Right Plan for You Be Well Good Eats

FALL 2017 Smarts

Eating right and staying active key to managing diabetes Right plan for you Post-acute care is a benefit for A fruitful some patients Be well Immunizations lifestyle are ‘worth a shot’ Good eats Finding ‘ho ho’ help for the holidays Welcome LETTER

Happy, healthy holidays!

Welcome to the autumn edi- some of our doctors will share what they’ve learned tion of Health Smarts! Looking from patients like you. Finally, you already know how forward to the holidays can important it is to take good care of your body, so bring great joy as we antici- check out our crossword puzzle and we’ll keep your pate gathering with friends mind sharp, too. and loved ones. Sharing family This publication is designed for and distributed to meals, family stories and lots Medicare beneficiaries whose doctor participates in of laughter are the experiences that connect us. the Medicare Shared Savings Program Accountable Unfortunately, the holidays can also bring Care Organization through Banner Health Network. anxiety to those of us who may have suffered a The Medicare Shared Savings program does not loss this year or whose health has taken a turn require a sign up and does not change your Medicare for the worse. Whether the year has been good benefits. ThisHealth Smarts magazine is an added or more difficult, we can all benefit from reducing bonus, providing you with valuable information on unhealthy stress. Reducing stress is particularly the latest health care news and how to achieve your important during the holidays when anxiety peaks best personal health. for many, while we would like to be at our best for We’re here to help you, so if you have any ques- friends and family. In this issue, you’ll find tips to help tions about your health you can access our 24-hour you safely and joyfully navigate the season including Banner Health Nurse On-Call service. Our nurses ways to enjoy healthy foods. Not only are we likely can answer questions about medications, symp- to feel better when we eat well, we are also likely to toms you are experiencing, or make recommenda- avoid adding unwanted holiday pounds. tions about where to get care. Just reach out to us at We also introduce you to a gentleman diagnosed (602) 747-7990 or (888) 747-7990. with diabetes who’s not letting the disease get the best of him. You’ll read his inspiring story and learn how he’s controlling his disease through proper diet To your health, and exercise. We’ll provide you with valuable information about adult immunizations, how to get the most out of your Fitbit and other health-monitoring devices and we’ll break down the myths and facts about statin medications. Robert Groves, MD This edition also features information about Chief Medical Officer skilled nursing facilities and long-term care, and

2 | Health Smarts 10 Fall 2017 CONTENTS

COVER STORY 8 A fruitful lifestyle Even small changes can make a big difference

4 Doc Talk What is one thing your patients have taught you? 5 Worth a shot Immunizations protect patients from disease 6 The right care plan for you Post-acute care may be a benefit 10 Finding ‘ho ho’ help Don’t let your mental health take a hit during the holidays 12 Health Smarts Easy high-tech solutions to get your workout started 13 Get Moving Understanding high cholesterol 14 Good Eats Avoid the holiday pounds 15 Crossword

NEED TO CONTACT MEDICARE? 16 Calendar 800-MEDICARE (800-633-4227) Healthy living events and activities 14 www.Medicare.gov On the cover: (left to right): Marilyn Cryan, registered dietitian; Michael Yabroff, diabetes patient; Margaret O’Brien, registered dietitian.

General Manager: Cami Kaiser If you no longer wish to receive this magazine: Creative Development Director: Isaac Moya Please notify us at healthsmarts@ CREATED BY REPUBLIC MEDIA Editor: Jim Williams republicmedia.com or 602-444-2235. Be CUSTOM PUBLISHING Project Manager: Nick Kostenko sure to include your full name, address, city A division of The Arizona Republic Design: Rachel Tullio and zip code as it appears on the mailing 200 E. Van Buren St., Phoenix AZ 85004 Cover Photo: Rick D’Elia label of the publication.

NOTICE OF NONDISCRIMINATION Banner Health provides free language services to people whose 684-6325 or email bannerhealthpatientrelations@bannerhealth. Discrimination is Against the Law: Banner Health complies with primary language is not English, such as: com. You can file a grievance in person, or by mail, fax, or email. applicable federal civil rights laws and does not discriminate on • Qualified interpreters If you need help filing a grievance, the Banner Patient Relations the basis of race, color, national origin, age, disability, or sex. • Information written in other languages Services Center Director is available to help you. Banner Health does not exclude people or treat them differently You can also file a civil rights complaint with the U.S. Depart- because of race, color, national origin, age, disability, or sex. If you need these services, contact Banner staff. ment of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, Banner Health provides free aids and services to people with dis- If you believe that Banner Health has failed to provide these available at ocrportal.hhs.gov, or by mail or phone at: U.S. Depart- abilities to communicate effectively with us, such as: services or discriminated in another way on the basis of race, ment of Health and Human Services, 200 Independence Avenue • Qualified sign language interpreters color, national origin, age, disability, or sex, you can file a grievance SW, Room 509F, HHH Building, Washington, D.C. 20201 800-868- • Written information in other formats (large print, audio, with the Banner Patient Relations Services Center Director, P.O. 1019, 800-537-7697 (TDD). Complaint forms are available at hhs. accessible electronic formats, other formats) Box 16423, Mesa, AZ 85211-6423, or call 602-747-6880, fax 480- gov/ocr/office/file.

bannerhealthnetwork.com | 3 Doc TALK

What is one thing your patients have taught you?

