N OR T H ER N C OLORADO
five dollars
volume II 2009
medspa
excellence colon cancer screening
north colorado medical center
community care for northern colorado
pathways hospice
A STYLE MEDIA AND DESIGN, INC. PUBLICATION :: EST. 198 4
Expert heart care in the heart of Loveland. The CardioVascular Institute of North Colorado now has a new clinic at McKee Medical Center. The Institute's physicians and staff will screen and diagnose heart problems and provide emergency chest pain consultation. Cardiology services offered include cardiac catheterization and placing of pacemakers and defibrillators. Make sure your heart is in the right place- right here in Loveland.
Banner Health
CardiaVascular Institute of North Colorado ® Appointments: 970.203.2400 • McKee Medical Center 1900 Boise Ave. • Suite 200 • Loveland www.BannerHealth.com • Keyword: McKee CVI
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Child Health Association/Physician Assistant Program, University of Colorado Health Sciences Center of Denver
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Northern Colorado Medical & Wellness 2009
3
PRECISION
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NEUROSURGERY & ORTHOPAEDIC SPINE SERVICES ALL IN ONE PRACTICE
WHEN
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The blend of both neurosurgery and orthopaedics in one practice is unique to the region! This allows our surgeons to offer patients the best and most comprehensive care from both disciplines. • We
use the same precision and respect for nervous tissue required for brain surgery in your spine surgery.
• We
use the latest technological advances in spine care, such as cervical and lumbar disc replacement, minimally invasive surgery, and kyphoplasty.
• We
regularly review each other’s surgical recommendations providing a second opinion for free, without charge to you.
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routinely work together assisting each other in the surgical procedure.
• Together
we now have over 95 years of neurosurgical and orthopaedic spine experience and more combined continuing education than any other spine practice in our region.
• Our
practice has a spine and brain surgeon on call for emergencies 24 hours, 7 days a week, at all local hospitals, and provide the brain and spine surgery trauma coverage for regional trauma centers at NCMC and MCR.
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work in all of the hospitals and surgery centers in the tri-city region thereby allowing you to choose the facility most convenient for you and your family.
We are in network with all the major insurance carriers in our region, ensuring that you will be able to maximize your insurance benefits.
New patients and referrals are welcome.
Ft. Collins:
1313 Riverside Ave. • (970) 493-1292
Greeley:
2001 70th Ave. • (970) 356-4488 Donn M. Turner, M.D. • Timothy C. Wirt, M.D. Hans C. Coester, M.D. • Douglas W. Beard, M.D.
Loveland:
2500 Rocky Mountain Ave. Ste. 360 • (970) 669-0470 (800) 458-0306 • www.brain-spine.com
2701 SOUTH COLLEGE AVENUE • FORT COLLINS (970) 226-1 000 Come by our showroom today or visit us on the web at
www .sutherlandsdesigngallery .com
style media and design, inc. | 970.226.6400 |
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 Dody
creative director Scott Prosser Graphic Designer Lisa Gould
Contributing Editor Erica Pauly 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 Office Assistant Ronda Huser Contributing Writers Kevin E. Bachus, M.D., Faith Brandt, Allie Comeau, Lydia Dody, Angeline Grenz, Connie Hein, Kay Rios, Gloria Willis Staff Photographer Warren Diggles Contributing photographers Lydia Dody, Erik Stenbakken Affiliations Fort Collins Area Chamber of Commerce Loveland Chamber of Commerce Greeley Chamber of Commerce Windsor Chamber of Commerce 2009 Style Magazines January-Loveland/Greeley Medical & Wellness Magazine and Directory February-Building & Remodeling March-Northern Colorado Medical & Wellness March-Family, Community & Philanthropy April/May Northern Colorado Business & Building May-Northern Colorado Medical & Wellness June-Business & Building July-Fort Collins Medical & Wellness Magazine and Directories August-Women In Business September-Building & Remodeling Home Interiors & Entertainment October-Women’s Health & Breast Cancer October-Northern Colorado Medical & Wellness November/December Holiday/Winter Style Media and Design, Inc. magazines are free monthly publications direct-mailed to homes and businesses in Northern Colorado. Elsewhere, subscriptions for 13 issues cost $30/ year. Free magazines are available in stands at 100 locations throughout Northern Colorado. For ad rates, subscription information, change of address, or correspondence, contact: Style Media and Design Inc., 211 W. Myrtle St., Suite 200, Fort Collins, Colorado 80521. Phone (970) 226-6400. Fax (970) 226-6427 E-Mail: ronda@StyleMedia.com ©2009 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.
6
Lydia’s STYLE Magazine
ONE IN THREE WOMEN WILL BE DIAGNOSED WITH CANCER IN HER LIFETIME* AND NEARLY 60% OF WOMEN REGARD HAIR LOSS AS THE SINGLE WORST SIDE EFFECT OF CANCER TREATMENT.** •cancer Facts & Figures 2007, American Cancer Society. ••cancer Practice: Journal of the American Cancer Society, November 2001.
Help the Cancer Center of the Rockies create wigs for cancer patients by participating in the 1st annual Hair- Raiser event . This event is a contest among all salons in Northern Colorado to see who can collectively cut the most number of inches. The winning salon will receive the coveted "Hair Raiser of the Year" trophy. This traveling trophy will give the top salon bragging rights throughout the next year. Any stylist can participate and everyone is welcome to participate in the celebration.
Don't have a stylist, come anyway. Can't participate on April 19th? Visit your stylist from now until April and the hair collected will help your salon with their total inches collected. Salon owner or stylist . . . Go to www.raisesomehair.com to register your salon for the event. Each stylist should register individually. After registration, download and print all the specifics for the event. This includes how the hair should be handled, what you need to bring to the event plus other pertinent information for making the 1st annual Hair-Raiser a success.
DATE: April 19, 2009 WHERE: Fort Collins Hilton Garden Inn 2821 E. Harmony Rd Ft. Collins, CO 80528 970.225.2900 TIME: 1 pm- 5 pm
Paolo Romero, MD Anne Kanard, MD Matthew Sorensen, MD Regina Brown MD Miho Toi Scott MA, MD
Northern Colorado Medical & Wellness
7
CONTENTS
northern colorado medical & wellness
MARCH 2009
10 12 18 22 26 32 38 42 46 48 51 54 58
Publisher Letter
Palliative Care and Grief Support Pathways Hospice
Excellence in Medspas
Five Medspas In Northern Colorado
Colon Cancer Screening
North Colorado Medical Center
First Annual Hair-Raiser
Put On By Cancer Center Of The Rockies
12
Palliative Care and Grief Support
22
Colon Cancer Screening
32
MeadowView
46
Bright & Beautiful
51
Endodontics, Periodontics, and Prosthodontics
58
Home To Heaven
Pathways Hospice
North Colorado Medical Center
MeadowView
On The Cutting Edge
Bright & Beautiful Cosmetic Dentistry
Bright Smiles Across Northern Colorado
Pediatric Dentists Making Check-ups fun
Start Smart
Infant Dentistry
Endodontics, Periodontics, and Prosthodontics Q & A Session
Pulse Fitness Center Group Fitness Classes
On The Cutting Edge
Cosmetic Dentistry
Happy Feet On Hardwood
Hot Spots To Burn Calories This Fall
Pet Dentistry
Why Our Pets Need Dentists Too
Q & A Session
At-Home Pet Euthanasia
(from left) Theresa Honesto, Branch Manager; Sheri Shovlin, CFO; Denise Swingle, Owner; Renee Lesser, Business Development & Marketing; Adrienne Roth, DON, the team at Caring Hearts at-home healthcare service. The articles in this issue of Northern Colorado Medical & Wellness 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 healthcare provider.
8
Lydia’s STYLE Magazine
The earlier a health problem is detected, the
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including CTA (computed tomography angiography), CT cardiac calcium scoring, CT lung scan, and CT virtual colonoscopy ~ MRI (magnetic resonance
completed subspecialty fellowship training.
imaging), including MRA (magnetic resonance angiography) and cardiac MRI
This high level of expertise ensures that our
~ Nuclear medicine, including PET
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(positron emission tomography) ~ Neuroradiology ~ Ultrasound, including Doppler
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including diagnostic angiography, carotid stenting, radiofrequency ablation (RFA), uterine fibroid embolization (UFE), and vertebroplasty ~ Bone densitometry
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EXCLUSIVE PROVIDER FOR HOSPITALS IN NORTHERN COLORADO, SOUTHERN WYOMING, & SOUTHWEST NEBRASKA
Publisher’s Letter
A
Support & Sustain!
as our Style team was recently meeting, we reflected on the close of a busy year. It feels as if we may be embarking on a year of new challenges. We have unanimously reaffirmed our commitment to improving each issue of Style, and thereby, increasing the value and importance of Style Magazine to readers and advertisers. Improving design and photography, writing interesting and timely articles, and lending support to businesses and non-profits are our goals for 2009. We understand and acknowledge that it may not be an easy year for many of us, but we are committed to our readers, our advertisers, to our fine staff, and to our communities along the front range. This year I am celebrating 43 years as a small business owner in Fort Collins. My heart has always been supportive of hard working small businesses and courageous entrepreneurs. These people and their businesses are the backbone of our free enterprise system. In support of them, I ask you to make a special effort to buy locally and keep our dollars in our region. Let us keep these businesses healthy through our current economic times. We, at Style, will also do our part. Through our articles, we will introduce you to more people, businesses, and non-profits. We ask you to patronize these fine folks and tell them you saw them on the pages of Style Magazine. I have enjoyed meeting and getting to know the family of Sutherland Lumber. Bob Sutherland, owner, is a warm and engaging entrepreneur who deeply cares for his business, his employees and his community. This is a family business with its roots going back nearly 100 years and stores spread over 20 states. His employees speak very highly of their ownership, their stores and their jobs. We enjoyed getting acquainted with them and learning more about their department. With two locations, Sutherland Lumber and Design Center will be joining forces under one roof to serve the region even better. So, if you are tackling a remodel, a fix-up project, or more, be sure you think of patronizing this local business before going to a nearby big box outlet. That is one way you can help to support our local economy! Creativity and construction talent is exceptional in the Colorado Front Range. Whether you are remodeling a home or commercial project, building a new structure, or renovating with green building in mind, the area has many qualified, creative, and caring contractors and subcontractors. Enjoy learning about some interesting, and sometimes dramatic, remodels that not only enhanced living and working spaces, but also improved quality of life for those enjoying these awesome projects.
lydia@stylemedia.com
10
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Pete Weeks
11
palliative care
pathways hospice
Hospice has provided physical, emotional, and spiritual support to more than 6,000 terminally ill patients and their families in its 30 years of existence.
Trudy Childress with her mother, Lucille Barnett
Palliative care
pathways hospice
by kay rios Photos by warren diggles
When Pathways Hospice changed its name from Hospice of Larimer County, the idea was to distinguish the organization from others offering palliative hospice care. The previous name suggested a limited range of involvement when, in fact, Pathways Hospice serves all of Northern Colorado.
C
hief Executive Officer, Evan Hyatt, says, “We are also different in that we are community based, a notfor-profit, and we have 30 years of experience in hospice care.” He adds, “The depth and breadth of the service provided also sets them apart.” While the name change provides a more appropriate branding, the service itself had already established Pathways Hospice as the leader in hospice care, according to those who have used the services. Trudy Childress and her mother, Lucille Barnett, vouch for that. “Hospice is certainly an end of life provider but, in the process of doing that, they bring so much life with them,” Childress says.
