September 2022 - NOAH | Neighborhood Outreach Access to Health

Who Should Get the New Bivalent COVID-19 Booster?

September 29, 2022/in COVID, Health Education, Medical, News

Along with the approval of the new bivalent COVID-19 booster comes new recommendations from the CDC that everyone who is eligible should receive this booster. So who needs which vaccines and when? NOAH’s expert and Pharmacy Director, Eric Scherf weighs in on the most frequently asked questions.

Q. How is this vaccine different from previous vaccines?

A. The new bivalent COVID-19 boosters protect against the original strain of COVID and the omicron variant. Previous vaccines and boosters have only been monovalent, meaning they only offered protection against the original strain of COVID-19.

Q. Which COVID vaccines should patients have before getting this vaccine?

A. To be eligible for the bivalent COVID-19 booster, patients should have completed their primary series vaccine and any boosters at least two months ago.

Q. Which bivalent COVID-19 boosters does NOAH offer?

A. NOAH currently offers Pfizer and Moderna bivalent boosters. Availability varies by clinic so patients having a preference of manufacturer should inquire when scheduling.

Q. What ages are eligible for the bivalent COVID-19 booster?

A. Patients ages 12 and up are eligible for the Pfizer bivalent booster and ages 18 and older are eligible for the Moderna bivalent booster.

Q. Can patients get the bivalent COVID-19 booster at the same time as their flu vaccine?

A. Yes! Patients can schedule to get the flu vaccine and bivalent COVID-19 booster during the same appointment.

Q. Will the bivalent COVID-19 booster make patients sick?

A. If patients experience any side effects, expect them to be minor and brief, as with previous COVID-19 vaccines, the bivalent booster may cause pain, redness and swelling at the injection site; fatigue; headache; muscle pain; joint pain; chills; nausea/vomiting and fever.

Q. How much does the bivalent COVID-19 booster cost?

A. At this time, COVID-19 vaccines and boosters are covered by the federal government. Insurance, if applicable, may be billed for costs associated with administration of the vaccine.

Q. How can I sign-up to get the bivalent COVID-19 booster?

A. Patients who would like to get the booster can request an appointment online or call 480-882-4545 to schedule.

For more details about COVID-19 vaccines and boosters, feel free to ask your NOAH provider or check out the CDC website.

5 Things to Know for Flu Season 2022-2023

September 28, 2022/in COVID, Immunizations, Medical, Pediatrics

Flu season is around the corner and NOAH is ready to keep you and your family protected. We know that with COVID there might be additional questions about the virus, symptoms, and the vaccines. NOAH has you covered with these top five things to know about flu season.

1. Flu Season is Almost Here

Flu season officially starts in October and can last through May of the following year. But the peak of flu usually happens around December through March with February being the month that often has the most flu cases nationwide.

2. Try These Safety Measures Stop the Flu

Many of the things we continue to do to slow or stop the spread of COVID like extra hand washing, more antibacterial gels and wipes, staying home when sick, and wearing masks (especially if sneezing or coughing), will help reduce the flu as well!

3. The Flu Vaccine Helps

Every year, flu shot manufacturers identify the strains of influenza A and B that pose the most risk for the coming season. Flu shots also include H1N1, and because of flu shots, H1N1 isn’t causing outbreaks anymore. Flu shots are adjusted every year with new influenza (flu) strains because it mutates like all viruses.

4. Flu Shots are Optimized by Age Group

Children are a high-risk group with flu so anyone 6 months and older should get the flu shot. When children under eight are getting the flu vaccine for the first time ever, they will need to have two doses, given four weeks apart. The following flu seasons will be just one dose.

A high-dose flu vaccine made specifically to support the more fragile immune system of people ages 65 and up is also available during flu season.

5. Flu Shots and COVID Shots Can Go Together

The CDC says that it is safe to get the flu and COVID vaccines/boosters at the same time. If you have any concerns about potential side effects or changes in effectiveness of the vaccines if given together we suggest talking to your NOAH provider to come up with a vaccine plan that is right for you. NOAH is administering bivalent COVID boosters along with flu vaccines in all of our health centers.

Almost everyone can and should get the flu shot every year. Even people with egg allergies can talk with their healthcare providers about egg-free vaccine options. The only people who shouldn’t get vaccinated for the flu are patients under 6 months old or someone with history of an anaphylactic reaction to the flu shot or one of its components.

