Written by Dr. Bartczak

Facing challenges repeatedly, you grow stronger and eventually overcome them. If you know your enemy and train for battle, you are on the path to success. We see this in sports, we’ve heard in schools and houses of worship, and we encounter it at the doctor’s office. It’s the concept behind “practice makes perfect,” and we inherently know it to be true. Immunization is based on this principle as well. A strengthened immune system is able to overcome the germs that could otherwise cause severe disease.

A vaccine is made from a small part of a virus or bacteria or a weakened version of it, treated in special ways so that it cannot cause illness, mixed with stabilizers, and given as shot into the muscle. For example, the Haemophilus influenzae b vaccine uses components from the outside capsule of the Haemophilus influenzae bacteria. The body learns to recognize this component as foreign, and then to fight against it. The body produces specialized cells that act as scouts, and when the Haemophilus bacteria is encountered after vaccination, the body quickly recognizes and fights it off without getting sick. Left unchecked, Haemophilus can infect the brain, lungs, epiglottis, blood, ears, joints, and heart. About 5% of children who get this infection will die; 15% of survivors may have lasting effects like cerebral palsy, seizures, blindness, and deafness.

Because vaccines stimulate the immune system, they may be followed by fever, swelling, rash, or pain where the shot was given. This means the vaccine is working as designed. Serious side effects are very rare and are monitored by the Center for Disease Control and Prevention.

Vaccines do contain stabilizers and preservatives such as citric acid, aluminum, and formaldehyde. We ingest these chemicals on a daily basis in food, water, and medications in quantities much larger than what is in a vaccine. The amount of formaldehyde present in any vaccine is fifty times smaller than that found in a pear.

The beauty of vaccines is that the first encounter with a germ is in a controlled environment, where that foreign protein or weakened germ cannot cause disease. If someone encounters the germ without a vaccine, the number of organisms is significantly higher, and they are fully functional, therefore capable of causing disease and spreading to other people. In areas with high vaccination rates and no travel, the risk of getting an infection may be low, although the risk of serious illness from that infection remains high. However, in an area that sees a million tourists a year, the chances of catching a disease jumps exponentially. The risk of serious illness, lasting consequences, or death, are simply not worth the exceedingly low risk of serious effect from vaccines.

The biggest successes in improving length and quality of life over the last century have come from public health measures, particularly vaccines. As they say, an ounce of prevention is worth a pound of cure. That is why I will happily get vaccinated, and encourage all of you to do the same.

The period following breast cancer treatment can be a time of excitement or relief, but also a time of worry and concern. You may have questions regarding follow-up, the likelihood of recurrence, and prevention, we are answering a few of these common questions here:

What does follow-up care look like?

Depending on your specific situation and your provider’s recommendations, follow-up care will likely be scheduled every few months following treatment. The longer you have been cancer-free, the less often the appointments are needed. After 5 years, they are typically done about once a year.

If you had a breast-conserving surgery, a mammogram will be scheduled about 6-12 months after surgery and radiation are completed, and then at least every year after that.

If you are on hormone treatments, you may need additional follow up as these can have side effects on osteoporosis or an increased risk of uterine cancer. Be sure to discuss these with your doctor.

Can I lower my risk of breast cancer coming back?

Breast cancer is one of the best-studied types of cancer and research has shown there are some things you can do that might be helpful to decrease your risk of recurrence. Controlling your weight, staying physically active, eating right, and lowering your levels of stress may help you lower your risk of breast cancer returning, as well as help protect you from other health problems.

Pregnancy after breast cancer

If you are a younger woman who has had breast cancer, you might have questions about how breast cancer could affect your ability to have children and whether there are any extra risks. Some treatments for breast cancer might affect a woman’s fertility. For example, chemotherapy for breast cancer might damage the ovaries, which can sometimes cause immediate or delayed infertility. Still, many women are able to become pregnant after treatment. The best time to talk with your doctor about fertility is before starting breast cancer treatment.

Women who have had breast cancer can experience recurrence and are at a higher risk for certain other cancers. Because of this, it is important to stay vigilant about prevention and follow up appointments. Staying up to date on mammograms and other recommended cancer screenings can help detect cancer early if it returns.

