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THE ARIZONA REPUBLIC

IN THIS ISSUE

A SPECIAL PUBLICATION CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING

2 Palliative Care

The latest on the

HEALTHCARE NEWS YOU CAN USE FOR YOUR WHOLE FAMILY

4, 7 Support Groups/Events

8 Blake’s Miracle

Vol. 4, No. 2

February 2014

9 Support For Grandfamilies

Affordable

Care Act

Deadline for enrolling for 2014 coverage is March 31st

BY DEBRA GELBART

ince some of the details and dates of the Affordable Care Act (ACA) have changed since the healthcare.gov website launched in October of 2013, we’ve asked some experts and done some research to help explain what’s new and what’s the same with the law. We’re also revisiting some of the law’s key components.

What’s new

What’s the same

Hardship exemption: If your 2013 individual health insurance plan was cancelled because it didn’t comply with the law, forcing you to consider enrolling in a plan through the Health Insurance Marketplace (via healthcare.gov), you can now get a hardship exemption if you don’t like your options in the Marketplace. The exemption qualifies you for a catastrophic plan (reserved for people under 30 or those with this specific hardship exemption). Source: Enroll America Website: GetCoveredAmerica.org

Adult children: People up to age 26 can stay on their

Pre-Existing Condition Insurance Plan: The Department of Health and Human Services announced in mid-January that about 85,000 people with a history of serious illness who are enrolled in the Pre-Existing Condition Insurance Plan (PCIP) created under the Affordable Care Act will have until March 31, 2014 before they lose that coverage. Originally, PCIP was slated to end in December 2013. This extension is intended to give PCIP enrollees more time to enroll in health plans through state and federal insurance enrollment websites. Source: Kaiser Health News, Kaiser Family Foundation Website: kff.org

parents’ health insurance plan, even if they are eligible for other employer coverage.

Preventive services: Many preventive health services, including mammography, colonoscopy, contraception, some immunizations plus folic acid supplements for pregnant women, are covered with no out-of-pocket expense for the patient. Pre-existing conditions: No one can be denied health insurance because of a pre-existing medical condition.

Medicare ‘donut hole’ shrinking: Although Medicare

recipients enroll for their coverage through a separate website (Medicare.gov) and during a different enrollment period for 2014 (the 2014 Medicare deadline was Dec. 7, 2013), the ACA does have good news for them, too. The so-called ‘donut hole’ for prescription medications, where cost-sharing is diminished when enrollees reach a certain expense threshold, will continue to shrink every year until it goes away entirely in 2020. Until then, however, the donut hole — mandated as part of the Medicare Part D law that took effect in 2006 — continues to affect patients. Continued on page 4 – AFFORDABLE CARE ACT

Patient advocate and ovarian cancer survivor Laurel Pracht believes that Congress should close the Medicare ‘donut hole’ sooner than 2020. “Some patients may be hospitalized due to not being able to afford their drugs.” /Photo RICK D’ELIA

By 2020, the ACA will close the ‘donut hole’ that affects Medicare recipients What it is: The coverage gap known

as the ‘donut hole’ (mandated as part of Medicare Part D in 2006) is the timeframe between when a Medicare enrollee reaches a specified threshold in out-ofpocket prescription medication expenses but before they reach another (higher) specified threshold in out-of-pocket prescription medication expenses. Not everyone will enter the donut hole.

How it works: In 2014, once a Medicare

IMPORTANT UPCOMING DATES FEBRUARY 15, 2014

The last day to sign up for health insurance coverage in order to be covered beginning March 1, 2014.

MARCH 15, 2014

The last day to sign up for health insurance coverage in order to be covered beginning April 1, 2014.

MARCH 31, 2014

The last day to sign up for health insurance coverage to be covered in 2014 and to avoid facing a penalty for not purchasing health insurance.

recipient and his/her plan have spent $2,850 on covered drugs (the combined amount plus the deductible), the recipient enters the coverage gap/donut hole. This amount may change each year.

Continued on page 11 – DONUT HOLE

Pharmacists: An important part of your healthcare team Highly trained medication experts are knowledgeable and accessible BY DEBRA GELBART

ntil now, you may not have considered the value of a relationship with a nearby pharmacist or thought about how much knowledge a pharmacist can offer you. He or she is likely to have a doctorate in pharmacy and may be more familiar with adverse reactions or side effects of medications than some physicians or nurses. “Physicians are the diagnosticians, the experts in physiology,” said Tara Storjohann, Pharm.D., assistant professor of pharmacy practice at Midwestern University College of Pharmacy. “Pharmacists are medication experts.”

Tara Storjohann, Pharm.D., (right), is an assistant professor of pharmacy practice at Midwestern University College of Pharmacy in Glendale. She said that pharmacists have become more interactive in guiding patients about medication, testing and other issues that improve patient care. Here, she is demonstrating a blood glucose monitoring kit to her administrative assistant, Julie Bennett./Photo RICK D’ELIA

First line of defense

“Pharmacists often serve as the first line of defense for patients seeking guidance for routine ailments,” said Stephen Mullenix, R.Ph., senior vice president, public policy and industry relations at the Scottsdale-based National

Council for Prescription Drug Programs. “There are times when it is not until the prescription is picked up that the patient begins asking basic but important questions about the medication. Making sure that patients obtain, understand and take their prescription medicines is an important part of treatment.” A pharmacist is typically more accessible than other health professionals and can answer questions you may have about non-prescription medications, treatments or supplements as well as prescription drugs, Storjohann said.

Questions to ask

To make sure you can be made aware of any and all potential drug interactions, purchase all prescription medications from a single pharmacy or networked pharmacy chain, Storjohann advised. To begin establishing a relationship with a particular pharmacist, Continued on page 10 – PHARMACISTS

2 | LIVING WELL A-Z | WEDNESDAY, February 5, 2014

Providing beneﬁts for patients, families

BY GREMLYN BRADLEY-WADDELL

hink the terms palliative care and hospice care are interchangeable? Think again. “All hospice patients get palliative care. But not all palliative care patients get hospice,” said David Butler, M.D., executive medical director of Hospice of the Valley, a not-forprofit organization that provides hospice and palliative care se services. Palliative care — a relatively new certified medical specialty that focuses on relieving suffering — is an adjunct to a patient’s overall treatment plan and is given earlier in the spectrum of life-threatening illnesses. Hospice offers more intense services and applies to the patient who is not seeking curative care. More and more Valley hospitals and hospices are now offering palliative care programs.

“ It’s what we all want, to be as comfortable as possible, whether we’re pursuing curative treatment or at the end-of-life.” — David Butler, M.D., executive medical director, Hospice of the Valley

HOSPICE OF THE VALLEY/MICHAEL GING

live, that’s not always the case, said Steven P. Sardo, M.D., medical executive for palliative care and medical services for Cigna Medical Group in Phoenix. Some individuals, for instance, may receive palliative care for years, and even on an off-and-on-again basis. “Many times, patients are able to dis-enroll temporarily,” he said. Palliative care has other benefits, too, said Rama Kunkle, D.O., medical director for John C. Lincoln North Mountain Hospital’s new palliative care program, not the least of which is that “it increases patient satisfaction and hopefully will decrease unnecessary testing and expensive hospitalization.”

‘A relationship of trust’

While patients often need assistance with medicalrelated concerns, most issues actually are social in nature, said Donna Nolde, R.N., manager of the 10-year-old palliative care program at Chandler Regional and Mercy Gilbert medical centers in the East Valley. “We have found that once symptoms are managed, the issues that need to be resolved are practical in nature,” she said. “Patients need help applying for Meals on Wheels, they need rides to physician’s offices and assistance shopping for food. Many patients don’t have family here to help.” Jeanette Boohene, M.D., medical director of palliative care at St. Joseph’s Hospital and Medical Center in Phoenix, said palliative care professionals also help patients and their families deal with the emotional burdens they carry. “We might find out other things that need to be addressed,” she said, “so the earlier we get involved, the better it is for the patients and for us. We build a relationship of trust.”

Engrid Toorock, a nurse with Arizona Palliative Home Care, visits with Scottsdale patient Charles “Chris” Christy.

‘We’re their quarterback’

Lee Ann Black, M.S.W., vice president of Arizona Palliative Home Care, a program of Hospice of the Valley, said it’s important to understand that hospice care serves patients of any age who are at a late stage in their disease and prefer symptom control over curative care. In contrast, she said, palliative care fills a gap for those who could use help with managing their illness or condition but are not in immediate need of hospice care. “We empower the patient to be able to manage their care on their own,” Black said, noting that programs offered by various providers may be available as an inpatient, outpatient or even in-home service. “We’re their quarterback, and we help them navigate the healthcare system.”

