How Important is it to See a Dermatologist?

NOAH is focused on providing primary care to our patients, but we often refer patients to specialists for secondary care specific to a medical concern or screening. One of those referrals is for a yearly exam with a doctor who specializes in our bodies’ largest organ – our skin! The Skin Cancer Foundation recommends people of average risk for skin cancer see a dermatologist once a year for a full-body skin exam. The purpose of this exam is to screen for skin cancer by looking for and testing unusual spots on the skin; and to identify and treat any other skin conditions.

What to Expect During Your Annual Exam

  • You’ll likely be asked to change into a hospital gown; removing all of your clothes except for your underwear.
  • The dermatologist will visually scan your entire body for any abnormal spots or skin conditions.
  • Your doctor will even check hard to see places like your scalp, behind your ears, and in-between your toes.
  • Some doctor’s will use a dermatascope to magnify your skin and see through the first few layers.
  • If you are at average risk for skin cancer and don’t have any other skin conditions or concerns, your exam may take as little as ten minutes.

Tips for a Successful Exam

  • It’s a good idea to do a self-exam before your appointment. If you find any suspicious spots, you can point those out to your doctor right away. Also check your genital area for any spots or skin conditions you may want to address.
  • Skip the makeup (or be prepared to remove it) but do keep your normal cleansing/moisturizing routine. It’s best for your doctor to see how your skin normally appears. If there’s excessive dryness, etc. they may recommend a change.
  • Remove nail polish from your fingers and toes, skin cancer can form there too.
  • Wear your hair down or in a loose ponytail so it’s easy for the doctor to examine your scalp; and remove earrings for better visibility behind your ears.

What Happens if you have an Abnormal Spot?

  • If the dermatologist finds anything that looks suspicious, part or all of the spot will be removed and sent to a lab for testing.
  • If the spot is determined to be skin cancer, the doctor will discuss treatment options with you. Treatment can be as simple as removing the entire spot plus a small margin around the edges if it’s caught early.

Do Your Part to Prevent Skin Cancer

  • May is Skin Cancer Awareness Month but skin cancer prevention is important year-round, especially in Arizona.
  • Reduce your exposure to the sun; especially between 10 a.m. and 4 p.m. when UV rays are strongest.
  • Use broad spectrum sunscreen with an SPF of 15 or higher as part of your daily skin care routine.
  • If you are spending time in the sun, try to reduce the amount of skin exposed by wearing long sleeves, a wide-brimmed hat, etc.
  • Be sure to reapply sunscreen throughout the day if you are outside for a long period of time.
  • Check the label on waterproof sunscreen and reapply as directed.
  • Opt for sunless tanner over indoor tanning beds.
  • Check your body monthly and contact your doctor with anything that concerns you. Here’s a handy Body Mole Map from the American Academy of Dermatology Association that guides you through a self-exam, reminds you what to look for, and even provides space to indicate the location and description of abnormal findings.

Women’s Health Week #2 – HPV Vaccine

By Dr. Hadass Fuerst & Dr. Marissa Jacobs

Women’s Health Week kicks off on Mother’s Day every year. This year for Women’s Health Week from May 8 – 14, NOAH is highlighting three health issues that women should be familiar with and can discuss with their provider any time of year.

NOAH recommends that everyone have a primary care provider (PCP) and a medical home. If you don’t have one or both of these, contact NOAH and establish a PCP who is right for you!

HPV Vaccine

Vaccines save lives in many ways, but the HPV vaccine and the virus it prevents is a little different. Two of NOAH’s providers, Dr. Hadass Fuerst and Dr. Marissa Jacobs explain why.

What is the HPV Vaccine?

The HPV vaccine protects against the human papillomavirus (HPV). This is a sexually transmitted infection and is extremely common. Almost everyone will be exposed to HPV at some point in their lives. Typically, if you are exposed, your body will fight off the virus easily. But when that doesn’t happen, HPV can lead to cancer later in life. In fact, HPV is responsible for more than 95% of cervical cancer cases.