“Every patient responds differently “Time after time, patients have “One thing my patients have taught to what I say. Some want a firm taught me not to underestimate me is that medical care is not a recommendation, others need more their resiliency and determination in spectator sport! The more engaged reassurance and moral support to help the face of serious disease. At the my patients are in their care, the make a decision. If the physician can same time, they have shown me the better the outcome. In this era understand what style works better value of preserving independence of team-based care, the patient for an individual patient, then together and maintaining a sense of humor in is the most valuable player.” they will have a healthier outcome.” promoting the healing process.” Jeff Wolfrey, MD Harvey Hsu, MD, Medical Director Jason Leubner, MD Family Medicine/Geriatrics Internal Medicine Family Medicine/Geriatrics Banner – University Medical Center Banner – University Medical Center Banner – University Medical Center Phoenix Phoenix Phoenix Family Medicine Clinic Internal Medicine Clinic Family Medicine Clinic

“My patients have taught me “As a family medicine physician, I “Since my patients often search to embrace each day with a learned that being available and actively for medical information on the positive attitude — that alone listening to all aspects of a patient’s internet, they have taught me will take you through the good life helps with providing better care. I how to carefully integrate that times and the difficult times.” value being a part of my patient’s lives information into my practice. I have and hold dear the trust they have in learned to guide them toward the Sarah Payne, MD me. My patients have taught me that a best resources which help them Internal Medicine/Geriatrics trusted relationship may be the ultimate become a better engaged, informed, Banner Medical Group factor to achieve better outcomes.” invested and healthier patient.“

Jesse Bracamonte, DO M. Zuhdi Jasser, MD, FACP, Divisional Medical Director, Arizona West Assoc. Medical Director Banner Medical Group Internal Medicine Neighborhood Physician Alliance

4 | Health Smarts Be WELL

Shingles Adults age 60 and older are encour- aged to get a shingles vaccine. A single shot can prevent this re- activation of the chicken pox virus. Shingles can be extremely painful when it forms itchy rashes throughout the body. “This is a shot you’d get once in your lifetime, and it doesn’t matter if you’ve had shingles before,” Dr. Leubner said. “But if you have a Worth a shot compromising immune condition, Immunizations protect patients from disease you should first talk to your doctor.” By Elise Riley “We’re prone to developing more Pneumonia When a patient visits Dr. Jason Leub- severe complications and infections.” There are many types of bacteria and ner’s office, his team goes over more Among the most commonly used viruses that can cause pneumonia. than vital signs, current medications vaccines for adults are those that Vaccines and antibiotics are available and symptoms - they also talk about protect patients from influenza, to prevent or treat bacterial pneumo- immunizations. shingles and pneumonia. nia. Generally, it’s recommended that Shots are not just for infants adults 65 years and older receive the or children. Whether it’s guarding Flu vaccine to prevent bacterial pneu- against the flu or arming yourself Every year, starting around Septem- monia. “With the development of the from exposure to a dangerous dis- ber or October, an annual flu shot is vaccines (for bacterial pneumonia), ease, immunizations can help adults available. It’s recommended for pa- we’re seeing fewer people who are stay healthy. tients older than 6 months, with few sick with it,” Dr. Leubner said. “It’s less “Increasingly, what we’re trying exceptions. “Flu vaccine is the most common than it used to be, but that’s to do is identify those patients who effective method we currently have because of the vaccine.” need vaccines when they’re in the of- to prevent flu,” Ivaska said. “It’s highly While there are some antiviral fice for any reason,” said Dr. Leubner, effective, even if you are exposed medications to treat viral pneumo- a family practice physician. Most to a strain that’s not covered by the nia, many times a person may have to major pharmacies now carry vac- vaccine.” wait it out with home treatments to cines, which means getting immu- It’s also important that older get better, depending on the sever- nized takes just a matter of minutes. patients get the flu shot every year. ity of their viral symptoms. However, Depending on your health history, an According to the Arizona Depart- the best defense against getting viral immunization might be a solution to ment of Health Services, more than pneumonia is to get the flu shot. help “boost” your defenses. Talk to 4,000 people are hospitalized and Another best defense to combat your doctor to find out which vac- more than 700 people die in the state both bacterial and viral pneumonia is cines are best for you. because of the flu each year. “Seniors to always wash your hands. “Especially as we age, our immune are at risk for severe complications Talk to your doctor about your systems don’t work quite as well as – pneumonia or even death – if they vaccination history to find out which they did when we were younger,” said don’t get immunized,” Ivaska said. vaccines may be best for you. Joan Ivaska, senior director for infec- “It’s extremely important.” tion prevention at Banner Health.