Numerous benefits

Although it’s typical for those receiving palliative care to have just a few years to

Hallmarks of palliative care • For patients of any age with a serious, life-limiting illness • Designed to soothe and relieve symptoms and improve quality of life not just for the patient but for the patient’s family as well • Includes a combination of different kinds of assistance; for example, a nurse who helps a patient organize medications to avoid adverse drug reactions or a social worker who makes sure a patient is getting adequate nutrition and is making follow-up visits to the doctor

Palliative and hospice care help man make ‘a heck of a recovery’ A quadruple bypass, arthritis, bleeding ulcers and other ailments had left 85-year-old Ray Chouinard, who also happens to be Donna Nolde’s father, unable to care for himself at his former home in New York. He moved to Arizona to live with Nolde, who enrolled her father in a palliative care program; later, they transitioned him to hospice. The changes he’s experienced since have been so dramatic that they’re getting ready to change his care back to palliative care. Nolde said her father now goes to morning Mass with assistance from a caregiver and is even writing his own checks again now that his arthritic issues have been resolved. “Just getting arthritis under control makes a big difference in a person’s quality of life,” Nolde said. “When an individual can move and function more independently without pain, life is just better. My idealistic vision is that someday everyone will know what palliative care is and our elderly will get the care they deserve.” Chouinard’s already ditched his wheelchair for a walker and is looking forward to dumping the walker for a cane. “I’m making a heck of a great recovery,” he said. “I really am.” 85-year old Ray Chouinard lights up whenever he sees his great-grandchildren

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Call 1-855-298-4379 (TTY 711) now to speak with a helpful sales representative today! We’re available 7 days a week, 8 a.m. – 8 p.m. *Certain enrollment restrictions apply. **Most recent 2014 rating from www.Medicare.gov. Medicare evaluates plans based on a 5- star rating system. Star Ratings are calculated each year and may change from one year to the next. ***You must continue to pay your Medicare part B premium. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, copays and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or copays may change on January 1 of each year. “Cigna,” and the “Tree of Life”logo are registered service marks of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries, including Cigna HealthCare of Arizona, Inc. (CHC AZ), and not by Cigna Corporation. Cigna Medicare Select Plus Rx HMO plans are offered by CHC AZ under a contract with Medicare. As of the date of publication, Cigna Medicare Select and Cigna Medicare Select Plus Rx plans are offered to employers and individuals in Maricopa County and certain zip codes within Apache Junction and Queen Creek, Arizona only. Enrollment in Cigna Medicare Select Plus Rx depends on contract renewal. H0354_022014 Accepted © 2014 Cigna AR-0008154804-01

DONNA NOLDE

Palliative care

WEDNESDAY, February 5, 2014 | LIVING WELL A-Z | 3

Flu shots: It’s not too late Arizona’s ﬂu season peaks in February, lingers through April BY MEGHANN FINN SEPULVEDA

What should a hospital offer to take care of your heart? A safety net?

ith more than two months to go, 2,424 flu cases* have been reported in Arizona so far this season, according to the Arizona Department of Health Services. The bad news is that the contagious rrespiratory illness ranges from mild to severe and has the potential to cause complications that may result in hospitalization and even death. However, the good news is that there’s still time to get a flu vaccination if you haven’t already done so.

ways to stop the spread of flu

1 Get vaccinated 2 Avoid close contact with people who are sick 3 Stay home if you are sick 4 Cover your mouth and nose when sneezing or coughing 5 Wash your hands frequently 6 Don’t touch your eyes, mouth or nose 7 Maintain a healthy lifestyle — Source: Centers for Disease Control and Prevention, cdc.gov

“Current recommendations suggest that everyone age six months and older should receive a flu vaccination unless medically contraindicated,” said Robert Fromm, M.D., chief medical officer, Maricopa Integrated Health System (MIHS.org).

High-risk categories

According to the Centers for Disease Control and Prevention, the majority of people who are diagnosed with the flu will not need medical intervention, antiviral drugs or experience any complications, and will likely recover in two weeks.

However, there are people who are considered to be at high-risk. “Children younger than age five, adults older than 50, pregnant women, people with existing medical conditions such as asthma and diabetes, and American Indians and Alaskan natives, are just a few who fall into the high-risk category,” Fromm said.

A beacon in the night? Men and women with skills that are off the charts?

Finding a flu shot

To find a flu shot location, ask your primary care physician, contact a local medical clinic or pharmacy, or log on to StopTheSpreadAZ.org, which is a partnership between the Arizona Department of Health Services and the Maricopa County Department of Public Health (Maricopa.gov/PublicHealth). You can also call the Community Information and Referral Services line at 211 (yes, just 211). *Number of cases as of Jan. 22, 2014

Who should not be vaccinated

What about all of the above? Plus, the area’s top technology.

Hearts need to be taken care of.

Some people should not be vaccinated without first consulting a physician. This includes:

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4 | LIVING WELL A-Z | WEDNESDAY, February 5, 2014

February Take advantage of over 100 opportunities for you to meet others with similar issues and learn more about various aspects of your health – from A to Z. All groups and events are believed, but not guaranteed, to be free unless otherwise stated. Every effort has been made to verify accuracy, but please call before attending to confirm details.

TOTAL HIP REPLACEMENT SURGERY Feb. 20, 6–7:30 p.m. By Scottsdale Healthcare at Scottsdale Orthopedic Institute 20401 N. 73 St., Scottsdale Register: 480-882-4636; shc.org/events

WELLNESS

NUTRITION CLASS Feb. 24, 1–2 p.m. Humana Guidance Center 5943 E. McKellips Rd., Mesa 480-325-4707

WALK-ERCIZE CLASS Various dates, 9–9:45 a.m. Humana Guidance Center 5943 E. McKellips Rd., Mesa 480-325-4707 SHINGLES, MRSA & FLU PROTECTION Feb. 5, 7–8 p.m. By Scottsdale Healthcare at Barnes & Noble 10500 N. 90 St., Scottsdale Register: 480-882-4636; shc.org/events WINE, SALT, CHOCOLATE & YOUR HEART Feb. 6, noon Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) CANCER SCREENING FOR WOMEN: WHAT YOU NEED TO KNOW Feb. 6, 6:30–7:30 p.m. By Midwestern University at Juniper Library 1825 W. Union Hills Dr., Phoenix 602-262-4636 HEART-HEALTHY DAY Feb. 8, 8–11 a.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) MINIMALLY INVASIVE SPINE SURGERY Feb. 10, 6–7:30 p.m. By Scottsdale Healthcare at Scottsdale Orthopedic Institute 20401 N. 73 St., Scottsdale Register: 480-882-4636; shc.org/events ALL ABOUT YOUR HEART Feb. 11, 1–2 p.m. By Scottsdale Healthcare at Appaloosa Library 7377 E. Silverstone Dr., Scottsdale Register: 480-882-4636; shc.org/events HEALTHCARE REFORM SEMINAR Feb. 12, 10:30 a.m.–12:30 p.m. Humana Guidance Center 5943 E. McKellips Rd., Mesa 480-325-4707 HEART-HEALTHY COOKING Feb. 12, 6–7:30 p.m. Virginia G. Piper Cancer Center 10460 N. 92 St., Scottsdale Register: 480-882-4636; shc.org/events SKIN CANCER PREVENTION Feb. 12, 6–7:30 p.m. Banner Gateway 1900 N. Higley Road, Gilbert 602-230-2273 EYE HEALTH Feb. 13, 1–2 p.m. By Scottsdale Healthcare at Civic Center Auditorium 3839 N. Drinkwater Blvd., Scottsdale Register: 480-882-4636; shc.org/events CANCER SCREENING FOR WOMEN: WHAT YOU NEED TO KNOW Feb. 18, 6:30–7:30 p.m. By Midwestern University at Foothills Library 19055 N. 57 Ave., Glendale 623-930-3868 HEART-HEALTHY NUTRITION Feb. 19, 10:30–11:30 a.m. Humana Guidance Center 5943 E. McKellips Rd., Mesa 480-325-4707 BACK PAIN Feb. 19, noon Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) FOOT HEALTH Feb. 19, 7–8 p.m. By Scottsdale Healthcare at Barnes & Noble 10500 N. 90 St., Scottsdale Register: 480-882-4636; shc.org/events BLADDER HEALTH & INCONTINENCE Feb. 20, 1–2 p.m. By Scottsdale Healthcare at Desert Foothills Library 38443 N. Schoolhouse Rd., Cave Creek Register: 480-882-4636; shc.org/events

A HEALTHIER YOU, NATURALLY Feb. 26, 10 a.m. Sun City Library 16828 N. 99 Ave., Sun City Info: 480-289-9395 or 602-652-3000 INNOVATIVE TREATMENTS FOR KNEE OSTEOARTHRITIS Feb. 26, 6 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) HOT TOPICS IN UROLOGY Feb. 27, 1–2 p.m. By Scottsdale Healthcare at Civic Center Auditorium 3839 N. Drinkwater Blvd., Scottsdale Register: 480-882-4636; shc.org/events BENEVILLA FARMERS MARKET Feb. 28, 4–7 p.m. Benevilla 16752 N. Greasewood St., Surprise 623-584-4999; Benevilla.org

CAREGIVERS SUPPORT GROUPS (DUET) Various dates, times & locations 602-274-5022; DuetAZ.org ONLINE NETWORKING (DUET) Feb. 8, 9–10:30 a.m. Register: DuetAZ.org (Events tab) 602-274-5022 SUPPORT GROUP Feb. 10 St. Joseph’s Outpatient Rehab 114 W. Thomas Rd., Phoenix Call for time: 602-406-6688 SUPPORT GROUP Feb. 12, 2:30 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) SUPPORT GROUP Feb. 17, 9–11 a.m. Birt’s Bistro 16752 N. Greasewood St., Surprise 623-584-4999; Benevilla.org HOW TO BE A CANCER CAREGIVER Feb. 22, 8 a.m.–1 p.m. By AZ Myeloma Network Franciscan Renewal Center 5802 E. Lincoln Dr., Scottsdale 623-466-6246; AZMyelomaNetwork.org

GRIEF GRIEF SUPPORT Various dates, times & locations Hospice of the Valley 602-636-5390; hov.org/grief-support-groups GRIEF SUPPORT Feb. 6 & 20 St. Joseph’s 350 W. Thomas Rd., Phoenix Call for time: 602-406-3275 LIVING WITH LOSS Feb. 11 & 25, 1–2:30 p.m. Cancer Support Community AZ* 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@cscaz.org GRIEF BEFORE LOSS Feb. 26, 10–11 a.m. By Benevilla at Birt’s Bistro 16752 N. Greasewood St., Surprise 623-584-4999; Benevilla.org

PAIN CHRONIC PAIN ANONYMOUS Feb. 11, 18 & 25, 3:30–4:30 p.m. Temple Chai Shalom Center House 4635 E. Marilyn Rd., Phoenix chronicpainanonymous.org; cpa-az@cox.net

HEART/STROKE HEART DISEASE Feb. 11, 6–7 p.m. John C. Lincoln Medical Office Bldg 19841 N. 27 Ave., Phoenix Register: 623-434-6265; JCLheartdisease.eventbrite.com

THINKSTOCK

MEDICATION CHECKS Call for personal appointment St. Luke’s, 1800 E. Van Buren St., Phoenix Tempe St. Luke’s, 1500 S. Mill Ave., Tempe Register: 877-351-WELL (9355)

Feb. 26 Community Health Forum

Please call to conﬁrm reservations and cost (if any).

