Bloom summer 2013
Read about the new anterior approach to hip replacement surgery, the noninvasive treatment for aortic valve stenosis called transcatheter aortic valve replacement (TAVR), what to think about before going to a freestanding ER, and what your child’s back-to-school physical should include in this quarterly magazine celebrating women’s health in CO. Written and produced by Clementine LLC of Littleton, CO.
Pantry Makeover | EMERGENCY ROOM MYTHS | Heart Murmur Care the buzz on hip health Maintaining healthy joints to avoid surgery FREE File of Life! Special offer for bloom readers. Page 3 Summer 2013 Volume 3, Issue 3 healthystart It only takes a few minutes to improve your health. Try out these FREE OR LOWCOST programs offered by Penrose-St. Francis Health Services: Movementum Track your daily movements with this smartphone app. Look in your phone’s app store for Movementum or download it at movementumapp.org. Flash Fitness A 15-minute routine developed by Penrose-St. Francis CEO Margaret Sabin. Watch a video and download the workout at penrosestfrancis.org/ flashfitness. Wellness Programs From weight-loss classes to aquatics fitness, Penrose-St. Francis experts can help you hit your goals. See a full calendar of classes at penrosestfrancis. org/wellness. Get Off your rocker and to the gym Women who sit all day — even if they go to the gym — are more likely to have heart attacks and strokes than women who move more, according to a study published earlier this year in the Journal of the American College of Cardiology. Sitting more than 10 hours raised a woman’s risk of heart attack or stroke 15 percent more than a woman who sits less than five hours daily. That was true even for women who regularly visit a gym, although women who exercise at a high intensity for four to five hours a week did not have increased risk. The same study found that it didn’t take running a marathon to reap benefits, either. “Many people can benefit tremendously by small changes in their daily activity and diet,” says Pamela Taylor, MD, a cardiologist at Colorado Springs Cardiology, A Centura Health Clinic. In fact, a well-known study found that losing just 5 percent of total body weight can actually reverse prediabetes. About one-quarter of Americans now have prediabetes. “If we can identify them early, they can benefit tremendously from a change in diet and exercise because it changes the makeup of their lipids and can move them to a much lower risk category.” 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 email@example.com. bloom is produced by Clementine Words LLC. Executive editor is Jill Woodford. Artificial sweeteners may not cause cancer, but they are not without harm, mostly due to misconceptions by consumers. “Many people think that when something says it is sugar-free that it’s also low in calories and healthy, so they overindulge,” says Sandy Weatherly, a registered dietitian and the clinical women’s program coordinator at Penrose-St. Francis Health Services. In fact, foods made with artificial sweeteners can actually contain more calories, as they try to make up for flavor, Weatherly says. And they are often “empty calories,” meaning that you are getting little if any nutrition from the food. Classic examples are soda, cookies, and candy. Other pitfalls associated with use of artificial sweeteners include: • Increased cravings for sweets • GI irritation and gas Do you have foods in the pantry or fridge that are sabotaging your efforts to improve your weight, mood, or overall health? Join our crew of nutritionists for Extreme Makeover: Food Edition on Aug. 15 to learn how to turn your kitchen into a center of wellness. See Page 7. 2222 North Nevada Avenue, Colorado Springs, CO 80907 bloom 2 Summer 2013 Penrose-St. Francis Health Services Cover photo: ©iStockphoto.com/chas53; This Page: ©iStockphoto.com/Jill Chen; Opposite Page: ©Ellen Jaskol (Both) The bitter bite of sweeteners Q&A With Katie Murray, DO Family Medicine Physician, Penrose-St. Francis Primary Care at Sisters Grove Pavilion Q: What should my child’s backto-school physical include? A: Your child’s annual physical is a great opportunity for your doctor to head off some common problems — especially in adolescents. A few of the less-common elements of the checkup should include: 1. Discussion of vaccines that are not required but are recommended. For 11 and older, that includes the HPV and meningitis vaccines. Virtually all cervical cancers are caused by HPV, according to the National Cancer Institute. By 2020, it’s estimated that HPV will cause more cancers of the base of the tongue and tonsils of men than cervical cancers. 2. Weight check and closer examination of family history. As your child nears adulthood, we begin to watch for the development of chronic diseases, such as obesity, high cholesterol, and diabetes. 