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Childress wasn’t won over easily. “When it was suggested that I bring in Hospice for my mother, I immediately thought of dying. But this organization is life affirming,” she says. Their association with Pathways Hospice began when Barnett had a massive coronary in August of 2007. “My heart stopped twice,” says Barnett. “The doctors said I had six months to live.” Childress reluctantly brought in Pathways Hospice. She says, “I put my mother in rehab, but I watched her for two weeks and knew she was dying. She was lying in a bed or just sitting in a wheelchair. She didn’t recognize me. I knew I had to get her out.” Childress, who lives in south Loveland, and works a fulltime job in Loveland, also knew she couldn’t do it on her own. “I’m a very private per-
son, and just didn’t want people coming and going in my house. But that’s not what happened. Hospice staff came in and made themselves part of the family. I never felt I was being invaded.” Instead, Childress says she felt supported. “I could call and someone would always be there.” Under Pathways Hospice care, Barnett’s health began to improve. “Hospice gave me my mom back,” Childress says. “She graduated from Hospice in August 2008. She was with them one year and then didn’t meet the requirements for receiving service.” That was good news and bad. “The months we were without Hospice, I saw a difference in my mother. I had the feeling she was giving up,” says Childress. Then, on December 10, 2008, Barnett had
Lydia’s STYLE Magazine
another heart attack. “I felt pretty alone. We were told she could either stay in the hospital or go home and call Hospice. That’s what we did.” Barnett is back in the Hospice program because, Childress says, “Her health is pretty precarious. Some days are better than others.” Pathways Hospice helps make those days a little better, Barnett says. “I love them all; the volunteers are terrific. They change my bed, do my laundry, and visit with me. The nurse comes once a week and draws blood, and checks my medication. Someone also comes by three times a week so I can take my shower. If it hadn’t been for Hospice, I wouldn’t have met all these wonderful people including my clergyman. It’s a tremendous comfort zone. Otherwise, since Trudy works all day, I’m here alone all day by myself so it’s nice to have somebody come in.” “But not just somebody,” Childress clarifies. “It’s an incredible team.” She lists the names of many people involved and also the wide variety of services they’ve provided. “I don’t know how you can put together a team like this. You can often find one star in a group, but they’re all stars. I will be eternally grateful to Hospice. They have given me my mom a little longer and that’s a treasure beyond price.” But that’s only one of the many stories of those Pathways Hospice has served in its 30 years of existence. In that time, Hospice has provided physical, emotional, and spiritual support to more than 6,000 terminally ill patients and their families. Its quiet origins began in October, 1978, when a compassionate group of Loveland nurses banded together to care for a co-worker in the final stages of breast cancer. They formed an unofficial group to help her die at home. After her death, they continued to meet and began providing similar services to other terminally ill patients. About that same time, a group in Fort Collins began a similar service. Interest in hospice care was beginning to grow as Great Britain created freestanding inpatient facilities offering comprehensive care to terminally ill patients. Information on those efforts crossed the Atlantic Ocean in the 70s and medical thinking began to change. On February 3, 1979, the organization was incorporated as a non-profit 501(c)(3) but both the Loveland and Fort Collins groups continued to operate informally as volunteers until 1982, when the federal government passed the Medicare Hospice Benefit. That’s when the two groups joined resources, formalized the operation, and began to pay CNAs, nurses, and chaplains. In the early days, Dr. Jim Danforth and Dr. Joe Lopez served as medical directors. Dr. David Allen later joined the staff as a fulltime executive medical director and Dr. Lopez and Dr. Danforth assumed assistant medical directors positions, stepping in when Allen was not available. All three are board certified in hospice and palliative care. With support from the community, Pathways Hospice built its current facility in 1996. A Care Center of five beds was added at McKee Medical Center in the fall of 2001. In 2005, a capital campaign raised money for an addition to house Pathways, Programs for Grief and Loss. More re-
Northern Colorado Medical & Wellness 2009
Lucille Barnett talks with Ben Gaibel, social worker for Pathways Hospice.
cently, in June of 2007, Hospice opened a branch in Windsor, and last summer, the Hospice Care Center at McKee expanded to seven beds. Pathways Hospice has grown, not only physically, but also in terms of programs offered. The staff and volunteers at Pathways Hospice offer a variety of services to help patients and their families through the last cycle of life, Hyatt continues, “The services range from on-call 24/7 nursing care, medical equipment and supplies, social services and counseling, to spiritual care, programs
for grief and loss, and community education. Our staff includes 130 medical, social work, counseling, administrative, financial, marketing, and fundraising professionals. We also have 200 active volunteers.” Pathways Hospice offers two distinct types of support. Clients for hospice care are referred by physicians, nursing facility staff, and hospital discharge planners. Bereavement care, which falls under the Pathways Programs for Grief and Loss, is open to anyone in the community who has suf-
13
Pathways Programs FOR
Grief and Loss
S
tion program. There are nominal fees for these services. Pathways Hospice serves Larimer County as well as portions of Weld County including Windsor, Severance, Ault, Eaton, Timnath, and Johnstown. It has a physical presence in the administrative and business offices at 305 Carpenter Road in Fort Collins, at 1226 W. Ash Street, Suite B in Windsor, and in a seven-bed, Inpatient Care Center located on the third floor of the McKee Medical Center in Loveland. In addition, its staff and volunteers provide care within 13 skilled nursing facilities and 26 assisted living facilities throughout the community. Pathways Hospice funding is generated through several sources. It receives payment through Medicare, Medicaid, commercial insurance, and client fees. Along with tax-deductible donations, several annual events help to raise
eventeen-year-old, Kayla Adsit, died one Friday evening in a car driven by her friend when a tractor-trailer truck struck the car on the passenger side. Her parents, Lisa and Eric, were in total shock. “She was in the prime of her life, just three weeks before her high school graduation. Her death was instantaneous and our lives changed forever in that instant.” After the accident, a friend called Pathways Hospice to see what services were available there and made an appointment for them with a counselor. “We were so lost and needed help dealing with our unfathomable loss. Going to Hospice and speaking to a counselor was the best thing we could have ever done. Our loss was so sudden, so unexpected, and so devastating that we needed the help of a professional to help us to even begin to breathe again. We would never have thought of Hospice as providing services like the ones we used there because we wrongfully associated them with only dealing with terminal illnesses.” The Adsits used the one-on-one grief counseling services through Pathways Programs for Grief and Loss, and also joined a bereaved parents group and a grief writing class. They also attended a couple of Pathways Hospice memorial services for those affected by loss and attended the Compassionate Friends Worldwide Candle Lighting ceremony at McKee Hospital. The counseling has been indispensable in helping deal with the loss and preparing them for the days ahead. They say, “Our counselor helped us gain some perspective on our feelings, helped us summarize our thoughts, and also deal effectively with some of the aspects of grief that are not helpful in the healing process. Joining the bereaved parents group allowed us to share our pain and our grief with people who knew all-too-well what we were going through. We still get together with them from time to time socially. It is always so safe to be with people who share a common bond: the grief for our children lost.” Based on their experience, the Adsits wholeheartedly recommend seeking help from professionals in times of loss. While they acknowledge that friends and family are unbelievably supportive during these times, and they say they could not be where they are today without their love and compassion. But, they add, the professional counselors at Pathways Hospice provided the benefit of their extensive experience in death, dying, and the painful grief that follows. “They did so in an objective, confidential, and empathetic way that made us feel safe and sane in the insanity that follows a sudden, gut wrenching loss. “It goes beyond words what we lost that night and there is simply nothing that can be done to soften it, to lessen it or make it better. What we simply must do now is live with what has happened to our little girl and where that now leaves us. She was our hope and our dream for grandchildren someday and that dream, and so
continued on page 16
continued on page 16
Janet Buck provides music therapy for Lucille Barnett.
fered the loss of a loved one. “We have five times the number of people that come in contact with our Pathways Programs for Grief and Loss than our hospice care,” Hyatt says. Along with providing specialized comprehensive care for those affected by advanced medical conditions, we also provide a range of support for those who have lost a loved one and are grieving. Through its Pathways Programs for Grief and Loss, families of a loved one who died in the program can access supplemental support for 13 months after the death. That assistance comes in a variety of packages including support literature, follow-up phone calls, counseling, and support groups. They are all without fees for a Hospice family. A second option is offered to anyone in the community who has had a death loss, and involves counseling, support groups, and an educa-
14
Lydia’s STYLE Magazine
Same agency, new name, same commitment to excellence Pathways Hospice. You’ve known us as Hospice of Larimer County since 1978. Our nationally recognized program includes
Dr. David Allen
Medical Director Executive Our full-time medical director, Board Certified in Hospice & Palliative Care and a practicing physician for 25 years, works with our experienced care team to ensure we continue our legacy—providing the highest quality hospice care and grief support in Northern Colorado.
• medical and comfort care in the last months of life • individual grief counseling, for adults, teens and children • support groups • memorial services • community education • consulting and de-briefing for businesses, organizations and schools • in-services for hospitals and skilled nursing facilities • library resources We offer our comprehensive non-profit services to anyone in Larimer and Western Weld County communities, regardless of insurance or financial status. As you face the challenges of serious illness, please know you are not alone. We’re here to help you.
www.pathways-care.org Fort Collins | 970.663.3500 Windsor | 970.674.9988
www.goesfuneralcare.com
Goes Funeral Care & Crematory proudly supports Pathways Hospice and their compassionate service to the Northern Colorado Community 15
money to fill funding gaps: Abby’s Signature Concert Series, the annual National Association of Insurance and Financial (NAIFA)/Hospice of Larimer County Golf Benefit, the Debbie Boose Memorial Tennis Tournament, and an annual wine tasting event, the Vintage Affair. The money raised supports the programs so Pathways Hospice can cater to the variety of needs within the community. Whether patients reside at home, in a long-term care facility, or an inpatient care center, hospice care is available. “We’re available when and where you need it,” Hyatt says. The services are for anyone who needs them, he says. “Being not-for-profit and community based, we would never refuse service to anyone.” In fact, 25 people served last year were without insurance coverage, but Pathways Hospice found a way to provide assistance. “We offer many ways to find exactly what’s needed,” Hyatt says. Everyone goes through the process differently and we know that people grieve differently. We help you find the best means specifically for you. We offer a holistic approach that includes medical, social, spiritual, and bereavement.” That is exactly what Childress has found to be true. “As the caregiver, I feel supported spiritually and emotionally. My biggest fear was being alone when my mom passed, but I suddenly knew that I could call and someone would be here when I needed them. I’ve never experienced that before. They’re here for us now and, when my mom does pass, I know they will still be here for me.” +
16
many others, died that terrible night. What we do with our loss now, however, is really how we have found we can deal with it. We have turned our pain towards making a difference (the motto Kayla lived by) in other people’s lives.” In that vein, the Adsits have established a scholarship in Kayla’s name at Colorado State University, and are creating a foundation to help meet the needs of underprivileged Poudre School District children. They have also held or participated in numerous fundraisers, helped out with the Teen Motor Vehicle Safety Coalition and have reached out to other parents who have lost their children. “Our counselor helped us by endorsing these positive steps towards making something good come from something so horrible. She was right as doing these things has given us the strength and the focus to continue on with some direction in our lives.” People around those who have experienced a great loss often try to encourage a rush to heal, but as the Adsits know, that loss always remains even though each day may become a little easier. “The rush to heal from grief is a modern American / western culture phenomenon and that it is not widely shared across the world. That said, what we would say to people who would wish to hurry along someone’s grief for their convenience is simply to stop. Everyone grieves differently, every death is unique, every relationship is equally unique and grief is a very long, arduous journey filled with pitfalls along the way. The grief journey, unlike what we were taught in psychology class actually tends to cycle back on itself making the journey a confusing and often discouraging
series of two steps forward and one or more steps backward. There is no way to know what a given day will bring. When grief overtakes us it often happens unexpectedly, making us feel like we’re being swamped by waves, pulling us under only to be buoyed by our relationships, our faith and the help that we receive from people like Pathways Hospice. Everyday is an effort to get up and move forward but we continue on as we really have little choice but to keep moving. Perhaps someday we will find land again but I doubt this sea of grief will ever completely leave us, that is until we join with her again someday.” They offer this advice to others who may be grieving: “Be patient with yourselves. You will deal with your grief in your own personal way and there are no right answers, only those that are right for you. There is wonderful help available from people who deal with death and grief on a daily basis. They have no answers but can give you a measure of peace with your grief, some compassion, unquestioned acceptance and some perspective on what you’re going through and how you might consider negotiating it. We all see specialists all of the time, whether it is something that needs to be fixed, something that needs to be done, or some ailment. Pathways Hospice has the grief specialists and they are there for anyone who needs them, regardless of the circumstances for their loss.” + Kay Rios, Ph.D., is a freelance writer living in Fort Collins. She writes on a variety of topics for both national and regional publications.
Lydia’s STYLE Magazine
I
OPENING
JUNE
2009
TWENTY THREE TREES MEDICAL & WELLNESS SPA
A
MEDICAL
SPA
BROUGHT
TO
YOU
BY
PVHS
Twenty Three Trees is a new medical and well ness spa owned and operated by Poudre Valley Health System . Staffed by a physician and licensed therapists and estheticians to ensure the highest quality care and medical expertise, Twenty Three Trees will offer comprehensive services in a luxury spa setting . cosmetic dermatology natural nail services
esthetic procedures I facials
massage therapy
in-room services for Poudre Valley Hospital patients
Twenty Three Trees is located across the bridge from PVH in the new Westbridge Medical Suites building . To be placed on our e-mail list to receive special introductory offers, e-mail
twentythreetrees@pvhs.org.
WHY
TWENTY
THREE
TREES?
During excavation for the Westbridge building, it was necessary for 23 trees to be removed, but all were relocated to the home gardens of PVHS employees. Twenty Three Trees Medical and Wellness Spa is located on the same grounds where the 23 trees once stood and carries on the same spirit of renewal. This summer, 23 new trees will be planted around the Westbridge building, bringing the story full circle .