Feb. 5, March 5, April 2, May 14 UA Mini-Medical School WHAT: Experience a glimpse of what med students are learning, from the latest in transplant technology to simulation, wearable tech and smartphone apps. WHERE: UA College of Medicine-Phoenix, 600 E. Van Buren St., Phoenix WHEN: 5:30–7 p.m. PARTICIPANTS: For highschoolers to retirees; can sign up for one or more sessions PRESENTED BY: University of Arizona College of Medicine COST: Free (light dinner available for purchase) INFO/REGISTER: phoenixmed. arizona.edu/mini-med

Feb. 7 Wear Red For Success WHAT: Info about women’s heart health, expert lectures, screenings and heart-healthy food samples. WHERE: Banner Boswell, 13180 N. 103 Dr., Sun City WHEN: 8–11 a.m. COST: Free INFO: 602-230-2273

Feb. 12 Family Relationship Checkup (Webinar) WHAT: Learn techniques for communication and coping with day-to-day struggles. WHERE: Online webinar WHEN: Noon–12:30 p.m. PRESENTED BY: DrugFreeAZ.org COST: Free INFO/REGISTER: DrugFreeAZ.org

HEART HEALTH SEMINAR Feb. 12, 9–10 a.m. Humana Guidance Center 5943 E. McKellips Rd., Mesa 480-325-4707 STROKE SURVIVOR Feb. 13, 2:30–4 p.m. Chandler Regional 1875 W. Frye Rd., Chandler 877-728-5414 HEART HEALTH Feb. 17, 10–11 a.m. Humana Guidance Center 5943 E. McKellips Rd., Mesa 480-325-4707 STROKE SUPPORT GROUP Feb. 19, 1 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) ATRIAL FIBRILLATION Feb. 26, 6–7 p.m. Cowden Center at John C. Lincoln 9202 N. Second St., Phoenix Register: 623-434-6265; JCLA-fib.eventbrite.com

Feb. 13 Coffee, Chocolate, Wine & Your Heart

Feb. 18 & Feb. 25 Journey of Dementia Seminar

WHAT: Learn why heart disease is the number one killer of women in the U.S., plus get tips (and some samples) on wine and chocolate from the Sassy Sommelier. WHERE: Scottsdale Healthcare Shea, 9003 E. Shea Blvd., Scottsdale WHEN: 6–7:30 p.m. COST: Free INFO/REGISTER: 480-882-4636; shc.org/events

WHAT: Learn how to use ways other than talking to connect with people with dementia. WHEN/WHERE: Feb. 18, 10:30–11:30 a.m. Scottsdale Public Library 10101 N. 90 St., Scottsdale Feb. 25, 10–11 a.m. Sun City West Foundation 14465 RH Johnson Blvd., Sun City PARTICIPANTS: For family caregivers of people with dementia PRESENTED BY: Hospice of the Valley COST: Free INFO/REGISTER: 602-636-5391; events5@hov.org

Feb. 14 Guardianship Clinic WHAT: Learn the procedures for becoming legal guardian of grandchildren. Children’s Law Center will help with paperwork. WHERE: 555 W. Glendale Ave., Phoenix WHEN: 3–5 p.m. PRESENTED BY: Duet COST: Free INFO/REGISTER: 602-274-5022, ext. 31

Feb. 15 All-Star Conference for Parkinson’s WHAT: Multiple resources including movement disorder specialists and an overview of leading research. Keynote speaker: Former MLB pitcher Ben Petrick, who was diagnosed with Parkinson’s during his pitching career. WHERE: Paradise Valley Community College, 18401 N. 32 St., Phoenix WHEN: 8 a.m.–3 p.m. PARTICIPANTS: For patients and caregivers PRESENTED BY: Baehr Challenge for Parkinson’s Research COST: Free INFO/REGISTER: 480-215-6192; BaehrChallenge.com

DIABETES TAKING CONTROL OF DIABETES Various dates, 6–7 p.m. Phoenix Baptist Hospital 2040 W. Bethany Home Rd., Phoenix 602-841-5505; pastoralcareaz.org DIABETES SUPPORT GROUP Feb. 6 & March 6, 7–8 p.m. The Nutrition Professionals 2158 N. Gilbert Rd., Bldg 2, Mesa Register: 480-216-1635; Nicole@nutritionpro.net DIABETES HEALTH MANAGEMENT Feb. 10, 10–11 a.m. Humana Guidance Center 5943 E. McKellips Rd., Mesa 480-325-4707 DIABETES SUPPORT GROUP Feb. 10, 3 p.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355)

Feb. 22 Advocacy & Special Needs Workshop WHAT: Learn how to advocate on behalf of your grandchild(ren). WHERE: Christ Evangelical Church, 918 S. Litchfield Rd., Goodyear WHEN: 10 a.m.–1 p.m. PRESENTED BY: Duet COST: Free; includes lunch and childcare with advance notice INFO/REGISTER: By Feb. 14. 602-274-5022, ext. 28

Feb. 22 Students Supporting Brain Tumor Research Walk-A-Thon WHAT: Proceeds benefit Barrow Neurological Institute, Phoenix Children’s Hospital, National Brain Tumor Society, TGen and Steele Children´s Research Center in Tucson. WHERE: Saguaro High School, 6250 N. 82 St., Scottsdale WHEN: Noon–3 p.m. COST: $20 pre-registration; $25 at the gate (student discounts apply) INFO/REGISTER: 888-772-8729; ssbtr.org

WHAT: Meet county leaders, participate in wellness activities and listen to presentations about health organizations. WHERE: Disability Empowerment Center, 5025 E. Washington St., Phoenix WHEN: 3–6 p.m. PRESENTED BY: Mercy Maricopa COST: Free INFO: MercyMaricopa.org

Feb. 27 Lewy Body Dementia WHAT: Helen and James Whitworth, authors of A Caregiver’s Guide to Lewy Body Dementia, will discuss stress management. WHERE: Arbor Rose Senior Care, 6033 E. Arbor Ave., Mesa WHEN: 1–2:30 p.m. COST: Free INFO/REGISTER: 480-641-2531

March 1 Community Health Fair WHAT: Information on programs and services plus screenings for glucose, blood pressure, pregnancy, height and weight. WHERE: Sunnyslope Family Health Center (part of the Maricopa Integrated Health System/MIHS), 934 W. Hatcher Rd., Phoenix WHEN: 9 a.m.–noon COST: Free INFO: MIHS.org

March 9–12 Children’s Neuroscience WHAT: Neurological issues in children and adolescents. WHERE: Ritz-Carlton, 2401 E. Camelback Rd., Phoenix PARTICIPANTS: For healthcare professionals PRESENTED BY: Phoenix Children’s Hospital COST: Fees range from $55–$395; see registration site for details INFO/REGISTER: 602-933-0923; phoenixchildrens.com/cns2014

Through March 14 Heart-Health Screening WHAT: Blood pressure, triglycerides, BMI and more. Learn how to lower your risk of heart problems. WHERE: Scottsdale Healthcare Shea, 9003 E. Shea Blvd., Scottsdale WHEN: 8–11:45 a.m. COST: Free INFO/REGISTER: 480-882-4636; LowerYourHeartRisk.org

DIABETES PUMPERS GROUP Feb. 18, 7–8 p.m. By Mercy Gilbert at Rome Towers 1760 E. Pecos Rd., Gilbert 877-728-3535

PLANNING AHEAD FOR CAREGIVERS Feb. 10, 10 a.m.–noon Banner Alzheimer’s Institute 901 E. Willetta St., Phoenix Register: 602-839-6850

ALZHEIMER’S/ DEMENTIA

CAREGIVER SUPPORT GROUP Feb. 10, 1:30–3 p.m. By Tempe St. Luke’s at Pyle Adult Recreation Center 655 E. Southern Ave., Tempe Register: 877-351-WELL (9355)

AS DEMENTIA PROGRESSES: NEXT STEPS FOR CAREGIVERS Feb. 6, 12:30–2 p.m. Banner Alzheimer’s Institute 901 E. Willetta St., Phoenix Register: 602-839-6850 ALZHEIMER’S & MEMORY SUPPORT Feb. 7, 9–11 a.m. By Benevilla at Birt’s Bistro 16752 N. Greasewood St., Surprise 623-584-4999; Benevilla.org LEWY BODY DEMENTIA & RELATED CONDITIONS Feb. 7, 12:30–2 p.m. Banner Alzheimer’s Institute 901 E. Willetta St., Phoenix Info: 602-839-6850

ALZHEIMER’S & MEMORY SUPPORT Feb. 11, 18 & 25, 10 a.m.–noon By Benevilla at Faith Presbyterian 16000 N. Del Webb Blvd., Sun City 623-584-4999; Benevilla.org ALZHEIMER’S PREVENTION DIET WITH DR. MARWAN SABBAGH Feb. 14, 10:30 a.m.–noon Banner Sun Health Research Institute 10515 W. Santa Fe Dr., Sun City Register: 602-230-CARE *The Wellness Community–Arizona is now Cancer Support Community Arizona Calendar of Events continued on page 7

Continued from cover AFFORDABLE CARE ACT

Penalties

Penalties for non-compliance with the law are still the same. If you do not qualify for a hardship exemption and you choose not to have health insurance in 2014, you’ll have to pay a federal penalty. For 2014, that translates to $95 per adult, $47.50 per child (maximum of $285 per family) or 1 percent of annual household income whichever is greater, said Cheryl O’Donnell, Arizona state director for Enroll America (GetCoveredAmerica.org). By 2016, that penalty could equal as much as 2.5 percent of your annual household income.

