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there are many options available Minimally invasive therapy for treatment of acute and chronic pain management. t Epidural Steroid Injections t Facet Blocks t Median Nerve Blocks t Radio Frequency Nerve Ablation Whether you are newly injured or a long-term sufferer, we have many pain management options. We strive to provide diagnostic and therapeutic services with care and compassion to help our patients improve their function and be pain free. Using a team approach, we work closely with: t Family Practice Physicians t Surgeons t Chiropractors t Physical Therapists
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Loveland Greeley Medical Magazine & Directory 2008
5
With breast cancer, early detection is the key to a positive outcome. That's why the experienced staff at McKee Medical Center is highly trained in the latest in digital mammography. This new technology gives a clearer, more accurate picture with much quicker results. Should mammography or ultrasound find an abnormality in one of our patients, we have a new BreastSpecific Gamma Imaging Camera, one of only 40 across the country, that helps quickly differentiate between benign and malignant masses. If cancer is discovered, you can take comfort in knowing that our comprehensive care is recognized by the American College of Surgeons Commission on Cancer.
McKee Medical Center. Remarkable health care inspired by you.
Banner Health
McKee Medical Center 2000 N. Boise Ave. • Loveland (970) 669-4640 Job opportunities: www.BannerHealth.com or 866-377-5627 (EOE/AA) Banner Health is the leading nonprofit health care provider in northern Colorado.
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w w w. s t y l e m a g a z i n e c o l o r a d o . c o m Publisher Lydia J. Dody Editor Corey Radman
creative director Scott Prosser Senior Designer Austin Lamb
Advertising Sales EXECUTIVES Jon Ainslie (970) 219-9226 Abby Bloedorn (970) 222-8406 Karen Christensen (970) 679-7593 Lydia Dody (970) 227-6400 Saundra Skrove (970) 217-9932 Office Manager Ina Szwec Accounting Manager Karla Vigil Data Entry Betty Frye Contributing Writers Alice Ashmore, Lynn M. Dean, Julie Estlick, Stephanie Eyster, John Penney, Corey Radman, Kay Rios, Jason Webb, Richard Yount Copy editor Richard Yount Contributing photographers Shaun Hudson, Dana Milner, Todd Newcomer Affiliations Fort Collins Area Chamber of Commerce Loveland Chamber of Commerce Greeley Chamber of Commerce Windsor Chamber of Commerce 2008 Style Magazines January-Loveland/Greeley Medical & Wellness Magazine and Directory February-Building & Remodeling March-Family, Community & Philanthropy March-Northern Colorado Medical & Wellness April-Business of Northern Colorado May-Building & Remodeling - Home & Garden May-Northern Colorado Medical & Wellness June-Business to Business June-Building & Remodeling July-Fort Collins Medical & Wellness Magazine and Directories August-Women In Business September-Building & Remodeling Home Interiors & Entertainment October-Women’s Lifestyle Health & Beauty October-Northern Colorado Medical & Wellness November-Holiday December-Winter/Wedding Style Media and Design, Inc. magazines are free monthly publications direct-mailed to homes and businesses in Northern Colorado. Elsewhere, subscriptions for 16 issues cost $24/year. Free magazines are available in stands at 75 locations throughout Northern Colorado. For ad rates, subscription information, change of address, or correspondence, contact: Style Media and Design Inc., 211 W. Myrtle, Fort Collins, Colorado 80521. Phone (970) 226-6400. E-Mail: ina@StyleMedia.com Š2007 Style Media and Design Inc. All rights reserved. The entire contents of Style Magazine is copyrighted and may not be reproduced without the expressed written consent of the publisher. Style Media and Design Inc. is not responsible for unsolicited material. All manuscripts, artwork, and photography must be accompanied by a SASE. The views and opinions of any contributing writers are not necessarily those of Style Media & Design Inc.
10
Ifyou're having ababy, were herefor you. If you're expecting a baby, the team of physicians and birthing center professionals at PVHS are here to ensure that you and your baby have a safe, comfortable delivery. State-of-the-art birthing centers are located at both Poudre Valley Hospital in Fort Collins and Medical Center of the Rockies in Loveland . Please call to learn more about your birthing center options. We look forward to being part of your special day.
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Take a Tour! Come take a tour of our state-of-the-art birthing centers. Call (970) 495-7000 for a schedule of upcoming tour dates at Poudre Valley Hospital and Medical Center of the Rockies.
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Lydia’s STYLE Magazine
publisher’sletter
Welcome to our 3rd annual issue of this Loveland/Greeley Medical and Wellness Magazine & Directory. We are honored to collaborate with the Banner Health organization, and the outstanding administrators and high caliber medical teams at McKee Medical Center and North Colorado Medical Center to bring you this annual magazine and directory. We hope you enjoy reading the interesting and informative articles about health issues, new technology, and healthcare providers in the area, and find the directory easy and useful to reference year round.
Rick Sutton, Chief Executive Officer of McKee Medical Center in Loveland, has provided exceptional leadership to continue to evolve McKee from a small community hospital to one recognized for providing high quality compassionate patient healthcare to Loveland and the surrounding area. And, through their hospital wide focused commitment of working on five major priorities McKee has engaged their employees to increase the quality of patient care resulting in consistently placing in the top third of all hospitals participating in patient satisfaction surveys. McKee’s recent expansion and renovation and continued success at being one of the lowest cost providers continues to keep McKee on the forefront of Banner Health facilities. Congratulations to Rick Sutton and McKee for your commitment to providing quality care and a wonderful hospital experience to patients and their families. Gene O’Hara, Chief Executive Officer of century old North Colorado Medical Center in Greeley, has much to celebrate. In 2007 NCMC was honored to receive several awards for hospital performance and processes related to their patient experience. NCMC was the recipient of the prestigious Magnet™ designation for excellence in nursing services. This award is highly regarded, and considered one of healthcare’s honors recognizing the importance of excellence in nursing in quality patient care. Another sought after award (formerly
HealthCare Excellence in our Region
Solucient) now Thomson Healthcare awarded NCMC designation as one of the nation’s 100 Top Hospitals® for cardiovascular care. This award reassures patients that the NCMC team of physicians and clinical staff perform well above national standards in cardiac care. In addition, with the recent completion of their $128 million Second Century expansion, NCMC is now the largest healthcare facility in the region. Congratulations Gene O’Hara and NCMC for your leadership and vision to not only maintain modern and state-of-the-art facilities but for providing exceptional healthcare in the region. Congratulations to the 3000 employees and medical staff of NCMC for their commitment to medical excellence. We are proud to have these two fine medical facilities in our Northern Colorado region serving our increasing medical needs. Thank you to the many physicians and clinical staff for spending time with us to inform and educate us for the articles in this issue; we appreciate your time and commitment to healthcare excellence. Wishing each of you a healthy and happy 2008,
Lydia@stylemedia.com
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Loveland Greeley Medical Magazine & Directory 2008
- Peter Weeks - Owner 13
table of contents
medical wellness Loveland /Greeley
magazine / director y 2008
page 55
NCMC Breast Cancer Treatment: MammoSite Radiation Therapy
page 58
NCMC CAIR: Path to Recovery
page 13 Publisher’s Letter
page 16
on the cover
Marie Klish, MD radiation oncologist from McKee Medical Center and Doug Kemme, MD, medical oncologist with Greeley Medical Clinic and cooperating physician with North Colorado Medical Center. Cover photos by Dana Milner. On location at NCMC.
19
McKee Surgery: McKee Boasts Latest Technology
page 30
30
75
86 14
page 75
PEDIATRIC VISION CARE: What Parent’s Should Know
page 78
page 35 medical directory
page 80
LOVELAND: Orthopaedic Center of the Rockies New Home
55
wellness section
NCMC DIAGNOSTICS: Endoscopic Ultrasonography
page 47
51
NCMC: Cervical Disc Replacement
Introduction Letters: page 64 MCKEE: Relationship Based Rick Sutton, CEO, McKee Care: The Secret to Success Medical Center Gene O’Hara, CEO, North page 68 Colorado Medical Center McKee/NCMC PREVENTION: Wait, Did You page 19 Wash Your Hands? McKee/NCMC Oncology: Clinical Trials page 71 Benefit Patients
page 24
24
page 60
McKee HOSPITALISTS: Inpatient Experts
OPHTHALMOLOGY: Refractive Eye Surgery Keeping an Eye on the Puck
page 86
McKee PREVENTION: HPV Vaccine
page 51
NCMC SURGERY: One Man’s Work is Another Man’s Miracle
The enclosed articles in this issue of Loveland/Greeley Medical Wellness Magazine/ Directory are for your general knowledge and not as a substitute for medical advice or treatment. If you have any questions or concerns about your health, please contact your doctor or health care provider.
Lydia’s STYLE Magazine
North Colorado Medical Center is proud to have achieved MagnetTM recognition status from the American Nurses Credentialing Center. Receiving this distinction for providing the highest quality of nursing practice and patient care is a rare honor. Less than 2 70 hospitals nationwide have received this status. We're pleased to recognize all of the people who made this happen. But we'd like to especially recognize the dedicated and compassionate nurses who are committed everyday to making a difference in people's lives.
~
~
Banner Health
North Colorado Medical CenterÂŽ
ANCC MAGNET RECOGNITION
180 I 16th Street • Greeley (970) 352-4121 www.BannerHealth.com keyword: NCMC
Job opportunities: www.BannerHealth.com or 866-3 7 7-562 7 Banner Health is the leading nonprofit provider of health care in northern Colorado.
DEAR NORTHERN COLORADO READER,
As I approach my first anniversary as Chief Executive Officer at
McKee Medical Center, a Banner Health facility, I am honored to be D ear Northern Colorado Reader, associated with such an outstanding medical team, and to lead this
Rick Sutton, MS, FACHE Chief Executive Officer Rick Sutton , MS, FACHE McKee Medical Center Chief Executive Officer McKee Medical Center
As 2008 begins I want to take this opportunity to inform you, the Mediorganization into the future. cal/Wellness of McKee Medical accomplishments We all arereader, very aware that the healthCenter’s care environment we liveand in goals for the coming year. is about to change dramatically. I assure you that the McKee team will The best way to begin is to let you know that we continue to raise the meet that change, and continue to deliver high-quality, compassionate bar in all five of our priorities. They are: health •care to the people of Loveland and surrounding communities. Employee engagement McKee has been providing the Loveland community with health care • Patient satisfaction for the•past 30 years. Many Quality of health careof you were born at McKee, and probably more of you havepartners received health care at McKee over the past three • Physician decades. We haveperformance always been the community hospital for Loveland, • Financial seen thevital levelrelationships of employee with engagement climb at McKee so and We havehave established this community. much thatwe werecognize have beenthat able as to enjoy 10 to 15 applicants for must every McKee. position Yet, the landscape changes, so posted. This enablesclass us toteam be very selectiveand andwe hireare only the besttostaff for We have a world at McKee, prepared move our patients families. forward. Beand assured your hospital team provides excellent care in all We continue to see patient satisfaction rise so much that, on average, aspects of the health care continuum. We have made, and will continue eight of every ten patients would definitely recommend us to family and to make, strategic decisions that will move us into the future, and put friends, and the same number would rate the overall services at McKee as hospital in a position of continued strength. ayour ninehometown or ten. We have have remained compiledfocused five priorities that everyone We on our quality indicatorsatasMcKee well. I has am committed to work withthat thewhen outcome of increased quality proud to report to thetoward, community you compare McKee with care and a wonderful the core.youThe other Northern Coloradohospital hospitalsexperience on qualityat indicators, willfive findareas that in areas McKee is at the Patient top of the chart. This Quality has not happened by are:most Employee Engagement, Satisfaction, Outcomes, accident. have focused on quality healthcare and being the best hospital PhysicianWe Friendly and Financial Strength. in Northern Banner Health, that and the We are Colorado, committed to ensuring all nation. staff at McKee are highly We were cited as being the lowest to cost provider in best the area four of engaged, determined and committed give you the care in possible. the top ten most common reasons for admission and second lowest in four We believe that having highly engaged staff results in the ability to more. provide higher quality care, lower turnover, increased productivity and Think about it. Of the top ten reasons you will be admitted to the hosa more effective overall. pital, McKee wasorganization either the lowest cost provider or next to lowest in eight Weten.also are concentrating on our patient satisfaction to make of the yourWe experience at grow McKee of the base best and in the country. At McKee continue to ourone physician work hand-in-hand with we are compared nationally to other Medical hospitalsGroup in theto country, and are physicians like those at Big Thompson provide excellent consistently placing topbeing one-third of all hospitals participating in care to patients. We in arethe also approached continuously by existing physician that aresurvey. interested in joining forces with us. Acquiring the patientclinics satisfaction existing clinics and growing is new that wehealth are serious Of utmost importance ourclinics abilitydemonstrates to deliver quality care, about being abletotoour provide affordable, healthcare to everyone and according metrics, you canaccessible be assured that quality health in Northern Colorado. care is something that you will receive at our hospital. Finally, we are financially strong. We have been able to continually We also ensure that our staff members are highly trained and that invest back into McKee Medical Center to ensure that we always have the we provide state-of-the-art technology so you receive the best health most advanced equipment to offer our patients. We are completing the last care in the market.II,You deserve that,ofand at McKee Medical Center, portions of Legacy which consists a $17 million investment into a that is what youdepartment, will experience. new emergency new laboratory, new pharmacy, new outpaalso continue to work hand-in-hand ourand physicians to tientWe registration, new chapel, renovated operatingwith rooms, a complete ensure theyofare with the care their patients are receiving. We are renovation thepleased first floor. making sure that all necessary and supplies are available to At McKee Medical Center, equipment we have focused our attention on being the best in Northern Banner Health, and the nation. We them as hospital they provide health Colorado, care to this community. realize that we all have to choices when it comes healthcare and that is McKee continues be financially strongtodue to the support ofwhy the we have stayed true to our vision making difference in to people’s lives community, physicians, and staff,ofand we’reawell prepared grow with through excellent in patient care. this community the future. When you have healthcare needs in your future, you can rest assured It boils down to this: Your community hospital is a physician that we are here for you. The entire McKee team is trained, equipped, and friendly facility, employing highly engaged staff members that provide capable of providing you the best healthcare experience out there. the highest level of quality to you and your family. May God Bless you, thehealth Unitedcare States Military, and the United States We will always strive to ensure that you will not have a better health of America.
care experience than the one you will have at McKee. Quality health
care at your hometown hospital – that’s what we’re all about. Sincerely, Rick Sutton, MS, FACHE Chief Executive Officer Sincerely, McKee Medical Center
Rick Sutton Chief Executive Officer McKee Medical Center
16 12 zzz.indb 12
Lydia’s STYLE Magazine
1/26/06 5:52:43 PM
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43 PM
DEAR NORTHERN COLORADO READER,
North Colorado Medical Center (NCMC) recently celebrated its
100th anniversary of providing quality health care service and leadership D ear Northern Colorado Reader, for the residents of Greeley, Weld County and northeastern Colorado.
This 3rdofannual of the Loveland/Greeley Medical Wellness Thousands peopleedition in Weld County, northern Colorado, western Magazine is the result of collaboration between North ColoNebraska and andDirectory southeastern Wyoming have experienced the quality rado Medical Center (NCMC), McKee Medical Center, Banner Health, and health care provided by NCMC’s caring employees and medical staff. Style Media and Design, Inc. It provides valuable resource information For over 100 years, North Colorado Medical Center has been about community and regional healthcare services as well a directory of dedicated medical excellence, education community service. A health and to wellness providers. It will serve as and a reference for your healthColorado 1904, NCMC, a Banner Health facility, is now care needslandmark throughoutsince the year. a standard by which 21stvision century centers can be measured. At NCMC, it is our andmedical our commitment to “provide the best Theexperience NCMC, anywhere.” Inc. BoardInof2007 Directors Banner Healthawards began patient we wereand honored to receive planning andnational preparation, in 1999, to meetwho theevaluate growingand population from leading independent companies measure hospital performance andinprocesses related to thefor patient experience. and health care needs our service region a second century of The American Nurses Credentialing named North service. The planning ofAssociation’s NCMC’s Second CenturyCenter Project led to the Colorado Medical a Magnet™ for excellence construction and Center opening of a new designation Emergencyrecipient Department in 2003; in nursing services. It’s Cancer one of the healthcare community’s highest honors. a new comprehensive Institute in 2004; and a new patient care It publicly recognizes the excellent patient care our nurses give each day services expansion in December, 2005. and reflects the commitment of our entire staff to serve as a team, providing The recently opened expansion includes the CardioVascular the highest quality care for the people of our community and region. Institute of North Colorado featuring a full range North of cardiac and Thomson Healthcare (formerly Solucient) awarded Colorado vascular Center servicesdesignation all in one as location the most diagnostic Medical one of with the nation's 100advanced Top Hospitals® for cardiology equipment in annual northern Colorado. The Monfort Birth cardiovascular care. The Thomson Healthcare awardFamily is based on Center hasperformance been expanded with comfort-enhanced spacious rooms and hospitals' in treating heart attacks, congestive heart failure, coronary artery bypass procedures. neonatal intensive care surgery nursery.and Thecardiac surgicalcatheritization needs of patients are met In in presenting Thomson organizations included in the twelve (12)the newaward, Surgical Suites, stated Pre-opthat Assessment area, Post Anesthesia 100 haveareas. set national benchmarks for be clinical process, outand Top PostHospitals® Surgical Care Robotic surgery will the latest surgical comes, efficiency and cost-effectiveness. advancement offered in early 2006. A new Intensive Care Unit with 16 As the in Northern Coloradosystems to receive private bedsonly andhospital sophisticated monitoring for this eachaward, patientpa-is tients in our region can be confident that NCMC has a team of doctors provided as well. and clinical staff who perform well above the national standards in cardiac care.Comfort and convenience is provided for our guests in familyfriendly waiting welcome center, retail pharmacy, shop and As the largest,areas, single-campus healthcare facility in the gift region, North café. OverMedical 100 newCenter privateisrooms available to meet patient needs. Colorado proudcan tobe offer a comprehensive scope of Special lift systemsworld-class in the ceiling of each ensure patient and services providing quality careroom to thehelp communities we serve. staff safety. comfortable areaand allows familyservices and friends toyour stay In 2008, we A will continue to alcove offer new improved to meet needs: with patients overnight if desired. The Westernof States only burn With•completion the Burn $128Center, millionNorthern Second Colorado’s Century expansion, unit, willMedical be expanded from four-bed to ainto ten-bed unit. most North Colorado Center is atransformed the largest, • The NCMC air medical transport helicopter service will introcomprehensive, state-of-the-art health care facility in the region. duce a second helicopter as well as a new program name. But excellent patient care is more than a modern facility. It’s • The latest procedures, technology and treatments will continue people—doctors, nurses and hundreds of medical professionals and to meet the medical needs of patients in the region. volunteers – all committed to medical excellence. The awards and recognitions, as well as our plans for the future, are Medical excellence is measured, incan part, by patient feedback about examples of the quality of care patients expect from an experience at our service national organizations for NCMC. And and your recognition experience isby thestate resultand of the commitment of our docthe world-class care provided. is proud our recognition as tors, nurses, hundreds of medicalNCMC professionals andofvolunteers at NCMC a Colorado Performance Excellence Awardinrecipient inour 2005 and the who are all committed to medical excellence the care of patients. On behalfofofthe theBariatric over 3000Surgery employees and medical staff atofNorth Colodesignation program as a Center Excellence rado Medical Center, I thank you for the opportunity to meet your healthby the American Society of Bariatric Surgery. care These needs.and We many are honored thousands of are people have chosen NCMC other that awards received significant recognitions for care. andtheir achievements. However, it is the day-to-day excellence of over
Gene O’Hara, PharmD, FACHE Chief Officer Gene O’Hara , Executive PharmD North Colorado Medical Center
Chief Executive Officer North Colorado Medical Center
350 physicians and medical staff members and 2,700 employees that results in providing the highest quality services to patients, families and guests.O’Hara, PharmD, FACHE Gene We are honored that thousands of people have chosen NCMC for Chief Executive Officer their care. We Medical are committed North Colorado Center to continuing to make a difference in people’s lives through excellent patient care. Sincerely,
Sincerely, Gene O’Hara Chief Executive Officer North Colorado Medical Center
Loveland Greeley Medical Magazine & Directory 2008
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17 13 1/26/06 5:52:53 PM
After a cancer diagnosis, we have the power to get you back to your way of life. When faced with a cancer diagnosis, you deserve the best possible care. That's where North Colorado Medical Center comes in. Our Cancer Institute offers compassionate, quality care in one convenient location. Our experienced professionals change lives with some of the most highly specialized technology in the world, including advanced radiation techniques that focus on cancerous cells, leaving healthy cells undisturbed. We provide the broadest range of treatment options, such as access to clinical trials, stem cell transplants and PET/CT technology to better track tumors. As an accredited cancer program by the American College of Surgeons, there is no reason to go anywhere else for a positive outcome.