The two- or three-part HPV vaccine (depending on your age) is given to preteens and is covered by most insurance, including Medicaid/AHCCS. If you don’t have insurance, you can get the vaccine at no cost at NOAH through Vaccines for Children.

Why is this vaccine so important?

The HPV vaccine provides coverage for nine strains of HPV which are linked to cervical cancer, anal cancers, and mouth cancers. Getting this vaccine protects against HPV and decreases the risk of future cancer. HPV vaccine is essentially a cancer vaccine.

Why does this vaccine start at 11?  

HPV vaccines can start as young as age 9, but according to the American Cancer Society, preteens have the best immune response with this vaccine, and the vaccine works best when given before someone is exposed to the virus. If the vaccines don’t start until age 15, they will need three doses instead of two. Vaccines can be given up to age 26.

Both males and females need the HPV vaccine because it protects you and your partners from getting or passing the virus. It also prevents genital warts and some cancers which both males and females can get.

What if you are 26 years and older?

The vaccine is now approved up to age 45, but it is less effective after age 18. Discuss this with your doctor if you are interested. Most sexually active adults have been exposed to some, but probably not all, strains of HPV. If you haven’t received the vaccine and are over 26, the best way to prevent these types of cancers is regular physicals and screenings with your PCP.

Women’s Health Week #1 – Cervical Cancer

By Dr. Hadass Fuerst & Dr. Marissa Jacobs

Women’s Health Week kicks off on Mother’s Day every year. This year for Women’s Health Week from May 8 – 14, NOAH is highlighting three health issues that women should be familiar with and should discuss with their provider any time of year.

NOAH recommends that everyone have a primary care provider (PCP) and a medical home. If you don’t have one or both of these, contact NOAH and establish a PCP who is right for you!

Cervical Cancer

Around 12,000 people are diagnosed cervical cancer every year. Understand more about this cancer from two of NOAH’s family medicine providers, Dr. Hadass Fuerst and Dr. Marissa Jacobs.

What is Cervical Cancer and what causes it?

Cervical cancer is a cancer that forms at the lower end of the uterus. Most cervical cancers are caused by Human Papilloma Virus (HPV), the most spread sexually transmitted infection (STI). About 80% of people will be infected with this virus at some point in their lives, and most people’s bodies will naturally fight off the virus. For those who can’t fight it off, HPV can lead to health issues like cervical cancer later in life. That’s why the HPV vaccine is so important. More on that later.

How Can I Lower My Risk of Cervical Cancer?

Yes! First, get regular Pap smears/tests. According to the CDC, millions of women aged 21-65 haven’t had a Pap test in the last five years! Pap tests are covered by private insurance and Medicaid/AHCCCS and are the best way to diagnose any problems. Pap tests save lives.

Second, get the HPV vaccine if possible. It is safe and very effective at reducing the risk of getting HPV-caused cancers later in life.

The CDC estimates that around 93% of cervical cancer cases could be prevented by regular Pap tests and HPV vaccine.

How Often Do I need a Pap Test?

It used to be that Pap tests were recommended every year. With what we know now about HPV and cervical cancer risk factors, that recommendation has changed. The new recommendation for people also being tested for HPV is every three years for people aged 21-29, and every five years for people 30-65.

Who Can Get HPV Vaccines?

Typically, the three-dose HPV vaccine is recommended for males and females around age 11 or 12. We wrote all about the HPV vaccine here!

How Important is Healthy Skin?

Did you know your skin is the largest organ in your body? Your skin protects you, tells you a lot about your overall health, and it grows and changes with you throughout your life. Our skin has a big job to do, which is why keeping skin healthy is so important.

Here are some useful tips to keep your skin healthy at every age.

Pay Attention to Dry Skin

Dry skin can be the result of environmental factors, or it can be because of what is happening inside our bodies. Either way, pay attention to it and hydrate your skin. Drinking a lot of water – 8 glasses – throughout the day, is one of the best things you can do for your skin (and other parts of your body!).