bannerhealthnetwork.com | 5 THE RIGHT CARE PLAN FOR YOU Post-acute care is a benefit for some patients By Debra Gelbart HOSPICE COMPARE Looking for information on local hospice hen you or a loved one Home Care and Hospice. However, options? Want to see how Banner Hospice leaves the hospital sometimes the patient doesn’t compares to other facilities? Thanks to Wafter surgery or treat- feel comfortable with a caregiver in the Centers for Medicare and Medicaid ment for an illness or injury, the their home. “There is a significant Services, you can review local hospice doctor may prescribe what’s percentage of patients who could options on their new Hospice Compare called “post-acute” care. benefit from home health who say, website: medicare.gov/hospicecompare/. ‘I don’t want someone I don’t know Post-acute care occurs after your coming into my house,’” Dr. Edwards therapist,” he explained. initial treatment and is designed to said. “For patients who decline home “Depending on the patient’s underly- help you recover quickly. It may come health services, their chance of having condition and how much he or she in different forms for the 40 percent ing to return to the hospital goes up is improving, a typical skilled nursing of patients who need it. This includes twofold,” he said. facility stay can run about two to three home care, an inpatient rehabilita- weeks,” Dr. Edwards said. tion facility or long-term nursing Other options If the patient requires intensive care. If your condition requires continu- therapy after a hospital stay, an inpa- Having your post-acute care at ous medical attention after a hos- tient rehabilitation facility may be the home with a home health nurse can pital stay, you may be admitted to a most appropriate post-acute setting. be the simplest option after you skilled nursing facility, Dr. Edwards However, Medicare requirements for leave the hospital. The nurse may explained. In this setting, you will be admission to an inpatient rehab facility help administer medication, change monitored 24 hours a day. “ A skilled can be strict, explained Susan Kreps, a wound dressing and assist with nursing facility is for patients who senior director for four Banner Health daily nursing tasks, explained David can’t go home but require ongoing inpatient rehabilitation programs. “A Edwards, MD, chief medical officer services from a nurse and possibly patient must be able to tolerate at least for post-acute services at Banner a physical, occupational or speech three hours each day for therapy usu-

6 | Health Smarts ATTENTION ALL FEE-FOR-SERVICE MEDICARE BENEFICIARIES Because your health care provider is a participant in the Banner Health Network (BHN) Medicare Shared Savings Program (MSSP), you may get a survey in the mail from the Centers for Medicare & Medicaid Ser- vices (CMS) that asks about your experience with your health care provider and his or her office staff. CMS is the federal agency that administers the Medicare program and is responsible for making sure that Medicare beneficiaries get high quality care. One of the ways that CMS fulfills that responsibility is by asking Medicare beneficiaries about the care they are currently receiving. If you are selected to receive a survey, please take the time to evaluate your health care provider honestly. Completing this survey is voluntary and your decision to participate or not to participate will not affect your Medicare benefits in any way. However, your opinion is important and we hope you will take this chance to tell CMS about the quality of care you receive. CMS will combine the information you provide with information from others to understand the quality of care delivered to Medicare beneficiaries. Your provider does not know who is selected to receive a survey, and will not see your individual survey or answers.

ally a minimum of five days a week,” Under the appropriate circum- Edwards said. Kreps said. The patient also must stances, Medicare typically will pay Where a patient goes after a require the services of a physical for home health, skilled nursing, hospital stay is “a shared decision- medicine and rehabilitation physician inpatient rehab and hospice, Dr. making process,” explained Kathleen who agrees to accept the patient, Edwards said. If the patient requires Harris, senior director of govern- she added. The typical stay in an in- only custodial care, rather than nurs- ment operations for Banner Health patient rehabilitation facility is about ing care, in a long-term care facility, Network. “You and your doctor will 13 days, Kreps said. Medicare will not cover these costs. customize a discharge plan that Sometimes, a patient coming out works for you.” of a hospital stay is either terminally A shared outlook ill or chronically ill to a degree where “The determination of the best post- GET MORE INFO they do not expect a full recovery. acute setting is made by the patient’s Visit our blog healtheconnect. In that situation, the patient may doctor in consultation with the pa- bannerhealth.com for more be discharged to a long-term nurs- tient, the family, the nursing staff, the information. ing facility, a memory care facility (if care manager (the professional who dementia is an issue) or hospice care, coordinates all of the care the patient Dr. Edwards said. receives) and the therapy team,” Dr.

bannerhealthnetwork.com | 7 LIFESTYLEA FRUITFUL

Even small changes can make a big difference By Meghann Finn Sepulveda Photos by Rick D’Elia

ccording to the American Diabetes Association, 1.5 Amillion Americans are diagnosed with diabetes every year. Fortunately, many people can manage their illness by eating healthy, being active and taking medication prescribed by their doctor.

