THRIVE-Fall 2012

thrive

An

epic battleFighting The U.S. Pain Epidemic

Healthy Eating Recipes With Skinnytaste.com

ThriveHealthMagazine.com

Fall Issue 2012 — Issue 1, Volume 1

PREMIERE ISSUE

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M C C O R M I C K

P A R A D I S E V A L L E Y

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Celebrating 10 years of serviceto the Greater Phoenix area.

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contents

Created By Republic Media Custom Publishing And Medical

Marketing Solutions

General Manager: Cami KaiserManager Creative Development: Isaac MoyaEditor: Jim WilliamsManaging Art Director: Tracey Phalen

Art Director/Design: Rachel TullioContributors: Rick D’eliaAdvertising: Brienne ChanceKelli Faucett

21 feature journey to the Summit With the Northern Lights in the distance, Jason Apelquist’s ascent of Mt. Rainier could only be described as magical.

26 Cover story An epidemic of pAin For some, pain comes and goes, but for over 116 million Americans, pain is a constant presence in their lives.

DepartmentsFeatures

[ thrive | fall 2012 ]

Thrive is published four times per year. To subscribe or receive more information, call 623-201-1700 or e-mail [email protected]. The advice and information contained in this article is for educational purposes only, and is not intended to replace or counter a physician’s advice or judgment. Please always consult your physician before taking any advice learned here or in any other educational medical material.

Medical Marketing SolutionsThrive Project Manager:Michael HardestyEditor-In-Chief and Content Writer: Rachel MeyerContributing Editorial: Jennifer GittDesign: Evan Hoffbuhr

14,410 ft Mt. Rainier’s height above sea level. Learn how Jason Apelquist achieved his dream. See page 21

6 Guest Editor

8 Vitals

14 Rest

15 Move

16 Q&A

18 Him

19 Her

20 Ask

32 Innovation

33 The Road Trip

34 Nutrition

36 Events

38 Free To

Be Me

39 Thrive 10

©Medical Marketing Solutions, 2012

4 thrive | fall 2012

Eva

RestoreSensor clinical study patient Using AdaptiveStim exclusively available with RestoreSensor since 2010.

Neurostimulation Systems for Pain Therapy Brief Summary: Product Technical Manuals and Programming Guides must be reviewed prior to use for detailed disclosure.Indication for Use - Chronic, intractable pain of the trunk and/or limbs-including unilateral or bilateral pain. Contraindications: Diathermy. Warnings: Defibrillation, diathermy, electrocautery, MRI, RF ablation, & therapeutic ultrasound can result in unexpected changes in stimulation, serious patient injury or death. Rupture/piercing of neurostimulator can result in severe burns. Electrical pulses from the neurostimulator may result in an inappropriate response of the cardiac device. Precautions: The safety and effectiveness of this therapy has not been established for: pediatric use, pregnancy, unborn fetus, or delivery. Follow programming guidelines & precautions in product manuals. Avoid activities that stress the implanted neurostimulation system. EMI, postural changes, & other activities may cause shocking/jolting. Adverse Events: Undesirable change in stimulation; hematoma, epidural hemorrhage, paralysis, seroma, CSF leakage, infection, erosion, allergic response, hardware malfunction or migration, pain at implant site, loss of pain relief, chest wall stimulation, & surgical risks. For full prescribing information, please call Medtronic at 1-800-328-0810 and/or consult Medtronic’s website at www.medtronic.com. USA Rx Only Rev 0209

The Choice ofContinuous Motion

Scan to watch Eva’s story or visit our website at:

www.tamethepain.com/Eva

Eva

Neurostimulation Systems for Pain Therapy Brief Summary: Product Technical Manuals and Programming Guides must be reviewed prior to use for detailed disclosure.Indication for Useunexpected changes in stimulation, serious patient injury or death. Rupture/piercing of neurostimulator can result in severe burns. Electrical pulses from the neurostimulator may result in an inappropriate response of the cardiac device. The safety and effectiveness of this therapy has not been established for: pediatric use, pregnancy, unborn fetus, or delivery. Follow programming guidelines & precautions in product manuals. Avoid activities that stress the implanted neurostimulation system. EMI, postural changes, & other activities may cause shocking/jolting. or migration, pain at implant site, loss of pain relief, chest wall stimulation, & surgical risks. For full prescribing information, please call Medtronic at 1-800-328-0810 and/or consult Medtronic’s website at www.medtronic.com. USA Rx Only Rev 0209

Neurostimulation Systems for Pain Therapy Brief Summary: Product Technical Manuals and Programming Guides must be reviewed prior to use for detailed disclosure.: Diathermy. Warnings: Defibrillation, diathermy, electrocautery, MRI, RF ablation, & therapeutic ultrasound can result in

unexpected changes in stimulation, serious patient injury or death. Rupture/piercing of neurostimulator can result in severe burns. Electrical pulses from the neurostimulator may result in an inappropriate response of the cardiac device. The safety and effectiveness of this therapy has not been established for: pediatric use, pregnancy, unborn fetus, or delivery. Follow programming guidelines & precautions in product manuals. Avoid activities that stress the implanted neurostimulation

: Undesirable change in stimulation; hematoma, epidural hemorrhage, paralysis, seroma, CSF leakage, infection, erosion, allergic response, hardware malfunction or migration, pain at implant site, loss of pain relief, chest wall stimulation, & surgical risks. For full prescribing information, please call Medtronic at 1-800-328-0810 and/or consult Medtronic’s website at www.medtronic.com. USA Rx Only Rev 0209




Neurostimulation Systems for Pain Therapy Brief Summary: Product Technical Manuals and Programming Guides must be reviewed prior to use for detailed disclosure.: Defibrillation, diathermy, electrocautery, MRI, RF ablation, & therapeutic ultrasound can result in

unexpected changes in stimulation, serious patient injury or death. Rupture/piercing of neurostimulator can result in severe burns. Electrical pulses from the neurostimulator may result in an inappropriate response of the cardiac device. The safety and effectiveness of this therapy has not been established for: pediatric use, pregnancy, unborn fetus, or delivery. Follow programming guidelines & precautions in product manuals. Avoid activities that stress the implanted neurostimulation

: Undesirable change in stimulation; hematoma, epidural hemorrhage, paralysis, seroma, CSF leakage, infection, erosion, allergic response, hardware malfunction or migration, pain at implant site, loss of pain relief, chest wall stimulation, & surgical risks. For full prescribing information, please call Medtronic at 1-800-328-0810 and/or consult Medtronic’s website at www.medtronic.com. USA Rx Only Rev 0209


Eva

RestoreSensor clinical study patient RestoreSensor clinical study patient Using AdaptiveStim exclusively available Using AdaptiveStim exclusively available with RestoreSensor since 2010.with RestoreSensor since 2010.

Neurostimulation Systems for Pain Therapy Brief Summary: Product Technical Manuals and Programming Guides must be reviewed prior to use for detailed disclosure.Neurostimulation Systems for Pain Therapy Brief Summary: Product Technical Manuals and Programming Guides must be reviewed prior to use for detailed disclosure.Indication for Use - Chronic, intractable pain of the trunk and/or limbs-including unilateral or bilateral pain. - Chronic, intractable pain of the trunk and/or limbs-including unilateral or bilateral pain. Contraindications: Diathermy. unexpected changes in stimulation, serious patient injury or death. Rupture/piercing of neurostimulator can result in severe burns. Electrical pulses from the neurostimulator may result in an inappropriate response of the cardiac device. unexpected changes in stimulation, serious patient injury or death. Rupture/piercing of neurostimulator can result in severe burns. Electrical pulses from the neurostimulator may result in an inappropriate response of the cardiac device. The safety and effectiveness of this therapy has not been established for: pediatric use, pregnancy, unborn fetus, or delivery. Follow programming guidelines & precautions in product manuals. Avoid activities that stress the implanted neurostimulation The safety and effectiveness of this therapy has not been established for: pediatric use, pregnancy, unborn fetus, or delivery. Follow programming guidelines & precautions in product manuals. Avoid activities that stress the implanted neurostimulation system. EMI, postural changes, & other activities may cause shocking/jolting. system. EMI, postural changes, & other activities may cause shocking/jolting. Adverse Events: Undesirable change in stimulation; hematoma, epidural hemorrhage, paralysis, seroma, CSF leakage, infection, erosion, allergic response, hardware malfunction or migration, pain at implant site, loss of pain relief, chest wall stimulation, & surgical risks. For full prescribing information, please call Medtronic at 1-800-328-0810 and/or consult Medtronic’s website at www.medtronic.com. USA Rx Only Rev 0209 or migration, pain at implant site, loss of pain relief, chest wall stimulation, & surgical risks. For full prescribing information, please call Medtronic at 1-800-328-0810 and/or consult Medtronic’s website at www.medtronic.com. USA Rx Only Rev 0209

The ChoiceChoice ofContinuousContinuous Motion

“I love AdaptiveStim. It’s all preset at different stimulation levels when I am sitting or standing, and lying down. It even boosts up the stimulation when I’m exercising, so I’m comfortable during my workout and afterward.”

AdaptiveStim®, exclusively available with RestoreSensor®, is a first-of-its-kind neurostimulation system. With other systems, if you want to adjust stimulation to remain comfortable when you change position, you have to make manual adjustments using your programmer.

With AdaptiveStim, exclusively available with RestoreSensor, you can be active without having to adjust your stimulation setting. AdaptiveStim automatically adjusts it for you.

