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County attorney says opioid makers 'lining their pockets'

Pinal County is taking pharmaceutical manufacturers, pharmacies and doctors to court over addiction and overdoses.

There have been 308 reported opioid overdoses in Pinal County in the past two and a half years.

Pinal County is taking on big pharmaceutical companies over opioid addiction. The law firms of Fennemore Craig and Theodora Oringher filed suit for the county in Superior Court Sept. 25.

“We know how many pills were forced into our county,” County Attorney Kent Volkmer said. “Every pill is tracked by the federal government. Needless to say, it falls far outside of appropriate norms.”

In suing many large drug manufacturers and all pharmacies that do business in Pinal County, Volkmer said his office is not as interested in getting a monetary award from the case as it is the opportunity to litigate it in the public forum.

Among the 50 defendants named in Pinal County vs. Actavis LLC, et al. are American Drug Company, Costco, Walgreens, Osco Drug, Walmart, Bashas’, Johnson & Johnson, Mallinckrodt LLC, Safeway, Par Pharmaceuticals, Smith’s Food & Drug, Sun Life Family Health Center and Watson Laboratories. The suit also names eight members of the Sackler family, who Bloomberg estimates to be worth $13 billion collectively.

By filing suit at the county level rather than joining the many federal-level lawsuits, Volkmer said, there is a better chance of getting the evidence known. Ongoing suits against the Sackler family, owners of Purdue Pharma, brought by states and other levels of government, will likely be filed into a national settlement. At the federal level, a U.S. bankruptcy judge paused those lawsuits against Purdue Pharma in October.

But Purdue and the Sacklers are only part of the Pinal County suit.

“We are prepared to litigate it. We want a jury to hear what they did and to determine a remedy,” Volkmer said. “We’re confident they acted badly. We want the public to know. The best way to get that is to try the case.”

The complaint does not cite a number for the monetary damages the county is seeking from the 50 defendants named. It seeks “to recover all measure of damages permissible under the statutes identified herein and under common law, in an amount to be proven at trial.”

“We’re confident they acted badly. We want the public to know. The best way to get that is to try the case.” – County Attorney Kent Volkmer

Volkmer said opioid addiction has cost the county manpower in law enforcement and health. And it is removing once-productive people from the economy because they can no longer work, shrinking the tax base that helps pay for the services impacted by opioid addiction.

Patients who could no longer afford an opioid prescription sometimes turned to heroin, causing more impact on law enforcement, the medical examiner’s office and county health resources. “And all of this cost was foisted on the county,” Volkmer said.

“Janssen fully recognizes the opioid crisis that exists in this country. But one thing is clear: Janssen’s medications did not cause or contribute to that crisis.” – Janssen Pharmaceuticals

The county complaint opens with the statement, “Opiates are killing people every day in this country and Arizonans have not been spared. Each of the [d]efendants in this action engaged in an industry-wide effort to downplay the dangerous and deadly potential effects of the misuse of prescription opioids. The opioid epidemic has hit every community in Arizona hard, including Pinal County.”

One of the defendants, Beverly Sackler, died Oct. 15 at the age of 95. Purdue filed for bankruptcy in September.

U.S. Bankruptcy Court Judge Robert Drain gave Purdue Pharma, the Sacklers and the government entities suing them until Nov. 6 to reach a disclosure plan that would show how much the company earned from OxyContin sales.

Fennemore Craig was hired by Pinal County this summer specifically for this case against Big Pharma. Its attorneys claimed the actions of opioid manufacturers were “a sophisticated, manipulative scheme” particularly designed to be effective in places like Pinal County because it “is home to a multitude of economically and medically vulnerable populations that defendants knew were uniquely predisposed to opioid addiction, including the elderly.”

Big Pharma companies, Volkmer said, are “lining their pockets” as a result of front-end and back-end domination of a field they created. Some of the same companies that make the opioids also make the overdose antidote naloxone, he said.

Those companies include Hospira (acquired by Pfizer) and Mylan, both named in the suit, which describes both as “a top manufacturer of fentanyl, oxycodone, morphine and codeine in Pinal County.” Mylan is further accused of withholding ingredients to treat “opioid-use disorder and opioid addiction” from its competitors.

Pinal County also accuses Janssen Pharmaceuticals and its parent company, Johnson & Johnson, of pushing “bogus research” to promote opioids.

It is similar to claims made in other cases against Janssen in Oklahoma and Ohio, where Janssen denied wrongdoing, stating in court papers: “Janssen fully recognizes the opioid crisis that exists in this country. But one thing is clear: Janssen’s medications did not cause or contribute to that crisis… Janssen will prove that its marketing was and remains supported by scientific medical evidence, offered in good-faith and without a scintilla of fraudulent intent.”

In the mid- to late-1990s, physicians started classifying pain as a “fifth vital sign.” That was allegedly pushed by the American Pain Society and resulted in pharmaceutical companies putting more attention on creating and marketing pain medication. Recent lawsuits from 23 states, as well as Pinal County’s suit, characterize the pharmaceutical companies as “pushing” drugs and turning up the heat on doctors to prescribe more.

Prescribed opioids like oxycodone and hydrocodone became commonplace.

“They said opioids addressed and alleviated pain. It was a miracle cure, supposedly,” Volkmer said.

He said, despite a lack of public research, opioids were marketed as addiction-free. Doctors who did not prescribe opioids to help their patients overcome perpetual pain virtually were “accused of malpractice.”

In Massachusetts’ claim against the Sacklers, they were accused of hiring hundreds more sales representatives to pressure doctors. “They directed reps to encourage doctors to prescribe more of the highest doses of opioids. They studied unlawful tactics to keep patients on opioids longer and then ordered staff to use them,” the Massachusetts’ complaint reads.

After the medical community started to acknowledge people were becoming addicted around 2010, the number of prescriptions began to decrease but the amount prescribed increased.

Harinder Takyar is the only physician named in the suit while other local doctors are grouped as so-called “John Does.” Takyar was a Florence-based doctor who was charged with 42 counts of prescribing opioids to his patients without medical need in 2014.

Gov. Doug Ducey declared a statewide emergency in 2017 after a health report found 790 Arizonans died of opioid overdoses the previous year. State tracking showed 431 million opioid pills were prescribed in 2016, “enough for every Arizonan to have a 2.5-week supply.”

Since the emergency declaration, between June 15, 2017, and Oct. 10, 2019, the Arizona Department of Health Services reported 3,633 deaths that were suspected of being opioid overdoses.

Volkmer said while the Pinal case is “very, very similar to Big Tobacco,” immediacy is the difference.

“If you smoke, in 20 or 30 years, you could get cancer,” he said. “Opioids have an immediate impact. It renders people unable to work. If one of my employees goes outside for a smoke break, they can come back to work. If they go out to pop a Percocet, they won’t be able to do that.”

Volkmer said he is “fairly optimistic” the case can be in court in 18-24 months.


This story appears in the the November issue of InMaricopa.

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Thirteen of 14 food establishments in the Maricopa area inspected by Pinal County health personnel from Aug. 16 to Sept. 15 received top marks.

The exception was a slight markdown for Rob’s Convenience, a store on Papago Road that did not have adequate hot water pressure in the hand-washing sink or its three-compartment sink.

