Bloom Summer 2012

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BOTOX FOR MIGRAINES

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LOWERING BLOOD PRESSURE

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NEW PAIN TREATMENT

Js! FREE P e about

r Learn mo ats and night swe f in a set o enter to w ajamas. wicking p See Page 3

for details.

SLIM DOWN THE MIDDLE Tips for trimming menopause belly fat DRUM AWAY YOUR STRESS BUILD A BREAST CANCER DETECTION PLAN RESCUE TIPS FOR MOMS OF TEEN DAUGHTERS SEE OUR SUMMER CLASSES ON PAGE 7

Summer 2012


Save a life by donating blood The need for donated blood peaks in the summer at the same time donations start running dry. “It’s a struggle getting blood donated in the summer because people are busy, and businesses and schools don’t hold their normal drives due to vacations,” says Carolann Books, donor recruitment coordinator at Penrose-St. Francis Blood Bank. Penrose-St. Francis Blood Bank needs about 600 donors each month to supply the blood needed in the Colorado Springs area. This is the only local blood bank that draws blood for use solely in the local community. “Only about 5 percent of the eligible population donates blood,” Books says. “It’s always a challenge to get enough, but particularly in the summer.” Donated blood is needed by people who get in accidents as well as by surgery patients and cancer patients.

COVER PHOTO: ©ISTOCKPHOTO.COM/CREACART

GIVE BLOOD

To find the locations of blood drives in your neighborhood, go to penrosestfrancis.org/donate or call 719-776-5822. 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 bloom@centura.org. Bloom is produced by Clementine LLC of Denver, Colo. Executive Editor is Jill Woodford. 2222 North Nevada Avenue Colorado Springs, CO 80907

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Schedule Your Mamm-ahh-gram Imagine being wrapped in a cozy robe and enjoying a relaxing hand rub while soothing instrumental music drifts softly above your head. This is the experience you can have while waiting for your next mammogram, bone density scan, or other imaging test at the new Center for Women’s Imaging. Built by women for women, this center provides an array of medical tests in a spalike environment. The Center is part of the new Penrose Pavilion, a freestanding medical office building that offers easy access, convenient parking, and a stressfree environment. One of the amenities offered at the Center is a free hand scrub that leaves soft, supple, sweet-smelling skin. Try it at home by following the recipe below.

SCHEDULE YOUR MAMMOGRAM at the new Center for Women’s Imaging. Call 719-776-8010.

SUGAR SCRUB

PHOTOS LEFT TO RIGHT: ©ISTOCKPHOTO.COM/SJLOCKE, ELLEN JASKOL, ELLEN JASKOL

healthystart

Ingredients: 1 cup white sugar 3 tablespoons olive oil 2 tablespoons vanilla extract Preparation: 1. Pour the sugar into a bowl. Add the olive oil and mix together to form a paste. If it is too runny, add more sugar. If it is too stiff, add more oil. 2. Add the vanilla extract last for a hint of scent. To use, scoop some into the palm of your hand and massage gently into your hands or feet. Avoid broken skin. Penrose-St. Francis Health Services


& QA

Are there any new treatments for chronic migraines?

The Food and Drug Administration has approved Botox injections to treat migraines, paving the way for insurance companies to cover this treatment. BJORK: Unfortunately, many patients are not being evaluated for this treatment because they have not been diagnosed or have been incorrectly diagnosed as having tension or sinus headaches. Of the 3.2 million Americans who are believed to have chronic migraines, only 20 percent have been correctly diagnosed. Migraine headaches are often called “sick” headaches because they are frequently accompanied by nausea. They are typically experienced as pulsating pain and can mimic a stroke, with weakness on one side of the face and body or speech loss. Patients usually get a warning of an impending migraine by

seeing an aura of flashing lights. Botox relieves migraine pain by blocking the motor nerve impulse to the muscle and the sensory nerves that relay pain messages to the brain. About half of patients who received Botox injections experienced a 50 percent reduction in the number of days they had headaches each month, according to the FDA studies. To qualify for Botox treatments, patients must experience more than 15 headache days per month, lasting more than four hours each. Botox is not effective in patients with episodic migraines, and it has not been studied in tension headaches.

