Thank You, Dr. Jackie Doris

There are moments that require us to reflect, to celebrate, and to say farewell. This week, we honor the career of Dr. Jackie Doris, a cherished member of our NOAH family upon her May 1 retirement.

Dr. Doris’s journey into medicine was inspired by her experiences at a young age. Growing up as the daughter of immigrants, she learned the value of diligence and education early on. However, it was a pivotal moment—the hospitalization of her father following a heart attack—that left an impact on Dr. Doris. Witnessing the dedication and kindness of the medical staff during this challenging time steered Dr. Doris towards her calling in medicine.

Throughout her 30 year career, Dr. Doris has been committed to providing personalized and compassionate care to countless lives within our community. To her patients, she was not just a physician but a trusted partner in their health journey, guiding them with empathy and expertise.

Congratulations, Dr. Doris, on your retirement, and may this new journey be filled with happiness, cherished moments, and new adventures. We thank you for all that you’ve done for NOAH. 

If you’re under the care of Dr. Doris at NOAH’s Midtown location, rest assured that you’ll receive excellent care from the Midtown’s other highly skilled providers: Andres Hernandez MD, Hannah Gammage NP, Tahirah Abdul-Rahman DO, and Johnathan Navarro PA, who will continue the standard of treatment you’ve come to expect.

Patient Experience Week

As we step into Patient Experience Week, we want to take a moment to express our deepest appreciation to each and every one of you. This week is not just about celebrating healthcare; it’s about celebrating YOU—the heart and soul of NOAH.

Your support means the world to us. Whether it’s a kind word, a warm smile, or simply showing up for your appointments, your presence makes a difference. You are more than just patients; you are valued members of our healthcare family, and we are honored to be a part of your journey to wellness.

We want to acknowledge how truly awesome our patients are. You face challenges with grace, advocate for your health, and you never cease to amaze us with your strength and courage. It is because of you that we are motivated to provide the best possible care, accessible to every community member.

As a token of our appreciation, patients that have appointments during the week of April 29 – May 3 will receive some fun giveaways, including NOAH branded sunshades and icepacks (while supplies last). 

So here’s to you, our amazing patients! Thank you for being the reason we do what we do. 

Asthma? Allergies? Or Both?

Springtime in the Arizona desert can be surprisingly full of blooms and trees. While it is beautiful, it can also wreak havoc on patients who suffer from seasonal allergies. For those with asthma, it can be a double whammy with uncontrolled allergies triggering their breathing troubles. Nearly 70% of asthmatics report that allergens are a major cause of their asthma symptoms.  Arizona’s allergy season usually occurs in spring and fall, but can start as early as January and last until November. Allergies are a result of your body’s immune system reacting to a foreign substance like pollen, dust, or animal dander. Living in the desert with its lack of rain also keeps the irritants suspended in the air, causing more allergy symptoms.  It is important to identify your asthma triggers, including allergies, to minimize symptoms and keep your asthma under control.

Allergy Symptoms  

Some symptoms of allergies can be confused with a common cold. If these symptoms last more than two weeks, consider seeing your doctor to be evaluated for allergies. Allergy symptoms may include:  

  • Runny nose or persistent nasal congestion  
  • Watery, itchy or red eyes   
  • Sneezing  
  • Scratchy throat  
  • Frequent sniffling  
  • Rash (hives) 

Asthma Symptoms and Triggers

Some patients may experience more of these symptoms during spring or fall if allergies are triggering their asthma. Asthma symptoms may include:

  • Shortness of breath  
  • Frequent coughing with exercise  
  • Chronic nighttime cough  
  • Wheezing  
  • Tightness in chest  

There can be many triggers for asthma around you. These can be seasonal or present all year round. Identifying and controlling these triggers is essential to bringing your asthma under control. Asthma Triggers may include:   

  • Seasonal allergies (pollen, dust mites, roaches, mold, trees, grasses, animals, dust, etc.)  
  • Tobacco smoke (pipe, cigarette, cigar, vape, etc.) 
  • Environmental pollution  
  • Exercise 
  • Seasonal changes  
  • Viral illness (common cold)  

It Runs in the Family

Allergies and asthma tend to run in families.  Children are more likely to be diagnosed with one or both conditions if their parents or siblings have been diagnosed with them in the past. Some children may even outgrow their allergies or asthma as they get older.  

Prevention  

Here are a few things you can do to help when allergies cause worsening of your asthma symptoms. 

