Bloom Fall 2013
Read about support programs for women with breast cancer, what men should know before taking over-the-counter painkillers like ibuprofen, the dangers of carbon monoxide, how to recognize signs of gynecologic cancers, and minimally invasive surgery to treat back and leg pain in this quarterly magazine celebrating women’s health in CO. Written and produced by Clementine LLC of Littleton, CO.
Ibuprofen Warning | Back Surgery With Less Pain | Special Holiday Shopping BenEfits of a buddy Support gives breast cancer patients better quality of life and eases anxieties Register to win a Carbon Monoxide Detector. Page 2 Fall 2013 Volume 3, Issue 4 FREE healthystart Beware of deadly winter gas Each year, more than 15,000 people will be hospitalized and 500 will be killed by carbon monoxide — a gas that can’t be seen or smelled. Carbon monoxide poisoning is more likely to occur during winter because it is a gas that is emitted by stoves, gas ranges, and heating systems. Its effects become life threatening when the fumes build up in areas that don’t have a flow of fresh air, which is also more likely to occur during winter. “The danger of carbon monoxide poisoning is that it can have no symptoms,” says Alain Eid, MD, a pulmonologist at PenroseSt. Francis Health Services. “Someone can go to sleep and never wake up.” Detection systems are the best prevention. These systems are typically small units, much like smoke detectors, that can be hardwired into a home or simply plugged into an outlet. A detector should have a backup battery, which needs to be checked each year at the beginning of winter, Eid recommends. Homes that use wood-burning fireplaces or stoves, or homes that have old furnaces or furnaces that are not checked regularly, have the highest likelihood of excess carbon monoxide. Collages are classic art projects most children get to do. But this nostalgic exercise could be just what people of any age need to set their goals into motion, says Tobi Steinberg, LPC, a clinical psychotherapist at the Center for Behavioral Health at Penrose-St. Francis Health Services. Vision boards use collage to deliberately recognize dreams, tapping into an older technique to propel future success. “Vision boards help people clarify and focus their life goals through a creative picture of what you want to happen in your life,” Steinberg says. Composed of magazine images, photographs, trinkets, words, poems, and other forms of self-expression, vision boards are unique to each creator. People who engage in the process of making a vision board are more likely to pursue their goals, says Steinberg, who has used vision boards for decades to help her clients realize and achieve dreams. Vision boards allow people to focus on the positive, rather than the negative. “With this exercise, your head and your heart are moving in a direction that you want to go,” Steinberg says. Tips for creating successful vision boards: General or specific (i.e., career Whether by a desk, on the Foster motivation and support or personal), big or small, refrigerator, or as a computer by inviting friends or family Recall childhood dreams and colorful or bold screensaver, let the vision over to create vision embrace subconscious ideas board be a constant reminder boards together of your goals Cast a wide brainstorming net 1 2 Make it your own 3 Keep it visible 4 Share the fun Learn how to create your own vision board by visiting penrosestfrancis.org/vision. bloom is published four times annually by Penrose-St. Francis Health Services. As part of Centura Health, our mission is to nurture the health of the people in our community. The information herein is meant to complement and not replace advice provided by a licensed health care professional. For comments or to unsubscribe to this publication, please email us at firstname.lastname@example.org. bloom is produced by Clementine Words LLC. Executive editor is Jill Woodford. Win a FREE carbon monoxide detector. Register at penrosestfrancis.org/ detector. 