EXCELLENT [No violations found]
Central Arizona College – Café
Central Arizona College – Culinary
Dollar General
F.O.R. Maricopa
Gyro Grill
Legacy Traditional School
Maricopa Elementary
Sequoia Pathway Academy – K-6
Sequoia Pathway Academy – Secondary
Shell – Dairy Queen
Shell – Food Mart
Sonic Drive-In
Wendy’s

SATISFACTORY [Violations corrected during inspection]
Rob’s Convenience

NEEDS IMPROVEMENT [Critical items noted during inspection cannot be corrected immediately requiring follow-up inspection]
None

UNACCEPTABLE [Gross, unsanitary conditions necessitating the discontinuation of service]
None

Once upon a time, the items at the top of the wish list for Maricopans were a “sit-down restaurant” and a solution for State Route 347.

Today, restaurant needs have taken a back seat as a hospital facility now rivals 347 for residents’ demands, according to recent polling. For some residents, the two are tightly connected.

“With all the accidents on 347, a trauma center staffed with the best physicians would save lives,” Carol Kaye Robinson responded in an InMaricopa Facebook post. “A top surgical center would go hand-in-hand with the trauma center.”

“I had to take my child to the ER twice this past year. One for an eye infection, one for asthma,” Jessica Truckner added. “When you have a sick child, a 20-minute drive on the nightmare road that is the 347 can feel like an eternity. Not to mention all the women that drive out of town to deliver babies.”

While Maricopa has doctor’s offices, clinics and urgent care, residents want something more. What that would look like and what needs it would fulfill vary. So does the identity of the entity that would be most likely to build a facility.

“We have had a recent and productive meeting with Dignity Health regarding their future plans for Maricopa,” City Manager Ricky Horst said. “This effort continues to be a work in progress. Dignity has reaffirmed their commitment to the city.”

Dignity and Banner Health have both invested in the city. Dignity Community Care continues to own about 18 undeveloped acres behind Maricopa Station and CVS and runs the urgent care at 20750 N. John Wayne Parkway, which operates from 10 a.m. to 8 p.m. daily. It is connected to Mercy Gilbert Medical Center.

Meanwhile, Banner Health Center at 17900 N. Porter Road has primary care physicians, X-rays and labs. It is affiliated with Banner hospitals in Casa Grande and the Valley.

An online question at InMaricopa.com found 85 percent wanted an emergency room or trauma center, preferably operating 24 hours a day.

“We need a small hospital with an emergency room, much like what Banner Health is building at Alma School and the 202,” Brent Egnal said in InMaricopa’s social media conversation. “It’s not a massive hospital, but it will have everything you need or want at a hospital.”

A hospital facility would serve the unincorporated area around Maricopa, one resident pointed out.

“While I appreciate all the people who live in Maricopa proper are concerned with the drive time, putting a full-service hospital in Maricopa will help Stanfield, Mobile, Hidden Valley, etc.” Michele Mayhugh commented to InMaricopa’s online query. “We have 45 minutes to an hour drive to a hospital.”

Not everyone agrees a hospital is necessary in Maricopa.

“I do not think we need a hospital,” Dawn Brunn said. “Maybe have the urgent care 24 hours to start. We are less than 30 minutes from two hospitals. This isn’t the first time I lived in a town without a hospital. I knew we didn’t have one when I moved here in 2008. I do not mind driving if I need to go to the hospital.”

Luchia Young was even more emphatic. “A hospital in Maricopa is a big no. I want a private helicopter company w/pad available to fly me to a major hospital with trauma care. If I need a trauma one with a neuro surgeon, I don’t want to be held up in some small-town hospital where I will end up a vegetable. We do maybe need a 24-hour urgent care.”

For the many residents who have been vocal about the need for a hospital, the push is driven by personal experience.

“I had to drive my husband with a ruptured appendix to Chandler Regional Hospital for care, then watch him writhe in agony every time a he had to wait for a gunshot victim to be treated first,” Anna Jones shared.

“I just spent over a week at Chandler Hospital, and to get there took the most terrible ambulance ride, and [I] prayed the whole trip,” Thomas DeGraphenreed II wrote.

“Well, if we had a hospital, I wouldn’t have almost had my baby in the bathtub,” Erin Tucker added.


This story appears in the 2019 Heath Guide. Click photo to see more.

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This item appears in the September issue of InMaricopa.

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While the holidays are a time to celebrate with friends and loved ones – passing around the turkey or passing each other gifts – it’s also the time to pass a cold or even the flu to someone if you catch either of those.

It’s not easy to determine what the flu season is going to be like until it hits. A couple of years ago, it hit the United States quite hard. This past season, it was a little less severe, but still considered deadly by the Centers for Disease Control and Prevention (CDC), as it was estimated that more than 50,000 people across the country died as a result.

According to the CDC, both the cold and flu are similar because they are both respiratory illnesses caused by different viruses. However, a cold is usually less severe than the flu. The symptoms for both can be the same, you may suffer from a runny nose and congestion. While a cold is usually milder in its symptoms, the flu can cause some serious and potentially deadly issues in some people.

With the flu, you may suffer from a series of other ailments you may not have with a cold, such as body aches, extreme fatigue, fever, chills, and possibly vomiting or diarrhea. The cold is usually gradual, but the flu can be quick. Some people get over the flu just as quickly, but others could get even sicker, with some developing more serious problems such as pneumonia.

According to health care providers, pneumonia becomes serious when it settles in the lungs. Children, the elderly, and people with underlying medical conditions can be susceptible. Unfortunately, if it goes untreated it can get worse and it could eventually become fatal.

Banner Urgent Care in Casa Grande at 1676 E. McMurray Blvd, Ste 1, is available if people are suffering from a severe cold, or if they think they may have the flu. However, if your symptoms of either develop into something even worse and you are having trouble breathing or having seizures, call 9-1-1 immediately. Banner Casa Grande Medical Center’s Emergency room is available for those who may be suffering from more severe cases, like the flu or pneumonia.

If you are looking at not getting sick this season, prevention for you and your loved ones is going to be important. In addition to good hygiene practices like washing or sanitizing your hands frequently, getting enough rest, drinking plenty of liquids, eating a healthy diet, exercising, and seeing your doctor regularly, other ways to prevent getting sick include:

  • Coughing or sneezing in the crook of your arm to prevent the spread of germs from one person to another. If you feel a cough or sneeze coming on, use your arm as guard. If you can’t do that, try to cover your nose and mouth with something so not to spread germs.
  • Getting a flu vaccination. While flu shots are not 100% effective against the flu, medical experts agree that the flu vaccine is still one of the best defenses when it comes to preventing the flu or helping people recover faster should they get the flu.

The CDC still reported a very active 2018-2019 flu season across the country. From Oct. 1, 2018 to May 4, 2019, the CDC estimates:

  • 4 million to 42.9 million people got the flu
  • 3 million to 20.1 million were treated for the flu by a health care provider
  • 531,000 to 674,000 were hospitalized for the flu
  • 36,400 to 61,200 died as a result of the flu

So, if you think you may have the flu, the CDC says these are the symptoms to look out for:

  • Fever
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Body aches
  • Headache
  • Fatigue
  • Some may suffer from vomiting and diarrhea (more common in children)

If you think you may be suffering from a cold, the CDC says these are the most common symptoms:

  • Sore throat
  • Runny nose
  • Coughing
  • Sneezing
  • Headaches
  • Body aches

Should you get sick from either a cold or the flu, it’s important to also check with your regular doctor if you experience any of the above symptoms. Your doctor should have your complete medical information and can advise how you should best be treated for cold or flu symptoms.

For more information about the services provided at Banner Urgent Care, and to find a location near you, please visit www.BannerHealth.com/urgentcare. For more information about the services provided at Banner Casa Grande Medical Center, please visit www.BannerHealth.com/casagrande.

 

 

Pinal County food inspectors looked at 31 Maricopa establishments, including several schools, from July 18 through Aug. 18 and gave all but one a clean bill of health.