If you are considering neurostimulation for chronic pain or for more information, talk with your doctor about RestoreSensor and visit www.TameThePain.com.

201204601_SensorAd_Eva_v4.indd 1 10/25/12 9:26 AM

editor

The word chronic isn’t necessarily a life-changing word, unless you are a pain sufferer.

For those 116 million Americans who suffer from pain that is classified as chronic, their condition has a significant impact on their lives. Chronic pain can strain relation-ships, cause sleeplessness and anxiety, and can lead to depression.

Disturbingly, the current care model for treating those in pain is indistinguishably linked with the prescription pain medication epidemic currently devastating the United States. Eighty percent of the world’s prescrip-tion pain medication supply is utilized by Americans, and yet, we only represent five percent of the world’s population. Overdoses of prescription pain medications, also known as opiates, are responsible for more daily deaths than heroin and cocaine combined. Even with the problems associated with opiates, these powerful medications are often the most com-mon plan of treatment for those with chronic pain. Stark facts like these cannot be ignored, but under the current care model, chronic pain is one of the most underserved medical condi-tions in the country. The system is broken, and must change.

As a pain management physician, I view ef-fective pain management as a moral obligation; it is my responsibility as a healthcare provider to offer solutions for those who suffer with chronic pain.

Pain is a sensation that reaches beyond the understanding of science; no two people will

experience pain in exactly the same way. Pain also extends far outside the realm of physical sensation in that it can have a considerable impact on the emotional and mental wellbeing of the sufferer. It is with all of these factors in mind that I introduce Freedom Pain Hospital.

This project is the realization of a vision many years in the making. Freedom Pain Hospi-tal is the first specialty hospital for pain suf-ferers in the country. I am proud and humbled to be the CEO of Freedom Pain Hospital, and am excited to bring its services to magnificent Scottsdale, Arizona.

I am a great believer in collaborative com-munity, and especially when it comes to the management of pain. At Freedom Pain Hospi-tal, pain management physicians, orthopedists, neurosurgeons, research specialists, behavioral therapists, and other expert medical staff will work side by side in a state-of-the-art facil-ity, and collaborative community will be at its finest. Pain sufferers will be able to work with world-class physicians in integrative programs that will feature the latest in medical innova-tion. No matter the condition, pain sufferers will be able to pursue relief in an environment that offers them the best in medical care.

Freedom Pain Hospital aims to help pain sufferers regain the sense of identity that is so often lost with their chronic condition. The goal of the medical team at Freedom Pain Hospital is to help those with pain, support their loved ones and caregivers, and give a renewed sense of hope.

Ending thE cyclE of pain

Steven Siwek, M.D. “i would like to thank Republic Media and Medical Marketing Solutions for giving me the opportunity to make people aware of the epic battle we are fighting in the war on pain.” Dr. Siwek is excited to bring Freedom Pain Hospital into existence to offer another dimension of pain care.

For more information regarding Freedom Pain Hospital and its world-class integrative programs, visit www.FreedomPainHospital.com or call 480-586-2300

[ Steven Siwek, M.D., guest editor ]

PAINis a sensation that

reaches beyond the understanding

of science; no two people will

experience pain in exactly the same

way.


After four back surgeries, Jason’s back pain was still persistent. A police offi cer, he was not able to go to work or even get out of

bed. “It was the worst thing I’ve ever gone through, and it was a terrifying feeling to not be able to walk without being in pain,” Jason

explains. Searching for relief, he eventually found a doctor who recommended neurostimulation, a therapy that uses mild electric

pulses to block pain signals and help manage pain. According to Jason, within the fi rst day of the evaluation period, the pain was

almost gone. Now he’s able to ride a bike and walk—things he thought he’d never be able to enjoy again.

Neurostimulation systems are FDA-approved or cleared to manage certain types of chronic pain and have helped thousands of

people, like Jason, reduce their chronic pain to a manageable level and return to a more normal lifestyle. The amount of pain relief

varies with each individual, and complications related to the surgical placement and/or use of a neurostimulation system may occur.

Be sure to discuss the risks and benefi ts of neurostimulation with your doctor.

To read more stories like Jason’s or to request a free patient information kit, view our website, PowerOverYourPain.com/living.

Twitter.com/SJMNeuro YouTube.com/SJMNeuro

Indications for Use: Spinal cord stimulation as an aid in the management of chronic, intractable pain of the trunk and limbs. Contraindications: Demand-type cardiac pacemakers, patients who are unable to operate the system or who fail to receive effective pain relief during trial stimulation. Warnings/Precautions: Diathermy therapy, cardioverter defibrillators, magnetic resonance imaging (MRI), explosive or flammable gases, theft detectors and metal screening devices, lead movement, operation of machinery and equipment, postural changes, pediatric use, pregnancy, and case damage. Patients who are poor surgical risks, with multiple illnesses, or with active general infections should not be implanted. Adverse Effects: Painful stimulation, loss of pain relief, surgical risks (e.g., paralysis). User’s guide must be reviewed prior to use for detailed disclosure. Rx only.

St. JUDE MEDICAL and the nine-squares symbol are trademarks and service marks of St. Jude Medical, Inc. and its related companies. ©2012 St. Jude Medical. All rights reserved.

“Neurostimulation has worked wonders for me.”

sobering statistiCs: The Centers for Disease Control and Prevention (CDC) recently released projections estimat-ing that by 2030, 42 percent of the adult American population will be obese. Currently, more than one-third of all American adults are obese, and more than 12.5 million American children are also struggling with obesity.

These numbers are significant and should not be taken lightly, as obesity has truly become an epidemic in the U.S., costing lives and millions of dollars.

Integrative medicine is a focus on the patient as a whole and seamlessly blends conventional, clinical medicine with alternative therapies including nutrition counseling, physical therapy, exercise counseling, and behavioral therapy. Because a large part of success-ful weight loss depends so much

on the continued maintenance of a healthy weight and healthy lifestyle after the individual achieves their weight-loss goal, integrative programs are an abso-lute necessity for medical weight loss.

Approximately 80 percent of all individuals who lose 20 or more pounds gain some or all of it back, and this is largely due to never learning and implementing permanent healthy habits. Many who lose weight consider it a diet and will return to unhealthy habits once the weight is lost, ultimately returning to where they began.

Integrative medicine can help individuals implement new lifestyles to ensure that the habits they engage in to lose weight are permanent. By losing weight through this approach, the individual can combine the clinical and medical aspects of losing weight along with the implementation of new lifestyle habits.

growing problem

Physical activity can increase the number of calories your body uses for energy or “burns off.” The burning of calories through physical activity, combined with reducing the number of calories you eat, creates a “calorie deficit” that can help

with weight loss.FITN

Ess

FAc

T

How integrative medicine can help control obesity

9 out of 10 People with newly diagnosed

type 2 diabetes are overweight, according to American

Diabetes Association. If you are overweight, a weight loss program could help you better

manage your diabetes.

america’s

vitals[ Treatments and advancements in health care ]


Professional athletes are often in search of medical innovations to aid them in their quest for the championship, but those who are recreational ath-letes or even weekend warriors will often experience the same injuries, fatigue, and pain that professional athletes endure.

Platelet-rich plasma therapy (PRP) is the one of the latest in-novations in orthopedic sports medicine, and both profes-sional and recreational athletes across the country have begun to seek this procedure. PRP garnered extensive media attention in 2009 after golfer Tiger Woods and Pittsburgh Steelers players Troy Polamalu and Hines Ward stated publi-cally that they had received the treatment and had seen sig-nificant benefit — the Steelers won the Super Bowl that year, so maybe this was more than media hype.

At that time, platelet-rich plasma therapy was a treat-ment option for only the rich and famous, as insurance companies did not cover the procedure, and the out-of-pocket cost was fairly high. In recent months, however, many clinics have been offering PRP as an affordable option for their

patients, causing a rise in this

therapy once again.

Platelet-rich plasma therapy

involves taking a sample of

blood from the patient and

placing it in a centrifuge to

separate the platelets from the

rest of the sample. The highly concentrated platelets are then injected into the area of injury or pain.

Platelets are one of the essential components to new tissue growth and the healing of damaged tissue, but only naturally make up approximately 6 percent of blood. Addition-ally, there are some areas of the body with naturally lower blood flow than others, which can inhibit the delivery of platelets to an injured area.

With PRP, the intention is to administer platelets directly to promote healing and new tis-sue growth and discourage the formation of scar tissue. What is

most unique about platelet-rich plasma therapy is that it com-bines cutting edge technology with the very basics of how the body functions and heals itself, and so rather than rely on medications, PRP encourages the body to heal using its own properties.

Platelet-rich plasma therapy has shown significant pain reduction in sports injuries in-cluding plantar fasciitis, Achilles’ tendonitis, tennis elbow, and other injuries involving tendons. Some orthopedic surgeons have used PRP to aid in the healing of fractures and post-surgically to help the patient heal more effectively.

What is most unique about platelet-rich plasma therapy is that it combines cutting-edge technology with the very basics of how the body functions and heals itself.

not just for the pros, platelet-rich plasma therapy has shown significant pain reduction for sports injuries.