2222 North Nevada Avenue, Colorado Springs, CO 80907 bloom 2 Fall 2013 Penrose-St. Francis Health Services Cover photo: ©IStockphoto.com/STILLFX; This Page: ©IStockphoto.com/lucato; Opposite Page: ©IStockphoto.com/diegocervo; Portrait ©Ellen Jaskol Envisioning Your Future No disease evidence of is a phrase every cancer patient dreams of hearing. And now, it is a gripping documentary that interweaves the experiences and courage of women diagnosed with gynecological cancers and their doctors. But these are not just doctors — they are rock ‘n’ roll musicians who have formed a band called No Evidence of Disease that tours nationally to increase awareness about this disease. The documentary is a featured film of this year’s Rocky Mountain Women’s Film Festival. Each year, more than 90,000 women are diagnosed with GYN cancers — and 1 out of 3 of those will die from this disease. Yet, most women don’t know the signs. “Like most cancers, the earlier it is diagnosed, the better chance of survival,” says Dirk Pikaart, DO, director of gynecologic oncology at Penrose Cancer Center and founder of Southern Colorado Gynecologic Oncology. Signs include: • Bloating • Spotting after menopause • Pain or bleeding after intercourse • Watery discharge • Itching Join Dr. Dirk Pikaart and Dr. Jeff James, also a gynecology oncologist, on Oct. 30 for a special FREE sneak preview of No Evidence of Disease, followed by a Q&A session. See Page 7 for details. Ibuprofen Warning Use of common over-the-counter painkillers such as Motrin® and Advil® increase the risk of heart attack and gastrointestinal bleeding, according to a new study published this summer in The Lancet medical journal. The Lancet article found that for every 1,000 patients with an average risk of heart disease who take high-dose ibuprofen or diclofenac (such as Cambia®) for a year, about three extra will have an avoidable heart attack, one of which will be fatal. Earlier studies found that these same drugs increase the risk of kidney problems, especially when taken in conjunction with blood pressure medications. With billions of doses of these over-the-counter drugs taken every year in the U.S., this problem is significant, says Charles Ripp, MD, an anesthesiologist at Penrose-St. Francis Health Services. “This is a big deal. Everyone should talk to their doctor about this, even if they don’t think they’re at risk,” Ripp says. “Studies show that 40,000 people go into renal failure annually due to anti-inflammatory medications.” More Info To learn how you can reduce the risks of NSAIDs, go online to penrosestfrancis.org/NSAIDs. For the man in your life: & Q A A: Guillain-Barré syndrome With Robert Dennis Weber, MD Infectious Disease Specialist, Penrose-St. Francis Health Services Q: Does the flu vaccine increase the risk of developing Guillain-Barré syndrome? is a rare disorder in which the immune system attacks the nerves. Nearly 40 years ago, a swine flu vaccine that is no longer used was linked to an increased risk of this disease. But a recent review of data published this spring in the Clinical Infectious Diseases journal found no evidence of a link between being vaccinated against the flu, tetanus, hepatitis, or pneumonia and developing Guillain-Barré syndrome. The study covered more than 3 million patients over 13 years. The benefits of being vaccinated against flu are so much more pronounced than any risks. Every year, many people die from flu and many more suffer severe illness and complications. Meanwhile, any complications of flu vaccine, even minor ones, are very rare. It is clear that the benefit of vaccination far exceeds the risk. Dr. Weber helped develop the flu vaccination policy for Centura Health employees. FREE FLU SHOT Penrose-St. Francis Health Services provides FREE influenza vaccinations for people in our community who cannot afford the vaccine. Supplies are limited. Anyone over the age of 4 who is uninsured/underinsured or without vaccine coverage is eligible. For more information, visit penrosestfrancis.org/flushot. penrosestfrancis.org Fall 2013 3 bloom Finding strength and comfort for the breast cancer journey Cut out for each other Being diagnosed with breast cancer, and getting through the treatment, is scary and often overwhelming. “I always thought, it can’t happen to me,” says Irma Kulikowski, who was 45 when she was diagnosed with breast cancer. At Penrose Cancer Center, Kulikowski got expert medical treatment — and lots of support from her care team and other patients. That support, along with support from her husband and teenage daughter, helped Kulikowski cope with nearly two years of treatment (surgery, chemotherapy, targeted therapy and finally, radiation therapy) and emotional