Four Corners Healthy Living - Stages of Life

OCTOBER

Stages of

Life

How to raise healthy children

Eat well at every age

Embrace a beautiful smile

2019

On the cover Girls laugh together during a photo shoot showcasing different generations for this issue of Four Corners Healthy Living.

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Eat well at every age

Photo by Terrance Siemon

Our team Embrace a beautiful smile

CHIEF EXECUTIVE OFFICER DOUGLAS BENNETT VICE PRESIDENT OF ADVERTISING DAVID HABRAT

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DIRECTOR OF FINANCE CARRIE CASS MANAGER OF CREATIVE SERVICES TAD SMITH

A team of community members can empower you to make better, healthier choices!

SPECIAL SECTIONS EDITOR HUNTER HARRELL

22 Awakening into aging

DESIGNER CHRISTIAN RIDINGS ADVERTISING DESIGN & PRODUCTION CHRISTIAN RIDINGS GARY MARKSTEIN MICHELLE MARTIN RYAN BROWN ADVERTISING SALES REPS ABBY FELDMAN AMY BAIRD COLE DAVIS HEATHER MOBLEY JOE NELSON KELLY BULKLEY TANA BOWEN SAMANTHA CREWS

“With age comes understanding and appreciation of your most important asset, your health.”

Oprah Winfrey

The Durango Herald uses reasonable effort to include accurate and up-to-date information for its special magazine publications. However, all information comes from a variety of sources and may change at any time for any reason. To verify specific information, refer to the organization or business noted. To view the online version of this guide, visit: www.durangoherald.com.

October 2019

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04 06 07 08 09 10 12 13 14 15 16 18 19 20 21 22 23

Letter from the Editor Family planning How to raise healthy kids Encouraging development Scheduling eye exams Eat well at every age Adjusting eating patterns How to stay in shape Embrace a beautiful smile Make braces more comfortable Address chronic joint pain How cycles change with age Signs of sun damage Caring for diabetic feet Avoid hearing loss Awakening into aging Health briefs Four Corners Healthy Living

Letter

From the

Editor “The more you know about yourself, the more patience you have for what you see in others.”

Erik Erikson

Psychologists have closely analyzed human development for decades, and what they learned is that individuals grow and change at different rates. However, there are some patterns that can help us understand these phases and embrace personal growth.

The Stages of Life Though physical development begins as early as conception, our social development begins at birth. During infancy, education is the focus. Babies develop motor skills, and learn to use their five senses. As infants grow into toddlers, they begin walking, talking and socializing with others. And as they continue to grow into children, they begin to differentiate between their inner life and outer world.

At adolescence, we begin to make decisions based on our individual preferences, seeking to create our own identity. This stage is one of exploration and independence, where we learn to confront failures and be selective about pursuits.

As we grow into adults, responsibilities increase. We learn to cope with crisis and confront new situations. Adults shift their focus from education to maintaining and nurturing the things that are important to them, such as careers, family, hobbies and long-term goals.

But still, our focus changes when we reach late adulthood. This stage allows people to reflect on previous stages, bringing them wisdom. Many people become mentors in this stage of life to guide younger generations through the challenges they once completed.

In this issue In the last issue of 2019, we feature articles and tips to navigate the stages of life in the modern age. We include contributions from health care professionals, full of advice on family planning, diet and nutrition, child development and fitness. We learn more about the benefits of braces, and explore topics like joint health, perimenopause and diabetic foot care, as well.

We hope you enjoy it!

Namaste,

Be Your Best

YOU!

At Sunshine Gardens, our focus goes beyond our residents’ physical health. We also nurture mental, emotional, spiritual, and creative well-being through hands-on caregiving and unique activities.

Sunshine Gardens: We’re in the Business of Caring.

For more information about Sunshine Gardens Activities and how you can participate, call us at 970-385-4090 or visit us at SunshineGardensSeniors.com.

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Four Corners Healthy Living

Family Planning

Reliable science of reproduction Today, modern couples have more safe and reliable control over the reproductive stage of their lives. As a fertility specialist, my daily professional focus is this unique stage of life.

According to the World Health Organization (WHO), the age-range for human reproduction is broadly defined as beginning at age 15 and ending at age 45 in women. However, this is an arbitrary definition that is somewhat inaccurate.

Although men have a starting age that is similar to women, they can be fertile into the eighth or ninth decade of life.

Recently, a steeper decline in male fertility has been measured in studies starting at age 45, due to a significant biological difference in the physiology of female and male gametes (eggs and sperm).

Women are born with all the eggs they will ever have, whereas men continue to produce new sperm from the later stages of puberty until late in life. However, stem cell research may change this scenario, particularly in women. Stem cells have the potential to become virtually any cell in the body and techniques are being developed to create gamete cells from an individual’s own stem cells.

For now, women start with several million eggs roughly divided between two ovaries. By the time of the first menstruation (menarche) at about age 12 or 13 (as early as 9 or 10 in overweight and obese girls) the egg count is down to about 500,000 total eggs. This normal ‘loss process’ is called atresia and it continues throughout life until about age 51 when menopause is most likely to occur. At the time of menopause, nearly all of the eggs in both ovaries are gone or ineffective even when some remain. The better eggs (more fertilizable) are ovulated earlier in a woman's reproductive life span. This is problematic to many modern couples who now desire fertility later in their reproductive stages of life.

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The early fertile stage in women starts in the adolescent years and through the teens but is actually not optimal until age 24 when the per cycle ‘risk’ of pregnancy with frequent ‘exposure’ is about 22% per cycle. Days 11 through 16 is the fertile range, especially when cycle length varies a bit. For women with regular cycles, newer over the counter technologies can be used prior to medical consultation to predict the most fertile time during a given cycle.

For males, because sperm production continues, the age range extends to later in life. Assessment of male fertility is generally less complex than the evaluation of women. Usually only one or two analysis-type tests are needed.

To prevent pregnancy, it is technically easier to block ovulation in women than it is to stifle sperm production in men in a way that is reversible. Hence the quest for reliable hormonal contraception in men is taking a longer time. The good news is that researchers appear to be on the verge of announcing a reliable method of reversible contraception for men soon.

So, in a more scientific way the reproductive stage of life in couples is most dependent on the female partner’s fertility. The reproductive stage starts in the teen years, is most optimal at age 24, with a slow but persistent decline into the late 30’s and early 40’s. Getting pregnant and staying pregnant until a child is born (referred to as fecundity) is maximal in the early 20’s at 22% per attempted cycle. This fecundity rate drops down to about 5% per cycle at age 40.