Latest innovations in ortHopedic sports medicine aid in HeaLing, tissue regrowtH

plasma thErapy helps pros, weekend warriors

7 most common sports injuries

> Ankle sprain

> Groin pull

> Hamstring strain

> Shin splints

> Knee injury: ACL tear

> Knee injury: Patellofemoral syndrome — injury resulting from the repetitive movement of your kneecap against your thigh bone

> Tennis elbow (epicondylitis)

source: webmd

fall 2012 | thrive 9

the institute for MusiC and Brain Science recently conducted a clinical trial regarding the effect of music on Parkinson’s disease, a neurological condition that severely affects walking, movement, and general coordination.

This recent research is just one development in the ongoing discovery of how the art of music can impact the neurological systems of the human body.

Scientists and research physicians have long studied how music can have an effect on the brain and how, specifically, music therapy can have an impact on neurological disorders like Alzheimer’s and Parkinson’s while also creating significant changes in the brain activity of those who are developmentally delayed or disabled. When music therapy has been administered to Alzheimer’s patients, the results vary from recognition of a previously forgotten loved one to soothing the anxiety and agitation that so often accompanies Alzheimer’s. Studies have shown that when family members sing familiar tunes, many Alzheimer’s patients will not only sing

along, but will have a memory triggered that can be the bridge to recognizing their loved one. Parkinson’s patients have been able to dance in time to music, where they had only minutes before struggled to take a few unaided steps.

Even when a neurological disorder or condition is not present, multiple studies have now shown that children who participate in music

lessons at a young age will generally have accelerated learning habits, improved fact retention, and higher IQs than their peers who have not received music lessons.

Undoubtedly, music has an impact on the body’s neurological functions and with further research into musical therapy; it has the potential to become a significantly beneficial treatment option.

Studies have shown that when family members sing familiar tunes, many Alzheimer’s patients will not only sing along, but will have a memory triggered that can be the bridge to recognizing their loved one.

researcH sHows music tHerapy can affect neuroLogicaL disorders, Learning

life changing

tunesMusIcAl NoTEArchaeologists have discovered ancient flutes — one of which is presumed to be the oldest musical instrument in the world — that play a scale similar to the modern Western scale. The flute was found in Hohle Fels Cave in Germany, and is thought to be 42,000 years old.

vitals


15-20%max percent of a child’s body weight that can be safely carried in backpack

MANY CHILDREN CARRY BACKPACKS full of textbooks, binders, notebooks, and various other supplies, making these backpacks extremely heavy and often off-balance.

If this habit is not corrected, it can begin to cause pain and discomfort for the child and may lead to prob-lems with chronic pain later in life. Many physical therapists recommend an appointment as soon as possible if the child feels tingling, pain, or numbness in the back or extremities.

Children should really only carry a maximum of 15-20 percent of their own body weight in a backpack ac-cording to the guidelines set forth by the American Physical Therapy Association. Children and adoles-cents are still developing and growing and should not be weighed down with a heavy bag. Continuousstrain and stress on the growing spine can eventually cause lasting damage.

1. WAIST HIGH. The bottom of a child’s backpack should not rest below their belt buckle. A backpack that hangs too low increases the weight on the shoulders, causing your child to lean forward when walking.

2. POCKET PROTECTION. A backpack with individual-ized compartments helps position the contents most effectively. Make sure awkwardly shaped items are packed toward the front of

the backpack while placing the heavi-

est items toward the body.

WHAT ITEMS ARE IN YOUR CHILD’S BACKPACK THAT MAY CAUSE THEM PAIN LATER IN LIFE?

Backpack essentials Here are few tips to help ease your child’s backpack load:

HEAVY LOAD AHEAD HEAVY LOAD AHEAD WARNING

3. DON’T SUPERSIZE ME. The more room there is in a backpack, the more your child will carry and the heavier the back-pack will be.

4. DOUBLE UP. Urge your child to wear both shoulder straps. Lugging the backpack around by one strap can cause a dispropor-tionate shift of weight to one side, leading to neck and muscle spasms, as well as low-back pain.

5. COMFORT IS KEY. Be sure the backpack has wide, padded straps. Non-padded straps are uncomfortable, and can dig into your child’s shoulders.

6. HANG TIGHT. The shoulder straps should be adjustable so the backpack can be fi tted to your child’s body. Straps that are too loose can cause the backpack to dangle un-comfortably and cause spinal misalignment and pain.


15-20%max percent of a child’s body weight that can be safely carried in backpack

Association. Children and adoles-cents are still developing and growing and should not be weighed down with a heavy bag.

stress on the growing spine can eventually cause lasting

packed toward the front of the backpack while

placing the heavi-est items toward the body.

spasms, as well as low-back pain.

backpack to dangle un-comfortably and cause spinal misalignment and pain.

THRIVE-102212-CS5.5.indd 11 10/30/12 4:29 PM


vitals


vitals

Did you know?There are certain foods and dietary measures that can help ease pain.

get your fill of vitamin D

eat flaxseed or walnuts

fish,

avoid caffeine

avoid in foodadditives

FREEDOM from cancer painTreatments can help patients maintain quality of life, function

eat vegetables and fruits

When undergoing treatment for cancer, many patients and their physi-cians are so focused on the eradication of the cancer itself that the associated pain of the cancer often goes untreated or is undertreated.

This discrepancy is sometimes caused by a lack of education in the treating physician, or an oversight to asking the

patient whether the patient is experienc-ing pain. Another major factor in the under treatment of cancer pain is often the patient's reluctance to admit that they are experiencing pain, in fear that pain means that their cancer is getting worse. Cancer pain can be caused by tumors placing pressure on bone, nerves, and organs, and can also be caused by the treatment itself; both radiation and chemotherapy can have painful side effects, and if the patient receives tumor removal surgery, there is often post-operative pain.

A solution for cancer pain patients can be surgically implanted devices called pain pumps, which deliver pain medica-tion directly to the spinal fluid to be distributed throughout the body. The device is implanted into a subcutaneous pocket between the skin and muscles of the abdomen with a catheter that delivers the medication directly to the spinal cord and surrounding nerves.

One of the greatest benefits to the pain pump is that it delivers medication directly to the systems of the body, rather than waiting for an oral medication to take effect. Because of this, the patient will require far less medication, and often experiences little to none of the associated side effects in addition to a higher level of functioning. The pain control possible with a pain pump has been shown to be extremely beneficial to cancer patients with pain.

According to MD Anderson, one of the leading cancer treatment centers in the United States, more than one third of all patients with invasive cancers are undertreated for their related pain.

““avoid inflammatory foods

participate in low impact exercise

QUALITYRESEARCH

WITH APATIENTCARE FOCUS

CONDUCTING

www.hriaz.comHope Research Institute conducts clinical trials across

multiple therapeutic areas. Call us today at 602.288.HOPE to

learn more about enrolling in a research study.

PARTICIPATE IN A RESEARCH STUDY

602.288.4673

Clinical research is an often forgotten field of medicine, but it creates one of the largest impacts across all aspects of healthcare.

Much of medical technology and advancement is the direct result of clinical research facilitated not only by large pharmaceutical companies, but also by dedicated research physicians and willing patient volunteers. Even though clinical research is extremely important to the advancement of medicine, many people are reluctant to volunteer for clinical research for several different reasons.

Misinformation can often be the basis of reluctance in volunteering for a clinical trial. Some perceive clinical trials as sitting in a cold, clinical room where faceless, nameless physicians scribble down data; others think clinical research and automatically link it to animals in cages being tested. In reality, clinical research is often conducted in a physician’s office or hospital, and will follow the normal pattern of an office visit, possibly with a few more questions than usual. There are standards and practices that are followed when conducting clinical research to guarantee the safety and comfort of the participants.

Successful clinical research cannot happen without willing participants. If you are interested in learning more or participating in a clinical trial, visit www.HRIAZ.com.

CliniCal researCh saves lives

Volunteers can contribute to

advancements in medicine


rest take time to

rElax

turn on the tunes Music can be extremely calming, and research shows that it may have the same calming effects as sedating medications. Studies show that using music for relaxation has the most impact if you focus on the rhythm and melody of the song.

Rest, sleep, and relaxation are some of life’s most basic functions, but are difficult for many to achieve because of health problems.

time outMost importantly, try to find an

activity or a place that calms

you. If there is a quiet place

in your home where you can

escape for several minutes

with a cup of tea to think

and meditate, make sure to

take time out in that space. If

watching a movie or a favorite

show can calm you down,

arrange your schedule to

make the time for it. One

of the most important

factors regarding rest

is ensuring that you

make it a priority and do not

feel guilty for taking that time

for yourself.

imagine you are on a beachAnother relaxation technique is through positive imagery. Picture something that calms you, whether it is your spouse, your child, or a favorite place. Try to really invest in the image with as much detail as possible.

write it down Journaling has many health benefits and can be a relaxing form

of expression. Writing down your thoughts can have a calming effect, and can help remove overwhelming feelings and

emotions. When journaling, be sure to just let the words flow, do not self edit or think about it — just write what comes to mind.

BREATHING ExERcIsEsDeep breathing is the most fundamental of all relaxation techniques and is one that is easy to learn and utilize on a daily basis. Take a deep breath, and then let it out in a slow and controlled manner, while imagining that the breath is moving up from your toes to the top of your head.


move

Walk the line Walking is the exercise that nearly anyone can do. Put on your best sneakers, comfortable clothes, and encourage your whole family to walk with you. Walking is fairly low-impact and as long as you do it consistently, it can lead to great health benefits.