Get the facts Center Phoenix. “Weight can also be sis and get screened for diabetes. Type 2 diabetes is the most com- a major factor.” “We want to intervene as early as mon form of diabetes, and occurs Symptoms of diabetes include possible so we can effectively treat when blood glucose (sugar) levels frequent urination, extreme thirst, and manage the disease,” he explained. rise higher than normal, according blurred vision and fatigue. When Michael Yabroff, a 72-year- to the American Diabetes Associa- “When people with diabetes old Phoenix resident, was diagnosed tion. There are risk factors that can have elevated blood sugar levels, with type 2 diabetes more than 30 contribute to the progression of the it exceeds the kidneys’ capacity to years ago, he didn’t manage his dis- disease and a blood test can detect reabsorb the sugar,” Dr. Haferkamp ease properly. Eventually, he needed whether a person has diabetes. said. “Over time, this puts people at emergency triple-bypass heart “We know that many people who risk for kidney failure and even heart surgery. are diagnosed with diabetes have attack or stroke.” “After the procedure, my doctor a strong family history,” said Scott Dr. Haferkamp emphasized that told me it was time to get my diabe- Haferkamp, MD, an internal medicine it’s important for people to see their tes under control,” Yabroff said. “I doctor at Banner – University Medical primary care doctor on a regular ba- knew I had to take it seriously.”

8 | Health Smarts insulin if needed.” Maintain a healthy diet STEPS TO Yabroff learned he wasn’t taking Those newly diagnosed might find MANAGE DIABETES the appropriate medication so his their new meal plan overwhelming Banner Health Network regis- doctor made an adjustment. Today and may worry about feeling restrict- tered dietitian Margaret O’Brien he takes two oral medications to ed or deprived. says today there are many treat his diabetes while watching more flexible strategies to ef- “You don’t have to make huge what he eats. fectively manage diabetes: changes,” said Marilyn Cryan, a Diabetics like Yabroff are encour- 1). Eat regularly – This keeps registered dietitian and health blood sugars from going aged to check their blood sugars coach at Banner Health Network. too high or too low daily, usually before and after a meal. “It’s just learning about foods that 2). Eat smaller servings – Follow “We like to teach patients how to affect blood sugar levels and making serving size guidelines from the adjust insulin on their own, which healthier choices.” American Diabetes Association ultimately empowers them to be in People living with diabetes should 3). Keep big sources of sugar to a control,” Dr. Haferkamp explained. stay away from refined sugars such minimum – Limit cake, candy, ice cream and sweetened drinks as candy and sweetened beverages Find support 4). Reduce fat and calorie intake along with simple carbohydrates like – Choose heart healthy fats A lifelong disease, diabetes requires white bread and pasta. such as avocado and nuts family encouragement and support, “While you do need to make some 5). Exercise – Whether you walk, which ultimately leads to greater diet modifications, you can easily re- swim or dance, just moving outcomes for everyone. place the foods you love with health- regularly is beneficial “A diabetic diet is truly beneficial ier options that raise blood sugars in for the entire family,” Dr. Haferkamp a more stable way,” Cryan said. “Food to take oral medications or insulin said. “It’s so important everyone in with fiber and nutrients fights crav- injections to manage blood glucose the household learns how to incorpo- ings and helps with weight loss.” levels effectively. rate these healthy behaviors to have Motivated to manage his diabetes, “We take into perspective the success.” Yabroff visited Banner – University whole patient to determine the right Medical Center Internal Medicine time to start medication,” Dr. Hafer- GET MORE INFO Clinic and quickly realized he wasn’t kamp said. “We often begin with oral To learn more about living with eating properly. medication and then transition to diabetes, visit bannerhealth.com. “I learned how to count carbohydrates and manage portions,” Yabroff (left to right): Michael Yabroff, said. “I stopped eating large quanti- diabetic patient; Margaret O’Brien, registered dietitian; ties of meat and fatty, greasy foods.” Marilyn Cryan, registered Today, Yabroff, now incorporates dietitian more fruit, vegetables and fish into his diet. “My blood sugar levels have sig- nificantly come down,” he said. “I feel really good.”

Follow the treatment plan Diabetes can sometimes be controlled through diet and exercise alone. However, experts say that most diabetics will eventually need

bannerhealthnetwork.com | 9 Don’t let your mental health take a hit during the holidays

FINDING ‘HO HO’ HELP By Kristine Burnett Health Hospital, cites unrealistic family and friends. As a result, some he holiday season is widely expectations as a key contributor to people may begin thinking about considered a time of cheer feelings of sadness, depression and loved ones they’ve lost through Tand good tidings. Unfor- loneliness during the holidays. He death, separation, or other life tunately, it can also be a trigger says this applies to people with a his- changes. for a wide range of mental and tory of mental illness as well as those “Thinking about family and friends emotional challenges. While the for whom mental illness isn’t a factor. who are no longer here can cause reasons for feeling blue during negative reactions for a lot of peo- the holidays are numerous, the Unrealistic expectations ple,” Dr. Singh said. “This is especially emotional toll it takes is very “Society and the media have cre- true if they lost someone at the holi- real. Recognizing the triggers of ated certain expectations of what day season.” emotional distress and finding the holidays are supposed to be When a traumatic event like an ac- ways to cope with and overcome like,” Dr. Singh said. “Often, those cident or death occurs around a holi- them can help make your holiday expectations don’t match reality. day, that day can become a lifelong season a little happier. That can be difficult for people to marker for the tragedy. For some, the accept.” holiday spirit may become overshad- Gagandeep Singh, MD, chief In most instances, holiday expec- owed by feelings of sadness, anger medical officer of Banner Behavioral tations include joyful gatherings with or isolation. Managing these emo-