Fertility does vary, so each individual and couple needs personal attention.

Newer assisted reproductive technologies (ARTs) are being developed to significantly improve success during the reproductive stage of life. And, very reliable and safe methods to prevent conception are also available when fertility is not desired.

Fertility specialist at Durango Reproductive Medicine, Joe Gambone, DO, MPH.

October 2019

Plant a garden. Kids are naturally curious and more likely to eat veggies they help to grow. Take advantage of their natural curiosity. Purple carrots are more exciting than orange ones, but they are still carrots.

As a twist to choose what to eat for dinner, have your child pick a theme color. All foods served at that meal can be a variation of that color. As an example, if your child chooses pink, you could serve salmon, roasted radishes (they get sweeter and pinker when prepared this way), red potatoes, watermelon and strawberry milk.

Parenting Help children establish healthy habits Bringing up healthy kids starts with healthy parental role models.

Kids observe and mimic behaviors of those around them. They take their cues for food choices and activity from the people they want to emulate, almost becoming a “mini-me.” Parents have an amazing opportunity to teach healthy behaviors that children will carry with them the rest of their lives. Healthy kids become healthy adults. Where can you start?

Think outside the box and get creative. Healthy behaviors go beyond simply eating a healthy plate. As a parent, it’s your responsibility to prepare healthy, balanced meals for your kids. It’s their responsibility to choose how much they want to eat. Kids have an innate way of knowing if they are hungry or full. Let them honor it.

Get kids involved in the kitchen. They will be more likely to eat foods they prepare. Take your kids to the supermarket with you, have them pick out a vegetable, look for a recipe and make the food together.

Children need to be exposed to a food eight to 12 times before deciding if they like that food. Don’t give up. Just make sure you put the new food on a plate with foods they are familiar with and you know they enjoy.

Family mealtime is important. Turn the TV off and talk to each other. You will focus on what you are eating and you will likely eat less.

Studies show that people who eat while watching TV or playing on the computer consume an average of 150 calories more per meal. Over the course of one year, that could add up to 47 pounds. Additional benefits of eating as a family include improved communication skills and academic performance, as well as higher self-esteem for your children.

October 2019

Physical activity is important for growing minds and bodies. Encourage exercise at all times throughout the year. In the fall, check out the changing leaf colors on a hike or bike ride, or rake leaves into a pile and jump in them. You’re never too old for that! Just because it’s cold in the winter, doesn’t mean you need to stay inside. Put on a warm coat, hat and gloves and get outside. Sledding is a blast at any age, but try ice skating, making a snowman, enjoying a snowball fight and enlisting the kids to help shovel. In the spring, go to the park, take a family walk to check out all of the new green growth around you or go fly a kite. Summertime fun includes swimming at the pool, running through a sprinkler, fishing, camping or hiking in the mountains to see wildflowers.

Encourage water first and always. Let your child pick out a decorative water bottle as they will be more likely to drink water from something they love. Sugar sweetened beverages, including juice, lemonade, sports drinks and soda, should be offered only as a treat every once in a while.

Incorporating these habits now will teach your children healthy behaviors they will use for the rest of their lives.

Laura W. Taylor is a full-time registered dietitian at Southwest Memorial Hospital. She splits her time between inpatients and outpatients. She specializes in weight management, bariatric surgery and diabetes, in addition to a variety of other nutrition concerns.

Jenny Nuuttila is the program coordinator for diabetes education at Southwest Memorial Hospital. She is a certified diabetes educator, clinical nutrition support specialist and a registered dietitian. Jenny assists with insulin pump management, continuous glucose monitor training and facilitates a Diabetes Support Group.

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Zucchini Pepperoni Nachos Ingredients: 3 medium zucchini, sliced into quarter to half-inch rounds 1 teaspoon Italian seasoning ¼ cup Parmesan cheese 8 ounces mozzarella cheese, shredded 20 slices turkey pepperoni, cut in half Instructions:

1. Preheat oven to 425° Fahrenheit.

2. Lightly grease a large baking sheet using non-stick cooking spray.

3. Cover baking sheet with zucchini

rounds, placing them as close together as possible. Evenly sprinkle zucchini with Italian seasoning, Parmesan cheese and mozzarella cheese.

4. Bake for 5 minutes. Take the pan out

of the oven and place pepperoni halves evenly over the zucchini rounds.

5. Turn the oven up to broil and place

the pan near the top of the oven. Broil for three to five minutes or until the cheese is melted and the pepperoni is slightly crisp.

Four Corners Healthy Living

Parenting

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Early Childhood (birth to 8 years of age) is a time of incredible growth that sets the foundation for life-long development, learning, health and well-being. At birth, the human brain contains more than a 100 billion neurons. During the first three years of a child’s life, the brain grows to 90% of its adult size and more than one million new neural connections (synapses) are made every second, more than at any other time in life.

This rapid development is supported and influenced by relationships, experiences and environment. A child’s day-to-day experiences, both positive and negative, influence these synapses. This stage of life provides the greatest opportunity to develop the connections needed to be healthy, capable and stable adults.

Children are born ready to learn, and parents and caregivers are a child’s first and most important teachers. These early relationships provide the stimulation and interaction that young children need to develop important emotional skills like self-regulation, communication and problem-solving. From the moment they arrive, babies invite interaction and connection through cooing, crying and body movements. When parents respond to these invitations with gentle physical touch, rocking, feeding and talking; they form a trusting bond that helps their child feel safe in the world. This secure attachment promotes the confidence a young child needs to explore her environment and communicate her needs.

As babies grow and mature, trusted adults become a safe haven for toddlers and young children as they begin to venture out to interact with the environment around them through exploration and play. No activity supports healthy physical, emotional and social development quite like play! Play is how young children learn. From peek-a-boo to building blocks, play is a powerful and fundamental way to help with language, math and social skills, and even help children cope with stress.

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As babies become mobile toddlers, play becomes a larger part of their day, and elements of play support different skill development. For example, songs, rhymes, gestures and facial expressions build communication, listening and

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early literacy skills. Experimenting with objects of different shapes, sizes, and textures allows children to figure out how things work, demonstrate cause and effect and increase opportunities to develop problem-solving skills. Sitting, crawling, walking and climbing offers young children the opportunity to build strength, balance and coordination.

This new mobility provides freedom to explore the world around them, fueling a children’s imagination and creativity.