Cilantro’s received a “Satisfactory” mark after the discovery of a walk-in cooler not keeping food at the required maximum 41 degrees. Menudo that was found at 60 degrees was discarded.

EXCELLENT [No violations found]
Brooklyn Boys Italian Restaurant
Burger King
Butterfield Elementary
Children’s Learning Adventure
Chipotle Mexican Grill
Culver’s
Desert Wind Middle School
The Duke at Rancho El Dorado
Dutch Bros
Firehouse Subs
Freddy’s Frozen Custard & Steakburgers
Leading Edge Academy
Li’s Garden
Maricopa Head Start
Maricopa High School
Maricopa High School – Concessions
Maricopa High School – Culinary Arts
Maricopa Wells Middle School
McDonald’s (John Wayne Parkway)
Native Grill and Wings
The New HQ
Pima Butte Elementary
Raceway Bar & Grill
Rosati’s Pizza
Saddleback Elementary
Santa Cruz Elementary
Santa Rosa Elementary
Sunrise Café
Sunrise Preschool
Wingstop

SATISFACTORY [Violations corrected during inspection]
Cilantro’s Mexican Cocina

NEEDS IMPROVEMENT [Critical items noted during inspection cannot be corrected immediately requiring follow-up inspection]
None

UNACCEPTABLE [Gross, unsanitary conditions necessitating the discontinuation of service]
None


This item appears in the September issue of InMaricopa.

Joan Koczor

By Joan Koczor

Headache is one of the most common and debilitating pain conditions in the world. The World Health Organization names headache the third leading cause of disability in the world and the No. 1 cause of disability in individuals under age 50.

Headaches cause a heavy personal toll in terms of social life, family life, anxiety and depression due to fear of the next headache. They affect people of all races, ages and geographical location.

According to WebMD.com, older people have fewer headaches than younger ones, and migraines tend to disappear with age. At age 70, only 10 percent of women and 5 percent of men have migraines.

Headaches can be triggered by certain environmental factors shared in a family’s household, such as:

  • Second-hand tobacco smoke
  • Strong odors from household chemicals or perfumes
  • Exposure to certain allergens
  • Eating certain foods

Stress, pollution, noise, lighting and weather changes are other environmental factors that can trigger headaches for some people. Changes in humidity, temperature, storms, dry or dusty conditions can all trigger a headache.

Headaches in senior citizens may indicate something more serious. They can be symptoms of several conditions, including:

  • Temporal arteritis
  • Cerebrovascular disease
  • Trigeminal neuralgia
  • Head trauma

Primary headaches

Primary headaches are not the result of another medical condition. The category includes tension-type, migraine and cluster headaches.

Common triggers of tension-type headaches or migraine headaches include:

  • Emotional stress related to family and friends, work or school
  • Alcohol use
  • Skipping meals
  • Changes in sleep patterns
  • Excessive medication use
  • Tension

Iron deficiency anemia has also been linked to migraines, headaches and an increased predisposition to pain.

Ocular migraine is the most unusual and often misdiagnosed type of migraine. It can happen with or without a headache and is often characterized by visual loss, blind spots, zig-zag lines or seeing stars and floaters or black spots.

Cluster headaches are the most severe type of primary headache. The pain of a cluster headache is intense and has a burning or stabbing quality that is throbbing or constant.

Secondary headaches

Secondary headaches result from another medical or neurological condition and include sinus headaches and medication-overuse headaches.

Sinus headaches are associated with a deep and constant pain in the cheekbones, forehead or bridge of the nose. Medication overuse headaches occur as a result of the overuse of over-the-counter analgesics or prescribed painkillers such as opiates and sedative hypnotic tablets designed for headache management.

Advances in the medical management of headache mean relief is no longer just possible but probable. Although some form of head pain will occasionally visit most people, no one should have to live and suffer with headaches.

Joan Koczor is a senior advocate and a member of the Age-Friendly Maricopa Advisory Committee.

 

https://nationaldaycalendar.com/national-senior-citizens-day-august-21/
https://www.notjustbingo.com/activity-calendars/august-calendar.html.

by -
Maricopa will be baking this weekend.

With temperatures continuing to sizzle, the National Weather Service has extended the excessive heat warning through 8 p.m. Friday in western Pinal County.

An excessive heat warning mans that a period of very hot temperatures, even by local standards, will occur. Overexposure can cause heat cramps and heat exhaustion to develop and, without intervention, can lead to heat stroke.

Stay indoors and seek air-conditioned buildings. Those engaging in outdoor work or athletic activity should be closely monitored. If engaging in outdoor activity, take longer and more frequent breaks and avoid the hottest parts of the day. Never leave kids or pets unattended in cars.

Today is sunny and hot with a high near 114 and little wind. Tonight will be clear with a low around 81.

Friday’s forecast is also sunny and hot with a high near 111. The night is expected to be mostly clear with alow around 80 and winds of 5-10 mph.

Saturday is expected to be sunny with a high near 109. The overnight low will be around 80 under mostly clear skies.

Sunday will likely see a few clouds with a partly sunny forecast and a high of 109. The night will have partly cloudy skies and a low around 81.

Next week will grow progressively hotter with the possibility of another heat warning.

by -

 

Maricopa will be under an excessive heat watch this week, according to the National Weather Service as temperatures soar.

The watch is in place Tuesday morning through Thursday evening. High temperatures are expected to reach at least 113 midweek. Excessive heat can lead to heat stroke, heat cramps, heat exhaustion and other related illnesses. Heat stroke can lead to death.

Stay indoors and seek air-conditioned buildings. Drink water, more than usual, and avoid dehydrating alcoholic, sugary or caffeinated drinks. Dress for the heat – lightweight and light-colored clothing. Eat small meals and eat more often.

Monitor those with a higher vulnerability to heat, including small children. Check in on family, friends, and neighbors, especially the elderly. If engaging in outdoor activity, take longer and more frequent breaks and avoid the hottest parts of the day. Never leave kids or pets unattended in cars.

Today, the expected high temperature is 107. The nighttime low will be around 78.

Tuesday, the high is forecast to be 109 under sunny skies. The overnight low will be around 82.

Wednesday, prepare for a sunny and hot day, with a high near 113 and little wind. The night is expected to be partly cloudy with a low around 83.

Thursday is forecast to be sunny and hot with a high near 113. The overnight low will likely be around 83.

Friday cools down a bit for a high of 110. Winds are expected to pick up, gusting as high as 20 mph. That will continue into evening, when the low is expected to be around 82.

The weekend will still be slightly above normal but below 110.

True Grit Tavern. File photo

Thirty-one of 34 establishments inspected by Pinal County Environmental Health Department in the Maricopa area from June 16 through July 17 received excellent marks. Two were found to be satisfactory, and one received the cautionary mark “needs improvement” because of a refrigeration problem.

True Grit Tavern received the “N” rating when the inspector found raw meats in the prep fridge at higher temperatures than the required maximum 41 degrees F. According to the report, fish was at 50 degrees, chicken and hamburger patties at 46 degrees and shrimp at 44 degrees. An embargo notice was signed to discard the food. The inspector also noted a floor drain not working and bad lighting in the prep area, circumstances that could not be corrected immediately.

Meanwhile, Denny’s and Say Sushi received “S” ratings. Say Sushi also had a cold-holding problem with its walk-in refrigerator, with cream cheese, rolls, dumplings and tofu cheese stored at 47 degrees, resulting in an embargo. At Denny’s, a small prep unit had lettuce, tomatoes and liquid eggs at 45 degrees, and a walk-in cooler had hash browns at 45 degrees. Both situations were remedied during inspection.

