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Living at the height of wellness Spring 2015 | Volume 3, Issue 2

Back In The Swing of Things

New clinic helps you work your way out of back pain.

Minimally Invasive Hysterectomies Page 7

Breast Cancer Prevention in a Pill Page 8

Midwives in the Hospital Page 9

Relief for Back Pain Page 11

Trusting Your Doctor The relationship you have with your doctor may be just as powerful as the treatments you receive, according to a report in the Journal of the American Medical Association. “The quality of interaction or trust between the patient and the physician can be extremely influential in patient outcomes,” the study concluded. “… and in some (perhaps many) cases, patient and provider expectations and interactions may be more important than the specific treatments.”

A matter of



rust is the foundation of any good relationship, be it a marriage, a lifelong friendship, or an unbreakable bond with a sibling. “All humans have a sense of justice. We need trust. Our lives just don’t work without it,” says David Martinez, director of mission and ministry at Castle Rock Adventist Hospital. Trust is also one of the key principles guiding the CREATION Health lifestyle, a scientifically proven health approach that serves as the foundation for Castle Rock Adventist Hospital’s wellness programs and philosophy. For Martinez, his trust is placed in God. “He’s the only one that’s never let me down. At times I thought He had, but as time went by, I realized He knew the future much better than I did. I wanted a certain outcome. He knew all along what was best.” But building this kind of trust takes some work. “It’s a relationship,” like any other, Martinez says. “We have to spend time with God and get to know Him and realize that He loves us and cares about us.”

ELEVATE is published four times annually by Castle Rock Adventist Hospital — Portercare Adventist Health System. 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 healthcare professional. For comments or to unsubscribe to this publication, please email us at elevate@centura.org. ELEVATE is produced by Clementine Words LLC. Executive editor is Christine Alexander. 2350 Meadows Boulevard | Castle Rock, CO 80109



Spring 2015

Faith in God and medicine Patients who believed in God saw the greatest benefits from treatment for depression and bipolar disorder, according to a study published in the Journal of Affective Disorders. One possible reason, researchers said, was that people who had faith in God had a stronger faith that treatment would work. A Healthy Devotion People who see as a force that helps them resolve problems in their lives reported the highest levels of marital satisfaction and satisfaction with their personal health, according to a UCLA study.

Cover photo: ©Istockphoto.com/ncognet0; This Page, clockwise: ©Istockphoto.com/Aldo Murillo, /GlobalP, /Steve Debenport, /hidesy, /XiXinXing

Trust Honor(able) Students A study of more than 800 high school seniors found that those who attend church are less likely to become delinquents, drink alcohol, or use marijuana, compared to other adolescents.

Spring into a healthy season One in 10 Americans suffer from hay fever, with half of all new cases showing up in adults typically in their 40s. In Colorado, allergy season starts in early spring with tree pollens and continues through summer and fall with grasses and weeds — often not ending until November. If you suffer from allergies, try these tips: • Take allergy medications at night. Pollen counts peak around 2 a.m., so taking allergy medicines in the morning generally leaves you playing catch-up. • Use newer-generation antihistamines such as Allegra and Zyrtec, which cause fewer side effects. Avoid Benadryl, which can cause drowsiness and impair mental and motor functioning. • Antihistamines can dry out eyes that are already irritated by allergies. Use cold compresses, nasal rinses, and artificial tear eyedrops to help provide relief.