Reaching out into the world also includes expanding social circles from immediate family, to peers. Through play with peers, young children learn cooperation, sharing and conflict resolution.

As a stage of life, Early Childhood is one of the shortest, but by far the most dynamic. To optimize this stage, parents and caregivers can provide stable and nurturing relationships that encourage and support play for young children.

These relationships also help to build selfesteem and social-emotional resilience that create a buffer against stress. The solid foundations of trust and security formed at this early stage, enables our children to navigate life’s challenges and thrive through all future stages.

Heather Hawk is the Executive Director of the Early Childhood Council of La Plata County. The Council is a collaborative team of early childhood advocates committed to bringing comprehensive, high-quality services to young children and their families in the Four Corners.

October 2019

Ocular Health How often do kids need eye exams?

Many people expect their vision to fade as they grow older. Such expectations are not unfounded, as the National Eye Institute notes that certain vision changes, including diminished vision and difficulty distinguishing colors, are a normal part of aging. But even children can experience changing vision, which only highlights the importance of kids receiving routine eye exams.

Eye examination frequency depends on the age of the child and the condition of his or her eyesight at the time of each exam. The American Optometric Association has established these guidelines for pediatric eye examination frequency to help parents know when to get their youngsters’ vision checked.

Birth to 2 years Children in this age group whose physicians have deemed them asymptomatic of potential eye conditions or at low risk of developing eye conditions should have their eyes examined sometime between six and 12 months of age. Kids who may be at risk should adhere to the same schedule, though the AOA notes that exams for at-risk children may need to be conducted more frequently, even in this age group, than kids who are symptomfree. Eye doctors will speak with parents and recommend an eye exam schedule based on their initial examination.

3 through 5 years Children between the ages of three and five who are at low risk of developing eye conditions should have their eyes examined at least once between their third and fifth birthdays. The same goes for kids who are at risk, though doctors may recommend more frequent examinations for such youngsters.

6 through 18 years Whether they are at risk of eye conditions or not, children between the ages of six and 18 should have their eyes examined before first grade and annually thereafter. Youngsters who are at risk may need more frequent examinations as they get older.

Eye examinations are an important component of child healthcare. By adhering to AOA eye examination guidelines, parents can ensure any vision problems their children develop are quickly caught and can be treated before they adversely affect youngsters’ lives.

Here are some tips, tricks and ideas to help you reach your goals.

1. Prioritize yourself. Self-care is never

selfish. Remember that you cannot give others your best self if you are not honoring your own needs, which can include all of the following tips.

2. F ood should be enjoyed. When we

restrict our flavors and choices, we fixate on what we are missing. There is no reason to eliminate food groups. Include a variety of foods, but remember that the first bite tastes the best; the second one tastes pretty good; and after that we are just eating to eat. Savor those first bites!

3. K eep healthy foods that you like at

Nutrition Eat well at every age The word “diet” means “way of life” or “way of living.” But in our society, the word “diet” has a negative connotation and is synonymous with short term, quick fix and restrictive behaviors. People should not need to be diagnosed with a chronic disease to be motivated to change eating and exercise habits. Rather than going on a diet, try changing your lifestyle. Prevention really is the best medicine.

People often ask for specific meal plans and “good” foods to incorporate. But nutrition is individual. What works for some people may not work for others. Giving patients an exact plan to follow emphasizes the shortterm mindset. Professionals can give people the tools and support to succeed; but since everyone has individual likes, dislikes, budget and lifestyle, it is important that you find out what works for you.

Four Corners Healthy Living

home. When you have healthy foods that you like available, you will probably reach for those before reaching for something else. It’s easier to eat well when your house is stocked appropriately.

4. P repare more meals at home. Not only

will you save money, but you will also have control over the ingredients. When you dine out, you tend to eat less nutritious food and put yourself at risk for weight gain.

5. E at more vegetables. It doesn’t matter

if they are fresh, frozen or canned – eat them. Include whatever veggies fit into your budget and lifestyle. In addition to all of those great vitamins, minerals and antioxidants, veggies add fiber and color to meals. They also make a quick and easy snack.

6. M eal prep. Spend a little extra time on

the front end, and you can eat healthful, nutritious meals all week, while giving yourself extra time to spend with your loved ones. Prepping for a few hours on Sunday afternoon can save several hours during the week. Create a menu for the week, make a shopping list and have some storage containers on hand.

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7. E at at regularly spaced intervals. This

includes both meals and snacks. Skipping meals sets you up for disaster. A small snack that includes both protein and carbohydrates can help with blood sugar management and prevent overeating at the next meal.

8. D rink water. Sugar sweetened beverages

add up calorically and do not provide you with any nutritional benefit. New research published in JAMA Internal Medicine showed that drinking two or more sodas daily, either regular or diet, is associated with an increased risk for all causes of death.

To give your water a flavor boost, add some sliced lemon or lime or fresh mint.

9. M ove more. Do you participate in

structured physical activity or do you simply consider yourself active? Are you getting creative to include more activity during the day? Every little bit helps. Take a walk with your family, go hiking with friends or ride your bike around the park.

10. A m I hungry? Ask yourself “Am I

physically hungry or do I just want to eat?”

There’s a big difference. Hunger can be confused for many things. If you think you’re physically hungry, would you be satisfied eating vegetables? If not, you likely just want to eat.

11. T ake time to rest and rejuvenate.

De-stressing is important for your overall health. Get creative and take 20 minutes to read a book, dance around the house, listen to music, color, put together a puzzle or meditate.

October 2019

ForFor over 1110 years now, families f over years, families from the area have haveentr entr the Four Four Corners Corners area care childrenan a 1199 Main Avenue · Suite 205 care of of their their infants, infants, children Pediatric Associates of Duran Pediatric Associates of D Durango, CO 81301 Chaudhuri honors this privile Pakhi Cha withproviders families Dr. to create the 970/259-PEDS (7337) Pediatric Practitionerfor Jessica Rensner hon a lifetime of wel Fax 970/259-7366

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by working with families to crea Pediatric Associates of Dura for a lifetime of wellness. The Jessica Rensner, MSN, RN, common goal to ensure thatCPNP the mentally, Ourphysically, goal is to ensure thatand oure

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Practicing healthy behaviors is important at every age. Whether you have general health goals or you have been recently diagnosed with a chronic disease, taking small steps each day will help you to work towards your big picture goal. Remember that regardless of your age, the best time to start incorporating healthy habits is today.