EXCELLENT [No violations found]
99 Cents Only
Arby’s
Bashas’
Bashas’ – AFC Sushi
Bashas’ – Bakery
Bashas’ – Deli
Bashas’ – Starbucks
Circle K (east)
Circle K (east) Made to Go
Copa Craze
Dickey’s Barbecue Pit
Francisco’s Mexican Food
Fry’s Marketplace
Fry’s Marketplace – Bakery
Fry’s Marketplace – Deli
Fry’s Marketplace – Starbucks
Fry’s Marketplace – Sushi
Good Donuts
IHOP
Jack in the Box
Jersey Mike’s Subs
Native Grill & Wings
Plaza Bonita
Panda Express
Starbucks
Subway
Tacos ‘N’ More
Walmart
Walmart – Bakery
Walmart – Deli
Yogurt Jungle

SATISFACTORY [Violations corrected during inspection]
Denny’s
Say Sushi

NEEDS IMPROVEMENT [Critical items noted during inspection cannot be corrected immediately requiring follow-up inspection]
True Grit Tavern

UNACCEPTABLE [Gross, unsanitary conditions necessitating the discontinuation of service]
None

 

Joan Koczor

By Joan Koczor

Joan Koczor

Falls are a real and growing risk to older adults’ health and independence and, in some cases, to their very lives. Falls can cause serious injury that can threaten independence and even result in death. A common misconception is falling is a natural part of aging and there is nothing you can do to prevent falling. Despite being labeled “accidents,” many falls are preventable and don’t have to be a part of aging.

The Healthy Aging Communications Network states, “Unintentional falls were the leading cause of injury-related mortality among Arizona residents 65 years and older. Accounting for an average of two deaths every day.”

  • Every 11 seconds, an older adult is treated in an emergency room for a fall; every 19 minutes, an older adult dies from a fall.
  • Falls result in more than 2.8 million injuries treated in emergency departments annually, including over 800,000 hospitalizations and more than 27,000 deaths.
  • In 2015, the total cost of fall injuries was $50 billion. Medicare and Medicaid shouldered 75 percent of these costs.
  • The financial toll for older adult falls is expected to increase as the population ages and may reach $67.7 billion by 2020.

A few safeguards you can implement outside the home:

  • Use bright outdoor lighting.
  • Install handrails on both sides of the stairs.
  • Check handrails periodically so see if they are loose or broken.

Inside your home:

  • Use night lights.
  • In the bathroom, install grab bars by the toilet and shower.
  • Use non-skid mats in the tub or shower. Have a light by your bed within easy reach.
  • Have a firm chair that has side arms, which can be used as support while you dress.Avoid walking on wet floors.
  • Remove throw rugs and other things on the floor that can cause you to trip and fall.

Additional proactive measure you can take to prevent falls include:

  • Review your medication with your doctor. Some medicines can make you dizzy or cause other side effects that can cause you to fall.Improve your balance and coordination with regular physical activity.Get yearly vision checkups as poor vision can increase your chance of falling.

This is a small sampling of what you can do to prevent falls.

ncoa.org/fallprevention, azdhs.gov/phs/healthy.aging

Joan Koczor is a senior advocate and a member of the Age-Friendly Maricopa Advisory Committee.


This column appears in the July issue of InMaricopa.

Newly reopened Native Grill & Wings was among food establishments earning excellent scores. last month.

The 20 establishments inspected by Pinal County Environmental Health Department in the Maricopa area from May 16 through June 15 all received excellent marks.

EXCELLENT [No violations found]
Circle K (Honeycutt Road)
Circle K Made to Go (Honeycutt Road)
Circle K (south)
Denny’s
Dickey’s Barbecue Pit
Domino’s Pizza (twice)
Good 2 Go Store
Helen’s Kitchen
Honeycutt Coffee
IHOP
JB Farmer’s Convenience Store
KFC/Long John Silver’s
Li’s Garden
Maricopa Shell – Dairy Queen
Native Grill and Wings
Raceway Bar & Grill
Rob’s Convenience
Sunrise Cafe
Sunrise Preschool
Walgreens

SATISFACTORY [Violations corrected during inspection]
None

NEEDS IMPROVEMENT [Critical items noted during inspection cannot be corrected immediately requiring follow-up inspection]
None

UNACCEPTABLE [Gross, unsanitary conditions necessitating the discontinuation of service]
None


This item appears in the July issue of InMaricopa.

Silver Spur Grill at the Duke at Rancho El Dorado.

All but one eatery inspected by Pinal County health inspectors April 16-May 15 received excellent marks. The Silver Spur Grill at The Duke at Rancho El Dorado, however, had some cold-holding and other problems to fix.

By law, refrigerated food must be held no warmer than 41 degrees F. The inspector found one refrigerator at 59 degrees and another at 50 degrees. A refrigerator was also leaking condensation. Some food items were found with expired date marks and may have been incorrectly dated. Several items were discarded. The person in charge was instructed to repair equipment, review date requirements and make a hand-washing sink more accessible. The restaurant was given a “satisfactory” mark.

EXCELLENT [No violations found]
Barro’s Pizza
Chipotle Mexican Grill
Cilantro’s Mexican Cocina
CVS Pharmacy
Firehouse Subs
Freddy’s Frozen Custard & Steakburgers
Good Donuts
Good to Go Store
Gyro Grill
Little Caesar’s Pizza
McDonald’s, Maricopa-Casa Grande Highway
The New HQ
Papa John’s Pizza
Pizza Hut
Plaza Bonita
QuikTrip
QuikTrip – Kitchen
Rosati’s Pizza
Say Sushi
Sunrise Preschool
Walmart – Deli

SATISFACTORY [Violations corrected during inspection]
The Duke at Rancho El Dorado

NEEDS IMPROVEMENT [Critical items noted during inspection cannot be corrected immediately requiring follow-up inspection]
None

UNACCEPTABLE [Gross, unsanitary conditions necessitating the discontinuation of service]
None


This item appears in the June issue of InMaricopa.

 

All 18 food establishments inspected by Pinal County’s health inspectors Feb. 16-March 15 received excellent scores. That included all nine Maricopa Unified School District campuses.

EXCELLENT [No violations found]
The Box Meat Shop
Butterfield Elementary
Desert Wind Middle School
Leading Edge Academy
Maricopa Elementary
Maricopa High School
Maricopa High School – Culinary Arts
Maricopa Wells Middle School
Pima Butte Elementary
Saddleback Elementary
Santa Cruz Elementary
Santa Rosa Elementary
Starbuck’s Maricopa Station
Walmart
Walmart – Bakery
Walmart – Deli
Water and Ice
Yogurt Jungle

SATISFACTORY [Violations corrected during inspection]
None

NEEDS IMPROVEMENT [Critical items noted during inspection cannot be corrected immediately requiring follow-up inspection]
None

UNACCEPTABLE [Gross, unsanitary conditions necessitating the discontinuation of service]
None


This item appears in the April issue of InMaricopa.

Myles Amsden was in a critical health crisis three years ago. Submitted photo
Myles Amsden today at age 3

The Maricopa family of a 3-year-old girl who nearly died as an infant from a sudden cardiac arrest recently reunited with the surgeon and medical team who saved her life at Cardon Children’s Medical Center.

The family expressed their heartfelt thanks during the emotional reunion Thursday at the hospital, located at 1400 S. Dobson Road. Seeing Myles Amsden giggling and playing was especially meaningful to the medical team who treated her, since they once helped connect her heart to a machine to keep it beating while her body healed.

Maricopan Ralph Amsden, the girl’s father, wrote a popular and deeply moving Twitter thread detailing his daughter’s illness and amazing recovery.

