at:

• Rio Vista Recreation Center monthly on the first Wednesday from 5:30 to 7 p.m. and second Monday from 8 to 9:30 a.m., 8866-A W. Thunderbird Road, Peoria
• Banner Olive Branch Senior Center monthly on the second and fourth Thursday from 9 to 10:45 a.m. (September through May), 11250 N. 107th Ave., Sun City
• Banner Boswell Rehabilitation Center monthly on the first and third Thursday from 8 to 9 a.m., 10601 W. Santa Fe Dr., Sun City

Support groups at Banner Boswell, Support Services Bldg., 13180 N. 103rd Drive, Sun City

• Cancer – Third Wednesday, Juniper Room, (602) 230-2273: “I Can Cope” – 1 to 2 p.m., Cancer Support Group – 2 to 3 p.m.
• Laryngectomee – First and third Tuesdays, 4 to 5 p.m., Pinyon Room, (623) 876-5349
• Ostomy – First Thursday, 2 to 4 p.m., Juniper Room, (623) 975-3671        
• Respiratory – Second Tuesday, 1:30 to 3:30 p.m., Juniper Room, (623) 876-5708
• Aphasia – First and third Friday beginning Oct. 16, 3 to 4 p.m., (623) 876-5349, Banner Boswell Ironwood Room, 10401 W. Thunderbird Blvd., Sun City

Support groups at Banner Sun Health Research Institute, 10515 W. Santa Fe Dr., Sun City

• Alzheimer’s Caregivers – Last Monday of each month, 1:30 to 3:30 p.m.
• Parkinson’s – Second Monday, 10 to 11:30 a.m., (623) 583-2040
• Parkinson’s and Partners – Fourth Monday of each month (except December), 10 to 11:30 a.m., (623) 583-2040
• Prostate Cancer – Fourth Thursday, 9 to 10 a.m., (623) 566-2604

Banner Boswell Medical Center invites the community to a free public lecture on deep brain stimulation at 9 a.m. Oct. 19 in the hospital’s Memorial Hall, 13180 N. 103^rd Drive, Sun City. Reservations are encouraged by calling 602-230-CARE (602-230-2273). Light refreshments will be served.

Neurosurgeon Dr. David Pootrakul will discuss DBS for patients with movement disorders such as essential tremor and Parkinson’s disease. Banner Boswell is one of only four centers in Arizona and 160 centers in the nation approved to perform deep brain simulation.

Qualified patients who opt for deep-brain stimulation have motor-skill challenges that significantly interfere with their quality of life and cannot be controlled by medication.

In the largest study of its kind published in the Jan. 7 issue of the Journal of the American Medical Association, researchers concluded that deep brain stimulation improves both physical function and quality of life after six months in patients with Parkinson’s disease. The surgical procedure is approved by the FDA and covered by most insurance providers, including Medicare.

There is no cure for the more than 1.5 million Americans who suffer from the Parkinson’s disease.

A local physician, researcher and expert on Alzheimer’s disease will talk with visitors and sign copies of his book, "The Alzheimer’s Answer," at Sun Health Auxiliary’s Banner Boswell and Banner Del E. Webb gift shops.

Dr. Marwan Sabbagh, director of clinical research at Banner Sun Health Research Institute, is scheduled to appear from 1 to 3 p.m. Oct. 5 at the Banner Boswell Gift Shop (inside the main lobby of Banner Boswell Medical Center, 10401 W. Thunderbird Blvd., Sun City); and 2 to 4 p.m. Oct. 19 at the Banner Del E. Webb Gift Shop (inside the east lobby of Banner Del E. Webb Medical Center, 14502 W. Meeker Blvd., Sun City West).

"The Alzheimer’s Answer" is a comprehensive tool for the entire family, guiding readers through facts of the disease and providing real tips for prevention as well as supportive information on diagnosis and treatment – including where to turn if you or a loved one has Alzheimer’s. The book covers available therapies – with Sabbagh discussing the advantages and downsides of each – as well as promising new developments and forthcoming treatments.

“Alzheimer’s is the embodiment of all that is sad and destructive with aging,” Sabbagh said. “My goal with this book is to translate some of the complex scientific ideas driving Alzheimer’s treatment and research today into practical information people can use to assess their risk and develop a prevention strategy.”

“Sadly, so many of us have had this terrible disease touch our families and friends,” noted Sandy Gialinas, auxiliary chairperson. “Our auxiliary is so grateful to have Dr. Sabbagh share his expertise with our community at these signings.”

For each copy of "The Alzheimer’s Answer" sold at the auxiliary’s gift shops, a portion of the proceeds returns to Sun Health Auxiliary. The auxiliary’s fund-raising efforts provide medical equipment to support Banner Boswell and Del E. Webb medical centers and their ancillary facilities as well as to support ongoing investigations at Banner Sun Health Research Institute.

Sun Health Auxiliary exists to make a difference in people’s lives by raising funds to purchase vital medical equipment for nonprofit healthcare facilities in the West Valley.

There are special interest groups trying to block progress on health care reform by using myths and scare tactics. Like the notion that health care reform would ration your care, hurt Medicare or be a government takeover. Actually, these are false statements.

All of the health care reform plans currently being debated in Congress would ensure that you and your doctor are the ones making decisions about your health. The majority of working Americans will continue to receive their health care through their employer. In addition, health care reform will strengthen Medicare by eliminating billions of dollars in waste while lowering prescription drug prices.

Throughout the debate on how to fix what's broken about our health care system, AARP pledges to help you cut through the noise and find the facts about what health care reform means for you and your family. When we see special interests using scare tactics, we'll make sure you're given the facts so you can make informed decisions about health care reform.

The following are some of the most common myths being spread about health care reform and the facts that prove them wrong – click here to watch a video by AARP on the myths and facts of reform.

Myth: Health care reform is socialized medicine.

Fact: Health care reform will preserve the employer-based health care system, meaning an estimated 200 million Americans will continue to get their coverage through their employers.

Fact: For people buying coverage for themselves, there would be a range of private health plans to choose from. Also, the so-called "public plan" option would seek to give American consumers another choice if they can't find affordable, quality coverage in the private insurance market. The goal of the "public plan" is to give consumers the best value for their money and force greater competition among insurance plans for our business.

Fact: Every proposal that Congress is considering would allow people to choose their own doctors and hospitals.

Bottom Line: Health care reform isn't about a government takeover. It's about guaranteeing all Americans a choice of health care plans they can afford.

Myth: Health care reform means rationed care.

Fact: None of the health reform proposals being considered would stand between individuals and their doctors or prevent any American from choosing the best possible care.

Fact: Health care reform will NOT give the government the power to make life or death decisions for anyone regardless of their age. Those decisions will be made by an individual, their doctor and their family.

Fact: Health care reform will help ensure doctors are paid fairly so they will continue to treat Medicare patients.

Bottom Line: Health reform isn't about rationing; it's about giving people the peace of mind of knowing that they will be able to keep their doctors and that they will always have a choice of affordable health plans.

Myth: Health care reform will hurt Medicare.

Fact: None of the health care reform proposals being considered by Congress would cut Medicare benefits or increase your out-of-pocket costs for Medicare services.

Fact: Health care reform will lower prescription drug costs for people in the Medicare Part D coverage gap or "doughnut hole" so they can get better afford the drugs they need.

Fact: Health care reform will protect seniors' access to their doctors and reduce the cost of preventive services so patients stay healthier.

Fact: Health care reform will reduce costly, preventable hospital readmissions, saving patients and Medicare money.

Fact: Rather than weaken Medicare, health care reform will strengthen the financial status of the Medicare program.

Bottom Line: For people in Medicare, health care reform is about lowering prescription drug costs for people in the "doughnut hole", keeping the doctor of your choice, improving the quality of care, and eliminating billions in waste that is causing poor care and medical errors.

Myth: Health care reform is too expensive – we can't afford it.

Fact: The President and Congress have committed to producing legislation that will be paid for so it won't saddle our children and grandchildren with debt.

Fact: If we do nothing to fix health care, families with Medicare or employer-based health coverage will likely see their premiums nearly double again in the next seven years.

Fact: If we do nothing to fix health care, the share of your income spent on health care will nearly double in the next seven years.

Bottom Line: When one in three Americans say someone in their family skipped pills, postponed or cut back on needed medical care due to the cost; when countless bankruptcies are related to medical expenses; when the number of uninsured approaches 50 million; when government spending on health programs rises so rapidly that it jeopardizes other priorities; and when employers struggle to pay for the costs of health care, the fact is, we can't afford not to fix health care.

Myth: Health care reform means the government can make life-and-death decisions for you.

Fact: Health care reform will NOT give the government the power to make life-and-death decisions for anyone regardless of their age. Those decisions will be made by individuals, their doctor and their family.

Fact: No one, including the government or your insurance company, will be given power to make life-and-death decisions for you.

Bottom Line: Health care reform isn't about putting the government in charge of difficult end of life decisions. It's about giving individuals and families the option to talk with their doctors in advance about difficult choices every family faces when loved ones near the end of their lives.

 

BOSTON (AP) — Should the federal government require virtually all Americans to be insured or face thousands of dollars in fines? Proponents say this requirement is crucial to extending coverage and reining in costs as Massachusetts has done. Critics say it would impose an unfair burden on individuals and families already struggling in harsh economic times.