Pediatricthis, Associates accomplish we callofonDurang our so For over 10 years, families from Durango every patient’s care with holistic conventional medicine as wel and the Four Corners area have entrusted management, and we pride multitude of alternative options the health care of their infants, children providing excellent fol to enhance the overall health and adolescents to Pediatric Associates of Durango.

We, Pediatric AssociatesofofDurango, Durango,are arepassio passi We at at Pediatric Associates about settinga anew newstandard standardfor forhealth healththat thatemp emp about setting Pediatric providers Dr. Pakhi Chaudhuri and children totoreach their full children reach their fullpotential. potential!

Nurse Practitioner Jessica Rensner honor this privilege by working with families to create a foundation for a lifetime of wellness. They both share a common goal to ensure that their patients thrive physically, mentally, and emotionally.

We are now offering Integrated Behavioral Health services, including therapeutic and psychiatric consultations.

Laura W. Taylor is a full-time registered dietitian at Southwest Memorial Hospital. She splits her time between inpatients and outpatients. She specializes in weight management, bariatric surgery and diabetes, in addition to a variety of other nutrition concerns.

Jenny Nuuttila is the program coordinator for diabetes education at Southwest Memorial Hospital. She is a certified diabetes educator, clinical nutrition support specialist and a registered dietitian. Jenny assists with insulin pump management, continuous glucose monitor training and facilitates a Diabetes Support Group.

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Take this comment and embrace it: Weight gain isn’t your fault. It actually has nothing to do with you or your personality. Often, people are told that to execute more discipline or willpower. But it has nothing to do with that what-so-ever. It is hormonally driven. Listen here: the body can only starve for so long, maybe a couple months, before you must eat again. You think of it as giving in and giving up; you think that you’ve failed again and are destined to be where you are right now, forever.

This doesn’t mean failure, it means it’s time to adjust your eating style.

Eating

Patterns

Understanding the dynamics of aging bodies

With each passing day our bodies change before our very eyes. Some look in the mirror or see a photo of themselves, and their jaw drops in disbelief. As sure as our outward appearance might change, our insides change too.

It is metabolically active tissue with its own agenda; it is completely unregulated. All this tissue wants to do is continue to grow and continue to get fatter as fast as possible.

The hormones it is secreting in your body are there only to encourage its continued growth. It has urges, demands, desires and cravings. It slows your metabolism.

This visceral fat also secretes major inflammatory hormones. It lowers testosterone in men and increases the risk of estrogen dependent breast cancer in women.

It is a beast and it’s why you’ve dropped weight in the past only to regain it.

People commonly say they don’t eat any differently than they did in the past. However, no matter the calories in and out, continued weight gain seems to materialize.

Throughout our lives, we experience different stressors or triggers.

These triggers, which vary from one person to the next, change the way that we tolerate food. Examples of common triggers are puberty, major lifestyle changes, stress (job, relationship, you name it), pregnancy, menopause, injury, general aging and birth (a heavy genetic predisposition).

To minimize the risk of weight regain and to be able to maintain weight loss, individuals must let go of all of the visceral fat that is causing this metabolic slow down. Understand this requires a different way of eating from the past for the rest of your life. Fortunately, these changes should feel outstanding!

Bodies change out of a response to this trigger. Hair might fall out, or nails might go rigid. Often, we neglect to think about how it affects metabolism, but it definitely does. Following this trigger, we may continue to eat the same way that we ate in the past which allowed us to maintain a state of wellness, yet now results in weight gain.

If you have tried to drop weight in the past, only to regain it, do not think of yourself as a failure. Recognize triggers, and adjust eating patterns to support optimal health for the long term.

But weight gain and loss isn’t that simple. It’s not that the metabolism is bad now or that something is wrong, it just means that your body and its tolerance level has changed. A switch has flipped and things are different.

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The primary culprit for easier weight gain once it has started is the accumulation of visceral fat.

This fat, the deep gel-like fat that packs in your belly area, fills up your organs, squeezes them tight, is different from the rest of the fat in your body. You can’t melt, laser, freeze or sculpt it away. This special fat grows blood vessels, has an oxygen supply and secretes toxic hormones.

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October 2019

Fitness

T

How to stay in shape In our ever-busy world it seems like there are a million barriers to fitness and good health. Busy schedules, endless bills, maintaining a social life and raising kids each make prioritizing our personal health difficult. While spontaneous hikes and trips to the gym may be easy in your early 20s, the aging process can make those healthy habits more and more difficult. Try some of the following fitness tips for battling the most common roadblocks to fitness in adulthood.

Raising kids takes tons of time and energy. It is a major reason many people struggle with fitness and nutrition. However, keeping fit sets a great example for kids and teaches them the importance of physical activity on health.

Incorporating kids into physical activity can keep the whole family both fit and healthy. Try going on family bike rides, hikes and letting little ones help prepare dinner. They’ll have fun and learn from your good examples.

Crazy schedules also make it difficult to choose nutritious foods or exercise. Fast food is quick and convenient, and going to the gym just isn’t an option after a long day at work.

Meal prep is a great way to overcome the fast food dilemma. Take a Sunday afternoon and cook a few simple meals for the week, dishing out individual portions that are easy to throw in your bag on the way out the door. Waking up a few minutes early to get a 15 minute workout in is a great way to start the day off when there’s just no time otherwise. Another great alternative is spending time with friends you’d see anyway doing a physical activity, like going for a walk, bike ride or hike together.

Financial limitations are another major barrier to healthy habits. After all, the student loans and mortgage won’t pay themselves.

However, making fitness and good nutrition a priority in the present can prevent health complications, saving time and money in the long term. Plus, cost effective ways to exercise and cook are becoming more readily available.

Skip the gym membership and take up running outdoors. Or perhaps use the internet to find workouts you can do at home. Stick to simple meals using a few unprocessed ingredients – a

Your Partner in All Stages of Life

Losing the naturally lean and fit physique that came so easily at 20 is hard to accept. Great physique is simply hard to get and maintain.

The good news is, physique is not the tell-tale sign of good health. Healthy habits lead to long lasting health while minimizing the risk of chronic disease.

To avoid chronic disease, feel better and set an example for your kids, it’s important to make a healthy lifestyle a habit. Habits are hard to break. For questions about how to prioritize healthy habits for your personal needs, seek assistance from personal trainers and dietitians that offer free initial consultations in your region.

Registered Dietitian Nutritionist and Certified Personal Trainer Carly Cooley is the founder of Carly Cooley, LLC, a local nutrition and exercise counseling practice.

