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By Dr. Allison Kaplan
Q: “Living in Arizona, I know that sun protection is extremely important. There are so many sun screens to choose from. As a parent, what should I be looking for in the SPF number and is there a difference between the lotions and the sprays?” – Crystal, Phoenix
A: Metropolitan Phoenix is known for its year-round sunshine, blue skies, and outdoor activities.That’s why it’s so important to protect your skin from harmful ultraviolet (UV) rays, astoo much sun exposure can cause dehydration, heat stroke, heat exhaustion, sun poisoning, electrolyte imbalances, and sunburns.
Just a few serious sunburns, according to the Centers for Disease Control and Prevention, can increase your child’s risk of skin cancer later in life. Kids don’t have to be at the pool, or on vacation to get too much sun. Their skin needs protection from the sun’s ultraviolet (UV) rays whenever they’re outdoors.
You can protect yourself and your family by staying hydrated and using sunscreen with a sun protection factor (SPF) of at least 15 with UVA and UVB protection every time you go outside to protect against sunburn, skin cancer, and early skin aging. For the best protection, apply sunscreen generously 30 minutes before going outdoors. Don’t forget to protect ears, noses, lips, and the tops of feet. Be sure to reapply sunscreen every hour after exercising, or after being in the water.
Follow the directions on the sunscreen bottle, especially when using a sunscreen product on babies less than six months old. All products do not have the same ingredients; if your or your child’s skin reacts badly to one product, try another one or call a doctor. Your baby’s best defense against sunburn is avoiding the sun or staying in the shade.
Sunscreen sprays, lotions, and sticks can all do an equally-solid job of protecting you from the wrinkle- and cancer-causing effects of UV rays. All three have certain advantages that might make one a better fit for your skin type and lifestyle. It really comes down to which type you prefer.
When you’re outdoors, wear sunscreen, sunglasses, hats, and protective clothing to protect your skin. If you can, limit how long you are in the sun, as 15 minutes is enough time to damage unprotected skin. Be sure to reapply sunscreen after a few hours, after exercising, or after being in the water.
To help keep skin safe this summer, practice these sun-safe habits:
- Limit exposure to the sun. Try to stay out of the sun between 10 a.m. and 4 p.m., when UV rays are the strongest and limit how long you’re in the sun the other times. If this is not possible, seek shade under a tree, an umbrella, or a pop-up tent.
- Wear sunscreen daily. Even when only spending a couple of minutes in the sun, wear sunscreen with an SPF 15 or more. Reapply sunscreen when outside for extended periods of time, as sunscreen can easily wear off.
- Wear protective clothing. In conjunction with sunscreen, lightweight clothing that covers the entire body, a wide-brimmed hat and sunglasses can help to minimize sun exposure. In general, darker, drier fabrics will have a stronger SPF than white fabrics, and some manufacturers produce clothing with specific UV protection.
- Spot the skin concern. Make a point to regularly examine your skin. Look for changes in moles, such as the spread of pigmentation beyond its border, or changes in sensation, such as itchiness, pain or tenderness. Another indication may be may be a red, scaly patch on the skin that does not heal. If you notice any abnormalities, make an appointment to see a physician immediately.
Sunburns can be treated by drinking a lot of fluids, applying aloe and fragrance-free lotions, and taking over-the-counter pain relievers. If a sunburn blisters, it is considered a second-degree burn and should be evaluated and treated by a medical professional.
Protecting your skin from harmful UV rays should be just as top-of-mind as drinking a lot of water to stay hydrated. Both are key to surviving the Valley’s summers!
Allison Kaplan, M.D., is board-certified family medicine physician at Desert Grove Family Medical, and is on the medical staff of Mountain Vista Medical Center where she is also an instructor with the hospital’s residency program. To book an appointment with Dr. Kaplan, visit desertgrove.net or call 480-834-7546.
Two well-respected maternal fetal medicine specialists and a seasoned OB/GYN family nurse practitioner with endocrinology experience have opened a physician’s office in Mesa to help women with high-risk and complicated pregnancies. Dr. Richard Blumrick, FACOG, and Dr. Julia Elizabeth Solomon, MDCM, FACOG, will be lending their support to the medical teams at Mountain Vista Medical Center in Mesa and Tempe St. Luke’s Hospital.