Dry skin can also become a problem if not treated with itching, flaking, even bleeding from dry skin. Many of us in Arizona have to deal with “hard water”, or water heavy in calcium and magnesium. This can make it harder for soap to wash off your skin, so spend a few extra seconds rinsing your hands, face, and body. Moisturize with ointments, creams or lotions after showers, baths, and handwashing, but make sure they don’t contain alcohol which can have the opposite effect.

Baby’s Skin Can Have Different Needs

Babies are a wonder, and so is their skin! Baby acne, birthmarks, diaper rash, hives, eczema, and others are common in babies, but they are things all new parents and caregivers should be familiar with. The American Academy of Dermatology Association has detailed information about these conditions and many more. If you ever have questions about your baby’s skin, talk to your NOAH provider.

Protect Your Skin from the Sun

The great news is that sunscreen is both the easiest and best way to protect your skin from harmful ultraviolet rays. Try for SPF 30 and wear it all year on whatever part of you isn’t protected by clothing – think hands, arms, face, even the tops of your ears. Sun can cause skin aging and increase the risk for certain types of skin cancer.

Everyone deals with some types of skin troubles during their life. Whether it is acne, blackheads, rashes, or dry skin, it is helpful to know how to protect your skin and when it’s time to call your provider. If you have any questions, make an appointment with your provider.

Q&A: Sexually Transmitted Diseases and Infections

Sexually transmitted diseases and infections (STDs and STIs) often have no symptoms but can lead to chronic health conditions if left undiagnosed or untreated. That’s why it is so important to get tested at least once and on a regular basis if you are more at risk due to multiple sexual partners or unprotected sex.

NOAH healthcare provider and STD, STI, and HIV expert Sarah DeRubeis gives answers to commonly asked questions about prevention, testing, and treatment.

Q. How does NOAH test for STDs, STIs and HIV?

A. To test for all STDs, STIs, and HIV, you will need a visual exam, blood draw and urine analysis; all of which can be performed at any NOAH health center.

Q. Is there one test for everything or does someone need to request to be tested for each disease specifically?

A. Each test can be ordered individually. However, most providers order a full panel for patients who have had an exposure or are wanting a screening for STDs, STIs, and HIV.

Q. Is an appointment required?

A. An appointment is required with a health care provider to get an order for STD, STI and HIV testing.

Q. How much does testing cost?

A. There is typically no cost to the patient if the testing is completed as part of a visit with a NOAH healthcare provider.

Q. How long does it take to get results?

A. Timing of results varies based on the type of test. Results for Rapid HIV testing are usually available in as little as 20 minutes. The STD and STI testing with urine and blood can take two to three business days to report and a skin biopsy can take up to seven days.

Q. Who should get tested and how often?

A. Every patient who is sexually active or otherwise at risk should get tested for STDs, STIs and HIV. NOAH providers recommend patients get tested yearly or before engaging in sexual activity with new partners. Even if you don’t have risk factors, it’s a good idea to get tested at least once.    

Q. What are typical treatments if someone tests positive?

A. Most STDs, STIs and even HIV can be treated or even cured with prescription medication. Getting tested and diagnosed is the first step in treating the issue AND preventing it from spreading to others.

Q. If someone tests positive for an STD, STI, or HIV and is treated elsewhere, is it important to share this info with their NOAH health care provider?

A. STD, STI, and HIV testing, diagnosis, and treatment should always be reported to your healthcare provider. This information should be provided as part of your standard health history questionnaire which is completed at your first appointment.

Q. What are the best ways to prevent STDs, STIs, and HIV?

A. The Center for Disease Control (CDC) recommends all individuals who are sexually active protect themselves and others from exposure to STDs, STIs, and HIV. Prevention methods include testing regularly for STDs, STIs, and HIV, using condoms or choosing not to have sex, and refraining from any other risky behavior. There are also vaccines available for human papillomavirus (HPV) and hepatitis B. To reduce the risk of contracting HIV, patients should also consider taking daily pre-exposure prophylaxis (PrEP) HIV prevention medication.  