turmoil. Like most women with breast cancer, Kulikowski became depressed. “Depression and anxiety can be incredibly debilitating,” says Diane Thompson, MD, a psychiatric oncologist and women’s health specialist at the Penrose Cancer Center. Thompson and a social worker counseled Kulikowski. “They helped me get over being scared that I was going to die and stop feeling guilty that I put my family through my having cancer,” Kulikowski says. Through the American Cancer Society Look Good Feel Better program held at Penrose Cancer Center, Kulikowski got tips on makeup, skin care, and wigs — and met other women with cancer. She also got to know other patients during chemotherapy. “I met some incredible ladies who I’m still in touch with. Knowing they are continuing on with their lives is helping me a lot,”she says. Irma Kulikowski, Colorado Springs breast cancer survivor bloom 4 Fall 2013 Penrose-St. Francis Health Services photo: ©Ellen Jaskol Cindy Rose, Colorado Springs breast cancer survivor and volunteer “Breast Buddy” at Penrose Cancer Center Breast cancer patients who get good support have better quality of life and may live longer than those who get less or no support. Improving life through support The support can be informal, like Kulikowski’s connections with other patients or the sympathetic ear of a friend or family member, or formal, such as support groups or counseling. Support also can be practical, like rides to and from treatments. Support groups help women with breast cancer cope with their feelings by connecting them with other patients and giving them information and practical help. “It’s very soothing to meet someone who’s been through what you’re going through and has made the decisions you’re trying to make,” says Sharon Halla, RN, a breast care nurse navigator at Penrose Cancer Center who co-facilitates the center’s monthly breast cancer support group. Breast cancer survivor Cindy Rose, now 55, agrees. “We could whine about the same thing and everyone understood,” she says. Patients with advanced cancer who had formal support had much better quality of life than other patients, found a study published this year in the Cancer journal. Another study, published last year in the Acta Oncologica medical journal, found that breast cancer patients who participated in support groups were less anxious than those who didn’t. Linking support and survival Whether support improves survival isn’t known yet. “We need years and years of data to fully assess survival,” Thompson says. But some studies do suggest that breast cancer patients with more support live longer. A study published this year of 2,264 patients found that women with breast cancer who had more social support lived longer than socially isolated women. And a recent review of 87 studies found that cancer patients with more support and larger social networks were less likely to die than other cancer patients. Connecting patients with support Supporting breast cancer patients and connecting them with support programs and services at Penrose Cancer Center is a key part of Halla’s role. She also teaches patients about breast cancer, and coordinates and monitors their care, which can be overwhelming. “A lot of women like to know that I’m here and available for them,” she says. In addition to support groups and counseling, Penrose Cancer Center recently began a new program that pairs a newly diagnosed patient with a survivor. The program is called, aptly enough, Breast Buddies. Grateful for the support she got from other patients, Rose was one of the first volunteer Breast Buddies. She went to her buddy’s first chemotherapy visit and stays in touch with her by email and text. The survivor can support her buddy in whatever ways work for both women, including meeting for coffee or chatting on the phone. As a patient, Rose also took Penrose’s Easy Chair Yoga, taught by a breast cancer survivor. “There are so many issues women with breast cancer face. Whether it’s during or after treatment, support helps women get back on their feet again,” Thompson says. “I could not have wished for a better support system than what I had at Penrose Cancer Center,” adds Kulikowski. How to be supportive Knowing what to say to or do for a family member or friend with breast cancer can be hard. But it’s important to be supportive. “Women with breast cancer want to stay as normal