POUDRE VALLEY HEALTH SYSTEM
beauty
medspas in northern colorado
excellence
in medspas
by Allie Comeau Photos by warren diggles
A
medical spa is defined as a spa facility where esthetic, laser, massage, and other skin and spa services are administered under medical supervision. Because a medical spa operates under the supervision of a physician, the benefits to the patient are many. Unlike traditional day spas, treatment plans at med spas are devised in accordance with the patient’s medical history and the medical knowledge of a physician. Patients are able to receive treatments like Botox® and certain laser treatments that traditional spas are unable to provide. The supervising physician is also able to prescribe prescription-grade skincare products for acne and aging. In addition, having a medical director ensures all other treatments, from massage therapy to microdermabrasion, are performed with the utmost attention to detail, safety, and efficacy. Med spas are able to produce dramatically better results than traditional spas for issues like acne, scarring, and signs of aging. Not only do they have more medical knowledge, but access to better equipment, technology, and products as well. From state-of-the-art laser technology to pharmaceutical skincare products, med spa services are a step above traditional spa services in more ways than one. Medical spas often employ estheticians, laser technicians and massage therapists to perform skincare treatments like chemical peels and skin rejuvenation, prenatal massage and laser treatments. All three of these positions must be licensed within the state of Colorado. These professionals, in cooperation with the supervising physician, are dedicated to the health and appearance of your skin and body. Because they’re supervised by a physician, licensed estheticians and laser technicians at med spas are able to better treat skin issues like redness, sun spots, and wrinkles. Medical spas may also offer traditional spa services like manicures and pedicures, facials, waxing, and spray tanning. Some med spas incorporate wellness aspects as well, like acupuncture, nutritional counseling, and alternative medicine. Depending on the supervising physician’s medical background, each med spa may offer something a little different. The med spa industry is regulated by the Colorado Board of Medical Examiners. Rule 800 states that a med spa must be under the supervision of a physician and that said physician must reside in the community and be available for consultations on an as-needed basis. The rule speculates that the director should live within 45 miles of the clinic and be available for weekly reviews. Unfortunately, not every med spa follows Rule 800 as closely as it should. These guidelines are loosely regulated and it’s not unheard of for a physician to lend his or her name to a spa without performing treatments or being available. When choosing a med spa, it’s important to ask what role the supervising physician plays at the spa. If the doctor is not involved, you’d be better off going elsewhere. The five med spas mentioned in this article go above and beyond Rule 800 by either having medical personnel (either physicians or nurses) perform treatments or by keeping a supervising physician on site at all times.
Northern Colorado Medical & Wellness
A step above the average med nurturing environment in line spa, Twenty Three Trees Mediwith PVH’s wellness philosocal & Wellness Spa (named phy,” says Brock. “We’re even for the trees that were relogoing to have a wellness concated during construction of ference center in the building the building) is the new PVHS where we’ll teach yoga, Pilates medical spa located on the and weight management.” first floor of the Westbridge Marilyn Owen, director Medical Suites across the street of retail, says, “We’ll have a from Poudre Valley Hospital. beautiful spa boutique with Dr. Michelle Tollefson, medical Owned and operated by our own line of personalized director for Twenty Three Trees. PVHS and set to open in early skincare products, home déJune, Twenty Three Trees is governed by the cor, clothing, jewelry, spa-related items, and Joint Commission, which means it’s held to gifts. We’ll also feature products geared to the higher standards than other med spas. Vice new mother and baby.” president of marketing and strategic planning, “We’ll also be able to provide services Pam Brock, says, “Because we are part of the across the street at the hospital. Massage, fahealth system we must comply with the same cials and manicures/pedicures will be offered stringent quality standards for patient safety to patients at PVH,” says Brock. “Say you want and healthcare quality as other parts of the to get the new mom in your life something hospital/health system.” other than flowers. You can send a facial, masMedical director and supervising physician sage or a mani/pedi right to her room.” Dr. Michelle Tollefson will perform all clinicalIn addition, Twenty Three Trees will offer ly-based procedures like laser treatments and physician-performed Botox®, dermal fillers, injectables. “I’ll be performing or overseeing laser hair removal, intense pulsed light treatall procedures and see to it that we only offer ments, and laser skin rejuvenation. “We have treatments with proven safety and efficacy,” the latest and absolute best laser equipment says Dr. Tollefson. “Patients can rest assured available in the area,” says Dr. Tollefson. “Our that our medical spa is backed by the quality brand new CO2 Affirm microablative laser will and safety they’ve come to expect from PVH.” be the only one in this area.” Spa manager “We are doing some really exciting things Sheila Parker adds, “We’ll also offer medical that differ from other spas in the area and and relaxation massage, natural nails, microfrom PVH,” she says. “ We’ll be offering the dermabrasion, facials, chemical peels and a highest quality medical care but in a spa-like full-range of esthetician services proven to environment complete with a changing area treat skin conditions like acne, eczema and the with personal lockers and a large shower, effects of aging.” dressing rooms and vanity area, and a lounge “Our goal is to provide spa treatments in a and relaxation room. We’re taking it to a highnurturing environment within a medically foer level.” cused atmosphere so we can ensure the qual“We will go the extra distance to provide a ity and trust patients deserve,” says Brock.
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Reflections Medspa, in Fort Collins, distinguishes itself by offering facial plastic surgery procedures in addition to spa services. Owners Kim and Mike Brunkhardt discuss their unique facility. They say, “We are the only medspa with a facial plastic surgeon on staff,” says Mike. “That allows Reflections to create a comprehensive experience for our clients.” “We have two physicians on our team – Eric Olsen, M.D., trained in aesthetics, a Board Certified emergency medicine physician, and a wound care specialist. Maria Chand, M.D., is our double Board Certified facial plastic and reconstructive surgeon,” says Mike. “Dr. Chand performs face lifts, neck lifts, blephroplasty (eyelid lifts), brow lifts, liposuction, rhinoplasty, and other facial plastic surgery,” says Kim. “Some procedures can be done right here in the office, and others are done at the Surgery Center of Fort Collins, depending on the patient and circumstances.” All other treatments at Reflections, from administering injectables, like Botox®, to giving facials, chemical peels and laser treatments, with the exception of permanent makeup, are done by either a nurse or physician. “Knowledge of physiology and anatomy is priceless
At Allura Skin and Laser Clinic, Becky de la Torre, M.D., owns and operates the facility and serves as medical director. Dr. de la Torre is a family practitioner and feels her medical background brings unique benefits to the med spa environment. “I retired from family medicine in May so I could devote all my time to Allura,” says Dr. de la Torre. “In addition to my years practicing family medicine, I worked as the medical director and laser operator at a local Laser Center for the past five years until I decided to branch out on my own.” Dr. de la Torre’s family medicine background and her laser and skin care experience make her an ideal medical spa owner. “Dermatology falls under the umbrella of family medicine, so in my years of private practice I treated various skin conditions including acne, rosacea, and pre-cancerous lesions,” she says. “So if an abnormal skin lesion is noticed, I am able to advise the patient to have the lesion biopsied.” “I have the background to treat traumatic, surgical or acne scars, and certain skin conditions with lasers,” she says. “In fact, the fractional laser is my specialty.” The fractional laser treatments at Allura
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Dr. Eric Olsen, medical director for Reflections Medspa.
when it comes to medical spa treatments,” says Mike. “We have nearly 100 years of combined medical experience between the nurses and doctors that work here.” Kim, who’s an R.N. herself, believes strongly that medical knowledge should be inherent in a medspa.
“Nothing is more important to us than patient safety,” says Kim. “Our professional medical training allows us to give patients the best quality of care. From skin consultations with teenagers about acne, to facelifts, we pride ourselves on safely helping our patients gain self confidence.” Reflections was designed with the patient in mind. From being available any time of day (all patients have Kim’s cell phone number), to the relaxing atmosphere of the spa itself, Reflections puts the patient first. “We wanted to create an environment that was calming and soothing,” says Mike. “But operationally, we run this place like a medical clinic. We don’t operate like a day spa with a little bit of medical stuff. This is run as a medical clinic with a little bit of spa stuff.”
Dr. Becky de la Torre, medical director for Allura Skin & Laser Clinic.
are state-of-the-art laser treatments with less recovery time that an ablative laser, and with excellent results. “The fractional laser is amazing and does a wonderful job with scarring, reduction of moderate wrinkles and textural improvement,” says Dr. de la Torre.
When asked if she would miss her family practice, Dr. de la Torre made it apparent that she considers Allura her new family practice. “I had to make a choice between family medicine and the med spa clinic. I chose to dedicate myself to the skin and laser clinic because I enjoy it so much. I really think I’ve found my niche. I enjoy seeing patients and building relationships and in that way, it’s very similar to family medicine.” Due to their success since opening last November, Allura has expanded to include a second location in the 25/34 business park development near Centerra. This will allow Dr. de la Torre and her experienced staff to offer state-of-the-art treatments in the Loveland and surrounding areas.
Lydia’s STYLE Magazine
Founded in 2003, A Woman’s Place Esthetics and Spa (AWP), is attached to a full service women’s wellness center. Both are run by supervising physician and medical director Dr. Karen Hayes. We interviewed Pam Roys, the office administrator. Upstairs, A Woman’s Place of Fort Collins offers comprehensive care in obstetrics/gynecology and midwifery. Conveniently located downstairs, AWP Esthetics and Spa, a full-service med spa, caters to the aesthetic needs of both women and men. “One benefit of A Woman’s Place (AWP) is that we have Dr. Hayes, a practicing ob-gyn physician, on site at all times,” says Roys. “This makes AWP especially adept at catering to the specific needs of both men and women. We also have a full-time massage therapist, a licensed laser technician, and a licensed esthetician.” AWP offers a full range of medical spa services like facials, laser IPL, laser hair removal and vein treatments, chemical peels, waxing, manicures and pedicures, spray tanning, and Genesis, a heat treatment for fine lines and wrinkles. While some of these services are available at non-medical spas
With the grand opening of Xanadu Med Spa on Valentine’s Day of this year, Xanadu is brand new and it shows. The relaxing atmosphere and polished appearance of the med spa speak volumes about its quality. Owner, Susan Muhlenkamp, and licensed medical aesthetician, Jessica Fish, sat down with Style. Their excitement was palpable. “It was always a dream of mine to open a med spa after I retired,” says Muhlenkamp. “Now I can finally say I’ve fulfilled my dream.” “We want to help people feel good about themselves by offering treatments that make them feel fresh,” says Mulenkamp. “These days, we don’t have to take aging and adverse skin conditions lying down. We are free to age more gracefully when we feel better about the way we look.” Fish and the other Xanadu staff will be working under the supervision of medical director Dr. Amy Brewster to ensure safety and quality. “Dr. Brewster is a Board Certified plastic surgeon,” says Fish. “She will perform the DOT therapy, a fractional CO2 laser treatment, and administer injectables such as Botox® and dermal fillers. She will also supervise and ensure the safety of the other
Northern Colorado Medical & Wellness 2009
Dr. Karen Hayes, medical director for AWP Esthetics & Spa.
around town, the training and medical experience of the staff at AWP ensures patient safety. “The in-depth training that we have at AWP sets us apart,” she says. “We also look at the whole person, including health and medical history, when we formulate treatment plans. We
don’t rush into treatment without knowing a client’s medical history.” Roys is quick to say that a med spa is not a substitute for a dermatologist or plastic surgeon. “We provide a service that’s complementary to our women’s health and wellness center, but we also work with a network of doctors and providers who we refer patients to if they require dermatological or other local medical services,” she says. Another difference between AWP and a traditional spa is the insurance. “My staff is covered under our physician’s malpractice insurance which sets us to a higher standard and offers additional patient protection under the licensing of a physician.”
Dr. Amy Brewster, medical director for Xanadu Med Spa.
medical aesthetic treatments and prescribe topical and oral medications to assist in the treatment of various skin conditions.” The partnership between Xanadu and Dr. Brewster, who has a private plastic surgery practice, will benefit patients considering surgical
cosmetic procedures because it will offer them a unique opportunity for the most complete plan of care and very best results. Dr. Brewster is thrilled with the new venture. “Susan has done everything right,” she says. “She’s chosen the best products, equipment, and technology and a wonderful staff. I’m thrilled to be part of the team.” Xanadu offers a full range of comprehensive spa treatments – from laser treatments to chemical peels and massage – but Muhlenkamp feels DOT therapy will be their specialty. “DOT therapy is a brand new type of skin rejuvenation treatment used as an alternative to other laser treatments and face lifts and has a much quicker recovery time,” says Muhlenkamp. “We’re the only med spa to offer DOT therapy in Fort Collins.”
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gastroenterology
COLON cancer screening
“Reducing the number of deaths from colorectal cancer depends on detecting and removing precancerous colorectal polyps, as well as detecting and treating the cancer in its early stages.” Centers for Disease Control and Prevention
COlon Cancer
screening
by Connie Hein
We read about it – we hear about it – as we age, our doctors talk to us about it, and then most of us dread it! During the dreading stage we wonder if colon cancer screening is really that important and worth the hours of colon cleansing preparation it takes before we even get to the test. And, if it is really that important to our quality of life as we age, which kind of screenings are most efficient and why? And how often should we be tested? Insurance providers, doctors, and other professionals sometimes disagree on which procedures are necessary and most efficient, so it can all be very confusing.
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e asked Dr. Yazan Abu Qwaider, Gastroenterologist at North Colorado Medical Center (NCMC) in Greeley, to help us understand the importance of colon cancer screening, the options we have for testing, and the advantages and disadvantages of the most common types of colon cancer screenings. Dr. Qwaider explains that there are many different methods of colon cancer screening procedures, but in his opinion, the colonoscopy is
the most thorough. During this test, the patient is placed under general anesthesia. “This is the most efficient way to screen for colon abnormalities and polyps because when polyps are found they can be removed immediately while the patient is still under sedation.” When polyps are found in other forms of cancer screening the patient must be brought back for further testing and removal of the polyps. Also in other screening procedures, harmless rectal matter can be detected and then further screening and testing must be done to determine
if they are actually polyps. A polyp is an abnormal growth tissue that can develop into cancer. Dr. Qwaider says the reason it is necessary to screen for Colon polyps is because it is rare that they cause any symptoms that would signal a need for screening until cancer has already developed in the polyp, and because of the potential for colon cancer being present microscopically. The removal of polyps reduces the future likelihood of developing colon cancer. Even though colon cancer is usually not found in smaller polyps, all polyps found are continued on page 24
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Lydia’s STYLE Magazine
CARING HEARTS IS RANKED
IN THE TOP 100 HOME HEALTH AGENCIES IN THE NATION!