We encourage you to discuss STD, STI, and HIV testing and prevention with your NOAH healthcare provider. Learn even more about awareness, prevention, and testing for STDs, STIs and HIV in this informative article.

Expert Tips for Combatting Bad Breath

By Jane Roots, RDH | Dental Hygienist

According to a study published by the National Institute of Health, while wearing a mask to prevent the spread of COVID, 34% of participants realized they had bad breath. Guess what? It wasn’t the mask. Just like breathing into cupped hands to check your breath, talking or exhaling through your mouth while wearing a mask traps air causing you to smell your own breath. Thankfully, knowing is half the battle. As we move away from mask requirements in public places, you may breathe a breath of fresh air, but let’s not forget about the the monster in your mouth.

For some, restoring fresh breath can be as easy as grabbing a mint or a piece of gum, but for those with chronic bad breath, or halitosis, the key factor in preventing it is determining the cause. From something as minor as changing your brushing habits to screening for a serious health condition, try these tips for fresher breath.

Brush and Floss

The American Dental Association recommends brushing your teeth twice a day and flossing between your teeth once a day. Proper brushing means spending at least two minutes brushing all sides of your teeth. Divide your mouth into four sections: upper, lower, left and right and spend 30-seconds brushing the inside, outside and chewing surface of each section. Finally, give your tongue a quick brush as well. Proper brushing and flossing helps to get rid of plaque and leftover food particles that affect your dental health and cause bad breath.

Visit the Dentist Regularly

You should schedule dental visits every six months for routine cleanings and checkups. Removing plaque and calculus buildup keeps your teeth healthy and can detect oral health issues like gum disease and cavities that might be harboring stinky bacteria.

Oral Appliance Care

Be sure to follow care guidelines for cleaning and maintaining any oral appliances such a dentures, retainers, or mouth guards. Failing to properly care for these items can not only cause bad breath but can also make you sick or prevent the appliance from working properly.

Stay Hydrated

Keeping your mouth moist maintains a healthy saliva flow which is important for fresh breath. Be sure to drink plenty of water and consult your health care provider about any contributing factors for dry mouth, such as taking certain medications or any underlying health conditions.

Quit Smoking

Smoking is also a contributing factor to bad breath and can increase your risk for gum disease. Discuss quitting smoking with your healthcare provider, it might be easier than you think.

Diet

Eating a balanced diet is important for fresh breath and oral health. Check out our Mouth-Healthy Cookbook for tips and tasty recipes.

Talk to Your Health Care Provider

Diabetes, liver or kidney conditions and gastrointestinal disorders can cause chronic bad breath. If you have or suspect you might have an underlying health condition, talk to your health care provider.

It’s Time to Talk About Colorectal Cancer Screenings

If you are over 45 then it’s time to talk to your doctor about Colorectal Cancer Screenings. We know it isn’t anyone’s favorite topic, but it is easier than you may think to get screened.

A few Colorectal Cancer facts to know before we talk about screenings:

  1. Colorectal Cancer is colon cancer and rectal cancer combined because they both begin in the large intestine.
  2. If caught early, around 90% of people survive this cancer diagnosis. Catching it early is critical!
  3. More men than women are diagnosed with colorectal cancer each year, but not by much. So everyone should be screened.
  4. It might make you a little uncomfortable to talk about, but discussing Colorectal Cancer and screenings saves many lives!

At NOAH, It’s Our Job to Save Your Butt!

All jokes aside, our providers WANT to talk to you about Colorectal Cancer and get you screened.

NOAH is here to discuss colon and rectal cancers with you. We want all of our patients to know the risks, the signs and symptoms (or lack of!), how easy it is to get screened, and that by talking about this can save lives! We have more details about Colorectal Cancer risks, ways to reduce your risks, and a few more details about screenings here. Our NOAH Nutrition Services team also put together some tips on ways to reduce your risk for Colorectal Cancer with food!

