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Create Your health. Your life.

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Celebrating your health

winter 2013

TimeOuT Get BaCK on Your feet faSt after a hYStereCtoMY or BreaSt CanCer

Clear

Clogged SinuSeS

stop aCl tearS on the SlopeS when doeS a fever spell e.R.?

volume 1 | issue 1


in Good health

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. 7700 S. Broadway Littleton, CO 80122

2 | winter 2013 • Create

rest for health

If the short days and cool temperatures make you long for a nap, grab a pair of PJs. Rest is

incredibly powerful. it refreshes, rejuvenates, regenerates, and rebuilds the mind, body, and soul. Rest empowers you to function at your best. Optimally, rest includes a good night’s sleep as well as time to relax and rejuvenate daily, weekly, and annually. Rest is the second guiding principle of the CReATiON Health Lifestyle, an Adventist wellness program that is supported by medical research. The program has been proven to result in longer healthier lives. To learn more about the science of rest, go to creationhealth.com.

Whipping Whooping Cough Once your child has made it into the tweens, you don’t usually think about whooping cough. But you should. Health officials now believe that the pertussis, or whooping cough, vaccine wears off by about age 11. And that has led to an outbreak in recent years, with Colorado being one of the hardest hit states. “We’ve seen a resurgence over the last three years,” says Jill Pechacek, mD, a family medicine physician at Littleton Adventist Hospital. “We are recommending boosters for kids over the age of 11 and all adults if they have not been vaccinated since childhood.” Whooping cough is hard to distinguish from a cold. But in most cases, the cough will grow worse within two weeks while the cold symptoms get better. “in young children, the cough usually has a distinctive ‘whooping’ sound,” Pechacek says. “if your child is not getting better after two weeks, you should have them seen.” Littleton Hospital’s Pediatric Emergency Care is open 4 p.m.-midnight on weekdays and noon-midnight on weekends.

WinteR sunbuRns Sun damage doesn’t stop with the winter solstice. indeed, with Colorado’s often-mild winter temperatures and 250-plus days of sunshine, skin damage leading to skin cancer continues year-round. Colorado has the 13th highest rate of skin cancer in the u.S. men who work outside are at highest risk because they spend the most time in the sun and are the least likely to use sunscreen consistently.

Watch Your Skin More than 90 percent of skin cancers are basal or squamous cell, which are highly likely to be cured if caught and treated early. Melanoma, the deadliest type of skin cancer, also is highly treatable if recognized early. Regular skin examinations at home and once a year by your doctor can help detect skin cancer early.

To learn more about skin cancer in Colorado and the symptoms to watch for, go online to mylittletonhospital.org/skin-cancer.

COveR pHOTO: ©eLLeN JASkOL; pHOTOS LefT TO RIgHT: ©ISTOCkpHOTO.COM/NyuL, ©ISTOCkpHOTO.COM/gRIgORy BIBIkOv, ©ISTOCkpHOTO.COM/DeNISe TORReS

People who get six or fewer hours of sleep nightly have higher levels of inflammatory proteins in their blood, which can lead to arthritis, heart disease, stroke, and more health problems.


in Brief

opening clogged sinuses with balloons ‘Tis the season for coughs, sniffles, and snorts. But when is your stuffy nose more than a cold or allergy?

“Patients who have three or four infections in a year and have been on multiple courses of antibiotics most likely have chronic sinusitis that should be treated,” says Randy Taylor, mD, PhD, an otolaryngologist (eNT physician) at Littleton Adventist Hospital. Headaches are typically the main complaint of sinus suffers, but they are not always a symptom of chronic sinusitis. in addition to nasal congestion, symptoms include: • Fatigue • Foul-smelling nasal drainage or inside of nose • Tooth pain Chronic sinusitis is typically treated with saline nasal washes twice a day and antibiotics. if those don’t clear up the problem, a CT scan is taken that could reveal a different problem. “migraines can masquerade as sinus infections,” Taylor says. if narrowed sinus passages are revealed, physicians can use traditional surgery to remove bone and enlarge the passages, or they might use a procedure called a balloon sinuplasty. This procedure, often performed in the physician’s office, uses a balloon to push open the passage and improve drainage. “The balloon offers a significant advantage because there is minimal pain, no bleeding, and patients can return to work quickly,” Taylor says. “And the results are very encouraging, compared to traditional surgery.”