FREE SEMINAR

Learn more about chronic headaches, Botox, and other new treatments at a FREE community seminar:

FOR THE MAN IN YOUR LIFE

PHOTOS LEFT TO RIGHT: ©ISTOCKPHOTO.COM/ALEXRATHS, STEVE BIGLEY, ©ISTOCKPHOTO.COM/DIANE39

Reducing the Pressure Men with “high normal” blood pressure are much more likely to develop atrial fibrillation, a heart rhythm disorder that increases the risk of stroke, heart failure, and death. A man’s risk of developing atrial fibrillation increased 50 percent if his systolic pressure (the top number) was between 128 and 138; and his risk increased 79 percent if his diastolic score was over 80, according to a study in the February issue of Hypertension. The study supports the growing belief that blood pressure should be kept under 120/80. “If a person is told they have ‘high normal’ pressure, they may only hear ‘normal’ and not make changes to address the problem,” says Heidi Stouffer, MA, RN, stroke program coordinator at Penrose-St. Francis Health Services. “The words ‘high normal’ should set off warning bells.” Besides eating healthy and exercising, men should look into stress reduction. Stress causes the body to release hormones that some researchers believe can weaken the blood vessels and cause high blood pressure. Stress also can lead to overeating, poor sleep, and drinking alcohol — all habits that can raise blood pressure.

MANAGE YOUR STRESS

Take our 8-week class to learn ways that work best for you to cope with stress. Begins Sept. 27. More info on Page 7.

penrosestfrancis.org

Randall Bjork, MD Neurologist with Penrose-St. Francis Health Services Date: Thursday, Aug. 16 Time: 6-8 p.m. Location: Penrose Pavilion 2312 N. Nevada Ave., 2nd floor Registration: 719-776-6558

Don’t Sweat It Waking up in the middle of the night drenched in sweat is a common problem for many women. Although it’s often a result of hormonal changes accompanying menopause, it also could be caused by low blood sugar, an infection, a neurological condition, or medication use. Antidepressants, for example, can cause night sweats in 10-20 percent of patients. It’s important to be checked by a physician to get to the root of your night sweats. In the meantime, try these tips: • Avoid coffee, alcohol, and spicy foods • Reduce stress • Get regular exercise • Wear clothes that wick moisture away from the skin and dry quickly

WIN A FREE PAIR OF WICKING PAJAMAS from the Mother Daughter Sister Friend boutique at the Penrose Pavilion by registering at

penrosestfrancis.org/nosweat.

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Banishing Belly Fat WOMEN CAN COMBAT EXPANDING WAISTLINES CAUSED BY MIDLIFE HORMONAL CHANGES

Chris Freeman and Sandy Weatherly don’t look like women who worry about belly fat. They are both petite, exercise regularly, and they’re experts in women’s health. Freeman is the director of women’s health at Penrose-St. Francis Health Services, and Weatherly, a dietitian by training, is the women’s program coordinator. But as both women passed through menopause, they found they had to make difficult — and unwanted — changes to stave off expanding waistlines, a problem that can lead to diabetes, heart attacks, and more.

“Ten years ago, I could eat whatever I wanted and I didn’t have to exercise,” Weatherly, 58, says. “Now I have to walk at least 20 minutes every day and be very careful about what I eat.” Freeman, 59, was once an avid runner, but hip pain forced her to switch to weight lifting — a move that has helped her retain muscle mass and counter an aging metabolism. “I’m not in the gym every day, but I don’t miss very often,” she says.

NOT-SO-LOVING HANDLES

Menopause not only makes women more prone to gaining weight, it also shifts fat

MEASURE UP While muffin tops may not be sexy, it’s the fat deep in your belly that is dangerous to your health. And even thin women can be toting around this type of fat. The best way to check is to measure your waist. A waist larger than 35 inches is considered high-risk, although research suggests there is some extra health risk at any size greater than 33 inches (even smaller for petite and Asian women).