Northern Colorado Medical & Wellness
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Underuse of Screening Colorectal cancer screening remains underused, despite the availability of effective screening tests. Screening for colorectal cancer lags far behind screening for breast and cervical cancers.
removed in a colonoscopy. Dr. Qwaider explains that new technology and equipment is being developed all the time to make colon cancer detection more efficient. He says “Earlier this year NCMC purchased the newest high definition fiber-optic endoscopes, which are able and equipped to use narrow band imaging for colonoscopies. I believe this method helps to better identify small flat lesions (flat adenoma), which could be missed using traditional endoscopes. These endoscopes improved the degree of detection of even the smallest polyps.” Dr. Qwaider says the disadvantages of the colonoscopy are the risks associated with sedation as well as a low risk of tearing a hole in the colon that would need to be treated with medication or surgically repaired. Also, because this procedure is more thorough, it is more expensive than the others and takes more time. The Flexible Sigmoidoscopy colon cancer screening method is a procedure that is less expensive and is believed to pose less risk of damage to the colon. In this procedure, the patient is not put under anesthesia, which for some patients is preferable, but for others it can be quite painful, or at the very least uncomfortable. This screening only examines the rectum and the left side of the colon. Dr. Qwaider says “Studies over the last ten years show an increase in colon cancer on the right side of the colon, which may indicate that this method is less effective in colon cancer prevention.” The Double Contrast Barium Enema gives the doctor a picture of the colon, which again, has the advantage of being less expensive and has less potential of damage to the colon, but may reveal harmless rectal waste that would have to be examined with further testing. With this procedure, it is easy to miss small polyps. The Fecal Occult Blood Test (FOBT) checks for rectal bleeding that can not be seen by the human eye. This test is less costly, but must be done more often than other tests. This method is less effective than other methods in the detection of polyps. Normally polyps don’t bleed unless they are malignant. Dr. Qwaider says, “This test is suboptimal since our goal is to identify the precancerous lesions and remove them, not to diagnose cancer, which typically bleeds.” The Virtual colonoscopy test uses special xray equipment to produce pictures of the colon and rectum. A computer then assembles these pictures into detailed images that can show polyps and other abnormalities. Because it is less invasive than standard colonoscopy and sedation is not needed, Virtual colonoscopy may cause less discomfort and take less time to perform. But as
with other methods, if polyps or abnormalities are found, other tests, such as colonoscopies, must be done. Doctors and scientists are continually studying colorectal cancer screening methods, using controlled trial testing and observation testing to determine how effective any of these tests are alone, and in combination, in reducing the incidence of colon cancer. Their findings conclude that colon screening is very important in the prevention of colon cancer, as stated in the 2008/2009 Colorectal Cancer Initiatives fact sheet, from the Centers for Disease Control and Prevention (CDC), “Reducing the number of deaths from colorectal cancer depends on detecting and removing precancerous colorectal polyps, as well as detecting and treating the cancer in its early stages. Colorectal cancer can be prevented by removing precancerous polyps or abnormal growths, which can be present in the colon for years before invasive cancer develops. When colorectal cancer is found early and treated, the five-year relative survival rate is 90 percent. In states where screening rates are low, less than 40 percent of colorectal cancers are found early. Colon cancer screening is quite effective in preventing colon cancer, but is underused at this point.” For this reason, the CDC engages in numerous colorectal cancer prevention and control efforts, which include increasing public awareness. Studies are also being done to help understand the roles that diet, lifestyle, and dietary aids (such as folic acid, Oemga 3 fats, antioxidants, calcium, anti-inflammatory drugs), play in the control of colon cancer. Dr. Qwaider says they show evidence that increasing exercise and the intake of fruits and vegetables lowered the incidents of polyps and colon cancer, but tests on the dietary aids were inconclusive. According to Dr. Qwaider, his recommended screening protocol for healthy adults is to have a colonoscopy every 5 to10 years starting at age 50. Patients at risk should be screened earlier and more often. At risk patients include those with a family history of colon cancer, have Familial Adenomatous Polyposis Syndrome, Hereditary Non-polyposis Colorectal Cancer, and those with inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease. +
Findings from the National Health Interview Survey (NHIS), which is administered by CDC, indicate that in 2000, only 42.5 percent of U.S. adults age 50 or older had undergone a sigmoidoscopy or colonoscopy within the previous 10 years or had used a fecal occult blood test (FOBT) home test kit within the preceding year. Screening for colorectal cancer was particularly low among those respondents who lacked health insurance, those with no usual source of healthcare, and those who reported no doctor’s visits within the preceding year. As many as 60 percent of deaths from colorectal cancer could be prevented if everyone age 50 and older were screened regularly.
Recommended screening tests and intervals are: Fecal occult blood test (FOBT), which checks for hidden blood in three consecutive stool samples, should be administered every year. Flexible sigmoidoscopy, where physicians
use a flexible, lighted tube (sigmoidoscope) to inspect visually the interior walls of the rectum and part of the colon, should be administered every five years.
Double-contrast barium enema, a test
that uses a series of X-rays of the colon and rectum (taken after the patient is given an enema containing barium dye followed by an injection of air in the lower bowel), should be administered every five years.
Colonoscopy, where physicians use a flexible, lighted tube (colonoscope) to inspect visually the interior walls of the rectum and the entire colon, should be administered every 10 years. During this procedure, samples of tissue may be collected for closer examination, or polyps may be removed. Colonoscopies can be used as screening tests or as follow-up diagnostic tools when the results of another screening test are positive. Percent of U.S. adults age 50 or older who had undergone a Sigmoidoscopy or Colonoscopy in the previous 10 years Percent of deaths that could have been prevented if everyone age 50 and older were screened regularly 60 45
Connie Hein is a freelance writer living in Windsor and the author of The Toliver in Time series of Children’s books.
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Lydia’s STYLE Magazine
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awareness
cancer center of the rockies
“With our main objective being the collection of hair, we feel that the enthusiasm of the stylists will make the event a success.” Linda O’Dea, marketing and event coordinator for the Hair-Raiser
1st Annual
Hair-Raiser!
By Erica Pauly
According to the Journal of the American Cancer Society, nearly 60 percent of women regard hair loss as the single worst side effect of cancer treatment.
T
he Cancer Center of the Rockies will host their first annual Hair-Raiser event. Salons across Northern Colorado will be competing to see who can cut the most inches of hair on Sunday, April 19th, from 1:00 to 5:00 p.m. All participants will be helping cancer patients who have lost their hair to chemotherapy feel beautiful again. The event, spearheaded by Cancer Center of the Rockies, is an opportunity for the Northern Colorado community to give in a whole new way. The idea came from Dr. Matthew Sorensen, who felt that the community should come together to “raise some hair,” he says. Linda O’Dea, marketing and event coordinator for this event says, “Dr. Sorensen sees that, along with all the other side effects, hair loss can be one of the most devastating aspects of cancer; particularly for women.” The dedicated committee of six includes Dr. Sorensen; Tania Adams, CEO of the Cancer Center of the Rockies; Brooks Pardew, also of the Cancer Center of the Rockies; Jill Hultin, cancer survivor; Nancee Testa, cancer survivor and hair salon owner; and Linda O’Dea, marketing and event coordinator. Although it has been a team effort up to this
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point, the competition will begin soon. The salon that cuts the most inches of hair will win the traveling “Hair-Raiser of the Year” trophy. Locks of Love and Beautiful Lengths organizations will receive all of the cut hair, which will then be transformed into beautiful wigs. The wigs will be available to Northern Colorado locals who are undergoing treatment and in need of a wig. Any salon in Northern Colorado is welcome to participate, but there can be no inches cut without the clients there to participate as well. The involvement of both the community members as well as salons is what will make this event a smashing success! Absolutely everyone with hair to donate is invited to attend the big event. One only needs to travel to the Hilton Garden Inn, in Fort Collins, on Sunday, April 19th between 1:00 and 5:00 p.m. Can’t make it on that date? No problem. O’Dea says, “If clients need or want their hair cut prior to April 19th, or can’t make it on that day or time, the stylists will hold on to their hair and present it at the event.” This will make all donated hair still eligible to count for the prize at the event. Being that this is the first year for the event, the committee doesn’t know what to expect. O’Dea says, “We hope that the word of mouth by
salon stylists along with our PR efforts, will garnish enough hair to help a substantial number of patients,” in hopes that the first year will be such a success that it will be the first of many years to come. The salon excitement matches the committee’s excitement. O’Dea says, “From my personal experience of contacting salons, the excitement level throughout Northern Colorado is great. With our main objective being the collection of hair, we feel that the enthusiasm of the stylists will make the event a success.” The Hair-Raiser committee is ready for the event to begin, as the salon stylists are ready to cut and create beautiful hair for those who have none left; are you ready to help make a difference with the donation of your hair? + For more information on the Hair-Raiser, visit the website at: www.raisesomehair.com Main sponsors include Cancer Center of the Rockies, Hilton Garden Inn, and Citizen Printing. Erica Pauly is a Contributing Editor at Style Magazine.
Lydia’s STYLE Magazine
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Northern Colorado Medical & Wellness
conceptions
in vitro fertilization
Reproductive associates of colorado
“We look at 150,000 points on the DNA from the mom, dad, and embryo. That typically allows us a 99 percent accuracy for each chromosome.” Mark Bush, M.D., Conceptions Reproductive Associates of Colorado
Conceptions Reproductive Associates of Colorado
Embryo Testing
by kay rios
For couples trying to conceive through in vitro fertilization (IVF), the emotional, physical, and financial investments are very high. So it’s comforting to know that new technology can help pave the way for a happy, healthy birth.
I
VF and other assisted reproductive technologies have helped thousands of previously infertile couples conceive. As part of that process, pre-implantation genetic screening of the embryo looks for chromosome errors that can impact a couple’s chances of conceiving and delivering a healthy baby through IVF. “The screening is particularly important for women over 35, for women with a prior history of miscarriage or who have had an unsuccessful IVF cycle,” says Mark Bush, M.D., at Conceptions Reproductive Associates in Littleton. Previous DNA screening techniques have been limited, only looking at seven to eleven chromosomes. But now, the newest and most advanced technology involves a microarray analysis that offers a look at all 23 chromosomes. “We look at the copy number across all of the chromosomes,” Bush says. “If you are over 35 and doing IVF, there
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will be abnormal chromosome numbers. A common abnormality is Down’s Syndrome with three copies of chromosome 21. Another is trisomy 16, which results in miscarriage.” Statistically speaking, he says that if a woman over 35 has eight embryos, four have a high probability of having chromosomal errors. Because the new technology allows careful scrutiny of each of the embryos, it allows the doctor to narrow that down and then implant only 1 or 2 healthy embryos. Bush says he’s always been interested in single embryo transfer. “If there are four DNA normal embryos, I will counsel to transfer one or two and freeze the others for transfer in the future. I’m not discarding healthy embryos or creating a risky situation for both mother and infants by transferring multiple embryos and running the risk of triplets. It is important to look at the Society of Assisted
Reproductive Technology website (http://www. sart.org/) and review the number of embryos transferred by the IVF practice and the percentage of births that are triplets. For the last two reportable years, Conceptions’ triplet rate is 0 percent.” This new process has been in a research phase for several years. “This technology is far superior than anything else out there for checking DNA,” he says. “The original DNA diagnosis was done in 1992 when they looked at the cystic fibrosis gene and were able to put back a non-afflicted embryo.” Since then the technology has continued to be improved but there were still limitations. “The problem was the technology still only allowed a look at some of the chromosomes.” Another technology that looks at all of the chromosomes is available in other areas of Colorado. “Comparative genomic hybridization (CGH)
Lydia’s STYLE Magazine
Dr. Bush performs an IVF egg retrieval at Conceptions’ on-site IVF lab and center in Littleton, Colorado. is less accurate than microarray analysis with Parental Support Technology and it takes five days to complete so the woman can not receive a fresh embryo transfer.” The single nucleotide polymorphism microarray analysis technology, used by Conceptions, includes the addition of Parental SupportTM bioinformatics. It incorporates genetic data collected from the parents with a simple cheek swab and improves result accuracy. “We look at 150,000 points on the DNA from the mom, dad, and embryo. That typically allows us a 99 percent accuracy for each chromosome.” The test has rapid turnaround allowing a woman to have an embryo transfer in the same cycle that she undergoes IVF. This technology has been greater than two years in the making in terms of being able to offer this to the general public, Bush says. Conceptions has partnered with Gene Security Network (GSN) to make it happen. GSN specializes in combining bioinformatic analysis with leading laboratory techniques to deliver highly accurate full-genome testing on small quantities of biological material. The Parental SupportTM is GSN’s proprietary testing technology. The company and its testing laboratory are based in Redwood City, California. Conceptions is the only group in Colorado, and one of five leading IVF centers in the country, to first offer this cutting edge technology. As a leader in the field, Bush is board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility. He has held the rank of Clinical Assistant Professor at the University of Washington School of Medicine in Seattle, Washington, and associate professor at the F. Edward Hebert School of Medicine in Bethesda, Maryland. Among his many awards is the American College of Obstetricians and Gynecologists CREOG National Faculty Award, which he received in 2001. He has been a partner at Conceptions for the last four years. Conceptions also has an office in Lafayette, Colorado. For additional information, log on to www.conceptionsrepro.com. Kay Rios, Ph.D., is a freelance writer based in Fort Collins. She has written on a variety of topics for national and regional publications over the past 25 years.