3. Discussion of touchier issues, including depression and suicide, steroid use (especially in teen athletes), drug use, tobacco, seat belt use, and early sexual activity. These are not issues that most teens will discuss with their parents, but they might with a physician, particularly with the right questions. If you’re taking your child for a back-to-school physical, it’s the perfect time to get an annual checkup yourself. Family medicine physicians treat children, adolescents, and adults. If you don’t have a primary care physician, please call Penrose-St. Francis Primary Care at 719-571-8100. Questioning Freestanding An emergency room is not always an emergency room just because it’s called that. A trend across the country is the opening of ERs that are not in hospitals. While these freestanding ERs cost the same as a hospital ER, you may need to be transferred to a hospital for critical services, resulting in delayed care and double bills, says Jack Sharon, MD, a board-certified emergency medicine doctor and medical director of emergency medicine at Penrose-St. Francis Health Services. Some myths: Freestanding ERs are cheaper than hospitals: Most charge the same, but insurance plans may not cover at the same rate as a hospital ER visit. • Waits are shorter: 90 percent of emergency patients at Penrose Hospital and St. Francis Medical Center are seen in less than 30 minutes. To check wait times, go to penrosestfrancis.org/emergency. • Freestanding ERs can treat all problems: Freestanding ERs do not have the capability of performing emergency surgery or complex procedures such as heart catheterization or stroke intervention. • Request a FREE File of Life that adheres to your refrigerator for quick access in emergencies. Go to penrosestfrancis.org/fol. penrosestfrancis.org For the man in your life: CyberKnife® Although it has knife in its name, the CyberKnife System does not use an incision. In fact, it’s not even surgery. CyberKnife is a cancer treatment technique that uses highly focused, small radiation beams with pinpoint accuracy to treat hard-to-reach tumors. Unlike surgery, CyberKnife results in no pain or downtime for patients. Given in just one to five treatments, CyberKnife patients also do not typically experience fatigue. CyberKnife was first used for prostate cancer in 2002, and multiple studies since have shown positive results, with minimal sexual dysfunction and virtually no risk of incontinence. CyberKnife also is used effectively in treating early-stage lung cancer as well as cancers of the brain, head and neck, liver, pancreas, and spine — areas that are often inoperable because the tumor exists in anatomy that cannot be cut without harm to essential organs. Penrose Cancer Center offers the only CyberKnife in southern Colorado with the most experienced physicians. More Info To learn whether you might be a candidate for CyberKnife treatment, call the Penrose Cancer Center Second Opinion Clinic at 719-776-5271. Read more at penrosecancercenter.org/cyberknife. Summer 2013 3 bloom New hip, happier, healthier life H elping scientists learn about humming birds is a labor of love for Tena Engelman. Every year, Engelman and her husband Fred spend months in Rocky Mountain National Park working with hummingbirds as “citizen scientists” for the National Park Service. “I hiked with a heavy backpack many miles every day and worked 12-14 hours a day,” says the 67-year-old retired public school art teacher. “I was having a real good time.” Engelman is also a volunteer docent at the Colorado Springs Fine Arts Center, where she leads tours of the exhibitions and teaches children’s art classes. When she couldn’t put off a hip replacement any longer, Tena Engelman chose Penrose-St. Francis Health Services. Penrose-St. Francis Health Services was ranked among the top 5 percent in the nation for joint replacement in 2013 by Healthgrades. bloom 4 Summer 2013 Arthritis pain makes life miserable When severe arthritis pain in her left hip forced Engelman to limit these activities, she was miserable. Within a few years, Engelman limped badly when she walked, hurt when she sat, and couldn’t get comfortable to sleep. Exercise and pain medications didn’t help. “Every day was exhausting,” she says. Convinced that the pain was coming from her aching back, Engelman went to a spine center, where X-rays and MRIs showed that her hip was the problem. The first orthopedic surgeon Engelman saw told her she had severe arthritis. He recommended a hip replacement, in which the diseased hip joint is removed and replaced with an artificial joint. A growing number of women have severe hip arthritis — some, like Engelman, because of their active lifestyles, but many because of obesity or aging. Having certain genes also increases the risk of arthritis a little. Women have more arthritis than men and are three times as likely as men to have hip pain. Long-lasting hip replacements More women are having hip replacements these days. “This used to be a last resort for 70- and 80-year-olds, but now the implants last longer, 20 to 30 years, and the success rate for the surgery is 96-98 percent,” says Michael E. Feign, DO, a joint replacement specialist at Penrose-St. Francis Health Services. Most women who have hip