North Colorado Medical Center. Your place for powerful medicine.
Banner Health
North Colorado Medical CenterŽ 180 I 16th Street • Greeley (970) 352-4121 Job opportunities: www.BannerHealth .com or 866-377-5627 (EOE/AA) Banner Health is the leading nonprofit health care provider in northern Colorado.
oncology
Clinical Trials
Doug Kemme, MD, monitors patient care with the assistance of his staff.
The word cancer strikes a fearful chord any time it creeps into a diagnostic discussion. The first thought can be to run to a large institution in some metropolis for the latest in treatment options and newest research information.
clinical trials
benefit patients by Kay Rios
And, prior to 1983, most cancer research occurred at medical universities and large treatment centers in major cities. But that added more stress and cost for the patient trying to get help. As demand for closer access to clinical trials grew, a push through the National Cancer Institute formed the Community Clinical Oncology Programs (CCOP), a networking system that provided research and clinical trials access to people across the country. Clinical trials are at the heart of research. They are controlled and monitored studies conducted with human subjects and involving new drug treatments or new approaches
for diagnosing, controlling or preventing disease. They are designed to answer key scientific questions that will advance medical knowledge. Oncology trials at McKee Cancer Center and the North Colorado Medical Center (NCMC) are carried out through affiliation with Colorado Cancer Research Program (CCRP), which is sponsored by the National Cancer Institute. A wide variety of trials are listed through CCRP and physicians can then enroll interested parties into appropriate ones. It’s an important part of the dayto-day business through both Centers. “We really believe that research should
Loveland Greeley Medical Magazine & Directory 2008
be an integrated part of the fabric of our cancer program,” says Julianne Fritz, director of Oncology Services at NCMC. “It’s important because it increases the body of knowledge and we feel that participating in national and regional trials contributes to that body of knowledge.” Doug Kemme, MD, medical oncologist with the Greeley Medical Clinic and a cooperating clinician at NCMC, says, “The number one reason to participate in research and clinical trials is that it improves our treatments and offers the latest and greatest for our patients right here. As an institution, it keeps us on our toes. Regulators
19
I tell [patients] we are taking at least as good care of their cancer as larger institutions in other parts of the country and we can take better care of them as a person. Samuel Shelanski, MD, medical oncologist, involves patients in clinical trials.
come through here, watch our work and do quality checks on how we’re doing. Another benefit for NCMC and McKee is that we stay up to date. When new things come along, it’s not a long discussion because we’re already aware and ready to go. Samuel Shelanski, MD, medical oncologist with the Greeley Medical Clinic who practices at McKee agrees and adds. “It not only benefits our particular patients, it also accrues a body of data that helps us come up with more efficient treatments down the road. And it allows McKee to be more of a full service cancer center. I am continually astounded at the quality of care we are able to provide. I always encourage people to get a second opinion but I tell them we are taking at least as good care of their cancer as larger institutions in other parts of the country and we can take better care of them as a person. It’s more personal. And with clinical trials we can keep more patients in the fold. I never want to feel a patient can get better treatment down the road.” Keeping patients at home is less stressful both physically and financially, Joan LeTourneau, senior research associate in oncol-
ogy at McKee says. “Many people want to participate in clinical trials and we feel that offering those opportunities locally keeps them from having to travel to other areas. They don’t have to travel to Sloan Kettering or other large hospitals to get into clinical trials. That can be very hard on them.” Clinical trials are the means for finding better ways of preventing, detecting, and treating disease and, in general improving healthcare for people with those diseases. Kemme terms it as being in search of the clinical grail. “We have seen a significant change in how various types of lung cancer are treated and, for the first time, we are seeing an average survival that exceeds one year in certain kinds of lung cancer. In the past several years, we’ve seen new drug improvements for renal cancer. That’s always been difficult to treat and there was usually a poor outcome but there have been leaps in treatment in that regard. Treatments are less toxic and we’re better at managing the side effects because of information through CCRP and other sponsoring organizations.” The idea, says LeTourneau, is to find a cure and do it safely and quickly. “By hav-
ing these clinical trials, results for a particular research question are found sooner.” That provides the foundation for future trials. “The next study builds on the knowledge gained through previous trials.” Being attached to a national research network increases the chances for greater and quicker discoveries, Fritz says. “If Dr. Kemme sees sixty breast cancer patients a year and only five of those fit into a particular study, by adding them to a national study, you may then have 500 patients in that trial.” “And, through that cooperative research,” adds Theresa Henley, clinical research nurse at NCMC, “instead of one or two hospitals, you have 50 sites, so you’re drawing on a larger research base.” Clinical trials fall into one of four categories. Treatment trials look for better drugs or improved approaches to surgery or radiation for patients who already have cancer. Prevention trials focus on lowering risks for certain types of cancer. Diagnostic and screening trials compare new techniques for finding cancer especially early-stage. Supportive care (also known as quality of life) tests new ways to improve comfort levels for
Many people want to participate in clinical trials and we feel that offering those opportunities locally keeps them from having to travel to other areas. Joan LeTourneau, senior research associate in oncology at McKee discusses keeping patients at home to reduce stress physically and financially.
20
Lydia’s STYLE Magazine
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Marie Klish, MD, radiation oncologist, discusses a diagnostic test with a patient.
people with cancer. All trials are open to patients referred by their doctors through the registered institution. Since NCMC and McKee are both members of CCRP, their doctors have access to all of the open studies through that organization. Studies are chosen based on physician interest and institutional priorities. “When a study becomes available, we make the decision to open it or not.” Kemme says. “There’s a lot of paperwork, and committee meetings where the decisions are made. We can only open so many at a time so we look at which ones we are likely to use and which ones where we will have patients. Our goal is to get the most important ones and the new drugs that might cure people.” “The purpose of all of these research trials is to help people survive longer and live better,” says Marie Klish, MD, board certified radiation oncologist at McKee Cancer Center. She is currently involved in studies exploring best radiation practices. For example, she says, some trials compare different radiation doses and some compare treating different amounts of tissue. “Based on study results, treatment is always evolving and we are always reaching for new and better ways.” While doctors pull information from those studies, it also works in reverse Henley says. “We give input into CCRP as to the types of cancers we see in Northern Colora-
22
Lydia’s STYLE Magazine
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Loveland Greeley Medical Magazine & Directory 2008
23
mckee surgery
McKee boasts
From left, Loretta Bush, RN, OR Circulator; Sarvjit Gill, MD; Colleen Chadwick, RN; Dave Arebalo CST; and Joreen Schupner.
latest technology by Alice Ashmore
Five years ago, McKee Medical Center might have fit the description of a small town community hospital. Forget that image! Today the hospital offers a wide range of new technologies and facilities that allow for highly sophisticated surgeries and excellence in patient care. 24
A Marathon Surgery Sarvjit “Sarj” Gill, MD, an ear, nose and throat (ENT) specialist, recently completed a 19-hour cancer surgery at the hospital. “From my perspective, we’ve done some really big cases there.” Gill’s patient, Glenn Wolvington says, “My surgery was one of the most comprehensive surgeries ever at McKee.” Wolvington originally consulted Gill for a nasal allergy problem when Gill saw cause for concern with his patient’s tonsils. Tests revealed invasive cancer in his right tonsil. During the marathon surgery, the lower half of Wolvington’s face would be cut apart through his lower jaw and “spread open like a book” to access and remove the tonsils, portions of the throat, and surrounding lymph glands in the neck. “We used a free tissue transfer technique from his arm to reconstruct the back of the throat.” This technique could be likened to repotting a plant and preserving its root supply. A six by eight centimeter sheet of tissue was removed along with the blood vessels supplying it. “We connected those to the carotid artery and jugular vein.” A traditional skin graft from Wolvington’s thigh was used to cover his arm. Gill, 43, is one of two ENTs in Colorado who perform microvascular surgery including free tissue transfer. Patients are referred to him from a wide region including WyoLydia’s STYLE Magazine
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The hospital has really made tremendous improvements in post-surgical care. The new expansion of ICU (Intensive Care Unit) and critical care staff have made it possible for us to operate at the highest caliber. Sarvjit Gill, MD, ENT Specialist with Alpine Ear Nose & Throat, P.C.
ming, Nebraska, and Northern Colorado. “The hospital has really made tremendous improvements in post-surgical care. The new expansion of ICU (Intensive Care Unit) and critical care staff have made it possible for us to operate at the highest caliber.” He praised the expertise of McKee’s critical care staff, pulmonary, and hospitalists – physicians who practice solely in a hospital setting. “The patient was really able to be served well at McKee. This type of surgery would typically be performed in a university setting.” Gill adds, “There is a great advantage for patients to be near home.” “The surgery was November 20, 2006; four weeks after he looked in my throat for the first time,” says Wolvington. Mental preparation was crucial. “One of the best things Dr. Gill did was to give me a general idea of what would happen without overwhelming me.” He adds, “I’m glad I didn’t know all the details.” Wolving-
Brad Keeler, MD, general surgeon with Loveland Surgical Associates and McKee Medical Center, Chief of Staff
26
ton says it was the only Stage 4 cancer Gill had ever seen that had not spread to neighboring lymph nodes. “I recovered from the surgery in about six weeks. My body healed in a normal amount of time.” Because Wolvington followed his surgery with radiation and chemotherapy, he has a 92 percent chance of surviving his cancer diagnosis. He describes enduring radiation and chemo as “really horrid.” That notwithstanding, he accelerated his chemotherapy with one objective in mind – to walk his daughter down the aisle at her June 19, 2007 wedding in St. Lucia. “That was my big goal.” He finished his last chemo treatment the day before he and his wife left for the wedding. “I didn’t know if I was going to make it. It was a 20-hour trip and the most I’d done here was walk around the block with my dog.” The journey was successful in many ways. “Going to St. Lucia was the smartest thing I ever did. It took me out of
my environment of illness.” He adds, “Dr. Gill is an amazing man. I knew him already because my wife has had thyroid cancer and he was her surgeon.” Wolvington also has praise for Loveland’s original hospital. “My care at McKee was wonderful. I have nothing but positive things to say about it.” “Sarj” Gill, MD practices with Alpine Ear Nose & Throat, P.C. with offices in Fort Collins, Loveland, Estes Park, and Laramie.
A Place for Teaching OB/GYN, John Crane, MD, FACOG, utilizes McKee to train physicians in new techniques for treating pelvic prolapse – a condition in women where the natural support system of pelvic organs weakens and the bladder, uterus, or rectum sag from their original position. “In the past few years there have been significant advancements in the treatment
Elizabeth Howell, MD, OB/GYN, FACOG, with McKee Center for Women’s Health
John Crane, MD, FACOG, OB/ GYN at Big Thompson Medical Group
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of pelvic prolapse.” He notes over 50 percent of women over 50 suffer from some sort of prolapse. Symptoms include vaginal pain or a feeling of fullness, loss of bladder or bowel control, involuntary urination, difficulty with bowel movements, and recurrent bladder infections. The 46 year-old Crane is a preceptor (instructor) for C.R. Bard, Inc., the manufacturer of the new Avaulta system for treating this condition. “This type of surgery has a 97 percent cure rate which is excellent.” Crane teaches the procedure in Loveland. “McKee has become a teaching center. I’ve had doctors from all over the country come to learn to do the Avaulta system. Most recently, I had a physician come from Ocala, Florida.” “In the last three years, McKee has really improved their quality of service and their relationships with their physicians.” Crane began practicing in Loveland in 1998 and is the head of OB/GYN Associates at Big Thompson Medical Group. “I began practicing with my wife, Suzanne Saenz, who is also an OB/GYN.”
New Doctors and the Latest Equipment McKee and Banner Health have made substantial improvements to the hospital in recent years including an expansion of the ER, ICU, and staff. “The biggest change has been in the consistency and quality of care. We now have full-time critical and cardiac care,” says Brad Keeler, MD, and the Chief of Staff at McKee. Keeler is also a general surgeon Lydia’s STYLE Magazine
with Loveland Surgical Associates. Keeler, 43, also notes big changes at McKee. “I’ve practiced in Loveland for 12 years. When I first came to town in 1995, only basic laparoscopy was being performed at McKee.” Keeler is a specialist in general surgery. “Most people don’t realize that general surgery is a specialty,” he says. He routinely performs non-emergency spleenectomy, gall bladder removal, and hernia repairs using a laparoscope. These surgeries would have required large incisions until recently. “The only type of surgery we refer to Denver are people with pancreatic cancer – we have less than ten cases a year. In general, we can take care of everything else.” Gill has nothing but praise for the hospital. “What they have done is make a tremendous financial investment in the hospital infrastructure,” says Gill. “The operating suites have had a major upgrade. The administrative staff is highly committed to providing state-of-the-art equipment.” Elizabeth Howell, MD, an OB/GYN with the McKee Center for Women’s Health, sees the same level of commitment. “The hospital administration provides a very supportive workplace for physicians. They have been very responsive to our needs. The recently renovated OR has a very nice design.” She cites a recent request for longer instruments for laparoscopic (small incision) surgery. “As patients have become more obese, there was a need for longer instruments.” A good portion of Howell’s surgeries are preformed laparoscopically. “Patients have a much easier recovery.” Howell relocated her practice to Loveland in August 2007. She is a Fellow of the American College of Obstetricians and Gynecologists (FACOG), and previously practiced for nine years in Farmington, New Mexico. “McKee has also been very welcoming of me as a new physician.” Howell arrived just in time to experience Colorado’s “blizzard baby” phenomenon. “In October 2007 we delivered over 100 babies. It was the busiest month in the history of McKee.” She moved to the area to be near family in Denver. Alice Ashmore is a regular contributing writer living in Loveland.
Loveland Greeley Medical Magazine & Directory 2008
29
NCMC diagnostics
eus
endoscopic ultrasonography
the view inside
Cindy Thompson, LPN, Ahmed Sherif, MD, and Sandy Foster, RN ready Oscar Martinez for surgery.
by Richard Yount
Ahmed Sherif, MD, is a gastroenterologist at North Colorado Gastroenterology, and the Medical Director for GI at North Colorado Medical Center (NCMC). He is enthusiastic about a relatively new diagnostic technology called endoscopic ultrasound (EUS). 30
“With EUS, oncologists and surgeons no longer have to perform invasive surgery to determine the nature of an abnormality, the stage of cancers, or have fewer treatment options of chemotherapy for tumor reduction prior to surgery for any of those areas where EUS is used.” Initially, endoscopic ultrasound (EUS) was developed for improved sonographic images of the pancreas. Today, that capability helps in the diagnoses of diseases of the digestive tract and nearby organs, including the liver, gall bladder, and bile ducts. It is used in the diagnosis of rectal, colon, esophageal, pancreatic and gastric tumors and can even see into the lungs to investigate lymph nodes for possible lung cancer. Specific diseases are: anal sphincter and incontinence; Barrett’s esophagus (precancerous change in the lining due to acid reflux); neuroendocrine tumors; common bile duct stones; gastric cancer; esophageal cancer; lung cancer; pancreatic cancer; pancreatitis; cystic neoplasms of the pancreas; rectal cancer; rectal fistulas; smooth muscle tumors; and enlarged lymph nodes. Endoscopic ultrasound uses high-frequency ultrasound to “visualize” the gut wall and nearby body structures. These include the mediastinum, or chest cavity, the abdomen, and the pelvis. It involves passing a thin, flexible tube (endoscope) through a patient’s mouth or anus. A small ultrasound transducer in the scope produces sound waves that create an image of the surrounding area. Most of us are familiar with sonogram images taken from the
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outside of the body on the skin, frequently used to monitor prenatal development. EUS images provide more definitive images because they are taken from the inside using variable frequencies depending on what the physician is focusing on. North Colorado Medical Center’s $1.4 million investment, however, relies on the skill of the physician to manipulate the endoscope and to interpret the images. “I am the only one doing EUS between Denver and the Canadian border and I have referrals from Utah, Wyoming, Montana and Nebraska,” Sherif said. He is also one of the most highly trained and skilled doctors performing this procedure. “There are only 15-20 training opportunities in the nation each year and the demand is growing for EUS trained doctors.” Sherif further noted that, “there are some states that do not have even one EUS trained physician.” EUS is not a screening procedure. It is used when there has been some symptom or indication on a CAT scan, x-ray, MRI or similar procedure that has caused the primary physician to want more information. And because EUS is usually referral-based, it is incumbent on doctors and patients to be aware of EUS and its availability at NCMC. “I will go anywhere to talk with people to educate them on this new procedure and its usefulness,” says Sherif. “Because it is so new, many are not aware of EUS’ capabilities.” The information from this new procedure is best utilized by oncologists and surgeons. “I work with all of the oncologists and surgeons here at North Colorado Medical Center and I have started working with physicians in Fort Collins too,” Sherif said. EUS is also used in determining how a cancer has advanced. “This is very important in determining treatment plans. EUS gives us a Lydia’s STYLE Magazine
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much better idea of what stage the cancer is at,” says Douglas J. Kemme, MD, Medical Oncologist and currently Cancer Liaison Physician for the oncology program at NCMC. Jason Ogren, MD, and General Surgeon who has consulted with and referred patients to Sherif, says that he “has been able to better diagnose because of EUS and Dr. Sherif’s diagnostic capabilities. Before EUS, we would have to do surgery to make determinations. Now, Dr. Sherif can take images and biopsies using fine needle aspiration provided by using the linear EUS rather than surgery.” “This is new technology… about eight years old. It is helping us to more properly stage treatment; and patients are benefiting from what we learn about their diseases. Determining what kind of tumor we’re dealing with and using chemotherapy alone or in combination with surgery has greatly improved our patient care,” Ogren says. Patient Don Gannon of Greeley says he was “out like a light and really had no ill effects from the procedure. Dr. Sherif and Dr. Ogren were wonderful!” Patients and their families, who have family histories of any of the diseases listed in this article, should ask their primary care provider if EUS would be appropriate for them. “Our patients are coming to us more informed and more involved. It is all about education and awareness,” counsels Sherif. For further information, contact North Colorado Gastroenterology at (970) 378-4475. Richard Yount is copy editor for Style Magazine.
