Inspire Fall 2018 by St. Thomas More Hospital

FALL 2018 | Volume 4, Issue 4

A Healthier You

St. Thomas More Hospital

Thanks to HRT, Dianne Bush is feeling healthy and happy â&#x20AC;&#x201D; and energetic enough to keep up with her grandkids.

HRT

HELPING HAND For many women, hormone replacement therapy can help manage menopause symptoms. Page 5 HEALTHY, HAPPY KNEES Page 4

NEW BREAST SCREENING Page 6

STREP WARNING Page 7

PHOTO BY STEVE BIGLEY

inspiring health

FIGHT OFF THE FLU A FLU SHOT IS THE ONLY SUREFIRE WAY TO PROTECT YOURSELF THIS SEASON

cut your risk of getting the flu in half, yet many people are still reluctant to get the shot.

“I hear a lot of patients say, ‘I don’t need it. I’ve never gotten the flu,’” says Steven Olson, MD, a family medicine physician with St. Thomas More Physician Group – Primary Care. “What I tell them is you haven’t gotten the flu yet.”

But it didn’t

work last year!

Scientists formulate a new flu vaccine every year in anticipation of the strain most likely to affect the greatest number of people. But not all flu vaccines are well-matched with the year’s strain. The 2017-18 flu vaccine was only 36 percent effective, which is lower than the usual effectiveness range of 40 to 60 percent. Still, that’s significant protection. Plus, getting vaccinated lessens the severity and duration of your symptoms if you do end up with the flu.

Dr. Steven Olson

Here’s what he says you need to know about protecting yourself this season.

WHEN SYMPTOMS GET SERIOUS While everyone should be on the lookout for typical flu symptoms — sudden onset of fever and a cough with severe fatigue or body aches, plus possible congestion, sore throat, and chills — some populations are more at risk, including:

CAN’T I SKIP THE VACCINE AND GET TAMIFLU INSTEAD?

A: No. Antivirals

like Tamiflu can reduce symptom severity, reduce complications like pneumonia, and shorten the duration of the flu by about a day; but they won’t cure you. Plus, getting treated after the fact doesn’t protect vulnerable populations in the community who can’t be vaccinated. And antivirals must be administered early to be effective — ideally within 48 hours, although they can be effective up to 72 hours after onset.

y Children under 5, and especially those under 6 months y Seniors 65-plus, particularly those in long-term

care facilities

y Pregnant women y People with asthma and other lung disorders y People with compromised immune systems

If you or a loved one falls into any of these high-risk groups, head to an urgent care center at the onset of symptoms to help avoid flu-related complications. Centura Health Urgent Care Cañon City, 3245 US-50, is open 8 a.m.-7 p.m. weekdays, and 8 a.m.-3 p.m. weekends.

INSPIRE ST. THOMAS MORE HOSPITAL

Take a shot at flu

If you are a patient with a St. Thomas More Physician Group provider, they can provide you with a flu shot — so contact your primary care provider at 719-285-2700. Otherwise, flu shots are available through local pharmacies or Fremont County Public Health and Environment.

ILLUSTRATION: ©ISTOCKPHOTO.COM/SERAZETDINOV; PHOTOS: ©ISTOCKPHOTO.COM/DIMA_SIDELNIKOV, /STOCKPLANETS

The flu vaccine can

Homegrown doc returns to practice medicine

When Dr. Breanna Berry isn’t caring for patients, she’s capturing the world around her through her love of photography.

Dr. Breanna Berry, having treated patients in clinics from Texas to Ecuador, is excited about the opportunity to care for the community that helped her become who she is today

Breanna Berry, DO, was born at St. Thomas More Hospital, as were her parents, grandmother, great-grandmother, and even her great-great-grandfather. When Berry was attending Cañon City High School, her grandmother suffered a major stroke shortly after being diagnosed with colon cancer.

and as Berry says, “He was my person.” When she learned that he was ill and in the ICU, she rushed to Cañon City. “I was blown away by how wonderful his care was,” she says.