  • Avoid outdoor activities when pollen counts are high or many flowers/trees are in bloom.   
  • If you can’t avoid outdoor activities, make sure to shower and change clothes immediately afterwards. Keep these dirty clothes outside of your bedroom.  
  • Keep windows and doors closed to prevent allergens from coming inside.   
  • Change air filters in the home regularly.   
  • If you can, remove carpets from the home or vacuum frequently.   
  • Clean frequently to keep bathrooms free of mold.   
  • Keep pets outside of the bedroom.   
  • Keep stuffed animals off the bed/sleeping surface.   
  • Start allergy medications.  

Treatment  

Make sure allergies are well controlled so they do not trigger your asthma. This may mean using a daily oral allergy medication or daily allergy nose spray.  Some of these medications are available over the counter, like cetirizine or loratadine.  Please avoid regularly using drugs containing diphenhydramine (such as Benadryl) for allergies without speaking with your doctor first. It is also important to avoid anything that can trigger your allergies, especially exposure to secondhand smoke. 

It is important to have your asthma well managed to reduce the frequency and severity of flares when you encounter a trigger. Your physician can help get your asthma under good control with the use of prescription inhalers. If you need the asthma quick-relief medication more than twice a week or two nights a month, then your asthma is NOT under good control.

Talk with your NOAH provider about additional treatment options to further control your allergies and asthma.  They may also recommend seeing an allergist or pulmonologist (lung specialist) for further care.  

Q&A: Sexually Transmitted Diseases and Infections

Get Fresh at Your Local Farmers Market

By Carolina Grant, RD, IBCLC | Registered Dietitian

There are many ways we can properly fuel our body, and a good way to start is by being surrounded by nutritious foods such as the ones you can find at the farmers market. Around the valley, you can find a variety of farmers markets with local vendors and farmers year-round. You can find fresh produce, delicious food, and even homemade products. It’s a great way to try new things you wouldn’t typically find in stores.

Reasons to attend a local farmer’s market:

  1. Enjoy seasonal produce – the produce is as fresh as it gets and usually at its peak in flavor.
  2. Support your local farmers – this helps the local economy by supporting small businesses and creating more jobs.
  3. Cheaper prices – you can typically find great deals on conventional and organic produce.
  4. Less carbon footprint – farm to table is much closer when you’re shopping at your local farmer’s market a few miles away from home.
  5. Physical activity – you’ll do plenty of walking while traveling between vendors and getting some fresh air is always a great decision.
  6. Variety – you’ll find a variety of vendors selling pasta, bread, and fruits and vegetables among many other edible and non-edible items.

Tips for the farmer’s market:

  1. Get there early – you want to increase your chances of finding the most variety before the crowd arrives.
  2. Bring your own bags – most booths don’t offer any and you can help save some plastic.
  3. Bring the family, pets are welcomed too – this is a great way to involve children by allowing them to choose their fruits and vegetables.
  4. Talk to the farmers – they love sharing about their farming practices and will share some tips and tricks on food preparation.
  5. Shop the color of the rainbow – For a well-balanced diet, pick fruits and vegetables of all different colors for a variety of vitamins and minerals.
  6. Sample before you buy – this allows you to try different products without having to buy them first.
  7. Shop the deals – walk around once writing down prices or produce and come around a second time shopping for the best prices. If you find a great deal, buy extra to freeze, or make into large batches for leftovers.  

On WIC, SNAP, or 60 years and older? You’ll want to keep reading.

If you are on WIC or are a qualifying senior, you may be eligible for at least $80 (per family member) or $100 respectively to spend at a participating farmer’s market on locally grown produce.

You’re eligible to collect coupons from February 15 to September 30.

Click here for participating locations: Locations – Arizona Farmers Market Nutrition Program (azfmnp.org)

SNAP Recipients:

Do you have a SNAP/EBT card with an active balance? For every $1 you spend, you receive an additional $1to spend on fruits and veggies, dried beans, and edible plants and seeds – there is no daily limit on how much you can double.

Click here for participating locations: Locations — Double Up Food Bucks Arizona (doubleupaz.org)

If you have any questions regarding nutrition related concerns, please reach out to one of NOAH’s Registered Dietitians!

Understanding AHCCCS and KidsCare

Access to healthcare is a fundamental right, yet navigating healthcare systems can often be stressful and overwhelming. Luckily, the Arizona Health Care Cost Containment System (AHCCCS) and KidsCare programs were designed to provide healthcare coverage to low-income individuals and families. Whether you’re new to AHCCCS/KidsCare or seeking a deeper understanding of its services, NOAH is here to provide you with a starting point on everything you need to know.