10 | Health Smarts tions becomes increasingly difficult DE-STRESS YOUR LIFE as people get caught up in the hustle By Barbara Holt Stress. We all experience and deal with it (or not) in our own ways. and bustle of the season, and let their Here are a few tips to help reduce the amount of stress in your life. regular self-care strategies slide. BREATHE DEEPLY: BEDTIME BREATH: If concentration, learn a new Self-care and stress When you feel your shoul- you can’t find time during language, learn to paint, management ders and neck beginning the day to meditate, then learn to cook or learn to “During the holidays, most of us to tense up, take one when you lie down at night, play a musical instrument. minute to close your eyes close your eyes, place your In other words, give your sleep less, take less care of ourselves, and breathe deeply. Try to left hand on your heart and brain a little exercise! and put ourselves in stressful situ- take the “in” breath all the your right hand on your SLEEP: Try to get 7 ations like being around negative way to the pit of your belly, belly. Allow your attention - 8 hours of sleep each people – sometimes family – with and then allow the “out” to rest with the gentle night. Rest is an impor- whom we’d rather not associate,” breath to release slowly, motion of your breathing. tant part of strengthen- Dr. Singh explained. “Drinking more, as you consciously follow As you follow the breath, ing memory recall. staying up late to attend events, or the flow of each breath. observe how your belly EXERCISE: Find time worrying about finances when we feel If you find this technique rises and falls while your for 30 minutes of exer- helpful, then try to prac- chest remains still. Con- cise each day. Those 30 obligated to make a lot of purchases tice it for one minute each tinue until you fall asleep. minutes can be broken can all lead to stress.” hour during your workday. EAT MORE “BRAIN” into 10-minute sessions While tolerance for stress varies HUG YOURSELF: Wrap FOOD: Add blueberries, throughout the day. They greatly from one person to the next, your arms around yourself, fresh fruits and veggies, can include walking, jog- Dr. Singh says everyone has a break- reaching for your shoulder fatty fish (such as salmon ging, lifting weights, or ing point for how much stress they blades, and pull gently as and sardines), and whole participating in sports. can handle. Thankfully, however, he you round your shoulders grains to your daily diet LAUGH: Laugh when- says people can increase their resil- forward slightly and lower while cutting back on ever and wherever you can. your head to your chest. saturated fats and sugars. Laughter releases endor- ience to stress. MEDITATE: Either in the PLAY “BRAIN” GAMES: phins into your system “We all have different skill sets for morning or at the end of Create time every other that decrease stress and FINDING ‘HO HO’ HELP handling stress,” he said. “Building the day, make time to sit day or so to exercise your promote happiness. resilience is about the day-to-day quietly for five minutes, mind by reading, working things we do to take care of ourselves closing your eyes and puzzles (such as Sudoku, Barbara Holt is a and make life more meaningful.” allowing your attention the jumble or cross- Banner Health Network to rest with the gentle word), play scrabble or Board Member and Ben- Resilience through motion of your breath. other games that require eficiary Representative. acts of kindness As part of the plan to build resilience, up a sort of reserve for dealing with a more significant negative effect on Dr. Singh suggests focusing on oth- stress when it arises.” people with mental illness, but it’s ers and doing something good in Doing for others, whether it’s vol- important we all learn how to manage return to help manage and counter- unteering or giving back in another our mental health.” act negative thoughts, feelings and manner, helps reduce stress and Dr. Singh urges people to cast emotions. feelings of isolation. Knowing you’re aside expectations about what the “Doing things for others adds a making a difference in someone’s life holidays should be like and instead sense of meaning to our lives, and can help you feel engaged and con- embrace reality. we all thrive when we feel there’s nected to others. “The disconnect between ex- meaning to what we’re doing and to “The reality is everyone experi- pectation and reality is what causes our overall existence,” he explained. ences stress, loss and loneliness,” Dr. trouble.” “These positive feelings can build Singh said. “These feelings can have

