A special supplement of
Personal stories of survival, growth and hope Pages 6-7
Know your medical risks
Birth control isn’t so simple Page 10
2 Women’s Health
October 19, 2017
A Breast cancer fighter stresses the importance of
living life with laughter and love Avery Elbeck
t age 38, I was diagnosed with Stage IV Metastatic Breast Cancer (MBC) in both breasts, hip, T2 of my spine and liver in 2014. When I was diagnosed my daughter was 2 years old. I did 6 rounds of Chemo Therapy, Herceptin and Perjeta, which seemed to work. I was declared to have No Evidence of Disease (NED) from the neck down after treatment. That is until the little buggers reared their ugly cancerous lesions/tumors again in 2016 when I was 41. I received my second diagnosis of Stage IV Metastatic HER2+ Breast Cancer with Brain Metastasis. While I am NED from the neck down, from neck up is a different story. For me, 2016 was not a good year because of my MBC and with this second diagnosis I’ve had: 1) A craniotomy 2) Went on a clinical trial, which failed after 4 months 3) Have done Whole Brain Radiation Therapy (WBRT) 4) Was taken off Perjeta 5) Was doing only Herceptin, but before the 2016 Christmas holiday, my second opinion breast cancer oncologist switched me to Kadcyla IV drug 7) Finished my eighth session of SRS
Radiation booster the afternoon of 2.2.2017 to kick start these buggers into shrinking or dying - preferably dying. I want them to go away! I feel like I’m a young wife who was able to celebrate my seventh wedding anniversary in May. I’m a young mom with a mini princess who turned 5. I should be looking forward to celebrating many more years with my family, but am fearful of this MBC disease. I worry even more today because I lost a fellow MBC sister. A bright light on this world, a good soul taken too soon! My goal is to be around for my husband and daughter, but reality wants to tell me otherwise. I’m not buying it! We have an amazingly fun life and I want to continue on that road. I know I don’t have control over this disease, but I will keep charging ahead and push for more treatment options, more drugs approved to be effective and/or fast tracked by the Food and Drug Administration (FDA), and hope that more lives will be saved from this currently terminal disease. Live, laugh and love - that’s our family motto and I’m sticking to it. I will live every day I have on this earth to the fullest and every day will be well into the future.
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The 2017 Fall Senior Solutions Section is a special supplement of Colorado Community Media, publisher of 18 weekly community papers and websites reaching over 300,000 readers.
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SURVIVOR CREATES PROGRAM AIMED AT HELPING WITH THE PYSCHOLOGICAL IMPACTS OF CANCER FAMILY OF EXPERTS AT SWEDISH MEDICAL CENTER HELP BREAST CANCER SURVIVORS PERSONAL STORIES OF SURVIVAL, GROWTH, ENCOURAGEMENT AND HOPE KNOW YOUR OWN MEDICAL RISKS WHEN CHOOSING BIRTH CONTROL METHODS A DOCTOR’S TAKE ON THE HPV VACCINATION GOING BEYOND BREAST CANCER: FACTS AND STATISTICS TO REMEMBER
Women’s Health 3
October 19, 2017
What advice would you give to women currently fighting cancer?
‘Find a purpose that you know you can embrace when you are done with cancer.’ Diane Simard, survivor
‘A joyous
life’
Cancer survivor creates program aimed at helping patients with the psychological impacts of cancer Tabatha Deans/CCM
T
he only time in 10 months that I felt good is the first five seconds of the day,” said cancer survivor Diane Simard. Yet despite her year-long battle with breast cancer, she said she has become a better person than she was before her harrowing ordeal started.
The entrepreneur, angel investor, and now survivor advocate said she was a very private person when she was diagnosed, and had some unresolved issues that were hindering her life. After facing the possibility of death, that all changed. “It was my first day back at work after my first chemo treatment. I felt lousy, and everything seemed to bother me,” Simard said. “The color of my office walls made me nauseous, my panty hose were too tight, and the smells were intolerable. So I decided to make a list of everything that was making me mad. Then I decided I could either be miserable every moment, or I could live and be happy. So I let it all go. I let go of past relationships that I had held onto, as well as past failures. I was going to live a joyous life.”