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storage from the hips to the belly. And it’s this visceral fat — the kind that lies inside the belly hunkered down around your organs — that causes deadly health problems. It is linked to diabetes, heart disease, colorectal and breast cancer, and even memory problems. “Fat is not just storage of excess fuel, it is metabolically active tissue that produces multiple hormones and compounds” that can cause inflammation, insulin resistance, high blood pressure, and unfavorable cholesterol levels, says Michael Koren, MD, an endocrinologist at Advanced Care in Endocrinology & Diabetes in Colorado Springs. Endocrinologists are physicians who specialize in treating hormonal diseases. “The risk of cardiovascular disease and diabetes increases in a significant way in menopause, changes that are mediated by an increase in abdominal fat,” Koren says.

TRIPLE WHAMMY

Three things occur during menopause that set the stage for health problems:

Penrose-St. Francis Health Services

PHOTOS LEFT TO RIGHT: ELLEN JASKOL, ©ISTOCKPHOTO.COM/STUARTBUR, ELLEN JASKOL, ©ISTOCKPHOTO.COM/DKART

Chris Freeman and Sandy Weatherly, women’s health experts at Penrose-St. Francis Health Services, fight midlife spread with regular exercise.


Estrogen levels drop, causing the ratio of male hormones to estrogen to increase — a shift that makes women’s bodies act more “manly” — depositing fat in the abdomen rather than the hips. Some researchers also believe decreasing estrogen could produce an increase in cortisol, a stress hormone linked to increased abdominal fat. But this theory is still being examined. • Decreased estrogen also can cause hot flashes, sleep disturbances, and achy joints that can deter a woman from exercising and lead to weight gain. If a woman is tired, she also may reach for high-calorie foods to help boost energy levels. Unlike in premenopausal years, this extra weight will tend to accumulate in the belly after menopause. • The natural process of aging — even without menopause — causes women to lose muscle mass faster than men. And because muscle burns more calories than fat, women will start to gain weight even if they are eating healthy and exercising regularly — again going straight to the belly. •

“It’s important to realize that doing exactly the same thing as when you were younger and expecting the same results, unfortunately, won’t work,” Koren says.

THE DANGERS OF BELLY FAT

There are two types of fat: Subcutaneous is the “pinchable” fat on the outside of the body; visceral is fat that is stored internally around organs. While muffin tops and spare tires aren’t very attractive, they don’t harm our health as much. It’s the visceral fat that is the problem. Visceral fat is hard to measure. A size-6 woman can be carrying around this ticking time bomb while a woman with a set of love handles could be just fine, metabolically speaking. That’s why doctors no longer think measuring body mass index alone is a good health measure. Instead, they recommend looking at waist size, waist-to-hip ratio, and regularly measuring risk factors, such as blood pressure, cholesterol, and blood glucose levels, which are affected by visceral fat. penrosestfrancis.org

Here’s how visceral fat is thought to cause problems: • Due to its location near the portal vein, it can release fatty acids into the liver. This causes insulin resistance and unfavorable changes in cholesterol particles, contributing to heart disease. • It pumps chemicals called cytokines (or adipokines) into your bloodstream that also increase insulin resistance and cause low levels of inflammation — two known risk factors for heart disease.

MAKING CHANGES

Women who enter menopause with healthy lifestyles have a leg up. But they, too, must make changes to stay healthy. In Freeman’s case, she works hard at managing her health to overcome a family history of heart disease. Weatherly maintains a healthy weight through diet and exercise to avoid getting diabetes, which affected her father. They are no different, they say, than every other woman in Colorado Springs. Their only advantage is something accessible to everyone — knowledge. “Because I work in health care, I’m aware of the issues,” Freeman says. “But I’m constantly researching and always asking the dietitians about stuff. I get a lot of information that helps me make healthy choices.”

BAN BELLY FAT Come learn the real science behind belly fat — and the scientifically based ways of banishing middle-age spread! Learn:

• Why liposuction won’t improve your health, but a daily walk will • Whether a high-protein or a complex carbohydrate diet works best • How positive thinking and goal setting can speed up weight loss Date: Tuesdays, Sept. 11-Nov. 13 Time: 5:15-6:15 p.m. Location: St. Francis Medical Center, 6001 East Woodmen Road Cost: $60 for 10-week program Registration: 719-776-7983