She still remembers all the dedicated physicians and entire medical team, whose collaborative efforts helped keep her grandmother alive for nearly seven years after her stroke. “I was so grateful for the team of doctors who took care of her and then took the time to sit down with us and explain what was happening.”

Sadly, Berry’s grandfather passed away, but she held onto his wish. She ultimately kept her end of the bargain and in July, joined Centura Health Physician Group as a family medicine/OB physician.

It was then when she first started to think of a future in the medical field.

MISSIONS AND MEDICINE

Berry soon left for college, and then medical school at Midwestern University’s College of Osteopathic Medicine in Glendale, Ariz. During college, she took a medical mission trip to Ecuador and got hands-on experience — doing surgery; practicing emergency, family, and internal medicine; delivering babies.

PHOTO BY STEVE BIGLEY

Once in medical school, Berry went abroad through the DOCARE organization for another medical mission trip to Guatemala, an experience that served her well when she began working in Hereford, Texas. The town’s large Hispanic and Guatemalan populations were put at ease by Berry’s Spanish-language skills and cultural knowledge. Berry visited Cañon City often to check up on her grandfather. He had planted the seed to return home and always joked about her being his personal physician. They had a very close relationship

COMMUNITY CONNECTIONS

Berry is enthusiastic to join the other providers at St. Thomas More and have the ability to collaborate and ultimately provide more of the heartfelt care that her grandfather received to the community. She’s especially excited about creating more community wellness events. “The administration is open to doing fun things in the community. It’s important that your wellness doesn’t just take place when you come in for a visit once a year.” Mostly, Berry looks forward to reconnecting with her hometown. She has wonderful memories of the people and the fun she had growing up. “I’m excited not just to provide care, but to be a part of the community.”

To schedule an appointment with Dr. Berry, call 719-285-2700.

STMHOSPITAL.ORG FALL 2018

JOINT CONTROL What you can do — on your own and through treatment — to keep your knees healthy and avoid pain or surgery

KNEE OSTEOARTHRITIS (OA) is among the leading causes of disability in the U.S. Whether you’ve already been diagnosed with knee OA or you’re experiencing discomfort that signals it could be coming, Eve Schoenefeld, MMS, PA-C, a physician assistant at St. Thomas More Physician Group – Orthopaedic Services, says there are things you can still do to decrease or prevent pain and potentially avoid surgery down the road.

Eve Schoenefeld

WHAT YOU CAN DO

WHAT TREATMENT CAN DO

Weight management plays a significant role in both the development and progression of OA. “Extra weight places excess stress on the joints that they were not designed to handle,” Schoenefeld says.

Physical therapy can help pinpoint weak areas and enhance strength, balance, and joint alignment. Most of the strongest research around exercise for knee osteoarthritis involves programs guided by physical therapists.

Staying active helps your knees stay happy. Stick with swimming, cycling, walking, and other activities that don’t load the joints and overstress the knee. Leg strength is critical because having strong quadriceps and hamstrings takes some of the stress off the knees. Glucosamine and chondroitin sulfate have been helpful for some people, even though research supporting its use isn’t strong. “We see too many people that it helps to not recommend it — especially because it doesn’t seem to have side effects for most people,” Schoenefeld says. Excessive sugar intake not only leads to weight gain, but some research shows it can also lead to joint inflammation. Quitting smoking has a surprising benefit: “Smoking has a negative effect on bone health and density, which can lead to deterioration of joints and related pain.”

Cortisone injections are used to reduce the pain associated with OA and often can help patients return to their activities of daily living. Acupuncture is a nontraditional treatment that can be effective for some patients, Schoenefeld says. “I’ve had patients say it helps quite a bit with muscular pain associated with OA.” Viscosupplementation, also referred to as Synvisc or Orthovisc, involves injecting hyaluronic acid into the knee joint to act as a lubricant. “It’s an excellent option for individuals with arthritis — with almost no side effects for most people.”

A 2015 Arthritis Care & Research study identified reciprocal connections between osteoarthritis pain, sleep problems, and depression. Having OA increases your depression risk, and depression can make pain worse. Both can also contribute to sleep disturbances. On the flip side, addressing depression can offer direct improvements in your sleep as well as help resolve pain.