for information about balloon sinuplasty as a treatment option for your chronic sinusitis, come to a FREE seminar. Date | feb. 27 Time | 6:30-7:30 p.m. Location | Littleton Hospital, Conference Room 3 Registration | 303-777-6877, option 1

Knee Knowledge Each year, about 150,000 people will tear the anterior cruciate ligaments (ACL) in their knees. ACL tears occur most often when the torso and the legs head in different directions. Think quick turns on the soccer field — or catching an edge while you’re skiing. “Changing direction on

an open field blows an ACL four times as often as getting hit,” says Timothy Lehman, mD, an orthopedic surgeon and sports medicine specialist at Littleton-based Center for Orthopedics. “When it comes to skiing, it can happen in the bumps or when you go from packed to powder or from groomed to ungroomed.” Women are four times more likely to injure their ACLs than men for a number of reasons. Their anatomy is smaller, which tends to pinch the ACL easier. Women also tend to overdevelop and overuse their quadriceps, compared to their hamstrings, pulling the tibia forward and placing extra pressure on the ACL. “When a guy jumps, his quads and hamstrings are in a one-to-one ratio,” Lehman says. “When a female jumps, it’s a three-to-one ratio, where the

quads fire more intensely than the hamstrings, and the quads win.” To protect your knees, focus on strengthening your hamstrings and glutes. “People overemphasize their quads, which could be putting themselves at increased risk,” Lehman says.

Learn More Come to a FREE community seminar to learn why women are 10 times more likely to experience knee problems and why these put you at risk for needing knee replacement later in life. Date | feb. 20 Time | 6:30-7:30 p.m. (light refreshments served) Location | Littleton Hospital, Conference Room 3 Registration | 303-777-6877, option 1 create | mylittletonhospital.org | 3


tiMeout iS JuSt not an o p t i o n f o r t o d aY ’ S

Busy Women

Kathleen hale and daughters ashlynn (l) and Kassidy (r)

t w o n e w p r o C e d u r e S t h at G e t B u S Y w o M e n B a C K o n t h e i r f e e t fa S t e r t h a n e v e r B e f o r e Candis hurst and Kathleen hale have never met and they live hours apart, but they share one thing in common — both have active lifestyles that don’t allow time for slowing down. So when both women were recently offered new medical treatments at Littleton Adventist Hospital that would minimize their downtime, they jumped at the opportunity. “I had surgery on Tuesday, went home Wednesday and on Thursday, I was at Target walking around. I was walking slowly, but I was walking,” says Hale, 34, who needed a hysterectomy. “And I was back to work a week and a half after surgery.”

4 | winter 2013 • Create


Recurrence of breast cancer after a lumpectomy is about 30 percent. but studies of lumpectomy and ioRt show a five-year recurrence rate of only about 4 percent.

Streamlining Breast Cancer Treatment

Hurst is equally satisfied with a new technique that is reducing recovery time for breast cancer patients. Littleton Hospital’s intraoperative radiation therapy, or iORT, provides women with one dose of radiation at the time of surgery rather than having to come back for radiation treatments for weeks after the surgery. “my doctor laid out the prospective options for me,” says Hurst, 63, who was diagnosed last fall with breast cancer. “i said, ‘if you can do it in one fell swoop, let’s do that.’” For Hurst, who has a 90-minute drive to Denver, the option to combine surgery with radiation meant she didn’t have to spend three hours a day in her car. Littleton Hospital has had patients come from Southern Colorado and even montana for this procedure. Without the availability of iORT, these women would have needed about six weeks of radiation after their lumpectomies.