Loveland Greeley Medical Magazine & Directory 2008
33
b b b m m m m nnm n m m m No matter which direction you're headed, we're close by. Each and every patient is important to us. So w e want to make sure we're doing everything we can to meet your health care needs. That's why w e've added new locations and new physicians to meet the needs of our growing community. No matter which location is most convenient for your family, you can rely on attentive care from experienced physicians to meet your health care needs.
Aspen Medical Center 1808 N. Boise Ave., Loveland 970-669-6660 2001 S. Shields, Bldg. H Fort Collins 970-498-92 26
Banner Medical Clinic Highland Meadows 8201 Spinnaker Bay Drive Suite D, Windsor 970-223-2272
Big Thompson Internal Medicine 1808 N. Boise Ave. Loveland 970-278-1862
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Foley, Kevin, MD 2204 Hoffman Dr., Ste. A Loveland, CO 80538...................... 970-667-9794 Gambrell, Wiliam M., MD 1801 16th Street, Main OR Greeley, CO 80631......................... 970-350-4800 Hart R. Ted, MD 2000 70th Avenue Greeley, CO 80634......................... 970-506-6789 Landes, Valdon G., DO Greeley, CO 80634......................... 970-506-6789 Lloyd, Alan, MD 2204 Hoffman Dr., Ste. A Loveland, CO 80538...................... 970-667-9794 Lord, Jonathan G., DO 1801 16th Street, Main OR Greeley, CO 80631......................... 970-350-4800 Michael, Christopher S., MD 1801 16th Street, Main OR Greeley, CO 80631......................... 970-350-4800 Pavlik, Rostislav, MD 1801 16th Street, Main OR Greeley, CO 80631......................... 970-350-4800 Peetz, Shelley L., MD 2000 70th Avenue Greeley, CO 80634......................... 970-506-6789 Regnier, Patricia L., MD 1801 16th Street, Main OR Greeley, CO 80631......................... 970-350-4800 Robbiano, Peter J., MD 1801 16th Street, Main OR Greeley, CO 80631......................... 970-350-4800 Song, Yo-Jun, MD 1801 16th Street, Main OR Greeley, CO 80631......................... 970-350-4800 Thomas, Christopher D., MD 1801 16th Street, Main OR Greeley, CO 80631......................... 970-350-4800 Thompson, William L., MD 1801 16th Street, Main OR Greeley, CO 80631......................... 970-350-4800
Loveland Greeley Medical Magazine & Directory 2008
Thornton, Margaret N., MD 1801 16th Street, Main OR Greeley, CO 80631......................... 970-350-4800
cardiology Beckmann, James H., MD 1800 15th Street, Ste. 310 Greeley, CO 80631................. 970-392-0900 Chapel, Harold L., MD 1800 15th Street, Ste. 310 Greeley, CO 80631................. 970-392-0900 Cullinane, David, MD 2121 E. Harmony Rd., Ste. 100 & 200 Fort Collins, CO 80528 .......... 970-221-1000 Doing, Anthony, MD 2121 E. Harmony Rd., Ste. 100 & 200 Fort Collins, CO 80528 .......... 970-221-1000 Green, C. Patrick, MD 2121 E. Harmony Rd., Ste. 100 & 200 Fort Collins, CO 80528 .......... 970-221-1000 Gryboski, Cynthia L., MD 1800 15th Street, Ste. 310 Greeley, CO 80631................. 970-392-0900 Hurst, Paul G., MD 1800 15th Street, Ste. 310 Greeley, CO 80631................. 970-392-0900 Johnson, C. Timothy, MD 2121 E. Harmony Rd., Ste. 100 & 200 Fort Collins, CO 80528 .......... 970-221-1000 Larson, Dennis, MD 2121 E. Harmony Rd., Ste. 100 & 200 Fort Collins, CO 80528 .......... 970-221-1000 Marsh, Randall C., MD 1800 15th Street, Ste. 310 Greeley, CO 80631................. 970-392-0900 Myers, Gerald, MD 2121 E. Harmony Rd., Ste. 100 & 200 Fort Collins, CO 80528 .......... 970-221-1000 Nath, Sunil, MD 2121 E. Harmony Rd., Ste. 100 & 200 Fort Collins, CO 80528 .......... 970-221-1000
Oldemeyer, J. Brad, MD 2121 E. Harmony Rd., Ste. 100 & 200 Fort Collins, CO 80528 .......... 970-221-1000 Purvis, Matthew, MD 2121 E. Harmony Rd., Ste. 100 & 200 Fort Collins, CO 80528 .......... 970-221-1000 Rath, Gary A., MD 1800 15th Street, Ste. 310 Greeley, CO 80631................. 970-392-0900 Shihabi, Ahmad H., MD 1000 Lincoln St., Ste 207 Fort Morgan, CO 80701 ........ 970-867-7900 Stoltz, Chad, MD 2121 E. Harmony Rd., Ste. 100 & 200 Fort Collins, CO 80528 .......... 970-221-1000 Treat, Stephen, MD 2121 E. Harmony Rd., Ste. 100 & 200 Fort Collins, CO 80528 .......... 970-221-1000 Voyles, Wyatt, MD 2121 E. Harmony Rd., Ste. 100 & 200 Fort Collins, CO 80528 .......... 970-663-3107 Zumbrun, Steven R., MD 1800 15th Street, Ste. 310 Greeley, CO 80631................. 970-392-0900
dermatology Blattner, Mary A., MD 5881 W. 16th Street Greeley, CO 80634................. 970-313-2734
ear,nose,throat Chand, Maria, MD 1120 E. Elizabeth St., Bldg. F-101 Fort Collins, CO 80524 ......... 970-221-1177 See ad on page 38
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Gill, Sarvjit, MD 3820 N. Grant Ave. Loveland, CO 80538 ........ 970-593-1177 See ad above Gupta, Sanjay K., MD 5881 W. 16th Street Greeley, CO 80634................. 970-313-2740 Peterson, Keith E., MD 2528 W. 16th Street Greeley, CO 80634................. 970-356-4646 Peterson, Thomas T., MD 2528 W. 16th Street Greeley, CO 80634................. 970-356-4646 Roberston, Matthew, MD 1120 E. Elizabeth St., Bldg. F-101 Fort Collins, CO 80524 ......... 970-221-1177 See ad above Woodson, Trudi A., MD 5881 W. 16th Street Greeley, CO 80634................. 970-313-2740 Zacheis, David, MD 1120 E. Elizabeth St., Bldg. F-101 Fort Collins, CO 80524 ......... 970-221-1177 See ad above
emergency medicine Baker, Jeffrey T., MD 1801 16th Street Greeley, CO 80631................. 970-350-6244 Campain, James J., MD 1801 16th Street Greeley, CO 80631................. 970-350-6244 Cole, Charles A., MD 1801 16th Street Greeley, CO 80631................. 970-350-6244 Dixon, Mark, MD MMC Emergency Dept-PO Box 830 Loveland, CO 80539.............. 970-635-4071 Doyle, Robert F., MD 1801 16th Street Greeley, CO 80631................. 970-350-6244 Fischer, Randy, MD MMC Emergency Dept-PO Box 830 Loveland, CO 80539.............. 970-635-4071 Fuhrmann, Eric, MD MMC Emergency Dept-PO Box 830 Loveland, CO 80539.............. 970-635-4071 Genova, Ronald T., MD 1801 16th Street Greeley, CO 80631................. 970-350-6244
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Huntington, Michael, MD MMC Emergency Dept-PO Box 830 Loveland, CO 80539.............. 970-635-4071
Rein, Jody A., DO 1801 16th Street Greeley, CO 80631................. 970-350-6244
Hurst, John G., MD 1801 16th Street Greeley, CO 80631................. 970-350-6244
Sato, Randall, MD MMC Emergency Dept-PO Box 830 Loveland, CO 80539.............. 970-635-4071
Hutchison, Timothy J., MD 1801 16th Street Greeley, CO 80631................. 970-350-6244
Schwartz, Jeffrey C., MD 1801 16th Street Greeley, CO 80631................. 970-350-6244
James, Tyler M., DO 1801 16th Street Greeley, CO 80631................. 970-350-6244
Sundheim, Scott, MD MMC Emergency Dept-PO Box 830 Loveland, CO 80539.............. 970-635-4071
Jobin, Michael, MD MMC Emergency Dept-PO Box 830 Loveland, CO 80539.............. 970-635-4071
Waggener, William, MD MMC Emergency Dept-PO Box 830 Loveland, CO 80539.............. 970-635-4071
Link, David W., MD 1801 16th Street Greeley, CO 80631................. 970-350-6244 Maxwell, Peter W., MD 1801 16th Street Greeley, CO 80631................. 970-350-6244 McLaughlin, Keith, MD MMC Emergency Dept-PO Box 830 Loveland, CO 80539.............. 970-635-4071
endocrinology Kumar, Nirmala, MD 1801 16th Street Greeley, CO 80631................. 970-378-4675
Purdie, Frank R., MD 1801 16th Street Greeley, CO 80631................. 970-350-6244
Lydia’s STYLE Magazine
family medicine Albritton, Eliz, MD 7603 Colland Dr. Fort Collins, CO 80525 .......... 970-461-8031 Allen, Thomas, MD 295 E. 29th Street Loveland, CO 80538.............. 970-669-6000 Anderson, Thomas, DO 2701 Madison Square Dr., Loveland, CO 80538.............. 970-663-0722 Armour, Ross, MD 401 10th Street Berthoud, CO 80513 ............. 970-532-4910 Bakanauskas, Elge A., MD 1300 Main Street Windsor, CO 80550 ................ 970-686-5646 Bearden, Jacqueline S., MD 5623 W. 19th Street Greeley, CO 80634................. 970-353-9011 Bradley, Robert C., MD 1300 Main St. Windsor, CO 80550 ................ 970-686-5646 Branum, Joanna H., MD 2520 W. 16th Street Greeley, CO 80631................. 970-356-2520 Brockmann, Robert, MD 2000 Boise Ave. Loveland, CO 80538.............. 970-203-6770 Brown, Cara E., MD 222 Johnstown Center Dr. Johnstown, CO 80534............ 970-587-4974 Brown, John M., MD 222 Johnstown Center Dr. Johnstown, CO 80534............ 970-587-4974 Budensiek, Richard L., DO 5623 W. 19th Street Greeley, CO 80634................. 970-353-9011 Cabrera, Anthony, MD 914 W. 6th Street Loveland, CO 80537.............. 970-667-3976 Carey, Michael V., MD 1300 Main St. Windsor, CO 80550 ................ 970-686-5646 Clang, Daniel R., DO 6801 W. 20th Street, Ste.101 Greeley, CO 80634................. 970-378-8000 Clang, Tamara S., DO 6801 W. 20th Street, Ste.101 Greeley, CO 80634................. 970-378-8000 Colgan, Ann T., MD 2520 W. 16th Street Greeley, CO 80634................. 970-356-2520
Coonrod, Aline R., MD 1600 23rd Avenue Greeley, CO 80634................. 970-356-2424
Hailey, Mark, MD 914 W. 6th Street Loveland, CO 80537.............. 970-667-3976
Oligmueller, William, MD 5881 W. 16th Street Greeley, CO 80634................. 970-313-2700
Corliss, Scott A., MD 5881 W. 16th Street Greeley, CO 80634................. 970-313-2700
Haskins, R. Scott, MD 6801 W. 20th Street, Ste.101 Greeley, CO 80634................. 970-378-8000
Paczosa, Michelle K., DO 2520 W. 16th Street Greeley, CO 80634................. 970-356-2520
Corona, Joseph A., MD 5881 W. 16th Street Greeley, CO 80634................. 970-313-2700
Hollos, Lori, MD 2701 Madison Square Dr. Loveland, CO 80538.............. 970-663-0722
Peterson, Jeffrey E., MD 6801 W. 20th Street, Ste.101 Greeley, CO 80634................. 970-378-8000
Dallow, Kurt T., MD 1600 23rd Avenue Greeley, CO 80634................. 970-356-2424
Jacob, Prema, MD 914 W. 6th Street Loveland, CO 80537.............. 970-667-3976
Pflieger, Daniel P., MD 2420 W. 16th Street Greeley, CO 80634................. 970-353-7668
Danforth, James, MD 2701 Madison Square Dr. Loveland, CO 80538.............. 970-663-0722
Jeffers, Wayne S., MD 1600 23rd Avenue Greeley, CO 80634................. 970-356-2424
Powell, Patricia K., MD 2930 11th Avenue Evans, CO 80620 .................. 970-353-9403
Deutchman, Mark E., MD 1600 23rd Avenue Greeley, CO 80634................. 970-356-2424
Johns, Stacie, MD 8201 Spinnaker Dr., Ste. D Windsor, CO 80528 ................ 970-223-2272
Rangel, Keith A., MD 1300 Main St. Windsor, CO 80550 ................ 970-686-5646
Kasenberg, Thomas, DO 295 E. 29th Street Loveland, CO 80538.............. 970-669-6000
Reents, William, MD 914 W. 6th Street Loveland, CO 80537.............. 970-667-3976
Kenigsberg, Thomas A., MD 222 Johnstown Center Dr. Johnstown, CO 80534............ 970-587-4974
Ripley, Lori A., MD 2520 16th Street Greeley, CO 80634................. 970-356-2520
Kennedy, Christopher T., MD 2420 W. 16th Street Greeley, CO 80634................. 970-353-7668
Risenhoover, Edwin, MD 295 E. 29th Street Loveland, CO 80538.............. 970-669-6000
Ley, James W., MD 5881 W. 16th Street Greeley, CO 80634................. 970-313-2700
Rommereim-Madden, Daphne, MD 222 Johnstown Center Dr. Johnstown, CO 80534............ 970-587-4974
Magnuson, Douglas A., MD 2520 16th Street Greeley, CO 80634................. 970-356-2520
Rule, Ingrid, MD 1323 Harlow Lane Loveland, CO 80537.............. 970-667-3030
Manter, Charles D., DO 2627 W. 10th Street, Ste. 3 Greeley, CO 80634................. 970-352-3274
Schaffer, Scott, MD 7603 Colland Dr. Fort Collins, CO 80525 .......... 970-461-8031
Martinez, Matthew L., MD 6801 W. 20th Street, Ste.101 Greeley, CO 80634................. 970-378-8000
Schmalhorst, Brian K., MD 5881 W. 16th Street Greeley, CO 80634................. 970-313-2700
McCall, Janis R., MD 5623 W. 19th Street Greeley, CO 80634................. 970-353-9011
Sheppard-Madden, Dena, MD 295 E. 29th Street Loveland, CO 80538.............. 970-669-6000
Mills, Angela, MD 5623 W. 19th Street Greeley, CO 80634................. 970-353-9011
Smith, David B., MD 1600 23rd Avenue Greeley, CO 80634................. 970-356-2424
Morgan, Dana M., MD 5623 W. 19th Street Greeley, CO 80634................. 970-353-9011
Stansloski, Julie, MD 914 W. 6th Street Loveland, CO 80538.............. 970-667-3976
Gregory, Joseph E., MD 222 Johnstown Center Dr. Johnstown, CO 80534............ 970-587-4974
Morgan, Frank D., MD 5623 W. 19th Street Greeley, CO 80634................. 970-353-9011
Trevino, Julia B., MD 2930 11th Avenue Evans, CO 80620 .................. 970-353-9403
Grosboll, Robert, MD 232 W. 4th Street Loveland, CO 80537.............. 970-667-3565
Olds, Kenneth M., MD 6801 W. 20th Street, Ste.101 Greeley, CO 80634................. 970-378-8000
Volk, John W., MD 2930 11th Avenue Evans, CO 80620 .................. 970-353-9403
Doft, Anthony, MD 2701 Madison Square Dr. Loveland, CO 80538.............. 970-663-0722 Dubin, Jeremy, DO 3320 W. Eisenhower Blvd. Loveland, CO 80537.............. 970-669-2849 Fahrenholtz, Daniel H., MD 1600 23rd Avenue Greeley, CO 80634................. 970-356-2424 Finnoff, Gregory J., DO 2930 11th Avenue Evans, CO 80620 .................. 970-353-9403 Flake, Zachary (Zach), MD 2701 Madison Square Dr. Loveland, CO 80538.............. 970-663-0722 Flower, Thomas J., DO 2122 9th Street Greeley, CO 80631................. 970-356-7555 Ford, Amy K., MD 2930 11th Avenue Evans, CO 80620 .................. 970-353-9403 Frickman, C. Elmo, MD 3320 W. Eisenhower Blvd. Loveland, CO 80537.............. 970-669-2849 Garber, Stacey L., MD 2420 W. 16th Street Greeley, CO 80631................. 970-353-7668 Greene, Dana, MD 2420 W. 16th Street Greeley, CO 80631................. 970-353-7668
Loveland/Greeley Loveland GreeleyMedical MedicalMagazine Magazine&&Directory Directory2008 2008
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Ward, John David, II, MD 6801 W. 20th Street, Ste. 101 Greeley, CO 80634................. 970-378-8000
Sherif, Ahmed M., MD 1800 15th Street, Ste. 300 Greeley, CO 80631................. 970-378-4475
Waugh, Kyle B., MD 2520 W. 16th Street Greeley, CO 80634................. 970-356-2520
Strong, Lewis, MD 2555 E. 13th Street, Ste. 220 Loveland, CO 80537.............. 970-669-5432
Wiggins, Michael, MD 914 W. 6th Street Loveland, CO 80537.............. 970-667-3976 Wildeman, Christine, MD 3880 N. Grant Ave. Loveland, CO 80538.............. 970-663-0047 Wilson, D. Craig, MD 2520 16th Street Greeley, CO 80634................. 970-356-2520 Young, Mark D., MD 2420 W. 16th Street Greeley, CO 80634................. 970-353-7668 Zucker, Charles I., MD 6801 W. 20th Street, Ste.101 Greeley, CO 80634................. 970-378-8000
gynecology Burke, Robert MD 1817 N. Cheyenne Ave. Loveland, CO 80538.............. 970-669-4176
Englert, Thomas, MD 1900 Boise Ave., Ste 410 Loveland, CO 80538.............. 970-667-2009
Breen, John F., MD 1801 16th Street Greeley, CO 80631................. 970-350-6360
Abu Qwaider, Yazan, MD 1800 15th Street, Ste. 300 Greeley, CO 80631................. 970-378-4475
Carter, Susan D., MD 1800 15th Street, Ste. 220 Greeley, CO 80631................. 970-353-1335
Burgert, Stephen, MD 2555 E. 13th Street, Ste. 220 Loveland, CO 80537.............. 970-669-5432
Lynch, Kathryn, MD 2555 E. 13th Street, Ste. 220 Loveland, CO 80537.............. 970-669-5432
hyperbaric medicine (hbo)wound
Radin, Robert A., MD 1801 16th Street Greeley, CO 80631 ................ 970-350-6071
hematologyoncology Kemme, Douglas J., MD 1800 15th St., Ste. A Greeley, CO 80631 ................ 970-353-6722
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Liao Ong, Jacob, MD 2121 E. Harmony Rd., Ste. 380 Fort Collins, CO 80528 ......... 970-224-0429 See ad on this page Peskind, Robert, MD 2121 E. Harmony Rd., Ste. 380 Fort Collins, CO 80528 ......... 970-224-0429 See ad on this page
Ebens, John B., MD 1900 16th Street Greeley, CO 80631................. 970-350-2438 Keefe, Kevin, DO 1808 N. Boise Ave. Loveland, CO 80538.............. 970-278-1862 Loecke, Steven W., MD 1900 16th Street Greeley, CO 80631................. 970-350-2438 Norman, Edward, MD 1808 N. Boise Ave. Loveland, CO 80538.............. 970-278-1862 Parliment, Joel, MD 1808 N. Boise Ave. Loveland, CO 80538.............. 970-278-1862
internal medicineinfectious disease Currie, James B., MD 7251 W. 20th Street, Bldg. K Greeley, CO 80634................. 970-353-4322
Farstad, David J., MD 1801 16th Street Greeley, CO 80631................. 970-350-6071 Olsen, Eric B., MD 1801 16th Street Greeley, CO 80631 ................ 970-350-6071
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Stone, Michael, MD 2050 N. Boise Ave., Ste. A Loveland, CO 80538.............. 970-667-7870 1800 15th Street, Ste. C Greeley, CO 80631................. 970-378-4170
infectious disease
gastroenterology
Kading, Steven O., MD 1900 16th Street Greeley, CO 80631................. 970-350-2470
Shelanski, Samuel A., MD 2050 N. Boise Ave., Ste. A Loveland, CO 80538.............. 970-667-7870
Carlton, John, MD 1817 N. Cheyenne Ave. Loveland, CO 80538.............. 970-669-4176
gynecologybreast center
