Inspire Summer 2018 by St. Thomas More Hospital

SUMMER 2018 | Volume 4, Issue 3

A Healthier You

St. Thomas More Hospital

OPENING DOORS

TO COMMUNITY HEALTH Care for all ages and stages of life is now available under one CaÃ±on City roof. Page 4

IS IT AN EMERGENCY? Page 2

WEIGHT LOSS SURGERY CAN AID FERTILITY Page 6

TEENS NEED ANNUAL CHECKUPS, TOO Page 7

PHOTO BY MATTHEW STAVER

inspiring health

ARM YOURSELF AGAINST TENNIS ELBOW

WHERE TO GO FOR

SUMMER

DOCTORS CALL IT LATERAL EPICONDYLITIS. The rest of us, even those who’ve never picked up a racket, call it tennis elbow.

EMERGENCIES

YOU’RE OUT HIKING ON A SUMMER DAY, when you fall and twist an ankle. During a rafting trip, you have a close encounter with a tree branch. Or you forget the sunscreen and get blistered. You know you need medical care, fast. But where? Urgent care or emergency room? The rule of thumb, says Joe Garcia, clinical supervisor at Centura Health Urgent Care Cañon City: If life or limb is in jeopardy, go to the emergency room. But when you’re not sure, here’s a guide to some of summer’s common plights:

Injury or illness

URGENT CARE

EMERGENCY ROOM

Sprains or strains Suspected fractures, or anytime a bone is visible Any injury that causes loss of consciousness

Anyone who’s endured it knows tennis elbow is pain in the tendons and muscles where the forearm meets the elbow. The pain results from repetitive motion. If not a backhand, it could be lifting or any movement that puts pressure on the muscles, says St. Thomas More Hospital orthopedic surgeon Keith Minihane, MD.

Dr. Keith Minihane

Only rarely does tennis elbow require surgery, he says. Instead, typical treatments include: Taking a break from whatever motion is the culprit Stretches and exercises y Physical therapy y Anti-inflammatory pain relievers y In-office needle tendon release procedure y y

Cortisone injections for tennis elbow can cause ruptured tendons, so they are rarely used, Minihane says.

To schedule an appointment with Dr. Minihane or another St. Thomas More orthopedic specialist, call 719-285-2646.

Minor allergic reactions and asthma attacks Difficulty breathing Cuts and scrapes Deep wound that won’t stop bleeding Chest pain; numbness in the face, arm, or leg; difficulty speaking Minor burns Rashes, poison ivy

Centura Health Urgent Care Cañon City Hours: Monday through Friday, 8 a.m. to 7 p.m. Saturday and Sunday, 8 a.m. to 3 p.m. Location: 3245 East Highway 50, Suite E Phone: 719-285-2888 Centura Health Urgent Care Cañon City takes appointments for workers’ compensation patients.

HERE’S LOOKIN’ AT YOU IS IT BROKEN, OR JUST A SPRAIN? Patients treated at the new medical office building adjacent to St. Thomas More Hospital can find out in a flash, thanks to an outpatient digital X-ray machine, says Rick Kamerzell, the Rick Kamerzell hospital’s administrative director and project manager for the medical office building. Several features make digital X-ray superior to the old analog X-ray. “First, the image is dramatically clearer. That makes it much easier to get an accurate diagnosis,” he says. And, it’s instantaneous. In less than the time it takes a patient to walk back to the exam room, the image is ready to be read and interpreted by the physician.

To schedule an X-ray or any other imaging test, call 719-285-2255. INSPIRE INSPIREST. ST. THOMAS THOMAS MORE MORE HOSPITAL HOSPITAL

TYPES OF BELLY PAIN

that need to be seen right away YOU KNOW THAT SUDDEN CHEST PAIN signals a trip to the emergency room. But when does belly pain warrant the same response? “If your abdominal pain lasts more than a few hours or is associated with a fever over 100.4, or if you have vomited multiple times, visit the emergency department,” says Heather Roberts, RN, BSN, director of acute care services at St. Thomas More. You also should get emergency care for severe belly pain after an accident or injury, or if the pain is accompanied by bloody vomiting, unconsciousness, or chest pain.