As you saw in the video, there are options for screenings and we will help you find the one that is right for you. Request an appointment with a NOAH provider today online or by calling 480-882-4545.

Colorectal Cancer Risk, Prevention, and Detection

Colorectal Cancer Fact A

March is colorectal cancer awareness month and “It’s Our Job to Save Your Butt!” In all seriousness though, colorectal cancer is the fourth most diagnosed form of cancer and the second leading cause of cancer death in the United States. According to the American Cancer Society the overall lifetime risk of developing colorectal cancer is about 1 in 23 (4.3%) for men and 1 in 25 (4%) for women. The good news is that if caught early nine out of ten people diagnosed will survive.

Risk Factors for Colorectal Cancer

  • Age 50 or older
  • Lack of physical exercise
  • Being overweight or obese
  • Certain types of diets
  • Family history of colorectal cancer
  • Personal history of inflammatory intestinal conditions
Colorectal Cancer Fact B

How to Prevent Colorectal Cancer

Colorectal Cancer Screening

NOAH providers recommend people at average risk for colorectal cancer begin regular screenings at age 50. How often you get screened depends on the type of test you get.

Here’s a look at how the different options at NOAH stack up:

TEST NAMETYPEHOW IT WORKSPREPHOW OFTENCOST
VARIES BY INSURANCE

(Often Covered in Full)
Fecal Immunochemical Test (FIT)Stool sample collected at home and mailed to a lab for testingLooks for blood in the stool.NoneEvery yearLeast expensive
Cologuard TestStool sample collected at home and mailed to a lab for testingLike the FIT test, looks for blood in the stool but also checks DNA in the stool for abnormal (possibly cancerous) cells NoneEvery 3 yearsMore expensive than FIT test but less expensive than a colonoscopy
ColonoscopyVisual screening performed in a hospital or specialized clinicChecks for polyps (small growths in the colon or rectum) that may be cancerous or pre-cancerousRequires bowel prep before the procedure and anesthesia duringEvery 10 yearsMost expensive

Talk with your provider about which type of test is right for you. Then, be sure to follow through with your testing, understand your results and even schedule a reminder on the calendar for your next screening.   

Questions? Ask away, we don’t mind because it’s our job to save you’re butt! Request an appointment today!

Fiber and Your Colorectal Health

By Stephanie Olzinski, MS, RDN |Nutrition Supervisor

Fiber is an important nutrient. But why is it important and what can we eat for more fiber are common questions.

Simply put, fiber helps keep us ‘regular’ going to the bathroom more frequently. That is a good thing! When we are regular, stool spends less time in the large intestine. That means less chance of harmful bacteria or carcinogens (substance capable of causing cancer) building up. In a study, The American Medical Association found that when 1,500 patients with early-stage colorectal cancer began eating more fiber-rich foods, it reduced their risk of dying from colorectal cancer by 20%!

Good Sources of Fiber

  • Beans
  • Lentils
  • Oats or oatmeal
  • Nuts
  • Seeds
  • Fruits and vegetables
  • Whole grains or whole wheat products like wheat bread and wheat pasta

A good tip for determining what foods are a good source of fiber is to read the nutrition facts label on products. Grab a package of bread at your house or the next time you’re in the grocery store – if the line for fiber says one serving contains at least three grams of fiber per serving, then it’s a good source of fiber. You can also look for 100% whole wheat as the first ingredient. 

Daily Fiber Intake

Fiber recommendations are different for everyone depending on age and any other medical conditions. In general, achieving an intake of over 20 grams of fiber per day is recommended. Start by trying to add just one extra fiber source daily, like switching to oatmeal for breakfast or adding a larger serving of vegetables at dinner. Not only does a gradual approach make it easier to adapt to new eating habits over time, introducing fiber into your diet slowly prevents bloating and cramping sometimes associated with increased fiber intake.