Chase, Jerry, MD 2555 E. 13th Street, Ste. 220 Loveland, CO 80537.............. 970-669-5432
Lininger, Thomas R., MD 2050 N. Boise Ave., Ste. A Loveland, CO 80538.............. 970-667-7870 1800 15th Street, Ste. C Greeley, CO 80631................. 970-378-4170
internal medicine Berntsen, Mark F., MD 1900 16th Street Greeley, CO 80631................. 970-350-2438 Bohm, Martin, DO 2802 Madison Square Dr., Ste 120 Loveland, CO 80538.............. 970-776-1950 Cash, Robert L., MD 1900 16th Street Greeley, CO 80631................. 970-350-2438
Christiansen, Dana, MD 7251 W. 20th Street, Bldg. K Greeley, CO 80634................. 970-353-4322
Pearson, Antony, MD 2000 Boise Ave. Loveland, CO 80538.............. 970-203-6770 Randle, Michael T., MD 1900 16th Street Greeley, CO 80631................. 970-350-2438 Reinhardt, Marcus R., MD 1900 16th Street Greeley, CO 80631................. 970-350-2438 Smith, Peter, MD 1808 N. Boise Ave. Loveland, CO 80538.............. 970-278-1862 Tallman, Marsha, MD 1600 23rd Ave. Greeley, CO 80634................. 970-356-2424 Tello, Robert, MD 232 W. 4th Street Loveland, CO 80537.............. 970-667-3565 Thompson, Keith S., MD 1900 16th Street Greeley, CO 80631................. 970-350-2438 Tryggestad, David I., MD 1900 16th Street Greeley, CO 80631................. 970-350-2438
Lydia’s STYLE Magazine
Valin, James, MD 2000 Boise Ave. Loveland, CO 80538.............. 970-203-6770 Zenk, Daniel R., MD 1900 16th Street Greeley, CO 80631................. 970-350-2438
nephrology Merritt, Jason, MD 1600 Specht Point Dr., Ste. I Fort Collins, CO 80525 ......... 970-493-7733 See ad on page 40 Muelken, Kevin, MD 1600 Specht Point Dr., Ste. I Fort Collins, CO 80525 ......... 970-493-7733 See ad on page 40 Rademacher, Donald R., MD 1900 16th Street Greeley, CO 80631................. 970-350-2438 Simmons, Richard E., MD 1600 Specht Point Dr., Ste. I Fort Collins, CO 80525 ......... 970-493-7733 See ad on page 40 Singer, James R., MD 1600 Specht Point Dr., Ste. I Fort Collins, CO 80525 970-493-7733 See ad on page 40 Teruel, Mark A., MD 1600 Specht Point Dr., Ste. I Fort Collins, CO 80525 ......... 970-493-7733 See ad on page 40
nephrology-
internal medicine Bruce, Julia L., MD 900 14th Street Greeley, CO 80631................. 970-304-0010
neurology Ewing, David L., MD 7251 W. 20th Street, Bldg. C Greeley, CO 80634................. 970-356-3876 Jacobs, Marianne B., DO 295 E. 29th Street, Ste. 240 Loveland, CO 80538.............. 970-669-2668 Schmitt, Joseph, MD 295 E. 29th Street, Ste. 240 Loveland, CO 80538.............. 970-669-2668
Loveland/Greeley Loveland GreeleyMedical MedicalMagazine Magazine&&Directory Directory2008 2008
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Tolge, Celina F., MD 5890 W. 13th Street, Ste. 112 Greeley, CO 80634................. 970-353-2255
ob-gyn Abbott, Stewart M., MD 1715 61st Ave. Greeley, CO 80634 ................... 970-336-1500 Allen, Neil H., MD 2410 16th Street Greeley, CO 80634................. 970-352-6353 Berdahl, Laurie D., MD 2410 16th Street Greeley, CO 80634................. 970-352-6353 Beresford, Kaea N., MD 1900 16th Street Greeley, CO 80631................. 970-350-2403
Loken, Karla, DO 1813 N. Cheyenne Ave. Loveland, CO 80538 .... 970-203-6801 See ad on page 29 O’Neal, Jean-Pierre, MD 2410 16th Avenue Greeley, CO 80634................. 970-352-6353 Saenz, Suzanne, MD 1900 N. Boise Ave., Ste. 300 Loveland, CO 80538.............. 970-203-2150 Slack, Kenneth, MD 1813 N. Cheyenne Ave. Loveland, CO 80538 .... 970-203-6801 See ad on page 29 Sokolowski, Irene, MD 1900 N. Boise Ave., Ste. 300 Loveland, CO 80538.............. 970-203-2150
Burket, Charles R., MD 1900 16th Street Greeley, CO 80631................. 970-350-2403 Colberg, Craig S., MD 1900 16th Street Greeley, CO 80631................. 970-350-2403 Crane, John, MD 1900 N. Boise Ave., Ste. 300 Loveland, CO 80538.............. 970-203-2150 Elkington, Kenneth W., MD 1600 23rd Ave. Greeley, CO 80634................. 970-356-2424 Fiala, Jenna E., MD 2410 W. 16th Street Greeley, CO 80634................. 970-352-6353 Hess, Kevin D., DO 1715 61st Ave. Greeley, CO 80634 ................... 970-336-1500 Hiratzka, Paul S., MD 2410 16th Street Greeley, CO 80634................. 970-352-6353
Bussey, Randy M., MD 5890 W. 13th Street, Ste. 101 Greeley, CO 80634................. 970-348-0020
Welch, John R., MD 1616 15th Street Greeley, CO 80631................. 970-352-6688
Chamberlain, Satoru, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 .......... 970-493-0112
oral & maxillofacial surgery Bley, Justin C., DMD 1707 61st Ave., Ste. 102 Greeley, CO 80634................. 970-506-0350
Stoltz, Michelle, MD 2410 W. 16th Street Greeley, CO 80634................. 970-352-6353
oral surgery
Bader, Todd, MD 1900 N. Boise Ave., Ste. 300 Loveland, CO 80538.............. 970-203-2150 Budd, L. Ginger, MD 1900 N. Boise Ave., Ste. 300 Loveland, CO 80538.............. 970-203-2150
Weeks, Jeffrey B., MD 1931 65th Avenue, Ste. C Greeley, CO 80634................. 970-352-1877
opthalmology Adams, John C., MD 3400 W. 16th Street, Ste. O Greeley, CO 80634................. 970-351-6216 Brotsky Rochelle J., MD 1616 15th Street Greeley, CO 80631................. 970-352-6688 Carter, Douglas B., MD 1931 65th Avenue, Ste. C Greeley, CO 80634................. 970-352-1877 Cecil, Jennifer, MD 2902 Ginnala Dr., Ste. 1 Loveland, CO 80538.............. 970-669-8998 Crews, Michael J., MD 3400 W. 16th Street, Ste. O Greeley, CO 80634................. 970-351-6216 Foe, Elaine V., MD 1931 65th Avenue, Ste. C Greeley, CO 80631................. 970-352-1877
Kirk, John, MD 3650 E. 15th Street Loveland, CO 80538.............. 970-669-1107
Mellin, Richard W., DDS, MD 3400 16th Street, Bldg. 1S, Ste. A Greeley, CO 80634................. 970-353-5826 Nicholas, Kenton C., DDS 1900 16th Street Greeley, CO 80631................. 970-350-2458
orthopaedics Anderson, Gilbert I., MD 1801 16th Street Greeley, CO 80631................. 970-392-2496 Baer, Robert, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 970-493-0112 See ad on page 51 Beard, David, MD 2923 Ginnala Dr. Loveland, CO 80538 .... 970-663-3975 See ad on page 51 Benz, Robert, MD 2923 Ginnala Dr. Loveland, CO 80538 .... 970-493-0112 See ad on page 51
Howell, Elizabeth, MD 1813 N. Cheyenne Ave. Loveland, CO 80538 .... 970-203-6801 See ad on page 29
Palmer, Charles F., MD 3400 W. 16th Street, Ste. P Greeley, CO 80634................. 970-351-0999
Biggs, William MD 2500 E. Prospect Rd. Fort Collins, CO 80525 970-493-0112 See ad on page 51
Kiser, Rick E., MD 1900 16th Street Greeley, CO 80631................. 970-350-2403
Uyemura, Matthew J., MD 1616 15th Street Greeley, CO 80631................. 970-352-6688
Brackett, Bess, MD 7251 W. 20th Street, Bldg. N Greeley, CO 80634................. 970-330-5400
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Dhupar, Scott K., MD 1800 15th Street, Ste. 320 Greeley, CO 80631................. 970-353-5959 Donner, E. Jeffrey, MD 3810 N. Grant Ave. Loveland, CO 80538.............. 970-669-8881 Durbin, Mark, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 970-493-0112 See ad on page 51 Grant, Michael, MD 3810 N. Grant Ave. Loveland, CO 80538.............. 970-669-8881 Grossnickle, Mark D., MD 1900 16th Street Greeley, CO 80631................. 970-350-2427 Hajek, Michael R., MD 5890 W. 13th Street, Ste. 101 Greeley, CO 80634................. 970-348-0020 Houghton, Michael, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 970-493-0112 See ad on page 51 Hunter, Brett P., MD 1900 16th Street Greeley, CO 80631................. 970-350-2427 Jackson, Wesley, MD 2500 E. Prospect Rd. Fort Collins, CO 80525 970-493-0112 See ad on page 51 Mahon, John (Jack), MD 2121 E. Harmony Rd., Ste 260 Fort Collins, CO 80528 .......... 970-221-2827 Martin, Dale, MD 2923 Ginnala Dr. Loveland, CO 80538 .... 970-663-3975 See ad on page 51 McFerran, Mark, MD 2923 Ginnala Dr. Loveland, CO 80538 .... 970-663-3975 See ad on page 51 Pazik, Thomas J., MD 6801 W. 20th Street, Ste. 201 Greeley, CO 80634................. 970-330-1090 Pettine, Kenneth MD 3810 N. Grant Ave. Loveland, CO 80538.............. 970-669-8881 Sanderford, Kelly R., MD 5890 W. 13th Street, Ste. 101 Greeley, CO 80634................. 970-348-0020
Lydia’s STYLE Magazine
Seiler, Steven J., MD 1900 16th Street Greeley, CO 80631................. 970-350-2427
pathology
Sides, Stephen D., MD-TCH 1900 16th Street Greeley, CO 80631................. 970-350-2427
Allen, Patrick, MD PO Box 419 Loveland, CO 80539.............. 970-635-4126
Tartaglia, Louis, MD 1708 Boise Ave. Loveland, CO 80538.............. 970-669-6880
Bee, Christopher, MD PO Box 419 Loveland, CO 80539.............. 970-635-4126
Watkins, John J., MD 1900 16th Street Greeley, CO 80631................. 970-350-2427
Chaffin, D. Joe, MD 1801 16th Street Greeley, CO 80631................. 970-350-6720
Young, Eric, MD 3810 N. Grant Ave. Loveland, CO 80538.............. 970-669-8881
Dunn, Cory D., MD 1801 16th Street Greeley, CO 80631................. 970-350-6725 Halbert, Richard E., MD 1801 16th Street Greeley, CO 80631................. 970-350-6726
pain management McCeney, Michael, MD 2001 S. Shields St., Bldg. L Fort Collins, CO 80526 .......... 970-221-1919 Sisson, C. Brad, MD 1136 E. Stuart St., Bldg. 4-104 Fort Collins, CO 80525 .......... 970-221-9451
Hamner, H. Wentzell., MD 1801 16th Street Greeley, CO 80631................. 970-350-6720 Libby, Arlene L., MD PO Box 419 Loveland, CO 80539.............. 970-635-4126 Neuhauser, Thomas, MD PO Box 419 Loveland, CO 80539.............. 970-635-4126
Loveland/Greeley Loveland GreeleyMedical MedicalMagazine Magazine&&Directory Directory2008 2008
Walts, Michael J., MD 1801 16th Street Greeley, CO 80631................. 970-350-6720 PO Box 419 Loveland, CO 80539.............. 970-635-4126
pediatrics Bruce, Robert, MD 2555 E. 13th Street, Ste. 130 Loveland, CO 80537.............. 970-663-5437 Dubynsky, Orest G., MD 1620 25th Avenue, Ste. D Greeley, CO 80631................. 970-356-2600 Kaplan, Kenneth H., MD 1620 25th Avenue, Ste. B Greeley, CO 80631................. 970-352-1900 Kolanz, Meshelle M., MD 5881 W. 16th Street Greeley, CO 80634................. 970-313-2700 Marler, McKay, MD 2555 E. 13th Street, Ste. 130 Loveland, CO 80537.............. 970-663-5437
Mead, Andrea, MD 2555 E. 13th Street, Ste. 130 Loveland, CO 80537.............. 970-663-5437 Moore, Christopher P., MD 5881 W. 16th Street Greeley, CO 80634................. 970-313-2700 Norman, Jennifer, MD 2555 E. 13th Street, Ste. 130 Loveland, CO 80537.............. 970-663-5437 Patrick, Jenny, MD 2555 E. 13th Street, Ste. 130 Loveland, CO 80537.............. 970-663-5437 Pedersen, Robert L., MD 5881 W. 18th Street Greeley, CO 80634................. 970-313-2700 Quintana, Michael, MD 2021 N. Boise Ave. Loveland, CO 80538.............. 970-669-3298 Ryan, Joseph P., MD 5881 W. 16th Street Greeley, CO 80634................. 970-313-2700 Teruel, Katherine MD 2555 E. 13th Street, Ste. 130 Loveland, CO 80537.............. 970-663-5437
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Venard, Neil A., MD 928 12th Street Greeley, CO 80631................. 970-352-4284
Wallick, Kristin, MD 2121 E. Harmony Rd., Ste. 300 Fort Collins, CO 80528 970-224-9102 See ad on page 41
pulmonology
radiation oncology
Breyer, Diana, MD 2121 E. Harmony Rd., Ste. 300 Fort Collins, CO 80528 ......... 970-224-9102 See ad on page 41 Fitzgerald, David J., DO 1900 16th Street Greeley, CO 80631................. 970-350-2448 Gunstream, Stanley, MD 2121 E. Harmony Rd., Ste. 300 Fort Collins, CO 80528 ......... 970-224-9102 See ad on page 41 Hoyt, James, MD 2121 E. Harmony Rd., Ste. 300 Fort Collins, CO 80528 ......... 970-224-9102 See ad on page 41 Janata, Kelli R., DO 1900 16th Street Greeley, CO 80631................. 970-350-2448
Wiesner, Mark, DO 2555 E. 13th Street, Ste. 130 Loveland, CO 80537.............. 970-663-5437 Wright, Jason, MD 2555 E. 13th Street, Ste. 130 Loveland, CO 80537.............. 970-663-5437
pediatricsdentistry Morin, Charles K., DMD, MSC 2003 46th Avenue Greeley, CO 80634................. 970-330-4600
podiatry Atwood, Thomas C., DPM 2122 9th Street, Ste. 3 Greeley, CO 80631................. 970-353-5800 Hatch, Daniel J., DPM 1931 65th Avenue, Ste. A Greeley, CO 80634 ...... 970-351-0900 See ad on page 27 Vaardahl, Michael D., DPM 1931 65th Avenue, Ste. A Greeley, CO 80634 ...... 970-351-0900 See ad on page 27
psychiatry physical medicine & rehabilitation Cutter, Nancy C., MD 1800 15th Street, Ste. 200 Greeley, CO 80631................. 970-353-1009
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Collier, Carol D., MD 928 12th Street Greeley, CO 80631................. 970-352-1056 Ruegg, Robert G., MD 928 12th Street Greeley, CO 80631................. 970-352-1056 Sills, Theron G., MD 900 14th Street Greeley, CO 80631................. 970-352-4284
Janata, Robert J., DO 1900 16th Street Greeley, CO 80631................. 970-350-2448 Kukafka, David, MD 2121 E. Harmony Rd., Ste. 300 Fort Collins, CO 80528 ......... 970-224-9102 See ad on page 32 and page 41 Milchak, Richard, MD 2121 E. Harmony Rd., Ste. 300 Fort Collins, CO 80528 ......... 970-224-9102 See ad on page 41 Neagle, Mark, MD 2121 E. Harmony Rd., Ste. 300 Fort Collins, CO 80528 ......... 970-224-9102 See ad on page 32 and page 41 Negron, Ana, MD 2500 Rocky Mnt Ave., Ste. 300 MOB Loveland, CO 80538 .... 970-619-6100 See ad on page 32 Petrun, Mark, MD 2121 E. Harmony Rd., Ste. 300 Fort Collins, CO 80528 970-224-9102 See ad on page 32 and page 41 Stevens, Eric, MD 2500 Rocky Mnt Ave., Ste. 300 MOB Loveland, CO 80538 .... 970-619-6100 See ad on page 41
Casey, William B., MD 1801 16th Street Greeley, CO 80631............... 970-350-6680 See ad on page 43 Klish, Marie D., MD 2050 N. Boise Ave. Loveland, CO 80538............. 970-679-8900 1801 16th Street Greeley, CO 80631............... 970-350-6680 See ad on page 43 Lim, Meng Lai, MD 1801 16th Street Greeley, CO 80631 ...................................970-350-6680 Lisella, Gwen H., MD 1801 16th Street Greeley, CO 80631............... 970-350-6680 See ad on page 43 Simpson, C. Kelley, MD 1801 16th Street Greeley, CO 80631 ...... 970-350-6680 See ad on page 43
radiology Bauerle, Gary W., MD 1801 16th Street Greeley, CO 80631................. 970-350-6860 Bodenhamer, John, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757 Contreras, Jaime, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757 Dunphy, Thomas, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757 Fuller, Samuel, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757 Geraghty, Michael, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757
Vassaux, Carlos, MD 2121 E. Harmony Rd., Ste. 300 Fort Collins, CO 80528 .......... 970-224-9102
Lydia’s STYLE Magazine
Goodbee, David, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757
Pacini, Richard, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757
Harris, John P., MD 1801 16th Street Greeley, CO 80631................. 970-350-6860
Peck, Steven, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757
Hayes, Amy, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757
Peet, Gary, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757
Howshar, Mark, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757
Powell, David F., MD 1801 16th Street Greeley, CO 80631................. 970-350-6860
Jess, Sarah Jane, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757
Raque, James D., MD 1801 16th Street Greeley, CO 80631................. 970-350-6860
Koplyay, Peter, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757
Reese, Mark, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757
Kreider, Dan F., MD 1801 16th Street Greeley, CO 80631................. 970-350-6860
Singer, Charles, MD 2008 Caribou Dr. Fort Collins, CO 80525 .......... 970-484-4757
Markel, Curtis, MD MMC Radiology Dept.- PO Box 830 Loveland, CO 80538.............. 970-203-6502
Weissmann, Jeffrey, MD MMC Radiology Dept.- PO Box 830 Loveland, CO 80539.............. 970-203-6502
Nelson, Todd P., MD 1801 16th Street Greeley, CO 80631................. 970-350-6860
Loveland/Greeley Loveland GreeleyMedical MedicalMagazine Magazine&&Directory Directory2008 2008
rheumatology Murray, Garvin C., MD 239 W. 67th Court Loveland, CO 80538.............. 970-461-1880
surgerycardiothoracic Lyons, Maurice I., DO 1800 15th Street, Ste. 340 Greeley, CO 80631................. 970-378-4593 Richards Kenneth M., MD 1800 15th Street, Ste. 340 Greeley, CO 80631................. 970-378-4593 Tullis, Gene E., MD 1800 15th Street, Ste. 340 Greeley, CO 80631................. 970-378-4593
surgerygeneral Burton, Lisa K., MD 1800 15th Street, Ste. 210 Greeley, CO 80631................. 970-352-8216
Blomquist, Thomas, MD 1900 N. Boise Ave., Ste. 420 Loveland, CO 80538.............. 970-669-3212 Collins, Jerome, MD 1900 N. Boise Ave., Ste. 420 Loveland, CO 80538.............. 970-669-3212 Cribari, Chris, MD 1148 E. Elizabeth St. Fort Collins, CO 80524 .......... 970-221-5878 Dubs, Steven M., MD 1900 16th Street Greeley, CO 80631................. 970-350-2426 Fraser, Lesley A., MD 1900 16th Street Greeley, CO 80631................. 970-350-2426 Johnell, Michael W., MD 1800 15th Street, Ste. 200 Greeley, CO 80631................. 970-378-4433 Keeler, Bradford, MD 1900 N. Boise Ave., Ste. 420 Loveland, CO 80538.............. 970-669-3212 Lee, James S., MD 6801 W. 20th Street, Ste. 202 Greeley, CO 80634................. 970-350-0948 Livengood, Joseph C.., MD 1900 16th Street Greeley, CO 80631................. 970-350-2426