The physicians have teamed up with Raquel Castaneda, FNP-BC – an existing Physician Group of Arizona employee and a seasoned OB/GYN family nurse practitioner with extensive endocrinology experience – to assist pregnant patients who have diabetes or gestational diabetes.
“As the East Valley grows, so too does the need for highly-specialized, quality health care options, especially for patients facing complex medical circumstances,” said Jake Golich, Chief Executive Officer of Mountain Vista Medical Center. “Adding the experience from Dr. Blumrick and Dr. Solomon in partnership with Raquel Castaneda to our network allows us to offer even more specialized services for high-risk and complicated pregnancies in the East Valley.”
The trio belong to Physician Group of Arizona’s Fetal Diagnostic Center, which is home to the network’s team of perinatology specialists. The Fetal Diagnostic Center guides at-risk patients through challenging pregnancies, providing necessary evaluations, risk assessments, advanced ultrasounds to identify medical problems early, and treatment options. The team focuses on some of the most daunting medical conditions during pregnancy, including congenital birth defects, particularly cardiac; genetic disorders; fetal or placental abnormalities; maternal health, autoimmune and hereditary conditions; pregnancy-related disorders; preterm labor; multiple gestation (twins, triplets, etc.), and blood, mineral or vitamin deficiencies.
With more than 20 years of experience, Dr. Blumrick has an intrinsic interest in medically-complicated pregnancies, including heart disease in pregnancy, and extreme prematurity. He received his medical degree from the State University of New York at Stony Brook and completed an internship in OB/GYN at St. Luke’s Roosevelt Hospitals in New York, and a fellowship in maternal-fetal medicine at Duke University Medical Center in Durham, North Carolina.
A former adjunct at University of California at Los Angeles School of Medicine, Tufts University School of Medicine in Boston, and McGill University Faculty of Medicine in Montreal, Dr. Solomon is a board-certified Maternal Fetal Medicine specialist who is an internationally-renowned authority on 3D and 4D ultrasound and fetal echocardiography. She earned her Bachelor of Arts in psychology and later her Doctor of Medicine and Master of Surgery from McGill University. Dr. Solomon completed an OB/GYN residency at Cedars Sinai Medical Center in Los Angeles and a Fellowship in Maternal Fetal Medicine at New England Medical Center.
Castaneda, an Arizona native, has spent the last two decades honing her skills in various areas of patient care, including Labor and Delivery, NICU, Post-partum and Prenatal Education. Due to gestational diabetes becoming more common, she has spent nearly three years hyper-focused on Endocrinology and Diabetes Management. Fluent in Spanish, Castaneda earned a Bachelor of Science in Nursing from Arizona State University, and her Master of Science as a Family Nurse Practitioner from the University of Phoenix.
Through the addition of Dr. Blumrick, Dr. Solomon and Castaneda, patients will have access to more advanced services and technologies, including:
- 3D/4D obstetric ultrasound, providing multi-dimensional views of the baby and his/her developing organs;
- Fetal echocardiograms to study the anatomy and function of a baby’s heart;
- Detailed (level II) ultrasound for higher risk conditions;
- Genetic counseling for helping patients understand and evaluate treatment options for genetic conditions or birth defects;
- Amniocentesis and chorionic villus sampling to screen for developmental abnormalities;
- Non-invasive prenatal screening for common chromosomal disorders;
- Cerclage placement to strengthen the cervix to help a developing baby;
- Percutaneous umbilical cord blood sampling (PUBS) to detect fetal abnormalities; and
- Amnioinfusion and fetal shunt placement to balance amniotic fluid levels.
All three practitioners are currently accepting new patients, and appointments can be scheduled by calling 480-257-2699 or visiting arizonaperinatology.com.
In the United States, more than 1 million surgeries are performed annually to replace worn-out knees and hips, and that number is only expected to grow in the coming years as the population ages. Total knee replacements in the U.S. are expected to increase 673 percent by 2030, yet studies have shown that approximately 30 percent of patients are dissatisfied after conventional surgery.