Financial assistance

“The most important thing we try to get across to people when we go out in the community is that financial assistance is available to lowincome households and to middle-income households and that shopping for health insurance on the healthcare.gov website does not at all obligate you to purchase health insurance from that site,” O’Donnell said. Just by browsing the website, she added, you can find out if you’re eligible for an advanced premium tax credit (subsidy) or whether you qualify for AHCCCS, Arizona’s Medicaid program, which was expanded last October.

Subsidies

The 2013 federal poverty guidelines are used to compute eligibility for a subsidy. If your household income is 400 percent of the federal poverty level or less (a maximum of $62,040 yearly for a household of two people or $94,200 for a family of four), you’re eligible for a subsidy. If you qualify, the maximum premium you would have to pay before receiving help through a subsidy is 9.5 percent of your annual income, according to the Kaiser Family Foundation (kff.org).

To access a recorded listing of places where you can go for help and information related to the Affordable Care Act, call the Community Information and Referral Services hotline at 211 (yes, just 211). Or, you can text LOCATOR to 877877.

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6 | LIVING WELL A-Z | WEDNESDAY, February 5, 2014

Sprouted grain breads

A healthy choice BY ALISON STANTON

You are what you eat Nutrition that helps your body fend off cancer and other diseases BY ELISE RILEY

ho knew?

The right diet can not only keep you slim and trim, but can also help to fend off one of our biggest enemies: cancer. “While we haven’t yet targeted specific f foods to fight specific cancers, we know t that a healthy diet rich in antioxidants and phytochemicals is helpful,” said Debra Kohl, MS, RD, CNSC, a clinical nutrition specialist with Arizona Oncology in Phoenix.

Antioxidants important

Some of the best chemicals with the potential for fighting cancer are antioxidants, which help purge harmful cells from the body. Think of it this way: if your body was a nightclub, the antioxidants would be the bouncer. Antioxidants and phytochemicals are commonly found in fruits and vegetables. Berries — strawberries, blueberries, blackberries and more — are “crammed with antioxidants,” Kohl said, as are cruciferous vegetables, such as broccoli, cauliflower and Brussels sprouts. Green tea is also antioxidant-rich.

Rainbow of colors

The key to getting the most out of these foods isn’t focusing on just one. Instead, it’s about introducing many different phytochemicals through a variety of foods. Christi Kirk, RD, CSO, a board-certified specialist in oncology nutrition with

The James M. Cox Center for Cancer Prevention and Integrative Oncology at the Banner MD Anderson Cancer Center in Gilbert, recommends making vegetable and fruit salads with multiple ingredients — a rainbow of colors. She also suggests eating plant-based proteins such as quinoa or lentils, which can further boost the immune system.

Think of it this way: if your body was a nightclub, the antioxidants would be the bouncer. Helpful for anyone

Regardless of a person’s health, phytochemicals and antioxidants are helpful for any diet. They are particularly important, however, for someone who is undergoing or recovering from cancer treatment. “Those foods are helpful when we’re talking about people who are at high risk for cancer, but they’re also extremely helpful for someone who is in treatment or survivorship,” Kirk said, adding that a plant-based diet shouldn’t be confused with being vegetarian or vegan. “It’s emphasizing those plants that have phytochemicals, which can help prevent disease — in this case, cancer.”

healthy-eating tips and tricks

Our experts provided these tips for integrating cancer-fighting phytochemicals and antioxidants into your daily diet:

1 Think about portions: Two-thirds of your meals should be plant-based (fruits and veggies). Reserve one-third for lean animal protein. 2 Talk to your doc: If you’re at risk of cancer or undergoing treatment, ask your doctor about your diet. An appointment with a nutritionist could help. 3 Avoid fads: Fad diets come by the dozens but often forget the basics of nutrition. Avoid anything that advertises a ‘miracle’ or ‘cure’. 4 Think about color: Make colorful salads with different types of lettuce and vegetables. Eat fruit salads with multiple berries. You’ll glean all the benefits of different phytochemicals that way. 5 Read up: The American Institute for Cancer Research (aicr.org), American Cancer Society (cancer.org), and the Academy of Nutrition and Dietetics (eatright.org) all have websites with recipes and research on cancer-fighting foods.

prouted grain breads use seeds that straddle the line between a seed and a plant, said Janet Little, director of nutrition for Sprouts Farmers Market. “Grains are seeds that can become a plant, given the right temperature and moisture,” she said. “The germination process breaks down the starches and the seed begins to sprout. Once sprouting occurs, the grain is at its highest nutritional potential.”

Breaks down starches

The germination process increases the grains’ digestibility by breaking down starches into simple sugars so the body can easily digest them, Little said, adding that this sprouting process also increases the protein profile — especially the amino acid lysine — and boosts the bioavailability of vitamins, particularly vitamin C. In addition, the sprouting process increases other desirable minerals such as calcium, magnesium, iron, copper and zinc.

Packs more fiber

Little said that sprouted breads are free of refined carbohydrates, pack more fiber than most white or wheat breads, and are especially healthful, “because they can provide a complete set of amino acids — the building blocks of protein — making them a great option for those on a plant-based diet.”

Look for Livingwell a-z on the first Wednesday of each month! Each month, we bring you local health information you can use to keep you and your family living well. From A to Z, we tackle a broad range of health issues and offer you a wealth of resources where you can find more specific information. This publication is produced by Republic Media Custom Publishing. For questions concerning any content included in this publication please contact: Editor Paula Hubbs Cohen, Paula.Cohen@cox.net or call 602-444-8658. A division of The Arizona Republic. 200 E. Van Buren St., Phoenix, AZ 85004

General Manager: CAMI KAISER, ckaiser@republicmedia.com

Contributing Editor: JIM WILLIAMS, jlwilliams@republicmedia.com

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Editor: PAULA HUBBS COHEN, Paula.Cohen@cox.net

Design: LISA QUIRIN, lisa_q@me.com Editorial Coordinator: NICK KOSTENKO Advertising: RHONDA PRINGLE, 602-444-4929, rpringle@republicmedia.com. For general advertising inquiries, contact Republic Media at 602-444-8000.

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WEDNESDAY, February 5, 2014 | LIVING WELL A-Z | 7

February Calendar of Events LUNG CANCER Feb. 8, 1–2:30 p.m. Cancer Support Community AZ* 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@cscaz.org

FOR CAREGIVERS: AFTER THE DIAGNOSIS Feb. 18, 10–11:30 a.m. Banner Alzheimer’s Institute 901 E. Willetta St., Phoenix Register: 602-839-6850

SURVIVING & THRIVING Feb. 11 & 25, 1–2:30 p.m. Cancer Support Community AZ* 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@cscaz.org

ALZHEIMER’S CAREGIVERS Feb. 18, 12:30–2 p.m. Duet 555 W. Glendale Ave., Phoenix 602-274-5022; DuetAZ.org BRAIN ACTIVITIES FOR PEOPLE WITH DEMENTIA Feb. 19, 12:30–2 p.m. Banner Alzheimer’s Institute 901 E. Willetta St., Phoenix Register: 602-839-6850 FREE MEMORY SCREENING Feb. 21, 9 a.m.–1 p.m. Banner Alzheimer’s Institute 901 E. Willetta St., Phoenix Register: 602-230-CARE

BREAST CANCER BOSOM BUDDIES SUPPORT GROUPS Various dates, times & locations Ahwatukee/Chandler: 480-893-8900 East Valley: 480-969-4119 Northwest Valley: 623-236-6616 Scottsdale: 623-236-6616 West Valley: 623-979-4279 YOGA FOR RECOVERY Feb. 5, 12, 19 & 26, 6–7:30 p.m. John C. Lincoln 19841 N. 27 Ave., Phoenix 602-780-4673; bhrc@jcl.com YOUNG SURVIVOR GROUP Feb. 11, 6–8 p.m. John C. Lincoln 19646 N. 27 Ave., Phoenix 602-780-4673; bhrc@jcl.com LEARN & SUPPORT Feb. 13, 6–8 p.m. John C. Lincoln 19646 N. 27 Ave., Phoenix 602-780-4673; bhrc@jcl.com BREAST BUDS SUPPORT GROUP Feb. 15, 11 a.m.–1 p.m. MidFirst Bank Conference Room 6508 W. Bell Rd., Glendale 480-657-0500; BreastBuds.org TRIPLE NEGATIVE Feb. 26, 6–7:30 p.m. By Cancer Support Community AZ* at Banner Good Samaritan 1111 E. McDowell Rd., Phoenix Register: 602-712-1006; rsvp@cscaz.org

CANCER SUPPORT

NON-HODGKIN’S LYMPHOMA Feb. 13, 6–8 p.m. Virginia G. Piper Cancer Center 10460 N. 92 St., Scottsdale Register: 480-882-4636; shc.org/events COLORECTAL CANCER Feb. 15, 10–11:30 a.m. Cancer Support Community AZ* 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@cscaz.org OVARIAN CANCER Feb. 15, 10–11:30 a.m. Cancer Support Community AZ* 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@cscaz.org ESOPHAGEAL CANCER Feb. 20, 6–7:30 p.m. By Cancer Support Community AZ* at Banner Good Samaritan 1111 E. McDowell Rd., Phoenix Register: 602-712-1006; rsvp@cscaz.org ORAL, HEAD & NECK CANCER Feb. 20, 6:30–8 p.m. Virginia G. Piper Cancer Center 10460 N. 92 St., Scottsdale 602-439-1192 SPANISH CANCER SUPPORT Feb. 24, 6–7:30 p.m. Cancer Support Community AZ* 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@cscaz.org LIVING WITH LYMPHEDEMA Feb. 24, 6:30–8:30 p.m. Virginia G. Piper Cancer Center 10460 N. 92 St., Scottsdale Register: 480-882-4636; shc.org/events KIDSUPPORT (AGES 7-12) Feb. 25, 6–7:30 p.m. By Cancer Support Community AZ* at HEALing House 4458 E. Sharon Dr., Phoenix Register: 602-712-1006; rsvp@cscaz.org