bannerhealthnetwork.com | 11 Health SMARTS

“This is a good option for people looking for basic body weight type exercises such as pushups, sit ups and air squats. It’s very short and is easy to use,” says Steward. ■■8Fit (8fit.com) – This workout/meal planner combo app helps you set Fitness goals, suggests meals and activities and allows you to track your progress. helpers ■■Today (apple.com/itunes) - This habit tracker allows you to track up to three healthy habits, such as walking, planning meals or drinking water. Easy high-tech solutions to get your workout started More than wrist candy ■■If you’re looking for a simple gadget By Leigh Farr and gather a lot of information it’s to track your steps, a pedometer You’ve probably heard it from your easier now than ever because there’s (think Yamax Power Walker, WPX doctor: an exercise program helps so much good information out Walking Pedometer or Omron you feel better and also lowers your there,” says Steward. Alvita Pedometer) may be all you risk for heart disease, diabetes, high To get the most reliable facts, she need. But if you want to monitor blood press and colon cancer. says, look for websites sponsored your heart rate, meals, sleeping But the question is, how do you by national organizations and steer habits and more—and you’re will- get started? A high-tech gadget away from manufacturer-sponsored ing to pay more for a device — a might help. sites. Here are a few sites to try: fitness tracker may come in handy. “With all the technological options ■■American Heart Association: Here are some snazzy wearables to nowadays it’s easy to find something heart.org help you get started: that fits you,” says Kimberly Steward, ■■American Physical Therapy Asso- ■■Apple Watch Series 1 – This user- a physical therapist at Banner Del E. ciation: moveforewardpt.com friendly smartwatch comes with a Webb Medical Center Rehabilitation. ■■National Institutes of Health: nih.gov built-in activity tracker to monitor To ensure success, she says, “You ■■Centers for Disease Control and your heart rate, steps, standing want to define your goals and make Prevention: cdc.gov hours and calories. sure you start out really simple. And ■■Fitbit Alta HR – Not only does be sure to consult with your physi- Apps to get you active this device come with an app that cian before you start any exercise To start a new workout routine, here tracks your pulse, your steps, and program.” are some free fitness apps you can sleeping patterns, it stays charged Here’s a mini guide for finding the easily download from the internet for seven days. most reliable fitness information, the onto your mobile phone or tablet. For ■■Garmin Vivosmart HR+ – This sleek best gizmos to track your daily prog- extra motivation, you can use these contraption tracks your heart rate, ress and fitness apps that support apps to connect with other fitness and monitors your steps, distance, you every step of the way. enthusiasts online: calories and floors climbed. Bonus: ■■Strava (strava.com) – This app You can even go swimming with it. A click away helps you track the number of These days, there is a wide variety of miles you bike or run and it allows GET MORE INFO tips and strategies online to help you you to easily keep track of your Need help getting started on a fitness start a workout routine. times and your routes. routine? Call Banner Del E. Webb “If you like to do your own research ■■Johnson and Johnson 7 Minute Medical Center Rehabilitation at Workout (7minuteworkout.jnj.com) – (623) 524-4038 for a consultation. 12 | Health Smarts GET MOVING

Myth 2: All statins are the same “They aren’t all equal in potency, in their chemical makeup or in the way your body uses the medication,” Lou- ton said. She recommends that if patients believe they are having side effects, they should talk to their doctor about switching medications rather Understanding than avoiding statins altogether. Myth 3: Statins are causing your muscle pains or memory lapses high cholesterol While these are symptoms that Statin medications are simvastatin (Zocor). can occur to people who take these an effective treatment There are a number of reasons you medications, Louton noted that many can be prescribed statins, including: of these can also be attributed to the By Julie Maurer ■■High Cholesterol normal changes that come with age. Hearing you have high cholesterol ■■Atherosclerosis, or fatty buildup “If you have any unusual, really se- can be daunting, but physicians have that can clog arteries vere muscle pain, you need to contact a tool to help combat the disease – ■■Diabetes your doctor,” Louton said. “But before statin medications. ■■Coronary Artery Disease blaming your medications, stop and With every prescription, side ef- “Cholesterol can cause a lot of ma- think about what physical activities fects are a possibility, but most of jor problems if it blocks and starves could also be the cause of your aches them are minor. Unfortunately, many your body of the blood it needs,” and pains.” people are shying away from their Louton said. medications because of second- Talk to your doctor, hand information rather than listen- Myths and concerns not your neighbor ing to their doctor or pharmacist. By understanding some of the myths Louton urged patients to never just “It has a lot to do with what they and concerns about statins, you can stop taking something because you read, or what they watch on televi- be equipped to discuss your medica- do not like the side effects, and to sion – or somehow hearing it from tions with your doctor rather than make that important call to your doc- your neighbor gives it more credence taking the advice of non-experts. tor first. than hearing it from a doctor or phar- “People should never just stop macist,” said Betty Louton, clinical Myth 1: Grapefruit and statins taking their medication a doctor has pharmacist at Banner Health. “It (grapefruit) does contain com- prescribed for them. The doctor But according to the American pounds that can change the way prescribed it because a patient needs Heart Association, studies have your body processes a statin,” Lou- it and has weighed the benefit of the shown that the benefits of statins far ton said. “It can cause more of the medication over the risk of side ef- outweigh the risk of side effects. drug to be in your bloodstream.” fects,” Louton said. However, she said that it would To research a medication beyond What is a statin? take a large amount of juice or sev- consulting a doctor or pharmacist, According to Louton, statins are eral grapefruits to cause any impact. Louton recommends specific medi- a class of medications that block the Patients should consult with their cal websites, such as the National production of cholesterol in your physicians first, but they can prob- Institutes of Health, www.nih.gov liver. Most of these medications have ably still enjoy a half of grapefruit or the American Heart Association, “statin” at the end of their name, or 8 ounces of grapefruit juice with www.heart.org. such as atorvastatin (Lipitor) or their medication. bannerhealthnetwork.com | 13 Good EATS