She simplifies and personalizes nutrition and exercise strategies to make healthy living possible for anyone.

Connect with her at www.carlycooley.com

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October 2019

good rule of thumb is a protein, starch and vegetable. Make a list of your favorites and shop for what’s on sale. Shoot for making plant based foods a staple in each meal, as they are a cost-effective way to fill up and boost fitness.

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Orthodontics

What is the difference between a dentist and an orthodontist?

What types of braces are available?

Many patients are referred to an orthodontist by a dentist, which both care for our oral health in different ways.

Phillis said all orthodontists are dentists, but not all dentists are orthodontists.

Dentists focus on overall oral health and individual teeth, while orthodontists are concerned with the way our teeth align relative to how the jaw functions.

Traditional metal wired braces are the most common type of braces made from stainless steel brackets and wires. These braces allow the person wearing them to choose colored elastic bands to hold the wire to the bracket.

When is the right time to see an orthodontist?

Though the American Association of Orthodontics (AAO) recommends an initial screening by age 7 to spot potential issues, Phillis said she sees patients as old as 82. Age is rarely a factor in determining whether a patient pursues orthodontic treatment, because healthy teeth can be moved at any age. In fact, about one in four orthodontic patients is an adult. Phillis said she believes the stigma around wearing braces as an adult has diminished as more people embrace the benefits of a balanced bite.

Embrace a beautiful

smile Smiles come in all sorts of shapes and sizes. Some are small and framed with smiles lines, while others are wide with dimples. In addition to affecting appearance and self esteem, a smile affects both health and wellness too, said Daniella Phillis, an orthodontist at A Smile By Design. She works in the Durango office with patients to improve jaw function, align teeth, alleviate speech impairments and reduce risk of cavities and periodontal disease.

Four Corners Healthy Living

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According to the AAO, there are a number of benefits to early intervention such as taking advantage of predictable growth. But Phillis said the downside to treatment at an early age is responsibility and retention. Oftentimes, children and teens are reluctant to change their hygiene habits which can lead to decay. Adults who choose to commit to treatment, however, usually have overwhelming results, Phillis said.

What types of tools are used for treatment?

Orthodontists use tools called appliances to align a patient’s teeth.

These appliances can include, but are not limited to wires, brackets, liners, bridges, expanders and elastic bands. But more often, patients want to know how the treatment will affect their appearance.

Thanks to advances in technology, Phillis said even traditional metal wired braces are smaller and sleeker than those used a few years ago.

Self-ligating braces are made from the same material as traditional braces, but do not require elastics. Because there are no elastics, these braces require less adjustments than traditional braces.

Ceramic braces are made of clear or tooth-colored materials. They are less visible, but are larger and more brittle than traditional or self-ligating braces.

Lingual braces are hidden behind the teeth, and are 100% customized to match the shape of a patient’s teeth. Lingual braces are a great option for athletes and musicians, as well as individuals who do not want braces to show when they smile.

Clear aligners are invisible, removable acrylic trays that can straighten teeth like braces without using metal and wires.

How long will orthodontic treatment last?

Though the AAO reports an average length of 22 months for patients, Phillis said that treatment times will vary based on an individual’s case and its complexity. Patients can expect to hear orthodontists estimate treatment lasting anywhere from 12 to 36 months. In order to avoid extending treatment, patients can follow instructions regarding dental hygiene and regularly attend scheduled appointments with orthodontists.

Overall, orthodontists are often able to help people overcome oral health issues by embracing their concerns one at a time. From overbites and underbites to crowded and misaligned teeth, each treatment is customized to the individual.

Phillis said: “In many cases, the results are overwhelming.”

October 2019

Thankfully, there are ways to make wearing braces more comfortable.

Orthodontics

• Check for comfort before leaving. During each orthodontist visit, use a finger or your tongue to check for any areas that are poking cheeks or rubbing gums. Bring this to the orthodontist’s attention so that wires can be clipped very short.

Make braces more comfortable

• Invest in orthodontic wax. Use the wax to cover up brackets or wires that are causing irritation. Over time, the mouth will get used to the braces and sore spots will not be as prominent.

Braces can straighten teeth and improve bite health.

According to Harvard University Health, the science of orthodontics and braces involves placing constant pressure on teeth. The root then presses against the underlying alveolar bone, forcing a portion of the bone next to the root to dissolve, allowing the tooth to incrementally move into the direction it is pushed. After the tooth migrates, new bone will replace the spot where the tooth vacated.

Due to the pressure braces exert, it is common for people who wear braces to experience discomfort. Soreness and discomfort typically occurs when braces are initially put on the teeth and then after various appointments if adjustments are made. The brackets and wires of the braces also may rub the gums or irritate other areas inside the mouth.

• Use OTC pain relievers. Over-the-counter pain relief products can alleviate soreness for a few hours until the mouth adjusts to the braces being placed or tightened.

• Enjoy soft foods. When teeth are sore, stick to soft foods.

Smoothies, soups, stews, mashed potatoes and yogurt are soft foods that won’t increase your pain.

• Follow the rules. Your orthodontist will recommend that you avoid certain foods that can damage or get caught in the braces. Eating these foods can make it even more uncomfortable to have braces on.

• Practice good hygiene. Braces create more crevices and spots where bacteria can accumulate, which could lead to dental caries. Be sure to floss and brush thoroughly to keep the teeth clean to avoid painful cavities.

Though having braces means experiencing some discomfort along the way, there are ways to alleviate pain and discomfort.

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15

Four Corners Healthy Living

Joint Health Chronic pain can lead to serious concerns It’s nothing new for a doctor to hear questions about how our bodies change as we grow older. People want to know things like: what are normal signs and symptoms of aging? And what warrants a trip to the doctor?

One of the most common concerns for middle-aged and senior patients: joint pain and overall joint health.

Most people accept that the aging process comes various aches and pains.

Joint pain is especially common as we get older. Aging-related pain and discomfort in our joints can start as early as 45 for men, and 50 for women.

Nearly half of those ages 65 and older suffer from some type of joint pain.

People tend to dismiss joint pain as simply the price of growing older in a human body by relying on over-the-counter medicines or quietly enduring the pain. However, leaving joint conditions untreated can lead to chronic issues, as well as greatly diminish our quality of life. Joint pain impacts our ability to be physically active, engage in social activities and live a comfortable, pain-free existence. All of these things are just as important for our mental health as our physical health, especially as we age.