Heather Roberts, RN, BSN

Head to the ER for these belly pains: Location

Symptoms

Possible cause

Lower right side

• Pain around the belly button that moves lower • Sudden onset, lasts hours, worsens • Fever • Vomiting

Appendicitis

Upper right side

• Pain above and to the right of the belly button, usually after eating a large meal or fried or fast food • Gradual onset, worsens over several hours • Fever • Vomiting

Gallstones

Upper belly

• Pain that feels like heartburn • Cold sweat, nausea, or light-headedness • Pain in the arms, back, neck, or jaw

Heart attack

Upper belly

• Severe pain • Fever • Cough • Chest discomfort

Pneumonia

• Cramping or sudden, severe, persistent pain • Chills, fever • Nausea, vomiting • Spotting or bleeding

Pregnancy-related problems

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Lower belly

To check wait times at the St. Thomas More Hospital ER, go online to stmhospital.org.

Do medication expiration dates really matter? IF YOU USE MEDICATIONS AFTER THE EXPIRATION DATE, there’s no guarantee they will be safe and effective. Some expired medications are riskier than others. Using insulin even a few days after the expiration date, for example, can cause a lifethreatening infection. When medications for serious problems don’t work as well as they should, like Nitrostat for chest pain, the consequences can be deadly. “I would never recommend taking medications past the expiration date, because you can no longer count on the stability or effectiveness of the medication,” says Sadie Spencer, pharmacy director at St. Thomas More Hospital. Medications can lose strength before the expiration date if they aren’t stored properly. “People like to keep their medications in the bathroom medicine cabinet. But there the medications are exposed to temperature changes, moisture, and steam. This hardens the pills, which can prevent them from dissolving in the stomach,” says Spencer. Instead, store medications in the kitchen — away from the sink, stove, or faucet — and out of the reach of children.

To get rid of expired or no-longer-needed prescription or OTC medications, you can drop them off at the St. Thomas More ER waiting area any day from 7 a.m. to 5 p.m. as part of the new drug take-back program.

STMHOSPITAL.ORG SUMMER 2018

Take a L

ETTER

A who’s who and what’s what of the health care provider alphabet soup

n your great-grandparents’ day, medicine was simpler. Maybe not as effective, but simpler: When someone got sick, a man with a black bag and a stethoscope came to the house and did what he could.

Now, your PCP may be an MD, a DO, family physician, or NP. Or you may see a PA. So, what do all those letters mean? St. Thomas More Hospital’s chief medical officer, Kern Low, himself an MD, guides us through the alphabet jungle.

M D and D O

A medical doctor, MD, is trained to focus on, diagnose, and treat diseases. DO stands for doctor of osteopathy. Traditionally, DOs approach medicine holistically, emphasizing disease prevention and treating the whole person. Both attend medical school, both complete residencies, and both must pass an exam to become licensed, Low says.

Which one’s for you? Decades ago, the difference between the two was more pronounced, Low says. “Traditionally, DOs did joint manipulation and rarely entered specialties. Those differences are pretty much gone now.” Which means that you can choose either one and be assured you’re getting equal medical care.

INSPIRE ST. THOMAS MORE HOSPITAL

Dr. Kern Low

P C P

A PCP is a primary care physician, and as their name implies, they provide a range of medical care. A PCP physician may be an MD or a DO. Primary care can be provided by a family practice doctor, an internal medicine physician, a pediatrician (in the case of children), or an OB-GYN (in the case of women). To complicate things further, primary care also can be offered by a physician or another licensed health professional, such as a nurse practitioner. With the shortage of primary care physicians, nurse practitioners and physician assistants are filling in those gaps and also are considered primary care providers. “The ideal model of care is when the team works together,” Low says. Read on to learn the difference between all of these professional health care providers.

See a PCP when: You want to establish a relationship with a provider, you need treatment for a short-term or chronic illness, you need a referral to a specialist, or you need a physical or annual exam.