Staying hydrated is important before and during exercise. You should drink:

FITN

Ess

FAc

T

15-20 8-10 ounces of water 2 to 3 hours before you start any exercise

ounces of water every 10-15 minutes during exercise

Easing Pain Through

loW impact fitnEss

Ride like the wind As far as cardio exercise goes, biking is one of the best for those with chronic conditions. In addition to the benefits of exercise, many people find that biking is simply enjoyable. If a standard bike is not a possibility, a stationary bike can have the same benefits. As with all exercise, be sure to take it slow in the beginning and only push yourself as far as you feel comfortable.

Make a splash Water aerobics, or even walking the length of the pool, offers a great workout. The water of the pool not only provides resistance, which can help build strength and muscle stability but also cushioning, minimizing the jarring impact of the joints. Whether you join a water aerobics class, purchase weights specifically for pool use, walk the length of the pool, or swim, being in the water is a highly recommended workout. If you are exercising in an outdoor pool, be sure to frequently apply sunscreen, and stay hydrated just as you would with any other form of exercise.

3Salute the sun — Yoga is extremely beneficial for strengthening weakened muscles and joints. The deep stretches required in yoga also help build stability and balance, which is beneficial for those prone to fractures. Always move into the positions at a pace comfortable for you, and if something hurts, stop. Do not push yourself if you are feeling pain, as you may cause injury.

24

1

It may seem counterintuitive, but sometimes the best method for reducing chronic pain is not through bed rest, but through exercise and consistent movement. The saying, “a body in motion tends to remain in motion” rings true for those with any type of condition that is accompanied by symptomatic pain.

One of the challenges with exercise and chronic pain is finding exercises that will not result in higher pain levels. Low-impact exercise is always the most recommended for those who have chronic conditions like arthritis, fibromyalgia, osteoporosis, or any other chronic condition.

It does not matter what exercise you choose to do as long as you remain consistent. Even if you are having a particularly bad pain day, try to get moving for just ten to fifteen minutes. Often, stiff joints will loosen, aching muscles will relax, and the endorphins gained from exercise will give you a general feeling of wellness.


Q&A

Those who already have health insurance may see a change in their insurance plan as insurance companies will need to make adjustments to meet the regulations that are now required by law. For those concerned regarding premium increases, many sources are saying that an increase in premiums and co-payments are inevitable due to the fact that the new laws require basic insurance benefits to become more robust, which will inevitably raise the cost.

hEalthcarE rEform

Most of the governmental mandates and laws are scheduled to take effect in

2014

How will the most recent changes in healthcare reform affect me?

If you have more questions regarding healthcare reform, visit www.Healthcare.gov for additional information, or speak to your current insurance provider.

QuEsTIoN:

ANswER:


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The total annual incremental cost of health care due to pain ranges from

$560-$635 billion

(in 2010) in the United States, which combines the medical costs of pain care and the economic costs related to disability days, lost wages, and loss of productivity. source: institute of medicine of tHe nationaL academies

Many are wondering if there are other changes that will take effect immediately. For the most part, until 2014, many of the same rules still ap-ply. Children are able to be dependents on their parents’ insurance plans until the age of 26 and those who receive Medicare will continue to see dis-counts on their prescription medica-tions. Most of the governmental mandates and laws are scheduled to take effect in 2014, at which time most Americans will be penalized if they do not carry health insurance (early sources say the penalty will be-gin at $95 a year or up to 1 percent of a person’s income, whichever monetary amount is greater).

In September, health insurance companies were required to provide their customers with a short, plain lan-

guage Summary of Benefits and Cover-age, or SBC. Additionally, companies must also provide a uniform glossary of commonly used terms, like “copay-ment” or “deductible.” This is intended to make insurance policies as simple to understand as possible.

As of 2014, companies with 50 or more employees will be required by law to offer insurance to their employees or suffer a penalty. Additionally, those who may not qualify now will be eli-gible for the federal-state Medicaid pro-gram, and those who have low incomes will receive tax credits to pay for their healthcare costs. Insurance compa-nies will be required to sell policies to everyone, regardless of pre-existing conditions or medical history and will be required to restrict discrepancies in the cost of policies due to age.


him

ExERcIsEFor those American men who remain active, there has been a noticed decrease in the risk level for prostate cancer over those who are generally inactive. Consistent exercise is recommended in general, and may be achieved through formal exercise or through playing sports.

DIETIn regard to prostate cancer, diet has been found to be one of the most significant risk factors. Prostate cancer is much more prevalent in the U.S. and other countries where diets are largely based on meat and dairy over soy products, rice, and vegetables. Men who consume highly fatty diets derived mainly from red meat have been shown to have a higher incidence of prostate cancer.

PRoFEssIoNThose who are regularly exposed to the metal known as cadmium have shown abnormally high instances of prostate cancer. These professions may include battery manufacturers, welders, and rubber workers.

Steps you can take to prevent prostate cancerknow tHe risk

241,000

In 2012, approximately 241,000 new prostate cancer cases will be diagnosed, with approximately 28,000 deaths as a result. Affecting nearly as many men as breast cancer affects women, prostate cancer is the most common cancer among men. Though prostate cancer grows slowly and often has no symptoms until it has reached a late stage, about 85% of cases are diagnosed early enough and may be effectively treated.

Prostate cancer is most common in older men, with 80% of all cases diagnosed in men over 65. Risk factors for prostate cancer most often include genetics or hormonal factors, but there are certain risk factors that may be avoided or controlled to lessen the risk of prostate cancer.

EARly wARNING sIGNsMen are far less apt to visit a physician or take note of physical changes than women, and so it is important to be carefully aware of signs and symptoms that may indicate early cancer warning signs.

Pain. Ignoring pain is never recommended, especially if it persists and has lasted beyond the expected healing time. Feeling tired. Unusual fatigue and persistent tiredness in men may indicate

early cancer warnings and should be discussed with a physician. Frequent urination. An enlarged prostate may also cause urinary problems in men, which should be brought to the attention of your doctor.

wHAT To Do?Similar to women, medical professionals recommend that men perform a self-examination once monthly to include the testicles, skin, and an overall body assessment. If anything has changed or if pain, cough, or a fever is consistent, it is always safer to schedule an appointment with your physician for an examination to rule out anything serious.

Diet has been found to be one of

the most significant risk factors.

In 2012, approximately 241,000 prostate cancer cases will be diagnosed.


her

Understanding and controlling your risk factors

225,000 New cases of breast cancer across the U.S. as of September 2012.

241,000

Breast cancer is the most common cancer among women, with more than 225,000 new cases of breast cancer across the United States as of September 2012.

While the number of deaths due to breast cancer has been on a decrease due to education and early detection, health professionals encourage consistency in awareness regarding the signs of breast cancer, urging women to perform self-examinations and get mammograms every one to two years after turning 40.

As medical studies advance, genetics play a major role in the instances of breast cancer, however, many women who have been identified as “high risk” for breast cancer end up never seeing cancer, and approximately 75 percent of all breast cancer cases are present without the known risk factors.

Regardless, risk factors that are controllable should not be taken lightly. Here are some breast-cancer factors to consider:

Oral contraceptive use. Those women who choose to use an oral contraceptive have been shown to have a slightly elevated risk for breast cancer. When considering oral contraceptives, it is important to discuss your personal risk factors with your physician.

Alcohol Use. Recently, a link has been studied between breast cancer risk and alcohol

use. Women who average one alcoholic drink per day had an elevated risk over non-drinkers, while those who consume an average of two to five drinks per day were seen to have approximately 1.5 times the risk over non-drinkers.

Exercise. In general, exercise is never a bad idea, and those who stay active are usually healthier than their non-active counterparts. Studies have shown those who remained active were reported to have a lower risk for breast cancer.

Obesity. Post-menopausal women who are obese show an elevated risk for breast cancer. While obesity may be linked to breast cancer, it is also linked to other cancers and diseases, which is why maintenance of a healthy weight is an overall advantage.

What’s next? Whether you are at risk for breast cancer because of genetics or another factor, it is

important to focus on healthy living. Exercise, maintain-

ing a healthy weight, and eating nutritious foods may have an impact on your breast

cancer risk, but will also help you to generally feel better and live a healthier life.

Additionally, many health profes-sionals continue to advocate early detection, and so it is important to speak with your doctor regard-ing your personal risk factors, how and when to properly administer a self-exam, and when the best time to get a mammogram is based on your risk factors. In addition to a monthly breast self-examination, it is always wise to note changes in the skin or any other changes that you are aware of and concerned about and make a doctor’s appointment to have everything checked out as soon as possible.

BrEast cancEr

About her 17% of all women suffer

from migraine headaches - Mayo Clinic

28% of all women report experiencing severe stress - American Psychological Society

75% of all women rate getting enough sleep as being very important to them - American Psychological Society

68% of women use social media to stay in touch with friends - Huffington Post



EXPERT[ Matthew Doust, M.D. ]

Q:A: It has been estimated by researchers that one in three Americans are living with chronic pain. Over time, it has become clear to me that under-treatment of pain is one of the largest contributing factors to the current pain epidemic. This may be due to a lack of access to appropriate medical care, diagno-sis, and treatment for some patients. However, a lack of education in the medical community about chronic pain cannot be underestimated as a contributor to the problem. After a patient has been diagnosed with chronic pain, it is important to address the biological and psychological issues associated with chronic pain.

Our aging population is another reason behind the epidemic of pain. Patients with chronic diseases such as diabetes, cardio-vascular disease, cancer, and rheumatologic disorders (to name just a few) are living longer and are actively seeking to maintain their active lifestyle despite living with chronic pain.