as possible and not be treated like they have the plague,” says Halla. Ways to help include: Talking and listening • • • Let the woman know you’re thinking about her, even if you don’t know what to say Ask what she does and doesn’t want to talk about Ask if she simply needs you to listen or whether she’d like your help solving a problem Offering specific help • • • • Drive to a treatment Make a healthy dinner Pick the kids up from school Do the grocery shopping Checking in after treatment ends • Getting back to normal activities takes time and help Loads of Support The Penrose-St. Francis Breast Care Center offers many types of breast cancer support programs so that women can find what best fits them. For more information, go to penrosestfrancis.org/bcc. Support: Breast Cancer Support Group Couples Facing Cancer Breast Buddy Program Exercise: Non-Impact Aerobics Easy Chair Yoga Pamper Me Pink Chair massages, aromatherapy, spa hand treatments, shopping … What more could a woman want? How about special discounts on early holiday shopping, door prizes, wine, hors d’oeuvres, and a scavenger hunt for answers to breast health questions and myths? Join Penrose-St. Francis Breast Care Center for Pamper Me Pink, a program for all women — not just breast cancer survivors. Date | Friday, Oct. 25 Time | 4:30-7 p.m. Visit penrosestfrancis.org/pampermepink to reserve your spot. penrosestfrancis.org Wellness: Integrative Therapies — Use music, humor, nutrition, origami, and gardening (among many other things) to strengthen the immune system, relieve symptoms and side effects, and reduce stress. Therapeutic Drumming — Improve your mood and decrease tension and anxiety. No experience necessary. Drums are provided. Look Good Feel Better — Cosmetologists teach female cancer patients how to combat the appearance-related side effects of cancer treatment. Education: Angel Network — Cancer awareness and education for individuals or groups focused on improving cancer-related health outcomes. Open to all and FREE of charge. Fall 2013 5 bloom Making severe back and leg pain vanish with minimally invasive surgery Checklist for spine surgery hile most back pain gets better on its own or with treatments like physical therapy, yoga, and over-the-counter pain medicines, sometimes surgery is the only way to find relief. “If symptoms are getting worse instead of better after trying conservative therapy for a few months, we talk about fixing the problem surgically,” says Paul Stanton, DO, an orthopedic surgeon and spine specialist at Penrose-St. Francis Total Joint and Spine Center who completed a fellowship in spine surgery. Back and leg pain together usually means there’s a problem with the discs (the rubbery cushions separating the spinal bones) or nerves that won’t heal without surgery. The discs sometimes wear out enough to cause severe, worsening pain, or tilt and make the back curve. Other times the nerves in the back get pinched, causing leg pain that won’t go away. Less pain, faster recovery These problems can be fixed with minimally invasive spine surgery, where surgeons use special instruments and technologies to operate through small incisions. “We don’t have to damage the soft tissues around the spine. That means significantly less pain and a much shorter recovery,” Stanton says. Patients are usually in the hospital just one or two nights after minimally invasive spine surgery, compared to a few days plus up to a week in a rehabilitation center after traditional surgery. They also can go back to normal activities a few weeks faster. To relieve pain from disc wear and tear (degenerative disc disease, herniated disc, or spinal stenosis), the surgeon trims the disc or the bone near the nerves. To realign and stabilize a slipped or curved spine (spondylolisthesis, or adult or degenerative scoliosis), the surgeon straightens and connects (or fuses) two or more bones in the spine using bone grafts and metallic implants. Spine surgery is no longer as difficult for patients as it used to be, says Stanton. “With minimally invasive spine surgery, we can get the same job done with a lot less discomfort to the patients.” It may be time to consider spine surgery if: ✓ Pain medicines (like Tylenol®, Motrin®, or Aleve®) and conservative treatment like physical therapy don’t relieve your pain ✓ Both the back and the leg hurt, the pain is getting