Shoulder On

If you’re headed out to the tennis courts or golf courses this spring, be sure to give your rotator cuff a little TLC — especially if you’re over 40. Injuries are more common as you age because the blood supply to the rotator cuff decreases, making it harder to repair damage, and the likelihood of bone spurs goes up. Proper stretching daily — not just when you’re getting ready to play — helps keep the tendons supple. Exercises to maintain strength are key, too, but you need to be sure to hit all four of the tendons that make up the rotator cuff. The Centura Health Center for Therapy at Castle Rock Adventist Hospital creates customized plans to prevent sports injuries. For information, call 720-455-3700. FAST FACT

100 miles:

Distance pollen can travel on a windy day castlerockhospital.org

Ridgeline Family Medicine has three locations to serve you: The Meadows 2352 Meadows Blvd. Suite 300 720-455-3750

Castle Pines 250 Max Drive Suite 102 303-649-3350

Plum Creek 831 S. Perry St. Suite 200 303-649-3120

For more information, go to ridgelinefamilymedicine.org.

protect your lips As the days grow longer and sunnier, be sure to protect your lips along with the rest of your skin. Exposure to sunlight not only causes cancer on the lips, it also can trigger an outbreak of fever blisters (also known as cold sores). While most Americans realize the risks of sun rays, 70 percent do not routinely use lip protection, according to the Skin Cancer Foundation. Some fever blister sufferers swear by lysine supplements to ward off outbreaks. However, the National Institute of Dental and Craniofacial Research says there is no evidence that lysine works, and taking this amino acid can have serious side effects, so you should talk to your doctor before giving it a try.

Spring 2015


photos: ©Istockphoto.com/Nastco, /Devonyu, /4x6, /peolsen

Dry Up Allergies

Take a Hike!

As a new season springs, Kelly Morales, MD, starts pushing her patients out of the nest, metaphorically speaking. “I encourage my patients to get outside as the weather gets better and the days get longer,” she says. Just 30 minutes Dr. Kelly Morales of moderate-intensity exercise five times a week makes an enormous difference on your heart health as well as reducing anxiety and stress. “Find a buddy and hit the trails,” Morales says. “You just need to make sure that you are walking fast enough to be a little out of breath.” She also reminds patients to wear sunscreen and drink lots of water, particularly those who have a history of kidney stones. Morales is a family practice physician at Ridgeline Family Medicine in Castle Rock. She enjoys treating all ages, from newborns to grandparents, with a focus on prevention. She and husband Pablo are expecting their first baby and are members of Front Range Christian Church. To make an appointment with Dr. Morales or another physician at Ridgeline, call 720-455-3750.


at your best

Four steps to safe and effective plastic surgery






f you’ve considered having a little work done, but have seen one too many “surgeries gone wrong,” like on the new TV show, “Botched,” we’ve got good news. You can get safe and effective plastic surgery if you know what to look Dr. David Archibald for. David Archibald, MD, a plastic surgeon at Castle Rock Adventist Hospital, walks us through what it takes.

Understand your own motives. “The first step is to understand that plastic surgery can improve your lifestyle, but it’s not going to change your life,” Archibald says. “We want to give patients an outer appearance that reflects their own inner spirit, but they need to make sure they aren’t being pressured to do it, or believe it will solve all their problems.”

Be medically healthy and psychologically fit. “There are small but real stresses of having cosmetic surgery, so patients need to make sure they’re ready for that,” Archibald says. “I spend a great deal of time with patients before surgery, getting to know them and their interests and helping them prepare.”

Do your homework. Make sure your surgeon is boardcertified in plastic surgery and has a specialty in the procedure you’re seeking. Beyond this, one of the best ways to choose a surgeon is by word of mouth. “If you know someone who’s had a positive experience and outcome with a particular surgeon, that’s important,” Archibald says. He is board-certified by two medical organizations, the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology — Head and Neck Surgery.

Watch for red flags. Extravagant promises, pressure tactics, rushed consultations, excessive advertising, and bargain prices are all signs that should make you apprehensive. “Good plastic surgeons don’t offer Groupons for their services,” Archibald says.

ELEVATE 4 Spring 2015

Men account for

20% of plastic surgery patients.