Clearly more focus on pain and its affects on today’s society is warranted. Healthcare providers need to know the resources that are available in their communities in order to effectively treat chronic pain.

Q:MATTHEW DOUST, M.D.

A: A healthy diet and exercise cannot be underesti-mated when we are discussing prevention of any chronic disease in the United States, and includes the prevention and treatment of chronic pain as well. In my opinion, any talk of prevention should focus on education, and would include education for both the patient and the health care provider.

As health care providers, it is crucially important to take pain seriously. A detailed history, physical exam and treatment plan should be followed and appropriate diagnostic imaging and specialty referrals should be made to ensure the patient is treated effectively. If a treatment plan fails, it is important to re-evaluate the patient, question the initial diagnosis, and alter the treatment plan if needed. Pain is now the fifth vital sign and should never be ignored.

ask the

Matthew Doust, M.D. is a double-board certified pain management physician with The Pain Center of Arizona, the Southwest's premier pain management practice.

What do you think are thebiggest contributing factorsto the pain epidemic?

Other than healthy diet and exercise, what preventative methods should people take to avoid becoming oneof the 116 million Americans suffering from chrinic pain?

ask



EXPERT[ Matthew Doust, M.D. ]

Q:A: It has been estimated by researchers that one in three Americans are living with chronic pain. Over time, it has become clear to me that under-treatment of pain is one of the largest contributing factors to the current pain epidemic. This may be due to a lack of access to appropriate medical care, diagno-sis, and treatment for some patients. However, a lack of education in the medical community about chronic pain cannot be underestimated as a contributor to the problem. After a patient has been diagnosed with chronic pain, it is important to address the biological and psychological issues associated with chronic pain.

Our aging population is another reason behind the epidemic of pain. Patients with chronic diseases such as diabetes, cardio-vascular disease, cancer, and rheumatologic disorders (to name just a few) are living longer and are actively seeking to maintain their active lifestyle despite living with chronic pain.

Clearly more focus on pain and its affects on today’s society is warranted. Healthcare providers need to know the resources that are available in their communities in order to effectively treat chronic pain.

Q:MATTHEW DOUST, M.D.

A: A healthy diet and exercise cannot be underesti-mated when we are discussing prevention of any chronic disease in the United States, and includes the prevention and treatment of chronic pain as well. In my opinion, any talk of prevention should focus on education, and would include education for both the patient and the health care provider.

As health care providers, it is crucially important to take pain seriously. A detailed history, physical exam and treatment plan should be followed and appropriate diagnostic imaging and specialty referrals should be made to ensure the patient is treated effectively. If a treatment plan fails, it is important to re-evaluate the patient, question the initial diagnosis, and alter the treatment plan if needed. Pain is now the fifth vital sign and should never be ignored.

ask the

Matthew Doust, M.D. is a double-board certified pain management physician with The Pain Center of Arizona, the Southwest's premier pain management practice.

What do you think are thebiggest contributing factorsto the pain epidemic?

Other than healthy diet and exercise, what preventative methods should people take to avoid becoming oneof the 116 million Americans suffering from chrinic pain?

TO THE

one man’s personal battle

against chronic pain

by rachel meyer

For those who suffer from chronic pain, it can often be a trial to do simple tasks like laundry and grocery shopping. Pain can be so severe that the only option is to lie in bed until enough energy is mustered up to combat the searing pain and simply get through the day. There are some days when pain patients are unable to make it out of bed; their pain is so severe that they are rendered motionless. Achieving pain relief and regaining functionality is paramount, but for many pain patients, finding that relief and functionality is sometimes just a lost hope.

summitJourney


Jason Apelquist, a marketing and strategic planning senior manager at Honeywell is also a chronic back pain patient who has been suffering from pain since 1998. Following an emergency surgery due to a football injury, Apelquist has suffered from low back pain consistently as a result, and says his pain was regularly an 8, but occasionally as high as 10 on the pain scale. He routinely would injure himself while going to the gym in an attempt to maintain a base level of fitness, but inactivity was also not an option, as that would make his pain worse. Though Apelquist has been living with this pain for several years, it wasn’t until he had an appointment with Abram Burgher, M.D. that there seemed to be a light at the end of the tunnel.

“I saw at least four other pain specialists, but none of them looked at the problem from a multi-prong point of view like Dr. Burgher,” Apelquist says. “The other doctors were unwilling to peel back the layers of my pain to understand what the root causes were and only focused on one layer of my pain.”

“Jason has multiple sources of pain which is typical of those who have previously had spine surgery,” Burgher says. “He is a thoughtful person who is invested in his treatment, and this has helped his care tremendously. Jason is able to tell which type of pain is bothering him most at any given moment, and because of this, we have been able to treat each pain source individually, with the most precise ap-proach. In effective pain management, this type of approach to treatment always leads to the biggest impact.”

Jason Apelquist hiking Piestewa Peak in Phoenix, Arizona


“I sAw AT lEAsT FouR oTHER PAIN sPEcIAlIsTs, BuT NoNE oF THEM lookED AT

THE PRoBlEM FRoM A MulTI-PRoNG PoINT oF VIEw lIkE DR. BuRGHER.”

— JAsoN APElQuIsT



THE BIG PIcTuREMany physicians are so intent on treating the physical symptoms of a patient’s pain that they often miss the big picture, and thereby the source, of a patient’s pain. In Apelquist’s case, there were multiple causes of pain, including pinched nerves, joint arthritis, and torn spinal discs, which required an extremely defined approach to his treatment plan, something Burgher is careful to always commit to with his patients.

Another hurdle that many pain sufferers face is getting to the level of functionality that they want to, rather than settling for basic function-ality. Some pain patients are happy being able to take a walk with their spouse or sit through a movie without pain, but Apelquist had a much loftier goal in mind.

“I’ve climbed Mount Rainier twice before in my life and it just kicked my butt,” Apelquist says. “Given my age, I wanted to set a goal of doing it once more and do it really, really well.”

MAkING A PlANIt was with this goal in mind that Burgher worked with Apelquist in devising a systematic plan to find the pain sources and not only treat the symptomatic pain, but discover a way to help Apelquist improve his general health and condition to support his climb.

Apelquist credits Burgher with the ability to be able to train for his climb. “Dr. Burgher has given me the means to live more comfortably and to then be able to work harder on my physical therapy exercises to help stabilize my back.”

This stability was crucial during the training, as Apelquist likens his training schedule to having a second full time job. Daily workouts included a variety of cardio exercise and yoga, with a specific focus on getting his core and lower body as strong as possible to protect the spine during the climb. Apelquist did several training hikes, and practiced going into an anaerobic zone to mimic the extremes he would experience during the climb.

“Due to my experience, I led the climb, and we made it up in 4 hours and 15 minutes, each carrying 60 pound packs,” Apelquist explains of the climb. “Approximately 10,000 per year attempt to climb Mount Rainier, but only roughly 4,500 make it, and more than 75 percent of those people go with a guide.”

Abram Burgher, M.D. is a pain management specialist at the Pain Center of Arizona and has operating privileges at Freedom Pain Hospital in Scottsdale, Arizona.


REAcHING THE suMMITThis final climb of Mount Rainier for Apelquist was a personal quest, but one that he couldn’t have done without the pain man-agement program put in place by Burgher.

“It has been phenomenal working with him,” Apelquist says of Burgher. “Not only did he finally work to find the source of my pain, but he respected that I have been a student of my pain condition for over ten years, and I want to take an active part in my treatment and recovery process.”

Though Apelquist has made the Rainier climb before, there were some significantly remarkable moments during this particular summit.

“The climb went great and I was relative-ly pain free for the duration,” Apelqust says. “We climbed very safely, but very quickly; summiting first of the fifty plus people that day. We kicked off for the summit at mid-night — you go at the coldest point of the day to lessen the risk of avalanche — and we saw the northern lights on the way up. It was magical.”

Seeing Apelquist improve has been a sig-nificant moment for Burgher, as well.

“Seeing Jason not only as a successful person in his career, but also as someone who has been able to literally reach new heights is an inspiration to me,” Burgher says. “Jason should be an inspiration to all who suffer from chronic pain.”

JAsoN sHoulD BE AN INsPIRATIoN To All wHo

suFFER FRoM cHRoNIc PAIN.” — ABRAM BuRGHER, M.D


By RAcHEl MEyER


More Than 116 Million people Suffer froM chronic pain

the battle lines are drawn i n t h e f i g h t a g a i n s t p a i n

AFFEcTING MoRE PEoPlE than coronary heart disease, diabetes, and cancer combined, pain is the universal human condition that everyone will experience at some point. Pain is a disrespectful condition, holding no regard for age, sex, heredity, geographic location, or socioeconomic status.

For some, pain comes and goes, but for over 116 million Americans, pain is a constant presence in their lives. coupled with this staggering number is the fact that there is a significant lapse in care for those suffering from pain.

THE PAIN EPIDEMIcPain significantly changes lives. People who were once vibrant, active individu-als are now unrecognizable to family members and friends, crippled by pain so severe that they are unable to function on even a basic level.

“I have lost a lot of my friends over my pain condition,” Barby Ingle, a reflex sympathetic dystrophy sufferer says. “My family saw me go from the top of the world to a wheelchair.”

Damon Eversole, another reflex sym-pathetic dystrophy patient, echoes Ingle’s sentiments on the impact of chronic pain.