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Ogren, Jason W., MD 1800 15th Street, Ste. 210 Greeley, CO 80631................. 970-352-8216 Peetz, Michael E., MD 1900 16th Street Greeley, CO 80631................. 970-350-2426 Schiefen, James C., MD 1900 16th Street Greeley, CO 80631................. 970-350-2426 Tyburczy, Joseph A., MD 1800 15th Street, Ste. 210 Greeley, CO 80631................. 970-352-8216
surgerygeneral-burn Goodwin, Cleon W., MD 1801 16th Street Greeley, CO 80631................. 970-350-6301
surgerymaxillofacial Zulian, Michael, DDS 2800 Madison Square Dr. Loveland, CO 80538.............. 970-669-6850
surgery-neuro Coester, Hans C., MD 1313 Riverside Ave. Fort Collins, CO 80524 ...... 970-493-1292 2001 70th Ave., Ste. 300 Greeley, CO 80634............ 970-356-4488 See ad on page 45 & 61 Turner, Donn M., MD 1313 Riverside Ave. Fort Collins, CO 80524 970-493-1292 1630 17th Avenue Greeley, CO 80631 ...... 970-356-4488 See ad on page 45 & 61 Viola, John J., MD 2001 70th Avenue, Ste. 300 Greeley, CO 80634 ...... 970-356-4488 See ad on page 45 & 61
Wirt, Timothy, MD 1630 17th Avenue Greeley, CO 80631............ 970-356-4488 See ad on page 45 & 61
surgeryplastic surgery Brewster, Amy E., MD 2121 E. Harmony Rd., Ste. 360 Fort Collins, CO 80528........ 970-266-0456 See ad on page 44 Chapman, Jeffrey, MD 2315 E. Harmony Rd., Ste. 160 Fort Collins, CO 80528 .......... 970-493-8800 Gonyon, Denis L., MD 5881 W. 16th Street Greeley, CO 80634................. 970-313-2760
urology Bruns, Thomas C., MD 1907 Boise Ave. Loveland, CO 80538.............. 970-669-2770
Eddy, Michael J., MD 1647 E. 18th Street Loveland, CO 80538 .... 970-669-9100 See ad on page 22 Goodman, Gary R., MD 1900 16th Street Greeley, CO 80631................. 970-350-2491 Henderson, Stephen, MD 1925 W. Mountain View Ave. Longmont, CO 80501 ............ 720-494-3137 Nemeth, Clifford J., MD 1647 E. 18th Street Loveland, CO 80538 .... 970-669-9100 See ad on page 22 Phillips, George H., MD 1647 E. 18th Street Loveland, CO 80538 .... 970-669-9100 See ad on page 22 Soper, Timothy, MD 2315 E. Harmony Rd., Ste.140 Fort Collins, CO 80528 970-484-6700 See ad on page 22 Wolach, James W., MD 5890 W. 13th Street, Ste. 106 Greeley, CO 80631................. 970-378-1000
*Physicians list provided by McKee Medical Center and North Colorado Medical Center. The list is current as of 12/1/2007
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Lydia’s STYLE Magazine
Loveland
OCR
Early rendering of the Orthopaedic Center of the Rockies new Loveland facility.
Orthopaedic Center of the Rockies:
new home coming soon by John Penney
The Orthopaedic Center of the Rockies has provided vital medical service and care to the Northern Colorado region and the immediate surrounding states for the past 39 years by diagnosing and treating illnesses and injuries of the musculoskeletal system.
The Orthopaedic Center of the Rockies has had a physical location in Loveland offering care to Loveland and its surrounding communities for more than fifteen years. The specific medical care offered by the Orthopaedic Center of the Rockies (OCR) includes treatment for bone fractures, strained ligaments, joint injuries and deterioration, torn cartilages, sprained muscles, and damaged connective tissues. In its first years of medical service in Loveland, during the early 1990s, OCR maintained a staff of seven physicians who covered both the Loveland and its sister site in Fort Collins, primarily serving the communities in Larimer and Weld counties. Today, with the inclusion of Fort Collins, the Orthopaedic Center of the Rockies has grown to a staff of eighteen physicians, and has expanded its care to the Northern Colorado region and beyond. According to Mike Bergerson, Chief Executive Officer, OCR now provides its exceptional care to patients throughout Colorado, Wyoming, Western Nebraska, and Western Kansas. The projected 2008 physician staffing needs include adding four more orthopaedic doctors. Along with those growth projections are the plans to build a new OCR facility. This new facility will be situated on approximately 8 acres on Highway 34 in the Boyd Lake Village commercial development, and will replace the current OCR facility on 29th Street in Loveland. As Bergerson notes, the new facility is envisioned to be capable of providing an expanded scope “multi-specialty orthopaedic home” with “state-of-the-art orthopaedic care” for Loveland, Greeley, and the surrounding communities. OCR and Dando Development, the developer of Boyd Lake Village, worked closely with the City of Loveland regarding the naming of the main entrance to the Boyd Lake Village
Loveland Greeley Medical Magazine & Directory 2008
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The new facility is envisioned to be capable of providing an expanded scope “multi-specialty orthopaedic home” with “state-of-the-art orthopaedic care” for Loveland, Greeley, and the surrounding communities. Mike Bergerson, Chief Executive Officer, OCR
development and OCR’s future campus. The street, which will be located directly north of the Mountain View High School main entrance, has been named “Horstman Place” in honor of James Horstman, MD. Horstman, a long term partner of OCR, passed away from cancer in early 2007.
How will the new OCR facility benefit Northern Colorado’s orthopaedic patients? OCR currently serves patients ranging from newborns through seniors. According to Mark McFerran, MD, an orthopaedic surgeon at OCR and a specialist in trauma surgery, the additional space will promote an increased flow of services to all patients, as well as allowing for the expanded development of examination and treatment resources dedicated to all orthopaedic specialties and programs. The specialties and programs offered by OCR include spine; foot and ankle; knees; hand and upper extremities; shoulders; joints; as well as trauma, sports medicine, podiatry and pediatrics. Preliminary plans for the building will also consider additional accommodations for increased efficient movement throughout the facility. One such example of this is to create a floor plan wherein the diagnosis and treatment rooms for hand and upper extremity injuries are within close proximity to each other. In this way, the physical distance between the exam room, x-ray, the cast room, and access to therapy would be decreased to a minimum. The patient flow for all other specialties, such as lower extremity and spine, are being given the same considerations in the building design.
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What benefits will the new Orthopaedic Center of the Rockies offer to physicians and staff? As part of OCR’s ongoing objective to offer the highest quality of orthopaedic healthcare, they actively ensure that its physicians and medical staff have access to the most advanced technologies and equipment obtainable in the healthcare profession. One such advancement is digital x-ray technology, which allows physicians and staff to produce x-ray images without using the tra-
ditional film applications. The digital x-ray image is a superior tool because along with superior visual clarity, the computer image can be rotated and adjusted for better diagnostic quality. OCR also maintains a mutually collaborative relationship with McKee Medical Center/Banner, and Medical Center of the Rockies/PVHS. These mutual relationships help ensure that OCR’s patients and physicians have access to the hospital’s best equipped for needed tests and procedures. As Northern Colorado grows, so does the need for expanded medical services.
Mark McFerran, MD orthopaedic surgeon and trauma specialists with OCR
Lydia’s STYLE Magazine
The future OCR facility will offer an effective response to those growing needs in orthopaedic care. This upcoming ability to house more specialty orthopaedic physicians at one time will give OCR the ability to provide assistance to a greater number of patients who may be in need of orthopaedic treatment. Additionally, Bergerson notes, the future facility will be “scalable so that it can continue to grow.” Design plans will allow for future expansions, both horizontally on the surrounding property, and vertically. This allowance will ensure that our region will have the finest orthopaedic care available for the long term.
Expanded Quality Orthopaedic Care for our Region. The future OCR facility represents a major addition to orthopaedic care in Northern Colorado and surrounding regions, and symbolizes OCR’s focus and ongoing commitment to increase its ability to provide superior quality healthcare. The facility is in the programming and planning phase at this time, and CEO Bergerson, along with a team of financial directors and design consultants, will be closely connected to many of the Project Management decisions. The targeted planning, design, and construction of the new OCR facility is approximately three years. The facility will be similar to the Fort Collins OCR campus, and preliminary models are for the initial construction of a two level facility, with approximately 45,000 square feet of space. This broadened range of available medical treatment -- administered by highly specialized, expert physicians – positions OCR as one of the most vital and beneficial medical institutions in our entire Northern Colorado region. The new facility will be an efficient and aesthetically pleasing building for the community. Additionally, during programming and design, OCR will be exploring all possibilities to build a “green” building. With this vision, Bergerson adds, “We are excited to be putting a new facility in Loveland, a facility which will allow us to offer an expanded scope of orthopaedic specialty care to Loveland and our surrounding communities on a daily basis.”
John Penney is a freelance writer living in Fort Collins.
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Lydia’s STYLE Magazine
ncmc minimally invasive
endografts
Maurice Lyons, DO, vascular and cardio-thoracic surgeon
According to the odds, fifty-nine year old Tim Larson should not be alive today. On September 26, 2007, a horrendous car crash east of Loveland tore a hole in his aorta along with other serious injuries. Larson was airlifted to North Colorado Medical Center - a happenstance that likely saved his life.
one man’s work is another
man’s miracle by Alice Ashmore
Larson, his wife Wanda, and their two granddaughters were hit broadside when the driver of a pick-up truck ran a stop sign. “The last thing I remember was my wife saying, ‘I don’t think he’s going to stop.’” Larson arrived at the ER and passed into the skilled hands of Maurice Lyons, DO. “He had an aortic transection, an injury with a ninety percent mortality rate. Nine out of ten patients don’t make it to the hospital.” The same type of injury claimed the life of Britain’s Princess Diana. Says Larson, “My wife and granddaughters went to Medical Center of the Rockies,
and I went to NCMC. They (the EMTs) knew Dr. Lyons was on call.” He details the severity of his injuries. “I also had a broken pelvis, a broken clavicle, a huge gash, massive head injuries, and several broken ribs. My car seat was folded in half sideways.” To staunch the internal bleeding, Larson received an endovascular graft – a titaniumnickel alloy graft coated with Gore-Tex – via a minimally invasive approach to repair the torn aorta. “It was keenly suited for this type of surgery.” Lyons notes, “This type of procedure is only done at a few hospitals in the state.”
Loveland Greeley Medical Magazine & Directory 2008
Lyons, 42, is currently involved in two FDA clinical trials utilizing endografts to treat thoracic aneurysms. The Gore TAG Endografts and Bolton Medical Thoracic Aortic Grafts are currently approved to repair aneurysms – a weakening in the wall of a blood vessel. “In certain situations they can be used to treat patients who are not candidates for other open surgical procedures.” In other words, these same grafts can be used to treat other medical conditions in an ‘off label’ use for special situations. The patch is placed inside the aorta using guidance from an x-ray to cover and seal
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We can now do complex aortic work with minimally invasive techniques. The procedure results in less bleeding and trauma than traditional open techniques. Maurice Lyons, DO
the tear from the inside. “This eliminates the need for a large incision and the use of a heart-lung machine.” He is the only physician in Colorado involved in this type of clinical trial. “We can now do complex aortic work with minimally invasive techniques. The procedure results in less bleeding and trauma than traditional open techniques.” He adds, “Endovascular surgery is an option suitable for patients who are not candidates for more traditional techniques.” Lyons commuted from Denver to Greeley before joining the staff of NCMC full-time in February of 2007. His arrival in Northern Colorado brings very specialized skills to the region. Lyons is board certified in both vascular and cardio-thoracic surgery. “Banner Health saw the need for an upper-end vascular ward in the region.” He adds, “I have patients referred to me from all over the region.” He credits the administration at NCMC for providing him with the tools he needs for these specialized surgeries. “The administration is very willing to spend the money necessary for these types of clinical trials. That type of approach allows us to do the very best for our patients,” says Lyons. The hospital will spend well over $3 million to build an “endo-suite” for surgeries. “It is a fully functional OR equipped with state-of-the-art image intensifiers used in endovascular surgery.” NCMC has spent over $200,000 to keep a full complement of available grafts on hand and is the only hospital in Northern Colorado to stock the devices. The hospital recently received the annual Thomson Healthcare award ranking it among the top 100 cardiac centers in the country. The prestigious award is based on the hospital’s performance treating heart attacks, congestive heart failure, coronary artery bypass surgery, and cardiac catheterization procedures. “He is a great doctor,” says Larson. “The
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first time I met him was a month after the accident when I was in rehab. I wanted to thank him for saving my life.” Lyons spent a great deal of time answering his questions. “He took me to his office and showed me the CAT scans and the x-rays and walked us all through it (the procedure). He’s just a great man.” Larson wishes every hospital carried the lifesaving graft. “It would be great if they would all have them.” Both Larson and his wife, Wanda, credit God for their recovery. “It’s a miracle that the Lord spared his life. I’m so thankful for Dr. Lyons.” Wanda also sustained serious injuries in the crash. “I had ten broken ribs, a punctured lung, a compound fracture of my arm and a broken elbow and wrist.” She suffered facial fractures to her eyes, cheek bones and jaw. “It was a month before I saw my husband.” She explained the couple was finally reunited during their rehabilitation. “We were both in rooms on the fifth floor of North Colorado Medical Center.” Larson calls his wife, “My inspiration.” Their granddaughters escaped serious injury even though they were ejected from the vehicle during the accident. “The real miracle part of this story is that my granddaughters were not hurt. They’re age 9 and 15. As the older one was sliding down the road, the younger one landed in her lap!” The teen suffered what Larson described as minor injuries and “road rash.” She was hospitalized overnight. Wanda remembers Lyons on a daily basis. “I’m forever thankful to Dr. Lyons. I thank God every day for his skill and pray that he will be able to save the lives of many others.” Alice Ashmore is a Loveland-based freelance writer and a regular contributor to Style.
Lydia’s STYLE Magazine
At the Cardiovascular Institute of North Colorado, we have the power to change the course of your life. In fact, we're ranked in the top I% in the nation by Total Benchmark Solutions for heart attack care. Our highly specialized teams use world-class technology, like our 64slice CT scanner, to provide the clearest possible picture of your overall heart health. In addition, our Cardiac Alert Program, recognized regionally for health care excellence, offers quicker care for emergency heart situations due to outstanding coordination between paramedics, cardiologists and the ER. All of this means there's no reason to go anywhere else for leading heart care.
North Colorado Medical Center. Your place for powerful medicine.
Banner Health
North Colorado Medical Center 1801 16th Street • Greeley (970) 3 52-4121 Job opportunities: www.BannerHealth.com or 866-377-5627 (EOE/AA) Banner Health is the leading nonprofit health care provider in northern Colorado.
I choose digital mammography because I want to be sure. Our Breast Center at Summit View Medical Commons is the first health care provider in northern Colorado to offer the latest in breast health technology - full-field digital mammography. With this state-of-the-art innovation, you can now benefit from less radiation exposure, shorter exam times and enhanced image clarity resulting in up to 28% more breast cancer being detected. Early detection is the best way to protect yourself from breast cancer. The American Cancer Society recommends an annual mammogram for every woman 40 and over. Feel confident about your breast health. Schedule your annual mammogram by calling 970-350-6082. Self referrals are welcome.
Appointment: 970-350-6082
Banner Health
North Colorado Medical Center
Summit View Medical Commons 2001 70th Avenue • Greeley www.BannerHealth.com Keyword: NCMC
Breast Center
North Colorado Medical Center is a Spirit of Women hospital. Banner Health is the leading provider of nonprofit health care in northern Colorado.
ncmc
breast cancer treatment
William Casey, MD is a radiation oncologist.
While nothing can lighten the blow of a breast cancer diagnosis, there is some comfort in knowing that new techniques are helping make life during treatment a little easier. Offering an alternative approach to treatment, the MammoSite Radiation Therapy System focuses directly on the affected site and reduces treatment time, explains William Casey, MD, radiation oncologist at North Colorado Medical Center (NCMC).
MammoSite radiation
alternative breast cancer treatment
by Alice Ashmore
“At the time of the lumpectomy, a single catheter with a balloon at the end is placed in the space created when the tumor is removed,” he says. (See Figure 1) “A channel runs through the center of the catheter and the radioactive source is sent down the catheter. The source sits in the center of the balloon for several minutes. So you are basically treating the cavity that was created by the lumpectomy and treating the surrounding tissue.” (See Figure 2) Because the MammoSite therapy works from the inside, a higher daily dose can be used over a shorter period of time – five days
versus the standard procedure that runs six to seven weeks. “The treatment is given as an outpatient, twice a day, six hours apart for five days. On the last day, the catheter is removed. (See Figure 3) It shortens the time the patient has to commit and limits the area that is treated with radiation,” he says. The MammoSite Radiation Therapy System received Food and Drug Administration (FDA) approval in 2002. A study started in 2002 by the MammoSite device’s manufacturer, Cytyc Surgical Products, and taken over by the American Society of Breast Surgeons in 2003, involved 1500 women. The partici-
Loveland Greeley Medical Magazine & Directory 2008
Figure 1
Figure 2
Figure 3
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pants received partial-breast irradiation with the device and returned for follow-up evaluations at 6 months, 1 year, 1.5 years, 2 years and every year after that. The study showed that only eleven out of 1449 women (0.8%) developed a recurrence in the breast that was treated. Five (0.4%) had the cancer return in their lymph nodes. The results were similar to those for women on other studies who had whole-breast irradiation therapy after breast-conserving surgery. The results, however, were reported after a short followup period and researchers caution that a
The big question is the longterm outcome: is MammoSite better than conventional treatment? ... While we know that the cosmetic result is excellent and the recurrence rate is excellent, we need to follow it for another five years before we can say it is the standard of care. William Casey, MD
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much longer follow-up time is needed to make a reasonable comparison. But the procedure is becoming more popular. According to Cytyc Surgical Products’ data, over 32,000 women have been treated since the FDA approval. Casey agrees that it has become a trend. “About 20 years ago, there were studies that indicated that women did not have to lose their whole breast in order to treat breast cancer. The studies showed that you could remove just the tumor and the tissue around the tumor and then follow that with six to seven weeks of radiation to the whole breast. But about 40% of women are still having mastectomies because they don’t have the time to commit to six or so weeks of radiation.” Researchers began to look at ways of shortening the treatment. “They also wanted to limit the side effects by limiting treatment to the cavity created by the surgery,” Casey says. “Historically, this was done using several catheters that would be placed in the breast across the lumpectomy site. Then radioactive sources were sent down the catheters.” The treatment proved effective, he says. “Those studies showed that the incidence of recurrence was quite small and the procedure was comparable to treating the whole breast. But it was difficult and time consuming for both patient and physician to lay the multiple catheters in the breast across the cavity.” About that time Cytyc (then known as Proxima) came out with a special catheter that could be used singly and dubbed it the MammoSite system. “It’s now used all over the country and there’s more literature out showing it to be effective. There’s currently a national study comparing it to conventional treatment and there’s been so much interest that the accrual goals (number of participants) were reached very early. The big question is the long-term outcome: is it better than conventional treatment? We have historical studies by single institutions that run over ten years showing good results with multiple catheters. But we only have five years on MammoSite. While we know that the cosmetic result is excellent and the recurrence rate is excellent, we need to follow it for another five years before we can say it is the standard of care.” An ongoing study through the National Cancer Institute, offers that means of followup and Casey provides patients information about the study and can enroll patients in the study at NCMC. “We prefer patients to enroll in the study but they must meet the criteria, which includes characteristics of the tumor, and whether or not it has spread to the lymph nodes. “They’ve accumulated so many patients so far that they’ve narrowed
down the patients they are willing to accept. Patients that have early stage diagnosis and a good prognosis are no longer being enrolled in the study.” Those patients, however, can still opt for the MammoSite treatment if they have a unifocul tumor, if it’s smaller than 3 centimeters and hasn’t spread to the lymph nodes, he says. Melva Jean Shults, a resident of Brush, Colorado, was diagnosed with a Stage I breast cancer, which made her eligible for MammoSite radiation therapy. “When they presented it to me, they said I could go the regular route which would take several weeks or months, or I could do this in one week. Since we live so far away, travel was a problem. She made her choice. “We were able to rent an apartment for my husband, myself and my daughter from Oklahoma so the three of us could stay in it while I was having treatment. I went twice a day for five days and each treatment lasted around 2 hours.” The treatment started with a CT scan. “They had to make sure everything was in place. The actual radiation only lasted 8 minutes.” Shults says she didn’t experience any side effects. “The only thing is it’s tiring to go in for two hours at a time and twice a day but we just took it in stride. And they are such a wonderful group of people. Dr. Casey and the whole bunch were just great. If it wasn’t for the seriousness of the situation, it was almost fun working with them because they treated me so nice.” The results are excellent, she says. “I’m done and I’m cancer free. All of my hormone tests came back cancer free and there wasn’t any in my lymph nodes.” She is pleased and relieved and has a request. “Please send this message from me. “Women, please go have your mammogram done. I had cancelled one and I just didn’t go back for 5 years. So when I finally went, I was lucky they found it at stage I. It could have been much worse.” “So all I can say is that everybody needs to be so careful and on top of their checkups.”
Kay Rios is a freelance writer based in Fort Collins. She is currently a doctoral candidate in Educational Leadership at Colorado State University.
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We take Greeley hearts seriously.
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ncmc
CAir rehabilitation
Kathleen Talkington RN, CRRN and Jenna Swarbrick, RN BSN, patient care services manager, consult at the 5th floor charge station.
CAIR:
the path to recovery by Jason Webb
What would you do? If you or one of your loved ones were involved in an accident, do you know where you would turn for help? What if that person became a paraplegic? How would you get your life back on track and learn to be self-sufficient again? 58
Sure, it’s a grim thought, but an excellent local resource does exist: the Center for Acute Inpatient Rehabilitation, or CAIR. The CAIR Unit is a 20-bed rehabilitation hospital found on the fifth floor of North Colorado Medical Center. Started in 1984, the CAIR Unit was founded to help patients needing intensive rehabilitation because of debilitating conditions such as burns, strokes, brain injuries, spinal cord injuries, and other traumas. The patients admitted to CAIR are classified as “medically complex.” These are the people that are unstable or may even need to see a doctor every day. Patients are admitted to CAIR so they can learn to live life in a wheelchair, on crutches, or to learn to walk or speak again. Kathy Van Soest, RN, MSN, APRN, has been the Patient Care Services Director of the CAIR Unit for the last four years. “A big plus is a hospital surrounds us. If a patient needs an MRI, an exotic test, or to see a doctor, it’s all right there,” says Van Soest. The CAIR Unit is the only one of its kind in the region. Other facilities are not as close to hospitals, so when a patient needs an exam, they have to be transported by ambulance to a hospital. The CAIR Unit sees people of many ages, and can care for pediatric patients although it’s not specifically designed to handle them long-term. To be admitted to CAIR, patients must meet all the criteria for in-patient care. Sometimes, a patient may have a wound still draining or sutures still in place. Those with injuries to the brain often need to be taught to walk or talk again. In fact, “over half of our patients have had strokes or brain injuries,” says Van Soest. The traumatic brain injury patients are treated by CAIR Unit’s Medical Director, Nancy Cutter, MD, PT. Twenty-three nurses, a case manager, and a cadre of physical therapists make up the rest of the CAIR Unit staff. They all have the goal of helping patients improve enough that they can go home and live their lives on their own. “We have to be able to see what the patient can do on their own,” says Jenna Swarbrick, RN, BSN, who is the Patient Care Services Manager. She’s been with CAIR for five years. The CAIR Unit is there to provide intensive physical therapy, which amounts to a total of three hours a day. While it may seem intimidating for someone who has just had a severe injury, the therapy is broken up into five or six small sessions throughout the day. “The 24-hour nursing staff is very busy,” says Swarbrick. “We have a very committed team, and we try to keep the patients giggling through a very tough time.”
Lydia’s STYLE Magazine
The staff very closely monitors what the person can do to take care of him or herself, so arrangements can be made to supply the patient with necessary materials to help them when they are home. However, the focus isn’t only on the physical rehabilitation, but also on the psychosocial rehabilitation. “Our team does a good job of showing patients the beauty on the inside,” says Swarbrick. It can be a tough, demanding job for the CAIR Unit staff with so many traumatic injuries, but they still find the work quite rewarding. “The reward is seeing the patient leave a lot healthier and able to view life differently,” says Swarbrick. To get to the point where they can go home, however, the patients must overcome a mountain of work. Swarbrick states that the relationship with the patient helps make the difference in how well the patient does. “And, the family is always very involved,” adds Van Soest. Not only is there the family and the staff helping the patient, but many of the past patients come back to volunteer within the program. These volunteers come to share stories of their success; they come to show the patients that, despite how they feel at the moment, it will be worth it when they graduate from the CAIR Unit. Graduation is something the staff, volunteers, and patients all look forward to. When a patient is discharged from CAIR, Van Soest says patients are given a t-shirt and a certificate announcing their accomplishment. “It’s about where they’re going and how they got there,” says Van Soest. Each September, the CAIR Unit staff hosts a picnic where past patients can come back and see some of the staff and other patients who helped them recover. They get together because of a special connection the staff and the patients build through the treatment. “The patients help each other by talking to each other,” says Van Soest. The CAIR unit is about recovery. It’s about helping people “optimize their level of life,” as Van Soest describes it. With a traumatic injury or debilitating disease, the patient is going to need the best care, and with the CAIR Unit, they have it. Because so few people know it is here, Van Soest says, “It’s the best kept secret in Greeley.” In the event that the unspeakable happens to someone you know, keep in mind there is a very good resource available to help them get on with their lives. Trained, caring professionals wait to lead them down the path to recovery. Says Swarbrick, “The CAIR Unit is a great place to get well.” Jason Webb is a freelance writer who lives in Johnstown. Loveland Greeley Medical Magazine & Directory 2008
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ncmc
spine surgery John Viola, MD, neurosurgeon at Front Range Center for Brain & Spine Surgery, P.C.
P
Cervical Disc Replacement prosthesis
cervical disk replacement
at North Colorado Medical Center by Corey Radman
There is neck pain, and then there is chronic neck pain. The first might have you popping a couple of Advil or begging neck rubs from loved ones; the latter has you at your wit’s end, seeking something, anything (perhaps explosive in nature) to relieve the throbbing. 60
According to the journal Spine, approximately five percent of adults will be significantly disabled by neck pain in a given year. Further studies showed that after age 40, almost 60 percent of the population shows some radiographic evidence of cervical spine degeneration. By age 65, 95 percent of men and 70 percent of women will have some sort of degenerative change on x-ray. While most people have little or no pain related to the degeneration, some must seek medical intervention. Gerald Bradley understands living with pain. A cervical disc in his neck ruptured and he lived and worked with it for four months. “I just woke up one morning, felt like my left arm was asleep, and it never woke up again.” He couldn’t attribute the ache to anything specific. “There was no trauma. I never had a neck injury or broken collar bone. It just started hurting.” That pain prohibited Bradley from working his business to the fullest. He owns a landscaping and hardscape company, All-Pro Lawns and Hardscapes, LLC, where he depends on his strength and mobility. He says he was taking pain medication, “as needed instead of as directed,” and was so weary of the simplest things being so hard - like having to turn his whole body around to answer a question. He missed everyday things, “I wanted to be able to reach down and swing up my boys or pick up my 60 lb girl.” Picking them up had become excruciatingly painful and no fun for anyone. The long-term pain made him irritable and impatient. He says, “When you’re in pain, nobody really understands. They’d ask, ‘Is there anything I can do for you?’ and I would just snap, ‘Not unless you’re a back surgeon – no!’” At 36 years old, Bradley could see Lydia’s STYLE Magazine
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Our spine surgeries are documented as lowest in the region for: • complication rate • infection rate • length of stay • time under anesthesia • cost Together we have over 75 years of neurosurgical spine experience and more combined continuing education yearly than any other spine practice in our region. New patients and referrals are welcome.
Donn M Turner, M.D. • Timothy C. Wirt, M.D. Hans C. Coester, M.D. • John J. Viola, M.D.
Ft. Collins: 1313 Riverside Ave. • (970) 493-1292 Greeley: 2001 70th Ave. • (970) 356-4488 Loveland: 2500 Rocky Mountain Ave. Ste. 360 • (970) 669-0470 (800) 458-0306 • www.brain-spine.com
that it would be a long road if he didn’t do something. Then, a sharp increase in the pain on his left side sent him to the ER one night with thoughts of a heart attack. The ER doctor and his family doctor led him to Front Range Center for Brain and Spine Surgery (FRBS) where an MRI confirmed that Bradley had a ruptured cervical disc. Hans Coester, MD, the treating neurosurgeon at FRBS, suggested a few options for treatment, but recommended that the best choice for full recovery was a new procedure called Cervical Disc Replacement. In essence, they would remove the rup-
tured or misshapen disc, thereby relieving the pressure on the nerves, which were the source of Bradley’s numbness and pain. Once the impinging disc was gone, the surgeon would insert a prosthetic disc made from chromalloy stainless steel. Currently the only FDA approved disc is manufactured by Medtronic and is marketed as the PRESTIGE® Cervical Disc. Its ball-andtrough design duplicates the natural alignment of the neck. Coester explains in laymen’s terms, “We make a two inch incision on the front of his neck. Then we gently mobilize all soft tissues away from the anterior spine, remove
disc and bone spurs impinging on nerves, and decompress the spinal canal.” Neurosurgeon John Viola, MD, one of Coester’s partners at FRBS, continues the explanation. “We remove the disc with small instruments to bite away residual tissue – it’s really like sterile carpentry. Then we place the disc, implanting it with x-ray guidance. We finish with fixation screws that screw into the vertebral bodies above and below the new disc.” Coester adds that the engineers say the screws are biomechanically unnecessary, meaning that the prosthetic disc would actually remain in place and move properly without the screws. It appears to be an excellent replacement for a human cervical disc. In previous years, the standard of care was to remove a bad disc and fuse the two adjoining vertebrae together in a procedure called Anterior Cervical Discectomy and Fusion. Using a metal plate and screws, the vertebrae were butted against each other, where they would eventually grow together. This created stability and relieved the pressure on the spinal nerves. However, fusions come with a few risks that include limited motion and especially additional stress on the adjacent cervical joints, which can cause more ruptured disks in the neck. One-third of patients with fusions will require addi-
Hans Coester, MD, neurosurgeon at Front Range Center for Brain & Spine Surgery, P.C.
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Lydia’s STYLE Magazine
tional surgery within ten years, according to Coester. This is what happened to Richard Wiest, who had his first spinal fusion in 1996, and his second in 2000, performed by Viola. His third (and final, he thinks) neck surgery was just weeks ago. This time around, he had Dr. Viola do a disc replacement. Wiest says, “It went well – I could immediately feel a difference in the pain.” His recent surgery was precipitated by severe migraines, which, so far, have not recurred. Both patients interviewed for this story recounted their amazement at being able to move more naturally almost immediately after surgery. Bradley was happy to regain feeling in his hand the same day and he was discharged one day after surgery. Interviewed for this story nine days after surgery, he was shoveling snow. (Shhhhh… don’t tell his doctors.) Viola notes, “The FDA has shown that fusions have been the gold standard for years. This (Cervical Disc Replacement) has better patient outcomes, less post-operative pain, and seemed even a little bit better. For a lot of cases this will replace Anterior Cervical Discectomy and Fusion.” Some patients with spine stability problems like osteoporosis will not be candidates, but “for patients with normal spinal alignment this will become the standard of care.” The neurosurgeons from FRBS count the benefits of disc replacement. “The device is essentially stable when you put it in. Before, patients had to wear a brace for up to 6-12 weeks.” According to the PRESTIGE study, patients return to work 26 percent faster than fusion patients. Viola reports that the lower levels of post-operative pain seem to be due to the smaller opening made between patients’ vertebrae as he prepares the spines to receive the discs. Disc problems in your neck are often diagnosed as Degenerative Disc Disease (DDD). Symptoms include: numbness or tingling radiating down the arm continuing into the hand, weakness in the upper arm (deltoid or bicep muscle), or weakness in the hand grip. Most of the time disc disease can be controlled non-surgically through medication and physical therapy. However, it’s a comfort to know that should the need arise, Northern Colorado has gifted neurosurgeons who have had multiple successful disc replacement surgeries at North Colorado Medical Center (NCMC) and other area hospitals. Patient Wiest (who is a respiratory therapist at NCMC) reports, “The staff and surgical experience at NCMC was outstanding. They were on top of it all the way through.” Wiest is now enjoying taking his dog, Sophie, for long walks and planning summer hiking in Rocky Mountain National Park
with his family. Bradley, as noted, is already back to work and counting the days until he can pick his kiddos up and toss them in the air. And that is exactly what their neurosurgeons from Front Range Center for Brain and Spine Surgery would want for them. Viola adds, “We try to provide the same comprehensive care of the spine that we would make available to our own families. It’s the way we would want to be treated.”
X-ray of a Post operative Cervical Disc Replacement
Loveland Greeley Medical Magazine & Directory 2008
Corey Radman is the Editor at Style Magazine.
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mckee
relationship based nursing
relationship based care:
Mary Griffin, RN, oncology clinical nurse specialist, cares for a patient.
the secret to success I remember it as if it were yesterday. The day I knew my sister could die. Might die. How could I live without my best friend? And what would I tell the children? As I maneuvered the sharp curves on the small country road that skirted the perimeter of Boyd Lake, I thought about the words that had summoned me out at 2 AM. “Lynn, this is Paul, your sister’s nurse. We’ve transferred her to ICU. You should come right away.” She was septic and her blood pressure was dangerously low. If they couldn’t bring it up... Earlier that day, I knew it might happen. The doctor had discussed the possibility that my sister’s condition could get worse. But Paul had assured me that I could go home and rest. He would take care of her.