Northern Colorado Medical & Wellness 2009
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LITY Your locally owned leader in health care is a national role model for excellence. Poudre Valley Health System has received the 2008 Malcolm Baldrige National Quality Award - the highest Presidential honor given to United States businesses and organizations that demonstrate performance excellence . Thank you to our treasured patients and families, incredible volunteers, staff and physicians, and the many regional organizations who support us in achieving our vision to provide world-class health care.
Were herefor you.
www.youtube.com/user/PoudreValleyHealth
POUDRE VALLEY HEALTH SYSTEM Northern Colorado Medical & Wellness 2009
senior living
new facility in greeley
“We want our residents to be part of the community. We are hoping over time they can even have a neighbor over for dinner.” Michael Pietrzak, M.D., Founder of MeadowView
Meadowview
on the cutting edge
By Angeline Grenz photos by warren diggles
Nestled in a lively neighborhood, surrounded by residential homes and shopping centers, MeadowView offers something special to their residents: the nostalgia of home and a strong sense of community. The newly opened assisted living and memory care facility places a high value on keeping seniors active and engaged, no matter what level of care they may need.
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eadowView opened their doors on January 9, 2009. As they steadily welcome new tenants, the Greeley facility is gathering the finishing touches for their top-rate residence. Beyond the handsome decor, ice cream parlors, and theater rooms, MeadowView’s true beauty is in its commitment to enhancing residents’ quality of life during their retirement years. “Our goal was to create a real neighborhood feel at MeadowView,” according
to founder, Dr. Michael Pietrzak, “We want our residents to be part of the community. We are hoping over time they can even have a neighbor over for dinner.” Dr. Pietrzak has drawn high praise for similar senior communities in Iowa. MeadowView is situated on 5.3 acres with long views toward the mountains. The building is 68,000 square feet with one wing dedicated to senior assisted living, and the other for the memory care wing. “Our philosophy is to make every moment a great moment, allowing residents to grow older with dignity and grace,” says
Michelle Silva, marketing coordinator. Assisted Living The assisted living portion of MeadowView includes 51 apartments, ranging from studios, one bedroom and two bedrooms. The bright, airy apartments have kitchenettes with small refrigerators, microwaves, and sinks; only the two bedroom units have ranges. Pets are welcome at MeadowView, and apartments with outside access for easy care are available. While units are comfortably appointed, the
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Lydia’s STYLE Magazine
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Adult Neurology Pediatric Neurology Electroencephalography Neurorehabilitation Evoked Potentials Multiple Sclerosis
Michael P. Curiel, MD
Alzheimer’s Disease Electromyography Pain Management Head Injury Headache Seizure
Vagus Nerve Stimulators Parkinson’s Disease Neck and Back Pain Botox Injections Neuropathies Stroke
Now Doing Infusions in Office
F O R T C O L L I N S N E U R O L O G Y, P. C . D I P L O M AT E S , A M E R I C A N B O A R D O F P S Y C H I AT RY A N D N E U R O L O G Y Northern Colorado Medical & Wellness
Timothy J. Allen, MD
2 1 2 1 E a s t H a r m o n y, S u i t e 2 7 0 | F o r t C o l l ins, CO 80528
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goal is to lure seniors outside to enjoy the company of their neighbors. The assisted living wing is “designed to get people to come out and spend time together and create friendships. I think we have done an exceptional job of that,” says co-owner Fred Fuller. The majority of residents’ meals take place in the Grand Lodge dining room. Residents get three chef-prepared meals a day. “Everyone has told us how much they love our food,” according to Silva. A two hour window at breakfast, lunch, and dinner allow residents to eat at their leisure. They are able to order from prepared menus and are served at their table. The New York-trained chef, Jon Samson, makes everything from scratch, controlling the amount of saturated fats, salt, and cholesterol that enter their diets and takes special menu requests. “I try to provide our residents with three or four star meals every day.” Between meals, snacks are available in the kitchen, game rooms, or the community kitchen. The community kitchen is a full-size kitchen available to residents who want to get together to bake a holiday meal, or can be reserved by visiting family members who want to cook with their loved one. MeadowView’s layout is designed to encourage socializing. In addition to the community kitchen, outside of approximately every seven apartments is a gathering place with comfortable seating and snacks available so residents can get together to play cards, talk, and watch televisions. Upstairs is a rooftop deck for ice cream socials and light happy hours. Seniors can also compete in Nintendo Wii tournaments in the downstairs gameroom, which allows for larger gatherings. A 24-hour internet café is available and a few doors down is the large exercise room with television, weights, exercise machines, and cork floor for low impact comfort. Craft rooms are sprinkled throughout the facility. Finally, a theater room with giant television and popcorn machine allow seniors to gather for a movie night. A beauty salon and spa room also gives residents the opportunity for extra pampering. The spa features a walk-in jetted tub. Situated on five acres, seniors have plenty of opportunity to stay fit and active, either walking the grounds or the neighborhood beyond. Just a few blocks away, seniors can access shopping and dining for those days they want a change of pace. Assisted living residents have a wealth of planned activities available to them throughout the day at MeadowView along with weekly outings arranged to take residents off campus for shopping and other activities. Assisted living apartments range from $2,950 to $4,495 a month. The rent includes three meals a day, utilities, two loads of laundry a week, housekeeping, daily bed making, and a 24-hour emergency response system. Healthcare assistance plans are available for an additional cost, which include help bathing, dressing, grooming, eating, help with medications, and mobility assistance. Guests can eat a gourmet meal with a resident for a very reasonable $6 a meal. Memory Care Village MeadowView’s Memory Care Village offers true innovation for seniors with special cognitive
Halls are color coordinated to help with memory loss.
Themed rooms help residents with memory.
Murals are painted in hopes to help residents recall memories from their childhood. needs and is where Dr. Pietrzak’s real passion lies. “Our concept is a protected environment that is open and engaging, and provides a set of experiences that are satisfying on a daily basis.” The memory care wing opens in May this year. Already, MeadowView has a waiting list. “Most assisted living facilities often lock down the unit for people with cognitive issues. The problem: there is less engagement. If no one is doing anything with these individuals, their behaviors worsen. Then, they are placed on sedatives and pharmaceuticals, making dementia worse.” At MeadowView, the philosophy is just the opposite. Planned activities for memory care residents keep them active. Though the wing is secure, huge windows let in plenty of light and
a view of the world beyond the walls. Outside, a memory garden, with raised flower beds, is available to residents who can get outside for a stroll or get their hands dirty and help plant some flowers. The large security fence offers privacy and safety, with pockets of visibility that allows them to feel part of the neighborhood. MeadowView’s memory care utilizes groundbreaking methods to help Alzheimer’s and dementia patients live a full, colorful life. Wayfinding is the core methodology used to assist these residents. “Our practices are centered around stimulating the senses to help trigger memory,” according to Fuller. Inside their facility, hallways are extra wide. “This feels more open, not closed or locked in,” says Silva. continued on page 34
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MeadowVeiw provides ice cream, malts, and rootbeer floats for its residents at anytime.
The bright, airy apartments have kitchenettes with small refrigerators, microwaves, and sinks.
Hallways are color coded and referred to as neighborhoods. Each residence is marked by its own color. A memory care patient can be told they live on “green lane at the blue door.” Outside each of the 20 apartments is a memory board that staff fills with family pictures, mementos, and other objects to help activate memory and recognition. Inside the apartments, there is a bedroom and bath. The baths feature frameless showers with the dark tiles on white, making it easier for residents to utilize and decrease tripping accidents. All units are equipped with emergency pull cords. Common areas feature sense-stimulating details, such as bright colors and changing textures. A wall of brick, another of barn siding, and picturesque country scenes painted on the walls stimulate memories of childhood. “We really wanted to make our facility reflective of the region and give residents the feel of where they grew up,” explains Pietrzak, “These memories of nostalgia are our strongest memories, and iconic feels from the past create a pleasant, comfortable environment. The dining area even features a mock ice cream parlor, complete with malts and rootbeer floats available anytime for residents. Private living rooms are available for visits with family members. A beauty salon and spa offer similar services as the assisted living wing. The chapel has a nostalgic prairie chapel feel and craft rooms are available for daily activities. Another key provision for residents are the Snoezelen rooms, a Dutch word meaning “to doze.”
These rooms, scattered throughout the wing, are available when residents become agitated, tense or frustrated, as can happen from time to time with memory loss. Residents can make use of the rooms to sit quietly, talk with staff, or listen to music, giving them time to calm down and regroup. The engaged lifestyle promoted at MeadowView has enabled some residents to stay off medications, such as anti-depressants, and actually encourage memory. In other facilities, Dr. Pietrzak has even seen some regain memories to the point that they are able to return home for a time. Not a cure, says Dr. Pietrzak, but residents enjoy an enhanced living while at MeadowView. “This is very important to us. Someone without a memory can only focus on now. We want to make now as good as possible,” concludes Dr. Pietrzak. Memory care residences start at $4,800 a month. Services include health monitoring, meals, pet and music therapy, utilities, laundry and housekeeping, and barber and beauty salon services. Additional healthcare assistance is available, including nightly or two-hour safety checks. MeadowView has future phases planned for the remainder of their five acres. As need grows, the memory care portion will add on ten more units. Twenty-four senior condominiums are also included in future phases as the economic climate allows for expansion, says Fuller. +
Angeline Grenz is a Fort Collins freelance writer.
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Curtis E. Crylen James W. Wolach MD MD
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Northern Colorado Medical & Wellness
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pain management
Colorado Spine, Pain, and Sports Medicine, P.C.
“I treat the whole person, not just the body part injured.” -Ricardo Nieves, M.D., FAAPMR, Colorado Spine, Pain, and Sports Medicine, P.C.
New Pain Management Specialist
Doctor Makes Fort Collins Home by erica pauly | Photos by warren diggles
Moving somewhere new is never easy. But when research, magazines, and close friends all reveal that Colorado is the place to be, a doctor and his family may find themselves at home in a different medical mecca: Northern Colorado.
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hen Ricardo Nieves, M.D., FAAPMR, and his wife, Kim, decided to leave the practice he owned in southeast New Mexico, a two-year search began for the perfect place to grow old, grow a business, and raise their three children. “We were selfemployed and had the ability to move anywhere in the world, which made the search more interesting. Our main concern was healthcare for ourselves and education for kids,” says Kim. When job offers came from more than ten states, the Nieves family traveled to many places and looked at multiple opportunities in hopes that it would
be the one. “Every place we went, we just didn’t feel like that was where we wanted to be,” says Ricardo.
Replanting After years of looking for a perfect place to settle down and plant their roots, Ricardo and Kim visited Colorado. “We came on a Friday, and the house was closed that next week,” Kim says while laughing. The education available for their three young children, Austin, Jillian, and Anton, and the healthcare that will be here for them when they decide to retire made the entire family ready to plant their feet into the Fort Collins community.
What to expect Dr. Nieves is Board Certified from the American Board of Physical Medicine and Rehabilitation, with sub-specialties in Pain Medicine and Sports Medicine. After completing 13 years of school, 9 board certifications, 14 years in practice, eight of those years owning a private practice, and serving on many organizations as a leader for Non- Surgical Spine Care, Dr. Nieves fits like a glove in this community. Dr. Nieves performs a comprehensive spine, musculoskeletal, and neurologic consultation, which also includes a McKenzie Mechanical Assessment of the spine and extremities, on every new patient. Then, he says, “I review the diagnoscontinued on page 40
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Christopher Bee, MD
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Northern Colorado Medical & Wellness 2009
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tic studies and discuss the diagnosis and treatment options with the patient. A very important part of the initial evaluation is educating the patient about their condition and providing them with tools on self management of their problems.” The McKenzie Assessment allows Dr. Nieves to better educate his patients on self-treatment, and early return to daily function. He continues, “If minimally invasive procedures are indicated, this will be performed under direct Fluoroscopic Visualization in my office, and if necessary, at a surgical center or hospital.” Kim, an R.N., works alongside her husband during any procedures done in the office. Dr. Nieves has been involved with the community since day one. Patients are referred to him from other specialists in the area and he is on staff for Physical Medicine and Rehabilitation and Pain Management at PVH and MCR. After eight months of experiencing our medical needs, Dr. Nieves says the most common types of pain he sees are neck, lower back, shoulder, hip, knee, and nerve pain. “The most common procedures I’ve been doing include non-surgical spine intervention procedures, like epidural injections, selective nerve root blocks, facet joint injections, radiofrequency ablations, joint (knees, shoulders, hips) injections, acupuncture, and electrodiagnostic studies.” An electrodiagnostic study, which is a physiologic study, is performed in cases that are necessary to fully determine the origin of a patient’s symptoms.
Thomas F. Overton, DDS
Call or email us at tfodds@overtoncenter.com for a complimentary consultation!
1220 Oak Park Drive | Fort Collins | (970) 223-6677 www.overtoncenter.com 40
Dr. Nieves briefs patient, Abby Bloedorn, on the spine and its role in the body.