PARKINSON’S DANCE, EXERCISE, YOGA, ART, TAI CHI & POLE-WALKING Various dates, times & locations By the Muhammad Ali Parkinson Center Register: 602-406-6903 ART, SINGING & EXERCISE (SPANISH) Various dates, times & locations By the Muhammad Ali Parkinson Center Register: 602-406-2453

MULTIPLE MYELOMA Feb. 6, 10–11:30 a.m. Cancer Support Community AZ* 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@cscaz.org

FOR PATIENTS & CAREGIVERS (INTRO) Feb. 5, 12, 19 & 26, 10–noon By the Muhammad Ali Parkinson Center at King of Glory Lutheran Church 2085 E. Southern Ave., Tempe 602-406-6903

PROSTATE CANCER Feb. 6, 6–7:30 p.m. Cancer Support Community AZ* 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@cscaz.org

SUPPORT GROUP Feb. 6, 13, 20 & 27, 10–11 a.m. Muhammad Ali Parkinson Center 240 W. Thomas Rd., Phoenix 602-406-4931

LYMPHOMA Feb. 8, 10–11:30 a.m. Cancer Support Community AZ* 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@cscaz.org

FOR PATIENTS & CAREGIVERS (IN-DEPTH) Feb. 10, 17 & 24, 1–3 p.m. By the Muhammad Ali Parkinson Center at Desert Palms Presbyterian Church 13459 W. Stardust Ave., Sun City West 602-406-6903

PANCREATIC CANCER Feb. 8, 10–11:30 a.m. Cancer Support Community AZ* 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@cscaz.org CARCINOID Feb. 8, 1–2:30 p.m. Cancer Support Community AZ* 360 E. Palm Ln., Phoenix Register: 602-712-1006; rsvp@cscaz.org

PARKINSON’S CAREGIVERS Feb. 12, 1:30–3 p.m. Duet 555 W. Glendale Ave., Phoenix 602-274-5022; DuetAZ.org

EDUCATION FOR NEWLY DIAGNOSED PATIENTS Feb. 13, 1:30–3 p.m. Muhammad Ali Parkinson Center 240 W. Thomas Rd., Phoenix Register: 602-406-3840 SUPPORT GROUP Feb. 18, 3–5 p.m. By Benevilla at Shepherd of the Hills Methodist 13658 Meeker Blvd., Sun City West 623-584-4999; Benevilla.org POWER OVER PARKINSON’S (TUCSON) Feb. 22, 9 a.m.–2 p.m. Jewish Community Center 3800 E. River Rd., Tucson Register: 520-460-6406 or apdaarizona.org Fee: $25

BETTER BREATHERS Feb. 19, 2–3 p.m. Chandler Regional 1875 W. Frye Rd., Chandler 877-728-5414 BETTER BREATHERS CLUB Feb. 27, 1:30–3 p.m. By the American Lung Association at John C. Lincoln 9202 N. Second St., Phoenix 602-870-6060; breatheeasyaz.info

SENIORS

BRAIN ANEURYSM SUPPORT Feb. 19, 6–8 p.m. St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 760-333-7658; Kimberly@JoeNiekroFoundation.org

MEDICATION CHECKS Feb. 18, 11 a.m. Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) CARING FOR CHRONIC WOUNDS Feb. 26, noon Mountain Vista Medical Center 1301 S. Crismon Rd., Mesa Register: 877-924-WELL (9355) HEALTHY FEET Feb. 28, noon–1 p.m. By Tempe St. Luke’s at Tempe Public Library 3500 S. Rural Rd., Tempe Register: 877-351-WELL (9355)

GASTROINTESTINAL INTERSTITIAL CYSTITIS Feb. 9, 2 p.m. Phoenix Baptist Hospital 2000 W. Bethany Home Rd., Phoenix 623-349-4611; HeatherBarrowBrown@gmail.com

OSTOMY SUPPORT Feb. 16, 2–4 p.m. First Presbyterian Church 161 N. Mesa Dr., Mesa 480-812-0324

RESPIRATORY LUNG TRANSPLANT Feb. 11, 11:45 a.m.–1 p.m. St. Joseph’s 350 W. Thomas Rd., Phoenix 602-406-7009 BETTER BREATHERS CLUB Feb. 13, 1:30–2:30 p.m. By the American Lung Association at Banner Boswell 10401 W. Thunderbird Blvd., Sun City 602-286-8507; breatheeasyaz.info BETTER BREATHERS CLUB Feb. 19, 1–2 p.m. By the American Lung Association at HealthSouth East Valley 5652 E. Baseline Rd., Mesa 480-567-0350; breatheeasyaz.info

GRANDPARENTS RAISING GRANDCHILDREN By Benevilla; various dates, times & locations 623-207-6016 GRANDPARENTS RAISING GRANDCHILDREN By Duet; various dates, times & locations 602-274-5022; DuetAZ.org

PROGRESSIVE SUPRA PALSY SUPPORT Feb. 8, 1:30–3:30 p.m. Pyle Adult Recreation Center 655 E. Southern Ave., Tempe 480-966-3391; aludwig@asu.edu BRAIN INJURY SUPPORT FOR YOUNG ADULTS & CAREGIVERS Feb. 12, 6–7:30 p.m. St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 602-996-1396 or 602-406-6888

CHOLESTEROL, BLOOD PRESSURE & GLUCOSE CHECKS Feb. 18, 8:30–9:30 a.m. St. Luke’s 1800 E. Van Buren St., Phoenix Feb. 20, 8:30–9:30 a.m. Tempe St. Luke’s 1500 S. Mill Ave., Tempe Register: 877-351-WELL (9355)

PARENTING

BRAIN

CAREGIVER BOOT CAMP Feb. 26, 9:30 a.m.–noon Muhammad Ali Parkinson Center 240 W. Thomas Rd., Phoenix Register: 602-406-3840

NEW CHOLESTEROL GUIDELINES Feb. 7, noon–1 p.m. St. Luke’s 1800 E. Van Buren St., Phoenix Register: 877-351-WELL (9355)

BREASTFEEDING Feb. 10, 17 & 24, 10–11:30 a.m. St. Joseph’s 350 W. Thomas, Phoenix 602-406-4954

SUPPORT THROUGH OTHER PARENTS (S.T.O.P.) Various dates & locations, 7–9 p.m. 623-846-5464 POSTPARTUM DEPRESSION Feb. 5, 12, 19 & 26, 1–2:30 p.m. Chandler Regional 1875 W. Frye Rd., Chandler 877-728-5414 CHILDBIRTH EDUCATION CLASS (2-WEEK SERIES) Feb. 6 & 13, 6:30–9:30 p.m. Maryvale Hospital 5102 W. Campbell Ave., Phoenix 855-292-WELL; azhealthyhours.com

BRAIN TUMOR SUPPORT Feb. 25, 6–8 p.m. St. Joseph’s 350 W. Thomas Rd., Phoenix 602-205-6446

MOTHER-TO-MOTHER SUPPORT Feb. 7 & 28, 10–11:30 a.m. St. Joseph’s 350 W. Thomas, Phoenix Register: 877-602-4111

ADULT BRAIN INJURY SUPPORT Feb. 27, 6–7:30 p.m. St. Joseph’s 350 W. Thomas Rd., Phoenix 602-508-8024 or 602-406-6688

INFANT BRAIN DEVELOPMENT CLASS Feb. 8, 9 a.m.–1 p.m. Tempe St. Luke’s 1500 S. Mill Ave., Tempe Register: 480-784-5588

BREASTFEEDING

WEIGHT LOSS

BREASTFEEDING SUPPORT Feb. 5, 12, 19 & 26, 11 a.m. Chandler Regional 1875 W. Frye Rd., Chandler 877-728-5414

WEIGHT LOSS SURGERY SEMINARS Various dates & times Banner Gateway 1900 N. Higley Rd., Gilbert Banner Thunderbird 5555 N. Thunderbird Rd., Glendale Info: 480-543-2606

BREASTFEEDING Feb. 7, 14, 21 & 28, 10 a.m. Mercy Gilbert 3555 S. Val Vista Dr., Gilbert 877-728-5414

BARIATRIC SUPPORT GROUP March 4, 5-6:30 p.m. Bridges Center at St. Luke’s 555 N. 18 St., Phoenix Register: 602-251-8828

SPINAL CORD INJURY/ DISABILITY SPINAL CORD INJURY WOMEN’S DISCUSSION GROUP Feb. 19, 6–7:30 p.m. DEC-Disability Empowerment Center 5025 E. Washington St., Phoenix Info: twocats345@msn.com MEN’S DISCUSSION GROUP Feb. 20, 5:30–7 p.m. DEC-Disability Empowerment Center 5025 E. Washington St., Phoenix 602-980-3232; donp@abil.org

ADDITIONAL SUPPORT GROUPS HUNTINGTON’S DISEASE Feb. 17, 6–8 p.m. St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 602-402-1774 INTELLECTUAL DISABILITIES Feb. 21, 9:30–10:30 a.m. By Benevilla at Lakeview United Methodist 10298 W. Thunderbird Blvd., Sun City 623-584-4999 MULTIPLE SCLEROSIS (WOMEN) Feb. 22, 10 a.m. St. Joseph’s Barrow 350 W. Thomas Rd., Phoenix 480-829-6563

POISON CONTROL BANNER GOOD SAMARITAN Poison & Drug Information Center Hotline: 800-222-1222

Info Online CHANDLER REGIONAL MEDICAL CENTER: ChandlerRegional.org CIGNA: Cigna.com JOHN C. LINCOLN HOSPITAL: JCL.com LASER SPINE INSTITUTE: LaserSpineInstitute.com MARICOPA INTEGRATED HEALTH SYSTEM: MIHS.org

ABRAZO HEALTH CARE (AZ Heart Institute and AZ Heart, Arrowhead, Maryvale, Paradise Valley, Phoenix Baptist and West Valley hospitals): AbrazoHealth.com BANNER HEALTH: BannerHealth.com BARNET DULANEY PERKINS EYE CENTER: GoodEyes.com BARROW NEUROLOGICAL INSTITUTE:TheBarrow.org BLUE CROSS BLUE SHIELD OF AZ: AZBlue.com

MAYO CLINIC: MayoClinic.com

CARDON CHILDREN’S MEDICAL CENTER: BannerHealth.com

MERCY GILBERT MEDICAL CENTER: MercyGilbert.org MOUNTAIN VISTA MEDICAL CENTER: MVMedicalCenter.com

PHOENIX CHILDREN’S HOSPITAL: PhoenixChildrens.com SCOTTSDALE HEALTHCARE: SHC.org SENIOR LIFESTYLE CORP: SeniorLifestyle.com ST. JOSEPH’S HOSPITAL AND MEDICAL CENTER: StJosephs-Phx.org ST. LUKE’S MEDICAL CENTER, PHOENIX: StLukesMedCenter.com TEMPE ST. LUKE’S HOSPITAL: TempeStLukesHospital.com VI AT SILVERSTONE: ViLiving.com

MEDICARE ADVANTAGE PLANS Learn About Medicare Advantage HMO Plans from Cigna. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings call 855.298.4382 (TTY 711).