As we grow older, the repercussions of chronic joint pain can become more harmful, leading to more serious health concerns like decreased mobility and an increase in the risk of falling. Chronic joint pain can inhibit the ability to get restful sleep. Chronic pain can also lead to mental health issues like depression and anxiety. These cascading health concerns can become real obstacles to overall wellness during the aging process.

More than joint pain It is important to recognize the "red flag" symptoms, signaling that it's time to make an appointment with your primary care physician: • New swelling or swelling that is more severe than usual and out of proportion to other joints.

It's important to understand how our joints change as we age. The connective tissue and cartilage, the cushioning between the joints, can thin over time. The less there is, the more the bones will grind against each other, causing osteoarthritis.

Additionally, if you've experienced a jointrelated injury earlier in life, even a minor

• Redness and/or warmth at the joint • Any whole-body symptoms, such as a fever or increased fatigue

one, that joint might manifest signs and symptoms of osteoarthritis or "wear and tear" arthritis earlier than expected.

Muscles also change as we get older.

Loss of muscle mass is common. Rather than muscles absorbing most of the impact of daily life, joints begin to bear the brunt, causing joint damage, cartilage erosion and inflammation. Keeping your muscles strong, through exercise or even physical therapy, can decrease joint pain and prevent future joint injuries.

There are types of arthritis that aren't related to wear and tear alone, but to inflammatory processes, diseases or infection. These types of arthritis often require a range of different treatments, including specific medicines or perhaps a referral to a specialist It's a good idea to talk to your doctor about treatment options and preventative measures for ensuring good joint health as you age.

Dr. Charlotte Barry works in internal medicine at Southwest Health System focusing on the diagnosis and treatment of medical conditions, as well as overall preventative care for adults of all ages.

Four Corners Healthy Living

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October 2019

Sponsored Content: Mountain Hyperbarics HBOT & Aging “Restoring brain functioning is one of many important goals of anti-aging therapies.”

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Diminished oxygen supply to the areas of the brain that are damaged is one of a few causes for the loss of bodily functions. Restricted blood supply to the tissues, causing a shortage of oxygen needed for cellular metabolism, may be responsible for many of the symptoms. These symptoms may be reversible with HBOT, even in cases with onset years prior to the treatment.

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During HBOT, the abundance of breathable oxygen causes absorption to happen beyond the hemoglobin.

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SouthweSt Medical Group, MancoS Valley 111 eaSt railroad aVe, MancoS, co 970-533-9125 October 2019

17

Four Corners Healthy Living

Women’s Health

So, what is perimenopause?

Do you know your Greek prefixes?

“Peri” means around, near or about.

So, perimenopause refers to the time around or near menopause.

Perimenopause refers to the time before menopause. Menopause begins 12 months after your last menstrual period. Women report a variety of symptoms during perimenopause. The most obvious symptom is alterations in their regular menstrual cycle.

It is not unusual to experience a variety of menstrual changes, including lighter flow, heavier flow, more days of bleeding, less days of bleeding, a change in the color of the flow, a change in other symptoms around your period, or a change in frequency. In general, women welcome fewer and lighter periods as they approach menopause.

However, if you notice heavier periods lasting longer or coming more often, you should discuss this with a health care provider.

Perimenopause How cycles change with age As a practicing gynecologist, I notice confusion around the topic of menopause and perimenopause, and the many emotions attached to the topic, too. I assure you, what is happening to the body is a normal part of aging. For most women perimenopause does not need to be “treated,” but I have a few recommendations to help alleviate and navigate the symptoms.

Many other symptoms of perimenopause are symptoms associated with menopause such as hot flashes, night sweats, vaginal dryness, painful intercourse, mood changes, weight gain, sleep issues, headaches, hair loss, heart palpitations, foggy thinking, difficulty concentrating and memory issues. Hormone testing during this time is limited by the fact that your levels are changing on a daily basis. Therefore, any testing that might be done is usually looking for other reasons to explain your symptoms versus confirmation of perimenopause.

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Perimenopause is all about symptoms. We are not able to predict when or even if perimenopausal symptoms will occur for any individual woman, but we can say that it is possible as early as the late 30s. The average age at which signs and symptoms of perimenopause begin is 47 years old. In addition, the perimenopause period can last several years; and the average is 4 years, but it can be as long as 10 years.

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As I stated earlier, perimenopause is a natural part of aging. With age, the ovaries become less effective at releasing an egg every month and producing hormones.

Basically, more cycles end without the release of an egg at the normal time of ovulation. This continues until no more eggs are available for ovulation and menopause occurs. As the release of eggs slows down, so does the production of sex hormones. Some of the symptoms associated with perimenopause are due to the decline in the sex hormones, while other symptoms are due to the change in the balance of the various hormones.

So, what can I do about perimenopause?

My first recommendation for dealing with perimenopause is to learn more. You will be much better equipped to make an informed decision if you become aware of your symptoms, your options and your goals. My second recommendation is to focus on what you can change and let go of fear concerning what you cannot control.

The unpredictability of the transition from perimenopause to menopause is part of the whole journey.

My last recommendation is lifestyle.

Slight modifications are the key to managing many issues concerning an individual’s well-being, and perimenopause is no different. You will be happier and healthier if you are eating well, sleeping well, exercising often and managing your stress. If you smoke, you should stop, as hot flashes have been associated with tobacco use. Avoid things that worsen your symptoms, which could include alcohol, caffeine, hot drinks or food and smoke.

Finally, have a sense of humor about the change that your body is going through.

Most women do not need supplements or hormones to manage perimenopause.

If your symptoms begin to affect your daily routine, I encourage you to educate yourself, review your options and visit your provider to discuss what’s in your best interest for your long-term well-being.

Dr. Nicole Pinkerton is a board certified obstetrician-gynecologist. She provides compassionate and personalized care to women in all stages of life. As a gynecologic specialist, she is able to perform a variety of surgical procedures, including hysterectomy, laparoscopy, sterilizations, contraceptive procedures, colposcopy and LEEP procedures.

For more info visit drpinkerton.net Four Corners Healthy Living

What is happening during perimenopause?

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October 2019

SPF SOS

Skin Health

1. Wrinkles Wrinkles aren’t always a byproduct of aging. Skin becomes less elastic and more fragile as it ages, increasing the likelihood that wrinkles will develop, wrinkles also can indicate sun-damaged skin.

Signs of sun damage

2. Age spots

Soaking up the sunshine on a clear day can be a great way to unwind.

However, that sun-kissed skin will change over time.