Thanks to an innovative robotic-arm-assisted technology, Mountain Vista Medical Center in Mesa and St. Luke’s Medical Center in Phoenix are among the first hospitals in the Valley to offer a highly-advanced reconstructive surgery option for total knee and total hip replacements.
“This is changing the way that joint replacement surgeries are performed,” said Dr. Andrew Wellman, a board-certified orthopaedic surgeon on the medical staff at Mountain Vista Medical Center. “Using a virtual 3D model, we can create a surgical plan for each orthopaedic patient before entering the operating room. During surgery, we can validate that plan and make any necessary adjustments, while guiding a robotic arm to execute that plan.”
The Mako Total Knee application is a knee replacement treatment option designed to relieve the pain caused by joint degeneration due to osteoarthritis. Through CT-based 3D modeling of bone anatomy, surgeons can identify the implant size, orientation and alignment based on each patient’s unique anatomy. This gives surgeons the opportunity to virtually modify their plans during an operation, and assists in executing bone resections.
After losing her footing while doing the “Twist” in the front row of a Chubby Checker concert, 72-year-old Jerri Boswell learned that not only did she tear her ACL, but she also had early stages of arthritis in her knee that was only going to get worse. The Scottsdale resident recently had a total knee replacement at St. Luke’s Medical Center. “I was initially somewhat concerned about my surgery being done robotically,” said Boswell. “However, the results and recovery were amazing, and were nothing like what I expected after hearing stories from my friends. I didn’t have to take any pain medicine after three days, and had almost complete flexion after just two weeks. ”
Using a robotic arm in surgeries appears to be here to stay due to the multiple benefits to surgeons and patients. “Each patient receives a personalized surgical experience based on their specific diagnosis and anatomy, bringing a high level of accuracy and predictability to the procedure,” said Dr. Brandon Gough, an orthopaedic surgeon on the medical staff at St. Luke’s Medical Center. “The combination of these features has the potential to lead to better outcomes and higher patient satisfaction rates.”
The Mako Total Hip application is a treatment option for adults who suffer from degenerative joint disease of the hip. During surgery, the surgeon guides the robotic arm during bone preparation to prepare the hip socket and position the implant according to a pre-determined surgical plan. In cadaveric studies, Mako total hip replacement has been shown to be four times more accurate and reproducible than manual total hip replacement procedures.
Forty-eight-year-old James Gounaris, a Laveen resident, was the first patient to have a total hip replacement using the Mako Total Hip procedure at Mountain Vista Medical Center. He only had a two-day hospital stay. Today he’s walking a mile to his local gym to work out. “The day I returned home, I was able to walk up the 18 stairs of my two-story home with little-to-no assistance,” said Gounaris. “Of course, I was on bed rest for a few days, but what really surprised me was that I was never on any type of pain medication at the hospital, or even once I returned home – not even Advil. All I needed was ice packs for the pain, which I thought was rather remarkable. I’m looking forward to getting back into the outdoor activities I enjoy, like mountain biking, road cycling, running and hiking.”
IASIS Healthcare, the parent company of Mountain Vista Medical Center and St. Luke’s Medical Center, looks forward to using this new robotic technology to help patients who require a total knee or hip replacement. “We’re thrilled to be among the first hospitals in the Valley to offer this transformative technology for knee and hip replacement procedures,” said Eric Paul, IASIS Healthcare’s Market President in Arizona. “It’s an addition to our orthopaedic service line that further demonstrates our commitment to provide the community with outstanding healthcare options.”
April is Foot Care Awareness Month, and St. Luke’s Medical Center is using the occasion to bring greater attention to one of the most debilitating foot ailments in the U.S. – treating bunions.
Typically brought on by ill-fitting shoes and high heels, bunions are especially common among women, who are 10 times more likely to get bunions than men.
According to the Centers for Disease Control & Prevention, approximately 5.2 million people are plagued with bony bumps that develop at the joint of the big toe, which can lead to progressive pain, including dull joint aches, painful toes and throbbing pressure on the ball of the foot, as well as difficulty walking.