To schedule your annual mammogram at Moab Regional Hospital, give us a call at 435-719-3794.

We all know someone who has been impacted with cancer, and with about 1 in 8 women developing invasive breast cancer in the US, it’s important to understand the resources available to you. In honor of National Breast Cancer Awareness Month, we’re sharing the breast cancer care resources that are available to our community, right here at Moab Regional Hospital. From our 3D mammography preventative services to our experienced staff members and our chemotherapy infusion services, you can trust that you’re receiving the best care there is.

3D Mammography vs. 2D Mammography

A number of studies have found that 3D mammograms find more cancers than traditional 2D mammograms and also reduce the number of false positives. With 3D mammography, the radiologist reviews about 200-300 images, compared to only four derived from a 2D mammogram. At Moab Regional Hospital, we are proud to offer 3D mammography to the women in our community. Prevention and early detection is key in the successful treatment of breast cancer.

Meet Our Oncology Team

Alicia Swink, MD

Dr. Alicia Swink has extensive training in diagnosing and treating a wide array of cancers and blood disorders. Her clinical abilities include the diagnosis and treatment of all types of cancers, including solid tumor malignancies, malignant hematologic conditions, and benign blood disorders. Dr. Swink is a visiting specialist at Moab Regional Hospital and we love having her as a part of our oncology team.

Anna Page Kanopsic, NP

Anna specializes in breast cancer care, as well as inherited genetic cancer risk, enhanced cancer screening, prevention, and treatment. Anna is a visiting specialist at Moab Regional Hospital, is Board Certified, and is a valuable part of our oncology team.

Gayle Audenried, Outpatient Nursing Services Director

Gayle is a registered nurse and has over 25 years of nursing experience with 15 years in Oncology Nursing Care. The nurses at Moab Regional Hospital who provide outpatient nursing services are specially trained in chemotherapy and biotherapy administration. The nursing team, in coordination with the onsite pharmacist, can provide the necessary treatments and support services needed for those receiving cancer treatment.

Reconstructive Surgery

If you’re receiving a mastectomy or a lumpectomy, you may decide that breast reconstructive surgery is a good fit for you. Dr. Chick is a visiting plastic surgeon and specializes in breast reconstructive surgeries. He is board certified by the American Board of Plastic Surgery and is a member of the American Society of Plastic Surgery. Dr. Chick has numerous years of experience and is happy to see you for a consult to determine if reconstructive surgery is something you’d like to move forward with.

If you’re facing breast cancer, it’s important to understand the resources available to you. Our visiting specialists and in-house staff make superior cancer care available, right here in your community.

There are several types of breast cancer, and they are broken into two main categories: invasive and noninvasive, otherwise known as “in situ”. While invasive cancer has spread from the breast ducts or glands to other parts of the breast, noninvasive cancer has not spread from the original tissues.

Some of the most common types of breast cancer include:

– Ductal carcinoma in situ. This is a noninvasive condition. The cancer cells are confined to the ducts in your breast and haven’t invaded the surrounding breast tissue.
– Lobular carcinoma in situ. This cancer grows in the milk-producing glands of your breast. Like ductal carcinoma in situ, the cancer cells haven’t invaded the surrounding tissue.
– Invasive ductal carcinoma. This is the most common type of breast cancer. It begins in your breast’s milk ducts and then invades nearby tissue in the breast. Once the breast cancer has spread to the tissue outside your milk ducts, it can begin to spread to other nearby organs and tissue.
– Invasive lobular carcinoma. This cancer first develops in your breast’s lobules and invades the nearby tissues.

Potential Stages
Once an individual is diagnosed with breast cancer, the next step is to determine if the cancer has spread and if so, how far. This process is called staging. The stage of cancer describes how much cancer is in the body. It helps determine how serious the cancer is and how best to treat it. Cancers range from stage 0 (carcinoma in situ, noninvasive) through stage IV. As a rule, the lower the number, the less the cancer has spread. Within each stage, an earlier letter means a lower stage.