What Is AHCCCS?

AHCCCS is Arizona’s Medicaid program, designed to provide comprehensive healthcare coverage to individuals and families who meet certain eligibility criteria. Established in 1982, AHCCCS is jointly funded by the federal and state governments and administered by the Arizona Health Care Cost Containment System Administration.

Who Is Eligible for AHCCCS?

Eligibility for AHCCCS is primarily based on income and other factors such as age, disability, and family size. Eligible individuals include but not limited to:

  • Low-income families with children
  • Pregnant women
  • Seniors
  • Individuals with disabilities
  • Women who want screening for breast or cervical cancer

It’s important to note that eligibility criteria may vary, and applicants should check with AHCCCS or NOAH’s community resource specialists for the most accurate information.

What Services Does AHCCCS Cover?

AHCCCS provides a wide range of healthcare services, including but not limited to:

  • Doctor visits
  • Hospital services
  • Prescription medications (not covered if you have Medicare)
  • Lab and X-rays
  • Behavioral health services
  • Dental treatment (for children under age 21)
  • Vision exams (for children under age 21)
  • Transportation to medical appointments
  • Immunizations

Choosing a Health Plan

Once enrolled in AHCCCS, individuals are required to choose a health plan from a list of care organizations. These health plans vary in terms of covered services, provider networks, and benefits.

How Much Does AHCCCS Cost?

While AHCCCS provides coverage for most healthcare services, some services may require copayments. Copay amounts range from $0 to $30 depending on the type of service. Some people and certain services are exempt from copayments which means that no mandatory or optional copayments will be charged.

KidsCare

What Is KidsCare?

KidsCare is designed to help families who earn too much for AHCCCS (Medicaid) yet earn too little to afford to pay for health insurance for their children.

Who Is Eligible for KidsCare?

In general, an applicant may qualify if they are:

  • Under the age of 19
  • A U.S. citizen or a qualified immigrant
  • An Arizona resident
  • Under the income limit
  • Not eligible for AHCCCS coverage
  • Not currently covered by other health insurance

What Services Does KidsCare Cover?

For those that meet the eligibility requirements, KidsCare covers healthcare services including but not limited to:

  • Doctor visits
  • Immunizations
  • Hospital services
  • Emergency room care
  • Lab and X-rays
  • Prescription medications
  • Dental treatment
  • Vision care

How Much Does KidsCare Cost?

KidsCare will cost no more than $50 a month for one child or no more than $70 a month no matter how many children are in the household. The amount a family pays depends on their income and number of children. 

What Is the Difference Between AHCCCS and KidsCare?

KidsCare specifically targets children, while AHCCCS serves a wider population including children, pregnant women, seniors, and individuals with disabilities. Additionally, the benefits and services covered may vary between KidsCare and AHCCCS due to differences in program design and guidelines.

How Do I Know If I Qualify for AHCCCS or KidsCare?

Deciding on the right program can be overwhelming, which is why NOAH’s community resource specialists are here to help. Schedule an appointment so our specialists can help you apply for AHCCCS, KidsCare, and notify you of any other services that might be available to you. 

What to Bring to Your Appointment

Once you’ve set up a meeting with a NOAH community resource specialist, make sure you bring these documents with you to your appointment. If you’re missing any, don’t worry, our specialists can still help you.

The Importance of Pediatric Vision Screenings

Growth and development are tracked in many ways throughout every stage of life. Just like weight, height, brain function, and dental health are regularly measured, it’s important to monitor eye health as well. Children don’t have a reference point for “good” or “bad” vision like adults do and rarely feel pain or discomfort from conditions affecting eyesight. That’s why regular vision screenings are so important for young children.

Vision screenings are simple tests performed by a pediatrician or other primary care provider during your child’s routine well-child exams. According to the American Academy of Ophthalmology, eye health should be checked on the following schedule:

Newborn

Your NOAH provider will examine baby’s eyes to check for basic indicators of eye health including:

  • red reflex (like seeing red eyes in a flash photograph). If shining a bright light into the eye fails to produce a red reflex, further testing may be needed
  • blink and pupil response

An ophthalmologist (a doctor who specializes in eye health) should do a comprehensive exam if the baby is:

  • born prematurely
  • has signs of eye disease
  • or has a family history of childhood eye disease

6 to 36 months

A second check is usually part of a well-child exam between 6 and 12 months and a third screening by 36 months. During these exams your child’s pediatrician or primary care provider will:

  • reevaluate red reflex, blink, and pupil response
  • visually inspect the eyes
  • check for healthy eye alignment and movement

3 to 5 years

Between the ages of 3 and 5, or as soon as they can read an eye chart, children should begin having routine visual acuity testing. This testing determines the sharpness or clarity of eyesight (ie. 20/20). This is also a good time to look for issues like misaligned eyes, lazy eye, refractive errors, or other focusing problems.

5 years and older

By age 5, children should be getting regular vision screenings during their yearly well-child exams. Your provider will conduct a visual acuity test and reevaluate for vision problems or symptoms of eye disease.

If anything from your child’s vision screening is considered abnormal, your provider may recommend further testing (a comprehensive eye exam) with an ophthalmologist. It’s important to diagnose issues as early as possible and begin treatment. Untreated vision problems can worsen over time and affect a child’s development and ability to learn to read and write.

To schedule a well-child exam along with recommended vision screenings, request an appointment online or call 480-882-4545.

La importancia de los exámenes de visión pediátricos

El crecimiento y el desarrollo se rastrean de muchas maneras a lo largo de cada etapa de la vida. Al igual que el peso, la altura, la función cerebral y la salud dental se miden regularmente, también es importante controlar la salud ocular. Los niños no tienen un punto de referencia para la visión “buena” o “mala” como los adultos y rara vez sienten dolor o molestias por afecciones que afectan la vista. Es por eso que los exámenes regulares de la vista son tan importantes para los niños pequeños.

Las pruebas de detección de la visión son pruebas simples realizadas por un pediatra u otro proveedor de atención primaria durante los exámenes de rutina de su hijo. De acuerdo con la Academia Americana de Oftalmología, la salud ocular debe revisarse en el siguiente horario:

Recién nacido

Su proveedor de NOAH examinará los ojos del bebé para verificar si hay indicadores básicos de salud ocular, incluyendo:

  • reflejo rojo (como ver ojos rojos en una fotografía flash). Si el brillo de una luz brillante en el ojo no produce un reflejo rojo, es posible que sea necesario realizar más pruebas
  • parpadeo y respuesta de la pupila

Un oftalmólogo (un médico especializado en salud ocular) debe hacer un examen exhaustivo si el bebé es:

  • nacido prematuramente
  • tiene signos de enfermedad ocular
  • o tiene antecedentes familiares de enfermedad ocular infantil

de 6 a 36 meses

Un segundo examen suele ser parte de un examen bien infantil de 6 a 12 meses y un tercer examen de detección de 36 meses. Durante estos exámenes, el pediatra o proveedor de atención primaria de su hijo:

  • reevaluar la respuesta de reflejos rojos, parpadeos y pupilas
  • inspeccionar visualmente los ojos
  • comprobar si hay alineación y movimiento ocular saludable

de 3 a 5 años

Entre los 3 y 5 años de edad, o tan pronto como puedan leer una carta ocular, los niños deben comenzar a someterse a pruebas de agudeza visual de rutina. Esta prueba determina la nitidez o claridad de la vista (es decir. 20/20). Este también es un buen momento para buscar problemas como ojos desalineados, ojos perezosos, errores refractivos u otros problemas de enfoque.

5 años o más

A los 5 años, los niños deben someterse a exámenes de visión regulares durante sus exámenes anuales de bienestar infantil. Su proveedor realizará una prueba de agudeza visual y reevaluará los problemas de visión o los síntomas de la enfermedad ocular.

Si algo de la detección de la visión de su hijo se considera anormal, su proveedor puede recomendar más pruebas (un examen ocular completo) con un oftalmólogo. Es importante diagnosticar los problemas lo antes posible y comenzar el tratamiento. Los problemas visuales no tratados pueden empeorar con el tiempo y afectar el desarrollo del niño y su capacidad para aprender a leer y escribir.

Para programar un examen bien infantil junto con las pruebas de visión recomendadas, solicite una cita en línea o llame a 480-882-4545.

Know the Facts about Children and Diabetes

The Defeat Diabetes Foundation (DDF) has named April Defeat Diabetes Month. Defeat Diabetes Month is a time to raise awareness about diabetes prevention, management, and treatment throughout our communities. At NOAH, we are here to help you through all aspects of defeating diabetes, from awareness to treatment.

There are multiple forms of diabetes, but the two most common forms are called type 1 and type 2 diabetes mellitus. Both forms can occur at any age, but a child is typically more likely to be diagnosed with type 1 diabetes. However, with childhood obesity rates on the rise, the number of children diagnosed with type 2 diabetes or who are at risk of developing type 2 diabetes later in life is also increasing. According to the DDF, 1 in 3 US children is overweight or obese. 75% of these children will become overweight or obese adults, and 87.5% of adults diagnosed with type 2 diabetes in the US are overweight or obese.

The DDF has created three different steps to help win the fight to defeat diabetes. The three steps include awareness, action, and prevention.

  • Awareness – creating awareness of the risk factors, warning signs, and complications.

Diabetes is a chronic disease that is characterized by high levels of glucose (sugar) in the blood. Insulin is needed to help lower the levels of sugar and maintain normal blood sugar levels. Diabetes occurs when insulin is not produced in sufficient amounts or the cells of the body are unable to use the insulin properly. Over time, high blood sugar levels may lead to serious complications such as diseases of the eyes (retinopathy), kidneys (nephropathy), nerves (diabetic neuropathy), and blood vessels (that can eventually lead to poor circulation in the extremities). Diet and lifestyle changes can help decrease the risk of these complications.

Type 1 diabetes is a chronic disease that is almost exclusively based on genetics, and it cannot be prevented. With type 1, the pancreas produces very little or no insulin, leading to high blood sugars. Symptoms include increased urination, excessive thirst, increased appetite, and weight loss.

Type 2 diabetes is highly preventable and can be characterized by insulin resistance, decreased insulin production, or a combination of both. Some of the modifiable risk factors for type 2 diabetes include diet, physical activity, and weight management.

  • Action – taking action and providing individuals with the information they need to make the right dietary, lifestyle, and treatment choices to ensure their optimal health.

It’s important to talk with your child’s doctor to find the best treatment plan. Your child’s doctor will talk you through the importance of lifestyle, diet, and medication in order to keep your child’s blood sugar under control. Eating healthy and maintaining an active lifestyle can help manage BOTH type 1 and type 2 diabetes. As mentioned, Type 2 diabetes is highly preventable, so it is even more important to start creating healthy nutrition and lifestyle habits at a young age.

Children who are at risk or are diagnosed with diabetes can live a happy, healthy life through self-management and with an integrative team approach with various medical professionals. An integrated approach with your child’s doctor, a registered dietitian, and a behavioral health specialist can help develop a nutrition, physical activity, and medication plan that can help.

Here are some healthy nutrition tips from The American Academy of Pediatrics:

  • Eat at least 5 servings of fruits and vegetables each day.
  • Stick with water, avoiding juices and other drinks high in sugars.
  • Include high-fiber, whole-grain foods such as brown rice, whole-grain pasta, corns, peas, and breads and cereals at meals. Sweet potatoes are also a good choice.
  • Choose lower-fat or fat-free toppings like grated low-fat Parmesan cheese, salsa, herbed cottage cheese, nonfat/low-fat gravy, low-fat sour cream, low-fat salad dressing, or yogurt.
  • Select lean meats such as skinless chicken and turkey, fish, lean beef cuts (round, sirloin, chuck, loin, lean ground beef—no more than 15% fat content), and lean pork cuts (tenderloin, chops, ham). Trim off all visible fat. Remove skin from cooked poultry before eating.
  • Include healthy oils such as canola or olive oil in your diet. Choose margarine and vegetable oils without trans fats made from canola, corn, sunflower, soybean, or olive oils.
  • Use nonstick vegetable sprays when cooking.
  • Use fat-free cooking methods such as baking, broiling, grilling, poaching, or steaming when cooking meat, poultry, or fish.
  • Serve vegetable and broth-based soups or soups that use nonfat (skim) or low-fat (1%) milk or evaporated skim milk when making cream soups.
  • Use the Nutrition Facts label on food packages to find foods with less saturated fat per serving. Pay attention to the serving size as you make choices. Remember that the percent daily values on food labels are based on portion sizes and calorie levels for adults.
  • Prevention – take a personal pledge to prevent diabetes in your family and your community.

Feel free to reach out to one of your NOAH Health Centers with any questions you may have. NOAH offers a full range of primary and preventable health services for all ages!

To learn more about the DDF and the prevention and management of diabetes, visit their website at https://defeatdiabetes.org/

To read more about Type 1 Diabetes in children visit https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Diabetes.aspx

To learn more about type 2 diabetes and tips for healthy living check out https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Type-2-Diabetes-A-Manageable-Epidemic.aspx