While comfortable, roomy shoes, protective patches, and ice can ease pressure on the foot and relieve bunion pain and inflammation, surgery tends to be the only solution to achieve more permanent relief.
St. Luke’s Medical Center’s leading podiatric surgeon, Dr. Daniel Schulman, is helping to revolutionize bunion surgery, offering patients an innovative and natural solution that allows for regeneration of the area instead of implanting screws or metal plates. “It is the same bone graft we used for decades safely as a bone void-filler (e.g., paste/putty),” said Dr. Schulman. “Now it can be used effectively in this form as a fixation device.”
During the past seven years, Dr. Schulman pioneered the use of human allograft cortical bone implants in all types of bunionectomy procedures, a revolutionary alternative to temporary and permanent metal implants (such as screws/plates and wires). Unlike metal implants, these implants fully incorporate with a patient’s bone, and do not need to be removed. As a result, patients experience less pain and swelling, have improved healing, and are at less of a risk for infection. “Even absorbable fixation devices that are synthetic can develop a sterile abscess, which mimics infection and leads to a complex removal,” said Dr. Schulman.
According to Dr. Schulman, implanting screws or metal plates to correct a bunion can create a host of potential issues – from failed hardware, metal allergy and increased risk of infection, to pain from poor positioning and the potential for a fracture. “There is one significant advantage to using these osteobiologic implants other than their biocompatibility,” he said. “These implants have a very forgiving surgical implantation, which gives the opportunity to re-drill intraoperatively through an undesirably-placed implant to insert another implant without bone loss or fracture.”
St. Luke’s Medical Center is the only hospital in Arizona using this innovative procedure to treat bunions, and is one of only a few hospitals in the country currently utilizing this advanced regenerative solution. A strong believer in the power of osteobiologics, Dr. Schulman is the only surgeon in Arizona to use this type of fixation in many types of common forefoot reconstructive procedures (which is not limited to the bunionectomy).
Incorporating the use of allograft cortical bone pins and nails in foot reconstruction is just one of the most recent advances that St. Luke’s Medical Center has embraced. The hospital has a long history of innovation. It was the first hospital in the Valley to perform open heart surgery, and is often one of the first hospitals in the state to introduce new technologies, labs and procedures. At the heart of each medical advancement is the desire to achieve even better patient outcomes.
St. Luke’s Medical Center, the first hospital in Arizona to offer a same-day coronary angioplasty through the radial artery in the wrist, is reporting significantly improved outcomes and cost savings for patients and the health system using the new artery access point. As a result, the less-invasive procedure is attracting national attention.
According to a national study from the Journal of the American College of Cardiology, radial access could save hospitals across the U.S. more than $300 million each year due to the ability it gives hospitals and patients to have same-day surgical procedures.
St. Luke’s Medical Center is still one of few hospitals in the U.S. performing same-day cardiac catheterization using the radial artery as a standard practice. The endovascular procedure, which improves blood flow to the heart, is typically performed using the femoral artery in the groin as the more common point of access to diagnose and treat arterial diseases, including coronary artery disease and peripheral artery disease.
A growing number of hospitals across the nation are now rethinking how they approach cardiac catheterization, as the new artery access point has shown a marked difference in the recovery time, pain level, reduction in complications and overall better short- and long-term outcomes for patients.
“St. Luke’s Medical Center has one of the most unique catheterization labs in the state, which has allowed us to get ahead of the curve in offering a better patient experience with better patient outcomes,” said Dr. Richard Heuser, chief of cardiology at St. Luke’s Medical Center, who started conducting radial access catheterization in 1993. “As a result, both patients and the health care system are enjoying significant cost savings. Since we began offering the procedure in 2010, the hospital has seen upwards of $750,000 in annual health care savings.”
Heuser, a trailblazer in cardiology, identified the potential benefits early on and was among the first wave of cardiologists in the nation to begin using this innovative procedure. According to Heuser, the radial approach reduces complications by 80 percent compared to the femoral approach.
“Although we’re using more technologically-advanced catheters and equipment, the fact that we can offer a less-invasive procedure by going through the wrist means we can keep patients out of the hospital, reduce potential complications, and help them get on with their lives, all of which saves money for them and the health care system as a whole,” said Heuser.