Avoid the holiday pounds Make a Plan to HEALTHIER Nourish Yourself EGGNOG By Joan Westlake Eggnog is a minefield of calories Many of us fall victim to holiday — from the heavy cream to the ■■ weight gain. The last months of the Maintain a steady blood sugar sugar to its main ingredient, eggs. year can be unforgiving for your level. Starving all day before the Weighing in at around 340 calories waist, especially if you enjoy the big meal sets you up for cravings per cup, with 19 grams of fat, this treats and feasts that come with the as well as energy crashes and is one holiday drink that’s better holidays. binge attacks. left at the bar — unless you make some serious changes. First, skip Don’t despair. Registered Dieti- ■■Make thoughtful choices. Skip the heavy cream and use skim milk tians Margaret O’Brien and Marilyn common foods like packaged rolls and fat-free half-and-half instead. Cryan have advice and tips to help or canned corn and enjoy tradi- Egg substitutes are just as good as you ward off the gain. tional holiday treats. the real deal, and a single packet of O’Brien said, “Holiday pounds pile ■■Indulge yourself with a serving artificial sweetener can add all the on because there is more food avail- of grandmother’s pineapple pie flavor of a teaspoon of calorie-heavy able. Parties, office potlucks, season- or those dark chocolate-covered sugar. And, since you’ve carved off al sweets and big family gatherings fill cookies shaped like stars, but the calories in all the right places — down to about 60 calories per your plate.” remember sugar is addictive. serving — feel free to add 1/4 cup “Also, we tend to prepare dishes ■■Survey the food choices and of brandy or rum for a little kick, or that have more calories,” she said. then prioritize what you put on spice it up naturally with a shaving of “And, there’s the element of emo- your plate. fresh nutmeg. —Courtesy of WebMD tional eating; especially for people ■■Fill your plate only once and who are lonely, depressed and remove it. Stand far away from the stressed.” buffet table. after you’ve eaten,” said O’Brien. Approaching each celebration ■■Keep your home full of fresh veg- Cryan concluded, “Give up be- with a practical plan is at the heart etables and fruits without tempta- ing ‘perfect.’ Taking care of yourself of gaining control. Cryan pointed tions like holiday candy or the plate of is important. The key is, if you eat out that the act of researching your leftovers your daughter handed you cookies or miss exercising, don’t fall upcoming food situation can be as you walked out her door. into the ‘all or nothing’ trap and eat empowering and help keep you from “Put some balance in the season. cookies everyday or stop working overindulging. Here are some tips Food doesn’t have to be the only out for a month. Every day is a new the nutritionists offer to guide you in focus. Plan gatherings to increase chance to nourish your body and feed creating your strategic plans. activity. Go to the park, play a game your spirit.” of flag football or take a family stroll