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morning and afternoon seminars are available WHERE: Cigna Medical Group locations throughout the valley COST: Free seminar, receive a free no obligation gift

Join Banner Olive Branch Senior Center to commemorate 25 years of serving the West Valley community and celebrate the opening of Operation American Patriot. Friday, Feb. 21 9 a.m. – 2 p.m. 11250 N. 107th Ave., Sun City FREE AR-0008150976-01

You can choose one doctor.

Or you can choose Mayo Clinic.

At Mayo Clinic, teams of experts work together to focus on one patient at a time. Each year, more than 75,000 Arizonans choose Mayo Clinic, and many health insurance plans include in-network coverage. Learn more at mayoclinic.org/arizona or call us at (800) 446-2279. PHOENIX/SCOTTSDALE, ARIZONA | ROCHESTER, MINNESOTA | JACKSONVILLE, FLORIDA

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WEIGHT LOSS SURGERY SEMINARS Various dates, times & locations St. Luke’s, 555 N. 18 St., Phoenix Register: 800-248-5553

*The Wellness Community–Arizona is now Cancer Support Community Arizona

AR-0008154808-01

SUPPORT GROUP Feb. 16, 11 a.m.–12:30 p.m. Huger Mercy Living Center 2345 W. Orangewood Ave., Phoenix Info: 602-406-5600

(continued from page 4)

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8 | LIVING WELL A-Z | WEDNESDAY, February 5, 2014

“One of Blake’s favorite times in the hospital was the music therapy program.”

SWIMKIDSUSA/DEVON ADAMS

— Kelle Whitehead, Blake’s mother

Left to right: Hannah Hogle, Devon Hogle and Cade Whitehead training for the next SWIMkid-A-Thon at SWIMkids USA in Mesa

Blake’s Miracle

SWIMkid-A-Thon beneﬁts Cardon Children’s BY MICHELLE TALSMA EVERSON

n 2006, Blake Whitehead died a few short months after being diagnosed with acute lymphoblastic leukemia. He was just-shy of two years old. In his memory, the Whitehead family created ‘Blake’s Miracle Foundation’ to help financially support integrative therapies at Banner Children’s at Cardon Children’s Medical Center in Mesa. Integrative therapies, including massage, aromatherapy, pet therapy and more, are used to improve the comfort and healing of children undergoing treatment for a wide variety of serious illnesses and injuries.

Integrative therapy

According to Teri Reyburn-Orne, CPNP-AC, Cardon Children’s pain management team manager, integrative therapy is when complementary therapies like the ones mentioned earlier are combined with traditional therapies to treat the whole person. “Medical professionals choose to utilize integrative therapies as these treatments have been shown to decrease stress hormones and improve healing,” she said. “They also promote a sense of wellbeing.” Integrative therapies cannot be provided without philanthropic support since many insurers do not fund their usage despite research that shows it improves healing and decreases hospital length of stay, Reyburn-Orne said.

SWIMkid-A-Thon

Since 2006, Blake’s Miracle Foundation’s annual SWIMkid-A-Thon has been held at SWIMkids USA in Mesa, the Whitehead’s family-owned business. The event has raised more than $220,000 for Cardon Children’s integrative therapy program as well as for the Safer 3 Water Safety Foundation for drowning prevention initiatives. The event includes not just swimming, but also a carnival, silent auction, music and more. For more information about Cardon Children’s Medical Center, visit bannerhealth.com/cardonchildrens. For more information about Blake’s Miracle Foundation, visit BlakesMiracle.org.

Blake’s Miracle Festival and SWIMkid-A-Thon WHEN: March 1, 9 a.m.–2 p.m. WHERE: SWIMkids USA, 2725 W. Guadalupe Road, Mesa DETAILS: Swimmers of all ages get their friends and family to pledge money for each lap they swim BENEFICIARIES: Cardon Children’s integrative therapy programs; drowning prevention initiatives MORE INFO/REGISTER: BlakesMiracle.org; 480-820-9109 AR-0008152670-01

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Parenting the second time around

You are not alone — support is available for grandfamilies

BY GREMLYN BRADLEY-WADDELL

If you think kids are exhausting and expensive, just try adding 15 or 20 years (or more…) to your age and doing the entire child-raising routine again. That is the reality that many grandparents in Arizona face every day. So it’s no surprise that many of these ‘grandfamilies’ need extra assistance in terms of money, guidance and emotional support. Luckily, there are agencies ready to offer advice, provide resources and lend a helping hand.

Grandfamilies Conference March 15, 2014

Are you a grandparent raising a grandchild and interested in learning more about available services? Considering attending the 2014 Grandfamilies Conference on Saturday March 15 at the AASK (Aid to Adoption of Special Kids) Building, 15396 N. 83rd Ave., Suite A100 (just off Bell Road and Loop 101) in Peoria.

Not uncommon

One of the first things a grandparent who finds him- or herself raising a grandchild should do is realize that he/she is not alone. While it may seem to a grandparent that he or she is the only one dealing with this kind of situation, in fact, Arizona alone has more than 100,000 children being raised by their grandparents or other relatives, according to Duet, a nonprofit organization in Phoenix that provides an array of services for older adults. Indeed, the situation is not uncommon in society, said Amy Goyer, AARP’s Phoenix-based grandparenting expert. She noted grandparents have played a role in raising such notable personalities as President Barack Obama, former President Bill Clinton and country music legend Willie Nelson. Even George and Martha Washington raised grandchildren, she said.

Sponsored by First Things First and Benevilla, the conference will run from 9 a.m. to 3 p.m. Lunch and childcare is free for pre-registered attendees. For more information, call 623-207-6016.

More stability

Statistics show that kids in kinship care experience more stability than in foster care, said Joanna M. Prusa, program supervisor for Arizona Kinship Support Services, part of Arizona’s Children Association, which — like Duet, one of several agencies with which it collaborates — connects individuals with services and information they need and provides caregivers with education and training. But there are many added bonuses. “The kids’ chances of success are better, and they know their family history and their culture,” said Sherry Griffin, a program specialist for the Grandparents Raising Grandchildren program at Benevilla’s Family Resource Center in Surprise. Griffin speaks from personal experience, having raised a grandchild.

THINKSTOCK

Kinship care

Patricia Dominguez, M.S.W., director of kinship services for Duet, said that kinship care — the modern-day term that refers to the care of a child, usually by someone who’s related by blood or family ties — cuts across all socioeconomic strata, with no regard for race, ethnicity, culture, etc. While substance abuse, mental illness and incarceration (on the part of one or both parents) are the top three reasons she sees for children needing to be cared for by a grandparent, there are several other causes, including: • domestic abuse • teen pregnancy • stress • unemployment • deportation

“ Grandparenting takes a lot from the grandparent and they will often sacrifice their own needs, including forgoing medication for themselves. They don’t always take care of themselves.” — Patricia Dominguez, M.S.W., director of kinship services, Duet

Finances loom large

The most overwhelming issue for grandparents who are parenting the second time around tends to be — you guessed it — money, Dominguez said. The need to take over the care of a grandchild often arises unexpectedly, and most grandparents are not prepared to handle such challenges immediately. “Many times, grandparents don’t have beds or clothing for their grandchildren, and now they also are faced with having to buy diapers, formula and food,” she said. “That can be really stressful if you don’t have the extra money.”

Help is available

That’s one area where Duet can help, however, thanks to its network of partners. Dominguez said that she and her staff usually can assist with needs such as: • Beds or other furniture, supplied by Bridging Arizona Furniture Bank • Clothing, supplied by Helen’s Hope Chest

• Baby food, formula or vouchers, available from WIC and the Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps Every situation is different, however, and some grandparents may find they need to take on a job to cover the extra costs of raising a grandchild while others may have to quit a job to take care of the child or children, especially if a child has special needs.

In addition, the grandchildren may experience divided loyalty to both parents and grandparents. That’s just one of the many reasons why Duet, Benevilla and Kinship Care’s support groups, workshops and educational programs are so vital, said Dominguez, Prusa and Griffin. Another is that grandchildren need to feel like they’re part of a community and don’t have to explain their situation; grandparents also need to feel like they’re not alone. While none of the agencies offers legal advice or gets involved with custodial issues, all provide referrals for such matters. “We work together to wrap our services around these families,” Dominguez said, and if a caller or visitor isn’t sure where to start, that’s just fine. “You don’t know what you need?” Dominguez said. “That’s okay! Let’s talk.”

‘Let’s talk!’