One Treatment Replaces 30

“Because they don’t have access to radiation where they live, they’d have to move or live with somebody else for six weeks,” says Jodi Widner, mD, a breast surgeon at Littleton Hospital. “it’s offering something a little more streamlined to get them in and out and on their way.” Another key benefit, she explains, is that doing radiation at the time of surgery allows doctors to see the cavity where they’ve removed the lump and target the radiation more directly to minimize damage to surrounding organs or tissue. Plus, because the radiation treatment is so short, many women experience less fatigue than with longer radiation regimens. “most women are back to work in a couple of days and feeling very, very good,” Widner says. And the best news: Recurrence of breast cancer after a lumpectomy is about 30 percent. But studies of lumpectomy and IORT show a five-year recurrence rate of only about 4 percent, Widner says. Littleton Hospital is the only hospital in Colorado that uses the iNTRABeAm® radiation device used in those studies. Hurst was thrilled with her experience. “it far exceeded my expectations. i thought it was really fantastic,” says Hurst, who retired from her career in real estate this year. “There’s no way i would consider it any other way.” new medical procedures are reducing recovery time for many common procedures. here’s a look at the benefits of two new procedures available at littleton adventist hospital. Radiation Sessions Needed Following Lumpectomy 30

1

TRAdITIOnAL

Being an educated patient means you can better understand your treatment options and feel more confident in your decision. Here are a few tips to help:

Be smart online. Look to

governmental sites, such as health.nih.gov, for reliable information on your condition.

Ask questions. Write down

your questions the night before your appointment so you don’t forget. And if you don’t understand your treatment plan, ask your doctor to repeat or clarify it.

Get a second opinion if you need one. Don’t worry about

hurting your doctor’s feelings. Doctors want you to be on board with your treatment plan. So, if you’re not comfortable with your doctor’s recommendation, get a second opinion.

To learn more about the many types of robotic surgery available at Littleton Hospital or to find a robotic-trained surgeon, go to mylittletonhospital.org/ robotic-surgery.

Recovery Time Following Hysterectomy 6 weeks

IORT

BE A MORE InfORMEd PATIEnT

6 days

TRAdITIOnAL

ROBOTIC create | mylittletonhospital.org | 5

pHOTOS LefT TO RIgHT: ©eLLeN JASkOL, ©ISTOCkpHOTO.COM/MuRAT gIRAy kAyA

An Easier Hysterectomy

With two young daughters and a job, robotic hysterectomy was the perfect answer for Hale, who was struggling with bladder problems caused by her uterus pushing down on her bladder. Her surgeon performed the surgery using Littleton Hospital’s new da Vinci Surgical System® through four incisions of less than a half inch each. “The surgical robot gives us better manipulation and better visualization,” explains Bruce Dorr, mD, an obstetrician/gynecologist and co-medical director for robotic surgery at Littleton as well as Hale’s surgeon. The surgical robot can be used for hysterectomy (the removal of the uterus) as well as procedures to treat ovarian cysts, uterine fibroids, endometriosis, and more. Because of the small incisions and delicate precision, robotic surgery means less blood loss during surgery, which helps speed recovery times. Women also have smaller scars and less pain. “i wouldn’t even classify it as pain. it was more discomfort,” Hale says about her surgery. Hale is not only back to work, but she’s able to sneeze, laugh, and run without losing control of her bladder. “i would absolutely recommend (the robotic surgery),” she says. “i don’t know how people do it the other way.”


emergency

a head-to-toe handbook Winter ailments that lead your child to the ER

When your child isn’t feeling well — especially in the middle of the night — it can be easy to panic. Leslie Tourangeau, MD, a pediatrician in the Pediatric ER at Littleton Adventist Hospital, offers advice to help you know when you need a trip to the emergency room.

FeVeR

RespiRatoRY pRobleMs

What to know:

What to know:

A fever is not something to fear. “Fevers are actually good things,” Tourangeau says. “They help your immune system respond to infections. Even a temp as high as 104 or 105 can be OK.”

Croup, signaled by a “barky” cough, congestion with a loose cough, or asthma with a wheeze and cough, can all lead to breathing trouble.

When to go: Let your eyes, not the thermometer, be your guide. if your little one isn’t drinking or playing, or if the fever lasts more than three to five days, bring him or her in. You should head to the eR if your infant under 3 months has a temp of 100.4 or higher.

head inJuRies What to know: if your kiddo takes a spill sledding, skiing, or running around the house, it could cause a concussion. “if it’s a bonk on the head that leaves your child dazed or stops him in his tracks, monitor him closely for the next 24 to 48 hours,” Tourangeau says.

When to go: if your child has blurry vision, nausea or vomiting, confusion, memory loss, dizziness, or is disproportionally tearful or angry, go to the eR. With babies, watch for behaviors such as fussiness or not eating, drinking, or sleeping as usual.