worse despite treatment, or you have weakness ✓ It is hard to stand up straight because you are tilted forward or to the side When considering spine surgery: ✓ Get an accurate diagnosis of the cause of the pain ✓ See a spine surgeon who: - Does all types of spine surgeries - Has training in minimally invasive spine surgery ✓ Ask the surgeon about: - The types of surgery available for the problem - How likely it is that the surgery will relieve the pain - The risks of the procedure - What the recovery will be like - Alternatives to surgery Learn More Join Dr. Paul Stanton, orthopedic surgeon, for a FREE seminar and learn when it’s time to get spinal surgery and how to know if you’re a candidate for minimally invasive surgery, Tuesday, Oct. 22, 6-8 p.m. in the St. Francis Medical Center auditorium located in the NorthCare Building, 6071 East Woodmen Road. Register at penrosestfrancis.org/spineseminar. bloom 6 Fall 2013 Penrose-St. Francis Health Services Mother Daughter Sister Friend Holiday Shopping Extravaganza Date | Sat, Nov 9 Time | 9 a.m.-2 p.m. Location | Penrose Pavilion, 2312 North Nevada Avenue Cost | FREE Get an early start on your holiday shopping and save 20 percent at the Mother Daughter Sister Friend boutique on this special pre-holiday shopping day. Enjoy hot gourmet tea samplings, live music, product demonstrations, prizes, and more. We carry unique gifts for you and all the women in your life, including candles, lotions, scarves, jewelry, and more. Plus, you will receive another 20 percent off coupon you can use Nov. 11-Dec. 23, 2013. For more information, call 719-776-8333. dozens of health classes each quarter. Here is just a sampling of our classes. For a complete list, go to penrosestfrancis.org/calendar. Minimally Invasive Spine Surgery : Get BACK to Life Date | Tue, Oct 22 Time | 6-8 p.m. Location | NorthCare Building Auditorium, 6071 East Woodmen Road Cost | FREE Registration | penrosestfrancis. org/spineseminar Technology… you hear about new surgical techniques in the news, in magazines, and from friends and family. The information can be overwhelming and confusing when deciding which option may be right for you. Many spinal conditions can be treated using a less invasive technique. Join Dr. Paul Stanton, spine surgeon, for a discussion about minimally invasive spine surgery. Learn about the benefits, how it can lead to faster recovery, and who is a potential candidate. penrosestfrancis.org Bloom FALL Calendar Pamper Me Pink Date | Fri, Oct 25 Time | 4:30-7 p.m. Location | Penrose Pavilion, 2312 North Nevada Avenue, 2nd Floor Conference Room Cost | FREE Registration | penrosestfrancis. org/pamperme pink Let us pamper you pink with chair massages, reflexology, aromatherapy, spa hand treatments, and shopping in the Mother Daughter Sister Friend boutique. Go on an indoor scavenger hunt to search for answers to common breast health questions and myths. Door prizes, wine, and light hors d’oeuvres will be provided. This event is open to all women, not just breast cancer patients. WomenHeart Support Groups Dates | 2nd Wed of each month Time | 11:30 a.m.1 p.m. Dates | 4th Wed of each month (men and women) Time | 6:30-8 p.m. Location | Penrose Hospital, 2222 North Nevada Avenue Cost | FREE Info | 719-200-2645 Join a group of women beating heart disease. Share encouragement while learning the latest in heart science, and strategies for coping. The support group that meets on the fourth Wednesday of each month is open to both men and women. Call for information on topics and speakers for upcoming meetings. $99 Screening Mammograms For women at normal risk, an annual screening mammogram starting at age 40 is the best tool to help detect breast cancer in its earliest and most treatable stage. To schedule a $99 screening mammogram at the Center for Women’s Imaging, Colorado Springs’ newest outpatient facility that offers screenings in a spalike setting, call 719-776-8010 or request an appointment online at penrosestfrancis. org/mammogram. Penrose-St. Francis Health Services offers Becoming a Woman Class for Teens Date | Sat, Dec 7 Time | 1-3 p.m. Location | St. Francis Medical Center Cost | $20 per mother/ daughter pair (additional daughters $5 each) Registration | 719-571-3101 Not sure how to sit down with your daughter and have “the talk?” Mothers and daughters are invited to attend this class