To learn more about the services available at St. Thomas More Physician Group – Orthopaedic Services, visit stmhospital.org or call 719-285-2646. INSPIRE ST. THOMAS MORE HOSPITAL

PHOTO: ©ISTOCKPHOTO.COM/KALI9

A TRIPLE THREAT

HRT of the matter What you should know about hormone replacement therapy THE 2002 WOMEN’S HEALTH INITIATIVE study on hormones changed how women and their doctors made decisions about hormone replacement therapy following menopause. “We learned hormones can help with quality of life, but they can also increase the risks of heart attack, breast cancer, strokes, and dementia,” says Mollie Miller, DO, an OB/GYN at St. Thomas More Hospital. So, what do women need to consider?

BALANCING the Risks

Dianne Bush began taking HRT 20 years ago — first to address changes in her menstrual cycle and later to help with hot flashes, night sweats, and severe mood swings. “The least little thing would set me off,” she says. “I could go from pleasant to almost out of control instantly.”

Dr. Mollie Miller

Symptoms. Creams and rings can help for vaginal symptoms like dryness. For hot flashes and night sweats, many women prefer bioidentical hormones, which mimic the molecular structure of your body’s own hormones, over synthetic HRT.

She initially went on hormones and an antidepressant. “I took the antidepressant for less than six months,” she says. “Once I felt like my hormones were in check, I didn’t need it.”

Cost and coverage. “There’s data showing transdermal patches are the safest form for women with hot flashes and night sweats, but it can be pricier than pills,” she says. She often prescribes Estradiol, a bioidentical hormone. “Some insurance plans won’t cover bioidenticals, while others cover it exclusively,” she says. “Women without insurance need to go with their most affordable option, and often that’s a bioidentical estrogen and a synthetic progesterone.”

PHOTOS: ©ISTOCKPHOTO.COM/GULCINYILDIZ; DIANNE BUSH BY STEVE BIGLEY

Health history. For women who have not had a hysterectomy that removed their uterus, “you need progesterone as well as estrogen; otherwise your risk of uterine cancer increases dramatically,” Miller says. And, women with breast cancer can’t use HRT because it could feed their cancer. Alternative treatments include antidepressants and blood pressure medications. The bottom line: “There’s a misconception that women are supposed to be on hormones after menopause,” Miller says. “But they should be on the lowest dose for the shortest time possible to maximize benefits and minimize health risks.”

To learn more about which option would best fit your needs, visit with Dr. Miller or Dr. John Heavrin at the St. Thomas More Physician Group by calling 719-285-2735.

Hormone replacement makes life a lot more enjoyable for Dianne Bush.

Taking hormone replacement for long periods of time is generally not recommended. But because Bush was not at high risk for breast cancer or other health issues impacted by HRT, she and her doctor felt the benefits of long-term use outweighed the risk. Bush says she’s tried to stop HRT multiple times but continues to have significant issues. “For me, it’s about balancing the risk of HRT with my general well-being, so I’ve stuck with it,” she says. “It’s made such a difference in my physical and mental state.”

STMHOSPITAL.ORG | FALL 2018

better detection

CATCHING

Hidden Breast Cancer

mammography

provides a clearer view and greater peace of mind — especially for women with dense breasts

WITH THE LAW PASSED IN COLORADO last year requiring women to be informed when they have dense breasts, you may be wondering what it means and what types of screenings you should consider if you’re told you have dense breasts. And why are the recommendations different than for women with “normal” breasts?

Dr. Conor Heaney

About half of all women over 40 have dense breasts. Women with dense breasts have an increased risk of developing breast cancer, and the breast cancer may be harder to detect in women with dense breasts, explains Conor Heaney, MD, a radiologist with St. Thomas More Hospital. “In dense breasts, cancerous tissue can hide and look much like normal breast tissue on a mammogram,” he says.

A 3D mammogram, which creates a three-dimensional picture of the breast using X-rays, provides a clearer view than traditional mammography; and it makes it easier to distinguish between normal breast tissue and breast cancer, especially in women with dense breasts.