When determining the stages, these key pieces of information are used:
The extent/size of the tumor
The spread to nearby lymph nodes
The spread to distant sites
The presence of certain proteins
Grade of the cancer

Outlook
Survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific kind of cancer, but they cannot predict what will happen in any particular person’s case. Survival rates can provide an idea of what percentage of people with the same type and stage of cancer are still alive after they were diagnosed. These statistics cannot tell you how long you will live, but they may provide a better understanding of how likely it is that your treatment will be successful.

Questions to Ask Your Provider
Being open with your team of providers and better understanding your own cancer will make treatment less difficult. Your provider wants to answer all of your questions so that you can make informed treatment decisions and fully understand your diagnosis.

Common questions you can ask your provider and cancer team include:
– What type of breast cancer do I have?
– How big is the cancer and where is it located?
– Has the cancer spread to my lymph nodes or other organs?
– What’s the stage of the cancer? What does that mean?
– What are my treatment options and what do you recommend?
– How soon do I need to start treatment?
– How does my type of cancer affect my treatment options and long-term outlook?
– What are my chances of survival, based on my cancer as you see it?
– How do I get a copy of my pathology report?

If you’re going through a breast cancer diagnosis currently, there is hope and help available. If you’re experiencing thoughts and feelings of overwhelming sadness and/or hopelessness, our mental health physicians are readily available to help you navigate this difficult time. We offer a comprehensive care team at Moab Regional Hospital that can care for your mental and physical health.

Did you know that death rates of those affected by breast cancer have decreased from 2013-2017? This is believed to be caused by catching the early signs of breast cancer through proper screening and improved treatments. Although a lump in the breast is typically an early indicator of breast cancer, much of the time these lumps that are found are non-cancerous, or benign. Common causes of these benign breast lumps can include:
– Breast infection
– Fibrocystic breast disease
– Fibroadenoma or noncancerous tumor
– Fat necrosis or damaged tissue

While the majority of breast lumps are caused by less severe conditions, new, painless lumps are still the most common symptom of breast cancer. Other early signs of breast cancer may include:
– Changes in the shape of the nipple
– Breast pain that doesn’t go away after a menstrual cycle
– A new lump that doesn’t go away after a menstrual cycle
– Spontaneous nipple discharge (without squeezing) that is clear, red, brown, or yellow
– Unexplained redness, swelling, skin irritation, itchiness, or rash on breast
– Swelling or a lump around the collarbone or under the arm

Having one or more of these symptoms doesn’t necessarily mean you have breast cancer. Nipple discharge, for example, can also be caused by an infection. If you do experience any of these symptoms, schedule an appointment with one of our providers for a complete evaluation and mammogram.

Breast Examination
A breast self-exam is an inspection of your breasts that you do on your own. Examining your own breasts once a month after a menstrual cycle is a good way to familiarize yourself with how your breasts normally look and feel. If you notice changes in your breasts, it’s important to discuss these with your provider.

To perform a breast self-exam, sit or stand shirtless and braless in front of a mirror with your arms at your sides. To inspect your breasts do the following:
– Look for puckering, dimpling, or changes in size, shape, or symmetry
– Inspect your breasts with your arms raised overhead and the palms of your hands pressed together
– Lift your breasts to see if ridges along the bottom are symmetrical
– Use a methodical technique to ensure you examine your entire breast
– Use different pressure levels when checking areas of your breasts

Understanding the early indicators of breast cancer can lead to earlier identification and diagnosis, as well as lead to more successful treatment. This is why it’s so important to perform self-exams regularly and have a conversation with your provider regarding your family history and your potential risk for breast cancer. Your risk will determine at what age your provider recommends you start receiving mammograms. Typically, women ages 45 and older, mammograms are recommended yearly.

Is your mammogram overdue? Give us a call at 435-719-3794 to schedule your appointment.

While some risk factors for breast cancer cannot be controlled, such as family history and aging, there are some lifestyle modifications that you can make now to decrease your risk for breast cancer. A risk factor is anything that increases your risk of getting a disease. However, having a risk factor for cancer, or even many risk factors, does not mean that you’ll be diagnosed with cancer.

In today’s blog, we’ll be going over the modifications you can make now to live a healthy life, and in turn, lower your potential risk for breast cancer.