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Caught In Action Style visited Dr. Nieves’ office during a procedure on a new patient, Abby Bloedorn, an account executive for Style Magazine. After having severe back pain for the last two years, Bloedorn came to Dr. Nieves for help, which he graciously provided. “I had a mountain bike accident more than two years ago. Ever since, I haven’t been able to lie down without pain; I even bought a new bed! I started doing pilates, and that helped, but I could tell that something was still off since my fall,” says Bloedorn. The initial assessment and evaluation by Dr. Nieves concluded that a lumbar transforaminal epidural steroid injection and facet joint injection was best suited to minimize the pain in Bloedorn’s back. Dr. Nieves explained the condition to Bloedorn, and prescribed her to receive an MRI and injections. “These injections are done to treat nerve root and facet joint irritation, inflammation, and pain,” says Dr. Nieves. The liquid injected is a long acting steroid medication and a local anesthetic. After the injections, Dr. Nieves sent Bloedorn on her way with home exercises, posture and spine mechanics, and a specific physical therapy prescription. Bloedorn says, “I was a little sore the day of the injection, but my backache was gone. I couldn’t believe that after two years I could finally lie down without any discomfort.”
rect, and ultimately, the most effective. “I treat the whole person not just the body part injured,” he says. Dr. Nieves stresses the importance of doing more functionally based and comprehensive types of evaluations, rather than treating just the spine or just the findings on an MRI. He explains that, many times, findings that are present in the MRI may not all be causing the patient’s pain. Therefore, the importance of the mechanical and functional assessment is crucial to determine the source of pain in order to maximize benefits of treatment interventions, and minimize unnecessary therapy, injections, or surgeries.
a patients pain, and work with them to alleviate it. His advice for anyone who wants to prevent future problems and to practice practical pain management: “Improve your posture, practice joint and spine mobility exercises, and stay active by using proper spine and extremity biomechanics.” Relocating Dr. Nieves’ family to Colorado has been the first step toward planting roots, but the next step for the Nieves family has been to meet and work with Northern Colorado residents, physicians, and healthcare providers. After eight months of practice, Dr. Nieves and his family say they have most definitely found their final home. +
Advice
Erica Pauly is a Contributing Editor for Style Magazine.
Plain and simple, Dr. Nieves’ passion is to find
Pinpointing Pain Dr. Nieves’ approach to medicine is to pinpoint the cause of pain so treatment can be di-
Dr. Nieves administers a lumbar transforaminal epidural steroid injection.
Kim Nieves, R.N., with her husband Dr. Nieves.
Northern Colorado Medical & Wellness 2009
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wellness
yoga for fitness
an invitation to
breathe again
by faith brandt | erica pauly Photos by warren diggles | courtesy of fort Collins club
“We are human beings, not humans doing.” – Faith Brandt
Y
ou’re rushing around town and working on your list of things to do. As you hurry along, you can feel the tension building in your neck, as your jaw tightens, and your breathing becomes shallow. You have a ton of bills due, and you are not sure your paycheck will cover them. Relationships are pushing you beyond what you can handle. Do these scenarios sound familiar? At times, our lives can be hectic and overwhelming. Yoga could be your answer. Yoga not only brings strength and flexibility to your muscles, but it additionally gives you a deeper awareness of your body, breath, and mind. What you learn on your mat can be easily transferred into your everyday experience. Let’s explore a few
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ways in which yoga can nourish you. Although we breathe consistently throughout the day, we are often unaware of it. Practicing mindful breathing provides us with a tool that can support us in many positive ways. When our minds are overwhelmed with our list of things to do and with the many other challenges in our lives, we can slow down and become more grounded by watching the path our breath takes as we inhale and exhale. As we pay closer attention to our breathing, we can also focus on deepening our inhalation, and lengthening our exhalation. This simple practice calms the nervous system, brings increased energy, alertness, and peace of mind. Unlike the mind that is trying to keep track of multiple things, the mind now can focus on one thing, what you are experiencing on a physical lev-
el. It is within this single pointed focus that we are able to lean how to unravel and release habitual tension and stress. The mind can also find peace in not doing anything. Often in a yoga class we may be asked to sit or lie down and do nothing. This suggestion is a welcomed invitation to some and an almost impossible feat for others. Usually we label ourselves as lazy or unproductive unless we are doing something. But it is also in the non- doing that we can begin the process of calming and centering the mind. As a friend once told me, “We are human beings, not humans doing”. The most beautiful thing about yoga is that anyone can practice. Whether you’re young, old, short, tall, injured or healthy, it doesn’t matter. Yoga can be adapted to each person’s individual
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needs. Whether you are struggling with a challenging illness, recovering from surgery, or feeling just plain out of shape, you can begin your yoga practice today. Finding an experienced teacher who is willing to work with you in a private session is a great way to begin so you can learn the modifications needed to take the best care of yourself.
Q & A Session with Maila Rider The director of yoga at Fort Collins Club took a few minutes to sit down and discuss yoga and Pilates with Style.
What do Pilates and yoga have in common with one another?
When you do Pilates and yoga, you approach them differently than running on a treadmill and lifting weights. You learn to focus on what you are doing, so you aren’t just in and out of the gym. You learn to focus on breathing and your entire body movement.
Who can practice Pilates and yoga?
Pretty much anyone can join the classes. There are some students who may be eliminated from doing certain exercises. These would be students
with extreme musculoskeletal problems. But at the same time, the time spent with a student is tailored that whatever needs they have. There are things we, as trained professionals, can do that are specific to healing those ailments. +
Faith Brandt directs The Yoga Center at Pulse Fitness Center. She specializes in Yin, Partner, Adaptive, Beginning, and Intuitive yoga. Erica Pauly is a Contributing Editor for Style Magazine.
What is Pilates?
Pilates is yoga inspired. Prisoner of war, Joseph Pilates began practicing a unique form of yoga, and when he moved to the United States, he started the Pilates trend.
What is the main mental goal when practicing Pilates?
The goal is to bring awareness to people’s bodies so they have a better kinesthetic approach to movement. Thinking about what they’re moving and what they’re using makes them more thoughtful and mindful about all their movements in and out of the class. We use moves that condition the entire body. This is known as ‘uniform development,’ which means that everything you do is a full body movement. Our focus is to always use the intrinsic muscles to move the entire body. We emphasize the core muscles, which most people think are the abs, but our core is actually made up of several muscles. The Pelvic Floor, which supports our internal organs; the Transverse Abdominus, which protects our lower back; the Diaphram, our main breathing muscle; our Multifidus, which works with our lumbar spine; and the Psoas muscle, which is the muscle that holds our leg in its socket.
How is Pilates different from yoga?
One of the most obvious differences is that yoga has a lot more static contraction. There is not as much dynamic contraction in yoga as there is with Pilates. Also, the breathing is different. There are eight different breathing techniques in yoga, but only one for Pilates. It is referred to as a lateral ribcage breath. Some other fundamental differences are that Pilates is a little more restorative and rehabilitative. Yoga is definitely restorative and rehabilitative, but there is more of a focus on rehabilitation and restoration in Pilates. In addition, Pilates classes are usually smaller, which creates an opportunity to make sure the students are in the right alignment and position for each exercise.
What is the biggest difference that Pilates can make physically?
Some people attend classes to lose weight, but everyone’s goal is different. Students will definitely see changes in their body, but, I also don’t think Pilates should be anyone’s primary fitness modality. You should still be doing cardiovascular exercises along with some type of weight training. Pilates and yoga come in as a restorative part of doing other modalities of fitness.
Northern Colorado Medical & Wellness 2009
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healthy lifestyle
biggest loser
wellness program by Lydia dody
M
ost of you have probably found yourself watching an occasional episode of The Biggest Loser on TV. I know when I have watched an episode, I’ve been in awe of the exercise demands, the emotional ups and downs, the competitive spirit, and the dramatic weigh-ins. The contestants are so committed to changing their lives that I have found myself cheering them on to success. So when I heard that The Other Club was offering a six-week Biggest Loser program I jumped at the opportunity and talked my sister into joining me. Bud Phillips, owner of The Other Club, has spent a lifetime in the health industry, and also
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happens to be my personal trainer. He is definitely committed to good health and as he says, “My goal has been to provide our members the best trainers, the latest ideas in exercise and health science, and the best opportunity to achieve their health and fitness goals. I also wanted to reach out to the community and offer a full service program to members and non-members that would include cardiovascular work-outs, weight training, and nutrition guidance.” Echoing this philosophy, Other Club trainer and program director, Nancy Stilson-Herzog, CPT, brought together all the components and formed the first Biggest Loser program in November 2008. Stilson-Herzog has more than 25 years of group fitness experience along with 15 years of personal training experience. Phillips
couldn’t be happier about the program results and speaks highly about Stilson-Herzog. He says, “Nancy is very knowledgeable about fitness, is extremely encouraging, and works with groups very well, while giving everyone individual attention.” Stilson-Herzog shares,”I have seen such good results with this program. Participants will work harder on behalf of their team. The two groups that have completed the program (a total of 24 participants) have lost a total of 166 pounds and 44 inches. My goal is to educate the participants to be proactive about their health instead of reactive. Exercise is critical as is what you put in your mouth. I am actually teaching a new way to look at self-care.” The program kicked off mid January with a
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“I’ve never done the whole team thing before. I’ve en joyed the support of the group. Te am spirit helps and holds me acco untable. I used to dislike exercise, bu t I’ve learned to like it. The nutrit ion portion has been a gift, and I’ll incorporate it into my lifestyle chan ge.” –Ina
out of lped me step “This has he joyed en ve ne. I ha my comfort zo d enan p ou gr e th being part of ” e. nc le experie joyed the who –Jean
“I learned the most about exercise. The group invo and accoun lvement tability has helped so much. In th e past I alw ays one way fo r my husban cooked d other way for my kids and an. Now I am working ha rd to prepar e healthy food for the entire family .” –Laura
with the p a notch u it r. d ke ic “I k d the wate rogram an t le n ca I ; exercise p lp as a big he w tp u le ro n g a The er th n a lot easi myself dow down.” up ting the gro –Julie
weigh-in and measure, in private, of course. My scale always seems to weigh five pounds less than those official ones so my starting weight was higher than I expected. Everyone had a starting point, and we were all excited about the up-coming six weeks. The commitment was to meet for a group exercise experience at 5:30 p.m. on Mondays and Thursdays, and attend a nutrition class on Saturday mornings. The allfemale group (this time) consisted of a broad spectrum of ages, fitness levels, and weight loss goals. Everyone was enthused, committed, and supportive of each other. Since this club is where I have worked out for a number of years, the facility and staff were familiar with me, but those who weren’t members quickly got acquainted and felt welcomed and comfortable.
Northern Colorado Medical & Wellness 2009
Our exercise sessions were very effective as they introduced us to and incorporated various ways to accomplish improving fitness and losing weight while having fun. We found ourselves panting and sweating off pounds to a super fun Zumba hour-long dance class led by Nancee Testa. The Latin music and the talented, highenergy instructor made the time fly. Another session was a Nia class, which incorporates fluid, but effective movement and breathing techniques in a non-impact aerobics class taught by Jana Kenezovich. Through the years, I have admired Katherine Sanford, ACE, and her great looks and fit body, and when I learned she was 52 years old, I was inspired! Her Big Results cardio kick-boxing class made us really work hard, pant and sweat pro-
fusely, but we kept on going hoping some day to look as fit as she is. Her class challenged us because of the quick pace and increased difficulty of incorporating hand weights, bands, balls, weight machines, and cardio machines into her powerful and effective hour-long class. This combination made a big difference in gaining strength, losing inches, losing weight, and improving endurance. She explains, “I have been teaching group fitness classes since 1993, and my approach is to have my participants push their limits while still having fun. I also make sure everyone learns good technique and the appropriate weights to use as we move through the sessions.” I’ve become a fan and show up at 5:30 on Wednesday’s knowing I’ll work off quite a few calories. It’s convenient for members
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or non-members because all the classes are on a punch-card basis, so it is ok if you have to miss an occasional meeting. As much as I loved the collective energy of our group exercising, I also really looked forward to Nancy Stilson-Herzog’s Eat For Health classes on Saturday mornings. They were eye opening and definitely life changing. She kept all of us engaged and asking questions as she educated us and opened our eyes to the impact of bad food choices on our bodies and the inflammatory process and disease; reading food labels and discovering hidden food additives; also demonstrating recipes using healthy choices. I enjoyed learning about new vegetables and grains, and then having an opportunity to actually taste them. The practical application of the information we learned is what will stick with me long term. In one of the early sessions, we each got our own copy of The China Study on CD’s with instructions to start listening in our cars. Well, I had previously read the book, and at the time, thought it was radical and impossible to incorporate into my lifestyle. This time, I was ready for the information and am now trying to be mindful of what I eat and to incorporate many of the things I learned into a healthier lifestyle. There was so much material to learn in the Eat for Health segment that I am thinking about repeating the entire program again. The group dynamics and commitment to be accountable made us all show up for our exercise classes. Sharing our frustrations, tips, recipes, and successes with each other was supportive and encouraging. The group dynamics kept us involved and on track. In fact, most of us are staying involved through repeating the program, or continuing with either the exercise or nutrition components. I signed up for the nutrition one, but have decided to repeat the entire program again. My sister felt she benefitted from the program, and is now continuing on her own in weight training and spinning classes. Her nutrition awareness made a dramatic shift and she is now focusing on healthy eating. Once you are finished with the program, Stilson-Herzog still stays in touch. She says, “I do a one month, three month, six month, and one year follow up with everyone to monitor lifestyle changes. In fact, the first group continued to lose more weight after the program, and several participants re-joined to continue their success with the second group.” I extend my thanks to Nancy Stilson-Herzog, for her passion and dedication to teaching us all a healthier and more wholesome way to live. I especially loved how you connected with each of us through your daily motivational tips; I have many of them taped where I can read them again and again. I highly recommend the Biggest Loser wellness program to companies who want their employees to learn proactive self-healthcare through healthy eating and fitness for life. Everyone can benefit from it! In closing, Stilson-Herzog reminds us, “Everyday you have the opportunity to make a decision about your health. It is what you do most of the time that makes the difference.” + Lydia Dody is commited to good health and physical fitness.