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He would call me if anything changed. He promised. I had trusted him, and Paul had kept his word. Even though it was after the shift change, Paul had called. He made sure that I knew. He cared. That thought comforted me as I made my way through the dark to the hospital. That trust and my relationship with Paul and the other nurses and staff members who worked to keep my sister alive, and then helped her regain her strength, epitomizes one of the key components of Relationship Based Care, a new nursing model at work at McKee, a Banner Health hospital in Loveland. “It’s a way of delivering healthcare that focuses on three primary relationships-the
by Lynn M. Dean
relationship with self, the relationship with colleagues, and the relationship with patients and their families,” explains Mary Griffin, RN, an Oncology Clinical Nurse Specialist at McKee. “Many people wonder why we don’t state family first. But if you don’t have a good idea who you are as an individual, if you don’t have a good understanding of how that melds with all of your colleagues and how you act as a team, then you can’t have good relationships with patients and families. In healthcare, very little is done on a one-to-one basis. It’s about all of the people who interact with patients.” “The clinical training that professional hospital chaplains receive is exactly what would dovetail hand in glove with Relationship Based Care,” says McKee Chaplain Bruce Rippe who’s been in hospital minis-
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Loveland Greeley Medical Magazine & Directory 2008
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try for 28 years and at McKee for ten. “In that larger realm of care, when we come into that place of relationship with patients, we no longer see them as a body in a bed. We see them as they embody the fullness of their being - physically, mentally, spiritually – and their story comes alive. Our story intersects with their story to create a healing process that is way beyond our understanding.” “Relationship Based Care is not only about relationships, it’s about how good communication, healthy teamwork and the impact on patient safety. These skills
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enhance patient handoff and the ability to communicate effectively with other caregivers regarding patient needs” states Griffin. “We deliver better care when we know the patients and family because we know what is important to them during their hospital stay as well as their clinical needs. When you care about your team, you help each other in ways that have the potential to decrease patient harm. You are trusting and comfortable enough with your colleagues to ask that second or third question.” Although the model is new to McKee, the concept behind the model is not.
“This work is actually based on nursing practice and theory,” says Griffin. “Much of the caring science has come out of the nursing discipline and Dr. Jean Watson who is a nurse theorist at the University of Colorado.” “Relationship Based Care really ties our priorities together as we focus on patients and families, as well as our employees,” adds Pat Village, RN, Director of Surgical Oncology and Orthopedics. “We clearly recognize that to be able to provide quality, effective, and safe healthcare, we have to have quality relationships between our patients and our staff.” “Relationship Based Care forms the infrastructure to sustain the work of culture transformation that has been going on at McKee for a number of years. It is a whole concept - a way of being,” adds Village. “It streamlines processes and enhances communications.” “It provides the infrastructure that will help to maintain a healthy environment at McKee,” adds Brian Quale, Director of Rehabilitation Services. “This is probably the most important work I’ve seen in our hospital, and our community. “ says Village who has worked at McKee for more than 30 years. “It’s not one discipline- it’s the entire hospital. Everyone is involved- touched in one way or another.” Village’s colleagues credit her with bringing the caring model to McKee and doing much of the groundwork to make the facility-wide initiative a reality. “My work with implementing a caring model in healthcare has been ongoing for about five years,” say Village who downplays her role. “It started with a Banner Health Imagine Grant. I had funds that were made available to provide training for the staff. We did a model unit in the hospital implementing a caring model. The outcomes were very successful.” That work eventually led to the Relationship Based Care model, which is being implemented hospital-wide in three phases. McKee is currently in phase two. “We started Relationship Based Care work in the first quarter of 2007,” says Griffin. “In all healthcare arenas, there are pockets of Relationship Based Care. Pat Village’s two nursing units have been involved with this work the longest.” Staff training includes Reigniting the Spirit of Caring. “It is a three day inspirational seminar that explores the three relationships - self, colleagues, and patients and their families,” explains Griffin who co-facilitates the seminar. “We have offered it five times in 2007.” “Part of the process is to have staff extensively look at themselves,” says Quale. “It’s a very emotional and introspective proLydia’s STYLE Magazine
It’s a way of delivering healthcare that focuses on three primary relationshipsthe relationship with self, the relationship with colleagues, and the relationship with patients and their families. Brian Quale, Director of Rehabilitation Services and Mary Griffin, RN, Oncology Clinical Nurse Specialist
gram. You really have to look at yourself, the reason you are in healthcare, your communication style and ability to care for self and others. You build your own action plan from that.” “You can see the change in the way employees regard and interact with one another after attending this seminar,” says Village. “We have a common purpose to provide the very best care and everyone in the hospital can relate to that,” explains Quale. “That makes collaboration possible and creates healthy relationships with colleagues.” Another aspect of the seminar is patient and family testimonials. “We have patients come in and talk about their experiencewhat they liked and didn’t like,” says Quale. “It’s a very important tool to make staff aware. A lot of the time it’s the little things you wouldn’t imagine they’d even notice.” “Interviews with patients, families and staff are powerful because staff realize the importance of every interaction and the impact on others. Staff can truly appreciate the fact that patients are very vulnerable when
entering the hospital environment,” adds Village. “ Patients need not only expert clinical care, they need our support emotionally, physically and spiritually. Healing is enhanced when our patient’s environments are calming and staff have caring relationships with patients and families.” “Technology is a hot-topic in healthcare,” adds Quale who reminds us that machines make up all that technology. “Machines don’t hear patient’s problems, concerns and needs. It’s the caregivers with a patient 24 hours a day who are there to offer the support patients and families need, who physically address those issues.” A final aspect of Relationship Based Care at McKee is moving to a Primary Nursing model where each patient is assigned a primary nurse who is responsible for the coordination and development of a plan of care throughout the patient’s stay in the hospital. “The nurse’s role is not only that of coordination of medical care,” says Griffin. “But it’s also about knowing and communicating a patient’s special needs as an individual. “With Primary Nursing you have continuity
of caregivers,” adds Village. “What’s unique at McKee is that we have extended this concept to therapists as well.” “That’s the biggest piece in streamlining communications,” explains Quale. “All the care team know who to contact for specific information regarding a patient’s care. The Relationship Based Care model seems to be working. “Our Gallup scores show us as being ‘world class’ for employee engagement and our patient satisfaction scores are in the top ten percent,” says Village. “This work is instrumental in helping us sustain that level of care.” “Other Banner facilities are asking, ‘What is happening at McKee?’” says Village who credits the administration’s support with making Relationship Based Care at McKee a reality. “My hope is that other facilities will see the value in this. Not just Banner facilities, but other hospitals throughout the nation.” Lynn M. Dean is a freelance writer living in Northern Colorado.
Our Gallup scores show us as being ‘world class’ for employee engagement and our patient satisfaction scores are in the top ten percent. Pat Village, RN, Director of Surgical Oncology and Orthopedics
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prevention
Joan Strauch, RN, CIC, McKee Medical Center’s Infection Control Practitioner demonstrates thorough hand washing.
In 1847, an AustrianHungarian obstetrician named Ignaz Semmelweis made a crucial discovery for the medical field. He found that as he assisted in a delivery, women had a much greater chance of surviving childbirth if he used chlorinated lime to wash his hands. His breakthrough came before the theory of germ-based diseases.
wait, did you wash
your hands? by Jason Webb
Even though Semmelweis published papers showing the link between proper hygiene and mortality rates, few believed his findings. He eventually went mad trying to tell the world to wash their hands to avoid often fatal infections. Fast forward to today, and medical professionals are still telling people to wash their hands. Every now and then, a story surfaces about a disease. Invariably, the message associated with that story is the same: wash your hands. And, that is clearly the case with methicillin resistant Staph aureus (MRSA). Medical professionals have known about MRSA since the early 1950s, but the recent
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interest was renewed when the October 2007 Journal of the American Medical Association ran an editorial discussing the rates of fatal invasive infections. At some point afterward, MRSA picked up the nickname “super bug” because of its resistance to some antibiotics. “It’s actually a misnomer,” says North Colorado Medical Center’s Infectious Disease Specialist, Jack Breen, MD. “It’s not the ‘super bug.’ Like all organisms, it has to be respected and treated accordingly.” Breen notes that just because MRSA is resistant to penicillin-based antibiotics, there are a host of other antibiotics that can treat
it. The important part, however, is identifying whether the Staph infection is indeed MRSA. “A culture can tell if it is MRSA, but it depends on how the doctor and patient interact,” says Breen, suggesting that patientdoctor communication is crucial to the patient’s care. Most importantly, Breen believes the best way to stop infections is through prevention. That prevention goes back to Semmelweis’ early findings: Hand washing can stop infections. Breen says, “The CDC has recognized that new soaps are effective against MRSA. Lydia’s STYLE Magazine
Washing your hands should include your wrists and the tips of your fingers. In fact, most soaps are effective.” On a visit to NCMC or McKee Medical Center, one will undoubtedly notice the alcohol-based hand sanitizers outside of patient rooms. They act as a subtle reminder to patients, visitors, and the medical professionals to wash their hands before entering a patient’s room. McKee Medical Center’s infection control practioner, Joan Strauch, RN, CIC, says, “Infection control is changing to be infection prevention and control.” As part of that campaign for prevention, hospitals are becoming more open to patient requests to see that the medical professional has washed his or her hands. “Doctors, nurses, and other healthcare workers should give the patient the opportunity to ask if they’ve washed their hands,” says Strauch. It isn’t as simple as just washing hands; in fact, there is a recommended technique. Both Breen and Strauch advise washing for 15 to 20 seconds with warm water and soap. If one sings the alphabet song or two verses of “Happy Birthday” as he or she washes, enough time will pass to effectively wash. It’s also important to be thorough about washing. “Washing your hands should include your wrists and the tips of your fingers,” says Strauch. “I also remind people of F.R.O.G., which means ‘Friction Rubs Off Germs.’” For people set to have surgery, Strauch eases concerns with the following recommendations: “Talk to your physician; ask about his or her rate of infection for this type of surgery.” Patients also can go online to check rates of infection for physicians and specific surgeries. There they can learn what they can do as an informed patient, to help decrease the chance for infection. Infections, however, don’t just come from inside the hospital. Many can be carried in from the outside. MRSA, in fact, can be carried by healthy people, and Breen says there is no effective treatment for carrier status. “MRSA is not just a hospital infection,” says Breen. “Approximately half of the cases come from outside of the hospital.” So, many hospitals are beginning to of-
fer a pre-surgical cleaning kit, complete with instructions and cleansers. “Those kits really help decrease the number of bacteria and infections,” says Strauch. In many cases, though, it can be an uphill battle to thoroughly kill bacteria. For example, automatic sinks in many public restrooms only run water for two and a half seconds. It’s not enough time to kill bacteria. “When you’re out in your community, don’t touch your eyes, nose, or mouth,” says Strauch, “because that is one way diseases are spread.” Strauch also recommends carrying a small bottle of alcohol-based hand sanitizer when going out to eat, because you can easily transfer bacteria off of tables, door handles, and a host of several other things. In most cases, people get sick from touching something handled by someone already sick. Sometimes, it’s inevitable that a person gets sick. A nasty cough, a runny nose, and other ailments make it hard to think about preventing the spread of germs, but with diligence, it can be mastered. Something else to think about is how often you see someone cover their mouth with their hands when he or she coughs. When that person touches something, the germs are passed from him or her to the next person to touch that thing. If the second person touches his or her mouth, that person most likely will end up sick. If you are sick, Strauch has some very important advice: “Cough into your elbow or into your clothes instead of your hands,” says Strauch. If you really want to avoid getting sick, Strauch recommends following some simple guidelines. “Eat right, drink lots of fluids, and exercise – that contributes to being healthy and stopping infections,” says Strauch. And, the final piece of advice both Breen and Strauch have to offer is the same thing Semmelweis said more than 150 years ago: Wash your hands. Jason Webb is a freelance writer who calls Johnstown home.
Loveland Greeley Medical Magazine & Directory 2008
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Experienced cardiac care that keeps you healthy Experienced cardiac care that keeps you healthy Experienced cardiac care that keeps you healthy so you can follow your heart. so can your heart. Experienced cardiac care that keeps you healthy so you you can follow follow your heart. so you can follow your heart.
McKee Medical Center keeps your life in rhythm with state-of-the-art diagnostic and McKee Medical Center keeps your life in rhythm with state-of-the-art diagnostic and interventional heart procedures, as well as in cardiac rehab services to get yourdiagnostic heart back in McKee Medical Center keeps your life rhythm with state-of-the-art and interventional heart procedures, as well as cardiac rehab services to get your heart back in shape. When you need more advanced care, you can take comfort in knowing that McKee interventional heart procedures, as well as in cardiac rehab services toinget yourdiagnostic heart in shape. When you need more advanced care, you can take comfort knowing that back McKee McKee Medical Center keeps your life rhythm with state-of-the-art and Medical Center is part of Banner Health, giving you access to an extraordinary network of shape. When you need advanced youyou can takeservices comfort knowing that McKee Medical Center is part ofmore Banner Health, giving access to an extraordinary network of interventional heart procedures, well care, as cardiac rehab toinget your back in cardiac physicians experienced inas providing comprehensive care for even theheart most serious Medical Center is part of Banner Health, giving you access to an extraordinary network of cardiac physicians experienced in providing comprehensive care forineven the most serious shape. When you need more advanced care, you can take comfort knowing that McKee heart conditions. McKee Medical Center andcomprehensive Banner Health.care Keeping youthe healthy so you cardiac physicians experienced providing for even most serious heart conditions. McKee Center and Banner Health. you healthy so you Medical Center isheart. part of Medical BannerinHealth, giving you access to Keeping an extraordinary network of can follow your heart conditions. McKee Medical andcomprehensive Banner Health.care Keeping youthe healthy so you can follow your heart. cardiac physicians experienced in Center providing for even most serious can follow your heart. heart conditions. McKee Medical Center and Banner Health. Keeping you healthy so you can follow your heart. Banner Health facilities include: Banner Health facilities include: BannerColorado Health facilities North Medicalinclude: Center North Colorado Medical Center Banner Health facilities North Colorado Medical Center McKee Medical Center Sterlinginclude: Regional MedCenter McKee Medical Center Sterling Regional MedCenter McKee Medical Center Sterling Regional MedCenter East Morgan County Hospital North Colorado Medical Center East Morgan County Hospital Morgan County Hospital McKee MedicalEast Center Sterling Regional MedCenter
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For more information, visit www.BannerHealth.com or call 800-505-6877. information, visit www.BannerHealth.com or call 800-505-6877. For For job more opportunities, visit www.BannerHealth.com or call 866-377-JOBS (5627). East Morgan County Hospital For For job more opportunities, visitvisit www.BannerHealth.com or call 866-377-JOBS (5627). information, www.BannerHealth.com or call 800-505-6877. Banner Health is the leading provider of not-for-profi t health care in northern Colorado. For jobHealth opportunities, visitprovider www.BannerHealth.com or call 866-377-JOBS (5627). Banner is the leading of not-for-profit health care in northern Colorado. For more information, visit www.BannerHealth.com or call 800-505-6877. Banner Health is the leading provider of not-for-profit health care in northern Colorado. For job opportunities, visit www.BannerHealth.com or call 866-377-JOBS (5627). Banner Health is the leading provider of not-for-profit health care in northern Colorado.
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wellness
vision
Ronald Mearsha, OD, helps adjust a new pair of glasses for Dianna Aguirre, 5, of Greeley.
pediatric vision care
what parent’s should know
by Julie Estlick
All seven of Marietta Van Gorp’s children began wearing glasses in grade school. The Greeley mom realized early on that it makes a huge difference in reading ability if a child gets corrective eye wear at a young age. It’s meant quite a few trips to the Colorado Vision Center over the years, but to her it’s worth it.
“I’ve found it’s a real advantage to have that small amount of correction for reading if your child needs it - they read much more fluently,” Van Gorp says. “That’s why we had all our kids’ eyes checked before first grade and started getting glasses for them if they needed any correction whatsoever. If the correction is small, some doctors will say they’re fine, but I can see a difference automatically if they are reading to me slowly with their glasses off and then put them on.” Ronald Mearsha, OD, owns Colorado Vision Center in Greeley and currently treats six of the Van Gorp clan, ranging in age from 8 to 23. Kristina, the youngest Van Gorp, started wearing reading glasses in first grade and will go to her backpack and grab them herself if her eyes get tired. Mearsha agrees that it’s important for children like Kristina to have a comprehensive exam before going into kindergarten. “Blurred vision is the biggest thing that brings patients in to our clinic,” Mearsha says. “If a child has difficulty with reading and learning, complains of headaches or has a hard time concentrating, you should get their eyes checked. That’s why we recommend that children have an exam before school starts to catch any conditions that could interfere with their learning.”
Examining the problem A comprehensive exam should include: checking visual acuity, or seeing short and long distances; ocular motility, or making sure all eye muscles work, and checking for eye align-
Loveland Greeley Medical Magazine & Directory 2008
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ment and crossed eyes; tracking to ensure that eyes can move and follow objects; depth perception; and color vision. An eye health assessment that consists of dilating the child’s pupils with drops and looking at every part of the eye structure should also be done. Parents may be surprised to learn that kids can get cataracts and congenital glaucoma, among other diseases. Checkups should be scheduled every one to two years after that. Even very young children who can’t yet talk will provide clues to vision problems, according to Jennifer Cecil, MD, the former chief of staff at McKee Medical Center
in Loveland. Cecil has her ophthalmology practice in Loveland and does surgery at McKee once a week. Things she tells parents to watch for are turning or tilting of the child’s head or objecting to having one eye covered, which could be signs of poor vision development in one eye, frequently referred to as “lazy eye.” Also, closing one eye when in sunlight could be an indication of “crossed eyes” referred to as strabismus. “If you notice any of these signs, you should have your child’s eyes checked immediately,” Cecil advises. While a short attention span can make it more challenging to examine young children, drops that relax the eyes make testing easier, Mearsha says. Props and certain noises that get kids to fixate on particular things are other tricks optometrists and ophthalmologists use to measure youngsters. For instance, he has fitted a patient as young as 6 months old with glasses. “For babies and toddlers, we fit them with strapon glasses,” Mearsha says. “The frames are rubber or plastic and they grip around the head so they stay on.”
Corrective Measures
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Glasses for school-aged children are available with cable temples that wrap around the ear and hold on so they don’t get knocked off easily on the playground. When picking out their glasses, it’s important to protect young eyes by choosing lenses that are impact-resistant, have a scratch coating and strong ultraviolet protection. “We often prescribe Polycarbonate lenses for kids which are impact-resistant, scratchresistant and have UV 400 protection which is essential in the intense Colorado sun,” Mearsha says.