A look at the issue in question-and-answer form:
———
Q: What's being proposed?
A: Democratic Sen. Max Baucus of Montana, chairman of the Senate Finance Committee, is proposing that, as part of any overhaul, insurance be mandatory for all Americans, much the way car owners are required to have auto coverage. People making up to three times the federal poverty level — about $66,000 for a family of four and $32,000 for an individual — would be eligible for tax credits to help cover the cost of premiums. Those who fail to get insurance would face stiff fines, from $750 a year for an individual to $1,500 for families. The maximum penalty on individuals would be $950, while families could face maximum fines of $3,800.
———
Q: What is the proposal based on?
A: The plan is based in part on an element of Massachusetts' sweeping health care law, known as an "individual mandate." When Massachusetts passed the 2006 law, it became the first state to require that virtually all residents have health insurance or face a series of steadily increasing fines. To help soften the penalty, Massachusetts first created state subsidized insurance plans for those earning up three times the federal poverty level, with the poorest residents getting essentially free care and those earning more paying increasingly higher premiums and copays. The state also created a Health Care Connector — similar to the "health care exchange" being proposed on a federal level — to help those ineligible for subsidized care connect with lower-cost private health plans. Finally, Massachusetts decided to exempt from fines for anyone who doesn't qualify for the subsidized plans but still can't find any affordable private plan based upon state affordability standards.
———
Q: Who has been fined in Massachusetts?
A: Massachusetts decided to phase in its fines. During 2007, the first full year of the health care law, those who refused to get insurance lost the personal exemption on their state tax returns — equivalent to a $219 fine. In subsequent years, the fines were scheduled to increase dramatically. In 2008, a fine for an individual who could afford insurance but refused was $76 for each uninsured month or $912 for the entire year. For couples, the maximum fine for the entire year would be $1,824. In 2009, the fines increased again, to $89 a month or $1,068 for an entire year for an individual. For couples, the maximum fine was $2,136.
———
Q: So how many people have actually been fined in Massachusetts?
A: The state has so far only released numbers for the first year. In 2007, nearly 3 percent of state's taxpayers — about 97,000 filers — were uninsured even though they could have afforded health care and were stripped of the $219 exemption. An additional 2 percent — or about 62,000 filers — were found not to earn enough for health care and weren't fined. The state allows taxpayers to appeal the fines. Numbers for 2008 are expected later this year.
———
Q: Why have fines at all?
A: There are a few basic arguments for requiring health care for as many people as possible. One argument is that it spreads risk among as wide a group as possible, which helps lower overall costs. Another argument is that insuring the largest number of Americans will take some of the pressure off premiums for those who are already insured. President Barack Obama has said insured Americans pay what amounts to a hidden fee to help pay hospitals for the cost of covering the uninsured. Without fines, advocates say, there would be no way of enforcing the mandate.
———
Q: What has Obama said about an individual mandate?
A: During the presidential campaign, Obama criticized the idea of fining individuals for not having health insurance. During a Democratic debate in February 2008, Obama warned that fines could lead to a situation like that in Massachusetts, where, he said, some residents were choosing to accept a fine because it was less expensive than health care premiums. "We don't want to put adults in a situation in which, on the front end, we are mandating them, we are forcing them to purchase insurance, and if the subsidies are inadequate, the burden is on them, and they will be penalized," he said.

Seasonal flu shot locations have been announced by Cigna and Mollen Immunization
Clinics. They are:

Mollen Immunization Clinics

The clinics are open from 10 a.m. to 5 p.m. Monday through Saturday at:

• Camino del Sol and R.H. Johnson Boulevard in Sun City West.

• North Del Webb Boulevard and West Thunderbird Boulevard in Sun City.

• Thunderbird Road and 43rd Avenue in Glendale.

Cigna

Shots are available to those with and without insurance. Seasonal shots do not contain protection against the H1N1 virus. Protection against H1N1 will require two additional vaccinations once a vaccine has been approved and released by the federal government.

Seasonal flu shots cost $26 out-of-pocket for the public. Most people who have Cigna insurance will not incur a cost, as this is a covered benefit for preventive care. Those carrying non-Cigna medical insurance plans will pay $26.

• Cigna Medical Group Sun City Multi-Specialty Center, 13041 N. Del Webb Blvd., Sun City, 623-876-2300, available to those 9 years old and above only, 8 a.m. to noon Sept. 19 and Oct. 10.

• Cigna Medical Group Sun City West Medical Office. 13991 N.W. Grand Ave., Suite 105, Surprise, 623-455-7800, available to those 9 years old and above only, 8 a.m. to noon Sept. 26 and Oct. 3.

• Cigna Medical Group Westridge Medical Office, 2302 N. 75th Ave., Phoenix, 623-849-7500, 8 to 11:30 a.m. Sept. 26, Oct. 10 and 24.

Seasonal flu shots also are available daily, without appointment, to those with or without Cigna insurance at all Cigna Medical Group CareToday locations:

• Cigna Medical Group CareToday Arrowhead, 20165 N. 67th Ave., Suite 107, Glendale, 623-561-1590, today through Nov. 30.

• Cigna Medical Group CareToday Surprise, 13794 W. Waddell Road, Suite 207, Surprise, 623-214-8755, today through Nov. 30.

For additional dates and times, call 602-906-2750.

To help prevent the spread of the influenza viruses, including H1N1, Banner Health medical centers and facilities began enacting visitor restrictions in their facilities Tuesday, which include restricting children 12 and under from patient-care areas.

Banner Del E. Webb Medical Center in Sun City West is one of three Banner locations that will completely ban children from entering the facility beginning Sept. 14. Banner Good Samaritan Medical Center and Page Hospital are the other two facilities enacting the ban.

Cindy Hammond, infection preventionist with Del Webb, said they chose to enact the stricter ban because of the patient population.

"As a facility, we wanted to institute more restrictions on children’s visitations to help protect patients, visitors and staff," Hammond said. "We have a lot of women and infants who are part of the higher risk (category for H1N1). And we have a lot of older clientele who are immuno-compromised and are more susceptible to the flu."

Visitors will be told they either need to return home with the children, or arrange for them to be supervised by an adult in an area outside the hospital, Hammond said.

"We don’t want kids sitting in cars waiting," Hammond said. "We’re concerned about their safety."

Visitors at Banner Boswell Medical Center in Sun City will be allowed to bring those 12 and under into the facility, but not to patient-care areas.

Meenal Patel, infectious disease physician on Boswell’s staff, said the facility is discouraging children 12 and under from coming into the building, but is not going to ban them entirely.

"We’re not being that aggressive," Patel said. "But they cannot go into patient-care areas."

Patel said Boswell has the same concerns about spreading influenza viruses, which have higher incidences of infections in the younger populations.

Since Boswell does not have a neo-natal unit, the patient population at Boswell doesn’t warrant further restrictions.

Banner Thunderbird Medical Center in Glendale also will allow children 12 and into the facility, but not in patient-care areas.

"Banner Thunderbird has a different mix of population than Del Webb visiting its facility," said Rainey Daye Holloway, director of public relations. "Del Webb’s visitors tend to be of an older population, putting them at higher risk for the flu."

Stricter restrictions may be in the future, if warranted, she said.

"Here at Thunderbird, we are evaluating decisions regarding our visitor restrictions on a daily basis," Holloway said. "Depending on the severity of the flu season, it is possible that we could institute stricter visitor policies at a future time. It’s a day-by-day decision based on what is best for our patients, their families, our employees and the community as a whole."

The Banner facility general restrictions are:

• Do not visit the hospital if you have signs of possible flu (runny nose, cough, fever, etc.)

• Children 12 and under will not be permitted in patient-care areas in the hospital. Research indicates that children are the main carriers and transmitters of the flu

• Typically, patient care areas include any location where a patient may receive care, such as patient rooms, medical imaging, speech/occupational/physical therapy, outpatient services, etc. Visitor restrictions do not apply to public areas such as waiting rooms, lobby, cafeteria or gift shops.

• Each hospital will determine what is considered a patient-care area.

• Children may be allowed into patient care areas on a case-by-case basis only after a child has been provided with a respiratory mask, gloves and observes strict precautions during this visit.

• Visitors are asked to wash their hands often and before entering a patient’s room and upon leaving. Sinks and waterless hand sanitizer units are available on all nursing units.

These restrictions were developed by Banner Infectious Disease workgroup.

Joy Slagowski may be reached at 623-876-2514 or jslagowski@yourwestvalley.com.

Children who get sick with flulike symptoms need to stay home, health experts agree.

The first step to help temper the spread of the H1N1 virus this fall is to limit exposure.

“The main key is to send sick kids home,” said Dr. Bob England, Maricopa County’s director of public health. “Parents need to make a plan right now if their kids wake up sick in the morning.”

The H1N1 virus is now the dominant flu striking people around the globe. But so far, it is not making people any more sick than the seasonal virus has in the past, according to the Centers for Disease Control and Prevention.
“For the vast majority of us, including most kids, this will feel just like seasonal flu,” England told participants in a Tribune online event Monday. “We’ll feel exhausted, achy, feverish, and probably have a cough and/or sore throat.”

Underlying conditions — such as diabetes, respiratory illness or immune disorders — can make some children more vulnerable.

England said parents of children with a history of these illnesses should call a doctor as soon as flulike symptoms arise.

“A lot of providers will tell you to come in and be seen. Others may prescribe antivirals over the phone,” England said.

Both the H1N1 virus and the seasonal flu have similar symptoms: fever, body aches and a cough. Though one is not more lethal than the other, the H1N1 virus is proving to be more transferable.

Parents may want to call a doctor if their child:
• Has a fever that doesn’t go away after a few days or has a dramatically high fever.
• Is listless or seems to have no energy.
• Has difficulty breathing.
• Struggles to keep fluids down.

“That’s the big one with kids,” England told the Tribune. Parents need to make sure their children stay hydrated.

Marti Reich, infection preventionist at Mesa’s Banner Desert Medical Center and Cardon Children’s Medical Center, said patients should come to the emergency room when they have symptoms they can’t manage at home. “If you’re having respiratory distress or can’t manage the fever or keep hydrated, it’s appropriate to see your doctor or the emergency room,” she said. Signs of respiratory distress include difficulty breathing, a bluish color to skin or lips, and lethargy or difficulty arousing a person. 

In the spring, emergency rooms and urgent cares saw increased traffic when news of the H1N1 virus hit and so little was known about it. The East Valley will have more capacity at its emergency rooms, though, when the Cardon Children’s Medical Center opens in November.

Unlike last spring, Banner Desert’s emergency room — as well as the children’s emergency room on the same campus — will not conduct a rapid test for influenza because the test was too unpredictable in the spring, Reich said. Emergency room patients also will not be offered medication, such as the antiviral Tamiflu, she said.