replacements today are in their 60s, like Engelman, or their 70s. Severe arthritis is the most common reason, although some hip replacements are done in women with osteoporosis who break a hip. Like many women, Engelman put off having a hip replacement. “I didn’t like to hear the word arthritis. It made me feel old,” she says. Engelman went to four more orthopedic surgeons, hoping for a different diagnosis, and had two steroid injections, which only relieved her pain for a few weeks. Penrose-St. Francis Health Services Hip Seminar Date | Wed, Sep 11 Time | 6-8 p.m. Cost | FREE Location | NorthCare Building, 6071 East Woodmen Road Registration | penrosestfrancis.org/hipseminar Most people don’t think much about their hips until they break one in their 70s. But the hips aren’t only the most overlooked joints in the body, they’re also the most crucial to your overall health and well-being. Join Dr. Michael E. Feign, orthopedic surgeon, for a discussion about hip pain diagnosis, total hip replacement, nonoperative and operative treatment options, and expected outcomes of each. Plus, learn from Mark Deysher, physical therapist, how to keep your hips healthy with easy, at-home exercises. FREE refreshments will be provided. Healthy Hips Take action early, when arthritis is mild or before it starts, to keep your hips healthy. Warning signs of arthritis, which increases after age 50, are pain and stiffness. Be active penrosestfrancis.org A balanced exercise program also includes stretching and strengthening the muscles around the hip, back, and core, for example, with yoga, Pilates, or tai chi. Deysher recommends developing your exercise program with a physical therapist or medical professional and seeing your doctor before starting to exercise. A 2012 study of people with hip arthritis showed that those who exercised with physical therapists six to eight times over eight weeks had much better function and range of motion than those who did not exercise. Summer 2013 5 bloom photoS: ©Ellen Jaskol After falling on the dance floor at a A happy, active life wedding, she knew the time had come for a Less than six weeks after getting her new hip replacement. She studied the procedure hip, Engelman and her husband were back online and went to see Feign, who had in Rocky Mountain National Park working taken care of three of her friends. On April with hummingbirds. While she can’t do 2, Feign replaced Engelman’s left hip with major hikes this year, she is pain-free and an artificial one. able to do much of the work “It wasn’t much harder she loves. Engelman is also than having a baby by back at the Colorado Springs Consider a hip C-section, which I’ve done Fine Arts Center. “My life replacement if you continues to be more and twice,” she says. can’t do what you more fulfilling,” she says. Healthy lifestyle improves To stay healthy, want to do recovery Engelman exercises every without pain. Engelman has worked hard day, walking the hills in her at her physical therapy, neighborhood and doing core which began the day of her conditioning, stretching, and surgery. She went home two days later, weight lifting. Her diet is mostly plantwhere a physical therapist worked with her based, with lots of fresh foods and moderate daily for two weeks, followed by outpatient amounts of other foods. physical therapy several days a week for about two months. The right time for hip replacement “She’s kept herself very healthy, is Figuring out the right time for a hip motivated, and is doing very well,” says replacement isn’t easy. “Everybody is Feign, who noted the importance of exercise different,” Feign says. and a healthy diet to a successful hip “When your daily life is compromised replacement. enough that you can’t do the things you “Ultimately, I am responsible for my want to do without pain, consider hip body,” Engelman says. “I better do the best replacement.” I can if I want the best quality of life.” “Exercise can’t prevent arthritis, but it can keep the joints healthy,” says Mark Deysher, a physical therapist at St. Francis Medical Center. It is also one of the mainstays of treatment for arthritis of the hip (and knee), says the American College of Rheumatology in its 2012 guidelines for treating arthritis. A panel of experts studied more than 50 treatments for arthritis and evidence from many studies before making this recommendation. As little as 30 minutes of low-impact exercise five times a week will help you stay healthy and exercise your legs and hips, according to the American College Sports Medicine and American Heart Association. Good types of aerobic exercise are: m Walking m Using a stationary bike m Using an elliptical machine m Swimming or doing water aerobics TAVR New, noninvasive treatment for deadly heart condition The Penrose- St. Francis Heart & Vascular Center is part of the Centura Heart Network, Colorado’s leading provider of cardiovascular care. Who is TAVR right for? A new treatment — transcatheter aortic valve replacement (TAVR) — is now available for people with aortic valve stenosis who can’t