Simard was diagnosed with Stage III infiltrating ductile carcinoma in January 2015. The disease was discovered after a routine mammogram. It had spread to her lymph nodes, and she received what she called the “nuclear bomb” treatment. Determined to face her disease with courage and strength, she continued working throughout her treatment. While the treatments seemed to be working, Simard was disappointed in the lack of psychological support offered to cancer fighters. “I was referred to support groups, but I’m a very private person so that really wasn’t for me,” she added. She began keeping a journal, which, she said, helped ease her anxieties and brought meaning to
her battle. Still determined to find mental support, she found Dr. Nicole Taylor, whom she refers to as an Oncologist Psychiatrist. Taylor had spent years working with cancer survivors, and her help inspired Simard to create the Center for Oncology Psychology Excellence (COPE). “I knew we had to do something to get more help for women like me,” said Simard. “I seedfunded COPE, which is a 12-credit specialty offered through the University of Denver. It teaches health-care professionals, and caregivers, specifically how to work with people as they deal with cancer.” Simard never considered defeat as an option, but said the closest she came to giving up was when she suffered a terrible bout of vertigo, which is not deadly. “I laid there, and thought this is it. I’m dying. I’m done.” The episode passed, and Simard said she realized then that she needed to share her story, and vowed to publish her journal for others to read. Her book, ‘Champagne with You’ is expected to be available for sale next year. Simard is currently cancer free and in what she calls the “close monitoring” stage of her journey, and considers her ordeal a literal physical and spiritual cleansing. To learn more about the COPE clinic, visit the website at https://www.du.edu/gspp/services/ cope/ppc.html.
4 Women’s Health
October 19, 2017
A family of experts support breast cancer patients at Swedish Medical Center Sponsored By Swedish Medical Center
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ith no family living nearby, Tina Hamilton said going through seven surgeries and procedures, stemming from a breast cancer diagnosis last November, was bearable because of the “family of experts” at Swedish Medical Center. “Their care and support has been extremely important,” Hamilton said. “I have this family of brilliant people who surround me and tell me what they are going to do to kick cancer’s butt. My doctors have big hearts, and since I’ve gone through seven different procedures, I’m kind of a regular. They definitely know me there.” Breast and general surgeon, Dr. Laura Hafertepen, at SurgOne in Englewood, has been with Hamilton since her treatment started. Hafertepen said there’s a reason Hamilton feels like a member of a family. “It’s because we are a family,” she said. “We understand that every patient is unique and that individualized care is one of the most important services we can provide. When it comes to treating our breast cancer patients, all the doctors are in constant contact by email and phone, and we meet in person once a week. We discuss patient options and we understand what they are going through.” Hamilton, 47, said she had scheduled her regular mammogram and annual exam for December last year, but a month earlier felt something that caused some alarm. She explained that during a self-exam she noticed a lump. Getting in to see her doctor sooner, Hamilton said she was quickly diagnosed with breast cancer. When it came time to seek treatment, Hamilton said she knew Swedish Medical Center was the way to go because they were highly recommended by the medical professionals she worked with while teaching CPR classes. “Every health professional that I have dealt with over the years said they have never had a bad experience there,” Hamilton said. “When it was time for me to get this important treatment, I knew Swedish is where I
had to go.” Hamilton said she’s never regretted the decision for a second, especially considering her course of treatment over the past year. With one breast being diagnosed with breast cancer, and given that she carried the BRCA gene, a bi-lateral, or radical mastectomy, was what Hamilton decided to do. By testing positive for the BRCA gene, the chances of getting rediagnosed with breast cancer again through a single mastectomy or a lumpectomy is around 60 to 70 percent. A bi-lateral mastectomy decreases the chance of re-diagnosis tremendously, reducing the risk to about 10 percent. Hafertepen said the decision between a lumpectomy, which just removes the cancerous lump, and a mastectomy which removes the whole breast, is an especially personal one for women. It’s even more personal when you are deciding to do a double mastectomy. “There is no cookie cutter approach in treating breast cancer,” Hafertepen said. “In Tina’s case, she has several issues and concerns, but I think she made the decision that was right for her case.” Just over a month after the official diagnosis, Hamilton went through a double mastectomy. However, she had no idea what would happen next. Besides going through three months of chemo and seven rounds of radiation, Hamilton had other complications come up. Hamilton said not long after the surgery, it was discovered that she had blood clots. Plastic and reconstructive surgeon, Dr. Lily Daniali, of the Burn and Reconstructive Centers of Colorado, is in charge of Hamilton’s reconstruction process. Daniali said it’s through
Tina Hamiilton started treatment for breast cancer last November, and continues through the process of reconstruction at Swedish Medical Center. knowing Hamilton’s case and working directly with her team of doctors that they were able to pin point the cause of the blood clot. It turned out Hamilton had May-Thurner syndrome (MTS), a rare condition that can cause discomfort, swelling, pain or blood clots, called deep venous thrombosis. After the diagnosis of May-Thurner syndrome, which explained why she also had clotting when she was pregnant years before, Hamilton underwent a radical hysterectomy. Daniali said over the last year, the breast cancer team at Swedish Medical has focused on treating Hamilton’s breast cancer and getting her healthy. Moving forward, Hamilton and her doctors will be able to focus on the process of breast reconstruction. When it comes to reconstruction, it is a lengthy process that requires three steps, Daniali said. Those three steps include the following: 1. Never compromising treatment. Dealing with, treating and eliminating the breast cancer has to take place before reconstruction is considered. 2. Avoid any complications. With breast cancer being such a personal ordeal, Daniali said it’s important to plan, strategize and do whatever it takes to minimize and avoid any chance of complications. For Hamilton, unforeseen complications came up early, but Daniali said that will