“For people who come to the ER thinking they have the flu, they’re going to receive supportive care and education. If they don’t require admission, they won’t be getting a test or medication unless they’re in a high-risk group that has special needs,” she said.

With surveillance of the disease going on around the world, the medical community knows more about what to expect. Health care providers can also track local cases of the illness through the Maricopa County Department of Public Health Web site and track statistics from local emergency rooms.

Reich said those reports will help predict staffing needs for the hospitals. Administrators can also look at how ill patients are to determine staff ratios.

Hand sanitizer is available at all entrances, Reich said. Instructions at the emergency room will request that patients with a cough put on a mask.

Reich said signs are now posted explaining restrictions at the Banner hospitals around the Valley. Beginning today, children 12 and younger will not be allowed to visit in the hospitals.

Local health offices are preparing for the seasonal flu vaccine clinics to start, some this week. Health officials around the state suggest that the public get vaccinated for the seasonal flu vaccine now — and the H1N1 vaccine when it’s available — to try to reduce the impact of both illnesses on emergency rooms, urgent cares and doctors’ offices.

Dr. Bob England, director of the Maricopa County Department of Public Health, answered questions about the H1N1 virus online Monday during a CoveritLive event at evtrib.com.
Questions came from participants as well as the Tribune, the Daily News-Sun's sister paper in the East Valley. All questions and comments are online.
Some excerpts:

Q: Dr. England, there have been a lot of comments and concerns from parents regarding the vaccine for H1N1. Can you give us a description of what is required to get a vaccine from idea to market? What tests are done?

England: Clinical trials for the Novel H1N1 vaccine began on July 22, 2009. Results are expected very soon. The trials are designed to answer three primary questions:
• Are these vaccines safe in healthy people of various ages?
• How large a vaccine dose, and how many doses of vaccine, are needed to induce an immune response that is predictive of protection?
• Can 2009 H1N1 influenza vaccine be safely administered at the same time or sequentially with the seasonal flu vaccine, and will both vaccines induce protective immune responses?

Q: What are the latest recommendations about who should get the H1N1 vaccine?

ENGLAND: On July 29, 2009, the Advisory Committee on Immunization Practices (ACIP) — an advisory committee to CDC (Centers for Disease Control) — recommended that novel H1N1 flu vaccine be made available first to the following five groups: pregnant women, health care workers and emergency medical responders, people caring for infants under 6 months of age, children and young adults from 6 months to 24 years, people ages 25 to 64 years with underlying medical conditions (e.g. asthma, diabetes). Combined, these groups would equal more than half of us.

Q: Will health care providers be required to receive vaccinations?

England: I only know of one state that is requiring health care providers to be vaccinated when it’s available — New York. But … health care workers should always be vaccinated against all flu. You work very hard to care for people, and the last thing you want to do is give someone an illness that could kill them.

Q: I have heard that the virus has already mutated. Is that a fact?

England: Flu mutates a lot. Already, there have been many slight mutations that have been detected. None of them, however, has shown a major change in how sick it makes people, and that’s the key one to watch for.
This is a rapidly changing situation, and details are likely to continue to change as we go along. How sick it’s making people, when and where vaccine is available, on and on. The take-home point is to stay tuned. We’re building a Web site, StopTheSpreadAZ.org, that will have all sorts of info as well as links to everything else you may need.

Q: The H1N1 virus has been in the headlines a lot in the last week. Why is this any different than a regular flu illness or season?

England: Because it’s a new strain to which most of us have no partial immunity, and it is expected to spread a lot faster than regular flu. We expect an early wave of this to begin sooner than our regular flu season, and to make perhaps one-quarter or one-third of us sick over the next few months, unless we take actions that decrease the spread. It does not seem to be making more people than usual seriously ill, but if you have, say, three times as many people getting sick, then perhaps three times as many people may be hospitalized or die than in a usual flu season.
On top of that, although nearly everyone who has become seriously ill so far has underlying risk factors, it is seriously affecting many more young people than the regular, seasonal flu does. More than half of our hospitalized cases have been children, and the average age of death, the last I looked, was in the 30s. By contrast, older people seem to have some cross immunity, probably from a virus that went around 50 to 60 years ago, so that people older than 65 seem much less likely to become infected.

Q: Is the vaccine already in Arizona in the amount we need, or is it “coming?”

England: We expect to begin to receive vaccine at some point in October, the earlier the better. Eventually, I think we’ll have enough for anyone who wants it, but at first, that won’t be the case because they’ll be shipping it as fast as they can.
It will be delivered to private providers, mass flu shot providers, hospitals, some clinics and elsewhere, but it won’t go to everyone at once. We’ll be trying to direct it to those most in need first.

Q: Given that the vaccine will arrive rather late, will I still need to get it if I’ve already contracted and recovered from the flu?

England: A lot of people who got sick may have had something other than the flu. Others who had true influenza, especially if they got it last spring, when the novel flu was first circulating, may well have had last season’s regular, seasonal flu. So it’s not an easy answer, and all the standard guidelines will tell you to err on the side of caution and get it anyway.
Having said that, if you really had the flu during the summer, the odds are very good that indeed, you’ve already had the novel flu and probably wouldn’t benefit from the vaccine (unless there’s a major mutation that occurs in the meantime to decrease your natural protection).

Q: Do you expect that here in Arizona where it is hot, that we would have less of an outbreak of the flu?

England: I expected it to practically go away this summer, like seasonal flu does every year, but I got surprised. We had six or so people hospitalized every week here all summer long, meaning that a LOT more people than that were getting sick.
Novel strains, that cause pandemics, don’t always follow the usual flu season.

Q: I know they’re testing the new vaccine, but does anyone know how it will interact with the seasonal vaccine? Are both really necessary?

England: There’s no reason to think that there would be any interaction between them. Don’t forget, there are three different strains in the regular, seasonal flu vaccine, and that doesn’t cause any interaction. This is essentially adding a fourth strain.
Having said that, your question is one of the things the clinical trials will answer for sure, including making sure that they can be given at the same time, which there’s no reason to think that they couldn’t be.
And yes, they’re both protecting against different viruses, so you still need your regular flu vaccine to protect against seasonal flu, and the novel flu vaccine to protect against the new strain.

Q: In addition to testing the vaccine for efficiency, will they test it for side effects?

England: Yes, they’re testing for side effects. This is being made in the same basic way as any flu vaccine, so there’s no reason to expect any significant difference in side effects. But … you need to understand that very rare side effects won’t be detectable until a very large number of people have been vaccinated. The CDC is planning a more aggressive search than usual for rare side effects as this rolls out.
And don’t forget … a lot of people are going to die from this disease before we’re done. I’d rather take a really rare risk of a side effect than a one-in-three risk of getting sick, and a much higher risk than side effects of becoming seriously ill or dying from the disease. If the disease were rare, you might reconsider, but this disease is going to affect a lot of us, and many more people than we’re accustomed to seeing may die from it before we’re through.

Q: I have six kids. How much will the vaccine cost me?

England: The novel flu vaccine is being entirely purchased by the federal government, so it will be free. However, a provider may charge an administration fee, or bill your insurance for it. We’re asking mass vaccinators, like Mollen Immunizations, to sign up through us to do mass clinics in schools, to cover school-aged kids.

Q: What about seniors over 65? Usually they are urged to get flu shots as well.

England: Regular, seasonal flu seriously affects older adults the most. And most older adults are good at getting their flu shots every year. However, the good news for seniors is that they’re much less often affected by the novel flu strain than others.
By focusing on children (who are not only at higher risk but also spread the infection much more) we hope to slow the spread throughout the community, so that older adults, and everyone else, are also less likely to be exposed in the first place. That will allow us enough time to get enough vaccine shipped that everyone who wants it can then get it, including seniors.

Q: Can nursing mothers receive the shot and if so, does the vaccine pass through breast milk?

England: Yes, nursing moms (and pregnant women) can and should get the vaccine. Yes, some passive immunity should pass to your child, but especially so if the vaccine gets here while you’re still pregnant.
Vaccinating pregnant women is important for two reasons. First, while pregnancy is always a risk factor for seasonal flu, historically, during novel flu pandemics, that risk goes WAY up. We’ve already seen deaths in pregnant women from this.
Second, infants less than 6 months of age can’t get their own shot. If their mom was vaccinated during pregnancy, they’ll have good antibodies from the mom throughout that period to help protect them.

MIAMI (AP) — Cecile Sangiamo liked her health insurance — until she needed to use it.

The 72-year-old Clearwater, Fla., resident had been on the federally subsidized, privately run Medicare Advantage policy through WellCare Inc. for about three years when she started having pain that made it hard to walk.

Her doctor's referral to an orthopedic specialist was denied by the insurer. Her out-of-pocket costs were higher than she was initially told. And when Sangiamo needed surgery, she said, WellCare offered some unexpected medical advice.

"Take pills and use a walker," Sangiamo remembered being told by the insurer, which declined to comment on the case. "I wanted to say, 'I'll take the walker and bang you in the head with it.'"

Seniors have flocked by the millions to Medicare Advantage, privately run plans offered as an alternative to traditional, government-run Medicare. Programs that promise lower premiums or other perks have combined with heavy marketing from insurance companies to make the programs double in size in the last six years to nearly 11 million members and growing.

But critics say that Sangiamo's case is all too common and that the plans put profits above care and denials of service are routine.

Profits at the insurers offering Medicare Advantage have far outpaced expectations, and their expenses to treat clients have been far lower than projected.

Advantage insurers are required to offer perks beyond traditional Medicare, such as gym memberships or hearing aids. Enrollees also often get care coordination among the many doctors an older person might have. But there is no standardization of the thousands of plans seniors can choose from, and co-pays and premiums vary widely.

In the debate on overhauling the U.S. health care system, Advantage has been criticized as an example of a broken system that costs too much, confuses enrollees and suffers from a lack of oversight.