The short list A big part of getting good results from plastic surgery involves squaring your expectations. “Your results should look refreshed and rejuvenated, not surgical. No one should be able to tell that you’ve had something done,” Archibald says. He recommends several nonsurgical and surgical options, including: Skin resurfacing via chemical peels, lasers, or dermabrasion Great for: fading sunspots or discolorations, smoothing fine wrinkles, and stimulating collagen for a more youthful, fresh appearance. Botox injections Great for: wrinkles between the eyebrows, around the eyes, and on the forehead. “When used correctly, you won’t look frozen or expressionless,” Archibald says. “We inject smaller amounts in just the right place.” Eyelid and brow-lift surgery Great for: enhancing overall look. “Eyes tend to show the aging process earlier than any other part of our face, and they’re how we interact with people socially,” Archibald says. “We can help people express how they feel inside on the outside with this procedure.” Injectable fillers for filling in wrinkles Great for: around the nose and mouth, or to augment cheeks fallen over the years into jowls.


Q&A: CoolSculpting Get the skinny on this nonsurgical alternative to liposuction from board-certified plastic surgeon Paul Rhee, MD, FACS What is CoolSculpting, and how does it work? CoolSculpting is a noninvasive treatment that uses a cooling process (known as cryolipolysis) to kill fat cells deep within the dermis. As skin and fat are pulled into an applicator that sits between two chill plates, the fat cells die and are removed by the liver. Each treatment (or cycle) achieves around a 20 percent reduction in fat in the area treated, and results will be visible for most people within two to four months. The number of cycles needed is determined on an individualized basis. What body parts does it work best for? CoolSculpting can effectively treat stubborn areas such as love handles, muffin tops, and belly fat, as well as the inner thighs and bra area. Are there any potential side effects? When CoolSculpting is used in the extremities, some people may be more prone to temporary neuropathic pain. This short-term side effect typically only lasts one to two weeks and can be treated with oral medications. Who might benefit most from CoolSculpting? While many factors may come into play, generally people who are good candidates for liposuction are good candidates for CoolSculpting — that is, those with localized problem areas with overlying skin that has good elasticity. Because the fat is suctioned into an “envelope” about 3 to 4 inches wide to be cooled, if you have very dense, fibrous tissue that doesn’t want to be sucked into that space, it doesn’t work well. CoolSculpting is a relatively new procedure. What does the science say? CoolSculpting is FDAapproved and proven to be safe and effective. Like any weight loss endeavor, diet and exercise are key components of CoolSculpting, as was shown in a recent independent study conducted by the University of Kentucky School of Medicine and published in the Journal of Clinical Endocrinology and Metabolism. This study found that cooling fat prompts white fat (the kind that is considered the most unhealthy) to turn to brown fat, which burns calories in the form of body heat. So there may be some synergism in the two mechanisms: freezing the fat cells, which causes them to die, and diet and exercise, which enhances the results.

Photos: ©istockphoto.com/NightAndDayImages, /iofoto, /doram, /IS_ImageSource, / PeopleImages

Effective procedures:

If you’re considering CoolSculpting, what should you look for when choosing your physician? Obviously, it’s helpful to have someone experienced and trained in the procedure, as well as someone who regularly does liposuction, because a lot of the same principles apply.

The Alexander Building at Castle Rock Adventist Hospital houses 29 physician practices and specialty clinics, including the plastic surgery practice of Drs. Archibald and Rhee. For a list of practices in the Alexander Building, go to togetheratcastlerock.com/ tenants.

Spring 2015


Take Control If you experience incontinence, chances are good that Kegels — if you learn to do them right — can help repair the problem


f you’ve given up jumping on the trampoline with your kids or have to clench your core when you sneeze, you’re not alone. It’s Kerri Daniels estimated that one in four women over the age of 18 experiences some level of incontinence. And if you’re one of these women, you’ve probably tried thousands of Kegels without results. Chances are you’ve been doing them incorrectly — and may even be making the problem worse. “Studies show only 50 percent of women are able to do pelvic floor contractions successfully with verbal instruction alone,” says Kerri Daniels, a physical therapist who specializes in women’s pelvic health at Centura Health Center for Therapy at Littleton Adventist Hospital. “Unfortunately, 25 percent perform these contractions in a way that makes urinary incontinence worse.” Stress incontinence occurs when the muscles that control the bladder are weakened, resulting in a loss of urine during activities such as coughing, sneezing, laughing, or exercising. Childbirth, constipation, strenuous ELEVATE