3 STEPS TO SLIMMING YOUR MIDDLE Here are some tips for losing belly fat: • Diet: There’s no doubt about it — you’ll have to eat less after menopause to maintain your weight. The average 50-year-old woman needs about 300 fewer calories than when she was 20 to maintain the same weight. To decrease your appetite, eat more complex carbohydrates (like whole grains and vegetables). These are slower to turn to glucose in your blood, which means you’ll feel full longer. • Exercise: Exercise is particularly effective at reducing belly fat, and it doesn’t take much. Women who walked or jogged 12 miles a week didn’t gain any visceral fat, compared with a 9 percent increase by non-exercisers, according to a study conducted by Duke University Medical Center. Exercise is particularly effective because it increases transport of glucose into muscle without insulin. • Sleep: Disturbances in your sleep, caused by hot flashes or other conditions, are believed to release cortisol, the stress hormone that is linked to abdominal fat. Some studies show that lack of sleep also may decrease leptin (an appetitesuppressing hormone) and increase ghrelin (an appetite stimulant), resulting in increased hunger and appetite, particularly for high-carbohydrate foods. To assess your sleep habits, TAKE A FREE ONLINE SLEEP QUIZ AT penrosestfrancis.org/ sleep and talk to your doctor about treatment options for hot flashes.

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AN INSIDE LOOK For nearly 20 years, Tina Barney has been living with chronic pain in her abdomen. It can become so severe that she is admitted to the hospital for days at a time. But six months ago, Colorado Springs gastroenterologist Austin Garza, MD, brought her relief. He carefully inserted a small wand down her throat into her abdomen and injected steroids and anesthesia into the nerves feeding her pancreas and causing her pain. A few hours later, Barney left the hospital free of pain for the first time in years. “It was awesome,” says Barney, 48, of Colorado Springs. “It’s so much better than relying on narcotics.” The procedure that brought Barney relief is called endoscopic ultrasound. While this procedure has been used for the last two decades to diagnose cancers in the esophagus, advancements in the technology allow physicians to go deeper and use it to diagnose and stage cancers in the pancreas and liver, and to deliver medications that help relieve pain in those regions. “Where this is very helpful is in the diagnosis and accurate staging of pancreatic cancer,” Garza says. “It’s more sensitive than MRI or CT (scans), so it can spare unnecessary trips to the OR for surgery that won’t be beneficial.” The procedure also is being used for other illnesses besides cancer. Barney, for instance, was diagnosed with chronic pancreatitis. Created when the pancreas cannot produce enzymes necessary for digestion, this lifelong condition causes severe abdominal pain. “It’s horrible pain that makes you nauseated; it’s so bad you’re almost begging for pain medicine,” Barney says. Using endoscopic ultrasound, Garza was able to provide Barney with a short-term block of steroids and anesthesia. The block lasted five months before she needed to have the procedure repeated. “This is so much better. I think it’s awesome and only a few GI doctors are certified to do this procedure, so we’re lucky to have it here,” she says.

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PHOTO: STEVE BIGLEY

Doctors use tiny technology to go deep into the body to relieve abdominal pain

Tina Barney is stepping back into a full life thanks to a new procedure that ended her pain.

CANCER AID Endoscopic ultrasound is helping physicians more easily diagnose and treat pancreatic and liver cancer. It also offers much-needed pain relief for many patients. Austin Garza, MD, and Bill Lunt, MD, perform about 300 of these procedures each year at Penrose-St. Francis Health Services. They are the only physicians outside of Denver providing the procedure. For cancer, they use it to: • Diagnose cancer: Physicians can retrieve tissue to determine whether a tumor is cancerous. • Stage cancer: Physicians can precisely visualize the tumor to deter-

mine how large it is and whether it has grown into critical arteries that would make surgery to remove the tumor impossible. • Guide treatment: Markers placed in the tumor guide radiation oncologists to pinpoint radiation on cancer cells and minimize damage to surrounding healthy tissue. • Alleviate pain: Physicians can inject steroids and anesthesia into nerves for short-term blocks in conditions, such as pancreatitis, or completely kill the nerves to eliminate pain in patients with terminal cancers.

FOR MORE INFORMATION ON THESE DOCTORS AND OTHERS, GO TO PENROSESTFRANCIS.ORG/PHYSICIAN-DIRECTORY. Penrose-St. Francis Health Services


calendarsummer Penrose-St. Francis Health Services encourages you to experience the wide variety of health programs, screenings, and fitness classes that we offer throughout the Colorado Springs area. This calendar briefly highlights some of our beneficial programs and classes, many of which are ongoing throughout the year. See the key below for location information, and visit penrosestfrancis.org/wellness for a complete listing. Registration is required for all programs and can be made by calling the number listed.