Government payouts for Advantage of $111 billion a year and, on average, 14 percent more per patient than traditional Medicare have made the plans a key target for lawmakers and President Barack Obama, who has cited it frequently as too costly.

Proponents of Advantage and the many seniors who like their coverage hail its added benefits and care coordination. But even many backers acknowledge one of its toughest problems is few seniors understand the essential difference in private plans: Even services covered by traditional Medicare that doctors deem medically necessary routinely need the insurers' advance approval and are sometimes denied.

"There are so many hoops to run through, there are so many rules, it's just mind-boggling," said Mary Johnson, policy analyst for The Senior Citizens League, a nonpartisan, 1.2-million-member group. "Woe is you if you have any kind of chronic problem, and woe is you if you're ever hospitalized."

Participants have been denied visits to specialists, rehabilitation to help them walk again and countless other services they'd be entitled to under traditional Medicare.

"Every decision is based on not what's right for the patient, but what's right for the bottom line," said Dr. Michael Sedrish, who coordinates HMO payments for Medisys Health Network, which runs three New York City hospitals.
———
Everyone over 65 and many disabled people qualify for Medicare. Private plans, paid for by the government but run by private insurers, were added in the 1970s to give added choices in coverage.

In 2003, the government added lucrative subsidies for insurers, now totaling more than $15 billion a year. Many more companies got into the business, with massive marketing efforts, and enrollment went from 5.3 million in 2003 to more than 10.7 million in July.

With basic Medicare, seniors generally know what sort of coverage they're getting. That's not the case with the roughly 7,000 Medicare Advantage plans, where one person's coverage could be completely different from a next door neighbor's.

Another notable difference between traditional Medicare and Advantage plans is that the vast majority of traditional Medicare denials come after treatment, when the doctor or hospital is fighting to get paid. Advantage denials sometimes come before treatment, delaying it or preventing it.

The Centers for Medicare and Medicaid Services acknowledges having more data on what services patients are getting and what ones are denied would be beneficial, but it is complicated by the sheer number of plans.

"It's a pretty daunting task," said Tony Culotta, Medicare's director of enrollment and appeals, "but it's something that we're working toward."
———
Ask seniors about Medicare Advantage and you'll get an earful.

Michelle Mancini, 42 and on Medicare because she has spinal degeneration, was on traditional Medicare but signed up last year for an Advantage plan from Citrus Health Care, believing she'd have fewer out-of-pocket expenses.

The St. Petersburg, Fla., resident suffers from a jaw disorder that causes clicking, popping and pain when she eats or yawns. Getting approved to see a specialist took months. Approval for needed surgery took longer. When it was finally over, she realized the post-operation therapy she should have received to deal with the pain had never been submitted for approval.

And so she waited, in pain. For a month. Unable to eat.

The process was so taxing, the pain so agonizing, she felt she needed a psychologist to talk through the experience. And so she had to fight to get that approved, too.

"There's a hoop-jumping you have to go through," she said. "This goes on week after week, month after month — I just want to give up."

A Citrus spokeswoman, Lisa Brock, said Mancini was treated well but that Advantage clients sometimes were confused about benefits.

Citrus, as well as WellCare, which handled Sangiamo's case, were disciplined for contract violations this year by the Centers for Medicare and Medicaid Services, the government agency that oversees the program, and ordered to stop marketing their plans and enrolling new clients.

Advantage supporters and insurers say problems have been isolated.

"Seniors are getting additional benefits, they're getting additional services and they're very happy with the program," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans, an industry group. He cited a 2008 study paid for by AHIP that showed similar rates of satisfaction for both Advantage and Medicare enrollees.

Carolyn White, 55, of Maynardville, Tenn., is happy with her coverage even with its hassles.

She has a split pancreas that affects nearly every aspect of her life. Her doctor recommended a gastric pacemaker costing more than $67,000 to help control crippling nausea.

Cariten Senior Health denied the device, and White went through months of appeals. But in the end, she got it, and has nothing negative to say about her insurer. "They were more than wonderful," she said. "They've gone to bat for me."
————
Enrollees in both traditional and private plans pay part of the costs. Under traditional Medicare, many carry an additional private policy, known as MediGap, to cover what the government doesn't, and that policy can cost a few hundred dollars per month.

Seniors often join Advantage plans because they think they'll cut expenses through lower premiums or co-pays, and this can be true. But it's difficult to tell when signing up, because the benefit rules can be daunting and medical issues can crop up unexpectedly.

A 2008 Government Accountability Office report found wide differences in enrollee costs depending on the plan, including home health service costs that could be up to 84 percent more than traditional Medicare.

A half-million Advantage enrollees were in plans with no co-pay for hospital stays. But a roughly equal number were in plans with high hospital co-pays and no limits on out-of-pocket inpatient expenses, potentially costing patients thousands more.

The disparity was greatest for some of the sickest seniors, the GAO found — those who return to the hospital within 60 days of discharge. Under traditional Medicare, those patients would not pay any deductible. Under many Advantage plans, it could be steep.

"The plans tell them they have the same coverage," said Delores Bowman, who handles calls to the Medicare Rights Center, "and they don't."

The independent nonprofit helps Medicare enrollees, and the makeup of its roughly 10,000 annual calls has changed dramatically, dominated by complaints from Medicare Advantage customers.

"The HMOs seem to deny everything," she said.
————
Insurers make big profits from Advantage.

Another GAO report released last year and based on 2006 data shows Advantage insurers' profits were $3.36 billion, far exceeding a projected $2.03 billion. And though enrollment grew quickly, medical expenses were $360 million lower than projected.

A year earlier, the insurers' profits were nearly triple projections.

The Obama administration already has announced new restrictions on Advantage plans, including closer scrutiny of high-deductible coverage, but more are expected and might be included as part of the overall health reform bill.
Obama has focused on Advantage as one of an array of changes to pay for his health initiatives.

"There's no showing that seniors are healthier using Medicare Advantage than using regular Medicare," he said last month in Raleigh, N.C. "But, taxpayers, you fork over an additional $177 billion to them over 10 years. You take that out — that right there helps pay for millions of people who could get coverage."
————
At Jamaica Hospital, it all became clear with Angela Dispenza.

The New Yorker was a healthy 77-year-old when she fell two years ago and fractured her back.

Doctors thought it obvious that Dispenza should be admitted to the hospital, then receive rehabilitation as her best chance to walk again. The hospital says her Medicare Advantage plan, Oxford, denied her hospital admission, rehabilitation and even an ambulance ride home.

The hospital admitted Dispenza anyway. It was paid, though not in full, only after going public with the case. Dispenza was able to walk out of the hospital on her own; doctors said she would have been bedridden and died without the treatment they insisted on.

Sedrish, whose Medisys network of hospitals in New York owns Jamaica Hospital, found her case such an egregious example of denials he says he sees so often that he set out to prove it.

He analyzed files for 16 months in 2006 and 2007, looking only at patients from on insurer, Oxford, in need of just two types of care, acute rehabilitation and treatment for traumatic brain injuries. Of 46 such cases, the hospital says, all but three were denied.

Oxford declined to comment.

"There are barriers on top of barriers on top of barriers to try and prevent people to get the services," Sedrish said. "No one ever gave these insurance companies the right to decide who should live and who should die."

READ MORE ABOUT MEDICARE ADVANTAGE IN MONDAY'S DAILY NEWS-SUN.

Effective Sept. 2, all Banner Health hospitals in Arizona will enact visitor restrictions to protect patients, visitors and employees during this influenza season.

The visitor restrictions are:

• Do not visit the hospital if you have signs of possible flu (runny nose, cough, fever, etc.)
• Children ages 12 and under will not be permitted in patient care areas in the hospital. Research indicates that children are the main carriers and transmitters of the flu. Each hospital will determine what is considered a patient care area.

Typically, patient care areas include any location where a patient may receive care, such as patient rooms, medical imaging, speech/occupational/physical therapy, outpatient services, etc. Visitor restrictions do not apply to public areas such as waiting rooms, lobby, cafeteria or gift shop. Banner Health believes this solution provides options for places children could stay with an adult while others visited patients.

• Children may be allowed into patient care areas on a case-by-case basis only after a child has been provided with a respiratory mask, gloves and observes strict precautions during this visit. Some hospitals may choose to implement stricter visitor restrictions under special circumstances.
• Please wash your hands often and before entering a patient’s room and upon leaving. Sinks and waterless hand sanitizer units are available on all nursing units.

These restrictions were developed by Banner Infectious Disease Workgroup. For information on how to protect yourself and your family against the flu, go to http://bannerhealth.com, Keyword: flu.

Age-old advice from grandmothers is being reinforced by modern-day advertising, but a recent study indicates that allowing babies to sleep on their sides or tummies amid stuffed animals and colorful mobiles can contribute to sudden infant death syndrome.

Pediatrics magazine found two-thirds of the images depicted in magazines show dangerous baby sleep environments, and Janet Peirce-Hollett, Women’s Health educator at Banner Del E. Webb Medical Center in Sun City West, is trying to make that point to soon-to-be moms.

"It’s a big concern when parents are thumbing through a magazine and see pictures and images of a nursery and get an unrealistic view of how it should look," said "A safe crib is a boring crib," Peirce-Hollett said. "It’s a firm, well-fitted, new mattress in a new crib with one nice sheet over it. And that’s it: no bumpers, no mobiles, no pillows."

Placing babies on their backs for sleep is the recommended method.

"There are parents who may have been given advice from their mother that recommends putting a baby on its side because if it spits up, while on its back, it can choke," Peirce-Hollett said. "But that isn’t true. There is a lot of misinformation out there."

Safe sleep recommendations and other real-life skills for new parents are taught through the hospital’s women’s education department, which offers Survival Skills for New Parents classes.

Newborn safety is focused, including proper sleep positions. Peirce-Hollett said the program also dispels myths and misinformation.

In 1992, the American Academy of Pediatrics issued sleep recommendations to place babies in a nonprone position to reduce the incidence of sudden infant death syndrome. Since then there has been a dramatic decrease in SIDS.