“My reflex sympathetic dystrophy (RSD) symptoms greatly impact how I in-teract with others,” Eversole explains. “My intolerance to vibrations or light touch keeps me away from people in general, but especially crowds. I also can’t tolerate loud noises, so no ball games, racetracks, movie theaters or concerts, the list goes on and on. My pain affects relationships as many people do not understand what living with this pain is like.”

With symptoms like those described by Ingle and Eversole, it should be expected that physicians are well equipped to treat this brutal, relentless pain, but many pain patients visit multiple physicians and spe-cialists, and some never experience relief from their unrelenting pain.

“In the past 10 years, I have seen over one hundred healthcare professionals for my condition,” Ingle says. “It took 43 healthcare professionals to get to the right doctor — one who could properly test and diagnose me.”

Eversole went through a search similar to Ingle’s for relief, as he has seen physicians all over the country, number-ing over sixty in the last twelve years.

“This is an issue where we’re failing at some level as providers with management of pain and education of our patients,” says Steven Siwek, M.D., CEO of Freedom Pain Hospital, the first specialty pain hos-pital in the country. “The more physicians a patient has to see, the more they begin to lose hope, and the less likely it is that they will find any form of relief.”

oPIATE EPIDEMIc“The current care model is at a crisis point,” Siwek says. “So often when a patient in pain comes to a physician, medication is often the first and only op-tion, and dosages escalate as a patient becomes tolerant to the effects of the medication. By masking symptomatic pain with powerful medications, we are creating a dependency problem in our country that is now claiming lives.”

Tragically common, many pain suf-ferers become physically dependent on powerful prescription pain medica-tions known as opiates. Eighty percent of the entire world’s supply of opiates is used in the United States, where

only five percent of the global popula-tion resides.

The opiate epidemic is rampant, with its daily death toll due to over-doses outnumbering heroin and cocaine combined. While there are certainly some physicians engaging in inappropriate prescription prac-tices, there are many physicians who prescribe opiates because that is the standard of care, that is how they

EllEn MARdER Fibromyalgia and sciatica pain

Ellen Marder is a kind, caring woman who has been a pain sufferer for many years.

A coin expert, Marder has been in this business for 35 years, has been on national television shows and radio stations to educate on coins and bullions, and still does appraisals and manages investments for a select number of clients. She wishes she could do more, but her pain limits her to what she describes as a once thriving career. Marder says the biggest challenge in being in so much pain is the strain it has put on her relationships with family and friends.

Even with as much pain as she suffers from, she is a fighter. Marder has been treated by Matthew Doust, M.D. at The Pain Center of Arizona, and says that he and the staff are the heart of what a good pain management center should be. Doust has helped Ellen go from an electric wheelchair to a walker, which has not only improved her functionality, but also her quality of life. She has also recently undergone gastric bypass surgery and lost 85 pounds since February 2012. This weight loss has allowed her do physical therapy, and she says that the stretches. Doust have recommended for her have been extremely beneficial.

sNAPsHoT

have been educated regarding pain management, and they believe that they are adhering to best practices for their patients.

There is certainly a use for opi-ates – when taken for a short period of time and in appropriate dosages, opiates can significantly benefit those in pain. It is only when opiates are the exclusive method being uti-lized for pain management that they become dangerous.

Relieving Pain In America, pro-duced by the Institute of Medicine, encourages physicians to think of effective pain management as a moral imperative and as their duty

as someone in a healing profes-sion. Physicians, especially those practicing pain management, must realize that the pain epidemic and the opiate epidemic are intrinsi-cally linked. Most physicians identify chronic pain as a serious healthcare problem but lack the education and resources to offer their patients effective pain management.

INTERDIscIPlINARy MoDEl“There must be a shift in the care model for pain management,” Siwek says. “One of the most basic elements of pain management should be an interdisci-plinary approach. While pain is in fact the universal human condition, it is still one of the most unique experiences in a person’s life. As individual to some-one as a fingerprint, chronic pain will affect everyone differently and as such, should be treated with a team of spe-cialists able to offer a treatment plan tailored to the individual patient.”

To fully understand an interdisci-plinary program, it may be helpful to regard chronic pain as a puzzle where no single health care provider holds the missing piece, rather, several providers all hold critical pieces to the

Pain is a disresPectful condition,holding no regard for age, Sex, herediTy, geographic locaTion, or SocioeconoMic STaTuS.

80%Of the entire world’s supply of opiates is used in the United States, where only five percent of the global population resides.


puzzle that, once fitted together, create the full picture of relief and wellness for the patient. Pain should ideally be treated with an interdisciplinary program and on an individual basis, because pain itself goes beyond the ba-sic rules of science and medicine. Pain is not one set of physical symptoms, rather, it is a combination of emotional and mental factors in addition to the physical factors. There is often no link between the amount of pain a person endures and the diagnostic indicators like tissue damage or imaging.

Alternative therapies like massage, acupuncture, nutritional counseling, and behavioral therapy are often over-looked by physicians and medical pro-fessionals, but can be one of the puzzle pieces for a chronic pain patient.

SUSAn CRUz Back pain due to nerve damage

Once a runner and a teacher for over 30 years, Susan Cruz is a wonderful, courageous woman who has endured terrible pain for almost five years.

Cruz’s MRIs showed major nerve damage that caused back and hip pain, and often traveled down to her foot. Susan has been treated at The Pain Center of Arizona by Jeffrey Bucholz, M.D. and Diane Siego, N.P., with injection therapy and medication management. She says with their encouragement and treatment protocols, she has gotten over 50 percent better and has seen a much improved quality of life.

Cruz used to dread any activity that would end up causing her pain, feeling that it wasn’t worth it. After treatment, she is now able to enjoy activities with her husband Rob, and is able to cook and enjoy the little things in life.

Cruz’s recommendation to those who are suffering from chronic pain is to not ignore it. She encourages pain sufferers to tell their doctor, be proactive about seeing a specialist, and do not wait for pain to resolve on its own.

“I get regular massages in addition to my other treatments,” fibromyalgia sufferer Rachel Doyle explains. “I have a massage therapist who works won-ders in a fibro attack, for those days when I’ve gone from being able to take on the world to crying in bed less than twenty-four hours later.”

As a physician dedicated to an inte-grative approach, Siwek is an advocate for the combination of traditional clini-cal therapies with alternative therapies.

“The advantages of an interdisci-plinary approach are second to none,” Siwek says. “For example, a migraine sufferer receiving interdisciplinary care may be treated by a neurologist, a pain management specialist, a behav-ioral therapist, and a nutritionist. The neurologist can determine the cause of the migraines, the pain management specialist can perform minimally inva-sive procedures for pain management, the behavioral therapist can teach the patient exercises for coping with migraines when they occur, and the nutritionist can work with the patient on a preventative diet. The scope of care with an interdisciplinary program can create remarkable results.”

The interdisciplinary approach builds its foundation on integrative medicine and a patient-centered model.

According to the Spring 2011 issue of The Pain Practitioner, “integrative medi-

cine returns to the basics of self — self-responsibility, awareness, and belief.”

The article further states that the physician should become a support system for their patients, helping them identify their needs and the choice that are available to them. Healthcare fa-cilities that practice a patient-centered approach find that outcomes are much improved and the environment is sig-nificantly better for patients and medi-cal staff alike. Increases in staff and patient satisfaction have been seen, along with improved recovery rates postoperatively, decreased mortality rates, and far fewer medication errors. When the focus moves from physician centered care to patient centered care, clearly, everyone benefits.

socIAl IMPAcTSocial stigma can also be a hurdle that a pain patient must clear.

An alarming number of pain suffer-ers have been told by family members, friends, and even treating physicians that their condition is contrived, or not as bad as they make it out to be. There are also individuals that believe pain is simply a part of getting older, and they will only visit their physician if the pain becomes severe, or unbearable. This lack of education is at a detriment to pain patients, as they are not receiving

sNAPsHoT

continued next page >>


the care they need. “Education regarding pain is in desper-

ate need of a cultural transformation,” Siwek says. “Healthcare providers need to make

the commitment toward the education of their patients and the community, and pain patients need to become invested in their treatment process, asking questions and doing indepen-dent research on their condition and available treatments.”

Resources for pain patients include educational websites, including social media and blogs on practice websites. Some pain physicians have begun to cultivate an educational online pres-ence that not only offers education and current news regarding effective pain management but also gives those with pain an online support group.

“The chronic pain epidemic will continue if patients do not feel com-fortable speaking to their provider,” Si-wek says. “Honest conversations about treatment plans and medications must take place, especially if a patient feels uncomfortable taking a certain medi-cation, or has researched an alterna-tive treatment option that they would like to discuss with their doctor.”

Those suffering from pain have a responsibility to themselves to take an active role in their pain manage-ment. Seeking out an interdisciplinary approach is the first step, but continu-ing education on treatments, research, and their condition is vitally important for each patient to ensure the best pain management possible. Patients should never feel uncomfortable asking questions of their treating physician, whether they have questions about their treatment plan or their medications.