6 | winter 2013 • Create

When to go: Watch to see if your child is breathing faster than normal, or working hard to breathe. “With breathing trouble, we want parents to always err on the side of caution,” Tourangeau says.

stoMaCh Flu

When your little one needs expert emergency care, you can rest easy knowing the best pediatric care in the metro area is available right in your own neighborhood. Littleton Adventist Hospital has affiliated with Rocky Mountain Hospital for Children to provide emergency pediatric care to the community. At Littleton Hospital’s emergency room, your child will be cared for by board-certified pediatric physicians and pediatriccertified emergency nurses partnering with the area’s leading pediatric specialists. “With access to a wide network of affiliated specialists,” says Christine Freeman, RN, MSN, director of pediatric services for Centura Health, “patients at Pediatric Emergency Care at Littleton Hospital get the best of both worlds — the extensive resources of Rocky Mountain Hospital for Children and the familiar, family-friendly care of a hospital close to home.”

What to know: Viral gastroenteritis is not really the flu, it’s an inflammation of the intestines caused by a virus, leading to vomiting and diarrhea. it’s the second most common illness in the u.S., so your family is likely to be hit this season.

When to go: Dehydration is the danger. “Offer tiny sips of water or Pedialyte every five minutes — more can induce vomiting,” Tourangeau says. if your child hasn’t urinated for six to eight hours or the vomiting isn’t ceasing, take him or her to the eR. And if he or she has severe stomach pain, an eR visit to rule out appendicitis is in order.

Littleton Hospital’s pediatric ER is located within the hospital’s main ER at Broadway and Mineral Avenue. It is open weekdays 4 p.m.-midnight, and weekends noon-midnight.

pHOTOS LefT TO RIgHT: ©ISTOCkpHOTO.COM/ABeL MITJA vAReLA, ©ISTOCkpHOTO.COM/DTkuTOO, ©eLLeN JASkOL

PEdIATRIC ER AT LITTLETOn HOSPITAL


banish bellY Fat Join the Cooking Cardiologist®, Dr. Richard Collins, to learn the biomechanics behind why you accumulate belly fat and the best ways to get rid of it. You’ll also learn to cook — and sample — the dishes that help you maintain a healthy weight and a healthy heart. date | Feb 20 time | 11:30 a.m.-1 p.m. location | South Denver Cardiology, 1000 Southpark Drive, Littleton Register | 303-777-6877, option 1

FREE health tips and seminars

suRgeRY FoR MoVeMent disoRdeRs Join Dr. David VanSickle, neurosurgeon, to learn how deep brain stimulation can improve daily life for patients suffering with Parkinson’s disease, dystonia, and other neurological disorders. date | Feb 27 time | 6:30-8 p.m. location | Parker Adventist Hospital, 9395 Crown Crest Boulevard, Parker Register | 303-777-6877, option 1

CholesteRol sCReening Show your heart some love on Valentine’s Day. Stop by Littleton Hospital for a FREE cholesterol profile, including HDL, LDL, and triglyceride levels. Screenings are limited to the first 200. Fasting is required. date | Feb 14 time | 7-9 a.m. location | Littleton Hospital, Main Lobby Registration is required | 303-777-6877, option 1

CanCeR eduCation seRies Join the cancer experts at Littleton Adventist Hospital to learn the latest in cancer news while also sharing your experience. All classes are FREE. Jan 22 | Lymphedema: What are the risks and treatment options for this disease? Feb 26 | Cancer & Your Heart: How cancer treatment effects your heart. Mar 26 | Complementary Therapies: How acupuncture, massage, and holistic treatments can help you fight cancer. time | 4:30-5:30 p.m. location | Littleton Hospital, Conference Room 3 Register | 303-734-3991

See Page 3 for fREE classes on chronic sinusitis and knee injury prevention!