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Lydia’s STYLE Magazine
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podiatry
A Step Ahead Foot and Ankle Center
“The procedure offers less dissection, much less post operative hassle, quicker healing time and much less pain.” Robert C. Schulte Doctor of Podiatric Medicine, A Step Ahead Foot and Ankle Center
Innovative New Bunion Procedure
Less Pain, Short Recovery
By Angeline Grenz Photos by warren diggles
The pain from a bunion can be debilitating, making walking in a normal shoe an impossibility. For most, surgery is the common answer, along with months of crutches and walking casts. A Step Ahead Foot and Ankle Center now offers their patients a new option: a repositional bunion technique that involves little or no invasive surgery, works with the normal anatomy of the foot, and has patients up and walking the same day.
A
bunion is the painful protuberance of the big toe joint. Bunions generally happen when the foot flattens out, which puts increaded pressure on the first metatarsal bone. “The first metatarsal bone moves up and out, and the big toe moves in the opposite direction,” says Robert C. Schulte, Doctor of Podiatric Medicine. The condition graduates from uncomfortable to painful over time. “Shoes become uncomfortable to wear and cartilage can end up wearing out.” Schulte says bunions can occur at any age. Though they are more common with middle age to older patients, it can develop in children as well.
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Without correction, a patient must modify the shoe to accommodate the bunion; pads, braces, and arch supports cannot improve the condition. A modified shoe often involves cutting open the side of the shoe to allow more room. This ends up being a temporary solution because patients remain “in quite a bit of pain,” says Dr. Schulte. Dr. Schulte began offering the repositional technique to his patients at the clinic this past November. A Step Ahead Foot and Ankle Center is one of the only clinics in Fort Collins to offer the procedure as an alternative, according to Dr. Schulte. He has successfully performed several procedures to date and says the procedure is making a huge difference for some of his bunion pa-
tients. Elizabeth Bauer had her repositional bunion procedure done by Dr. Schulte in late November of last year. Bauer had the bunion since she was in her twenties, but at first she noticed only occasional achiness. In recent years, however, the pain had increased and she noticed her foot becoming wider and thicker. “The pain wasn’t huge yet, but it was more and more constant and there wasn’t much more I could to with my shoes.” Bauer consulted with Dr. Schulte and he recommended the repositional technique. “The healing time was a big incentive. I was worried about being laid up for quite a while and in retrospect, I realize what an ordeal that would have been.”
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Put Your Feet in Our Hands Bauer had the technique done while under local anesthetic. Because of a difficulty with her second toe joint, Bauer did have to have some minor surgery as well. However, the procedure went smoothly. She was able to control any pain following the procedure with Tylenol and Ibuprofen. She kept her foot elevated for a few days after the procedure, and moved immediately into a walking boot. After the procedure, Bauer first noticed a marked difference in the appearance of her foot, the wide, thick profile was greatly reduced. Approximately four months since the procedure and
OVER 45 YEARS Serving Our Communities Emergency Care for Fractures & Injuries | All Doctors are Board Certified | www.asafoot.com EFFECTIVE, NON-SURGICAL & SURGICAL TREATMENTS FOR: Heel Pain/Plantar Fasciitis • Bunions • Hammertoes • Flat Feet & High Arches • Ankle Sprains/Fractures Nail Fungus/Trauma • Skin Problems • Warts • Corns & Calluses • Infant & Pediatric Deformities Sports Injuries & Prevention • Chronic Foot & Ankle Pain Diabetic Foot Care/Ulcer Management • Nerve Problems Lunchtime & Evening Hours Same Day Appointments | Major Insurance Accepted
Michael J. Burns DPM
Chad M. Knutsen DPM
Robert C. Schulte DPM
2001 S. Shields St., Bldg. F Spring Creek Medical Park Fort Collins, CO 80526
493-4660
3850 N. Grant Ave., Ste 130 Loveland Medical Plaza Loveland, CO 80538
667-0769
A left foot before bunion procedure.
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Bauer says she often forgets she even had the procedure done. The slight bit of stiffness remaining, she attributes to the minor surgery on her second toe joint. “I would not hesitate to recommend the procedure. It was a very quick turn around to feeling good again and being back on my foot.” The repositional technique uses a fiber wire threaded between the bones of the foot, pulling them together to reposition the bunion bone, says Dr. Schulte. The procedure realigns the bone and holds it in place without screws. The wire is strong and cannot be pulled apart. “It is also inert,” adds Dr. Schulte, “the body does not seem to react to it.” The procedure corrects the bunions while maintaining the normal anatomy of the foot, sometimes without the need to cut bone. Often, the lessor are straightened out as well. “The pro-
cedure offers less dissection, much less post operative hassle, quicker healing time and much less pain.” Occasionally, the repositional technique may be accompanied by traditional techniques on certain patients, such as Bauer’s case. The outpatient procedure is relatively quick and patients are immediately moved into a weight bearing walking boot. “Often you are back into a regular shoe in four weeks.” No crutches, and little fuss. It is recommended that patients who have had the procedure wear a supportive shoe, such as an athletic shoe, for the first few weeks when returning to regular shoes and avoid the tightness of a dress shoe for at least three months after the surgery. Bauer, however, says she has been able to get into a heeled boot three months after her procedure.
A left foot after the bunion procedure. “In the past, bunion surgery required us to take out good cartilage, destroy the joint, and fuse the bone in the corrected position,” according to Schulte. Screws and pins are used to hold the bone in its new position. “This required patients to be non-weight bearing on crutches as much as six to ten weeks, followed by three to four weeks in a cast boot before they could even think about shoes.” Surgery like that is not an option for people whose work will not allow them to be off their feet for three months or more. Others, such as the frail or elderly, do not have the upper body strength to support themselves for an extended period of time on crutches. Not every bunion patient is a candidate for the repositional technique. Those with severe arthritis, or who have a deteriorated joint do not make good candidates. There also needs to be a degree of flexibility in the joint in order for the bones to be pulled back over to their original position. Patients who are interested in the procedure will have the foot and joint evaluated to assess the degree of movement to ensure they make a good candidate for the procedure. Deformity of the joint, age, activity level, and other concerns are part of the evaluation. If you are suffering from the agony of a bunion, Dr. Schulte encourages you to consider the new procedure. Repositional bunion technique offers an excellent option for correction with “less pain, quick healing time, and a procedure that salvages the joint and returns the foot to its normal anatomic position.” + Angeline Grenz is a local freelance writer living in Fort Collins with her husband. She enjoys writing about lifestyle issues affecting the Northern Colorado community.
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Lydia’s STYLE Magazine
Rocky Mountain
Center for Reproductive Medicine P.C.
in vitro fertilization
“Since the story broke, it seems a day doesn’t pass without a continuum of questions from patients, colleagues, and even strangers as to the specifics of this story.” Kevin E. Bachus, M.D., Reproductive endocrinology specialist, Rocky Mountain Center for Reproductive Medicine, P.C.
OCTOMOM:
Octopinions From a Local Fertility Physician By Kevin E. Bachus, M.D. | Rocky Mountain Center for Reproductive Medicine, P.c.
The case of Nadya Suleman has now captured the attention of the public unlike any patient since Louise Brown, who was conceived as the first baby from In Vitro Fertilization (In Vitro) in 1978.
T
here have been other “supermultiple” pregnancies, such as the McGaughey septuplets in Iowa, or the Chukwu octuplets in Houston. What makes this case particularly notable? 1) The complex social situation involving six other children, all under seven years of age, 2) This conception occurred by In Vitro where a choice was made by the patient and the physician concerning the number of embryos transferred, 3) Extremely unusual efficiency of the number of babies born given the number of embryos transferred, and
Northern Colorado Medical & Wellness 2009
4) A lack of many of the details of the case that continues to fuel speculation about how this could have happened. Since the story broke, it seems a day doesn’t pass without a continuum of questions from patients, colleagues, and even strangers as to the specifics of this story. It is not the purpose of this article to address the complex social issues, or for that matter to continue to speculate on the motives on the part of Octomom or her physician. Rather, I would like to focus on what is known about the medical facts of In Vitro and provide some insight into how unusual this situation is by posing eight of the more common questions I receive and their answers (octopinions).
Question #1: How can this happen? Octopinion #1: Every embryo transferred to the uterus from the laboratory (reports are that it was six) attached to the uterine wall (implanted) to form nonidentical (fraternal) siblings, and two of these embryos divided after the transfer to form identical (monozygotic) siblings.
Question #2: What are the odds this would happen?
Octopinion #2: Extremely low. The incidence of monozygotic division (ie identical twinning) is believed to be approximately 1 in 100. Speaking
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with reference to strict statistical odds and not that of biological systems, the odds that two embryos would do this per transfer would be 1/100 x 1/100 or 1/10,000. These odds don’t even begin to estimate the odds that all of the other four embryos would also implant without a chance of miscarriage of any of the developing fetuses which could be expected to occur at a rate of 10 percent to 15 percent per fetus.
a greater number of embryos are transferred. Interestingly, increasing data would support the contention that especially in such younger aged patients, particularly where they have been successful in a prior In Vitro cycle, the transfer of multiple good quality embryos beyond two does not substantially increase pregnancy rates, but may increase the incidence of supermultiples.
Question #3: What are the facts that predis-
tuplets?
posed Nadya to the octuplets?
Octopinion #3: In Vitro is generally more successful in younger patients and in patients where a prior pregnancy has been established. A higher multiple pregnancy rate is to be anticipated where
Question #4: How dangerous is it to have ocOctopinion #4: Most people do not really realize the risk of extreme premature birth that frequently occurs with supermultiples. The attendant life long complications, such as cerebral palsy or lung problems, rise considerably with such a
supermultiple pregnancy. The risk to the mother is also increased for such conditions as high blood pressure and diabetes in pregnancy. Not all patients and their babies will be as fortunate as this situation appears at the present time.
Question #5: What has been happening with the multiple pregnancy rates and for that matter pregnancy rates with In Vitro through the years? Octopinion #5: Years ago it was not uncommon for clinics to transfer three, four, or even five embryos, even in patients with the history of Nadya’s. Even with the transfer of so many embryos, success rates and multiple rates were quite low. The reason appears to be that the laboratory conditions and the techniques for transferring the embryos to the uterus for implantation were not as refined. In the late 1990s, however, significant improvements in both the laboratory and the transfer techniques resulted in a substantial improvement in pregnancy rates. Unfortunately, this also resulted in a comparable increase in multiple pregnancies. Most clinics, with the encouragement of the American Society of Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART), began to reduce the number of embryos transferred such that it is common to consider the transfer of only TWO embryos (see Question 6 below). This has been effective in allowing the pregnancy rates to continue to increase through the years, at the same time actually curb the incidence of the supermultiples. Our clinic has taken this issue very seriously and over the last several years have been able to suppress the problem of supermultiple pregnancies and, at the same time, keep pregnancy rates in excess of 50 percent, especially among younger patients who are at greatest risk of multiple births. Question #6: Are there guidelines for infertility specialists on the number of embryos to be transferred to a patient? Octopinion #6: Yes, years ago the ASRM and SART worked to put together a set of guidelines that have served to curb the multiple pregnancy rate as noted in #5 above. The guidelines are somewhat complex depending on when in embryo development the embryos are transferred back into the uterus. Generally, we adhere to the following guidelines.
Recommended limits on the numbers of embryos to transfer. Cleavage-Stage Embryos Prognosis
Age <35
Favorableb All others
1–2 2
Age Age Age 35-37 38-40 >40 2 3
3 4
5 5
Favorable – First cycle of IVF, good embryo quality, excess embryos available for cryopreservation, or previous successful IVF cycle b
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These guidelines provide for a change in the number of embryos to be transferred to accommodate for the fact that each embryo will be, in general, of poorer quality as the age of the woman increases. It therefore follows that pregnancy and multiple rates are highest in the younger patients. The guidelines, when followed, will help to keep the supermultiple pregnancies to a minimum as only one or two embryos will be transferred when patients are young. When a person has been through In Vitro previously, without success, it would be appropriate to consider transferring more than two embryos.
Question #7: What happens to any embryos not transferred?