1. Limit your alcohol intake. Research has shown that the more alcohol you drink, the higher your risk for breast cancer is. The general recommendation is to limit yourself to less than one drink a day.
2. Avoid smoking. If you’re a smoker, take the steps today to quit. There is a correlation between smokers and breast cancer that places them at a higher risk of developing this kind of cancer.
3. Manage your weight. Being overweight or obese increases your risk for breast cancer, especially if this weight gain has occurred after menopause.
4. Maintain a physically active lifestyle. Physical activity can help you manage your weight, which helps to lower your risk of breast cancer. How much exercise should you aim for each week? For healthy adults, 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity plus strength training a couple of times a week is recommended.
5. Breastfeeding. Research shows that breastfeeding may play a role in preventing breast cancer. The longer a woman breastfeeds, the greater the protective and preventive effect.
6. Limiting dose and duration of hormone therapy. Being on hormone therapy for more than 3-5 years increases your risk for breast cancer. If you’re on hormone therapy due to menopause symptoms, discuss your other potential options with your provider.

What Else Can You Do?
It’s important that throughout your life, you’re vigilant about self-checks and mammograms. Adult women are encouraged to perform self-exams on their breasts at least once a month. Johns Hopkins Medical Center states, “Forty percent of diagnosed breast cancers are detected by women who feel a lump, so establishing a regular breast self-exam is very important.” If you feel a lump, reach out to your provider for further examination and tests.

For women ages 40 and older, it is important to speak with your provider regarding your breast cancer risk and screening recommendations. Typically regular mammograms are encouraged annually starting between the age of 40 to 50. With our state-of-the-art 3-D mammography machine, you can trust that you’re receiving the best care possible, close to home. To schedule your mammogram screening, give Moab Regional Hospital a call at 435-719-3794.

Most of you don’t know me yet, I haven’t been in town very long. But, in the short time since I moved to Moab in August 2019 to become the Addiction Psychiatrist at Moab Regional I have been inspired by the warmth and proactivity of this community. As a psychiatrist I often care for people who have endured incredible hardships, but the strength required to seek and accept help remains one of the most awe inspiring things about my job. Moabites have certainly endured terrible hardships and the people who stay here demonstrate a special type of grit. But, as is true with all survivors, “the body can only take so many hits before the cracks start to show”. So even the most resilient among us are bound to feel a shift in their reserve in these frightening and uncertain times. But sometimes, the cracks can shape us in surprising ways.
For some, mental health feels like something apart from regular medicine, something not so serious or something shameful. But, long before we had traditional medicine, it could be argued that mental wellness is all we really had under our control. After all, our camp could be washed away by floods, or a famine or drought could destroy our food sources, or a disease could sweep through our communities. To cope with these uncertainties, we used rituals and ceremony to create connection and meaning, herbs and special foods to nourish our body and soul, and tests of physical endurance to challenge our spirits and fortitude. These days, we have changed our lifestyles such that most of us have lost our sense of routine self-care. We may rely so much on the comforts of modern society that we have lost track of the power of our own ability to guide our sense of wonder. So, what can we do, when the pressures of the world are stealing our security and dependability? This is when re-building resilience and finding connection and meaning in our lives matters most. And perhaps this is when we start to rebuild a renewed sense of self-empowerment about what lies ahead.
Resilience refers to a person’s ability to sustain health and adapt through periods of stress. Resilience, like all fundamental mental health needs, is unfortunately not found in a day. It takes routine effort, like strengthening a muscle. Things that improve resilience often feel like they should be simple, like going to bed on time, limiting screen time, eating vegetables, and getting a little exercise. But, these are usually the first things we put aside when things get tough. Why would this be? Why would we deprive ourselves of self-care when we need it most? The answer probably lies in our most basic survival mechanisms. Simply put: instant gratification, meaning our brains choose the most rewarding and soothing activity to get through the moment. Our stressed, tired brains want high calories, physical relaxation, and mental distraction. Choosing instant gratification can happen spontaneously and without thinking. Those who have never struggled with substance use may find a little empathy here for those with addiction when you consider your own struggles with self-care- if it were easy, wouldn’t you be doing it already?
When your spiritual, emotional and physical tank is low, the first step in rebuilding can feel like the most difficult, so start with the most manageable and realistic change. For example, change often starts with thinking alone. Consider the pros and cons of taking a walk in the evening, calling your sister, or playing with your kid, instead of watching TV for another hour. Make a list of these pros and cons, or talk them out with a friend. Consider whether you have real balance in your life between work and play- are you working too much and neglecting your family, pets, health? Or, perhaps you are avoiding the work for distractions?- it can go both ways. Regardless, prioritize one impactful change at a time and practice this daily.
Certainly some people will have more on their plate than they can think their way out of. When this is the case, reaching out for help is best. You may need to see a medical professional or a therapist. You may need help with housing, rent, food, health insurance. You may need a day off work to run errands or make phone calls. You may need help escaping an abusive relationship. Remember, those who have experienced the most chaos and trauma are sometimes those who come out the other side stronger, more thoughtful, more creative, and with more appreciation of life than ever, but it can take time and the creation of new, safer spaces in our lives. Sometimes a little self-exploration can lead to tremendous post traumatic growth.
All in all, building resilience is a basic way to honor your humanity and your most basic needs. Setting boundaries by increasing balance in your life may help you feel a greater sense of control in an out of control world. As Austrian psychiatrist, Viktor Frankl said, “When we are no longer able to change a situation, we are challenged to change ourselves”. I know times are difficult, but there may be space between the hardships where we can find new meaning, greater connection, or to finally take that step forward toward self-care.