"When baby’s breathing is blocked, they breathe back their own air, which can cause asphyxiation," Peirce-Hollett said. "Crib bumpers that are not breathable can cause babies to rebreathe the wrong air. And things that crowd a crib also reduce the amount of fresh air a baby receives."

Babies should not be placed on their tummies, either.

"Baby has to have access to fresh air," Peirce-Hollett said.

For information on parenting classes, call the Banner Care Line at 602-230-2273.

The Volunteer Services department at Banner Boswell Medical Center selected Donna Cluckey as the August Volunteer of the Month.

Cluckey started volunteering at Banner Boswell in 2003 at the South and Main information desks, where she has logged more than 4,000 volunteer hours. Her role as a trainer is vital in providing mentoring to new volunteers working at these desks. 

"I was very impressed with her commitment to donate her time several days a week. She has been providing excellent service since she began volunteering with us," said Julie Mudric, director of Volunteer Services at Banner Boswell.

Banner Boswell has 1,500 active volunteers, from age 13 (junior volunteer program) to 102. On average, there are 100-150 volunteers in the hospital each day. In 2008, volunteers worked 168,000 hours. To learn about volunteering at Banner Boswell, call 623-876-5387.

Those people considering joint replacement can preview a program offered at the end of August at Banner Boswell Medical Center.

Banner Boswell’s Joint Club will have an open house at 10 a.m. Aug. 31.

The Joint Club is a special unit dedicated to the care of patients undergoing total knee or total hip replacements. Patients recover in the golf-themed Joint Club unit in an environment that emphasizes wellness, socialization and maximizes patient recovery.

The tour will meet in the main lobby at Banner Boswell, 10401 W. Thunderbird Blvd., in Sun City.

Experts from the Joint Club will show visitors the unit, the therapy gym and answer questions about joint replacement. Light refreshments will be served.

Joint replacement has helped many people suffering from osteoarthritis achieve a better quality of life, free from pain. Today, more than 400,000 total knee and total hip replacements are performed annually in the United States. More than 1,000 total joint replacement surgeries are performed at Banner Boswell every year, and more than 90 percent of patients are discharged directly to their homes.

Reservations are encouraged. Call the Joint Club at 623-876-5710.

Think a clean family history will keep you from getting breast cancer?

Think again.

"Having a family history puts a patient at a higher risk," said breast surgeon S. Brenda Moorthy of Comprehensive Breast Center of Arizona. "But not having a family history doesn’t negate it."

The family history connection is just one of the myths Moorthy will discuss in a free public lecture.

Banner Boswell Medical Center will present "10 Myths About Breast Cancer" at 9 a.m. Friday in the hospital’s Memorial Hall, 13180 N. 103rd Drive, Sun City.

Moorthy, a fellowship-trained surgeon specializing in the treatment of breast diseases, will dispel some of the most common myths about breast cancer and answer questions about a disease that affects one in eight women nationally.

She said the myth about the link between family history and breast cancer is commonly believed.

"The risks are not just family history, they are being female, older and having a history of hormonal therapy use," Moorthy said. "There is a genetic test for a gene mutation. But if you look at all of the breast cancer cases, only 10 percent have that gene."

Moorthy said another common misconception is younger women aren’t at risk.

She has treated a 29-year-old woman.

"A lot come in and feel a lump when they are pregnant, or a lump and they blow it off because they don’t have a family history," Moorthy said. "But every lump needs to be examined — young, old, everyone."

Moorthy said another common myth is if a lump is felt and a mammogram test result is normal, nothing else needs to be done.

"This is a big myth," Moorthy said. "A mammogram can miss up to 15 percent of masses, which could be because of the sensitivity of the mammogram or the density of the breasts. Mammograms are not perfect, but they are the best and only screening test."

More than 190,000 new cases of invasive breast cancer are expected to be diagnosed in 2009. While deaths from breast cancer have decreased slightly due to earlier detection and treatment, more than 40,000 Americans are expected to die from breast cancer this year.

Enhanced awareness and regular screenings can significantly increase chances for survival. There are more than 2.5 million breast cancer survivors in the United States.

Reservations for the presentation are encouraged by calling 623-876-5333 from 8 a.m. to 4 p.m. Monday through Friday. Light refreshments will be served.

Joy Slagowski may be reached at 623-876-2514, or jslagowski@yourwestvalley.com.

Sun Health Research Institute is enrolling patients with Alzheimer’s disease in the CONCERT study, a new clinical trial that will test an investigational drug.

The test involves the drug Dimebon (latrepirdine) for patients currently taking Aricept(r) (donepezil HCI tablets), an Alzheimer’s disease medication.

"Alzheimer’s is a complex disease and while current medications address symptoms for some patients, the disease often requires combination therapy to maximize clinical benefit," said Dr. Marwan Sabbagh, chief medical/scientific officer at the institute. "CONCERT is an important study because Dimebon is thought to work differently than current medications, and this study will evaluate whether adding it to one of the most commonly used Alzheimer’s medications will provide more effective symptomatic treatment to patients."

CONCERT is an international, randomized, double-blind, placebo-controlled study that will enroll about 1,050 patients with mild to moderate Alzheimer’s disease. It will be tested at 100 sites in the United States, Australia, New Zealand and Western Europe.

According to estimates from the Alzheimer’s Association, 5.3 million people in the United States are living with Alzheimer’s, which hinders a patient’s ability to remember, learn and perform daily activities and relate to others.

As the Baby Boomer population ages, Alzheimer’s is expected to increase dramatically, health experts say.

For information on eligibility and enrollment, patients and caregivers can call the Sun Health Research Institute at 623-875-6500 or visit www.concertstudy.com.

For information, visit www.shri.org or www.bannerhealth.com.

M.D. Anderson Banner Cancer Center is sponsoring a free skin-cancer screening from 9 a.m. to 1 p.m. Aug. 15 at Westgate City Center, Loop 101 and Glendale Avenue, between Johnny Rockets and the AMC theater.

You'll especially want to be examined if you've experienced:

• A change on the skin, especially in the size, color or appearance of a mole.
• Scaliness, oozing, bleeding or change in the appearance of a bump or nodule.
• The spread of pigmentation beyond its border, such as dark coloring that spreads past the edge of a mole or mark.
• A change in sensation, itchiness, tenderness or pain.

To register for this screening, call 602-230-CARE.

 

Permanent residents of Arizona who have original Medicare now have free access to a better way to manage medication and health information.

A new program, Medicare PHR Choice, helps build a personal health record.

Medicare and Arizona Health-e Connection, a nonprofit organization specializing in health-care information, are co-sponsoring town-hall-style meetings to raise awareness of the benefits of personal health records.

Dr. Holly Miller, a national expert on personal health records, will keynote the series.

To learn about Medicare PHR Choice, residents may attend one of the free information sessions for original Medicare beneficiaries and their families at 7:30 a.m. and 7 p.m. Wednesday at Surprise City Hall Council Chambers, 16000 N. Civic Center Plaza in Surprise.

Individuals who choose one of the preferred PHR companies can authorize Medicare to send up to two years of past claims to their personal health record.

A personal health record, known in the health-care industry as a PHR, allows patients easy access to important medical information. Participants may enter medications, doctor visits, medical conditions, claim history and more, then view it on the Internet.

PHR is private since each of the vendors in the Medicare PHR Choice program has privacy and security standards in place to help keep information safe. Many PHR Web sites offer additional tools such as wellness and appointment trackers and links to health education resources.

Banner Health’s Sun Health Research Institute invites the community to a screening of HBO’s Alzheimer’s documentary, "Momentum in Science Part 1," from 10 a.m. to noon Monday in the institute’s Morin Auditorium, 10515 W. Santa Fe Drive, Sun City.

"Momentum in Science" is part of a four-part documentary film from HBO Documentary Films’ The Alzheimer’s Project. "Momentum in Science Part 1" looks at groundbreaking discoveries made by the country’s leading scientists, as well as the future of the disease.

Filmed in part at SHRI, "Momentum in Science" features Alzheimer’s research being conducted in Sun City.

The screening will be followed by a panel discussion and question-and-answer session with Dr. Douglas Walker and Dr. Li-Fen Lue.

Seating is limited. Call 623-875-6565 to RSVP.

Older adults are at higher risk of health problems if they don’t take the proper precautions to protect themselves from the sweltering heat. About 200 Americans die of health problems caused by high heat and humidity every year, most of them are 50 or older.

Because of some of the physical changes that happen as we age, older adults can’t cool down as easily as others.

The AGS’ Foundation for Health and Aging suggests these steps for seniors to help stay safe in the summer months:

• Use air conditioning in the home or go where it’s air-conditioned — a shopping mall, grocery store, senior center, movie theatre, museum or library, for example. (Fans are not effective enough to adequately cool down the body during intense heat waves.)

• Drink a lot of water and other clear beverages that don’t contain alcohol or caffeine. A good way to measure if enough fluids are being ingested is to check urine color. If urine is a light yellow color, enough water is being taken into the body. If it’s darker yellow, the body needs more water.

• Take cool showers, baths, or sponge baths.

• Wear lightweight, light-colored, loose-fitting clothing and hats.

Avoid:

• Extended periods of sun exposure.

• Walking long distances, lifting heavy objects, or other strenuous activities.

Following are the most common health problems caused by heat:

• Dehydration: Weakness, headache, muscle cramps, dizziness, confusion and passing out.

• Heat stroke: A body temperature of or above 103 degrees; red, hot and dry skin; a fast pulse; headache, dizziness, nausea or vomiting, confusion and passing out.

• Heat exhaustion: Heavy sweating or no sweating, muscle cramps, tiredness, weakness, paleness, cold or clammy skin, dizziness, headache, nausea or vomiting and fainting.

Sun Health Auxiliary's board of directors recently approved allocating nearly $175,000 of funds raised this year to acquire medical equipment benefitting local health care and to support medical research.