According to the AAD, age spots, which are flat brown, gray or black spots on the skin, appear on areas of the body that are most often exposed to the sun, including the face and hands. The AAD notes that what looks like an age spot could actually be skin cancer. If any such spots are detected, men and women should see a boardcertified dermatologist for a through skin exam.

It’s not always easy to recognize signs of sun damage, especially for people who spend a lot of time outdoors. Over time, the damage may be overlooked or more evident in the fall. However, sun-damage should not be taken lightly, because it can affect five different parts of the skin including the epidermis, dermis, blood vessels, melanocytes and sebaceous glands.

3. Loose skin

Sun exposure is responsible for most the visible signs of aging, and the Skin Cancer Foundation notes that one study from researchers in the United Kingdom found that 86 percent of melanomas can be attributed to exposure to the ultraviolet radiation from the sun.

Loose skin is sometimes a byproduct of aging, but it also can be indicative of sun damage. Various products claim to treat loose skin, but the AAD notes that faceliftlike results likely won’t come from any product sold in a jar. For example, the AAD says results from skinfirming creams will be subtle at best. Products that contain a retinoid like retinol, which can help the body make more collagen, might produce minor results.

Sun-damaged skin will not necessarily lead to skin cancer. However, the American Academy of Dermatology (AAD) notes that sun damage can lead to skin cancer. Going outdoors without adequate protection makes skin vulnerable to sun-related damage. Learning to recognize three of the more common types of sun damage may compel people visit their physicians and take potentially life-saving steps to prevent future damage.

Learn more by visiting the American Academy of Dermatology at www.aad.org.

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Four Corners Healthy Living

Work closely with your primary care provider, keeping regular checkups and discussing your concerns during your appointment. Early diagnosis of diabetes and good blood sugar management is the cornerstone of care for diabetics. To get the most out of a primary care visit, be sure to take your shoes off at every appointment to have your feet inspected.

Regular foot exams have been shown to reduce the risk of amputation by over 45%. At times, your primary care physician may refer you to a specialist, such as a podiatrist or a wound care specialist for further evaluation and treatment.

Diabetes

Sound footing Diabetic patients can follow steps to avoid amputation risks One of the most common conversations I have when I am meeting a diabetic patient for the first time is about amputations. For so many people, this is a pressing concern born not only out of immediate worry for their health, but out of experience with friends or family members who have struggled with diabetic foot complications.

According to the CDC, approximately 30.3 million Americans are currently living with diabetes or roughly 9.5% of all Americans. Among these patients, diabetic foot infection is the leading cause of hospital admission. The lifetime risk of developing a foot ulcer (or wound) in a diabetic is 19-34%. Diabetic foot ulcers, far from being just a blister or sore, are serious events that can lead to infection or amputation. Annually, there are roughly 70,000 lower extremity amputations due to diabetes in the United States. 85% of these amputations are preceded by an ulceration (infection).

As scary as those numbers sound, there’s some good news buried in there. First, it’s important to understand that the vast majority of diabetic patients will never have any type of amputation. Second, it’s important to understand that many amputations are preventable and that you, as the patient, have a big role to play in preventing them.

Healthy Feet Can Take You Anywhere

The next step in amputation prevention is education and self-awareness. It’s not enough to have your feet checked at the doctor’s office. You should check your feet at home every day. If you can’t see your own feet, use a mirror or have a friend look. You should feel your feet as well. If you notice increased temperatures, sores, blisters or open wounds, you should report this to a health care provider immediately. Early reporting and detection can make a huge difference in how quickly problems can be resolved and in how quickly patients can get back to regular activity.

Ben Carelock is board-certified in foot surgery by the American Board of Foot and Ankle Surgery. He went to medical school at the Arizona College of Podiatric Medicine and completed residency at Yale-New Haven Hospital/VA Connecticut Health Care System.

CARE CLOSE TO HOME

Dr. Ben Carelock, DPM SMG Podiatry 1311-A N Mildred Road, Suite A, Cortez, CO For an appointment call: (970) 564-2681 www.swhealth.org/podiatry

Comprehensive Foot & Ankle CAre, inCluding diAbetiC Foot CAre, sports mediCine, FrACtures, bunions, hAmmertoes And plAntAr FAsCiitis Four Corners Healthy Living

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October 2019

5

Ways to protect against hearing loss 1.

A certain degree of hearing loss can be a normal part of the aging process.

However, people who take steps to protect their hearing long before Father Time takes his toll can prevent the extreme hearing loss suffered by millions of seniors across the globe.

Get a baseline hearing exam. Speak with an audiologist, who can test your hearing and establish a baseline level against which future tests will be measured. This way it is easier to see if hearing loss is increasing over time.

John’s Hopkins Medicine states that approximately 15 percent of adults aged 18 years and older report some difficulty hearing and up to 39 percent of adults in their sixties have hearing problems.

Lost hearing cannot be restored, though hearing aids and other devices can help people with hearing loss hear better.

Hearing aids are not always an accessory people look forward to needing, so it’s good to know that a few simple strategies can protect people’s hearing over the long haul.

Wear protective gear. Protective gear includes ear plugs and protective earphones.

This gear should be worn whenever you expect to encounter loud noises, such as when you mow the lawn, go hunting or shooting, attend rock concerts, or visit construction sites.

2.

Turn down the volume. Audio devices can contribute to hearing loss. Earbuds are particularly dangerous because they fit directly next to the eardrum. The World Health Organization says that 1.1 billion teens and young adults worldwide are at risk for noiseinduced hearing loss from unsafe use of audio devices. Set the maximum volume on audio devices below 60 percent and wear headphones for no more than an hour a day. Keeping music low on other devices is also adviseable.

3.

4.

Limit use of cotton swabs. Ear wax is beneficial to the ears and can stop dust and other particles from entering the ear. Furthermore, using a cotton swab can potentially cause damage to sensitive organs in the ear if they are inserted too far or too roughly, advises the hearing testing service Ear-Q.

5.

Avoid loud noises. Steer clear of fireworks, noisy city centers, loud performances, and other situations if you do not have hearing protection.

Remember, hearing loss often doesn’t produce immediate symptoms or pain. However, over time, hearing loss can become noticeable. A proactive approach can help people avoid significant hearing loss as they age.