Family Physician

NP and PA

A family physician can be an MD or a DO who has received three additional years of specialty training to care for adults and children, as well as provide obstetrics and preventive medicine.

An NP, or nurse practitioner, is a registered nurse (RN) who has received additional training from an accredited program. In Colorado, nurse practitioners can diagnose and treat illnesses, and prescribe medications, after working in a structured prescribing mentorship for 1,000 hours or under a physician or another NP who has full authority to write prescriptions.

See a family physician when: “Family physicians take care of people from when they are born through adulthood,” Low says. Family physicians are also a good choice for women who like the option of having obstetric care and wellwoman exams with their primary care provider.

Like nurse practitioners, physician assistants (PAs) can diagnose and treat illnesses, and write prescriptions. PA training programs are open to those who have completed a bachelor’s degree, and typically have experience caring for patients, maybe as a paramedic or medical assistant. A licensed PA must be supervised by a physician.

Internal Medicine Physician Internal medicine physicians are trained to prevent, diagnose, and treat diseases in adults, including chronic diseases. They are especially trained to make difficult diagnoses, and care for patients with several conditions or illnesses.

NPs and PAs can specialize, much like physicians. So, there are pediatric NPs, and PAs who work in orthopedics or obstetrics and gynecology.

See an internal medicine physician when: You are an

with medication or monitored or controlled long term, like type 2 diabetes, or when you need a checkup. NPs also are especially good at helping manage chronic conditions when ongoing education is involved, such as with diabetes.

adult with several chronic conditions (such as COPD) or a hard-todiagnose illness.

Pediatrician

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See an NP or PA when: You have an illness that can be treated

Obstetrician-Gynecologist (OB-GYN)

These are physicians who care for children. Like all physicians, they attend medical school and complete a residency, but they also receive additional training in caring for kids.

Obstetricians deliver babies, and care for women during pregnancy. Gynecologists care for women’s health, especially their reproductive health, throughout their lives. OBs and GYNs can be MDs or DOs. They have spent additional years in training to take care of women’s health, and they also are trained in performing women’s surgery.

See a pediatrician when: From the moment your child is born up to the teenage years. There is no set age to stop seeing a pediatrician. “It depends on the comfort level of everyone involved,” says Low. But generally around 16 or 17, teens want to start seeing a family practice physician or internist or, for girls, an OB-GYN.

See an OB-GYN when: You want a specially trained physician caring for your gynecologic health or pregnancy.

WHO’S THERE?

Since it opened in April, the new medical office building adjacent to St. Thomas More Hospital has been filling up fast with a variety of medical providers — and it’s still growing. So far, the St. Thomas More Physician Clinic practices include:

SECOND FLOOR

Orthopaedic Surgery 719-285-2646

Pediatrics 719-285-2091

General Surgery 719-285-2760

Primary Care 719-285-2700

PHOTO: ©ISTOCKPHOTO.COM/BAONA

The new medical office building on the St. Thomas More Hospital campus provides one-stop health care services.

FIRST FLOOR

Obstetrics and Gynecology 719-285-2735 Internal Medicine 719-285-2730 STMHOSPITAL.ORG | SPRING 2018

ask us anything

Q&A

Should obese women have weight loss surgery before getting pregnant? With Tim Brown, MD, bariatric surgeon at St. Thomas More Hospital

Women with a body mass index over 35 with diabetes or over 40 without any health problems should consider weight loss surgery if they have tried diet and exercise to no avail. And because diet and exercise are effective in only 1 percent of the morbidly obese, chances are that most obese women will qualify for surgery. Bariatric surgery can help you — and your future baby — in many ways. Gastric bypass has been shown to cure type 2 diabetes in around 90 percent of patients, and in closer to 100 percent of patients who have had the disease fewer than eight years. Getting rid of your diabetes before getting pregnant significantly increases your chances of having a healthy pregnancy, delivery, and baby.

Dr. Tim Brown

Reversing the obesity trend in your family culture also may prevent your children from becoming obese and acquiring diabetes and other related health problems later in life.