“

In addition to your breast density, other risk factors — like family history, as well your age when you had your first period and your first child — are used to calculate your cancer risk and determine the type and frequency of screenings right for you.

3D mammography offers thin-slice views that keep the cancer from hiding,” Heaney says. “It has actually been shown to detect up to 40 percent more invasive breast cancers — the more aggressive kind — than 2D mammography.” The technology also decreases the likelihood of a callback for further testing, he says. And it’s quickly becoming a standard of care.

KNOW YOUR TYPE Category:

% of women affected:

Screening type:

1. Almost entirely fatty

10%

Mammogram

2. Scattered areas of fibroglandular density

40%

Mammogram

3. Heterogeneously dense

40%

3D mammogram; breast MRI

4. Extremely dense

10%

3D mammogram; breast MRI

St. Thomas More Hospital is part of the Centura Health Cancer Network, delivering integrated, advanced cancer care across Colorado and western Kansas.

INSPIRE ST. THOMAS MORE HOSPITAL

7th Annual Margaritas & Mammos Date: Monday, Oct. 22 Time: 4:30 - 7 p.m. Don’t miss our signature women’s event — an evening of education on breast health, a delicious dinner, giveaways, (nonalcoholic) margaritas, and prizes. Location: Evangelical Free Church, 3000 East Main Street Cost: FREE Registration: 719-285-2179 or stmhospital.org/events For a screening mammogram, a physician referral is not required. But you must have an established relationship with a primary care provider. For scheduling, call 719-285-2255.

“We offer 3D mammography to every patient, and we hope they all choose it because it helps us see more,” says Heaney. “Most insurances cover the cost of 3D mammograms, while others require a fee. If you are able to pay the fee, I encourage you to opt for a 3D mammogram so that we can read the high-quality image that 3D produces.”

INSPIREKids BABY’S BREATH Teaching others the tools to save infants’ lives

ABOUT ONE OUT OF EVERY 10 BABIES needs help to breathe at birth, says St. Thomas More Physician Group pediatrician Ananya Lusero, MD. In Cañon City, where medical providers have training and equipment to step in, that’s rarely a serious problem. But worldwide, 1 million babies die each year because they can’t breathe initially, the World Health Organization (WHO) estimates. Through her work in Nepal, as part of a program offered by Centura Health’s Global Health Initiatives, Lusero is helping give all newborns a better chance to take that first breath. Helping Babies Breathe, a curriculum developed by WHO and the American Academy of Pediatrics, teaches lifesaving resuscitation. More importantly, it teaches those in resourcechallenged nations how to pass along the techniques to others, Lusero says. In two trips to Nepal over the past year, Lusero trained 18 doctors and more than 20 nurses. Altogether, the program has reached 250 medical personnel in Nepal. A sister program has trained hundreds more in Peru. Techniques are shown in pictures, Lusero says, “so a birth attendant who may not be literate can learn the skills.”

New guidelines can reduce kids’ time out of class For kids, strep throat usually means missing a few days of school. For parents staying home with them, it can mean using up precious sick days. New guidelines give parents the green light to safely send kids back to school 12 hours after starting antibiotics, says Amanda Nedzinski, DO, of St. Thomas More Pediatric Health Services. “The recommendation used to be 24 hours. That’s not the case anymore.”

If your child has a fever, though, keep her home, Nedzinski says.

Helping Babies Breathe teaches lifesaving resuscitation to health care providers in Nepal.

International medical aid is Lusero’s passion, and she is grateful Centura Health supports Helping Babies Breathe, she says. “Education is a way we can have a positive and lasting impact.”

GET SCHOOLED ON STREP

Does my child need to see a doctor if he has the flu?

home is going to be tough for a A: If your child has the flu, life at ’s arily mean a trip to your doctor week or so. But it doesn’t necess s ma Tho St. h Dr. Melissa Byram , a pediatrician wit office, says Melissa Byram, MD kept home be uld sho d chil The s. vice Ser More Pediatric Health of fever for 48 hours to avoid from school or day care until free g a lot, and sleepy or The child may be feverish, coughin spreading contagious influenza. he or she is drinking well, to see a health care provider if grumpy. But you may not need altered mental status. iratory distress, and is not having not having severe cough or resp such as asthma or type dren with chronic health issues Infants, young children, and chil ptoms. tor with onset of significant sym 1 diabetes do need to see the doc

ts on Page 2.