“The doctor had this look of determination that I’ll never forget,” he wrote. “The moment we gave her the go-ahead (for surgery), it was like she was taking the ball, bases loaded with a one-run lead in game seven of the World Series. ‘All right. Let’s go. Let’s do this.’ And she did it. She replaced a two-week-old baby’s heartbeat with a machine by connecting a tube into her carotid artery. There were a dozen improbable things that saved my daughter that night, but this one I was able to put a name to.”

When Myles was only 2 weeks old, she suddenly stopped breathing and was rushed to the Emergency Department at Cardon Children’s, where doctors determined she wouldn’t survive unless she was emergently placed on cardiac bypass to give her body time to recover. Dr. Heidi Cox, a pediatric surgeon, connected the infant’s heart to an “ECMO” machine, which pumped and oxygenated the baby’s heart outside of her body to allow her heart and lungs to rest.

Amsden said Myles was without oxygen for several minutes before being transported to Cardon and could have suffered brain damage, but she’s now in great health and neurologically fine. She spent about three weeks in Cardon Children’s Pediatric Intensive Care Unit, then later required a year of physical therapy.

“We call her a miracle, and she smiles,” Amsden said. “She doesn’t comprehend too much of what she went through, but her family and friends sure do.”

Three years ago, Ralph Amsden with daughter Myles

All 13 restaurants and eateries inspected by Pinal County Environmental Health from Dec. 16 to Jan. 15 received a clean bill of health.

EXCELLENT [No violations found]
Barro’s Pizza
Culver’s of Maricopa
Dickey’s Barbecue Pit
The Duke at Rancho El Dorado
Francisco’s Mexican Food
Gyro Grill
IHOP
Maricopa Head Start
The New HQ
Panda Express
Pizza Hut
Rosati’s Pizza
Tacos ‘n’ More

SATISFACTORY [Violations corrected during inspection]
None

NEEDS IMPROVEMENT [Critical items noted during inspection cannot be corrected immediately requiring follow-up inspection]
None

UNACCEPTABLE [Gross, unsanitary conditions necessitating the discontinuation of service]
None


This item appears in the February issue of InMaricopa.

Amnesty Marshall sits on the lap of her father Dusty while mom Krystal and siblings Noel and Marie look on. Photo by Jim Headley

Four-year-old Amnesty Marshall is much more than a walking miracle.

She is a bright, intelligent, beautiful and fun-filled girl, who just happens to have been born with spina bifida, a birth defect that occurs when the spine and spinal cord don’t form properly.

As a result, she was limited in her movements. She was unable to walk independently until a year ago.

After less than a year of diligent work with physical and occupational therapists at Head To Toe Therapy in Phoenix, Amnesty took her first steps without a walker and began a whole new chapter in her life in March 2018.

Amnesty is the daughter of Krystal and Dusty Marshall of Maricopa. The couple has two other daughters, Noel, almost 3, and Marie, who was just born in December.

Dusty Marshall is a professional Christian hip hop artist, and the family often travels the country with him as he performs.

“We have seen the results in trusting God. Our faith and trust in Christ is something that has been huge,” Dusty said. “Going through the struggles together and being able to lean on Him and one another.”

Dusty said when Amnesty was in the womb, doctors discovered she had a serious heart problem and might not survive.

“It was something they had monitored weekly while she was in the womb. The day she was born, they did a scan of her heart and it was perfectly healthy,” Dusty said. “They were also saying she would never have use of her legs at all.

“To go from that extreme to now, where she is 4 and she’s walking, has been a rollercoaster,” Dusty said.

Amnesty Marshall was first able to walk without a walker at age 3. Photo by Jim Headley

Krystal Marshall said doctors gave them an option to terminate the pregnancy, but they chose not to do that.

“We never would have seen what God could do in her life if we would have succumbed to that fear,” she said. “It looked really grim. It looked like it wasn’t going to go well. Even if it didn’t go well, that really is not our say. Watching her thrive has really been a huge blessing in our lives.”

Krystal said no one really thought Amnesty would ever walk.

“Now she’s in a dance class here locally in Maricopa, and so is Noel. She’s just a regular little girl,” Krystal said.

Dusty said Amnesty had two major surgeries days after being born.

One was to close her spinal cord back into her body because “her spine was sticking out when she was born.”

A few days later, doctors installed a shunt into her brain to release fluid that was built up. She still has the shunt as well as a scar on her back from the surgeries.

“We spent three weeks in the NIC-U and we didn’t even know how to change a diaper,” Krystal said.

With Dusty traveling the nation for his work, Amnesty and Krystal have gone along on the road.

“Amnesty has been to more places than most people will ever go,” Krystal said. “She’s been to 22 states. We have traveled the country, and Amnesty’s story has been shared in all these states. People have chosen life for their babies because of her story. They have been inspired with hope and all of this is from this amazing blessing of having this little girl come into our lives.”

The family will go on an 11-state tour beginning in May.

The Marshalls moved to Maricopa from Las Vegas in late 2016. During the first year they lived in Arizona, Amnesty received in-home care from therapists. After their in-home benefits expired, they began searching for a clinic that could provide therapy services for Amnesty.

“We searched across the Phoenix area, but every clinic we went to had a waitlist of six months to a year,” said Krystal. “We were praying God would lead us to the right place.”

In early 2018, Krystal contacted Head To Toe Therapy and it made an immediate appointment for Amnesty with Melissa Pink, one of the clinic’s therapists.

Head To Toe ensured that Krystal could watch Amnesty’s weekly therapy sessions with Pink.

Krystal said, “Pink wouldn’t fit Amnesty into a box, and she tailored a specific therapy plan to fit Amnesty’s specific needs. She would even let Amnesty play and would target the therapy around Amnesty playing.”

After 12 weeks of continuous and regular therapy sessions, Amnesty took her first steps without the aid of a walker in March 2018.

“When she started walking it was kind of like falling with feet underneath her,” Krystal said. “When those controlled steps started happening, we were looking at each other thinking, ‘She’s going to walk without a walker.’ There was no doubt, and now she’s doing it.”

Head To Toe founder Dr. Bridget O’Brien went out of her way to get to know the Marshall family and forged a relationship with the entire family. She would make time once a week to get coffee with Krystal and forged a friendship with the Marshall family.

After Amnesty took her first steps, O’Brien partnered with the Spina Bifida Association of Arizona and the Marshall’s to host a special play date at Head To Toe for families and kids with spina bifida. O’Brien covered the costs of the entire party, and nearly 30 people attended.

“Last year’s play date was an immense success, and Head To Toe Therapy is proud to host this family friendly event once again,” said O’Brien.

This year, Head To Toe is hosting the “Phoenix Spina Bifida Play Date” group again, and the families are very excited about it.  The event will take place on March 16 from 11 a.m. to 1 p.m.

“They are happy and joyful kids,” Dusty Marshall said. “Obviously, they have special needs, but they don’t know any different. They are enjoying being children.”

Photo by Jim Headley

by -
There is still time to get a flu shot this season.

A lot of people in Arizona aren’t feeling very well this week.

The Center for Disease Control reports that 1,196 cases of influenza occurred in Arizona in the final week of 2018, bringing the total for the season so far to 3,216. In Pinal County, there are 322 cases

While that is a normal number of flu cases for this time of year, it propels Arizona into the widespread category, along with New Mexico, California, Nebraska, Florida, Georgia, North Carolina, New York, Connecticut and Massachusetts.

Several area hospitals, including Banner Health, have placed restrictions on visitors to prevent the spread of influenza to their patients.