If you or someone you know needs help, please call one of the numbers below. Or, check out some of these helpful websites for guidance on increasing your wellness and resilience.
Resources:
Hotlines and treatment access:
National Disaster Distress Helpline: 800-985-5990 / 800-846-8517 (TTY)
Utah Crisis line: 800-273-8255
MRH Mental Health access: 719-5531
Addiction treatment: 719-5585

Helpful websites:
Happify.com
Tenpercent.com
Headspace.com
Tryhealthymind.org
Insighttimer.com
Recoverypath.com
My.life
Superbetter.com

In the event of sickness or injury, have you ever wondered whether you should call the doctor or just “wait it out”? Sometimes, a cold can clear up on its own within a couple of days. But occasionally, what you thought was a cold lingers or turns into something more.

When you’ve decided it is time to call the doctor, which one do you call? Should your Primary Care Physician be on speed dial or should you skip the call and head into Urgent Care? We’re here to help with these questions today.

Here’s an important distinction to start with: Urgent vs. Emergent.

An injury or illness is urgent if you need to be treated soon. An injury or illness is considered an emergency when it is threatening your life and you need to be treated immediately.

Some examples of times when you should call 9-1-1 or head to the Emergency Department at Moab Regional Hospital include:
Broken bones where the skin is punctured
Head injury, including concussions and fainting
Severe allergic reaction
Severe asthma attack
Shortness of breath or difficulty breathing
Vomiting or coughing up blood

Here are some examples of times when Urgent Care would be your best choice:
Animal or insect bites
Flu or cold symptoms
Ear pain
Minor broken bones
Mild burns or rashes
Minor cuts
Pink eye
Sore throat
Sprains
Urinary tract infection
Vomiting or diarrhea

So, when do you call your Primary Care Provider? Primary Care is a great resource for preventative care (screenings, annual checkups, etc.) or concerns that don’t need urgent or emergent treatment. If you have a health concern that requires routine visits outside of your standard annual appointments, your Primary Care Physician will be a valuable resource to you.

There can be a lot of overlap in treatments that could be taken care of in our Urgent Care or your Primary Care Provider’s office. In these cases, one of the most important factors is how soon you need to be treated. Because of the nature of primary care, the availability of your physician may determine how soon you’ll be able to be seen in their office. If your health concern isn’t a part of an ongoing treatment or routine visits, you may consider visiting Urgent Care to receive treatment sooner than when your Primary Care Physician would be available for an appointment with you.

Moab Regional Urgent Care provides after-hours and weekend medical care for non-emergent minor illnesses and injuries. Urgent care appointments are walk-in only.