LOCATION KEY: CSSCA – CSSC Aquatics Center, 1625 Medical Center Point, No.160 PCC – Penrose Cancer Center, 2222 North Nevada Avenue PH – Penrose Hospital, 2222 North Nevada Avenue PHLCG – Penrose-St. Francis Health Learning Center Gym, 1644 Medical Center Point PHWC – Penrose Hospital, Wellness Center, 2222 North Nevada Avenue SFMC – St. Francis Medical Center, 6001 East Woodmen Road SFMC-NCB – St. Francis Medical Center NorthCare Building, 6075 East Woodmen Road

PHOTO: ©ISTOCKPHOTO.COM/JEPOPLIN

PP – Penrose Pavilion, 2312 North Nevada Avenue

E MOR SES E E S CLAS E R F E N BACK! O VER CO

penrosestfrancis.org

FITNESS

HEALTH

Therapeutic Drumming PHLCG | Call for fee A group empowerment drumming experience that provides stress relief and helps strengthen the immune system. Call for dates and times. 719-776-5311

Bariatric Weight-Loss Surgery PH | FREE Learn if you are a candidate, your surgical options, and what to expect following surgery. Sat, Jul 28, 9-11 a.m., 719-776-5359

Yoga | PHWC | $60 (for 9 classes) Viniyoga is a therapeutic, breathinspired style of flow yoga that is designed to increase strength, flexibility, balance, and decrease stress. Tues, Sep 4-Oct 30, 5:156:15 p.m., 719-776-7983 Pilates | PHWC | $60 (for 9 classes) Pilates mat class emphasizes core strengthening, flexibility, and overall muscle stability. Tues, Sep 4-Oct 30, 6:307:20 a.m., 719-776-7983 Aquatics Classes | CSSCA Call for fee Warm water exercise classes that are good for cardiovascular conditioning. Call for dates and times. 719-776-4780

Healthy Back Class | SFMC — Sister’s Grove Pavilion, Suite 100 | FREE Learn the common causes of back and neck pain, back pain prevention strategies, and how to be proactive in caring for your back. Tue, Jul 31, 5:30-7 p.m., 719-776-4852 Breast Cancer Early Detection Plan | PP — 2nd Floor Conference Center | FREE Develop your customized breast cancer detection plan based on your unique health history and lifestyle. Then learn some great scarf-tying techniques! Thu, Aug 9, 6-7:30 p.m., 719-776-5052 Relief for Chronic Migraines PP — Conference Center FREE Learn about the latest treatments, including Botox, that are being used to treat chronic migraines. Thu, Aug 16, 6-8 p.m., 719-776-6558 Healthier Living Colorado PHLCG | $40 (for 6 classes) If you’re living with a chronic condition, learn techniques to live a more fulfilling life. Weds, Aug 22-Sep 26, 57:30 p.m., 719-776-7983

Healthy Weight | SFMC — Conference Room 1 | $60 (for 10 weeks) Learn to control your weight by choosing healthy foods, developing an activity plan, positive thinking, and goal setting. Workbook, recipe book, and Dyna-Band® exercise and relaxation CD included. Tues, Sep 11-Nov 13, 5:156:15 p.m., 719-776-7983

SUPPORT WomenHeart Support Group PH & SFMC | FREE Providing encouragement and strategies to cope with heart conditions. 2nd Wed of month, 11:30 a.m.1 p.m., PH; 4th Wed of month, 5-6:30 p.m., SFMC, 719-200-2645 Creating My Future: Mapping a Healing Journey | PH | FREE Annual spirituality retreat for cancer survivors and their loved ones. Lunch included; refreshments provided throughout the day. Sat, Aug 4, 8:30 a.m.-4:30 p.m., 719-776-5311 Beginning Again: Tools for the Journey Through Grief PCC | FREE Grief support group for adults who have lost a loved one to death. Tue, Sep 25, 5:30-7 p.m., 719-776-5311