have surgery, the only other treatment for this condition. Aortic valve stenosis happens when the heart’s aortic valve narrows, blocking blood from flowing through the major artery leading out of the heart and throughout the body. Shortness of breath and fatigue are the most common symptoms of aortic valve stenosis, which mostly affects people in their 70s and 80s. “Because the symptoms come on very slowly, patients usually just attribute it to aging,” says John Mehall, MD, medical director of cardiothoracic surgery at Penrose-St. Francis Health Services. Anyone with shortness of breath that interferes with daily activities should see a cardiologist. Aortic valve stenosis also can become severe without any symptoms. Doctors often find it during a physical, when they hear an abnormal heart sound, called a heart murmur. Catheter-based treatment If left untreated, 50 percent of people with severe aortic stenosis and symptoms die within two years. Replacing the diseased valve is the only treatment. Until recently, patients who were too sick or high risk for open-heart or minimally invasive heart surgery couldn’t be treated. TAVR, available in southern Colorado only at Penrose Hospital, changes that. TAVR is done by threading a long, flexible tube 1.5 million Americans affected with aortic valve stenosis bloom 6 Summer 2013 TAVR is right for people with health issues such as: through an artery, usually in the groin, to the heart. The valve is squeezed into a balloon on the end of the catheter and once it’s inside the natural aortic valve, it’s inflated. This opens the valve and restores the blood flow. Frailty Fast relief and recovery “Patients do remarkably well,” Mehall says. “In most patients, shortness of breath is markedly improved days after the procedure.” Recovery is much easier after TAVR than after open-heart surgery or minimally invasive aortic valve replacement. Patients spend about three days in the hospital and about two weeks recovering after that. That compares to four days in the hospital and four weeks of recovery for minimally invasive aortic valve replacement, or seven days in the hospital and eight weeks of recovery for open-heart repair. Because TAVR is limited to use in patients who cannot tolerate surgery, minimally invasive aortic valve replacement is the best option for younger, healthier patients, notes Mehall. Previous heart surgery Aortic Valve Stenosis 1/3 have severe disease and may die within two years without valve replacement 3 treatments open-heart surgery, minimally invasive repair, and TAVR Diseases (often more than one) such as: • Chronic obstructive pulmonary disease • Congestive heart failure • Diabetes • Lung disease • Kidney disease Learn More To learn whether TAVR is an option for you or a loved one, go online to penrosestfrancis.org/ tavr or call 719-776-8768. Penrose-St. Francis Health Services Extreme Makeover: Food Edition Date | Thu, Aug 15 Time | 6-7:30 p.m. Location | NorthCare Building, 6071 East Woodmen Road Cost | FREE Registration | penrosestfrancis.org/foodmakeover Are you eating the right foods? Do you have foods in the pantry or fridge that are sabotaging your efforts to improve your weight, mood, or overall health? Let our crew of nutritionists guide you on restoring your kitchen to a center of wellness. Find out what foods to banish from the pantry, which foods to add, and how to transform many unhealthy recipes into healthy ones. Plus, sample recipe makeovers that contain less fat and calories but are full on taste. Summer Class Calendar photo opposite page: ©iStockphoto.com/aldomurillo; This Page: ©iStockphoto.com/aurigadesign Penrose-St. Francis Health Services offers dozens of health classes each quarter. Here is just a sampling of our classes. For a complete list, go to penrosestfrancis.org/calendar. Woman in the Middle Date | Tue, Aug 20 Time | 5:30-7:30 p.m. Location | Penrose Pavilion, 2312 North Nevada Avenue Cost | FREE Registration | penrosestfrancis. org/woman-in-themiddle Sandwiched between two generations, women often find themselves caring for aging parents while still taking care of their own children. Join Dr. Diane Thompson, psychiatric oncologist, and Dr. Diane Crumb, clinical psychotherapist, who will help you find a healthy balance among parenting, caregiving, and daily activities. Learn how to adjust your perspectives, set boundaries, and recognize the early signs of stress and depression. penrosestfrancis.org Community Emergency Preparedness Night at Sky Sox Stadium Date | Fri, Aug 23 Time | 6 p.m. Location | Sky Sox Stadium, 4385 Tutt Boulevard Ticket Info | 719-597-1449 or visit skysox.com Get prepared, get trained, and get involved. Join Penrose-St. Francis Health Services and other first responders for fun interactive activities and information to keep you and your family prepared for any emergency. 