Spring 2015

exercise, and menopause all can increase a woman’s risk of stress incontinence. “Women have many muscles that form a hammock between the front of the pelvis and the tailbone,” Daniels explains. “For optimum pelvic floor health, these muscles must be strengthened through specialized daily exercises.” The Centura Health Centers for Therapy at Littleton Adventist Hospital, Parker Adventist Hospital, Porter Adventist Hospital, and Castle Rock Adventist Hospital offer a program that teaches women how to strengthen their pelvic floors correctly. Using ultrasound and EMG, therapists can actually show women when they are correctly contracting the right muscles. In addition, physical therapists use manual therapy techniques, functional activity training, and provide a home exercise program so women can maintain the gains they have made in therapy throughout their lifetime. The majority of patients see a marked decrease in their incontinence after completing the 12- to 16-week program, Daniels says. “This is where women’s health physical therapy can be most beneficial. We’re trained in assessing muscle strength and pelvic floor contractions while teaching women to do them correctly.” The therapy program also helps women who are struggling with pelvic floor weakness, prolapse, pain during and after pregnancy, and pelvic ring pain.

Therapy clinics to treat women with incontinence, pelvic floor weakness, prolapse, and pelvic pain are available at four Centura Health hospitals throughout the southern metro area. Call any for more information or to make an appointment. Centura Health Center for Therapy Castle Rock Adventist Hospital 720-455-3700 Centura Health Center for Therapy Littleton Adventist Hospital 303-730-5883 Centura Health Center for Therapy Parker Adventist Hospital 303-269-4590 Centura Health Center for Therapy Porter Adventist Hospital 303-778-5842

Photos: ©istockphoto.com/Joey Boylan, ©Lucky Lloyd

“Studies show only 50% of women are able to do pelvic floor contractions successfully with verbal instruction alone.”

Traditional vs. robotic

Two Castle Rock Adventist Hospital surgeons discuss popular laparoscopic approaches to gynecologic surgery If you’re facing gynecologic surgery, you’re likely to be a candidate for a minimally invasive procedure that is performed through small incisions and has you back at home within a day. Called laparoscopy, this surgical technique is used for most gynecologic surgeries, including hysterectomy, fibroid removal, and endometriosis-related surgery. In addition to traditional laparoscopy, you also may be offered robotic-assisted laparoscopy. To help you understand your options, two Castle Rock Adventist Hospital surgeons — who each perform both techniques regularly — explore common laparoscopic approaches. Straight stick laparoscopy

Robotic-assisted laparoscopy


What’s involved



Amanda Meyer, MD, OBGYN at RidgeGate OBGYN A thin, lighted tube, called a laparoscope, is inserted into the abdomen through a small incision in the belly button. Other instruments, held directly in the surgeon’s hands throughout the procedure, are inserted through two to three additional small abdominal incisions. • Ideal for less complex cases. “In general, a woman who has a normalsized or only slightly enlarged uterus, or minimal scarring or endometriosis, is a good straight stick laparoscopy candidate,” Meyer says. “But we discuss all surgical options in detail to ensure the best patient outcome.” • Shorter operating time. For straightforward procedures, straight stick laparoscopy may result in shorter operating time, which reduces the amount of anesthesia used on the patient.