>> Read more about flu treatmen

Strep rarely goes away on its own — and left untreated, it can produce serious complications. She recommends getting your child checked if she has strep symptoms, including: ✔ FEVER ✔ SORE THROAT ✔ UPSET STOMACH ✔ HEADACHE Strep doesn’t always include its infamous white spots. “But if you do see those spots, you definitely want to get tested,” Nedzinski says.

It is best to establish a relationship with a pediatrician for well-child checkups and sick care. Call 719-285-2091 to connect with Dr. Nedzinski or another pediatric provider.

STMHOSPITAL.ORG FALL 2018

NOW OPEN!

Whether you need a blood draw, physical therapy, or well-baby checkup, our physician clinics and other health care services are now available in the St. Thomas More Medical Office Building on the hospital campus.

St. Thomas More Hospital

Non-Profit Organization U.S. Postage

PAID

1338 Phay Avenue Cañon City, CO 81212

Denver, CO Permit No. 3280

Find a full list of services at stmhospital.org by clicking on “Medical Services.”

INSPIRATION

Join our health experts to learn how you can make small changes that make a big impact on improving your health! For a complete list of classes and details, visit stmhospital.org/events.

COPING WITH GRIEF DURING THE HOLIDAYS

7TH ANNUAL MARGARITAS & MAMMOS MONDAY, OCT 22  4:30-7 P.M.

Our signature women’s event offers education on breast health, a delicious dinner, giveaways, (nonalcoholic) margaritas, and prizes. Don’t miss it! Location: Evangelical Free Church, 3000 East Main Street Cost: FREE Registration: stmhospital.org/events or 719-285-2179

CHILDBIRTH EDUCATION TUESDAYS, NOV 6 AND 13  5:30-8:30 P.M.

Prepare yourself, your partner, and baby for labor and delivery during this four-week program — what to expect in your third trimester, labor techniques, pain management, breastfeeding, and post-delivery care. Location: St. Thomas More Hospital, Community Room Cost: $25 for you and a support person; scholarships available upon request. Registration: stmhospital.org/events or 719-285-2058

DIABETES MANAGEMENT

TUESDAY, NOV 13  8:30 A.M.-NOON

During National Diabetes Awareness Month, learn how to gain control of your diabetes and prevent complications with education from our diabetic experts! Breakfast will be served. Location: Evangelical Free Church, 3000 East Main Street Cost: FREE Registration: stmhospital.org/ events or 719-285-2712

THURSDAY, DEC 6  11 A.M.-2 P.M.

The holidays can be a difficult time for those suffering a loss. Learn how to seek support, acknowledge your feelings, and take care of your physical health. Lunch will be served. Location: Garden Park Building, 201 North 6th Street Cost: FREE Registration: stmhospital.org/events or 719-285-2061

NEW YEAR, NEW YOU!

Start the new year off right by attending St. Thomas More’s FREE tobacco cessation program! This 13-week program starts on January 8 and will provide education and support to help you live tobacco-free with weekly meetings, tools to maintain success, respiratory testing, and more! For details, call 719-285-2010.

INSPIRE

INSPIRE is published quarterly by St. Thomas More Hospital as part of our Mission to nurture the health of the people in our community. The information herein is meant to complement, not replace, advice provided by a licensed health care provider. To comment or unsubscribe, email us at inspire@centura.org. INSPIRE is produced by Clementine Healthcare Marketing. Executive Editor: Jillian Maes.

St. Thomas More Hospital is part of Centura Health, the region’s leading health care network. 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 1-303-673-8166 (TTY: 711). Copyright © Centura Health, 2018. ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-719-285-2209 (TTY: 711). CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-719-285-2209 (TTY: 711).

S T M H O S P I TA L.O R G