nEW HOSPITAL CEO fOCuSES On quALITY IMPROvEMEnT And PuBLIC REPORTInG For more than two decades, Littleton Adventist Hospital has partnered with local organizations to provide community services, including suicide prevention programs, EMS training, head injury prevention, and low-cost or FREE community health screenings and programs. For Brett Spenst, the new CEO and president of Littleton Hospital, it’s these partnerships that define a strong community hospital. At the same time, Littleton Hospital delivers a level of specialty care in areas such as trauma, neurosciences, surgery, and neonatology typically found only in regional medical centers. “Our mission has two parts — heal the sick and injured and also to nurture health in our community,” says Spenst, who took the helm of Littleton Hospital in November. “This hospital embodies the very best of both of those imperatives.” Before joining Littleton Hospital, Spenst served as chief operating officer and chief financial officer for Kettering Medical Center System in Ohio. Prior to that, he spent 20 years with Adventist Health in California. in addition to building community partnerships, Spenst also plans to partner with physicians to expand advanced specialty care. He also will focus the hospital on continued quality and service improvement as well as enhancing public reporting in those areas. “We will make sure that our clinical outcomes are the top in the state and ranked among the best in the nation,” Spenst says.

a neW appRoaCh to hip ReplaCeMent Join Dr. Robert Thomas, Littleton Hospital orthopedic surgeon, to learn about a new hip replacement surgery that results in less pain, no restrictions, and faster recovery. it’s called the anterior approach for hip replacement. dates | Feb 5 and Mar 26 time | 6-7 p.m. (light refreshments served) location | Littleton Hospital, Conference Room 3 Register | 303-777-6877, option 1

create | mylittletonhospital.org | 7

Ca le nd a r

WINTER 2013


porterCare Adventist Health System NoN-PRofIT oRg US PoSTAgE

PAID

DENvER, Co PERMIT No. 4773

7700 S. Broadway Littleton, Co 80122

Centura Health complies with the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973, and no person shall be excluded from participation in, be denied benefits of, or otherwise be subjected to discrimination in the provision of any care or service on the grounds of race, religion, color, sex, national origin, sexual preference, ancestry, age, familial status, disability or handicap. Copyright © Centura Health, 2013.

the Belly-heart Connection

If you’re a woman and your waist is larger than 35 inches — 40 inches for men — you’re in the danger zone for heart disease. Visceral fat, the kind that lies deep in your abdomen around your organs and causes your girth to expand, is linked to high blood pressure, high triglycerides, and low HDL, which increase your risk of heart disease and death. “Fat doesn’t just sit there, it creates reactions that harm your heart,” says Richard Collins, MD, a cardiologist at Littleton Adventist Hospital. The fat effect is complex. Basically, it works like this — when a person develops intra-abdominal fat, insulin levels rise. Because the liver then can’t get enough energy to fuel the muscles, it shifts to using triglycerides. And it stores those triglycerides in fat nearby, which starts the whole process over, Collins explains. most people can get rid of belly fat through diet changes, says Collins, also known as the Cooking Cardiologist®. He recommends limiting sugar, alcohol, and carbohydrates while increasing lean or vegetarian protein to 20 grams per meal.

Learn More Learn more belly-busting tips and sample heart-healthy recipes at a FREE seminar on feb. 20 with Dr. Richard Collins, the Cooking Cardiologist®. See Page 7!

ARTIfICIAL HORMOnE COnTROvERSY

WITH SuzANNe WeBeR, MD, OB/gyN AT CHATfIeLD WOMeN’S CARe

A: Suzanne weber, Md, oB/GYn

Q:

Is hormone replacement therapy good or bad for my heart?

A recent Danish study on hormone replacement therapy (HRT) in newly postmenopausal women found a 50 percent decrease in heart attacks, heart failure, and death due to heart disease, without an increase in breast cancer or stroke. This study, reported in the British Medical Journal last October, studied the impact of HRT in women ages 45 to 58. In contrast, participants in the well-known Women’s Health initiative (WHi) had a mean age of 63. Although the WHi study found a marked

increase in breast cancer, it was in women who used HRT long after menopause or used it for many years. in the decade since, many women and their physicians have been hesitant to use artificial hormones for fear of breast cancer. Consequently, some menopausal women may not be offered HRT to relieve hot flashes and other issues. This study is not enough for us to disregard the potential risks of HRT. However, it does reexamine the HRT controversy. Hopefully more studies will help us determine the women who would most benefit from HRT.

pHOTO: ©ISTOCkpHOTO.COM/zORAN kOLuNDzIJA

Want to measure your heart health? Then measure your waist.


Create Winter 2013