Kristen Sorensen-Boylan, MD, OBGYN at RidgeGate OBGYN The surgeon makes four dime-sized incisions in the abdomen in which the various robotic instruments are placed. From a surgical console with a highly magnified 3-D screen, the surgeon manipulates the delicate robotic controls in real time. • Preferred for complicated cases. For patients who have uteruses with large fibroids, severe endometriosis, or scarring from multiple surgeries, robotic surgery provides better control and visibility. • Better visualization. The highmagnification, 3-D screen allows improved views of tissue and organs. • Increased mobility. “As a surgeon, I use my hands to guide the instruments and have a greater range of motion,” SorensenBoylan says. “The ability to rotate the robot’s hands 360 degrees allows for better dissection, especially in difficult cases.” • Shorter operating time for complex cases. “My robotic cases usually take less time than if I was using traditional laparoscopic techniques,” SorensenBoylan says. “However, this depends on each surgeon’s robotic surgery skill level, as well as the difficulty level of each case.”

According to Meyer and Sorensen-Boylan, the techniques are similar when it comes to: • Postoperative pain: Patient pain comes from internal procedures performed, and it is minimal from external laparoscopic incisions. • Length of hospital stay: Depending on the specific procedure, patients usually return home the same day or the day after surgery. • Patient recovery time: Recovery time varies based upon procedure performed, but it is the same regardless of laparoscopic technique. Castle Rock Adventist Hospital’s advanced robotic surgery program is supported by Centura Centers for Clinical Innovation, extending advanced health technologies across Colorado and western Kansas.

RidgeGate OBGYN’s surgeons offer many approaches to hysterectomy and other gynecologic procedures, ensuring each patient a customized approach and treatment plan. For more information, go online to ridgegateobgyn.org. There are two locations to serve you: Castle Rock Office 2352 Meadows Blvd. Suite 300 303-649-3380 Lone Tree Office 9695 S. Yosemite St. Suite 255B 303-795-3110 To schedule an appointment to discuss your options with a RidgeGate physician, call 303-649-3380.

Spring 2015


Photos: ©Michael Richmond


Shared benefits of straight stick and robotic-assisted laparoscopy


in a

Drug cuts risk of developing breast cancer in half for women at high risk


drug that has been used in treating breast cancer is now being used to prevent cancer in high-risk postmenopausal women. The drug, called an aromatese inhibitor, cuts the risk of developing cancer in half, Dr. Nadine Mikhaeel according to two new studies. “Aromasin (the brand name) has been used in treatment for a long time, but it was never used in prevention until now,” says Nadine Mikhaeel, MD, a medical oncologist who specializes in breast cancer treatments at Castle Rock Adventist Hospital. After menopause, a woman’s body uses an enzyme called aromatese to convert other hormones into estrogen, which fuels the growth of breast cancer cells. This drug prevents that process and reduces the amount of estrogen in the body. The main side effect is hot flashes, Mikhaeel says, but women also may experience joint pain as well as be at slightly increased risk for bone loss and blood clots. “You always look at risk and benefit,” Mikhaeel says. “If a patient has had a stroke, they may not be a good candidate.”

• Two or more close relatives with breast cancer • Mom or sister with breast cancer before age 50 • Mom or sister with cancer in both breasts • Certain types of benign breast disease • Carry one of the mutated genes that cause breast cancer We are part of Centura Health Center Network, delivering integrated, advanced cancer care across Colorado and western Kansas.

Brand Names

How It Works

Recommended For

Side Effects

Aromasin, Arimidex, Femara

Prevents the aromatese enzyme from producing estrogen, cutting risk of breast cancer by 50%

Postmenopausal women at high risk of developing breast cancer

Hot flashes, bone loss, increased risk of blood clots, joint aches

Mom’s, Mammos, Massages, and more! If you are a mom or “like a mom” to someone, we want to treat you to a day of pampering. Enjoy a massage, receive a special gift, and enjoy live music during our special Mother’s Day event on May 7 from 3-7 p.m.


What does ‘high risk’ mean?