The CDC has a lot of information about flu season including updated flu cases and vaccine activity on their website here. If you have questions about the flu vaccine or want to schedule your appointment, contact NOAH today!

Celebrating Hispanic Heritage

September 28, 2022/in Health Education

By Lisa Nails and Leslie Pina | NOAH Patient Navigators

National Hispanic Heritage Month is observed from September 15 to October 15 by celebrating the histories, cultures, and contributions of American citizens whose ancestors came from Spain, Mexico, the Caribbean, and Central and South America.

The observation started in 1968 as Hispanic Heritage Week under President Lyndon Johnson and was expanded by President Ronald Reagan in 1988 to cover a 30-day period.

At first it may seem awkward this observation doesn’t follow a traditional calendar month but the dates make perfect sense! September 15 is set as the starting date for the month as it is important for many reasons. It is the independence anniversary for Latin American countries: El Salvador, Guatemala, Costa Rica, Nicaragua, and Honduras. From here onwards, the independence days of Mexico and Chile fall on September 16 and September 18, respectively. Dia de la Raza or Columbus Day also falls within this month on October 12.

NOAH is proud to recognize and celebrate the incredible contributions to medicine brought forth by Hispanic healthcare pioneers. Here’s the story of Carlos Juan Finlay, MD.

Solving the Yellow Fever Mystery

In a time when yellow fever was ravaging through several nations, one doctor had the answer and was ignored and mocked for his ideas. Dr. Carlos Juan Finlay was a Cuban epidemiologist who is recognized for his research on yellow fever and his discovery of how it is transmitted. Finlay was intrigued in finding the cause of yellow fever ever since he graduated from Jefferson Medical College in Philadelphia, Pennsylvania in 1855.

At this time, it was thought that filthy clothing and filth in the air was the cause of yellow fever. Finlay had a different idea on how yellow fever spread and he began to investigate the relationship between yellow fever epidemics and the increase in mosquito populations. In 1881, Finlay presented his idea that mosquitos are the ones who carry yellow fever from infected patients to healthy patients. Unfortunately, experts ridiculed his idea.

In 1898, during the Spanish-American war the U.S. Army looked to Finlay for help in reducing the number of deaths caused by infectious diseases. During this time more troops were dying from diseases than from combat. By applying the ideas Finlay had about mosquitos-as-vectors and mosquito control, the Army was able to reduce the number of disease outbreaks.

The completion of the Panama Canal had been repeatedly disrupted by disease outbreaks and with Finlay’s discoveries it could finally be completed. After all the ridicule Finlay encountered when he first presented his ideas, his thinking was later referred to by William Gorgas, MD as “the best piece of logical reasoning that can be found in medicine anywhere”.

The Function of Fiber

September 22, 2022/in Health Education, Nutrition

By Noel Ugarte, MS, RD | Registered Dietitian

Let’s talk about fiber. I’m sure most of us have heard that fiber is good for us – but how? It turns out that fiber can help manage and prevent many diseases.

What is Fiber?

Fiber is plant material that our bodies cannot fully digest. This means that the only food sources of fiber are plants. Vegetables, fruits, whole grains, and beans are all excellent sources of fiber. Fiber is a functional food. This means that as fiber travels through our bodies, it does different helpful jobs. But how does undigested plant material traveling through our body help improve our health?

Type 2 Diabetes

Fiber is technically a type of carbohydrate. The great news is, as stated above, we do not have the digestive tools to break it down into sugar. Instead, our stomachs break down fiber into smaller pieces. This takes a long time for our stomachs to do. Slower digestion time means that blood sugar levels will rise at a slower rate. This is great news for people who are trying to keep blood sugar levels steady. The American Diabetes Association recommends diabetics consume adequate fiber in their diets each day to help manage diabetes.

Whole grain bread, brown rice, beans, whole wheat pasta, oatmeal, popcorn, and potatoes with skins are all examples of high fiber carbohydrates.

Broccoli, carrots, onions, cauliflower, asparagus, green beans, eggplant, cucumbers, and celery are all examples of non-starchy vegetables. These vegetables do not raise blood sugar levels like potatoes and corn do. They are also packed with fiber!

High Cholesterol

Fiber may also help to lower LDL cholesterol (bad cholesterol) levels. Specifically, soluble fiber has been shown to help with this. Soluble fiber is a type of fiber that softens and grows when it comes into contact with liquid. Imagine what happens when you cook rice, oats, or dried beans – they soften and grow in size! As this thick fiber travels through your gut, it grabs some cholesterol that you ate in your meal and stops it from getting absorbed into your blood.