help her in planning how to move forward with final reconstructive surgery. 3. Finish the reconstruction process that will allow her to feel good about her body as an end result. While going through treatment, Daniali said she took steps to assure that reconstruction will go smoothly by inserting expanders after Hamilton’s mastectomy. Expanders are a common breast reconstruction technique, which involves expansion of the breast skin and muscle using a temporary tissue expander that serves as a place holder until reconstructive surgery. Now that the cancer treatment is finished, Daniali said she is giving Hamilton time to recover from the radiation. Hamilton’s process to go through full reconstruction can take between four and six months, but through a proactive approach in what became a tough year, Daniali said Hamilton’s positive outlook and struggles will pay off. “I can’t say enough about how caring all of my doctors have been,” Hamilton said. “As the process continues, I’ve known every step of the way what to expect, I’ve known the risks, I’ve known what I am going to go through. Dr. Daniali is a true artist and I know I am in good hands going forward.”
Women’s Health 5
October 19, 2017
TEAMING UP
AGAINST BREAST CANCER Sarah Cannon Cancer Institute at Swedish Medical Center treats 200+ patients per year. Our depth of experience, expertise, and collaboration means you will have the best team by your side, every step of the way.
Swedish Medical Center • 501 East Hampden Ave • Englewood, CO 80113 Learn More at www.swedishhospital.com/breast
6 Women’s Health
October 19, 2017
Personal Stories
A
positive attitude love children survive
and
for my
helped me
Barbara Johnson
Don’t be afraid to
get a second opinion Julie Snow-Kloppenberg
I
n 2009, I was 40-years-old and getting my very first mammogram. I had my appointment and then got a call to come back for an ultrasound. I was thinking that is a little strange as none of my friends ever got called in for an ultrasound, and then came the call for a biopsy. Oh dear, I thought this is not good. I still remember where I was when they called with the results. Over the phone in my lunchroom at work, I was told I had breast cancer, and would need to find an oncologist. Happy 40th birthday to me. My primary care doctor gave me the name of an oncologist. My husband and I went to see her where I was told I had Stage I breast cancer. Even in its early stages, they recommend a mastectomy, radiation and chemo. I
I Mammograms
can detect what you
can’t feel Cynthia Ergenbright
said that seems drastic, but she said it’s better to be sure we got it all. I went home in shock and called one of my best friends. She suggested I go to University of Colorado Health at the Anschutz Center and get a second opinion, as they had a program where you can meet a surgeon, oncologist and radiation doctor all in one visit. I called and made an appointment, and it was such a relief. They explained everything from suggesting I have a lumpectomy to remove the tumor and radiation only as it was DCIS, which meant the cancer was still “in Situ”. So here I am 8 years later with my breasts still intact and no reoccurrence. Getting a second opinion saved me from a lot of pain and suffering that was not needed.
was diagnosed in February 2015 and had a lumpectomy March 1 that year, which, ironically, was the first day of National Breast Cancer Awareness Month. The tumor could not be felt by manual exam, it was only detected through a mammogram. This is why it’s so important for women to get regular mammograms. It’s important even if you don’t feel anything. I’d had a bad fall a couple years before the diagnosis and injured the same breast in the same area. It was determined I had a contusion and it was watched for a couple years. When the mammogram in 2015 showed an area of concern, I immediately told the technician it was “just a contusion from a fall a few years ago”. Then a doctor came into the room and showed me the digital screen that had the lump in clear view and explained to me that it did not look like a contusion and I would need a biopsy. I still maintained
M
y name is Barbara Johnson and I am coming up on my 30-year anniversary of surviving breast cancer. I wanted to tell my story as encouragement for anyone going through the same thing, because when I started my fight, there was none. In December of 1987, I underwent a mastectomy and 16 out of 20 of my lymph nodes tested positive for breast cancer. This was not a good sign because the lymph nodes spread cancer throughout the body, and having even one drastically cut the chances of survival. This meant that my outlook was not good, and being a single mother with three children, I was terrified. I desperately tried to find someone who had beat cancer with a prognosis like mine. I wanted to be assured that it
it was a contusion, but consented to a biopsy just to prove the doctor wrong. Boy! Was I surprised with the biopsy results. I guess I was in such denial that I just couldn’t wrap my brain around the idea of cancer. No one in my family ever had breast cancer, so it was never on my radar. My medical team determined I was a good candidate for a study, so I agreed to participate. There were parameters for the study and I fit them all: negative BRCA gene, tumor was estrogen positive and under 1cm, stage 1, postmenopausal, and over 60. My oncologist told me the study included 1 week (5 days) of radiation, twice a day, but no chemo. He told me over the years it had been determined that women with Stage I breast cancer who had chemo did not live any longer or have any less of a chance of the cancer recurring. My chances of the cancer never coming back with radia-
was possible to win my fight. I wasn’t able to find anyone. Any survivors I met had no positive lymph nodes in their diagnosis. Television, books and even the Cancer Society was not able to find anyone I could talk to. The only thing I could do was fight on for the sake of my three kids. Well, it was enough because I have been cancer free for 30 years now. The doctor who originally treated me told me years later that he never knew of anyone with my diagnosis do as well as I had. I’d like to think that it was my positive attitude and the love for my children that helped me through. For anyone out there who is going through the same thing, know that it is possible to not only beat this horrible disease, but be cancer free again. I am living proof of that.