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Individuals with mild hearing loss were twice as likely to develop dementia.*

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Four Corners Healthy Living

Awakening into Aging I could see that “Joe” was in pain. Not just physical pain from the bone cancer that was slowly ending his life, but an emotional reaction to what he just learned. He asks me, “How will my wife afford to live in our home while I am living my final days or months in a nursing home that costs $7,000 to $9,000 a month?” He goes on. He tells me how hard he worked over the years, and how he consistently put money aside so that when they needed care in their elder years, they could afford it. I could only empathize with him, as I did not have any real answers.

While Joe is not my client’s real name, his story is very real and relatable. Over the years working in health care, I have seen too many scenarios like Joe’s. Individuals may falsely assume that their savings alone will provide enough financial support to care for themselves and their loved ones. They optimistically believe Medicare benefits or the supplemental policies they have been paying for will be enough to cover their needs. Unfortunately, for many, the reality is much different from the outcomes they expected.

Realistically people are aging into care systems most know little or nothing about. Unfortunately, true exploration usually does not begin until they experience a health crisis.

My intention is not to frighten or discourage people, but to educate them, provide guidance and let them know there is hope and a way forward.

I want to encourage uncomfortable conversations today rather than wait for life to happen to them.

Individuals and families can be prepared for the aging process by following a few helpful tips listed below: • Ask your loved ones about Advance Directives, and if they do not have them, they should talk to their physician or legal counsel. Closely examine your financial situation, compare it to potential future health care needs and associated costs. In our part of Colorado if you need to reside in an Assisted Living Community prices can range anywhere from $3500 a month to $12000 at higher end communities. Those wanting to age in place in their homes can pay $20 to $30 per hour for nonmedical care and more for private duty nursing.

• Decide what you can afford and for how long.

Medicare and Medicaid do cover some long-term care costs, yet the resources can be limited.

• Contact a local insurance representative, the Senior Center, San Juan Basin Health or Axis Health to learn more about these benefits. A great resource in each County is the Senior Center. Here you can find help with Medicare Part D enrollment (prescription plan) and other local housing/ disability/food agencies that offer help. Each County has an Aging & Disability Resources of Colorado (ADRC) representative who has access to many resources.

• Also, the Area Agency on Aging can be helpful.

Seek funding opportunities for both respite care and in-home care which may be available to those who qualify.

• Review your long-term care insurance plan, Veteran’s Benefit or any other Insurance Plan that may cover certain costs We are fortunate to live in a community with available resources and with professionals who can assist those in need.

Realistically people are aging into care systems most know little or nothing about.

Four Corners Healthy Living

The aging process can be challenging for many; however, by educating yourself, talking with loved ones and subject matter experts, taking advantage of available resources and by putting together a solid plan of action, many of these challenges can be mitigated, delayed or eliminated altogether.

For further information, please contact Erin Youngblood, Administrator of Comfort Keepers, In-Home Care at (970) 4227040 or email erinyoungblood@comfortkeepers.com. Go online to ComfortKeepers.com/DurangoCO. Erin has her Master’s Degree in Social Work and has worked in Health Care since 2010 in La Plata & Montezuma Counties.

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October 2019

Mercy Regional Medical Center hosts childbirth education

Health Briefs

Mercy Regional Medical Center will host a free childbirth education classes in October and December. The first class in October is a two-part series on Oct. 8 and Oct. 15 from 6-8:30 p.m.

The class will discuss labor and delivery, pain management and newborn care, and all questions are encouraged. To participate in the October class, register by Oct. 6. The Childbirth Education Express is Oct. 12 from 9 a.m. - 4 p.m. Register by Oct. 10. The December two-part series takes place Dec. 10 and Dec. 17. Participants must register by Dec. 8. The Childbirth Education Express is Dec. 14, and registration closes Dec. 12. For more information, call (970) 764-3100.

Four Corners local health events & education

Annual Trauma and Critical Care Conference this month Join Mercy Regional Medical Center Trauma Services for the annual Trauma and Critical Care Conference at Fort Lewis College in the Student Union Ballroom Oct. 17-18. The conference is a program that offers comprehensive look at methods to assess diverse trauma, discuss care priorities related to non-accidental trauma and learn about the technologies available to treat trauma. For more information, call (970) 764-3402.

Comfort Keepers encourages employee wellness Comfort Keepers is offering a health and wellness incentive program for employees. The program was developed after learning that many caregivers did not have access to a primary care provider. As the need for in-home care increases, this allows more individuals to consider a career in health care. To learn more about this program for employees call Erin Youngblood at (970) 422-7040.

PHD Weight Loss announces nutrition program for children

Free estate planning seminar Learn more about the basics of wills, trusts and other estate planning tools at Century 21 West Slope Realty. The free seminar is offered every third Thursday of the month at 5:30 p.m., and is open to the public. RSVP is required. Please email erin@fone.net for reservations.

A new weekly class, hosted by PHD Weight Loss, will introduce children to healthy eating habits and nutritious foods. The six-week class beginning in October is free, and open to children ages 7-12. For more information, call (970) 764-4133.

Birds and Bees hosts sex education for men Males ages 18 and up can join host Erin Brandt at The Bookcase and Barber Nov. 14 beginning at 6 p.m. for a fun conversation about male anatomy form and function. The event will feature information about vasectomies and how the body functions after the procedure.

Tickets cost $45, and participants 21 and over will receive a signature drink with their ticket purchase. For questions and information, email info@positivesexed.com.

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October 2019

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* Premium rate for 65 year old member, including $2 discount for automatic bank draft and 5% household discount.

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You are a whole person.

We have a whole lot of options.

We’re a good fit.

Primary Healthcare Our clinics in Durango and Cortez offer comprehensive primary care, including annual physicals, well-child visits, chronic disease management, immunizations and women’s health. Same-day sick visits are available.

Behavioral Healthcare The care team at the clinics includes professionals who help with behavioral health concerns, such as stress, anxiety, sleep issues, depression or substance use.

Oral Healthcare At La Plata Integrated Healthcare, hygienists on our team can do check-ups and cleanings. At Axis Health System Oral Health Clinic, we offer cleanings, fillings, extractions, restorations and emergency dental care.

AXIShealthsystem.org

24/7 Crisis Care: 970.247.5245

Your health... We’re in this together. Call today to make an appointment at one of our clinics.

Cortez Integrated Healthcare

La Plata Integrated Healthcare

Axis Health System Oral Health Clinic

691 East Empire St. Cortez, 970.565.7946

1970 East Third Ave. Durango, 970.335.2288

2530 Colorado Ave., A Durango, 970.335.2442

We accept Medicaid, Medicare, CHP+ and most private insurance, and we offer a sliding-fee scale for those who qualify.