The next most pressing issue for grandparents raising grandchildren tends to be the mental, emotional and physical toll such a situation can have on those involved. For example, Dominguez said that an adult child may be fearful his or her children are going to be taken away, a grandparent may be angry that an adult child “isn’t getting it together” or may feel guilt about what has happened.

Resources AARP: aarp.org; 866-389-5649 Arizona Kinship Support Services: ArizonaKinship.org; 602-233-0017 or 888-737-7494 Benevilla: Benevilla.org; 623-207-6016 Duet: DuetAZ.org; 602-274-5022

CT scans and mammograms The inside scoop on some common medical tests

BY GREMLYN BRADLEY-WADDELL

Editor’s note: In previous months, we’ve explained MRIs, ultrasounds, colonoscopies and sigmoidoscopies. If there are additional tests you’d like us to investigate, please email Paula Hubbs Cohen, Living Well editor, Paula.Cohen@cox.net.

hile it’s impossible to address every concern, these basic questions, along with their answers, will help prepare most folks who are facing a CT scan or a mammogram.

CT scan (Computerized Tomography)

What is it? Although it’s often called by the lay term ‘CAT’ scan, medical professionals don’t call computerized tomography that — it’s simply known as a CT scan. Like an MRI, a CT scan creates more detailed images of the body’s organs than an ultrasound can, but unlike an MRI, it uses a number of non-invasive X-rays to do it. It’s best for viewing denser materials within the body, such as bone, calcium or kidney stones, said Brett Skidmore, M.D., a radiologist with Cigna Medical Group in Sun City. The test is also administered in a hospital setting or outpatient center.

patient lies down on a table adjacent to the CT scanning machine. Are there risks? A patient is exposed to radiation during a CT scan and that could increase the risk of cancer. In addition, the contrast agent used for a CT scan is different than the one used with an MRI, and there is a low risk of a life-threatening allergic reaction for some patients. Patients with kidney conditions also need to consult a physician first.

Mammogram

Who needs it? As with an MRI, patients with a variety of medical issues can benefit from a CT scan, which can be used to examine all parts of the body.

What is it? A mammogram is an X-ray exam that can help detect the presence of cancer and other abnormalities within breast tissue, said Linda Greer, M.D., a board-certified radiologist and medical director of the John C. Lincoln Breast Health and Research Center in Phoenix.

What’s involved? A patient is either injected with a contrast agent or drinks the agent to enhance image details. Then the

Who needs it? All women age 40 and older should have an annual mammogram, according to Greer. Those women with

a history of breast cancer affecting an immediate member of their family (mother, father, sister, brother) should consult with their doctor about earlier testing. Women with breast implants and some women who have had mastectomies also should have mammograms. While men are not affected by breast cancer to the extent that women are, it’s important for those with a family history of the disease to talk with their doctor about testing. What’s involved? While Greer says standard mammography machines that

use film are acceptable, she advises women to ask their physicians about being tested with a more advanced digital method, specifically tomosynthesis 3D mammography (also known as DBT, or digital breast tomosynthesis), which is also available in a low-dose format that features reduced radiation. This new technology works by almost instantaneously obtaining 15 clear images and then reconstructing them into segments for a radiologist to review. “We can look, slice by slice, through the breast tissue, one millimeter at a time,” she said, “so we have a much better cancer-detection rate.” There’s no waiting for film to be processed — the radiologist reading the images can, if necessary, request and receive additional images almost immediately while the patient is still in the office. All the tests require compression of the breasts — putting them, one at a time, tightly between two plates so the tissue is flattened out, ensuring a better X-ray image. Although some women find this a little uncomfortable, it is a fairly quick process, Greer said. Are there risks? A mammogram uses low-dose X-rays and excess radiation could cause cancer, but recommended testing schedules are not likely to cause harm, Greer said.

EXPERTS CATARACT & REFRACTIVE SURGERY Scott A. Perkins, MD

As a nationally recognized ophthalmologist with Barnet Dulaney Perkins Eye Center, Dr. Perkins has performed more than 50,000 cataract surgeries and more than 10,000 vision correction procedures such as LASIK and Implantable Contact Lenses (ICLs). As an innovator in the field of ophthalmology, he has participated in over 25 clinical trials for both pharmaceutical and ophthalmic devices. In addition, Dr. Perkins serves on the Board of Directors for Arizona Visionaries, a donor driven non-profit organization providing cataract surgery and eyeglass fittings in third world countries. He is not only trusted for his surgical talents and modest nature, but is also well known for his compassion and ability to connect with and comfort patients. Board Certified by the American Board of Ophthalmology Member of the American Society of Cataract and Refractive Surgery Fellow of the American Academy of Ophthalmology Locations throughout Arizona (800) 966-7000 / www.GoodEyes.com

EMERGENCY MEDICINE Dr. Patricia A. Bayless, M.D., F.A.C.E.P Dr. Patricia Bayless is an Attending Physician in the ER Department at Maricopa Medical Center and President of the Arizona College of Emergency Physicians. At Maricopa Medical Center, she is actively involved in emergency medicine resident education and medical staff committee and leadership positions. She’s been practicing emergency medicine in the Valley for 28 years. She is qualified as a Fellow of the American College of Emergency Physicians (ACEP). She earned her M.D. from the University Of Arizona College of Medicine and has been continuously Board-certified by the American Board of Emergency Medicine since 1987. Maricopa Integrated Health System 2601 E. Roosevelt St. Phoenix, Arizona 85008 (602) 344-5011 • www.mihs.org

INTERNAL MEDICINE Kothandapany Shalini, MD Dr. Shalini is a board certified internist who has a special interest in women’s health, chronic disease management and preventive care. She is a graduate of the Kilpauk Medical College Chennai in Madras, India and completed her internship and residency at the University of Nevada School of Medicine in Las Vegas.

Continued from cover PHARMACISTS she added, get answers to the following questions the next time you pick up a new prescription: • Could I have an allergic reaction to this medication? • Could this medication interact with any other prescriptions or over-thecounter medications or supplements I’m taking? • How do I take this medication? • Are there any side effects?

Saving money

Your health insurance likely will cover only a portion of the cost of prescription medications. To save money on prescriptions, Storjohann offers these suggestions:

Tara Storjohann, Pharm.D., assistant professor of pharmacy practice at Midwestern University College of Pharmacy in Glendale, said that people should ask questions of their pharmacist. /Photo RICK D’ELIA

1. Lifestyle: “Often people will look

to medications to correct problems instead of taking the responsibility to live a healthy lifestyle to prevent the need to take medications,” she said. 2. Generics: “Ask your pharmacist if more expensive brand-name medications prescribed for you are similar to those on their discounted list of generics,” Storjohann said. “Bring that list, along with your pharmacist’s recommendations, to your doctor to see if any of your medications can be changed to generics.” 3. Discounts: Find out which drug manufacturers offer discounts. “These will be brand-name drugs only,” she said, “but there are coupons for free trials or rebates for many widely prescribed medications.” Helpful hint: Do an online search with the brand name of your medication followed by ‘discount’. You can also visit sites like needymeds.org, goodrx.com and rxassist.org.

4. Price-match: Ask if your pharmacy

will price-match medications you see advertised elsewhere. “Some pharmacies will do that as long as the discount doesn’t bring the price below their cost,” Storjohann said. In addition, Storjohann said consumers should be aware that brand-name medication samples from your doctor’s office (samples are never generics) could turn out to make your drug regimen more expensive in the long run because you may get used to the more expensive brand-name formula instead of beginning your regimen on a lessexpensive generic alternative. Switching to a generic after finishing the samples is more complicated than it may seem, because finding an equivalent dosage with a generic could be a process of trial and error, she said.

Buying medications from other countries

lthough many medications are safe to buy from Canada, for example, “when buying medications from another country, you’re assuming the risk of treating yourself without the guidance of a prescriber or an American pharmacy,” said Tara Storjohann, Pharm.D., assistant professor of pharmacy practice at Midwestern University College of Pharmacy in Glendale. “You could end up taking too much or too little medication

over time if you are not being regularly seen by your healthcare provider.” Storjohann added that medications purchased in this country are monitored regularly and dosages are adjusted by the doctor over time as a patient’s condition changes. She also cautioned that medications from other countries could be counterfeit, whereas in the U.S., the Food and Drug Administration ensures that all prescription drugs meet certain standards.

Banner Health Center Specializing in Internal Medicine 1435 South Alma School Road • Chandler 480.668.1600 • www.BannerHealth.com/HealthCenterChandler

EXPERTS

PAIN RELIEF Dr. Theodore Manos Dr. Manos is a Board Certified Specialist in Anesthesiology and Pain Management. He specializes in procedures such as epidural steroid treatments and facet joint block procedures that can relieve lower back pain and help improve patient’s daily comfort level. Whether it’s arthritis, a herniated disc, sciatica or spinal stenosis of the lower back, his treatments can help patients regain mobility and functionality. These treatments can help eliminate or reduce the use of oral pain medications that patients may be taking on a regular basis. Anyone experiencing chronic lower back pain may be a candidate. In most cases, pain therapy can last for long periods of time. During the first appointment Dr. Manos will evaluate the patients’ unique condition and develop a treatment plan specific to their needs.

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Janette Reeves, DO Dr. Janette Reeves is a family physician, providing comprehensive primary care to patients ages 4 to over 100. Dr. Reeves specializes in promoting overall health and wellness, by incorporating physical/emotional/nutritional health. She received her education from the Touro University College of Osteopathic Medicine in Vallejo, California; and recently served as the Assistant Program Director at St. Joseph’s Family Medicine Residency Program. Dr. Reeves is a member of the Arizona Academy of Family Physicians, American Academy of Family Physicians and Arizona Osteopathic Medical Association.