tion treatment and 5 years of Anastrozole (a hormone suppressing drug) was 98 percent. I thought those were pretty good odds, so I agreed to the study. The study also included mammograms every six months for up to 24 months and then once a year after that. I now have follow-up once a year for the rest of my life. I took a week off from work and had the radiation treatments every day and then started the medication. This October marks my 24th month with perfectly-clear mammograms. I expect them to stay that way. During the last two years I’ve done a lot of research on staying healthy, and have learned a great deal about food and supplements. For women who are diagnosed with breast cancer, I would advise the following: 1. Don’t panic. 2. Get educated.
Women’s Health 7
October 19, 2017
I Breast cancer survivor stresses the importance of
Valuing love grateful memories those you
and being
for the
Carla Coleman
M
y identical twin sister and I were both diagnosed with breast cancer within a week of each other. I was on June 16, and Stacey that following week. We were both diagnosed from routine mammograms that ironically we did not know each other had scheduled. We are 47 and each have a child going into third grade. It’s been a shocking, eventful ride. I have given it much thought as to if we should share this journey we are on together. It’s such a personal time, but if we could bring awareness to this issue and help just a few friends out there, it’s worth it. My friend created a Facebook page for us to share our story with close friends and family, Since we started the page, nine women have gotten their mammograms. God could not have chosen a better partner to go through this with me and we are well aware of the irony of it all. I found this out in June and honestly, July was a great month. My sister and I have chosen to stay happy and positive. It’s just not in our nature to be sad and sorry. We took my daughter river rafting, hiking in Crested Butte and Vail, and had a wonder-
n 2013, I was diagnosed with Stage I Triple Negative breast cancer, at the age of 44. Triple Negative, or TNBC, is an aggressive type of breast cancer which makes up about 10 to 15 percent of all breast cancers. TNBC attacks breast cancer cells that do not have estrogen, progesterone, or HER2 receptors. My breast cancer was not found on a routine mammogram. The mammogram did not show any type of tumor. It was found by doing my monthly breast exam. Mammograms are only 70 percent effective. What makes my story unique is that my husband, Tim, was fighting cancer at the time I was diagnosed. We checked in to our radiation appointments together. We often joked and asked for the family discount. Tim was diagnosed with head and neck cancer 18 months prior. He had surgery and chemo and radiation. He passed away 6 months after I was diagnosed in November of 2013 at the age of 46. I had just finished my radiation treatment a few weeks prior to his passing. I am grateful to be a 4-year survivor and mother to our son, Ben. And my husband is missed every second of every day. Ben is now a senior at Highlands Ranch High School.
Twin sisters
loving life and
fighting cancer
together Stephanie Buckley
ful July all while waiting for my double mastectomy. On July 21, I came through it with the help of my great doctors, wonderful friends, family, loving daughter and amazing husband. My sister was able to come from Kansas to
help after the surgery, but sadly I wasn’t able to travel there for hers on Aug. 15. I cannot tell enough people how well Sally Jobe at Skyridge Hospital, and their amazing staff has treated me. I cannot imagine it be-
ing my job to tell people such horrible news. The compassion and consideration with how they have treated me has been wonderful. They treated me like I was their most urgent case and I received results the next day after each procedure. I cannot begin to be able to express my gratitude at how that helped me to deal with this and come up with a game plan. They helped me to be a fighter. My nurse navigator at Sally Jobe, Michelle Weaver, has been a wonderful partner who held my hand at the very beginning when you haven› t had time to digest what is happening to you. She did an amazing job of explaining the different tests, pathology, and journey I would be on and we are still in touch. She went so far as to connect with my sister’s nurse navigator in Kansas and make sure that she was in good hands as well. We are not through it all yet. We are hoping for the best. This has taught us both to try to be more patient each day, speak more kindly, and appreciate each day we have.
8 Women’s Health
October 19, 2017
Centura Health Breast Care Centers
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hen it comes to breast health, only the most comprehensive and compassionate care should be expected. Ranked among the top Breast Care Centers for patient satisfaction, Centura Health offers complete care focused on a woman’s mind, body and spirit. We are setting the standard for excellence in breast health through a unique, patient-centered approach to care. Our Breast Care Centers located throughout our communities offer a full range of breast imaging and advanced screening services focused on caring for every aspect of a women’s breast health, from routine procedures to comprehensive treatments.
A
At Centura Health, we are committed to saving lives with early detection of breast cancer, offering the highest level of accuracy with state-of-the-art technology and diagnostic care. Our services include digital screening mammography, including 3D mammography, breast diagnostic services, including breast MRIs, ultrasounds, biopsies and DEXA bone density tests, genetic counseling, surgery and innovative treatment options. Find a location nearest you by visiting Centura.org/Mammogram. To help you through your journey, you need a comprehensive team of compassionate medical experts by your side every step of the way. Our dedicated multidisciplinary team of breast special-
Ann Ryan | Breast Cancer Screening Patient and Survivor
nn Ryan is living proof that continuing regular breast cancer screening into your 70s can be lifesaving. Last fall, when the 71-yearold’s annual mammogram showed a possible abnormality, she wasn’t taking chances. Twenty years ago, the Centennial resident and Colorado native had colon cancer, so she understood the importance of early detection from personal experience. When a needle biopsy came back negative but her care providers still thought they saw something atypical, Ryan was fully on board with further testing. She was then referred for a surgical biopsy at Centura Health for an even closer look. Cancer was detected, luckily it was so small — because it had been caught so early — that it was removed at that time, turning the biopsy into a lumpectomy. A second
surgery the following week to check for cancer in her lymph nodes came back negative. She’s now taking antihormones, the standard breast cancer follow-up treatment, for the next five years. But even after two cancer diagnoses, Ryan counts her blessings. In her work with Rocky Mountain Cancer Assistance, where she serves on their board and processes applications for assistance, Ryan sees cases like hers all the time. “I know how common it is, and I also know that people normally need to have radiation and chemo, but I didn’t. I was lucky,” she says. “This has been pretty much a piece of cake, all things considered.” Needless to say, Ryan remains an advocate for annual mammograms. “People use all kinds of excuses, but I wouldn’t just tell them to go, I’d drive them there,” she says.
Melissa Gilstrap | Centura Health Genetic Counselor
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t Centura Health, we’re dedicated to enhancing your understanding of your health through our advanced genetic counseling and testing services. Genetic counseling is the first step in the genetic testing process. In a counseling session, you and a genetic counselor will discuss your family history, personal history with disease, symptoms you may be experiencing and other factors to assess possible health risks. Before seeing the genetic coun-
selor, each woman fills out a family history questionnaire, Melissa Gilstrap, a Centura Health genetic counselor elaborates, “So, I have their risk determined when they come in. From there we can discuss what the guidelines say is right for them.” Then, a woman can pursue additional breast cancer screenings, like whole breast ultrasound or breast MRI, she says. Our clinics also offer testing for genetic mutations that have been linked to breast cancer risk.
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ists, including breast radiologists, breast surgeons, medical and radiation oncologists, nutritionists, pathologists, genetic counselors and nurse navigators, work with you to help coordinate care and address all your questions and concerns in a warm, healing environment. With our team, you can expect a more efficient, effective and personalized approach to meeting your individual needs and achieving the best possible outcome. Below are some powerful, informational and inspirational stories from a few of our expert breast care professionals and patients within our communities. See how, in their own words, breast care professionals and patients describe their experiences:
Dr. Monique Fox | On Site Breast Radiology
hile 3-D mammography is no longer considered just an investigational screening method, it’s still not widely used. Even for those who do have access to the FDA-approved technology, it’s typically only used in women with dense breast tissue and those needing a follow-up exam. Not at Centura Health, though. “We use it for everyone,” says Monique Fox, MD, a radiologist and dedicated breast imaging specialist at Parker Adventist Hospital’s Trio Breast Center. “Parker [Adventist Hospital] has seen phenomenal results for our patients with it.” The patient experience with 3-D mammography, also called tomosynthesis, is the same as with regular X-ray mammography. Breast compression is still required, and
the image scan only takes several additional seconds. But the accuracy is greatly improved. “Instead of looking at two images, I’m looking at 50 to 200 for each breast,” Fox says. “That allows me to see masses more clearly in breast tissue or to see things that aren’t masses. This decreases the callback rate for false positives.” While you should talk with your doctor about your individual risk factors, the American Cancer Society recommends the following screening schedule for women at average risk: A clinical breast exam every three years in your 20s and 30s, and then annually after age 40 An annual screening mammogram starting at age 40 Be familiar with your breasts through self-exams and report any changes to your doctor
Dr. Nadine Mikhaeel, Medical Oncologist with Cypress Oncology | CypressCancerCare.org
U
p to 20 percent of women who have beat breast cancer will have a recurrence within 10 years of their first diagnosis, according to the American Cancer Society. The risk of breast cancer recurrence depends on a variety of factors, including patient age, inherited susceptibility, stage and grade of the original tumor, and type of treatment for the original tumor. But women can help lower the odds of recurrence through lifestyle choices, says Nadine
Mikhaeel, MD, a medical oncologist at Parker Adventist Hospital, “Healthy living, limiting alcohol intake and watching vitamin D levels are three important factors when working on steps to lower breast cancer recurrence.” Dr. Mikhaeel’s three recommendations: Maintain a healthy weight through diet and exercise. Fat allows the buildup of estrogen in the body, which increases the risk of recurrence. Limit alcohol. Although
small amounts of alcohol may have a beneficial effect on the heart, significant daily alcohol intake has been linked to increased risk of recurrence. This may be related to its high sugar content, which may allow cancer cells to grow, Mikhaeel says. Watch your vitamin D levels. “In at least three studies, maintaining a level of 40 or above decreased the chances of recurrence,” Mikhaeel says. Every woman should have her vitamin D level checked to determine if she needs supplements.
Women’s Health 9
October 19, 2017
Comprehensive breast care so advanced the nation is paying attention.
Centura Health offers nationally recognized 3D mammography and breast care with comprehensive services and compassionate care. In addition to our top physicians, treatments and procedures, we make scheduling your mammogram quick and easy by providing multiple breast care centers to choose from throughout our communities. Plus, our breast care centers are part of Centura Health – Colorado's largest health care network. To schedule your mammogram today visit Centura.org/Mammogram and find a location near you.
The Breast Care Centers Centura Health does not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, and marital status in admission, treatment, or participation in its programs, services and activities, or in employment. For further information about this policy contact Centura Health’s Office of the General Counsel at 1-303-269-4188 (TTY: 711). Copyright © Centura Health, 2017. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-303-269-4188 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-303-269-4188 (TTY: 711).
10 Women’s Health
October 19, 2017
Local family stresses the importance of knowing your own medical risks BY JODI HORNER SPECIAL TO COLORADO COMMUNITY MEDIA
When Margaret Payne got a prescription for OrthoNovum, an estrogenbased birth control from her doctor, she never imagined the life-changing impact it would have. An undiagnosed bloodclotting disorder, called Factor V Leiden, was triggered by the estrogen in the pills, and Payne suffered a stroke in the bilateral ascetic region, often called “the heart of the brain,” her mother, Deb Payne, said. It was something that the prescribing doctor had taken notes on but did not remember at the time he prescribed the pills. “In spite of his own records, he gave it to her.” Deb said. “He should have known.”
Margaret was also a smoker at the time, a contributing factor for increased risk of stroke in reaction to birth control pills. The stroke happened in 1993, and for three years, Margaret, a recent Texas A&M graduate at the time, “could function if she was told to function,” her mother said. “She was living in an assisted living facility. They’d say ‘come to dinner,’ and she would go for dinner, but she had no concept of seasons,” Deb said. “She’d dress in shorts in the winter.” Then, on a ski trip with a special assistance group, Margaret fell and broke her knee. The EMT’s gave her morphine to combat the pain, which also had unexpected effects.