You can get soluble fiber into your diet by eating more lentils, beans, oats, chia seeds, fruits such as apples, oranges, and bananas, and vegetables such as brussels sprouts, carrots, and potatoes.

General Gut Health

Fiber is the main food source for the bacteria in our gut. It may not sound good to have bacteria in your gut, but in fact, these intestinal friends are necessary and help us to stay healthy. As they eat (or, rather, ferment) the fiber, they produce gas. This is why fibrous foods can sometimes cause bloating and gas! It’s important we feed them well in order to keep our gut bacteria diverse and flourishing.

According the the American Cancer Society, fiber has been linked to lowering colorectal cancer risk. It can also help to prevent polyps and diverticulitis flares. This is because the undigested plant material acts as a brush, brushing clean the lining of our intestines as it makes its way through us.

Fiber can also help regulate bowel movements. The different types of fiber – soluble and insoluble – work to change the shape and texture of our stools. Soluble fiber absorbs water and becomes thick, insoluble fiber travels unchanged throughout the body making stools more bulky in size. These two functions – viscosity and bulking – help our stools to be more regular in schedule and texture.

The great news is that most fibrous foods have a mix of both types of fiber.

Weight Loss

Higher fiber diets have been linked to weight loss. Foods that are naturally high in fiber tend to be higher in vitamins and minerals and lower in calories. Think about the difference between cheese puffs and carrots. You can eat a lot more carrots for 100 calories than cheese puffs for 100 calories. Thus, when meals are higher in fiber, you are more likely to feel fuller for longer while taking in less overall calories.

How Much Fiber Do I Need?

Adult females should get about 25g fiber per day, and males should get about 38g fiber per day (or about 14g fiber per 1,000 calories per day).

If you are looking to increase your fiber intake, consider increasing your fiber intake slowly. Going from a low fiber diet to a normal fiber diet too quickly can cause abdominal pain and bloating. Try increasing intake by 5-10 grams every few days as tolerated and remember to drink plenty of water.

Take a look at some of these higher fiber foods. Which foods can you add into your diet today?

High Fiber Foods (4 grams or more)

Food	Serving size	Grams of fiber
Artichoke	1 medium	10.3
Beans, baked, plain	1/2 cup	5.2
Beans, black	1/2 cup	7.5
Beans, kidney, canned	1/2 cup	6.9
Beans, lima	1/2 cup	6.6
Beans, navy	1/2 cup	9.5
Beans, pinto	1/2 cup	7.7
Beans, white, canned	1/2 cup	6.3
Blackberries	1/2 cup	3.8
Bulgur	1/2 cup	4.1
Cereal, high fiber, bran	1/2 cup	4-9
Chickpeas, canned	1/2 cup	5.3
Lentils	1/2 cup	7.8
Mixed vegetables, frozen	1/2 cup	4
Pear	1 medium	5.1
Peas, green, frozen	1/2 cup	4.4
Peas, split	1/2 cup	8.2
Potato, baked with skin	1 medium	4.4
Potato, sweet, baked with skin	1 medium	4.8
Quinoa	1/2 cup	5
Raspberries	1/2 cup	4
Soybeans	1/2 cup	5.1

Academy of Nutrition and Dietetics (sources: US Department of Agriculture, Agricultural Resource Service. 2008. USDA National Nutrient Database for Standard Reference, Release 20. Nutrient Data Laboratory Home Page, http://www.ars.usda.gov/ba/bhnrc/ndl; accessed November 5, 2008. Nutrition Data.com: Nutrition Facts and Information, www.nutritiondata.com; accessed April 28, 2008. American Dietetic Association, Nutrition Care Manual: Constipation Nutrition Therapy, http://cms.eatright.org; accessed June 25, 2008.)

Moderate Fiber Foods (1-3 grams)

food	serving size	grams of fiber
Banana	1 medium	3.1
Barley	1/2 cup	3
Beans, green or yellow	1/2 cup	2
Beets, canned	1/2 cup	1.5
Blueberries	1/2 cup	1.8
Bread, whole or cracked wheat, pumpernickel, rye	1 slice	2
Broccoli	1/2 cup	2.5
Brussels Sprouts	1/2 cup	2
Cabbage	1/2 cup	1.4
Carrots, frozen	1/2 cup	2.4
Carrots, raw	1/2 cup	1.6
Cauliflower	1/2 cup	2.5
Cereal, bran w/ raisins	1/2 cup	3.4
Cereal, wheat or oat	1/2 cup	2 – 4
Cherries, canned or fresh	10 cherries	1.4
Coconut, shredded	1 oz.	2.5
Corn, canned or frozen	1/2 cup	2.1
Cornbread	2″x2″ piece	1.4
Crackers, whole wheat	4 crackers	1.7
Cranberries	1/2 cup	2.6
Dates, dried	5 dates	3.3
Eggplant	1/2 cup	1.3
English muffin	1 english muffin	2
Figs, medium	1 fig	1.9
Fruit cocktail, canned	1/2 cup	1.2
Grapefruit	1/2 cup	1.4
Greens, such as turnips, beets, collards	1/2 cup	1.6-3.2
Kale, cooked	1/2 cup	1.3
Kiwi	1 medium	2.3
Melon	1 cup	1.4
Muffin, oat bran	2 oz.	2.7
Nuts, almonds	1 oz.	3.5
Nuts, pistachios, pecans, walnuts	1 oz.	2-3
Oat bran	1/2 cup	2.3
Oatmeal	1/2 cup	2
Okra	1/2 cup	2
Orange, 2 1/2″	1 orange	3.1
Papaya	1/2 papaya	2.8
Peaches, fresh or canned	1 fresh or 1/2 cup canned	1.5
Peanuts	1 oz.	1 oz.
Pears, canned	1/2 cup	1/2 cup
Peas, green, canned	1/2 cup	1/2 cup
Pineapple, fresh	1/2 cup	1.1
Plum, 2″	1 plum	1
Popcorn, air-popped	1 cup	1.2
Prune juice	1/2 cup	1.3
Prunes	5 prunes	3.5
Pumpkin, canned	1/2 cup	3.6
Raisins, seedless	1/4 cup	1.4
Rice, brown or wild	1/2 cup	1.8
Sauerkraut, canned	1/2 cup	3.4
Seeds, sunflower or pumpkin kernels	1/4 cup	1.1
Spaghetti, whole wheat	1/2 cup	3.2
Spinach, canned	1/2 cup	2.6
Spinach, frozen	1/2 cup	3.5
Squash, all varieties	1/2 cup	2.9
Strawberries	1/2 cup	1.7
Tangerine	1 tangerine	1.5
Tomato sauce, spaghetti or marinara	1/2 cup	3..3
Tomatoes, raw	1 medium	1.5
Tortilla, corn, 6″	1 tortilla	1.6
Veggie or soy patty	1 patty	3.4
Wheat germ	2 tbsp.	1.7

Academy of Nutrition and Dietetics (sources: US Department of Agriculture, Agricultural Resource Service. 2008. USDA National Nutrient Database for Standard Reference, Release 20. Nutrient Data Laboratory Home Page, http://www.ars.usda.gov/ba/bhnrc/ndl; accessed November 5, 2008. Nutrition Data.com: Nutrition Facts and Information, www.nutritiondata.com; accessed April 28, 2008. American Dietetic Association, Nutrition Care Manual: Constipation Nutrition Therapy, http://cms.eatright.org; accessed June 25, 2008.)

Ready to Vote?

September 20, 2022/in News

Register to vote, verify your registration, or request a ballot here:

READY TO VOTE?

NOAH has partnered with the national nonpartisan, non-profit organization, Vot-ER to help ensure our patients are ready to vote in the upcoming election. Healthcare organizations across the country are participating in this effort to build awareness about the impact of voting.

Why?

There are a couple of reasons why NOAH is part of this campaign.

Everyone needs healthcare. Our services reach a diverse population and can be effective in getting the word out throughout Maricopa County.

Health centers rely on government funding for a significant portion of our operating costs. This funding is decided on by our elected officials and/or guidelines set through legislation.

VOTE. It matters.

When you vote, you are helping to select people who will represent your views on important topics and legislation that impacts the way you live. Take the opportunity to share your voice by voting in every election. Voting can be complicated but there are lots of unbiased resources to help explain who and what is on the ballot in terms that are easy to understand.

If you need more information on how to register to vote or details about what’s on the ballot, click here or text VOTE NOAH to 34444.

Suicide Prevention: Supporting a Loved One

September 14, 2022/in Behavioral Health

Who is at Risk?