Visitors are restricted if they have a fever, cough or are suffering from vomiting or diarrhea and children younger than 13 are restricted from visiting the hospital, unless:

They are visiting a sibling in the obstetric or pediatric units and do not have a cold or flu symptoms. However, the child may be screened for illness by staff before visiting.

Children 12 years old and younger must have adult supervision at all times in public waiting areas and cafeterias.

Visitors to Banner are asked to wash or sanitize their hands while at the hospital as it is the best way to prevent influenza from spreading.

More than 35,000 cases of lab-confirmed influenza were reported in Arizona last flu season.

Statewide, 1,178 people died from influenza and pneumonia in the 2017-18 flu season, much higher than the 400 to 700 annual average.

Five of the deaths in Arizona were children.

Nationally, over 80,000 people died last flu season, according to the CDC. More than 180 children died and 80 percent of them were not vaccinated.

Last flu season, only 57.9 percent of Americans were vaccinated against the flu, down from 59 percent the year before.

Physical Activity Guidelines for Americans, 2nd edition

Released Nov. 12, U.S. Department of Health released an updated version of its “Physical Activity Guidelines for Americans.” It reflects the extensive amount of new knowledge gained since the first edition, released in 2008. Here are 10 areas of knowledge covered in the guidelines:

  1. Preschool-aged children (ages 3-5 years) should be physically active 3 hours throughout the day to enhance growth and development.
  2. Children and adolescents ages 6 through 17 years should do 1 hour or more of moderate-to-vigorous physical activity daily: Aerobic, muscle-training or bone-strengthening.
  3. Adults should move more and sit less throughout the day. Some physical activity is better than none. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits.
  4. Adults should do at least 2.5 to 5 hours a week of moderate-intensity, or 1.25 to 2.5 a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Preferably, aerobic activity should be spread throughout the week.
  5. Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes (5 hours) of moderate-intensity physical activity a week.
  6. Adults should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.
  7. As part of their weekly physical activity, older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities.
  8. Older adults should determine their level of effort for physical activity relative to their level of fitness.
  9. Older adults with chronic conditions should understand whether and how their conditions affect their ability to do regular physical activity safely.
  10. When older adults cannot do 150 minutes of moderate-intensity aerobic activity a week because of chronic conditions, they should be as physically active as their abilities and conditions allow.

bit.ly/USHealthGuidelines



This item appears in the December issue of InMaricopa.

Sponsored Content

submitted photo

By Davis Plunkett, Manager of Integrated Behavioral Health and
Maria Villalobos, Community Relations Coordinator Sun Life Family Health Center

Life can be messy and busy. We go through our day, juggling work, errands, children, sports, housework … the list goes on. Too often we go about the day that when we have a moment to reflect we have difficulty remembering what we did. There is such a rush to get things done or be somewhere that we don’t feel as were present in the moment but simply going through the motions. Many of us look for methods of not only being able to enjoy the moments life brings but being able to be present in those moments.

Mindfulness is simply being in the present moment and accepting it without judgment. There are many mental and physical health benefits of mindfulness. Mindfulness can bring improvements in both physical and psychological symptoms as well as positive changes in health, attitudes, and behaviors. Mindfulness improves well-being by making it easier to savor the pleasures in life as they occur, helping you become more engaged in activities, and creates a greater capacity to handle adverse events.

Mindfulness improves physical health as it can help relieve stress, treat heart disease, lower blood pressure, reduce chronic pain, and improve sleep. Mindfulness improves mental health by helping treat depression, substance abuse, eating disorders, conflict, anxiety disorders, and obsessive-compulsive disorder.

Mindfulness meditation builds upon concentration practices that primarily involve concentration. Concentration meditation techniques such as tai chi, yoga, focusing on the sensation of breathing can induce relaxation response which reduces the body’s response to stress.

Here are some tips to get started with mindfulness meditation:

  • Just go with it. Begin by focusing your attention. Just observe your natural state, your thoughts and emotions as they are today. Each day may be different. Each moment may be different. Just observe your thoughts without judgment.
  • Sensory awareness. Notice each of your five senses. What are you hearing? What are you seeing? What sensations can you notice in your body?
  • Mindfulness is a skill. Just with any skill it takes practice. Mindfulness may feel uncomfortable at first. It may not even seem relaxing. That’s okay- just notice those reactions without judgment.
  • Accept exactly where you are. Practice having compassion for yourself and where you are today. The goal is to accept each moment without judgment. If you become distracted, (which is expected!) gently redirect your thoughts to the present moment.

 Aspects of the above information were adapted from www.helpguide.org/harvard/benefitsof- mindfulness.htm#exercises and Seligman, M.E.P., Rashid, T., Parks, A.C., American Psychologist 61(8), Nov 2006, 774-788.


This column appears in the November issue of InMaricopa.

October is full of events benefiting the Relay for Life to help fight cancer. Now in its eighth year, the Maricopa Relay has raised more than $400,000.

According to American Cancer Society numbers, 47 Maricopans have used ACS services so far this year from Relay funding. “We’re hoping to raise awareness within our city, so more patients will call them and take advantage of these beneficial services,” said Relay organizer Trisha Paige.

Paige became involved in Relay after her father died of pancreatic cancer in 2010. She discovered how widespread the impact of cancer is across the country and has been helping with Relay since.

 

Relay for Life Maricopa

Nov. 3, 10 a.m. to 10 p.m.

At least 15 teams will participate in the Disney-themed event at Copper Sky Regional Park. There will be vendors, fundraising activities and DJ’d and live music. The day will include the survivors/caregivers walk and the luminaria ceremony.

BamaGoldens@msn.com, Trisha.Paige@hotmail.com



Trisha Paige is an employee of InMaricopa.

 

Sponsored content

Aaron Gilbert. Photo by William Lange

By Aaron Gilbert

 

Question: Why do some folks feel plant-based eating doesn’t provide enough protein?
Answer: Most people aren’t familiar with plant-based diets and the research supporting them. Look no farther than athletes who eat plant-based. Eat properly, and you’ll get all the protein you need. We’re also misled to believe that meat, milk, etc. are the best “protein” foods. Indeed, many people do not even know that plants contain any protein at all. Don’t worry, plants have protein.


Q: Joe/Jane Meat-Eater decides to start eating more plant-based. Where will Joe/Jane likely go wrong?
A: Eating too many refined and processed “vegetarian” foods. The real benefit from “plant-based” comes when the diet is centered on whole unrefined/unprocessed fruits, vegetables, intact whole grains and legumes with the addition of a few nuts/seeds.

Q. Some folks are concerned with controlling carb intake and often get scared away from plant-based eating. What do you tell them?
A: Over 90 percent of carbs consumed in America are highly refined, highly processed, and mostly in the form of refined flour and sugar. This is the problem. Avoid these. However, carbs in the form of fresh fruits, vegetables, starchy vegetables, intact whole grains and legumes are the healthiest foods for us and should be the center of any healthy diet.

Q. Some folks want to gain muscle/strength and fuel high levels of performance. What do you suggest they do to get enough nutrient-dense food each day?
A: Try to eat only when hungry, eat only until satisfied and drink lots of water. To lose fat, eat two meals and three snacks per day. To maintain body composition, eat three meals and two snacks per day. To gain muscle, eat five meals per day. Make yours meals using nutrient-dense foods like veggies, fruits, raw nuts and seeds, legumes and then grains (in that order). Eating like this consistently will lead to amazing results.