Staying Healthy
Regularly seeing the same Primary Care Provider throughout your life provides numerous benefits. Scheduling and attending your annual appointments can help to cultivate a healthy provider/patient relationship. When the relationship with your Primary Care Provider is strong, they’ll have access to your full health history and know how to advocate for you and your health. They’ll also have your family’s health history and understand the health risks unique to you.

Annual appointments are important throughout your entire life. When you schedule your annual appointment, there’s a physical exam involved as well as preventative services such as screenings for high blood pressure, blood sugar, and cholesterol. Young children are seen more frequently. The American Academy of Pediatrics recommends the following schedule from birth to age three. Keep in mind that your Primary Care Provider may choose a slightly different approach, depending on your child’s specific health needs.

The first week visit (3 to 5 days old)
1 month old
2 months old
4 months old
6 months old
9 months old
12 months old
15 months old
18 months old
2 years old (24 months)
2 ½ years old (30 months)
3 years old

After 3 years of age, visits to a Primary Care Provider are recommended annually for the remainder of your years. The purpose of these visits is to track growth and development with a focus on prevention at each milestone.

Additional Benefits of Seeing Your Primary Care Provider
If you’re needing to see a specialist, your Primary Care Provider can often provide advice or treatment in the interim. Some specialists schedule a few months out, so it can be helpful to visit with your Primary Care Provider regularly during your scheduled appointments. They can also help answer any general health questions or concerns that you have.

Our Primary Care Providers
We offer a diverse group of experienced and compassionate Primary Care Providers who are currently accepting new patients. When it comes to your family and your healthcare, we understand how important it is to find the right medical provider. We are committed to providing lifelong exceptional care to you and your family. It is our goal for you to live a healthy, vibrant, and well-balanced life. We know you’ll be well cared for by our excellent providers at Moab Regional Hospital.

At Moab Regional Hospital, we offer a wide range of inpatient and outpatient surgical services to meet the needs of our patients. On surgery day, patients are cared for in one of our three state-of-the art surgical suites or six private same-day-surgery rooms. You will recover in one of our two designated recovery rooms. Our highly skilled operating room team works hard to ensure optimum safety and quality of care for each of our patients throughout the surgical process.

Here are some examples of common surgeries performed right here at Moab Regional Hospital and an overview of some of the warning signs for each of these conditions, information on screenings and procedures, etc.

• Hernia repair
  • Possible signs and symptoms of a hernia include: 
  • Nausea, vomiting, fever, sudden pain that quickly worsens, a hernia bulge that appears red or bruised, lack of bowel movements, or inability to pass gas.
• Gallbladder
  • Possible signs and symptoms of gallbladder issues include:
  • Pain in the mid or upper right part of your abdomen, nausea, vomiting, fever, chills, changes in urination or bowel movements, or jaundice.
• Appendix
  • Possible signs and symptoms of appendix issues include:
  • Loss of appetite, nausea, vomiting, fever, pain in your lower right part of your abdomen or near your belly button, swollen belly, or inability to pass gas.
• Bowel procedures
  • Possible signs and symptoms of bowel issues include:
  • Nausea, vomiting, diarrhea, constipation, bloating, pain in your abdomen, or significant changes in bowel movements.
• Colonoscopies/EGD
  • An annual colonoscopy is recommended beginning at age 50 until age 75. 
• Pediatric surgery
  • This area of surgery focuses primarily on providing surgical care for any problems or conditions that affect children and require surgical intervention.
• Vasectomy
  • A vasectomy is one of the most effective forms of birth control.
• Tubal ligation
  • Tubal ligation is a form of permanent birth control.
• Breast Procedures
  • Common surgical breast procedures include: 
  • Breast reduction, breast augmentation, mastectomy, lumpectomy, breast-conserving surgery, breast lift, surgery for breast abscess, and surgical breast biopsies.
• Skin Cancer Removal
  • There are a wide variety of signs and symptoms of possible skin cancer dependent on the type of skin cancer.

If you are experiencing any of the above conditions or are in need of a surgical procedure our skilled surgical team at Moab Regional Hospital has the knowledge and expertise to take care of you. Schedule your appointment by calling 435-719-5550 between 8:00 and 5:00 Monday through Friday.