The all-volunteer board works with other West Valley volunteers who operate the auxiliary's gift shops and thrift shops as well as with donors and event sponsors to generate needed funds which enhance patient care in local nonprofit hospitals - Banner Boswell and Banner Del E. Webb medical centers - and support scientific research at Sun Health Research Institute.

At Banner Del E. Webb Medical Center's Medical Intensive Care Unit and Critical Care Unit, the proceeds will fund the purchase of a transport monitor, which allows observation of a patient's vital signs when away from the patient care unit to conduct tests or procedures, as well as two point-of-care devices, which deliver lab test results to physicians and nurses within two minutes of completion.

In the MICU and CCU units are four new CritiCare monitors to keep track of patients' critical fluid output and core temperature to detect signs of infection, and a hypothermia unit to induce hypothermia for patients who have experienced sudden cardiac arrest.

Additional new medical equipment at Banner Del E. Webb includes five telemetry monitors for Cardiac Rehabilitation, 10 wheelchairs to transport admitted patients, a specialized stretcher used to transport female patients for ultrasound procedures and a defibrillator monitor to benefit patients in the telemetry unit.

New equipment at Banner Boswell Medical Center includes four patient-safety lifts to assist nurses in moving patients - a measure which helps patient and caregiver alike - as well as two infusion pumps to enhance the safety of medication administration related to high-alert medications.

Also being purchased for Banner Boswell are four recovery-room monitors to assist patient vital-sign observation after surgery as well as a blanket warmer to enhance patient comfort in the emergency department.

To support ongoing investigations at Sun Health Research Institute, the auxiliary is funding the purchase of an electromyography machine measuring electrical impulses for Parkinson's patients with cervical dystonia - characterized by involuntary spasmodic movement - to treat the condition, and providing operating funds to support ongoing Alzheimer's research.

"It is an honor to be able to augment patient care in such an amazing and generous community," said Barbara Ryan, auxiliary chairwoman. "We would not be able to do so without the phenomenal volunteers who work on our fund-raising events and in our gift shops and thrift shops throughout the year, not to mention generous support of our fun-filled community engagement fund-raising events.

"Our friends and neighbors know how to give back, and it certainly is the Sun Health Auxiliary's pleasure to reward those efforts by supporting Banner Boswell and Banner Del E. Webb medical centers as well as Sun Health Research Institute."

Sun Health Auxiliary is a division of the nonprofit Sun Health Foundation, whose mission is to make a difference in people's lives by encouraging charitable giving for the enhancement of nonprofit healthcare services in the West Valley.

Kim Antoniou is manager of Community Engagement for Sun Health Auxiliary/Sun Health Foundation.

 

The Sun Health Auxiliary thrift shops will adjust hours to help customers beat the summer heat.

Beginning Monday through Aug. 29, the Boswell Thrift Shop, 10226 W. Santa Fe Drive in Sun City, and the Sun City West Thrift Shop, 14445 R.H. Johnson Blvd. in Sun City West, will be open from 8 a.m. to noon Monday through Saturday.

Bottled water is available for a small fee. Browsers are encouraged to visit both stores, and tax-deductible donations of gently used household items, furniture, books and clothing are welcome during business hours. All funds raised by the auxiliary support the purchase of medical equipment for Banner Boswell and Banner Del E. Webb medical centers; Banner Boswell Rehabilitation Center; the Sun Health Research Institute; Banner Boswell/Mesa Nursing Education Program; Banner Alzheimer's Residence; Banner Special Adults Residence, Natvig House; and Banner Olive Branch Senior Center.

The Boswell Thrift Shop may be reached by calling 623-876-5317, or contact the Sun City West Thrift Shop at 623-584-3869.

 

Some veterans who were previously denied enrollment in VA health care, those struggling financially due to job loss or other decrease in income, and those returning from a combat zone can get help from the Phoenix Veterans Affairs Health Care System through an assortment of programs that provide health-care services at no or reduced cost.

"VA recognizes that many veterans are feeling the effects of the downturn in the economy," said Dr. Jamie Robbins, interim health care system director. "It's important that eligible veterans learn of the many ways VA has to help them obtain the health care they have earned."

The Department of Veterans Affairs will re-open enrollment in its health care system nationwide to about 265,000 veterans whose incomes exceed certain limits. VA will expand enrollment to a group known as Priority 8 veterans, who have incomes that exceed current VA and geographic means test thresholds by 10 percent or less and who are not being compensated for a military-related disability.

VA will re-determine eligibility for veterans who applied for enrollment on or after Jan. 1 and were denied because of income limits. These veterans will not need to submit another application and will be notified if they are eligible. Veterans who applied for enrollment before Jan. 1 and were denied because their incomes were too high should reapply for enrollment.

In Phoenix, VA anticipates that the new regulations will affect about 2,000 local veterans.

VA nationally is sending letters to each of these veterans to notify them of the change. Locally, the Health Administration Service is reviewing other categories that were rejected prior to January.

VA's Medical Care Hardship program could help veterans qualify for VA health care services if they had a recent change in their incomes, even if they were previously denied enrollment based on their household incomes. Veterans who thought their incomes were too high may want to apply if they have lost their jobs or otherwise experienced sudden decreases in income. Increases in out-of-pocket health care expenses also factor into VA's hardship determination.

In Phoenix, the hardship applications have nearly doubled with about 10 veterans requesting assistance each week.

Most veterans who recently returned from a combat zone are eligible for five years of free VA care. The five-year eligibility period begins with their discharge from the military, not their departure from the combat zone.

For questions about eligibility or enrollment, call the Phoenix VA Health Care System at 602-222-6508, or toll-free 1-800-554-7174, Ext. 6508. Veterans may walk in to discuss eligibility with enrollment clerks from 8 a.m. to 4 p.m. Monday through Friday.

Veterans may also contact VA's national Health Benefits Service Center at 1-877-222 VETS (8387) or visit www.va.gov/healtheligibility.

What to get for Father's Day? Not to worry - the Sun Health Auxiliary gift shops have the answer.

From travel mugs, so Dad can take his coffee on the go, to  designer fragrances men love and women can't resist, the auxiliary's four gift shops can solve the annual dilemma of what to give the man who already has it all.

"We have all kinds of specialized gifts to please everyone from the consummate career professional to the carefree, retired golfer," said Sue Slezak, manager of the auxiliary's retail and resale operations. "Our selection includes pretty much anything that anyone could want - and, to top it off, all purchases are sales-tax-free. Plus Banner Health employees and volunteers, including all members of our Sun Health Auxiliary, have the added benefit of a 10-percent discount on all gift merchandise.

"When you consider that all proceeds made in our gift shops go back to benefit Banner Boswell and Del E. Webb medical centers, the Sun Health Research Institute and our other local ancillary facilities, there's no better place to shop."

Sun Health Auxiliary gift shops are inside Banner Del E. Webb Medical Center near the east lobby and at the entrance of the Louisa Kellam Center for Women's Health. On the Banner Boswell Medical Center campus, they reside inside the hospital's main lobby and also at the Banner Boswell Rehabilitation Center, Honoring Norbert and Sonia Grove.

GENEVA - The World Health Organization told its member nations it was declaring a swine flu pandemic today - the first global flu epidemic in 41 years - as infections climbed in the United States, Europe, Australia, South America and elsewhere.

In a statement sent to member countries, WHO said it decided to raise the pandemic warning level from phase 5 to 6 - its highest alert - after holding an emergency meeting on swine flu with its experts.

The long-awaited pandemic decision is scientific confirmation that a new flu virus has emerged and is quickly circling the globe. It will trigger drugmakers to speed up production of a swine flu vaccine and prompt governments to devote more money toward efforts to contain the virus.

"At this early stage, the pandemic can be characterized globally as being moderate in severity," WHO said in the statement, urging nations not to close borders or restrict travel and trade. "(We) remain in close dialogue with influenza vaccine manufacturers."

 

 

Here's an idea for the dog days of summer: Do your yoga workouts with your four-legged friend.

A young yoga and dog-loving entrepreneur named Amy Stevens has made that possible by creating a new DVD that provides instruction in yoga exercises viewers can perform with their canine pets.

Called "doga," the practice is catching on across the country, according to some published reports, with classes, videos and books being offered to those who want to find peace and enlightenment with their dogs as partners.

"I wanted to motivate people to get off the couch and get healthy along with their pets," Stevens said. "This is an ideal way for pet owners and their dogs to get fit without having to go to the gym."

For some, doga is hard to take seriously. An article on the subject in The New York Times elicited such reader comments as: "What next? Meditation with your cat? Tantra with your hamster?" and "Oh, please. Another sign of the decline of American civilization. What's next, Kitty Jazzercise?"

But Stevens, 24, says she has received only positive feedback about her video.

"It's a great stress release and a way to bond with your dog," said the Mesa woman.

Stevens, a longtime fan of yoga, became interested in practicing the body and mind control discipline with her dog, Ginger, after observing her furry friend try to join in as she did her exercises at home.

"She would walk up beside me or put her paw on my shoulder," Stevens said. "She loved stretching out, and I was spending extra time focusing on her."

After doing some research, Stevens discovered there actually were classes available in the Valley on yoga with dogs. But she said they were expensive and only seasonal.

That gave Stevens the idea of producing an instructional video that would demonstrate the exercises for humans and dogs together. She and three business partners formed a company called Redfield Manor Productions, which uses the brand name Yoga4Dogs, to create the DVD and related products.

She claims it's the only doga instructional video on the market.

The DVD, which can be purchased for $20 at Yoga4Dogs.com, includes 30-minute workout routines with big and small dogs plus a five-minute massage for the dog. It also contains sample recipes from a future "Cooking4Canines" book that Stevens plans to release soon.

With each DVD purchase, Stevens is donating $1 to either the American Society for the Prevention of Cruelty to Animals or the Wildlife Alliance.

Although Stevens is trained in yoga, she concedes she hasn't received formal training in doga, which has no official instructor-certification program yet.

"It has been mostly self-teaching," she said. "But we have done a lot of research to make sure they (the doga exercises) are safe."