Dos and don’ts:

If you’re considering moving toward a plant-based diet, or just want some more plant-based choices, here are the experts’ tips:

DO choose your protein sources carefully.
DO aim for about 1 gram of protein per kg of bodyweight; add 30-40 grams each day if you are in a phase of intense training.
DO get enough fat.
DO eat a variety of whole foods, especially lots of vegetables and fruits.
DO stay active.
DO use your body’s hunger cues to guide you. If you want to lose fat, eat a little less than you would normally. If you want to gain mass, eat a little more.
DON’T get your nutrition information from bodybuilding magazines.
DON’T just cut things out without adding healthy alternatives.
DON’T consume too many processed foods, including “healthy” protein powders and processed soy products.

Aaron Gilbert, CSCS, is the owner of Longevity Athletics.

520-261-4661
Aaron@LongevityAthletics.com



This column appears in the October issue of InMaricopa.

by -
Aaron Gilbert. Photo by William Lange

By Aaron Gilbert

Question: Why do some folks feel plant-based eating doesn’t provide enough protein?

Answer: Most people aren’t familiar with plant-based diets and the research supporting them. Look no farther than athletes who eat plant-based. Eat properly, and you’ll get all the protein you need. We’re also misled to believe that meat, milk, etc. are the best “protein” foods. Indeed, many people do not even know that plants contain any protein at all. Don’t worry, plants have protein.

Q: Joe/Jane Meat-Eater decides to start eating more plant-based. Where will Joe/Jane likely go wrong?

A: Eating too many refined and processed “vegetarian” foods. The real benefit from “plant-based” comes when the diet is centered on whole unrefined/unprocessed fruits, vegetables, intact whole grains and legumes with the addition of a few nuts/seeds.

Q. Some folks are concerned with controlling carb intake and often get scared away from plant-based eating. What do you tell them?

A: Over 90 percent of carbs consumed in America are highly refined, highly processed, and mostly in the form of refined flour and sugar. This is the problem. Avoid these. However, carbs in the form of fresh fruits, vegetables, starchy vegetables, intact whole grains and legumes are the healthiest foods for us and should be the center of any healthy diet.

Q. Some folks want to gain muscle/strength and fuel high levels of performance. What do you suggest they do to get enough nutrient-dense food each day?

A: Try to eat only when hungry, eat only until satisfied and drink lots of water. To lose fat, eat two meals and three snacks per day. To maintain body composition, eat three meals and two snacks per day. To gain muscle, eat five meals per day.

Make yours meals using nutrient-dense foods like veggies, fruits, raw nuts and seeds, legumes and then grains (in that order). Eating like this consistently will lead to amazing results.

Dos and don’ts:

If you’re considering moving toward a plant-based diet, or just want some more plant-based choices, here are the experts’ tips:

DO choose your protein sources carefully.
DO aim for about 1 gram of protein per kg of bodyweight; add 30-40 grams each day if you are in a phase of intense training.
DO get enough fat.
DO eat a variety of whole foods, especially lots of vegetables and fruits.
DO stay active.
DO use your body’s hunger cues to guide you. If you want to lose fat, eat a little less than you would normally. If you want to gain mass, eat a little more.
DON’T get your nutrition information from bodybuilding magazines.
DON’T just cut things out without adding healthy alternatives.
DON’T consume too many processed foods, including “healthy” protein powders and processed soy products.

Aaron Gilbert, CSCS, is the owner of Longevity Athletics.
520-261-4661
Aaron@LongevityAthletics.com

Sponsored content


This column appears in the October issue of InMaricopa.

Sponsored Content

Integrated Behavioral Health and a Family Practice Provider collaborate on patient care.

By Dr. Matthew Bertsch, PharmD. and Dr. Chinwe Chukwurah, M.D.
Sun Life Family Health Center

The opioid crisis has had an effect on many people around Arizona, and around the country. Although the problem with opiates is not a new one, it certainly has developed much traction recently. With governors, legislators, our national congressional representatives, our senators and even our president talking about the issue, it has garnered a lot of mainstream attention. Opiates/opioids, often used interchangeably, are not new, and neither is drug abuse. However, the attention on the crisis has made health care challenging, even to Sun Life Family Health Center.

Patient education
It really is not all about the opiates though. Drug abuse, legal and illegal, has run rampant for decades. People who abuse have abused promethazine with codeine for its pleasurable and sedative effect; have abused dextromethorphan for its mild euphoria or extreme hallucinations depending on dose; and have abused other medications meant to treat neuropathic pain for its marijuana-like effects. Drug abuse is not new.

The laws and technology in our state have changed, and there is now an Arizona Controlled Substances Prescription Monitoring Program for the safety of patients. Prescribers are now required to check the prescription monitoring program. Prescribers will also be required to prescribe addictive medications electronically. Continuing education will be required for providers as a part of maintaining their license. Prescription doses will also be limited and new opioid packaging requirements have been implemented.

The scrutiny around opiate prescribing has led to opioid refugees, those who have had to abandon their addictions to prescription opiates and have turned to illegal street drugs. Patients have turned to both methamphetamine and heroin. Because of all of these overdoses, both legal and illegal, access to the life-saving overdose drug naloxone has increased as well.

Sun Life
At Sun Life Family Health Center, we practice pain management responsibly. While our primary care providers have autonomy in pain management, their decisions are guided by policy and proper clinical judgment using guideline-based therapy.

Dr. Chukwurah and Dr. Bertsch consult about Pain Management at Sun Life Family Health Center in Casa Grande.

What makes us unique, however, is our integrated approach to pain management. We have a team of integrated behavioral health specialists who work with our patients, as many times symptoms can be managed at a behavioral level as opposed to prescribing a medication. This is where our Mindful Alternative Pain Program comes into play. MAPP is a series of classes that focus on alternative and natural ways to cope with issues associated with pain.

Clinical pharmacy has made a huge impact on the approach to pain management within Sun Life. Clinical pharmacy has teamed up with primary care providers to review dosing of pain medications of the patients we serve. Clinical pharmacists also provide education to patients about opiates, discuss pain goals with patients, check dangerous drug interactions and consult with providers to ensure proper therapy for patients. The goal of this collaboration is that patients learn to manage their pain and reduce their dependency solely on medications.

Sun Life’s community pharmacists assist in the process by providing a thorough review of the prescriptions sent by the providers to one of our six pharmacies. Although this is not different from how other pharmacies should operate, Sun Life pharmacies have the advantage of being in close proximity to the clinical pharmacy team, the behavioral health team and the primary care provider.

Pain management is a complicated subject. We have seen that with this collaborative, interdisciplinary approach, medication use is decreasing, and there is an overall decreased risk for medication-related problems. Patients benefit when health care providers set an example and work together to ensure proper care of our patients who are in need.

Matthew Bertsch, PharmD., is the director of pharmacy and Chinwe Chukwurah, M.D., is the medical director at Sun Life Family Health Center.


This article appears in the October issue of InMaricopa.

 

By Joan Koczor

Older adults need to be extra careful of overheating and heat stroke. As we age, our bodies cannot adjust to high temperatures as well.

Our sense of thirst decreases, which can cause seniors to not realize they are thirsty and face the dangers of dehydration. Common medications, such as those for blood pressure, flush water from the body. Diuretics or low-salt diets could also affect the way your body regulates temperature. Side effects from some medications can cause excessive sweating and diarrhea.

A daily intake of about six 8-ounce glasses of water is about average. Medications you are taking are also a consideration, so talk to your doctor about how much water you should be drinking each day.

A few simple steps can make a difference in how you handle these excessive temperatures.

Schedule a checkup for your home or car air conditioner – make sure both are running properly.

Keep the shades/blinds closed during the hottest part of the day. Eat light, cold meals like salads and chicken.