Kickstart your new eating habits with these tasty, fiber-rich, recipes:

Pozole Verde with Chicken - A Good Source of Fiber

Pozole Verde with Chicken

Hominy is a product of corn and is considered a grain. Low in fat and high in fiber, it has a similar taste to corn though the texture is much different. A main staple in Mexican cuisine, hominy is highlighted in this flavorful soup. We’ve taken it to another level by using chicken instead of the traditional pork shoulder. Also, add in those veggies for an added nutrition benefit and this hearty soup will be a crowd pleaser on any table.

Summer Black Bean and Rice Salad - Good Source of Fiber

Summer Black Bean and Rice Salad

This cold salad is perfect for a warm spring day! It’s packed with protein, high in fiber and delicious flavors that will rock your taste buds. Make this dish ahead of time and keep refrigerated until it’s time to serve! Make this recipe even more fiber-rich by choosing brown rice over white.

Avo Mango Smoothie - Good Source of Fiber

Avo-Mango Smoothie

The bright flavors of the mango and the creaminess of the avocado and banana is a perfect match. Plus you get some amazing health benefits from this smoothie that make it a yummy treat for anyone!

Drink Plenty of Water

Speaking of helping things move through your digestive tract, it is extremely important to drink more water once you start increasing your fiber intake. Constipation can be an unwelcome side-effect of consuming fiber without being sufficiently hydrated. Most people require a minimum of 64 ounces of water per day. You can use the same gradual method here and start by drinking one extra glass or bottle of water each day. It can also be fun to get a special water bottle for yourself, or set a reminder on your phone to remember to take a few extra sips of water throughout the day.

While making just a couple adjustments to your diet can impact your colorectal (and overall) health; there are many other factors like age, family history… that contribute to your risk of colorectal cancer. The next step after prevention is detection. If you are age 50 or older and at average risk for colorectal cancer, NOAH providers recommend you begin your regular screenings now.  It just might save your butt.

Honoring Black History Month: Dr. Kizzmekia Corbett

Dr. Kizzmekia Corbett

Saving Lives With Modern Day Medicine

Dr. Kizzmekia Corbett is a female African-American scientist known for helping to create the Moderna COVID-19 vaccine. She is currently the Assistant Professor of Immunology and Infectious Diseases at Harvard T.H. Chan School of Public Health and the Shutzer Assistant Professor at the Harvard Radcliffe Institute.

Dr. Corbett developed her interest in science early in life and committed to pursuing a career in science while she was still in high school. She embraced every opportunity to participate in lab research working alongside world famous scientists.  After earning her bachelor’s degree, Dr. Corbett went to work as a trainer for the National Institutes of Health (NIH) where she also studied respiratory illness and vaccine development. 

For the next five years she continued her research on the other side of the world in Sri Lanka before returning to the NIH in 2014 to work on vaccine development.  Dr. Corbett’s efforts led medical advancements that would later be used in the creation of the COVID-19 vaccine.        

At the onset of the COVID-19 pandemic, a team of NIH researchers including Dr. Corbett, began developing a vaccine based on some of the previous research conducted by Dr. Corbett.  To manufacture and test the vaccine, the NIH partnered with Moderna, a biotechnology company. The vaccine rapidly entered animal trials soon followed by clinical trials; eventually to become one of the first approved vaccines for COVID-19.   

When asked about her involvement with the development of the COVID-19 vaccine, Corbett said, “To be living in this moment where I have the opportunity to work on something that has imminent global importance…it’s just a surreal moment for me”. Corbett also stated she cried when results showed the Moderna vaccine worked.

NOAH honors Black History Month with snapshots of just a few of the important, impactful, and life-saving stories of Black history and healthcare in America. One of our primary goals at NOAH is to ensure quality healthcare for every member of our community. To do that, we will look at where we have been as a society, what we have accomplished, and how we will collectively achieve this goal.

For more life-saving stories of Black history and healthcare in America, check out these posts: