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Spring 2014 • Volume 2, Issue 2

Your health. Your life.

leading the way

Nurse guides help cancer patients navigate treatment and recovery Page 4

a n d ...

Spring Cleaning Page 2

Daddy Boot Camp Page 3

Weight-Loss Surgery FREE Health Classes Page 6

Page 8


Spruce up your spring Spring goes hand in hand with cleaning, but spicing up your surroundings may be just as beneficial as clearing the cobwebs. Freshening up your visual environment — from swapping out family photographs to rearranging furniture to cleaning out the refrigerator — creates a sense of peace and motivation, numerous studies show. Another visual cue certain to put spring in your step is moving your workout shoes to an area you see regularly, like by the back door or near your alarm clock. “Much of our happiness and success with health and fitness goals lies in our environment and what we see,” says Rita Sharma, MD, a board-certified family physician at Centura Health Physician Group — Denver Tech Center.

Environ ment is the third guiding principle of the CREAT ION Health Lifestyle, a n Adventist wellness progra m supported by medical research. Learn more a bout CREAT ION lifestyle principles at creationhealth.com.

Deck of

Cards

A serving of protein should be no more than 3 ounces (85 grams), roughly the size of a deck of cards.

Run for fun or mud

Nontraditional races, like the Tough Mudder and Warrior Dash, attracted more than

3 million participants

in 2013, accounting for nearly 15 percent of all run/walk participants. If running with a twist sounds like fun, try out the Color Run 5K (July 19 in Denver), where nearly 60 percent of participants are first-timers. See more at thecolorrun.com.

Motivation to Move

Centura Health is making it easier than ever to live a healthy, active life with CaféWell, a new FREE online platform that allows you to set goals, ask questions, track your progress, access health and fitness information, and gain support from online communities. Sign up for CaféWell at centura.org/cafewell. 2 | SPRING 2014 • Create

BAG

Dr. Rita Sharma Board-Certified Family Physician, Centura Health Physician Group — Denver Tech Center, 8200 E. Belleview Blvd., Suite 100

Meat-Free Monday

Eating less red meat can help you reduce your cholesterol, blood pressure, and weight. People who eat 4 ounces of red meat or more daily are 30 percent more likely to die of any cause during a 10-year period than those who eat less, according to a study by the National Cancer Institute. “Even cutting red meat out of your diet just one day a week will make a difference,” Sharma says.

Doctor’s

Originally from Canada, Dr. Sharma received her medical degree from St. George’s University School of Medicine and completed her residency through the University of Pennsylvania at hospitals in Philadelphia. She specializes in primary and preventive care for all ages.

To schedule an appointment with Dr. Sharma, call 303-770-6500 or visit dtcfamilymedicine.org.

Cover photo: ©IStockphoto.com/Idiego_cervo; This page: Clockwise ©IStockphoto.com/knape, /eurobanks, Portrait, ©Ellen Jaskol, ©IStockphoto.com//ronstik, /oohtee, /Sashkinw; opposite page: ©IStockphoto.com/JillLang

IN Good Health


«««««««««««««

Prostate cancer or benign prostatic hyperplasia?

PSA levels don’t tell the full story

prepped forparenthood

Getting dads

««««

Soon-to-be dads can now learn directly from others who

were recently in their shoes, thanks to Boot Camp for New Dads, a national program now offered at Littleton Adventist Hospital. The three-hour workshop features veteran dads who candidly share their experiences, from holding a newborn to the emotional changes of being a new dad. “The need for this program originated out of requests from expecting mothers,” says Stacy Kreil, RN, director of Women’s and Children’s Services at Littleton Adventist Hospital. “The course stays fresh and current, as new at now offered ntist veteran dads participate every session.” ve I In addition to Boot Camp for New Dads, Kreil Littleton Ad al Hospit recommends that expecting fathers attend all childbirth preparation programs with expecting mothers, including Baby Safe and Baby Care classes, not only to become more prepared for the child, but also to support mothers. “Parenting is becoming more of a 50-50 partnership between mothers and fathers,” Kreil says. “The sooner a father can become comfortable with his role and take on responsibilities, the better.” Numerous studies have shown that positive attachment between fathers and children results in fewer behavioral problems and higher academic performance. Fathers who have participated in Boot Camp for New Dads report greater confidence in parenting, improved support of new mothers, and increased involvement with their new infants.

Boot p C«a«m ««

FOR DADS

Expecting fathers can sign up for Boot Camp for New Dads by calling 303-777-6877. A complete listing of of Boot Camp dates is available at mylittletonhospital.org/boot-camp-fornew-dads. Interested in other classes and special tours for dads? Visit mylittletonhospital. org/birthplace.

Littleton Adventist Hospital brings specialized care to the people of South Denver in the complex areas of trauma, cancer, neurology, cardiology, orthopedics, women’s services, and more. We are part of Centura Health, the state’s largest health care network. The purpose of this publication is to support our mission to improve the health of the residents of our community. No information in this publication is meant as a recommendation or as a substitution for your physician’s advice. If you would like to comment or unsubscribe to this magazine, please email create@centura.org. Create is published four times annually by Littleton Adventist Hospital.

As a man ages, his prostate gland enlarges. Known as benign prostatic hyperplasia (BPH), an enlarged prostate puts pressure on the bladder, resulting in symptoms that include difficulty with urination, slower urination stream, sense of urgency to urinate, need to urinate during the night, and increased frequency of urination. Elevated levels of prostate-specific antigen (PSA), a blood test commonly used to identify prostate cancer, can also indicate BPH. “Roughly 50 percent of men will have BPH by the age of 50 and 80 percent by the age of 80,” says James Fagelson, MD, a urologist at Littleton Adventist Hospital. “PSA is a very good test in terms of screening for prostate cancer, but it has to be used with a grain of salt, as other factors can cause elevated PSA readings.” An increase in PSA levels of a half point from one year to the next can indicate BPH; anything higher may signal cancer, Fagelson says. BPH does not raise the risk of developing prostate cancer. BPH is treated with herbal and alpha-blocker medications to ease symptoms. Other medications shrink the prostate but can take years to take effect. For those with more severe symptoms or infections, GreenLight™ laser ablation, a minimally invasive surgical technique, is often recommended. Only one in 10 men with BPH pursue surgery, Fagelson says.

Test Your Man Bring your husbands, brothers, dads, sons, and friends to Littleton Adventist Hospital’s very popular Men’s Health Challenge on June 22. There will be booths featuring men’s favorite hobbies, along with FREE health screenings and health talks by local physicians. Visit mylittletonhospital.org/mens-health for full details and registration.

7700 S. Broadway | Littleton, CO 80122 | mylittletonhospital.org create | mylittletonhospital.org | 3


the

Littleton Adventist Hospital’s nurse navigators help map out journey for cancer patients and their families A cancer diagnosis can be overwhelming. With the many treatment options and often-difficult medical lingo, even the most astute patients can feel lost. Thanks to cancer nurse navigators at Littleton Adventist Hospital, patients now have dedicated registered nurses to help navigate their journey, from diagnosis through recovery.

Ellen Buchannan, RN/ FNP, (L), and Marla Talmadge, RN/OCN, cancer nurse navigators at Littleton Adventist Hospital

4 | SPRING 2014 • Create

“The most important thing for cancer patients to understand is that they are not alone,” says Ellen Buchannan, RN/FNP, the breast cancer nurse navigator at Littleton Adventist Hospital. Buchannan became the first breast cancer nurse navigator at Littleton Adventist Hospital in 2010 after years of managing the cardiac floor. “Having gone through breast cancer myself, I felt like I could make an impact on others’ journeys and help them feel less overwhelmed during the process,” she says. “I have learned through my experiences to be specific in how I can support patients and families.” Buchannan is also inspiring other nurse navigators, including Marla Talmadge, RN/OCN, who recently stepped into a new cancer navigator role at Littleton Adventist Hospital focusing on lung, gastrointestinal (GI), and other cancers. “I had met Ellen while taking care of several patients over the years,” says Talmadge, who was an oncology nurse at Littleton Adventist Hospital prior to becoming a cancer nurse navigator in November. “She does a fantastic job and was an influence on my decision to step into this new role.”


Priceless Piloting

Nearly one in two men and one in three women will be diagnosed with cancer at some point during their lifetimes. Cancer nurse navigators play a critical role in helping patients — even those with strong support systems — through the process and the challenging health care system. “A cancer diagnosis can be one of the biggest challenges someone faces,” Talmadge says. “Patients and their families are not alone. We’re here to help, whether it’s to provide information, answer questions, or just listen.” Cancer nurse navigators are the eyes and ears for patients — not to mention a strong shoulder of support — every step of the way. They help by: • Scheduling appointments • Joining meetings with surgeons and oncologists to take notes and help ask questions on behalf of the patient and family • Attending surgery • Reviewing treatment options • Offering support and information to the patient and family

Annual mammograms pay off Women ages 40-49 who receive annual screening mammograms have their breast cancer diagnosed at earlier stages, according to new research published in the American Journal of Roentgenology. Because the cancer is diagnosed earlier, tumors are typically smaller and less likely to require chemotherapy. “This is big news! This study proves that yearly mammograms save lives, and women have a chance of needing less-toxic therapy to cure cancer,” says Radhika Acharya-Leon, a board-certified oncologist at Mile High Oncology. All women ages 40 and older should obtain annual screening mammograms, according to the American Cancer Society. The Breast Center at Littleton Adventist Hospital is offering two new breast screening programs: • Schedule by Text: Just text your name to 720-358-5412 and Littleton Adventist Hospital will call you within two business days to schedule your mammogram • Join us for special Mother’s Day Mammogram events on Wednesday, April 30, and Tuesday, May 13 — see back cover for full details

FREE support! All cancer navigation services at Littleton Adventist Hospital are FREE to patients. For breast cancer patients, Ellen Buchannan can be reached at 303-738-7787. For patients with lung, GI, or other cancers, Marla Talmadge can be reached at 303-734-8669.

Dr. Lisa Ahrendt Oncologist Mile High Oncology

Lung cancer screening now covered for people at high risk

Lung cancer is the leading cause of cancer-related deaths in the United States, accounting for more lives lost than colon, breast, and prostate cancers combined. A lung cancer screening, which consists of an annual low-dose CT scan for three years, can detect lung cancer in high-risk people earlier and has been proven to save more than 10,000 lives each year, according to the American Cancer Society. Thanks to a recent endorsement by the U.S. Preventive Services Task Force (USPSTF), this screening is now covered by Medicare, Medicaid, and many insurance plans for people at high risk of lung cancer. “Early detection of lung cancer through screenings reduces the mortality rate,” says Lisa Ahrendt, MD, an oncologist at Mile High Oncology, part of Centura Health Physician Group. “With the USPSTF endorsement, now lung cancer screenings are more accessible. All high-risk patients should make it a priority, just like a mammogram and colonoscopy.” Roughly one in 16 women, mostly smokers, will develop lung cancer. The American Cancer Society, American Society of Clinical Oncology, National Comprehensive Cancer Network, and American College of Chest Physicians agree that all people at high risk of developing lung cancer should be screened. Those include people who: • Are 55-74 • Have a 30-pack history* • Still smoke or have quit within the past 15 years “Early detection through screening not only saves lives but can also alleviate the need for chemotherapy and radiation,” Ahrendt says. “When found early, surgery alone can be curative.” *A 30-pack history means one pack a day for 30 years or two packs a day for 15 years, etc.

Schedule Your Screening To learn more and find out if you are qualified for a lung cancer screening, please call 1-855-456-LUNG (5864). Lung cancer screenings are done at Littleton Adventist Hospital and Porter Adventist Hospital and cost $199, which usually is covered by insurance.

create | mylittletonhospital.org | 5

Photos: Opposite page: ©Ellen Jaskol,©IStockphoto.com/LdF; This page: ©IStockphoto.com/Graffizone

Littleton Adventist Hospital offers complete cancer services, including diagnostic testing, surgery, chemotherapy and other biological treatments, and radiation therapy. In addition to the free nurse navigator support, the hospital offers a vast array of other support services, from financial counseling to support groups and survivor celebrations. Littleton Adventist Hospital is part of Centura Health, which delivers integrated, advanced cancer care across Colorado and western Kansas.


Starting Anew How one woman used bariatric surgery as a stepping-stone to begin a more active lifestyle

Less than two years ago, Carol Timm was morbidly obese, had little energy to accomplish more than the minimum tasks of daily life, and was facing a future defined by serious health problems. “I have a family history of heart disease and my cardiologist told me that if I didn’t do something about my weight, he thought that within three to five years I’d probably have a cardiac arrest,” Timm says. It was this risk coupled with the regret that she wasn’t able to be active with her four young grandchildren that led Timm to decide on “A whole new bariatric surgery, and in November 2012 she underwent laparoscopic life has opened gastric bypass at Parker Adventist Hospital, a bariatric surgery center of excellence. up for me.” Since then, the 64-year-old has shed 159 pounds and counting, changed her eating habits for the better — including giving up the sweets that she used to love — and is a regular exerciser. In December, she competed in her first 5K run with her family. “I would never have been able to do that before the surgery. I would never have even considered it … but I made it!” she says. “A whole new life has opened up for me.”

Fighting a losing battle

While many people like Timm struggle for years losing and regaining weight, there’s solid scientific evidence showing that the hormonal production of fat cells pulls strongly in the wrong direction for them, says Joshua Long, MD, medical director. “They often come in buried in guilt and blaming themselves, but what they need is something powerful to help level the playing field.” Dr. Joshua Long According to Long, the best candidates for surgery are individuals with a body mass index (BMI) of 35 or higher with a health condition related to their obesity, or a BMI of 40 without a related condition. “The most successful candidates are also committed to the overall process and to using all the tools that we give them,” Long says. “Patients who are highly motivated and really interested in partnering with us to maximize their benefits will get the most out of it.” After bariatric surgery and losing 159 pounds, Carol Timm is now running 5k races and playing with her grandchildren.

6 | SPRING 2014 • Create

Beating diabetes with bariatric surgery The evidence that weight-loss surgery can resolve diabetes is mounting. A study published last September in the Annals of Surgery found that the biggest predictors of sustained diabetes remission after bariatric surgery were:

 Long-term weight loss  Having diabetes for less than

five years before surgery

 Having gastric bypass surgery

versus gastric banding

Matthew Metz, MD, a bariatric surgeon at Parker Adventist Hospital, helped collect data from his patients for the study. Another procedure not studied in this research offers even greater odds for long-term resolution of diabetes, he says. Dr. Matthew Metz The duodenal switch calls for removing a large part of the stomach and rerouting food away from much of the small intestine to limit how the body absorbs it. “We’re seeing as high as a 98.9 percent resolution of diabetes with the duodenal switch,” he says.

Learn More If you are interested in learning more about the types of weight-loss surgery and whether you are a candidate, join Dr. Josh Long, bariatric surgeon, for a FREE community seminar at Littleton Adventist Hospital on Wednesday, April 16, at 6 p.m. To register, call 303-777-6877 or go online to mylittletonhospital.org/classesand-events. PHOTOS: ©ELLEN JASKOL


REENING M C S E AY ON

Colonoscopies cut prep and death rate by half

save your life

Getting a colonoscopy might not be at the top of your to-do list, but chances are it won’t be as bad as you think and it could save your life. Colonoscopies have

☛ History of colon polyps, inflammatory bowel disease, or specific cancers ☛ Family history of colorectal cancer or polyps ☛ Inherited diseases like Lynch syndrome

☛ African-American ☛ Obese, physically inactive, a smoker, or a heavy drinker

Dr. Luke Evans

Preventable Cancer One out of three Americans are skipping out on colon cancer screenings, according to the American Cancer Society. “Colon cancer is a silent killer. But the majority of colon cancers can be prevented by a test, the colonoscopy, that potentially only needs to be performed once every 10 years,” Evans says. “It’s a perfect opportunity for us to save lives.”

Learn More For more information about colon cancer, risk factors, and how to prevent it, join Dr. Evans for a FREE seminar on Wednesday, May 21, at 6 p.m. See Page 8 for complete details.

Types of Colorectal Cancer Screenings

DESCRIPTION

FREQUENCY

PROS

CONS

Sigmoidoscopy

A long, flexible, tubelike instrument is used to examine the rectum and lower colon

Every 5 years

No sedation necessary; easier preparation for test; relatively inexpensive compared to a colonoscopy

Doesn’t allow for visualization of two-thirds of the colon; can be uncomfortable

Fecal occult blood test (FOBT)

Checks for blood in stool samples; typically 3 samples are examined

Annually

Noninvasive; inexpensive

Generally only detects cancer, not precancerous growths or abnormalities; not reliable — generates high number of false positive results

Colonoscopy

A thin, tubelike instrument is used to examine the entire colon and rectum and to remove polyps that are found

Every 10 years

Most comprehensive screening; allows for removal of precancerous polyps during procedure

Expensive although screening is covered by insurance; requires sedation

create | mylittletonhospital.org | 7

Photo: ©istockphoto.com/ ajafoto

been found to cut the death rate of colon cancer — the second leading cause of cancer-related death — by more than half, according to a 2012 study published by the New England Journal of Medicine. “Colon cancer is a preventable cancer,” says Luke Evans, MD, a boardcertified gastroenterologist at Littleton Adventist Hospital. “Colonoscopy is the preferred screening, because it gives us the best view of the colon while allowing us to remove precancerous polyps during the procedure.” Colonoscopy uses a thin, tubelike lighted instrument to examine the entire colon. Unlike other cancer screenings that are useful to detect cancer that has already formed, colonoscopies can actually prevent cancer. Colon cancer starts as precancerous lesions known as polyps, which can be removed during a colonoscopy to prevent the development of colon cancer. “While the other screening options (see chart) can provide valuable information, if any of the tests are positive, a colonoscopy is typically recommended as the next step,” Evans explains. Preparation for a colonoscopy has also improved. Newer preparations require that patients only drink roughly half as much of the bowel-clearing liquid, compared to the past. (A former preparation method that used only pills is no longer recommended, Evans says.) In addition, patients can now choose to be completely sedated during the procedure. The risk of colon cancer increases with age, so all people age 50 and older should be screened. People with risk factors should be screened earlier, including those with one of the following characteristics:


2014 Free health classes

Innovative Asthma Treatment Adult patients who suffer from severe, persistent asthma are invited to a FREE seminar on bronchial thermoplasty, a new long-lasting, nondrug procedure. Date | Sat, Apr 19 Time | 10-11 a.m. Location | Littleton Adventist Hospital, Conference Room 1 Information and Registration 303-777-6877, option 1 or mylittletonhospital.org/bt

Hot Topics in Breast Health Join Lisa Mullineaux, genetics counselor, and others from The Breast Center team, for a FREE seminar to learn about screening recommendations, new developments in genetic testing, and more. Date | Thu, Apr 24 Time | 6-7 p.m. Location | Littleton Adventist Hospital, Conference Room 1 Registration | 303-777-6777, option 1 or visit mylittleton hospital.org/breastcenter

Mammos, Mom, and Me It’s time to take care of yourselves! Bring yourself and your mom or daughter and join us for mammograms, chair massages, and refreshments, as well as personalized skin consultations and bra fittings. Date | Wed, Apr 30, or Tue, May 13 Time | 4-8 p.m. Location | The Breast Center at Littleton Adventist Hospital Registration (required) 303-738-2767

Non-Profit Org US POSTAGE

PAID

Denver, CO Permit NO. 4773

7700 S. Broadway Littleton, CO 80122

Littleton Adventist 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 303-804-8166. Copyright © Centura Health, 2014.

Signs of and treatment options for enlarged prostate Men, stay on top of your health! Join Dr. James Fagelson as he shares the signs and symptoms of enlarged prostate as well as treatment options, including minimally invasive treatment. Date | Wed, Apr 30 Time | 6-7 p.m. Location | Littleton Adventist Hospital, Conference Room 3 Registration | 303-777-6877, option 1 or mylittletonhospital. org/mens-health

Colonoscopies Save Lives A colonoscopy can save your life. Join Dr. Luke Evans at this FREE seminar as he shares how colon cancer develops, who is at highest risk for colon cancer, and how screening can prevent colon cancer. Date | Wed, May 21 Time | 6-7 p.m. Location | Littleton Adventist Hospital, Conference Room 1 Registration | 303-777-6877, option 1 or mylittletonhospital. org/colonoscopy

IS YOUR BACK PAIN REALLY YOUR SI JOINT? One-quarter of back pain is actually due to an SI joint problem. Join Dr. Bernard Guiot, neurosurgeon, for a FREE seminar on identifying the cause of your pain and new ways of treating it. Date | Wed, May 14 Time | 6-7 p.m. Location | Littleton Adventist Hospital, Conference Room 3 Registration | 303-777-6877, option 1 or mylittletonhospital. org/spine

2nd annual National Cancer Survivors Day® event “A celebration for those who have survived, an inspiration for those recently diagnosed, a gathering of support for families.” Featuring keynote speaker Maribeth Trujillo, activity booths, raffle drawings, complimentary massage treatments, a free buffet lunch, and more. Date | Sun, Jun 1 Time | 10:30 a.m.-1 p.m. Location | parking lot north of the hospital’s main entrance Information | ncsd.org

Sports Injury Prevention Join Dr. Timothy Lehman, orthopedic surgeon, for a FREE seminar about the causes of sports injuries, who is most at risk, and how to prevent them. Date | Thu, Jun 12 Time | 6-7 p.m. Location | Buck Community Recreation Center, Pacific Room, 2004 W. Powers Ave. Registration | 303-777-6877, option 1 or visit centerfor orthopedics.com

Light refreshments are provided at every seminar.

Photo: ©IStockphoto.com/swonder

spring

Portercare Adventist Health System


Create Spring 2014