Drink plenty of cool water throughout the day. A body that is hydrated feels cooler and can regulate temperatures better. Lessen your caffeine intake. Take a cool shower. Put a cold cloth on the back of your neck. Wear loose-fitting clothing. Fans help circulate the air and can make an air-conditioned house feel cooler. Freeze plastic bottles of water, take one with you when you go outside. As the ice melts, you will have a supply of cold water.

Visit a shopping mall, library or coffee shop. Go see a movie.

Drinking enough water every day is one of the smartest, simplest ways to keep the body functioning properly. Be aware of the signs of dehydration – dry mouth/skin, lightheadedness, low blood pressure, rapid heartbeat – and use these tips to keep cool throughout the summer. And don’t forget to take that water bottle wherever you go.

Remember, pets also need to be protected from dehydration and many heat-related illnesses.

Joan Koczor is a senior advocate and member of the Age-Friendly Maricopa Advisory Committee.


This column appears in the September issue of InMaricopa.

Sponsored content

By Aaron Gilbert

Aaron Gilbert. Photo by William Lange

Create systems that make health and fitness faster and easier, such as:

  • Keep fresh, whole foods in plain sight.
  • Reduce or eliminate “treat” foods.
  • Establish a morning or weekend routine to chop veggies and prepare protein+complex carbs in bulk.
  • Sign up for a CSA box or healthy meal delivery.
  • Keep berries and greens in freezer (for quick Super Shakes).
  • Join a gym or personal training studio close to home or work.
  • Keep a packed gym bag in your car or by the front door.
  • Leave weights and resistance bands lying around for quick, convenient workout.
  • Hold gatherings and meetings at parks and gyms.

Put meal prep and movement in your calendar. If we waited until we “felt like it,” a lot of important things would get neglected. Schedule it in, and stick to it.

Review at the end of each week: Did I use my time to support my health and fitness?

Yes
Explore what worked and keep doing that.
Celebrate! You deserve it.
Add 15 more minutes of health food prep and movement next week.

No
What do you do instead?
If it was low-priority stuff, combine those activities with fitness+nutrition. For example: Watch TV while prepping food.
If it was high-priority stuff, does it happen often? That’s OK! Life happens. Return to your goals and keep practicing. Set small weekly health+fitness goals and keep improving your systems. Get coaching to develop better systems and realistic goals.

As you can see, “being healthy and fit” is like an iceberg. Eating well and workout out is only the tip of the iceberg and it’s supported by all the thinking, prioritizing, strategizing and planning underneath.

Aaron Gilbert, CSCS, owns Longevity Athletics and can be reached at 520-261-4661 and Aaron@LongevityAthletics.com.

Only three Maricopa eateries were inspected by the health department of Pinal County June 16-July 15. All three earned excellent ratings.

Excellent [No violations found]
Chipotle Mexican Grill
Dickey’s Barbecue Pit
Firehouse Subs

Satisfactory [Violations corrected during inspection]
None

Needs Improvement [Critical items noted during inspection cannot be corrected immediately requiring follow-up inspection]
None

Unacceptable [Gross, unsanitary conditions necessitating the discontinuation of service]
None


This item appears in the August issue of InMaricopa.

By Joan Koczor 

Initially, your primary care provider will be the first step in diagnosing many health issues. He will recommend screening, help you manage chronic conditions and, if needed, refer you to other types of providers or specialists.

A short list of specialists may include cardiologists, oncologists, allergists, psychologists, podiatrists and orthopedists.

Through all this, your life has changed – you’ve become a patient.

Your days are no longer ordinary. There are examinations, medications, diagnosis and treatment options, doctor appointments, hospital stays, decisions to make, endless paperwork, phone calls to health insurers. Who can you turn to in time of an emergency?

Dealing with any illness can be a very stressful time for patients and their families.

Add to that the health care system has become so confusing – think walking through a maze – that some patients may need someone to help them navigate.

A new trend is enlisting a patient advocate.

An advocate may be a member of your family or a close friend. An effective advocate is someone you trust and will act on your behalf as well as work with other members of your health care team.

Another type of advocate is a professional advocate. Hospitals usually have professionals who play this role called patient representatives or patient advocates. Social workers or nurses may also fill this role.

In choosing a patient advocate, it is important to decide what you want help with and what you can handle without assistance.

Do you need a better understanding of options for hospitals, doctors, diagnostic tests? Assurance your wishes are carried out if there comes a time you might not be able to do that yourself? Would you like your advocate to accompany you to tests, appointments, treatments and procedures? Assist you in wading through the never-ending medical bills? Become your representative to health care providers?

It is important to let your physician and those caring for you know who your advocate is and how much involvement they have in your care. Make sure your doctors and nurses have your advocate’s contact information. And the same for your advocate – provide them with numbers for your health care provider, hospital and pharmacy and anyone you wish contacted in case of an emergency.

Not all advocates charge a fee. Not all who do will charge for their services in exactly the same way. The cost may depend on:

  • your location, or your location in relation to where they are located.
  • the advocate’s experience and education.
  • the amount of time you work together.

Additional factors like necessary travel, acquisition of medical records, or others may cause the price to fluctuate.

PatientAdvocate.org, AdvoConnection.com/advocatelocations/arizona

Joan Koczor is a senior advocate and member of the Age-Friendly Maricopa Advisory Committee.


This column appears in the July issue of InMaricopa Magazine.

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Aaron Gilbert. Photo by William Lange

By Aaron Gilbert

When life’s already busy, here’s how you can make time to eat better and move more often.

Ask yourself why

Understand exactly why you want to eat better and exercise more gives you the motivation to prioritize it over other things.

Examples:

Q: Why do I want to eat healthier and exercise more?
A: Because I want to fit in smaller pants.

Q: But why do I want to fit in smaller pants?
A: Because when I’m wearing smaller pants, I look better.

Q: But why do I want to look better?
A: Because when I look good, I feel good about myself.

Q: But why do I want to feel good about myself?
A: Because when I feel good about myself, I’m more assertive and confident.

Q: But why do I want to be more assertive and confident?
A: Because when I’m more assertive and confident, I’m in control, my fears won’t stop me, and I can finally go for my dreams.

Identify your top priorities

Think of your time as a jar, which you can fill with a finite number of rocks, pebbles and sand.

Your big rocks represent the stuff that’s most necessary to feel fulfilled in life. They often relate to family, health, and livelihood. Your pebbles add extra fun and satisfaction to life, but aren’t totally necessary. You sand is purely “bonus” activity. It can be enjoyable, but it’s not crucial to your survival or fulfillment

Everyone’s rocks, pebbles and sand will look different. But regardless, if you fill you jar with too much sand first, the rocks and pebbles won’t fit.

Keep a time diary

Your schedule reflects how you’re prioritizing the activities in your life. Track your time in 15-minute increments for a couple weeks to find out if it’s consistent with your goals and values. For example:

7:00-7:15 – Woke up, brushed teeth
7:15-7:30 – Checked Instagram
7:30-7:45 – Still on Instagram

Then analyze it:

Actual
Work 35%
Sleep 20%
Exercise 2%
Time with loved ones 10%
Watching TV 10%
Surfing the Internet 25%
Healthy meal prep 3%

Desired
Work 35%
Sleep 30%
Exercise 5%
Time with loved ones 20%
Watching TV/Internet 2.5%
Time in nature 2.5%
Healthy meal prep 5%

To start to align your schedule with what you want to accomplish, replace low-value activities with high-value ones, little by little.

Aaron Gilbert, CSCS, owns Longevity Athletics and can be reached at 520-261-4661 and Aaron@LongevityAthletics.com.


This column appears in the July issue of InMaricopa Magazine.