A day three (cleavage stage) embryo
Octopinion #7: Embryos not chosen for transfer may be cryopreserved (frozen) for future use. Such an option has enjoyed considerable improvements in pregnancy rates over the last several years. Such an option should encourage patients and clinicians alike to transfer a conservative number of embryos for the first attempt, with the surplus to be used for transfer at a later time if the first attempt is unsuccessful. Question #8: Who should decide on the number of embryos to be transferred? Octopinion #8: Obviously, this is a complex question. Should the patient decide, should the physician decide, or should the government decide? (as is the case in other countries). It is clear that everyone will not agree on who should decide, but I do think that the guidelines still provide the framework for the best balance between benefits (good pregnancy rates) and risks (lowered multiple rates). This will still allow the doctor-patient relationship to exist in making the best decisions for individual patients, at the same time minimizing complications from the supermultiples. Eventually, all the facts of Nadyaâ&#x20AC;&#x2122;s case will likely be known. Hopefully this background will keep everyone better informed as the details unfold. The ASRM and SART have been prudent in keeping a close eye on the details of this case. It is in everyoneâ&#x20AC;&#x2122;s best interest to continue to monitor pregnancy and multiple rates and this has been taken very seriously by the two organizations mentioned. The goal should be to achieve a healthy singleton pregnancy, avoiding supermultiples whenever possible. +
Kevin Bachus, M.D., of the Rocky Mountain Center for Reproductive Medicine P.C., is the only board certified infertility and reproductive endocrinology specialist serving the tri-state area of Northern Colorado, Wyoming, and Nebraska for more than 12 years.
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pet immunizations
veterinary care
protecting
our pets
By Gloria Willis Photos by warren diggles
Can’t resist those sad puppy dog eyes or that tiny kitten that fell asleep in your lap? It’s hard not to want to take home a new pet and anyone has a right to do so. However, before you take the pet plunge, it’s important to remember that being a pet owner is a big commitment; a pet relies on you to be a responsible guardian for many years by providing them with exercise, grooming, training, nutrition, healthcare, and affection.
O
ne of the most important things you can do for your fur-faced friends is to have them properly immunized to keep them healthy. Most veterinarians concur that vaccinations are a modern marvel, responsible for saving countless animal lives. Wellness and vaccination programs are designed to prevent disease and prolong the life of your pet. Disease prevention is always less costly than dealing with the treatment of an unnecessary illness. So how is today’s dog and cat caretaker going to make an informed decision about their pet’s vaccine needs? To find out, Style talked to three experts: Robin Downing, DVM, DAAPM, with Windsor Veterinary Clinic, P.C. (WVC); Christie Long, DVM at VCA Fort Collins Animal Hospital (VCA); and, Holly Mims, DVM, DACVIM, with VCA Veterinary Specialists of Northern Colorado (VCA VSNC).
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Windsor Veterinary Clinic, P.C.
Dr. Downing owns WVC, a state-of-the-art full service veterinary facility with a culture that she calls state-of-the-heart. The clinic specializes in comprehensive care for animal patients while being mindful of the human family-bond. Dr. Downing is an affiliate faculty member at the College of Veterinarian Medicine at Colorado State University. WVC offers an elective course on comprehensive team management and animal physical rehabilitation for junior and senior CSU veterinarian students and frequently hosts veterinarians and veterinary students from around the world to do hands-on learning at the clinic.
Robin Downing, DVM, DAAPM, Windsor Veterinary Clinic, P.C.
Rabies
Is it necessary to immunize your cats and dogs for rabies? “Absolutely,” says Dr. Downing. “Not only is it necessary; it’s the law.” rabies vaccine is
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almost a “no-brainer,” as it is considered a core vaccine in most areas, is high priority, and is governed by state law in the United States. Rabies is a highly contagious and deadly disease. Vaccination is the only effective means of preventing this disease in your pet. In addition, this disease can be transmitted to humans if they are bit by a rabid animal. Dogs and cats can be vaccinated against rabies at three months of age or older. A booster is given a year later, and then the animal is inoculated every three years thereafter. The rabies vaccine, labeled Rabdomun®, is regulated by the USDA. The label reads, “Administer a single dose at three months of age or older to healthy dogs or cats. A repeat dose should be administered one year later. Revaccination every three years with a single dose is recommended.” Just last summer, six people in Larimer County received preventative treatment for rabies after being exposed to rabid bats. The last reported case of rabies in Colorado was in 1931 and the Center for Disease Control states that two or three people die in the U.S. each year because of rabies. Surprisingly, 55,000 people die annually around the world from this dreadful disease. According to Downing there are pockets of areas in the U.S. where animals are not as well vaccinated and animals do die of rabies on a fairly common basis. Fortunately, in Northern Colorado that is not the case.
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Bordetella (kennel cough)
Bordetella, commonly referred to as kennel cough, is a bronchial infection caused by several different viruses and bacteria. It is usually a self-limiting disease and most animals don’t require treatment; therefore, in more severe cases, the prognosis is good when treated early with antibiotics. Although the vaccine for Bordetella is not considered a core immunization, Bordetella is incredibly infectious and is usually transmitted in areas where many dogs are together such as boarding facilities, doggy daycare, and dog parks. The most common symptom is a dry hacking cough sometimes followed by retching. Pet owners describe the cough as having a honking sound. If you plan to take your dog to puppy class or he will be around other dogs, check with your vet to see if your pet should be vaccinated. Keep in mind that even though most facilities that serve multiple dogs require immunization to Bordetella; no vaccine is 100 percent effective, so your dog can still become ill with this disease. The vaccine comes in both intranasal and injection form. The intranasal form is dribbled into your dog’s nostrils. There is also a Bordetella vaccine for cats. Again, always consult with your veterinarian for more information about immunizing for kennel cough.
VCA Fort Collins Animal Hospital
Dr. Christie Long is a veterinarian at VCA Fort Collins Animal Hospital. VCA FCAH is a small animal practice specializing in dogs, cats and a variety of exotic pets. Medical Director Dr. Heather Steyn specializes in reproduction and works with breeders, consults on pregnancy issues, and assists with difficult births including C-sections. The other veterinarians include Dr. Mary Wright, Dr. Sarah Haugo, and Dr. Sofia Arthur. The clinic is a full service provider including dentistry and general surgery. Dr. Long is trained in acupuncture as well. We talked with Dr.
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sumption, lethargy, fever, and abdominal pain. Even though Lepto is treatable and responds to antibiotics, time is an issue. If the disease is not treated in a timely fashion, a dog may have kidney or liver problems for the rest of its life. And, if the disease goes untreated, most dogs will die from it. While the thought of our beloved canine friends contracting a deadly disease is upsetting, perhaps even more concerning is that people can contract Lepto as well. This is one of the main reasons that Lepto is a core canine vaccine at VCA Fort Collins Animal Hospital. Dogs that have never been vaccinated need a series of two shots three to four weeks apart. Then, they are vaccinated once yearly after the initial series. While no vaccine can protect against all of the known types of Lepto, we can protect against the most commonly encountered types. Christie Long, DVM, VCA Fort Collins Animal Hospital. Long about immunizing dogs for Leptospirosis.
Leptospirosis (Lepto)
Lepto is caused by bacteria and is transmitted by contact with the urine of infected animals. Like many diseases, some animals don’t get sick themselves but can carry the disease to other animals. Wild animals such as voles, foxes, raccoons, and deer can be carriers. Dr. Long says, “In Northern Colorado, many of us have these common, wild animals running along our streets and through our yards. If these animals urinate on our property and shed the bacteria in their urine, our pets can possibly be infected.” Lepto can affect the kidneys and liver of a dog. Symptoms include vomiting, increased water con-
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Veterinary Specialists of Northern Colorado
Dr. Holly Mims is a doctor of internal medicine at VCA Veterinary Specialists of Northern Colorado. The clinic offers 24-hour care, and specializes in internal medicine, orthopedic and soft tissue surgery, rehabilitation, and acupuncture. To become a veterinary specialist, one must undergo additional extensive training after veterinary school graduation. They must gain clinical experience in the area of their chosen specialty, publish a clinical case or their research findings in a peer-reviewed journal, and pass both a credential review and specialty board of examinations.
What happens if you don’t vaccinate
“The whole idea behind vaccination is to pre-
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Holly Mims, DVM, DACVIM, VCA Specialists of Northern Colorado. vent infectious diseases from spreading from one animal to another or to prevent these diseases from spreading to people,â&#x20AC;? says Mims. â&#x20AC;&#x153;Core vaccines for cats and dogs are imperative; without them your pets can get severely ill and even die. Vaccinating is much less costly than treating a disease.â&#x20AC;? The core vaccination for cats is the FVRCP basic combination injection. This vaccine is given between six to eight weeks of age, and then every three to four weeks with the final booster being given no sooner than 16 weeks of age. A booster in given at one year and then every one to three years depending on the risk of exposure. FVR stands for feline rhinotracheitis, an upper respiratory infection resulting in conjunctivitis, sneezing, nasal discharge, eye lesions and occasional coughing. The letter C stands for calicivirus, a virus that can cause similar respiratory signs. Many adult cats are carriers, even though they may have no signs themselves of the disease. The P is for Panleukopenia or known as feline distemper virus. Feline distemper is highly contagious and deadly among cats. It is similar to the parvovirus seen in dogs. Symptoms include vomiting and diarrhea, weakness, dehydration, tremors, and loss of coordination. Cats with feline distemper need to be hospitalized and have intensive care. The mortality rate is high. The core vaccination for dogs is the DHPP Vaccine - DHPP stands for Distemper, Hepatitis, Parainfluenza, and Parvovirus. This vaccine is given between six to eight weeks of age, then every three to four weeks with the final booster being given no sooner than 16 weeks of age. A booster is given at one year, and then every one to three years, depending on the risk of exposure. Adult dogs may have a Leptospirosis vaccine included, even though some veterinarians do not consider Lepto a core inoculation. Without the DHPP vaccine your pet can potentially become very ill and die. Canine distemper attacks the lungs and affects the function of the brain and spinal cord. Hepatitis affects the liver and can cause loss of vision. Parainfluenza is a serious respiratory virus and Parvovirus attacks the lining of the intestinal tract and damages the heart of young puppies. We all care about our wonderful four-legged friends. The best thing you can do for their health and well-being is to check with your veterinarian about a regular immunization schedule to prevent illness before it happens. + Gloria Willis is a freelance writer living in Fort Collins with Bob, her husband, and her two Australian cattle dogs.
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physician profile
Dr. Ahmed Sherif “I have had patients that were discouraged and ready to give up, but I was able to diagnose their problem. That is my favorite part of being a doctor.” – Ahmed Sherif, Gastroenterologist, North Colorado Medical Center
insired by a
grandfather
By Connie Hein photo by Erik Stenbakken
Most six-year old boys spend their free time playing ball or running around in capes pretending to be super-heroes and saving the world from bad guys. Ahmed Sherif spent his time as a little boy with his grandfather who really was a superhero, saving the world from illness.
H
is grandfather, Mohamed Sherif, was the first professional physician in Libya, which stretches along the northeast Mediterranean coast of Africa. From the young impressionable age of about six years old, Ahmed Sherif remembers being constantly at his grandfather’s side helping the ailing people in Libya, while his father and mother always encouraged him to pursue the medical field. Dr. Sherif, who is now a Gastroenterologist at North Colorado Medical Center (NCMC) in Greeley, says he always knew he would be a doctor. “I never thought of it as a choice I made.” Dr. Sherif, born in Chicago, Illinois, was the eldest of eight children. He moved with his fam-
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ily to Tripoli, the capital city of Libya when he was a little boy. After working with his grandfather for many years, he went on to earn his medical degree at Al-Fateh University in Tripoli. He was then accepted to do his residency at the prestigious Albert Einstein College of Medicine, Montefiore in Bronx, New York. He knew his professional passion was gastroenterology. In 2001 he did a fellowship in gastroenterology at the University of Michigan. Then, after completing his fellowship, he and his wife moved to Greeley, Colorado. He is also very passionate about his work at the Gasteroentology Unit of NCMC. “I am extremely proud that we always keep up with the latest procedures and technology in gasteroentology at the NCMC Endoscopy Lab,” says Sherif. Earlier this year, he and his partner,
Dr. Qwaider, were instrumental in bringing the newest high definition fiber-optic narrow-band imaging scope to Northern Colorado. He loves working with the digestive system and especially enjoys the satisfaction of being able to improve the quality of life for patients. “I have had patients that were discouraged and ready to give up, but I was able to diagnose their problem. That is my favorite part of being a doctor,” he says, “I love taking on the challenging cases that take time and patience to diagnose.” Dr. Sherif has shared his expertise by writing for a number of professional publications, and actively participating in research efforts. He is a member of the American Gastroenterology Association and American Medical Association. Dr. Sherif is passionate not only about working in this community, but also contributing and volunteering. Part of his volunteer service is done for the Sunrise Clinic. Dr. Sherif and his partner, Dr. Qwaider, each volunteer half a day per week seeing patients and another half day per week doing procedures for the adults of Greeley who would not be able to afford this type of medical care. In his spare time, Dr. Sherif says he loves spending time with his wife and their five young children. The family continues to make time for family in Libya. He says, “We go back to Libya about once a year and enjoy visiting family and just relaxing.” Dr. Sherif also enjoys soccer, horseback riding, and site seeing in the mountains, plus he has a passion for scuba diving. Dr. Sherif is a very busy doctor because of his dedication to keep up on the latest technology and because of his attention to detail in every case. He is proud of what he has accomplished, and proud of his rich family heritage. He says his children are so young that he cannot tell yet if any of them will follow in the family’s medical footsteps, but says it would not surprise him at all. + Connie Hein is a freelance writer living in Windsor and the author of The Toliver in Time series of Children’s books.
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