BENEFITS OF BARIATRIC SURGERY

3 FOODS FOR FERTILITY

The results of bariatric surgery extend far beyond weight loss and improved fertility. Other healthy benefits include:

To improve your odds of conceiving — and get your body ready to support a healthy pregnancy — boost these nutrients in your diet:

 Lowers blood pressure, blood sugar, and

Zinc: Deficiencies can affect fertility in both men and women. Get at least 8 milligrams a day by eating oysters, red meat and poultry, whole grains, and fortified cereal.

 Relieves joint pain and results in better surgical

Folic acid: This B vitamin reduces the risk of some birth defects. Get 400 micrograms a day through leafy greens, citrus, nuts, and fortified foods.

cholesterol. Nearly 50 percent of patients who have surgery bring their numbers under control. outcomes if joint replacement is needed.

 Reduces risk of heart attack and stroke by 25 to 50 percent.

 A lower risk of death than obese people who do not have surgery.

 Improves sleep apnea and asthma.  Reduces acid reflux symptoms.

Vitamin E: This antioxidant is found in wheat germ, sunflower seeds, avocado, peanut butter, and mangoes. Aim for 15 milligrams a day.

Call 719-285-2548 or visit stmhospital.org for more information about weight loss services and the support group at St. Thomas More Hospital.

INSPIRE ST. THOMAS MORE HOSPITAL

Bariatric surgery can even help you get pregnant. Many obese women have polycystic ovarian syndrome (PCOS), causing irregular menstrual cycles that prevent them from getting pregnant. Bariatric surgery is so effective at reversing infertility problems that discussion about birth control is part of our preoperative counseling. Pregnancy should be avoided in the first 18 months after bariatric surgery.

INSPIREKids LET’S GET PHYSICAL Teens and older kids need annual checkups, too

Your child probably isn’t a fan of back-to-school physicals. St. Thomas More Physician Group pediatrician Melissa Byram, MD, isn’t either. “We can’t possibly do every child's exam at the same time,” Byram says. A better idea: Schedule yearly physicals around your child’s birthday — even into the teens. With an “off-season” annual physical, “you pick things up,” she says. “A complete well-child visit is preventive. That’s the name of the game.” So, what are they looking for? In addition to overall health and making sure your child is up-to-date on vaccinations, Byram says that obesity is one thing that should be detected and addressed early. If a child is putting on weight, but isn’t seen, type 2 diabetes or high blood pressure can gain a foothold. Another, less-common potential complication is slipped capital femoral epiphysis (SCFE). This condition of growing teens and preteens occurs when the ball at the head of the femur slips into a backward direction, causing pain and stiffness. Surgery may be necessary to correct SCFE.

> TAKE A SHOT <

Vaccinations don’t end with the toddler years. Teens still need:

> Tetanus: A booster every 10 years > HPV: A series of three shots at age 11 or 12; can be given through age 26 > Meningococcal vaccine: At 12, with a booster at 16 > Serogroup B meningococcal: Given at ages 16-18

Looking for a pediatrician? Visit stmhospital.org to see profiles of each of our pediatric providers and select the one that best suits your needs. To schedule an appointment, call 719-285-2091.

SINK YOUR TEETH INTO GOOD HEALTH

Regular checkups with a pediatric dentist are another key to helping your little one stay healthy. They should start at 1 year, or six months after the first tooth appears, says St. Thomas More Hospital pediatrician Amanda Nedzinski, DO. Poor dental health can lead to poor overall health later. And it can impact a child’s eating habits, sleep, and school performance now, Nedzinski says.

Nedzinski’s top three tooth tips: Keep fluoride flowing: It helps prevent cavities. It’s in most tap water. But if your child drinks bottled water, look for supplements. Always choose fluoridecontaining toothpaste. Make flossing fun: Kids should start by age 5. Look for kid-sized flossers in fun shapes and colors. Junk the juice: Stick to milk and water, Nedzinski says. If they insist on juice, try a splash in a cup of water. Sodas are a no-no. “Sugar changes the pH balance in the mouth, which makes us more prone to cavities,” Nedzinski says.

STMHOSPITAL.ORG SUMMER 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

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