By the time her mother found her at Swedish Hospital, “Margaret was laughing and talking and making jokes and teasing—truly her old, delightful self,” Deb said. The effect of the morphine lasted five days, for as long as she was on the drug. When the doctors switched her to Percocet, “she went back into her coma-like state,” Deb said. Margaret’s mother advocated to get her on the morphine again, and one doctor agreed, doing a blind study with morphine and liquid Benadryl. It worked, but he would not continue since he assumed it would require increasingly higher dosages to gain the effect. Two years later, Deb managed to find another Neurologist, Dr. Julie
Siebert, who was willing to try the Morphine again. This time she coupled it with Ritalin. “Bam—she came back again, and has been back ever since,” Deb said with a grin. Now 45, Margaret Payne is thriving in comparison to her previous solitary existence. “She has some memory deficits and some unusual quirks, and she lives at home with us, partly because she cannot manage her own finances, and mostly because she gets very lonely and craves contact with people,” Deb explained. Margaret takes karate lessons and has achieved her second-degree black belt, and she volunteers at the Castle Rock Thrift Store and the family
church. Although the women would like to see a doctor take on Margaret’s case for research in order to help others with brain trauma, they have advice for women who are considering birth control pills. “Research it carefully, research all the options,” Deb said. A history of clotting or blood disorders on the female side of the family are red flags, she said. “It’s easy to check, just get a blood test for Factor V Leiden,” Deb added. Deb also said women need to understand that the protein S deficiency is a major risk factor for women on estrogen. The bottom line, Margaret said, is “don’t just rely on your doctor to know your medical risks.”
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10107 Ridgegate Parkway #320 Lone Tree
Women Caring for Women
Practicing since 1986, our all women OBGYN practice consists of seven Physicians, three Nurse Practitioners and one Physician Assistant. Providing care at two locations: 7720 S. Broadway, Suite 440, Littleton, CO 80122 and 10107 Ridge Gate Parkway, Suite 320, Evergreen Building, Lone Tree, CO 80124. WHCA encompasses a full range of OBGYN services for women from adolescence to beyond menopause. These services include specialized care in routine and high-risk deliveries (VBAC), gynecology, surgery, infertility, hormone replacement therapies and acupuncture services with Jeff Faudem. In office procedures like ESSURE, is the latest method of permanent contraception for women. This procedure is performed under IV sedation. General anesthesia is not needed, as no incisions are required. The surgery takes about 35 minutes to complete and recovery time is a plus, with most women returning to normal activities in one to two days. The Novasure, another in office procedure, has been done at WHCA for over 10 years. Performed on patients
with heavy periods, or a type of abnormal uterine bleeding (AUB), the procedure is performed using IV sedation with a recovery time of 24 hours. If you are not planning on having children in the future and your physician has ruled out more serious causes of heaving bleeding you may be a good candidate. For those experiencing symptoms of hormone imbalance; lack of energy, difficulty sleeping, reduced mental focus and memory, moody, anxious, inability to lose weight and/or reduced sexual desire, chances are you may be a candidate for a Hormone Replacement Pellet Therapy called bioTE. Pellets introduce hormones into the bloodstream 24 hours a day for up to three to five months. This steady stream of cardioactivated hormones allows greater symptom relief over other hormonebalance methods. Come consult with one of our designated pellet providers to see if you are a good candidate. For more information about our specialized services, please call 303-7950890 to make an appointment today. We look forward to being a part of your healthcare needs.
Women’s Health 11
October 19, 2017
Doctor recommends parent get HPV vaccination for girls and boys BY JODI HORNER SPECIAL TO COLORADO COMMUNITY MEDIA
The vaccine against the cancer-causing human papillomavirus (HPV), first introduced to the public in June of 2006, has been a God-send for some and a cause for dismay for others. The HPV virus has more than 100 strains, according to the Centers for Disease Control (CDC), and causes more than 90 percent of cervical cancers. It is also responsible for most cancers of the vulva, vagina, anus, penis, and the oropharynx (part of the back of the throat, base of the tongue and tonsils). The virus also causes genital warts. According to an article in the New York Times last year, “as of 2014, only
Human papillomaviruses HPV, viruses which causes warts located mainly on hands and feet. Some strains infect genitals and can cause cervical cancer. 3D illustration. SHUTTERSTOCK IMAGE
40 percent of girls and 21 percent of boys ages 13 to 17 had received all three doses of the HPV vaccine.” Despite its potential benefits, many parents shy away from the vaccine, citing that their child is not sexually active.
Dr. Stephanie Stevens, of Advanced Pediatric Associates in Centennial, said that her office recommends the vaccine to parents for their children—both boys and girls—by the time they reach 11-years-old.
“Quite frankly, the controversy part is hard to understand from our perspective,” Stevens said, “Unless someone never has any sexual contact in their entire life.” Stevens said HPV can be acquired from any
kind of touching, not just sexual activity. “We don’t see it as a vaccine to prevent sexuallytransmitted disease, we see it as cancer-prevention vaccine. We are trying to prevent cancer at a later age in life,” Stevens said. Stevens said the HPV vaccine works better if given at an early age, recommending parents get their children the shot between 11 or 12-yearsold. The body’s immunebuilding systems are still in full swing at that time, rather than later, Stevens added. Stevens stressed the shot doesn’t work as well when someone is 19 or 20-years-old because when they are sexually active, the HPV shot is less effective.