Coping With Stress | SFMC — Room 5 | $40 (for 8 weeks) Learn effective coping strategies that work uniquely for you. Thus, Sep 27-Nov 15, 3:304:30 p.m., 719-776-7983

PARENTING Infant CPR Training Kit | SFMC $44.95/kit The American Heart Association has designed a personal learning program that will teach you basic infant CPR lifesaving skills in the privacy of your own home in just 22 minutes. The Infant CPR Anytime® kit contains a Mini Baby™ CPR learning manikin and an Infant CPR Skills Practice DVD. Kit is reusable for future CPR skills review. Ongoing — call for dates 719-571-3100 Proper Use of Car Seats SFMC | FREE Learn how to select and correctly use car seats to protect your child, starting from birth through age 7. Taught by a certified child passenger safety instructor. Sat, Aug 4 or Sep 8, noon2:30 p.m., 719-571-3101 Sky Sox Emergency Preparedness Night | Sky Sox Stadium, Security Service Field | $2/person Bring the whole family to the ballpark! Learn how to keep your family safe with information from local emergency responders, see the Flight For Life helicopter, and more! Fri, Aug 31, 6 p.m. No registration is needed.

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Catholic Health Initiatives Colorado

Non-Profit Org. U.S. Postage

PAID

2222 North Nevada Avenue Colorado Springs, CO 80907

Colorado Springs, CO Permit No. 14

Catching lung cancer early Screening heavy smokers with low-dose CT scans can reduce their risk of death from lung cancer by 20 percent, according to the National Cancer Institute. To help encourage more people at risk of lung cancer to be screened, Penrose-St. Francis Health Services is now offering a $199 CT scan. It includes an in-depth analysis by a multidisciplinary panel of experts who specialize in lung nodules. If you are a current or former smoker between the ages of 55 and 74 and have smoked W a pack of cigarettes daily for at least 30 KNO ing U O years, you are considered high-risk and y Y d DID risk of ancer may qualify for the study. You also may your lung c alf 10 qualify if you smoked less or are youngfrom ut in h uitting er but have other risk factors, including a is c after q ? lung disease such as COPD, a family hisg s year smokin tory of lung cancer, or exposure to radon.

CALL 1-855-456-5864 TO FIND OUT IF YOU QUALIFY TO GET A LOW-COST CT SCAN.

TUNE IN TO HEALTH Tune your radio to KLite 106.3 every Wednesday from 7-9 a.m. to hear health tips for women by experts from Penrose-St. Francis Health Services.

YOU’RE INVITED

SPECIAL HEALTH PROGRAMS Getting to the Root of Your Back Pain

S.O.S. I Have a Teenage Daughter!

Do you have back pain that never goes away? Have you been told you have spinal stenosis, a herniated disc, or bone spurs? Are you experiencing sciatic leg pain or other symptoms that result from wear and tear of the spine? If you answered yes to any of these questions, we invite you to a FREE seminar with Michael W. Brown, MD, medical director of the Spine Center at Penrose-St. Francis Health Services, to learn about treatments that may work to relieve your pain. Date: Thursday, Aug. 2 | Time: 6-8 p.m. | Cost: FREE Location: NorthCare Building at St. Francis Medical Center, 6075 East Woodmen Road Registration: 719-776-2225

Calling all moms of adolescent and teenage girls! Does your little girl go from princess to ogre and back again without a moment’s notice? Does she seem all grown up and ready to face the world one moment and ready to crawl back in the crib the next? If you’d like to understand your daughter and her journey better, join Nancy Bader, clinical psychotherapist and licensed clinical social worker with The Center for Behavioral Health at Penrose-St. Francis Health Services for a FREE seminar. She’ll help you understand your teenage daughter, the developmental stages of teens, what is “normal,” and when to be concerned. Date: Thursday, Sept. 13 | Time: 6-8 p.m. | Cost: FREE Location: Penrose Pavilion, 2312 North Nevada Avenue Registration: 719-776-5052

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.

PHOTO: ©ISTOCKPHOTO.COM/VLADYSLAVDANILIN

Penrose-St. Francis Health Services offers ongoing health education seminars to the community. Here are just two of our upcoming programs. See Page 7 for more or go to penrosestfrancis.org/wellness for a full list.


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