14 | Health Smarts Crossword PUZZLE

“ILK-CONCEIVED” 78 Kazan of film ACROSS 80 R&B singer Marilyn 1 TV-regulating gp. 82 Stalin’s fed. 4 Dems.’ foes 83 Z-to-A data- 8 May birthstone alphabetizing 15 Deform arrangement 19 Head of corn 86 Start dozing 20 Farm unit 88 Mao — -tung 21 Award hopeful 89 Not stray from, 22 Suspicion as a schedule 23 Bunch 90 Connector to 25 Course taken the WWW at night 91 Elhi support org. 27 “Wish Tree” 94 Split couple artist Yoko 97 Misfortunes 28 Meal for an 99 Take back, as echidna the title 30 Bic fluid 101 Esau’s father 31 Slogs 103 Family ride 32 Comment to a 104 Possesses very generous 105 Emphatic print person 107 Silky cats 35 Defeat 109 Actress Lucy 36 Martinique, of “Kill Bill” par exemple 110 iPhone voice 37 Cobwebby 111 Enzyme suffix room, often 112 Hollywood Crossword by Frank A. Longo 38 Operating publication 39 Pol Paul for 80 years 10 Edit, as text by Lanza 85 Germinated 40 Shape 115 Word with 11 Hockey site 51 Goof-offs 87 Taylor boy 41 Original texts: synonyms at 12 DiFranco of song 52 Riles of old TV Abbr. the ends of the 13 Like pre-Easter 53 Make beloved 90 Fuming mad 42 Hightailed it answers to the periods 54 Showed 91 Is profitable starred clues 44 Forest and 14 Abases clemency to 92 Narrowed 118 “Dame” Everage desert, e.g. 15 Savage 55 Florid gradually 46 Siam or Sudan 119 Stately street 16 Slow tempo 56 Year’s 12 93 Air hero ender shader 17 Put on eBay, say 58 Prominent 94 Avoids, as capture 48 Cat coater 120 Elderly 18 Went beyond 63 Advanced music 95 Site of Kubla 49 Credit card feature 121 Counterpart or drama deg. 24 Greiner of Khan’s palace 54 A portion of of masc. “Shark Tank” 65 Burning crimes 96 V-8, for one 57 Pal, to Pablo 122 Chop — 26 Chop or crop 67 Monetary 98 59 Sister of Bart 123 Sows again 29 Gear holder for penalties Lower-priced Simpson 124 Loch — the slopes 68 Web mags 100 Promiser’s proviso 60 Verse writer Nash 125 Rx watchdog 32 Orange tuber 69 Broadway’s 102 Doe partner 61 Spur 33 Tan color “August: — 104 Suffix with invent 62 47-Down or DOWN 34 English architect County” 105 Bar brew, in France 96-Down fuel 1 Sprinkling of Jones 70 Mediator’s skill 106 Quotes as an 63 It precedes Tue. 2 In — (conspiring) 35 Grounds 73 Almanac fill authority 64 Got tangled 3 Hybrid bakery 39 Eye layer 76 Future leaf 108 Big skin cream 66 Actress Sothern treats 40 Combine 79 Digs brand 67 Gravity, e.g. 4 Norma — 43 Region west 80 Econo Lodge, e.g. 109 Low-cal 71 Eden figure (Field part) of Catalonia 81 Throngs 113 Apt. parts 72 Stool pigeon 5 Dazzling effect 45 Brunch fruit 84 Member of 114 “Sure thing!” 74 When doubled, 6 We, he or it 47 Kitchen appliance Devo, say 116 Pub. house hirees a Gabor sister 7 Melees 48 Narc, e.g. 117 Sumac of song 75 Horse kin 8 Denver-to- 49 This and PUZZLE ANSWERS ONLINE 76 La — Tar Pits Detroit dir. that: Abbr. At BannerHealthNetwork.com/ 77 Hawke of film 9 Not lingering 50 Tenor played members/healthsmarts bannerhealthnetwork.com | 15 BANNER HEALTH NONPROFIT ORG 1441 N. 12th STREET U.S. POSTAGE PHOENIX, AZ 85006-2887 PAID LONG BEACH, CA PERMIT NO. 2297

Healthy Living CALENDAR To find more classes near you, visit BannerHealth.com/calendar.

Heart Healthy Eating - Free, but registration is required. To Dementia Dialogues Webinar: Banner Heart Hospital register, call (623) 832-3248 Facing Financial Issues: Is Let experts from Banner Heart Hos- the Rainy Day Here? pital help you navigate toward heart- Wednesday, Oct. 25; 10 -11:30 a.m. Most people plan to live indepen- healthy eating as part of a whole- Banner Sun Health Research Institute, dently their entire life, but when a Morin Auditorium some lifestyle. Free, but registration loved one is diagnosed with demen- 10515 W. Santa Fe Drive, Sun City is required. To register, call (602) tia, that is unrealistic. Most families 230-CARE (2273) or (800) 230- Finding Meaning While are not aware or prepared for the CARE (2273). Living with Loss high costs of care over an extended illness like dementia. This Dialogue Caring for someone with dementia Tuesday, Nov. 7: 11 a.m. - Noon reviews the logistics of how to plan creates ongoing awareness of loss as Tuesday, Nov. 21: 11 a.m. - Noon and pay for care over the course of the person with dementia is physi- Tuesday, Dec. 5: 11 a.m. – Noon cally present but psychologically dif- the disease. ferent from who they once were. This Banner Heart Hospital can be confusing and overwhelming NOTE: This is an Online Webinar. Mariposa Room for family and others who care about Register at banneralz.org under 6750 E. Baywood Ave., Mesa them. This class provides strate- events/education and online educa- gies to infuse hope and meaning into tion. All webinars are recorded and Emotional Changes: Understanding one’s life while providing care in order available for viewing 24-48 hours Symptoms beyond Memory Loss to cope with continual changes. Free after the live session. If you need to This program focuses on helping care- but registration is required. To regis- register for the audio only, call (623) givers grasp the common emotional ter, call (623) 832-3248 832-3248 changes that may occur in the person with Alzheimer’s. Learning to better Wednesday, Nov. 8; 10 -11:30 a.m. Wednesday, Nov. 15; Noon – 1 p.m. understand emotional changes can Banner Sun Health Research Institute, Arizona Time help increase your level of empathy Morin Auditorium and reduce caregiver frustration. 10515 W. Santa Fe, Sun City

For life’s potential emergencies Have you ever wondered, is this an emergency? If you aren’t sure, or you need a nurse’s advice about where to get care, call us. We are here to help. 24 hours a day. Banner Health Nurse On-Call: (602) 747-7990 or (888) 747-7990