“Through understanding how to be my own best advocate, my patient rights, setting expectations, and find-ing inspiration and motivation through my symptoms, I have become the chief

An inspiration to all, Michael Roman lost his life to cancer this past spring, passing away March 28, 2012. Roman was a one-legged racecar driver who fought a memorable battle against chronic pain and the way it can consume a life. More than that, he was an inspiration to everyone he touched.

dark timesRoman experienced a torn meniscus and underwent routine arthroscopic surgery on his knee to repair it. While the surgery may have been routine, the healing process certainly was not, as a staph infection set in following the surgery. Roman then endured 28 weeks of intravenous antibiotics, 12 procedures to remove infected skin, 33 surgeries, and three progressive amputations of his right leg, eventually leading to a full amputation at the hip joint.

As with many amputees, Roman experienced phantom limb pain and subsequently entered into his darkest times, being unable to get out of bed for more than 3 to 5 hours per day, heavily medicated to manage his pain, and unable to participate in the lives of his wife and children. There were times when Roman contemplated suicide because of the depths of his pain and the unrelenting fog of being heavily medicated.

It was only after a physician urged him to try spinal cord stimulation, known as the “pacemaker for pain,” that Roman began to see the light at the end of the tunnel. While his pain was not 100 percent gone, Roman was able to function without heavy doses of medication and began to live an active life again. Roman became a race car driver, broke several land speed records, and became an integral player in the fight against pain.

Sharing a giftRoman frequently worked with wounded veterans and gave educational,

inspirational speeches across the country. He also was integral in the development of the website, www.RaceAgainstPain.com, which offers those with chronic pain a place for community and education. Roman was active in Washington, D.C. and testified in front of a congressional committee to further raise awareness regarding chronic pain and fight against adopting federal rules that would inhibit the development of pain-fighting devices like the spinal cord stimulator, the device that unarguably saved his life.

Roman went on to be a national spokesman for Boston Scientific, the company that developed the spinal cord

stimulator he used. Boston Scientific also partnered with Roman as a sponsor for his race car. Other amazing accomplishments include completing the Los Angeles marathon, carrying the torch in the 2002 Winter Olympics in Salt Lake City, Utah, and being a member of the 2010 U.S. Paralympics Bobsled team.

Roman frequently visited the Phoenix area and was a close friend with much of the medical community. He will be remembered as full of life, vibrant, and a great friend. Roman is remembered having a contagious smile, an energized personality, and as someone who didn’t take life for granted. He had a gift in engaging those around him and continues to be an inspiration to not only those in the pain community, but any who have overcome enormous obstacles to live their lives to the fullest.

sNAPsHoT

don’t Give uP!— Michael Roman

celebrating the life of Michael Roman Chronic pain sufferer inspired many with his

positive approach to living>> continued from previous


of staff of my medical team, and I am now in remission,” Ingle says. “I did not give up or give in, and realized my limits are past the boundaries I had originally placed on myself.”

In addition to the physical symptoms and limitations pain puts on sufferers, there is often a loss of function and decrease in quality of life. Pain puts a strain on relationships with family and friends, can cause depression, and can make it difficult to perform well at work or school. To fight this battle, pain suf-ferers should be explanatory and trans-parent with their family and friends, and set reasonable expectations. Rather than feel guilty about not being able to participate in activities or events because of their condition, chronic pain patients should be open and honest

about their limits. Being reasonable and honest can improve relationships and make life easier for pain patients and their families.

“The pain epidemic is a serious glob-al issue and cannot be taken lightly,” Si-wek says. “Whether a physician, a pain patient, or the loved one of a chronic pain sufferer, the responsibility lies with us all. Physicians must examine their practices and ensure that they are offering their patients several options for effective pain management and are not just masking physical symptoms with powerful medications. Loved ones of chronic pain sufferers should

remain compassionate, ask questions to encourage conversation, and be un-derstanding regarding the limitations chronic pain causes. Lastly, pain suffer-ers should seek out interdisciplinary options, be advocates for themselves, and always take an active part in their care and treatment.”

If nothing else, the care model for patients must be changed across the span of healthcare. A cultural trans-formation must take place before any forward movement can be made, and it is the responsibility of patients and physicians alike to spearhead this transformation.

“this is an issue Where We’re failing aT SoMe level aS providerS wiTh ManageMenT

of pain and educaTion of our paTienTS.” — STeven Siwek, M.d., ceo of freedoM pain hoSpiTal

For leasing information call us at 623-972-1184

or visit www.theplazaco.com

Plaza del Rio Commercial CenterAnthem Medical Plaza

Founded in 1982, Plaza Companies is a full-service real estate firm specializing in the development, construction,

leasing and management of medical office and commercial office properties, technology and bioscience facilities, and senior housing communities.

We are also proud to be the home of two locations of The Pain Center of Arizona, one at Anthem Medical Plaza in Anthem, and the other at Plaza Del Rio Commercial Center in Peoria. The Pain Center of Arizona provides excellent services, and we have enjoyed our partnership with them over the years.

We congratulate The Pain Center of Arizona on the tremendous services they provide to their patients and the community, and support their effort in the fight against chronic pain.

Anthem Medical Plaza

Plaza del Rio Commercial Center

innovations

The latest and greatest in healthcare technology

INNOvATIONS FOR THE HEALTH REvOLUTION4

THE cHAMElEoN BANDAGEWound care is something that costs our nation in excess of $50 billion per year, with the average cost of each wound at approximately $4,000. The Chameleon Bandage aims to cut that cost with a “smart” bandage that changes colors as it heats up, thus indicating

infection. Wounds can often last months due to recurring infections that are not being identified early enough.

With the technology of the Chameleon Bandage, infections will be indicated and thereby treated much sooner.

http://bit.ly/mIdU3T

MIcRoFluIDIc cHIP When 18,000 people died due to the H1N1 pandemic in 2009, it became clear to the medical community that something had to be changed in the diagnostic process of the flu, making it faster and more accurate.

Researchers have produced a microfluidic chip that exceeds the accuracy of the standard flu diagnostic test, is faster to produce results, and is cheaper. Additionally, the chip is disposable, lessening the instances of cross-contamination.

http://cnet.co/GZZUjv

BluETooTH sMART HEART RATE MoNIToRWahoo Fitness has developed the first heart-rate monitor that does not need to be connected directly to a smartphone or other device to collect data. Worn around the chest like other monitoring devices, Wahoo Fitness’ heart-rate monitor transmits the data wirelessly to a smartphone without any wired connectivity or extra hardware devices.

This device is also fully integrated with MapMyFitness, MotionX, Runmeter, RunKeeper, and 321Run to increase the ease of use and capabilities of the monitor.

http://bit.ly/PzTfSE

RED BlooD cEll sENsoRsResearchers have discovered a way to make the body’s own red blood cells a sensor that

could one day be extremely beneficial for diabetics, who must prick their fingers daily to test their

glucose levels. Researchers took a sample of

blood and then placed red blood cells in a solution that would cause them to swell, and open a pore in the cell. The solution, containing a fluorescent dye, would be absorbed into the cell, and then replaced into the patient’s body. When using near-

infrared light, these fluorescent molecules would be able to be picked up by a monitor-ing device. It is the hope of researchers that this monitor-ing method would one day re-place the daily, invasive blood sample gathering of diabetics with a onetime injection.

http://smrt.io/RqtJdLb


the road trip


““


the road trip

DR. PETRA PEPER, PhD., is a behavioral therapy psychologist practicing in the Valley.

[ By Dr. Petra Peper, PhD. ]

the’road’well traveled

SOMETHING HAD TO CHANGE...For years we have listened to the stories of thousands of our patients. We heard a theme of medical care that missed the mark. Our patients told us about a healthcare system that did not support coordinated care nor educate patients about their treatment options. The system fell short of involving patients in making decisions about their medical care. Patients expressed frustration about the lack of communication between their doctors and felt disconnected from their treatment. They told us how emotionally draining it is trying to cope with chronic medical conditions and pain while dealing with a declining quality of life.

We watched our patients struggle with an increasing sense of discouragement as they tried to navigate through this medical system.

We saw the negative impact it had on our patients’ self-image, their relationships with their families, and their outlook on the future. We began to rethink our role in their medical care. We began to rethink our relationship with our patients.

After considering all we learned from our patients, we responded. We developed an approach to medical treatment that makes a patient’s needs, concerns, and goals the priority. It goes beyond treating just physical symptoms and incorporates the context of the patient’s life. It emphasizes the impor-tance of good communication and a collaborative doctor-patient relationship. It simplifies medical treatment by defining it as a journey the patient and medical providers take together. We call it The Road Trip™.

of uncertainty about how effective they will be. is arrival at your destination. Together, using the knowledge and information gained in Phase II, you and your medical navigation team have identified the most effective combination of treatment interventions for your pain symptoms.

GETTING YOU TO YOUR DESTINATION

At Freedom Pain Hospital, our specialty is treating chronic pain. It is our responsibility to provide you with the treatment modali-ties, educational information and emotional support you need to get to your Road Trip destination as quickly and smoothly as possible.

WHAT IS THE ROAD TRIP?

At Freedom Pain Hospital we are com- mitted to making medical care more patient-friendly and less confusing. As your medical treatment providers, we would like to take a Road Trip to wellness with you. On this trip you are the driver. You set the medical destination (the treatment outcomes you expect) and our role is to act as your navigation system.