Linda Sortor, one of Heuser’s patients, has already experienced the benefits. She considers her ability to walk out of the hospital on the same day of her procedure, with no external evidence of her surgery other than a small Band-Aid on her wrist, as a significant triumph. “I was back to normal the next day,” she said.
Cardiac catheterization is performed in more than 1 million U.S. patients a year in order to detect blockages in arteries and deploy stents to vessels that provide blood to the heart, particularly in patients with peripheral vascular disease and obesity. The American Heart Association estimates that 82 million American adults are living with some type of heart or vascular disease.
In the traditional approach, the cardiologist begins the procedure by inserting a catheter through the femoral artery in the groin. The catheter is then directed through the artery to the heart, where the cardiologist completes the procedure. Approaching through the femoral artery requires working through layers of muscle, which can increase the trauma to the patient’s body. Typically, patients are required to remain hospitalized overnight and must lie flat for several hours to prevent bleeding following the procedure. Because the femoral artery is large, if the resulting wound from the procedure accidentally opens up during the healing process, it can cause significant bleeding requiring medical intervention.
In the radial approach, the cardiologist inserts the catheter through the radial artery, a much smaller artery in the patient’s wrist. This artery is located close to the surface of the skin resulting in less trauma to the body during insertion. Because the radial artery is smaller and located in the wrist, it responds quickly to simple pressure. The technique has been associated with a fourfold reduction in major bleeding. Additionally, using the radial approach enables most patients to immediately get out of bed and move around following the procedure, which provides them greater comfort and a faster recovery period.
St. Luke’s Medical Center has a long history of innovation. It was the first hospital in Arizona to open a cardiac catheterization lab, and the first in the Valley to perform open heart surgery. St. Luke’s Medical Center is now one of only two hospitals in the state using radial access as its primary practice.
Dr. Adrian Harvey
Neurosurgeon at Mountain Vista Medical Center
Dr. Adrian Harvey, a board-certified neurosurgeon with IASIS Healthcare’s Physician Group of Arizona, has joined the neurosurgical team at Mountain Vista Medical Center in Mesa.
Dr. Adrian Harvey, a board-certified neurosurgeon with IASIS Healthcare’s Physician Group of Arizona, has joined the neurosurgical team at Mountain Vista Medical Center in Mesa. This expands the neurosurgical offerings available, enabling East Valley patients to receive complex treatments close to home.
“Dr. Harvey’s ability to offer the latest surgical technologies for the spine and brain make him a valuable addition to our team at Mountain Vista Medical Center,” said Eric Paul, market president of IASIS Healthcare in Arizona. “He will be here to help patients address disorders of the brain, spine and peripheral nerves, and enhance our trauma and stroke programs.”
Harvey is an Arizona native who graduated from Brigham Young University with a bachelor’s degree. He then graduated from Arizona College of Osteopathic Medicine at Midwestern University in 2006. Following that, he spent six years in Bloomington, Ill., for residency training in neurosurgery. As part of his residency, he completed a six-month complex spine fellowship at the University of Illinois–Peoria. After finishing his residency, Harvey completed a one-year fellowship in neurosurgical oncology at University of Texas MD Anderson Cancer Center. He practiced at Maricopa Medical Center and Banner MD Anderson Cancer Center before forming East Valley Brain and Spine Specialists and joining the staff at Mountain Vista Medical Center.
In addition to practicing medicine, Harvey is a major in the United States Army Reserve Medical Corps.
To learn more about Harvey, the neurosurgical practice at Mountain Vista Medical Center, or the 178-bed hospital’s full scope of health care offerings, new patients can call 480-257-2702.
Mountain Vista Medical Center, part of IASIS Healthcare, is a 178-bed, full-service hospital, featuring all-private rooms and advanced medical technology. Designed to provide comprehensive health care services for residents of the East Valley, the hospital is an accredited Chest Pain Center, Primary Stroke Center, Cardiac Receiving Center and a Level III Trauma Center.
Mountain Vista Medical Center is located at 1301 S. Crismon Road in Mesa. For more information, visit mvmedicalcenter.com or call 1-877-924-WELL (9355).