Spring 2015

Although there are no medical treatments to prevent cancer in women at normal risk, women can help lower their odds through lifestyle choices, says Nadine Mikhaeel, MD, a medical oncologist at Castle Rock Adventist Hospital. Three things she recommends: • Maintain a healthy weight through diet and exercise. Fat allows the buildup of estrogen in the body, which increases the risk of cancer. • Limit alcohol. Although small amounts of alcohol may have a beneficial effect on the heart, significant daily alcohol intake has been linked to increased risk of breast cancer. This may be related to its high sugar content, which may allow cancer cells to grow, Mikhaeel says. • Watch your vitamin D levels. “In at least three studies, maintaining a level of 40 or above decreased the chances of developing breast cancer,” Mikhaeel says. Every woman should have her vitamin D level checked to determine if she needs supplements.

Photo: ©istockphoto.com/ pamela_d_mcadams, /jenifoto ;Opposite Page: ©Ellen Jaskol


Prevention steps for every woman

a nd

Melding Midwives Medicine

hen Rachel Whitlow, of Castle Rock, became pregnant last year, she thought a midwife was the perfect fit for her. “A midwife offers the benefits of a skilled practitioner, the compassion of a best friend, and the understanding of a mom wrapped up into one,” she says. But the 25-year-old mom also wanted to deliver at Castle Rock Adventist Hospital. Although she planned a natural pregnancy and didn’t anticipate any problems, the hospital was a reassuring “just in case.” That just in case became a necessity after her delivery lasted much longer than normal and pure exhaustion led her to decide to use pain control medications. “My midwife did everything she could to keep me informed and help me make the best decisions for me and my baby,” says Whitlow, who gave birth to a healthy baby girl, Esther Grace, on Nov. 16. High touch and high tech

Many women like the thought of using a midwife for pregnancy care and delivery, but they worry about what would happen if anything were to go wrong. The midwifery program at Castle Rock Adventist Hospital helps alleviate those concerns by offering midwives who are part of obstetrical physician practices and deliver regularly in the hospital. “By delivering in a hospital, we can provide the mother with the personalized care she desires alongside OB-GYN physicians and an operating room nearby should we need either or both,” says Sarah Stone, a certified nursemidwife at South Denver OB/GYN and Midwives who delivers at Castle Rock Adventist Hospital.

While midwives are often thought of only in terms of home births, recent research has found that delivering in a hospital may be a safer route. In comparison with home births by midwives, a study that looked at more than 14 million births found that hospital-based midwife deliveries reduced infant death by 75 percent and by up to 85 percent for first births. (The study was presented at the February 2015 annual meeting of the Society for Maternal-Fetal Medicine and is considered preliminary until published in a peer-reviewed medical journal.) Team approach

The birthing teams at Castle Rock Adventist Hospital include physician obstetrical specialists, midwives, nurses, and other clinical experts. They work together to understand and adhere to the mother’s birth wishes while keeping both mom and baby safe, says Jacque Northrup, birth concierge for The BirthPlace. “Together, we collaborate to offer the best care possible,” Stone says. “Women can continue to receive the time and education that midwives provide and also benefit from the skills and expertise of a specialist.”

Certified nurse-midwives (CNM) are registered nurses with master’s degrees in nursing and a focus on women’s healthcare. A CNM provides a complete range of healthcare services for women, including prenatal care, assistance with nutrition, and labor and delivery services. Certified nurse-midwives have particular expertise in natural births, using different techniques to benefit both the mother and baby, says Sarah Stone, a certified nurse-midwife at Castle Rock Adventist Hospital. “Nurse-midwives really bridge the gap between natural birth and Western medicine, offering the best of both worlds.”

Castle Rock Adventist Hospital’s Birth Concierge Service allows you to share your labor and delivery preferences, tour The BirthPlace, and get your questions answered prior to your delivery. To schedule an appointment, call 720-455-0355.

1 in 8

women in the U.S. who deliver vaginally uses a midwife.


Spring 2015


Keep on Rolling

Getting to the root of IT band syndrome — and how to beat it If you’re not an avid runner or cyclist, the term IT band syndrome might sound like something has gone awry with your wireless network. But those who’ve experienced iliotibial band syndrome (sometimes called ITB or IT band friction syndrome) know the pain it can cause anywhere from the hip to the knee. We’ll explore this syndrome to help you get to the source of the pain — and get back to your active lifestyle.

IT band syndrome accounts for approximately




Why it happens While overuse tends to be the main culprit, it’s typically not the only one, Bartel says. “It’s often a combined issue of overuse combined with weakness. If the gluteal muscles are not strong enough and the individual is doing a significant amount of repetitive motion, irritation of the ITB can result.”

The Centura Health Center for Therapy at Castle Rock Adventist Hospital creates customized outpatient programs for sports injuries. Call 720-455-3700 for more info.


10 Spring 2015

Where it hurts Runners and cyclists often describe pain on the outer part of the knee or lower thigh, which is often made worse during their sport or through daily activities like climbing stairs or getting out of their car. It can cause pain in the hip, and back pain also can be related. “If you experience back pain, you may compensate with poor mechanics, which can create stress along the IT band. Alternately, weakness in the gluteal muscles may cause a mechanical change that irritates the ITB, resulting in compensatory motions that may then affect the back. So pain may be referred either direction,” Bartel says.

What you can do While there’s controversy regarding whether or not you can truly stretch your IT band (because there’s muscle at one end and tendon along the other, which you can’t necessarily stretch), you can definitely stretch the muscles around it, which may relieve stress on the IT band. Bartel recommends hip abductor and flexor stretches as well as using a foam roller along the IT band to help loosen the tissue. Additionally, targeted strengthening of weak musculature and correction of poor mechanics can be critical in preventing further irritation.

This depends on a variety of factors, including how long you’ve had symptoms and how quickly you get relief when you stop the activity. “Try a stretching and strengthening program that’s tailored to you. If you can continue your sport of choice at a decreased intensity level and not have pain, go for it,” Bartel says. “If you can’t, then decrease the time frame that you do it and if you still have pain, then you need to stop doing it until you get relief.” Working with a physical therapist may also be needed.

Photo: ©istockphoto.com/ OSTILL; Opposite Page: ©Michael Richmond, ©istockphoto.com/Moncherie

The IT band is comprised of fibers that run along the outside of the thigh. It is attached at the hip to the gluteal and tensor fasciae latae muscles, and attaches at the bottom to the top of the shinbone just below the knee. The IT band acts as a stabilizer during activities like running and cycling, and can become irritated from overuse. “When you have repetitive motion where that tendon has to ride back and forth over any bony surface — at your knee or your hip — it creates friction and can be irritated,” says Scott Bartel, DPT, SCS, director of physical medicine and rehabilitation at Castle Rock Adventist Hospital. Most commonly, this occurs over the end of the thighbone just above and to the outside of the knee.

of cyclists’ overuse injuries in the knee region.

Back to business Nearly every American will experience back pain at some point. Thankfully, the vast majority of people won’t suffer long Dr. Jonathan Clapp and will find relief with conservative treatments, like medications and physical therapy. “Most acute back pain will often resolve itself in a few weeks,” says Scott Bartel, DPT, SCS, a physical therapist and director of physical medicine and rehabilitation at Castle Rock Adventist Hospital. “However, while the back pain may go away, people often don’t deal with the root cause of their back pain and are more likely to suffer from recurrent episodes of back pain than individuals who receive early intervention from physical therapy.” While the majority of acute back pain subsides without a physician’s intervention, both Bartel and Jonathan Clapp, MD, a physical medicine and rehabilitation specialist at Colorado Pain Consultants, stress the benefits of seeking medical attention sooner than later. “If it’s not getting better on its own or if there are any issues with numbness, tingling, or bowel or bladder incontinence, seek medical attention,” Clapp says. “Oftentimes, physical therapy and a strong anti-inflammatory medication can do the trick.” Acute back pain can be connected to a lack of core strength and poor flexibility, Bartel says. By working with a physical therapist early during the onset of back pain, patients can strengthen their transverse abdominal muscles — the innermost flat muscles in the abdomen — to alleviate pain. Physical therapists will typically teach patients how to stretch and strengthen muscles and how to use their core muscles correctly to support the back, Bartel says. They also may use manual therapy to improve joint mobility and correct muscle firing patterns, he adds. To manage back pain on your own, Clapp suggests the following: • Move — Stay as mobile as possible. “Bed rest really does a disservice to people,” Clapp says. “If you are hurting too much to get out of bed, see a physician.” • Ice — Ice is better than heat, as heat can make inflammation worse. Only ice for 20 minutes or less each hour. • Take a nonsteroidal anti-inflammatory drug (NSAID) — Clapp recommends ibuprofen or Aleve to help with inflammation and pain. Seek a physician’s input if you need to take either for more than seven to 10 days. If back pain persists, seek a back pain specialist. “We like to get patients as active as possible and encourage them to play an active role in alleviating their back pain,” Clapp says. “We take a conservative approach and avoid doing injections first.”


Back pain and sleep disturbances are connected, according to new research from the University of Haifa. Researchers found that healthy individuals suffering from sleep problems had a


greater incidence of back pain than those with normal sleep patterns.

The Centura Health Center for Therapy at Castle Rock Adventist Hospital can help you get back to being pain-free, offering physical therapy and occupational therapy targeted at back pain. For more information, visit castlerockhospital. org/rehabilitation.

Spring 2015



Portercare Adventist Health System

Non-Profit Org US POSTAGE


Denver, CO Permit NO. 4773

Welcome Dr. Michelle Eason-Delhougne to Ridgeline Family Medicine!

2350 Meadows Boulevard Castle Rock, CO 80109

She will start seeing patients at the Plum Creek location on April 1.

Castle Rock Adventist Hospital is part of Centura Health, the region’s leading healthcare 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 303-804-8166. Copyright © Centura Health, 2015.

Boot Camp for New Dads This is a workshop led by dads, for dads only. In this class, you will get oriented to the unique aspects of fatherhood by the experts … NEW DADS and their babies! Topics include: troubleshooting crying babies, caring for new moms, bonding, work/family balance, what to expect postpartum, and the role of the protector. Date: Sats, Apr 11, May 9, Jun 20 Time: 9 a.m.-Noon Cost: FREE Location: Castle Rock Adventist Hospital Conference Center

I’m Pregnant, Now What? A Journey Through the First Trimester of Pregnancy This class is designed to help newly pregnant parents understand all that happens in the first trimester of pregnancy and into the second trimester. This is the first class that parents can take to get them off to a great start with their pregnancy. Topics include: exercise, nutrition, warning signs, changes to the body, what prenatal visits will be like, available testing and why it is done, things to avoid during pregnancy, and weight gain. Date: Wed, Apr 29; Thu, May 21; or Wed, Jun 24 Time: 6:30-9 p.m. Cost: FREE Location: Castle Rock Adventist Hospital Conference Center

Menopause Management Meet Dr. John Stallworth, an OB-GYN and certified menopause practitioner. He will review what to expect during the menopause transition, outline management options, and raise awareness of the predatory practices that take advantage of women going through menopause. Husbands and significant others are invited too! Refreshments will be provided. RSVP required. Date: Tue, May 5 Time: 6-7 p.m. Cost: FREE Location: Castle Rock Adventist Hospital

RSVP is required for all seminars. Go to castlerockhospital.org/register.

Photo: ©istockphoto.com/andreusK

elevate your Spring

Dr. Eason-Delhougne has been an internal medicine physician for more than 15 years and enjoys caring for all age groups, from babies to seniors. Contact the office to make an appointment at 303-649-3120.

Profile for Castle Rock Adventist Hospital

Elevate Spring 2015  

Read about the new clinic that helps you deal with the root cause of back pain; what IT-band syndrome is and how to beat it; have a healthy...

Elevate Spring 2015  

Read about the new clinic that helps you deal with the root cause of back pain; what IT-band syndrome is and how to beat it; have a healthy...