Cigna Medical Group | Outpatient Surgery Center 3003 N. 3rd Street, 2nd Floor Phoenix, AZ 85012 602.282.9600

PEDIATRICS Sultana Alkon, MD Dr. Alkon is a board-certified pediatrician. She received her early medical training at the Medical Pediatric Institute of Central Asia in Tashkent, Uzbekistan. In 1991, Dr. Alkon’s family immigrated to Toronto, Canada, where she continued her postgraduate education. Dr. Alkon came to the United States to complete her pediatric residency at State University of New York (SUNY-Downstate) in Brooklyn, where she was honored to serve as pediatric chief resident and subsequently as a nephrology fellow. In 2003, Dr. Alkon was hired by Nemours/ AI Dupont Children’s Hospital in Delaware and was working at its outpatient Pediatric Clinic and Nanticoke Memorial Hospital, caring for a large pediatric population in need in the southern part of the state. Dr. Alkon has more than a decade of clinical experience in pediatrics, most recently serving as a pediatric hospitalist, caring for complex and very ill patients requiring hospitalization, as well as premature infants. Banner Health Center located in East Mesa Specializing in Pediatrics 1917 South Crismon Road • Mesa 480.610.7100 • www.BannerHealth.com/HealthCenterEastMesa

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PRIMARY CARE

Cigna Medical Group 7000 N. 16th Street, #130 Phoenix, AZ 85020 602-567-1901 AR-0008160199-01

PSYCHIATRY Dr. Carol Olson Dr. Olson is certified in Psychiatry with added qualifications in Forensic Psychiatry by the American Board of Psychiatry and Neurology. She is a Fellow of the American Psychiatric Association and a member of the Executive Council of the Arizona Psychiatric Society. As Chair of the Psychiatry Department at Maricopa Integrated Health System, she is responsible for two inpatient psychiatric facilities, outpatient treatment settings and adult and child psychiatry residency training programs. Her clinical practice centers around treatment of those with serious mental illness, such as schizophrenia and bipolar disorder, as well as the interface between Psychiatry and the law.

Maricopa Integrated Health System 2601 E. Roosevelt St. Phoenix, Arizona 85008 (602) 344-5011 • www.mihs.org

PEDIATRICS

TRAUMA CENTER

John Sarmiento, MD

Dr. Jeffrey Paul Salomone, MD, FACS, NREMT-P

Dr. Sarmiento is board certified and specializes in pediatrics. As a pediatrician, he provides comprehensive medical care to children ages newborn to 17 years old. He is trained to care for all types of children, from healthy newborns to children with complex medical conditions and chronic diseases as well as adolescents and teens. If your newborn child is born at Banner Del E. Webb Medical Center he will examine him or her within 24 hours of delivery.

Dr. Salomone is Trauma Medical Director of the Trauma Center at Maricopa Medical Center and is also Vice Chairman of Surgical Services. Prior to Maricopa Medical Center, he spent 16 years at Grady Memorial Hospital in several roles, including Deputy Chief of Surgery, acting Medical Director of Grady’s Trauma Center and Director of the Trauma Sustainment Training Program for Special Operations Combat Medics from the US Army’s 75th Ranger Regiment. He received his MD at the University of Nevada School of Medicine and completed his surgery residency and trauma / critical care training at Tulane University in New Orleans.

Banner Health Center in Surprise Specializing in Pediatrics 13995 W. Statler Blvd. • Surprise 623.478.3100 • www.BannerHealth.com/HealthCenterSurprise

Maricopa Integrated Health System 2601 E. Roosevelt St. Phoenix, Arizona 85008 (602) 344-5011 • www.mihs.org

WEDNESDAY, February 5, 2014 | LIVING WELL A-Z | 11

SPECIAL ADVERTISING FEATURE

Robert Matura Vice President,

Continued from cover DONUT HOLE “We explain to Medicare recipients that depending on their individual circumstances, one of the big benefits for them with the Affordable Care Act could be the donut hole shrinking every year until 2020 when it goes away completely.”

Cigna Medicare Sales

Are you eligible for a new Medicare Advantage Plan?

—Steve Stedman, sales director, Humana

Brand-name drugs: When you’re in

the donut hole/coverage gap, you’ll pay 47.5 percent of the plan’s cost for covered brand-name prescription drugs. The discount will come off of the price that your plan has set with the pharmacy for that specific drug. Although you’ll pay 47.5 percent of the price for the brand-name drug, the entire price (including the discount the drug company pays) will count as out-ofpocket costs which will help you get out of the donut hole/coverage gap.

Generic drugs: In 2014, Medicare will

pay 28 percent of the price for generic drugs during the donut hole/coverage gap; you’ll pay the remaining 72 percent. For generic drugs, only the amount you pay will count toward getting you out of the donut hole/coverage gap.

Out of the hole: In 2014, you reach the upper limit of the donut hole/coverage gap when you’ve paid $4,550 in out-ofpocket prescription medication costs. Thereafter, enrollees pay either $2.55 each for generic and preferred drugs and $6.35 each for all other drugs, or five percent coinsurance, whichever is larger. Closing the hole: The Affordable Care

Act reduces the threshold every year until 2020, when the maximum co-insurance for any medication — brand-name or generic — will be 25 percent, regardless of how much in total has been spent. —SOURCES: OFFICIAL U.S. GOVERNMENT SITE FOR MEDICARE, MEDICARE.GOV; KAISER FAMILY FOUNDATION, KFF.ORG

Patient advocate and ovarian cancer survivor Laurel Pracht /Photo RICK D’ELIA

Caught in the donut hole: One person’s story

or Sun City resident Laurel Pracht, a long-time ovarian cancer survivor who originally qualified for Medicare because of her medical condition, the Affordable Care Act’s elimination of the donut hole in 2020 can’t come soon enough. One medication she takes daily costs $1,281.55 a month; it is a high-cost brandname drug. This year, before she reaches an annual expense threshold of $2,850, she’ll pay 33 percent of $1,281.55 per month out of her pocket. The percentage she pays is more than the 25 percent paid for many drugs because hers is a higher tier/more expensive medication. Once Pracht reaches the threshold, she will have to pay 47.5 percent of the drug’s negotiated-with-her-insurance price until she reaches $4,550 (this amount will likely change each year). Then she is responsible for a monthly coinsurance fee of 5 percent. “I would propose that Congress take an unbiased look at the real costs of drugs and close this gap sooner [than 2020],” she said, suggesting that perhaps closing the gap sooner could be paid for by increasing premiums slightly. “Some patients, unable to afford their medications, may ultimately be hospitalized due to not being able to afford their drugs,” she said, “which costs Medicare more.”

f you have Medicare coverage, you are probably familiar with a time of year known as the Annual Enrollment Period. This is a timeframe, typically from mid-October to early December, when people who are eligible for Medicare can enroll in, disenroll from or change their Medicare Advantage plan for the upcoming year. Once you select a Medicare Advantage Plan, you have a window from January to mid-February to disenroll and return to original Medicare. You can then purchase a separate Part D Prescription Drug Plan from a private company if you would like to do so. After the enrollment and disenrollment periods end, you are locked into original Medicare or the Medicare Advantage Plan you selected for the remainder of the year. However, there are some situations that may let you make a change to your existing coverage anytime of the year if you qualify. A Special Enrollment Period allows you to make changes to your Medicare coverage as a result of a specific circumstance. You may be eligible if you:

5-star rating for the third consecutive year in 2013 by the Centers for Medicare & Medicaid Services, no other health plan in Arizona rates higher than Cigna. Some highlights of Cigna’s 2014 Medicare Advantage plans include: • $0 monthly premiums • $0 deductible • $0 unlimited primary care doctor visits • Affordable prescription drug copays The network now includes: • 500 primary care doctors • 5,700 specialists • 145 pharmacies • 45 urgent care centers • 41 hospitals

To find out if you qualify for the Special Enrollment Period and to learn more about Cigna’s Medicare Advantage Plans, please call 1-855-298-4385 (TTY 711) or visit www.cignamedicare.com/az. • Are clinically diagnosed with certain chronic Representatives are available seven days a week conditions. from 8 a.m. to 8 p.m. • Are just turning 65 or gaining your eligibility *Most recent 2014 rating from www.Medicare.gov. for Medicare. Medicare evaluates plans based on a 5- star rating • Are on a Medicare Advantage Plan that is system. Star Ratings are calculated each year and leaving your zip code. may change from one year to the next. • Recently moved to a new County. You must continue to pay your Medicare Part B • Have a household income under $27,000. premium. The benefit information provided is If any of these situations apply to you, you may a brief summary, not a complete description of be eligible to make a change to your Medicare benefits. For more information, contact the plan. coverage for 2014. Limitations, copayments and restrictions may apply. Benefits, formulary, pharmacy network, Cigna Medicare Advantage HMO plans are provider network, premium and/or copayments among the highest rated Medicare Advantage plans in Arizona.* Achieving a 4.5-star out of may change on January 1 of each year.

H0354_212014 Accepted AR-0008154837-01

We’re 75! And we can’t think of a better way to celebrate than to share our birthday with you, who made this milestone possible. Post birthday greetings on our Facebook timeline or email them to socialcares@azblue.com, and we’ll send this cool tote bag to you.*

*If you send us an email be sure to include your name, address and phone number. D10711 02/14 AR-0008153579-01

101518-14

Free tote bag when you post Happy Birthday on Facebook!

Our Community Depends on Us A strong public teaching hospital and public healthcare system are as much a mark of a healthy community as quality universities, modern transportation systems, and thriving arts organizations. Through the Maricopa County Special Health Care District, you are supporting our vital work in preventing disease, training the next generation of physicians, and providing care that touches nearly every corner of our community. $ .!>&%26 ,=!2 *"2?"! $ .!>&%26 *@>8/!"2'A *"2?"! $ :74(.7); *8>2>1 $ *%5#!"@"2A><" :"68?@ *"2?"! $ -6!>1%#6 -"/>168 *"2?"! $ +">B@3%!@%%/ :"68?@ *"2?"!A $ ,"@6<>%!68 :"68?@ :%A#>?68A $ 0"<"8 7 9!6=56 *"2?"!