Pre-teens: Glasses or Contacts? Inevitably, as kids get older they’ll ask to switch to contacts. After all, contacts are cosmetically pleasing and offer a more exact fit and better peripheral vision than glasses, among other benefits. Attitudes among eye specialists vary about the right age for fitting kids for contacts, but a recent study by a professor at Ohio State University found that children as young as 8 years old are able to learn how to use contact lenses correctly. First, a child needs to get a comprehensive exam to ensure they are a good candidate for contacts. Then the key is the child’s maturity level. “I generally like to start kids with contacts at 13 years of age because by then they are ready for the responsibility,” Cecil says. “It’s a dexterity issue, too. Contacts are a medical device and the patient needs to be able to put them in right. They should also comprehend that you can get an infection, scarring, and even permanent vi-
Lydia’s STYLE Magazine
Jennifer Cecil, MD examines Mikayla Gallegos, 11, of Loveland.
sion loss if you don’t use them correctly.” Both Mearsha and Cecil require that patients demonstrate they can take out contacts and reinsert them without help before they are allowed to leave the office wearing them. They also insist it’s essential that a parent trusts their child enough to properly care for their contacts, including not wearing them too long (12 hours maximum) and cleaning them often. There is no contact lens that is best for teens and pre-teens. Choosing hard or soft lenses depends on the shape of the cornea, the prescription, and your budget to determine what will work best, Cecil says. “Once you have the prescription, whether you select disposables or durable ones that last a year, they are all good contacts, so a lot depends on comfort and personal preference.” Remember that your child should always keep a backup pair of glasses in case their last contact gets ripped and for times when they just don’t feel like wearing contacts. In the end, eye health is as essential to a growing child as any other part of the body and should be monitored regularly.
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Julie Estlick is a freelance writer and copy editor living in Fort Collins.
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wellness
hospitalists
It is four o’clock on Friday afternoon of a holiday weekend. An elderly female, who has had a cold and cough, is now running a high fever, shaking with chills, and gasping with each breath. She cannot reach her doctor and so she is rushed to the emergency room of McKee Medical Center. The ER doctor makes the diagnosis: pneumonia. The woman must be admitted to the hospital. She is anxious and worried; where is her doctor and who will take care of her? Enter James Valin, MD, hospitalist and director of the Hospital Medicine program at McKee. With warmth and concern, Valin informs the woman that he will be overseeing her care while she is in the hospital. “I walk into that room, a stranger, with only about five minutes to gain the trust of the patient and their families. It’s so much more than just diagnosing the problem and formulating a treatment plan.” Valin puts the patient at ease, assures her that he will be in contact with her primary care physician, and that either he, or one of his three partners, will be in the hospital at all times. That is the primary goal of the hospitalist program: to have a doctor on site at all times. Unlike other medical specialties, such as oncology or cardiology, which are centered on a disease or an organ, hospital medicine is organized around a site of care. Hospitalists are inpatient experts who take the place of primary care physicians. They are on duty at the hospital around the clock. Because they closely watch patients, they
78
Hospitalists
James Valin, MD, Hospitalist and director of the Hospital Medicine Program at McKee, explains to a patient that he will be overseeing her care.
inpatient experts by Stephanie Eyster
are able to recognize and diagnose atypical disorders, anticipate problems, and respond rapidly to crises or changes in a patient’s condition. Valin says, “I am there the entire day when specialists are there, tests are being done, social workers are there, and families are visiting. If anything changes during the day - if the patient deteriorates, or if a test comes back abnormal and we need to act on it right away - I’m there to do it.” The term, hospitalist, was first used by Robert Wachter, MD, in an article written for the New England Journal of Medicine in 1998. At that time, the healthcare market was experiencing severe financial pressures, so the need for physicians with proficiency in the care of hospitalized patients developed. Cost was a big factor initially, but other important issues were patient safety and quality improvement. Because hospitalists are present twenty-four hours a day, they are able to note where the management of treatment runs smoothly and where it does not. They take leadership roles in care quality and patient safety initiatives, and most cite the improvement of care level as a main reason for pursuing the position.
Quality of care indicators go up in facilities that employ hospitalists, thus the program is escalating across the country. The concept is particularly important in areas where there is a shortage of beds. When patients are seen and treated three times a day, they can often go home earlier or be released to a lower level of care. Valin states, “The establishment of a hospitalist program also contributes to the recruitment of other physicians and staff such as nurses, social workers, and specialists because the hospital becomes a better, easier place to work.” Elizabeth Henneman, PhD and Clinical Nurse Specialist at UCLA writes: “Because the hospitalist is more involved in the day to day activities of a ward/floor, he or she would get to know the staff, developing an appreciation of their unique qualities and contributions to patient care. This would lead to the development of trust and respect for the other healthcare professionals. The hospitalist role, by its very nature, promotes the collaborative relationships necessary to positively affect patient and organizational outcomes.” Hospital medicine has become the most Lydia’s STYLE Magazine
sought after system nationally for all sizes of medical centers, and the number of hospitalists has skyrocketed from 500 ten years ago to 15,000 today, and will likely double by 2010. Like Valin, most hospitalists are internal medical specialists who have chosen to focus on the general medical care of hospitalized patients. They are up to date with what’s going on nationally, and in tune with all the latest guidelines and care standards. “The concept is a change from the past,” says Valin, “but it is the evolution of medicine - where it is going nationally. Just like emergency room doctors evolved into a specialty, hospitalists will do the same and be generally accepted.” When the hospitalist program began at McKee in January of 2007, there were reservations on the part of the primary care physicians. Even though Valin had practiced in Loveland for seven years and had met with all of his fellow professionals in the community to solicit their support for his newly created position, he found that only 50% agreed initially. The other half waited to see how it would go. “They wanted to test it out. They worried if their patients would accept it, if the hospitalist docs would ‘steal’ their patients, and if they would be kept informed of what went on.” Information and communication are critical to the success of the program. Valin and the three other hospitalists at McKee stay in contact with the family physicians by way of fax, with detailed notes. Patients are reassured that their regular doctor has been contacted, and they no longer have to hold their questions until he or she makes the rounds. Other staff members benefit greatly from the program because teamwork and communication in “shift handoffs” is greatly improved. Now, only one year later, 80% of the primary care physicians are on board because they see that the idea makes sense. Patient care is managed more efficiently and quickly, and the outpatient doctors no longer have to run to the hospital every morning and evening. They can concentrate on their office patients without being distracted by phone calls to the hospital. The hospital medicine program actually allows all doctors to have a more predictable lifestyle. They aren’t torn in so many directions and they have more time with their families. Valin says that he misses seeing his office patients for their routine checks but he takes heart in knowing that he can be involved in their care when they are really sick. “Seeing patients at their worst hour is challenging, exciting, and so rewarding. It feels good to take care of a person, have them get better, and see the real time results.” Stephanie Eyster is a freelance writer who lives in Fort Collins. Loveland Greeley Medical Magazine & Directory 2008
79
ophthalmology
custom lasik
Randall Smith, MD, is an Ophthalmologist with Eye Center of Northern Colorado.
Tori Holt has always enjoyed play-byplay broadcasting for the Colorado Eagles hockey team, but his job got a whole lot easier this season thanks to refractive eye surgery. The “Voice of the Eagles” underwent Custom LASIK surgery at the Eye Center of Northern Colorado earlier this year so he could finally see the ice without strong prescription glasses or contacts. “I’m very nearsighted and I wore contacts most of the time, but I couldn’t see the players’ numbers well so I would take them out and put on glasses at the start of a game,” says Holt. “We do a telecast on the Altitude Sports & Entertainment Network between periods so I would take the glasses off and put my contacts in while on camera, then switch back to the glasses for the next period. It was a pain in the butt!” Since the surgery, performed by ophthalmologist Randall Smith, MD, Holt has perfect 20/20 vision and no longer needs contacts or his old scratched eyeglasses. “Custom LASIK surgery made such a huge difference for me, I was stupid for not doing it earlier,” the 32-year-old Holt says. LASIK (Laser In-Situ Keratomileusis) is a surgical procedure that eliminates or reduces the need for glasses and contacts. A flap
80
refractive eye surgery
keeping an eye on the puck
by Julie Estlick
is made to expose the stromal bed of the cornea and a cool beam laser is used to reshape the corneal surface of the eye to correct nearsightedness (also called Myopia), farsightedness (Hyperopia) and/or astigmatism (blurry or distorted vision caused by an odd curving of the cornea). The flap is then closed. Custom or Wavefront LASIK is the current standard of care for refractive errors and provides a higher precision level than the old technology, according to Smith. The Eye Center of Northern Colorado offices in Fort Collins, Loveland, and Windsor, uses CustomVue LASIK, which tracks eye movement to precisely center the laser on the cornea with the VISX Star System. CustomVue also incorporates “Iris Registration” technology that registers eye movements and cornea twists during the procedure, allowing
doctors to zoom in and fine-tune as much as possible. Before the surgery, the eyes are numbed with anesthetic eye drops and a device is used to hold your eyelids open to prevent you from blinking during surgery. The procedure lasts about 8 minutes per eye. More than 1 million patients undergo LASIK surgery each year in the United States, according to the U.S. Food and Drug Administration (FDA). LASIK was approved by the FDA in 1998 and Custom LASIK received approval in 2003. Patient trials on CustomVue LASIK found 100 percent of nearsighted patients achieved 20/40 vision and over 95 percent had 20/20 vision after the surgery, while 93 percent of patients with astigmatism saw 20/20 and 95 percent achieved 20/40 vision. “I couldn’t believe that within 15 minutes Lydia’s STYLE Magazine
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I stood up and I could see the clock,” Holt exclaims. “They did both of my eyes and my sight improved so fast. Going in, of course, you have fears that something might happen to your eyes, but I figured this is what these doctors do for a living and you have to trust somebody. They did a remarkable job for me.” Holt was referred to the Eye Center of Northern Colorado by Eagles’ founder and legendary hockey player, Ralph Backstrom, and builder Martin Lind, the team’s new chief executive officer. Lind, who took over as CEO in August, had a successful LASIK procedure with Karl Olsen, MD, and Backstrom later used Olsen for Conductive Keratoplasty, a non-surgical treatment to regain his reading vision. Both men were so thrilled with their care that they made the Eye Center of Northern Colorado the "Official LASIK Surgeons of the Colorado Eagles." Holt, whose vision was 20/800, was at the extreme end of treatment for Custom LASIK. “Tori’s level of nearsightedness and astigmatism made it a challenge, but he did fall within the parameters for CustomVue LASIK,” says Smith. “When a patient like him comes in, we know he’ll need a greater level of laser correction, but the gain is so much greater than what he’s used to even if it is less than 20/20.” The day after his surgery, Holt no longer needed contacts or glasses. He experienced a couple of common side effects like dry eyes that felt like sandpaper - which went away within hours - and a halo light effect, which disappeared in a few days. “I went home and went to bed, and eight hours later I woke up and there was no pain and it was like nothing had happened,” he said. Smith estimates he has performed about 3,000 LASIK surgeries during his career. A member of the surgery staff since 1997, he and Olsen are both trained in several refractive surgeries in addition to Custom LASIK. The Eye Center of Northern Colorado is the only laser center on the Colorado Front Range to have a non-mobile CustomVue LASIK laser system on site, a great convenience for patients and doctors. The surgery team performs around 1,500 procedures a year with 98 percent of patients seeing 20/20 afterward and 80 percent seeing 20/15 or better. In addition to halos, other potential risks for LASIK surgery include under-correction,
82
Karl Olsen, MD, Ophthalmologist at Eye Center of Northern Colorado., examines a patient’s eyes.
over-correction, infection and glare. LASIK enhancements are also available if the procedure is not a complete success, where the surgeon goes back in a few months later and does a small amount of laser work. Most patients opt for Custom LASIK, which offers less chance of glare and halos and overall improved quality of care, Smith says. An FDA study in the late ‘90s found that 68 percent of patients reported their night vision was better after surgery than with contacts or glasses and none said it was worse. “I wasn’t surprised by Tori’s excellent outcome, but I couldn’t guarantee perfect vision at the outset,” says Smith. “His astigmatism is virtually gone at this point. The nice thing about CustomVue LASIK is that it can even out surfaces when the patient has a somewhat irregular cornea. This is what allows for excellent clarity and great nighttime vision.” Anyone considering LASIK or other refractive surgeries should set up a consultation to see if they are a good candidate and make sure the ophthalmologist is certified in as many technologies and procedures as possible so you have a choice of treatment. The 70-year-old Backstrom, who starred on six Stanley Cup championship teams, still has very good distance vision, but was Presbyopic and needed help with his near vision.
Basically, the crystalline lens behind the pupil is flexible when you’re in your 20s and 30s and it can focus up close and far away, but beginning in your mid-40s that flexibility goes away and you can’t pull the focus up as well anymore, Olsen explains. Backstrom underwent Conductive Keratoplasty, or CK, a non-surgical procedure that uses a probe to deliver a radio frequency to shrink the glue-like connective tissue (collagen) in the periphery of the cornea. This steepens the cornea and gives better near vision. CK is a newer technology developed over the last six years. “It’s like a belt tightening the peripheral cornea that causes the central part of the cornea to become steeper,” Olsen says. “It’s very safe because no laser or blade is used and it works well for people like Ralph who only use reading glasses.” Backstrom says he simply got frustrated with having to find his glasses to read the morning paper and “fumbling for the right buttons on the heater or defroster in the car.” So he underwent the 5 minute procedure and no longer relies on glasses to read. “I see perfectly now, I have 20/20 vision and rarely use my glasses,” Backstrom says. “Your eyes need to get into sync and the first couple of months I had some glare with
Lydia’s STYLE Magazine
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Photo courtesy: Tanner Bennett
Eagles founder and legendary hockey player, Ralph Backstrom.
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oncoming headlights at night, but I knew that could happen. I fully expect it to go away.” CK isn’t necessarily a permanent fix because as the patient gets older the need for stronger reading glasses increases. Many patients need a secondary treatment within five to seven years. Backstrom doesn’t mind the thought of a repeat. “I’ll do whatever it takes to retain my eye sight at 20/20,” he says. “It was so quick and painless. If it means doing the CK treatment again then that is O.K. with me.” The Eye Center of Northern Colorado is just happy to be of service. “We’ve enjoyed working with the Colorado Eagles staff and organization as well as being fans,” Smith says. “Supporting the local team is to our benefit as well as theirs. I enjoy listening to Tori knowing that we played a role in helping him see the puck better.” Julie Estlick is a freelance writer and copy editor living in Fort Collins.
Photo courtesy: Stephanie Burchett
Tori Holt, “Voice of the Eagles,” scans the ice.
Lydia’s STYLE Magazine
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Julie Stansloski, MD, physician with Family Practice Associates
If you have a 70 percent chance of preventing cancer in your daughter, wouldn’t you do it? That’s the question Julie Stansloski, MD, a physician with Family Practice Associates asks us all to think about when we consider whether or not to have our daughters vaccinated against the human papillomavirus (HPV). For me, after reading the research and hearing the evidence, the answer was yes.
HPV Vaccine a shot of prevention
According to the Center for Disease Control’s National Center for Immunization and Respiratory Diseases (NCIRD), 20 million women in the United States have HPV, and each year, an additional 6.2 million women get infected. “Most HPV infections don’t cause symptoms and may go away on their own,” says the NCIRD. “But HPV is important mainly because it can cause cervical cancer in women.” According to the Center, every year 10,000 are diagnosed with cervical cancer and it’s the second leading cause of cancer death in women worldwide. “Vaccinations and antibiotics are two of the best medical advances we’ve had in the last 100 years to keep people healthy, and that’s my job,” says Dr. Stansloski. “The HPV vaccine is one of the first to cure cancer because the HPV virus is one of the first that’s been linked to cancer. It prevents about 70 percent of all cervical cancers.” Indeed, according to the CDC, “studies have found the vaccine to be almost 100 percent effective in preventing diseases caused by the four HPV types covered by the vaccine—including
precancers of the cervix, vulva and vagina, and genital warts.” Even so, many parents are still weighing the issue. Much of the controversy revolves around the fact that HPV is a sexually transmitted disease, and the timing of the vaccine is designed to catch girls before most are sexually active. The CDC recommends that all girls be vaccinated at age 11 or 12, and it can be given to girls as young a nine. It also recommends that girls and women between the ages of 13 and 26 be given a “catch-up” vaccination. “Many moms and patients have misconceptions about the vaccine,” says Dr. Stansloski. “Getting the vaccine is not giving girls the permission to be sexually active, nor is it insinuating that they are, because the recommended ages start as young as age nine.” “The reality is that it is not permission to have sex,” agrees Christine Wildeman, MD, a physician at the North Loveland Banner Health Clinic (opening at the end of January). “Instead it’s an opportunity to talk with
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by Lynn M. Dean
your child about the risks of extra-marital sex.” “My reasons for recommending the vaccine are two-fold,” Dr. Wildeman explains. “First, HPV is the most common sexually transmitted disease in the United States. More than half of all sexually active men and women will contract the virus in their lifetime. The second reason is because I’ve seen cervical cancer take the lives of young women.” Dr. Wildeman reminds us that while we may be able to influence the decisions our daughters make, we can’t predict what decisions their future husbands are making now, or what decisions they have yet to make in the coming years. If over half the men are carriers, then that future husband may be infected and “likely doesn’t know he’s a carrier because he’s asymptomatic.” Moreover, condoms don’t seem to be effective at stopping the spread of this particular virus. “When you’re a carrier, the virus can be on any part of the genitals,” explains Dr. Wildeman. “You can’t stop that skin-toLydia’s STYLE Magazine
Christine Wildeman, MD, at North Loveland Banner Health Clinic
skin contact.” And, adds Dr. Stansloski, “It doesn’t have to be sexual intercourse, it can be any kind of genital contact.” If right now you’re saying to yourself, “Not my daughter, no way she would be having sex or participating in any activity like that,” then you have to ask yourself, “Am I willing to bet her life on that?” 3700 women will die of cervical cancer this year. 3700 women will die next year and the year after that and the year after that. Women who are wives and mothers. Women like our daughters. Women like one of Dr. Wildeman’s patients who died in her 30s leaving small children and a young husband behind. “Once you actually see that, and having nothing else to offer the patient... ,” she says falling silent for a minute. “To know that we’re making medical advances to prevent that from happening to other young women, it’s really amazing. I try to see both sides of the issue because I’m a mother, too. With that being said, you have to understand we’re talking about huge numbers of people whose lives could be saved.” All it takes is a series of three shots to prevent those deaths. Our daughters may also need a booster shot later because right now we don’t know how long the immunity will last. “According to current research, this vaccine shows almost a 100 percent reduction in contracting any of those (four) virulent strains over a five-year period,” says Dr. Wildeman. “But right now I can’t tell you this is going to be helpful more than five years from now.” Even so, she doesn’t recommend that we wait. “In the research I’ve read, swelling at the injection site was the only bad reaction.” And while regular Pap smears can detect the virus, once you’ve got it, there is no cure. To vaccinate or not vaccinate. You make the call. Lynn M. Dean is a freelance writer living in Northern Colorado. Loveland Greeley Medical Magazine & Directory 2008
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