Suicidal thoughts can impact anyone regardless of age, gender, or cultural background. According to the National Alliance on Mental Illness (NAMI), 4.9% of all adults have experienced serious thought of suicide. That number increases to 11.3% in young adults ages 18-25, 18.8% in high school students, and 45% in LGBTQ+ youth. Suicide is the 12^th leading cause of death overall in the United States, second leading cause of death among people 10-14, and the third leading cause of death among people 15-24. We can impact these numbers by spreading the word about suicide awareness and prevention.

What to Look For and When to Act?

Everyone has a bad day from time to time, but when that bad day turns into multiple days, or difficulty with routine daily tasks, it’s important to take notice. Some might notice increased isolation from friends or family or decreased interest in social, work, or academic activities. Others may notice a change in anxiety, depression, substance use, performance at work or school, prolonged stress, or difficulty adjusting to situations. Regardless of the change, there is hope and ways to take action and offer support.

What to Do?

It can be extremely difficult and scary when a loved one, child, friend, or family member is experiencing mental health symptoms, especially suicidal thoughts. Have frequent conversations with your children and family about mental health and complete “emotion check-ins”. If you make this a part of your daily routine, you begin to normalize mental health and make it comfortable to have conversations when your loved ones when they are struggling, especially with suicidal thoughts.

Another way to offer support is to listen and validate their experience. You might not understand what they are going through, but you are able to offer support and create a safe place for active listening. Get feedback and support from others: siblings, family members, friends, community members, teachers. Noticing how behaviors change in multiple settings can help assess the severity of the problem and determine what the next steps should be.

The best way to prevent a suicide-related crisis is to seek help and support before the crisis occurs. If someone you love feels worried, but does not feel they are in imminent danger, encourage them to talk to their medical provider or mental health professional. It’s also important to get friends and family involved, we all need support. If you think your child or loved one is in immediate danger, call a crisis line, take them to the nearest hospital, or call 911.

National Suicide Prevention Lifeline (1-800-273-8255)
Crisis Text Line (“NAMI” to 741-741)
Suicide and Crisis Lifeline: 988

Cholla Health Center Provider Profile: Meet Dr. Eller

September 12, 2022/in News

NOAH’s newest location, Cholla Health Center, is expected to open in late 2022. Conveniently located in south Scottsdale, the 30,000 square foot facility will combine three of NOAH’s locations; Heuser Family Medicine Center, Heuser Pediatric Dental, and the north Scottsdale Cholla Health Center. With capacity to serve over 16,000 patients annually, NOAH is able to provide care for all of the existing patients as well as welcome many new patients. For more information about the new Cholla Health Center including details about the new facility, construction progress, services offered, and NOAH’s Scottsdale roots, visit the project website.

At NOAH, we believe high quality healthcare starts with great people and are pleased to have experienced, caring, and passionate providers like Dr. Eller on our team.

Q. How long have you been a provider with NOAH?

A. I started working for NOAH in February 2017 and have now been with NOAH for five and a half years.

Q. If I asked your patients to describe what makes you a good provider, what would they say?

A. I work with my patients in shared decision making to help them achieve their healthcare goals.

Q. What is the most rewarding thing about being a NOAH provider?

A. At NOAH I have had the ability to serve a diverse patient population and have earned the trust of many patients.

Q. What positive changes have you seen in community healthcare over the years?

Keeping telehealth as an option has been a great addition for our NOAH patients. At NOAH, our wonderful integrative team helps to offer comprehensive care for our patients.

Q. What about the new Cholla Health Center excites you the most?

A. As a provider at the previous Cholla location, we’ve been without a permanent home, off and on, for over two years. I am excited to have a clinic to serve my patients in full-time.

Q, What do you hope the new Cholla Health Center will bring to the south Scottsdale community?

A. NOAH has operated clinics in north and Old Town Scottsdale but has not had the capacity to extend services as far south and east as we will with this new location. There is a high demand in this area for an integrated healthcare offering that supports underserved populations

Q. What do you like to do in your free time?

A. My husband and I are passionate about traveling and recently visited Puerto Rico. We loved the beautiful island, the people, and culture. We hiked the rain forest, relaxed on the beautiful beaches, and enjoyed time with friends. More locally, Sedona is one of our favorite places in Arizona to explore. We love the delicious food, beautiful hikes, and peacefulness the town offers.

To learn more about Dr. Eller, check out her Provider Profile.