together in an atmosphere of love and learning to discuss the important topic of growing up and becoming a woman. This class covers information girls need to understand their growing bodies and establish a foundation for continued communication between mothers and daughters. Topics include: • Your changing body • The female and male reproductive systems • The onset of ovulation and menstrual cycles • The wonder of human life and the case for abstinence A Q&A time is included. opposite page Photo: ©IStockphoto.com/Dirima; Illustration: ©IStockphoto.com/PixelEmbargo; This Page: ©IStockphoto.com/bit245 SNEAK PREVIEW FILM FESTIVAL SCREENING Date | Wed,Oct 30 Time | 6-8 p.m. Location | Penrose Pavilion, 2312 North Nevada Avenue, 2nd Floor Conference Room Cost | FREE Registration | penrosestfrancis. org/film Get a jump on the 2013 Rocky Mountain Women’s Film Festival with a preview night hosted by PenroseSt. Francis Health Services. Enjoy your favorite movie treats as you watch No Evidence of Disease. The film is named after a rock band made up of GYN cancer surgeons who use medicine and music to raise awareness of these cancers that kill more than 30,000 women each year. nedthemovie.com/ video. PLUS, enter to win TWO FREE TICKETS to the RMWFF. Fall 2013 7 bloom Fantastic Five Catholic Health Initiatives Colorado Non-Profit Org. U.S. Postage Colorado Springs, CO Permit No. 14 PAID 2222 North Nevada Avenue Colorado Springs, CO 80907 Penrose-St. Francis Health Services has received the 2013 Women’s Health Excellence Award from Healthgrades, an independent hospital rating organization, for the fifth year in a row (2009-2013). Penrose-St. Francis Health Services is part of Centura Health, the region’s leading health care network. Centura Health complies with the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973, and no person shall be excluded from participation in, be denied benefits of, or otherwise be subjected to discrimination in the provision of any care or service on the grounds of race, religion, color, sex, national origin, sexual preference, ancestry, age, familial status, disability or handicap. Copyright © Centura Health, 2013. Examining the options for Alzheimer’s care Alzheimer’s destroys memory and the ability to think and causes dangerous behavioral problems. “It’s pretty devastating for patients and their caregivers,” says Donald Spradlin, DO, medical director for the Namaste Alzheimer Center in Colorado Springs. As the disease worsens, a person may start to do dangerous things, like leaving the stove on or wandering around outside without knowing how to get home. Most people with Alzheimer’s will need more care and supervision as the disease progresses. Relief for Caregivers Residential Alzheimer’s care or, for people with early Alzheimer’s, a day program gives caregivers much-needed relief and provides social interaction and activities geared to the needs of people with the disease. Assisted living facilities provide help with bathing, dressing, and other personal care tasks, managing medications, and daily activities. Nursing homes also provide medical care. Day programs offer services similar to assisted living on a day-to-day basis. Alzheimer’s residential and day care offer a structured, safe environment. Most people with Alzheimer’s do eventually need outside care. “Don’t feel bad about saying enough is enough when it’s clear the person represents a danger to himself or others, or you’re so worn out that your health is at risk,” Spradlin counsels. “As much as we hate to put a loved one into assisted living or a skilled nursing facility, it’s a consequence of a disease and not the failure of the caregiver.” Signs that a loved one needs professional Alzheimer’s care Consider residential Alzheimer’s care or an Alzheimer’s day program when: The caregiver can’t give the physical care needed The caregiver is worn out mentally The person with Alzheimer’s becomes a safety risk The person with Alzheimer’s can’t dress or do basic things such as washing up and using the bathroom without a lot of help Learn more If you have a loved one with Alzheimer’s disease and would like more information about Namaste Alzheimer Center, call 719-776-6300. For a FREE brochure, or to take a virtual tour, visit centuraseniors.org/ namaste. The number of Coloradans with Alzheimer’s disease photo: ©IStockphoto.com/FredFroese