In addition to the cookbook, Stevens plans other products in the future, including a Yoga4Dogs-branded clothing line for both dogs and owners.

"There are lots of opportunities for us to grow as a business," she said. 

Banner Health's Sun Health Research Institute will have a special screening of HBO's Alzheimer's documentary "Momentum in Science," from 2 to 4 p.m. June 5 in the institute's Morin Auditorium, 10515 W. Santa Fe Drive, Sun City.

"Momentum in Science" is part of a four-part documentary film from HBO Documentary Films' The Alzheimer's Project. "Momentum in Science" takes a look at groundbreaking discoveries made by the country's leading scientists as well as the future of the disease. Filmed in part at Sun Health Research Institute, "Momentum in Science" features Alzheimer's researchers Joseph Rogers and Tom Beach.

The screening includes a discussion with Dr. Marwan Sabbagh, director of clinical research at the institute, who also is highlighted in the film. Seating is limited. Call 623-875-6565 to RSVP.

 

TRENTON, N.J. - Ailing from the recession, many U.S. hospitals have had to begin making painful cuts to patient services and laying off staff, as previous cost-cutting hasn't been enough, an industry survey found.

In previous recessions the health care industry has held up well, but this time hospitals and other health care businesses are hurting. Besieged by financial pressures including more needy and uninsured people, hospitals now are making tough decisions that affect their patients and communities.

The American Hospital Association found 22 percent of hospitals that responded to its March survey have reduced services since the economic crisis began in September. Those services range from outpatient clinics and behavioral health programs to patient education and home health care after discharge.

University Medical Center of Southern Nevada had to close its mammography center and started phasing out outpatient cancer treatment in November, said spokesman Rick Plummer. The decision was made right after Nevada's legislature, squeezed because high unemployment and foreclosure rates have slashed tax revenue, cut about $30 million from the Las Vegas safety-net hospital's charity care and Medicaid funding.

"It's a domino effect," Plummer said. "We had to make some difficult choices."

He said there women can get mammograms at plenty of other places, but it's tougher for patients getting chemotherapy and other lengthy cancer treatments.

"Very few other community providers stepped up to the plate," Plummer said, so some patients without health insurance but not poor enough for Medicaid have had trouble getting care. Some have had to make long drives for treatment or even move.

Meanwhile, nine of 10 hospitals said they cut expenses in the first quarter, with eight in 10 cutting administrative spending. Other strategies include eliminating jobs, selling assets, reducing overtime, cutting staff hours, freezing salaries, cutting benefits and reducing supply costs. In addition, some hospitals are considering mergers to reduce costs.

Just under half the hospitals have cut staff, and the number resorting to mass layoffs - 50 or more employees at once - is up.

And while total employment at hospitals grew somewhat in 2008, even as millions of jobs were lost in other industries, hospital employment grew by only 0.1 percent each in January and February and was flat in March. That's according to the federal Bureau of Labor Statistics.

For the first quarter of this year, 43 percent of hospitals said they expected to lose money, up from 26 percent in the first three months of last year. About one in three hospitals saw a drop in the ratio of income to what they must pay creditors. Declines in such measures of financial health can lead creditors to demand immediate repayment of loans.

Meanwhile, many hospitals are seeing increased interest expenses, insurers taking longer to pay their bills, more difficulty or inability to borrow money and other problems. That's led more than three-fourths of hospitals to delay, stop or scale back building projects or upgrades to medical or information technology.

The survey was sent to all 4,946 community hospitals in the country, and 1,078, or 22 percent, responded. Data was collected from March 5 through March 27. The hospital association said the respondents generally represented all types of hospitals, such as urban, suburban and rural.

 

Dr. Amir Goldenberg will discuss colon cancer, prevention and the importance of early detection through regular screening at 1:30 p.m. April 27 at Banner Del E. Webb Medical Center Auditorium, 14502 W. Meeker Blvd., Sun City West. This is the second educational talk in the nonprofit hospital's Ask the Expert series.

Colon cancer is the second-leading cause of cancer death in the United States. But according to the Centers for Disease Control and Prevention, it doesn't have to be.

"If everybody ages 50 or older had regular screening tests, as many as 60 percent of deaths from colon cancer could be prevented," CDC officials said.

Goldenberg, who is certified by the American Board of Internal Medicine, is passionate about people learning how to prevent the disease.

"Colon cancer is easily detectable through colonoscopies," he said. "We can find precancerous polyps, which are abnormal growths in the colon or rectum, and remove them before they become cancer. Moreover, if a cancerous tumor is found at an early stage, it can be removed, giving the patient a much better chance of surviving the disease than if the tumor had languished for years before being detected."

Goldenberg is hoping his talk will encourage people to get screened regularly. He will also discuss the role proper nutrition and bowel habits have in disease prevention.

To join Goldenberg for the event, call 602-230-CARE (2273) to reserve a seat.

 

Nonprofit Banner Health recently announced five executive re-assignments and appointments, including a new chief executive officer at Banner Del E. Webb Medical Center.

The new assignments, which affect three of Banner Health’s 10 Valley hospitals, are effective immediately. Following are the re-assignments and appointments:

• Kathy Bollinger, CEO of Banner Estrella Medical Center in west Phoenix since 2006, has been promoted to president of Arizona West Region for Banner Health.

• Robert Gould, associate administrator at Banner Estrella since August, has been promoted to chief executive officer at the hospital.

• Becky Kuhn, chief executive officer of Banner Del E. Webb Medical Center since September, has been promoted to president of Arizona East Region for Banner Health.

• John Harrington Jr., chief executive officer of Banner Heart Hospital in Mesa since 2006, has been re-assigned to serve as chief executive officer of Banner Del E. Webb.

• Laura Robertson, chief nursing officer since 2006, has been promoted to chief executive officer at Banner Heart Hospital.

Harrington has served three years as chief executive officer of Banner Baywood Heart Hospital, one of the nation’s largest free-standing heart hospitals. During his tenure, the hospital received national recognition as a Top 100 Hospital by Thomson Reuter’s Healthcare, the nation’s primary source of information products for the health care industry. This recognition ranks the facility among the top 10 percent of cardiovascular programs nationwide.

Based in Phoenix, Banner Health is one of the largest, nonprofit health care systems in the country. In Arizona, Banner Health employs approximately 20,000 people, making it the state’s second largest private employer. In addition to basic emergency and medical services, Banner Health offers a variety of specialized services, from heart and cancer care to high-order multiple births and organ transplants, as well as Level 1 trauma services, rehabilitation services and behavioral health services.

For more information, visit www.BannerHealth.com.

Banner Del E. Webb Medical Center will be featured on "Mystery Diagnosis" today on the Discovery Health channel.

The show, which was filmed in December, will tell the story of Carly Eykhout, a Peoria resident who lived with intermittent pain for seven years before physicians at Banner Del E. Webb were able to solve the mystery and restore Eykhout to health.

Eykhout relived her experience when the film crew for the show was at the hospital to film the episode.

"It was quite emotional to re-enact the experience," Eykhout said. "But I wanted to tell my story and let people know how grateful I am to the doctors and staff at Banner Del E. Webb for their care."

Eykhout suffered for years with nausea, vomiting, abdominal pain and bowel dysfunction. Dr. Curtis Henderson, an emergency department physician, diagnosed what turned out to be an intussuseption, a blockage in her intestine caused by a folding or telescoping of the organ. Dr. Marco Canulla performed the surgery. Dr. Gordon Haugland, an interventional radiologist, confirmed the diagnosis.

After years of weight loss and failed attempts of trying to have a child, Eykhout gained weight and was able to get pregnant with her first child shortly after the surgery. She gave birth in Banner Del E. Webb Medical Center's The Nesting Place Obstetrical Suites.

Recently, Eykhout called Banner Del E. Webb's Public Relations department with more good news.

"I'm three months pregnant with my second child," she said. "And I'll be back to Banner Del E. Webb to have my baby."

Check local listings for the airing of "Mystery Diagnosis." The program's title is "The Black and Blue Baby."

 

DES MOINES, Iowa - As if saving for retirement wasn't enough to worry about, now comes a study that shows a couple retiring this year needs about a quarter of a million dollars to cover medical expenses.

The $240,000 estimate is a 6.7 percent increase from last year's and the cost is expected to keep rising.

The Fidelity Investments study is based on projections for a 65-year-old couple retiring this year with Medicare insurance coverage. It assumes no employer provided insurance and a life expectancy of 17 years for the man and 20 years for the woman.

To paint a full picture, Fidelity also factors in Medicare deductibles, copayments, as well as certain services that may not be covered.

In just seven years of its annual study, projected medical expenses have increased by 50 percent.

When you retire, health care is likely to be your largest expense and it's one that many people forget to factor fully into their retirement plans, said Sunit Patel, a senior vice president at Boston-based Fidelity.

"A lot of individuals feel today that Medicare covers a vast majority of costs," he said. "We know that's not true. It's better not to be blind about that."

In fact, Medicare pays about half of the health care costs for current retirees and it could be less very soon.

The Medicare trust fund reported last year that it expects to be insolvent in 2019 and needs either a payroll tax increase or a cut in benefits to keep it fully functional. That means Medicare may not provide the same level of support for future retirees, making it more vital to understand the medical costs in retirement.

"There are deductibles and co-payments and things that aren't covered that people aren't aware of until they get there unless they have a parent that they're helping navigate the system," said Paul Fronstin, director of health research and education at the Employee Benefit Research Institute.

EBRI has researched the issue of rising health care costs in retirement. It found that just 12 percent of private companies offer insurance for retired workers.

That means most retirees need to buy insurance themselves or pay medical costs out of their own savings.

Patel said it may make sense to start thinking about a savings account separate from your retirement account for health care.

"We think it's significant enough that it should potentially be a distinct goal," he said.

If you've been looking at a ravaged 401(k) balance, you likely don't want to hear that.

Patel said he understands that sentiment, but believes it's better to be forewarned than caught off guard.

Without a plan, you could end up significantly changing your lifestyle from what you had expected or looking for a job to help pay for health costs.