Westside Women’s Care
The Midwives at Westside Women’s Care Support Your Birth & Your Way in the Safety of a Hospital for 25 Years! Call and schedule ARVADA an appointment (303) 424-6466 today! 7950 Kipling St.
Suite 200 www.westsidewomenscare.com
Every low risk woman benefits from a midwife attended delivery. At Westside Women’s Care our group of 7 nurse midwives bring over 100 years of combined women’s health/ obstetric experience to our practice and strive to provide families with their ideal birth experience in a birth center -like environment within the safety of a hospital setting. We provide comprehensive women’s health and prenatal care in our new midwife suite and work collaboratively when necessary with our wonderful physician group to provide the safest care possible to our patients. We deliver our patients at the beautiful SCL Lutheran Medical Center where we are able to provide the environment and tools to support un-medicated labor and delivery, yet have the resources to manage more high risk conditions such as hypertension, gestational diabetes and can offer TOLAC (trial of labor after cesarean birth) with an 85% VBAC success
rate! For our patients who desire pain relief options, we are able to offer nitrous oxide, intravenous pain medication and epidural analgesia. We strive to prevent unnecessary cesarean birth by supporting physiologic labor and by providing high touch, low intervention obstetric care and celebrate a 12% cesarean birth rate. We routinely take steps to promote infant bonding and breastfeeding success such as immediate skin to skin contact after birth and delayed umbilical cord clamping. For our patients who undergo cesarean birth, our team of physicians work with us to provide family centered cesarean birth including skin to skin contact in the operating room. We strive for shared decision making with our patients to ensure a personalized, safe, and healthy prenatal and delivery experience. Schedule an appointment with us today to learn for yourself the difference midwifery care can make!
12 Women’s Health
October 19, 2017
Beyond breast cancer
Understaing the risks women face STAFF REPORT
While breast cancer gets most of the media attention each year, and pink ribbons are spread all over the country from magazines and Public Service Announcements to NFL stars sporting the color in support of the major cause, there are many more risks out there that women should keep in mind. With adulthood comes the responsibility of managing your health. Starting as early as your 20s, women should follow established guidelines to lead a healthy life. Women should also know their risks based on famiy history, bad habits and environment.
For more information on maintaining your health as you age, visit the Office on Women’s Health website at www.womenshealth. gov. You can also call the helpline for women’s health at 1-800-994-9662.
Heart Disease
Skin Cancer
Ovarian Cancer
As the leading cause of death for women in the U.S., nearly 300,000 women die each year, which amounts to 1 in every 4 female deaths. Almost two-thirds (64%) of women who die suddenly of coronary heart disease had no preview symptoms. Symptoms of heart disease include: • While some women may not have any symptoms, others can experience issues as simple as dull, or heavy to sharp back pain, or discomfort in the neck, jaw and throat. Discomfort in the upper abdomen or back is also a symptom. • Women with heart disease may not be diagnosed until they have symptoms of a heart attack, stroke, arrhythmia, heart failure and stroke. To reduce your chances of heart disease do the following: • Know your blood pressure • Quit smoking • Limit alcohol consumption • Lower your stress level • Have your doctor check your cholesterol and triglycerides.
The most common kind of cancer diagnosed among women in the U.S. each year is skin cancer. More than 300,000 are diagnosed each year. Decrease skin risks by doing the following: • Try to avoid the sun, especially during midday hours by sitting in the shade. • Wear clothing that covers your arms and legs. • Wear sunglasses that block both UVA and UVB rays • Use sunscreen with SPF 15 or higher and both UVA and UVB (broad spectrum) protection. • Avoid indoor tanning.
All women are at risk of ovarian cancer. About 90 percent of women diagnosed with ovarian cancer are over the age of 40, with the greatest number of cases being in women 60 and older. Each year, about 21,000 women in the U.S. are diagnosed with ovarian cancer. Ovarian cancer is the eighth most common cancer, and the fifth leading cause of cancer death. Symptoms of ovarian cancer include: • Vaginal bleeding (particularly if you are past menopause) or discharge from your vagina that is not normal for you. • Pain or pressure in the pelvic or abdominal area • Back pain • Bloating, which is when the area below your stomach swells or feels full • Feeling full too quickly or difficulty eating • A change in your bathroom habits, such as more frequent or urgent need to urinate and/ or constipation.
Lung Cancer While one of the lesser talked about cancers, lung cancer is the leading cause of cancer death and the second most common cancer among both men and women in the U.S. Lung cancer is also one of the most preventable. with experts stressing that the most important way to lower the risk of being diagnosed with lung cancer is to quit smoking and avoid secondhand smoke.