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 | 5-6:30 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. There is also a support group open to both men and women. Call for meeting dates and times. Healthy Back Class Dates | Sep 10, 17, 25 Time | 5:30-6:30 p.m. Location | NorthCare Building, 6071 East Woodmen Road Cost | $20 per person, or 2 for $30 Registration | 719-776-4852 Do you have muscle tightness, aches, and spasms? Let our experts teach you how to improve your overall back health. This three-week class includes tips on how to prevent aches; supervised stretches and exercises to get you moving safely; and discussions with a physical therapist, dietitian, exercise physiologist, and clinical psychotherapist. NIA Conditioning for Cancer Patients Dates | Sep 10, 17, 24; Oct 1 Time | 4:30-5:15 p.m. Location | Penrose Pavilion, 2312 North Nevada Avenue Cost | FREE Registration | 719-776-2510 NIA is a physical conditioning program and mind-body practice set to music that involves fluid, gentle, whole-body movements of different styles and speeds from a wide range of movement modalities, including tai chi, yoga, dance, and freestyle movements. What If? What Else? What Now? An Interactive Planning Session for Women to Design the Life of Their Dreams Date | Sat, Sep 14 Time | 8 a.m.-5 p.m. Location | Penrose Pavilion, 2312 North Nevada Avenue Cost | $125 per person Registration | penrosestfrancis.org/whatif Experience a one-day interactive, life planning session facilitated by best-selling author Sara Boatz. You’ll identify your dreams, articulate your goals, and develop an action plan. Guest speakers include clinical psychotherapist Tobi Steinberg, who will help you identify and overcome barriers to reaching your dreams, and registered dietitian Sandy Weatherly, who will give you tips on eating right to create your best life. You’ll leave with a clear purpose, direction, and a written plan to live the life of your dreams. Seminar includes continental breakfast, boxed lunch, work binder, and book. Registration is required by Sept. 6. Payment due at time of registration. Summer 2013 7 bloom Catholic Health Initiatives Colorado Non-Profit Org. U.S. Postage PAID Colorado Springs, CO Permit No. 14 2222 North Nevada Avenue Colorado Springs, CO 80907 Penrose-St. Francis Health Services is part of Centura Health, Colorado’s largest 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. Dream big at any age With Steve Tucker, PhD, the Center for Behavioral Health at Penrose-St. Francis Health Services Young age is no longer a prerequisite for dreaming big. Whether the goal is to run a marathon at age 70, start a business at age 50, or be debt-free by 40, dreaming big offers big-time health rewards. People who dream big are more likely to accomplish their goals. While unique benefits vary, common highlights include: • Sense of purpose: From defining a role within a family, to establishing a reputation in the community, to finding the drive to keep living, goals linked to self-worth boost motivation and rewards. • Self-esteem: The type of goal impacts self-esteem, according to a 2011 study at the University of Michigan. Self esteem increases more with intrinsic goals, like compassion and friendship, than with extrinsic goals, like self-image, the study found. • Happiness: Dreams focus attention, provide a source of interest, and foster a sense of accomplishment when achieved, all of which promote happiness. Tips and Tools | Fuel big dreams with: and time-bound. S.M.A.R.T. goals create structure for big dreams. Self-Awareness: By identifying natural tendencies, setting goals can be more successful. Assess yourself at authentichappiness.com. Technology: Everest, a FREE iPhone app, makes dreaming easier. Input a dream, create steps, track progress, receive reminders, and document the journey. 43 Things (43things.com) offers a platform for more than 3 million dreamers worldwide to list goals, share progress, and support each other. ou t of S.M.A.R.T. Goals: Specific, measurable, attainable, relevant, Americans have a bucket list* *Ketchum Global Research Network What If? What Else? What Now? An Interactive Planning Session for Women to Design the Life of Their Dreams Date | Sat, Sep 14 Time | 8 a.m.-5 p.m. Location | Penrose Pavilion, 2312 North Nevada Avenue Cost | $125 per person Registration | penrosestfrancis.org/whatif 14 Experience a one-day interactive, life planning session facilitated by best-selling author Sara Boatz. You’ll identify your dreams, articulate your goals, and develop an action plan. Guest speakers include clinical psychotherapist Tobi Steinberg, who will help you identify and overcome barriers to reaching your dreams, and registered dietitian Sandy Weatherly, who will give you tips on eating right to create your best life. You’ll leave with a clear purpose, direction, and a written plan to live the life of your dreams. Seminar includes continental breakfast, boxed lunch, work binder, and book. Registration is required by Sept. 6. Payment due at time of registration. photo: ©iStockphoto.com/Maridav Penrose-St. Francis Health Services has been named one of America’s 50 Best Hospitals by Healthgrades for the sixth year in a row. Learn more at penrosestfrancis.org/healthgrades.