"We have to face up to the reality of the situation and that may be that people have to work longer just for health care," EBRI researcher Fronstin said.

So as you digest what it all means, consider a separate savings account dedicated to health care. Also, research various supplemental health insurance options so you go into retirement informed.

You may want to consider a phased retirement in which you go from full time to part time if your employer offers health insurance for part-time workers. By gradually entering retirement, you delay tapping into savings.

Once you're retired, ways to save money on health care include getting routine screenings to stay ahead of any health issues, selecting quality providers by using the U.S. Department of Health and Human Services Web site www.hospitalcompare.HHS.gov and routinely reviewing claims for accuracy to ensure you're not paying more than necessary.

 

Tickets are on sale for Sun Health Auxiliary's Southwest Airlines drawing, which offers a prize of two $500 gift cards toward any Southwest Airlines destination.

The gift cards are transferable and have no expiration date.

Drawing tickets, priced at $1 each or six for $5, are available in the gift shops of Banner Del E. Webb and Boswell medical centers, as well as at the Sun Health Auxiliary Community Engagement office, 10448 W. Coggins Drive, Suite C, Sun City. Winner of the drawing will be announced at the auxiliary's seventh-annual Garden Soiree, "Springtime by the Lake," April 17.

Funds from the drawing go toward the purchase of an ultrasound stretcher to benefit patients at Banner Boswell Medical Center.

For information, call Sun Health Auxiliary Community Engagement at 623-876-4931.

 

WASHINGTON — You’ve heard that diabetes hurts your heart, your eyes, your kidneys. New research indicates a more ominous link: That diabetes increases the risk of getting Alzheimer’s disease and may speed dementia once it strikes.

Doctors long suspected diabetes damaged blood vessels that supply the brain. It now seems even more insidious, that the damage may start before someone is diagnosed with full-blown diabetes, back when the body is gradually losing its ability to regulate blood sugar.

In fact, the lines are blurring between what specialists call "vascular dementia" and scarier classic Alzheimer’s disease. Whatever it’s labeled, there’s reason enough to safeguard your brain by fighting diabetes and heart-related risks.

"Right now we can’t do much about the Alzheimer’s disease pathology," those sticky plaques that clog patients’ brains, says Dr. Yaakov Stern, an Alzheimer’s specialist at Columbia University Medical Center. But, "if you could control these vascular conditions, you might slow the course of the disease."

The link has staggering societal implications: More than 5 million Americans have Alzheimer’s, and cases already are projected to skyrocket in the next two decades as the population ages. The question is how much the simultaneous obesity-fueled epidemic of Type 2 diabetes may worsen that toll.

There are about 18 million Type 2 diabetics who are considered to have at least two to three times a non-diabetic’s risk of developing Alzheimer’s. Still, Type 2 diabetes often leads to heart disease and other conditions that kill before Alzheimer’s typically strikes, in the 70s.

Don’t panic if you’re diabetic, stresses Dr. Ralph Nixon of New York University, vice chairman of the Alzheimer’s Association’s scientific advisory council. Genetics still are the prime risk factor for dementia.

"It by no means means that you’re going to develop Alzheimer’s disease, and certainly many people with Alzheimer’s don’t have diabetes," he cautions.

But the latest research strengthens the link, and has scientists asking if diabetes and its related "metabolic syndrome" increase risk solely by spurring brain changes that underlie Alzheimer’s — or if they add an extra layer of injury to an already struggling brain, what Nixon calls "essentially a two-hit situation."

Among the findings:

• Brain functioning subtly slows as Type 2 diabetics’ blood-sugar rises, well before people have any obvious memory problems.

• Type 2 diabetes occurs as a result of insulin resistance, as the body gradually loses sensitivity to this hormone that’s essential for turning blood sugar into energy. A similar effect in the brain helps explain the dementia link.

AARP has launched Rx Snapshot, a free, online tool that Arizonans can use to help older family members, friends or neighbors manage their medications safely and effectively.

About 65 percent of Americans over 65 are using one or more inappropriate medications, and 57 percent are taking medications that are ineffective, duplicative or not necessary, accoring to AARP.

An initiative of Create the Good, a network of independent volunteers active in neighborhoods across the country, Rx Snapshot is a way to help older Americans record the medications they are taking and talk with their health care professional about how they might better manage the drugs. The free resource is available at www.AARP.org/CreateTheGood.

"Helping a loved one or a neighbor complete an Rx Snapshot is easy and it can have a big impact on their health and maybe even their pocketbook," said David Mitchell, AARP Arizona state director.

The Rx Snapshot toolkit provides:

-- A way to keep updated records of medications.

-- Tips to having a conversation with health care providers about the risks and benefits of their prescriptions.

-- The opportunity to consider generics as money-saving alternatives.

Information on where to volunteer or to get local community groups involved can be found at www.AARP.org/CreateTheGood.

 

NEW YORK - When Mike Stevens learned his lungs were riddled with cancer, it took only a week to start chemotherapy - but six weeks to find out if it was doing any good.

"You're going through all this suffering and stuff and you want to know, am I going to survive? Is this stuff working?" said Stevens, 48, of La Jolla, Calif. "Your whole life is in sort of a limbo."

Doctors typically must wait weeks or months to see if a treatment is shrinking tumors or at least halting their growth. But researchers are exploring a new use for medical imaging that could shorten the stay in purgatory, possibly revealing within a few days whether chemo is working.

That speed could save both lives and money. It would allow doctors to switch more quickly from an ineffective drug to a different one, and save health care dollars by waving doctors off expensive but futile treatments.

The same approach may also prove useful for monitoring radiation therapy.

This experimental imaging relies on a familiar hospital workhorse: PET scans, typically used for things like detecting cancer or revealing the effects of a heart attack. Unlike CT scans or MRIs, PET scans can show a tumor's internal activity, not just its size.

When used to assess the effects of cancer treatment, it can reveal inside information about what the therapy is doing to a tumor even when there's no outward sign.

To do a PET scan, doctors inject a patient with a radioactive substance that shows up on the scan in places where certain processes are happening - like hungry cancer cells gobbling up a lot of blood sugar. Think of it as looking around your neighborhood late at night for light in bedroom windows to see who is still awake.

Many cancer patients get PET scans now to assess their disease before treatment, or to spot recurrences later on. But except for lymphoma, PET scans aren't routinely used to get a quicker answer on how cancers are responding to therapy.

The new research tests both standard PET scans and a newer approach that involves injecting a different tracer substance.

The standard scan, which looks for blood sugar usage, has gotten good results in tests with a variety of tumors including breast, prostate, colorectal and esophageal cancers, said Dr. Steven Larson of the Memorial Sloan-Kettering Cancer Center in New York.

"I think it's going to be extremely valuable for most tumors where there are effective treatments," he said. Some experiments have revealed chemo's effects within 10 days to two weeks.

As a practical matter, the goal of researchers is to convince federal regulators to cover the procedure under Medicare and Medicaid, which would open the door to routine use. That might take two or three years, he said.

Farther out on the research horizon is a PET scan that uses injections of a different radioactive material and has revealed chemotherapy's impact even faster. Larson figures it will be especially useful for assessing newer drugs that aim to stop a patient's cancer from growing rather than killing the tumor.

This scan is called FLT PET, after radioactive fluorothymidine. These scans show whether cancer cells are dividing. Uncontrolled division is a hallmark of active cancer, and stopping that division should be an early effect of successful chemotherapy.

"Our hope ... is you might be able to give a single dose of a chemotherapy agent and within a day or two figure out whether the tumor is going to respond," says Dr. Michael Graham of the University of Iowa.

If the tumor doesn't respond, doctors would "go on to Plan B," he said. "This is really ... giving us the ability to tailor the therapy to the disease."

Research into FLT PET is still in the early stages. Graham said there are maybe a dozen published human studies so far, most involving too few patients to draw a firm conclusion.

One report that impressed him involved 28 patients in Korea who were treated for advanced lung cancer - just like Stevens, who had to wait six weeks to learn whether it was working. The researchers reported that just one week after treatment began, they could tell with 93 percent certainty which patients would eventually respond to the drug and which would not.

In a much smaller study at the University of Wisconsin in Madison, seven patients with acute myeloid leukemia were scanned at various times during a week of aggressive chemotherapy. Normally, doctors wait a month after chemo is stopped to see if it worked. But the FLT PET scans offered an answer as soon as a day after treatment started.

"It's always hard to get too excited about a study that just involves seven people," said Dr. Mark Juckett, one of the authors. But "in these few patients, it looked like we could predict those who were going to respond well to chemotherapy and those who weren't."

Other preliminary studies suggest the new PET technology might be useful in gauging treatment for breast and brain cancers as well as lymphoma.

Graham figures there's a good chance FLT PET scans will become routine for assessing therapy in the next 10 years.

"It's a terrible waste of money to spend thousands and thousands of dollars on these patients when it doesn't do any good," he said.

Graham, president-elect of the Society of Nuclear Medicine, has been involved in discussions between the society and drug companies about incorporating FLT PET in their studies of experimental cancer drugs.

The hope is that, over time, FLT PET would prove reliable for giving a faster answer on whether an experimental treatment is working. That would save companies a lot of money, because they could spot ineffective drugs more quickly and not waste further research on them. And the drug company research would produce data to help persuade federal regulators to approve FLT PET for use in tracking therapy.

Dr. Samuel C. Blackman of pharmaceutical giant Merck & Co. said he couldn't comment on the specifics of talks with the nuclear medicine group, but he said, "We're definitely enthusiastic about FLT PET" for cancer drug research.

Mike Stevens, the lung cancer patient, has seen his disease held generally stable by continuing chemotherapy since 2005. And along with the scientists, he also likes the idea of an earlier end to the limbo of not knowing whether a new treatment is working.

"It's like having a rope tied around you and you're leaning over a canyon at about a 45-degree angle, and you don't know if someone is going to pull you back in, or let go of it," he said. "If you get that encouragement earlier on that you're doing well ... you've got something to fight for."