The Road Trip is made up of three phases that cover the entire treatment experience from meeting your doctor for the first time to arriving at your medical treatment destination.

focuses on planning the trip. Planning involves assessing your pain symptoms, discussing your expectations about treatment with you and gaining a mutual understanding of your goals and objectives.

is driving toward your treatment destination. This phase can be challenging as it involves trying different treatment interventions with some degree

PHASE 1

PHASE 2

PHASE 3

™


GET THE SKINNY

on healthy eating

nutrition



GET THE SKINNY

on healthy eating


Skinny Chicken Parmesan Ingredients:

Directions:


boneless, skinless chicken breastssliced in half lengthwise to make 8

cup whole wheat seasoned breadcrumbscup grated Parmesan cheesetbsp butter, meltedtbsp olive oilcup reduced fat mozzarella cheesecup marinara saucecooking spray

4

3/41/4113/41

Preheat oven to 450°. Spray a large baking sheet lightly with spray.Combine breadcrumbs and parmesan cheese in a bowl. Melt thebutter in another bowl and combine with olive oil. Lightly brush thebutter mixture onto the chicken, then dip into breadcrumb mixture.Place on baking sheet and repeat with the remaining chicken. Lightlyspray a little more cooking oil on top and bake in the oven for 20minutes. Turn chicken over, bake another 5 minutes. Remove fromoven, spoon sauce over chicken and top with shredded cheese. Bake5 more minutes or until cheese is melted.

G ina Homolka is a self-trained home cook who focuses on healthy, light meals using whole ingredients.

Skinnytaste.com was born as a way to turn out healthy and satisfying dishes that don't take loads of preparation time or sacrifice taste. Gina wanted to create meals that would help her lose weight while at the same time get her family excited to come to the dinner table.

Millions of visitors regularly visit Skinny-taste.com, which was recently awarded the 2012 Fitness Magazine Best Healthy Eating Blog, and Babble's Top 100 Mom Blog award.

GINA HOMOLKAFounder, SkinnyTaste.com

Homolka is the brainchild behind Skinnytaste.com, a website born as a way to turn out healthy and satisfying dishes that don’t take loads of preparation time or sacrifice taste.

Skinnytaste.com recipes have been featured on sites such as Glamour.com, Gourmet Live, The Kitchn, Finecook-ing.com, More Magazine, and Country Living, to name a few. Skinnytaste.com was also the winner of the SHAPE Maga-zine Best Healthy Eating Blog 2011 and The Homies: Best Home Cooking Blog for 2011.


MAD MuD RuNNov. 17Four miles of scrambling up, over, around and through a mud-filled obstacle course.MacDonald’s Ranch26540 N. Scottsdale Rd., Scottsdale602-448-0933; madmudrun.com

IRoNMAN ARIzoNANov. 18Some of the best athletes in the country converge on Tempe for in this 7th annual competition. Tempe Beach Parkironman.com/events/ironman/arizona

zoolIGHTsNov. 22 thru Jan. 6Dazzling night-time light-show at The Phoenix Zoo.455 N. Galvin Pkwy, Phoenix602-273-1341; phoenixzoo.org

GlENDAlE GlITTERsNov. 23 thru Jan. 12Over 1 million lights illuminate 16 blocks of Historic Downtown Glendale; also vendors, concerts, carriage rides and more. Murphy Park59th Ave. and Glendale Ave., Glendale623-930-2299; visitglendale.com

eventsMARIPosA MoNARcA-MoNARcH BuTTERFly ExHIBITNov. 1 thru Nov. 25Hundreds of live butterflies in a lush,

walk-thru pavilion.Desert Botanical Garden

1201 N. Galvin Pkwy, Phoenix

480-941-1225; dbg.org

cAVE cREEk BIcyclE FEsTIVAl Nov. 10

Fourth annual bike fest showcases the

scenic Sonoran Desert and supports Cave Creek’s efforts to protect more than 4,000 acres of pristine desert habitat.Frontier Town, 6245 E. Cave Creek Rd., Cave Creek480-495-1119; cavecreekbicyclefestival.com

PHoENIx NATIoNAl VETERANs DAy RuNNov. 11This 2nd annual run includes a 11K and 1-mile charity walk, supporting the men and women of our armed forces. veterans and active-duty discounts. Arizona Capital Complex, 1700 W. Washington St.veteransdayrun.com/run/phoenix

Fitness, Fundraising and Fun Family Events

Nov. 1, 2012 thru Jan. 31, 2013

sportsARIzoNA cARDINAlsHome games: Nov. 25, Dec. 16, Dec. 23University of Phoenix Stadium1 Cardinals Dr., Glendale602-379-0101; azcardinals.com

PHoENIx suNsHome games: Nov. 2, 9, 12, 14, 17, 21, 23; Dec. 6, 9,114, 17, 19, 23 & 26; Jan. 2, 4, 6, 14, 17, 24 & 30US Airways Center201 E. Jefferson St., Phoenix602-379-7900; nba.com/suns

ARIzoNA skIN FouNDATIoN 5k AND FAMIly FuN RuN/wAlkDec. 1Arizona Skin Cancer Foundation is proud to host the First Annual 5K and Family Fun Run/Walk to educate our community about the prevention and treatment of skin cancer. Market Street, DC Ranch4peaksracing.com

JR. suNs wHEElcHAIR BAskETBAll TouRNAMENTDec. 8This free tournament for the junior members of the Banner Wheelchair Suns and its regional counterparts supports school programs that benefit kids with disabilities.DEC Sports and Fitness Center, 5031 E. Washington St.888-889-2185; bannerwheelchairsuns.org or azspinal.org/calendar

FoRT McDowEll FIEsTA Bowl PARADEDec. 29Colorful floats, helium balloons, bands, equestrian units and more.Route begins at Central Avenue and Bethany Home Road; proceeds

south on Central to Camelback Road; East on Camelback to 7th Street; south to Campbell Avenue.480-350-0900; fiestabowl.org

FIEsTA Bowl BAND cHAMPIoNsHIPDec. 30Top high school marching bands from across the country perform.University of Phoenix Stadium1 Cardinals Dr., Glendale480-350-0900; fiestabowl.org

BARRETT-JAcksoN collEcToR cAR AucTIoNFine cars, fine art, fine fashion and fine cuisine.Jan. 13 thru Jan. 20Westworld16601 N. Pima Rd., Scottsdale480-663-6255; barrett-jackson.com

P.F. cHANG’s Rock ‘N’ Roll MARATHoNvarious-length races with live bands along the route.Jan. 20Half-Marathon starts in downtown Tempe; Marathon starts in downtown Phoenix; both finish at ASU’s Sun Devil Stadium in Tempe.800-311-1255; runrocknroll.competitor.com/arizona/event-details

Senior Care | New Moms | Recuperative Care | Continuing Care

(623) 640-0701www.SunCityWestHomeCare.com

SM

Each office is independently owned and operated.

Providing compassionate and affordable home care assistance.

Margaret, with her granddaughter

Lauren, at Disneyland.

Barry, with his granddaughter Maggie.

Nastasha riding on her horse, Speed.

Jennifer, with sister Melissa,

zip lining in Hawaii.

Jonathan, completing a Mud Run.


free to be me

We would love to share your ‘free to be me’ photos. E-mail us a jpeg at a minimum 500K, 300 dpi to: [email protected]. Questions? Call 623-201-1700.

Ken and Barby, Queen Creek, Ariz.

THRIVE-pg38.indd 1 10/30/12 12:57 PM

medical terms

1. aCuTe

Acute defi nes a disease that is either or both

rapid in onset, or short-lived in duration. An

Acute disease usually comes on quickly, but is

also generally resolved in a short time span as

well. A good example of an Acute disease is the

common cold.

2. nP NP stands for Nurse Practitioner, an individual

who has completed graduate level education,

either a Master of Nursing or a Doctor of Nursing

Practice degree and is able to diagnose, treat

patients, and prescribe medication. Nurse

Practitioners often work closely together with

physicians, but are able to function as a patient’s

primary health care provider.

3. BiOPsY A Biopsy is when a sample of tissue is taken for

further examination under a microscope when

abnormalities are suspected. Biopsies are

often taken to check for cancer cells.

4. PCP PCP stands for Primary Care Physician.

This doctor is also known as a family

doctor, and is able to treat patients at

all stages of life, including infancy,

pediatrics, adult, and geriatric care.

5. Pa PA stands for Physician’s Assistant,

a medical professional who works

closely with physicians to diagnose

and treat patients. These individuals

have received graduate level medical

education, and may be found

in hospitals, clinics, and other

healthcare facilities.

6. anTiBiOTiC Penicillin is the most commonly known

Antibiotic, but there are others that are used to

treat bacterial infections. These medications

are most often taken orally, but for serious

infectious diseases, Antibiotics may be

administered intravenously.

7. ePiDeMiC An Epidemic is when new cases of a

specifi c disease in a given population and

given timeframe far exceed historical

expectations.

8. DiagnOsis A Diagnosis is the identifi cation of the

cause, source, or nature of an illness

or condition.

9. CO-PaY Different from a co-insurance,

a Co-Pay generally does

not contribute to any out-of-

pocket costs, and is a portion

of the actual cost of the

medical service. Co-Pays are

determined by the insurance

company.

10. ChrOniC Essentially the opposite

of Acute, Chronic is

indicating a disease,

condition, or symptom

that has lasted beyond

the expected time

of healing.

toP 10the thrive

thrive 10

THRIVE-102212-CS5.5.indd 39 10/29/12 2:47 PM

Free to Hope. Free to Move. Free to Live.

To start your journey to Freedom, call us today at 480.586.2220

Free to hope. Free to move. Free to live.

www.FreedomPainHospital.com

THRIVE-Fall 2012

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