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Accounting Manager Karla Vigil Office Assistant Ronda Huser Contributing Writers Laura Lee Carter, Allie Comeau, Julie Estlick, Lynn M. Dean, Connie Hein, Corey Radman, Kay Rios Photographer Warren Diggles Contributing photographers Lydia Dody Affiliations Fort Collins Area Chamber of Commerce Loveland Chamber of Commerce Greeley Chamber of Commerce Windsor Chamber of Commerce Home Builders Association of Northern Colorado 2009 Style Magazines January-Loveland/Greeley Medical & Wellness Magazine and Directory February-Building & Remodeling March-Northern Colorado Medical & Wellness March-Family & Philanthropy April/May Northern Colorado Business & Building May/June-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, a one year subscription is $35/year and a two year subscription is $50/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.
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Lydia’s STYLE Magazine
M
Ti
Michael P. Curiel, MD
Adult Neurology Pediatric Neurology Electroencephalography Neurorehabilitation Evoked Potentials Multiple Sclerosis
Alzheimer’s Disease Electromyography Pain Management Head Injury Headache Seizure
Vagus Nerve Stimulators Parkinson’s Disease Neck and Back Pain Botox Injections Neuropathies Stroke
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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
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 Timothy J. Allen, MD
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[ 9 7 0 ] 2 2 1 - 1 9 9 3 | FA X : [ 9 70] 221-9170
CONTENTS
northern colorado medical & wellness
VOLUME III 2009
14 16 20 26 32 33 37 38 42 46 50 52 54 58
Publisher’s Letter
Technology Advances in Healthcare
Faces of MS: Finding Peace in the Now Two community members share their experiences living with multiple sclerosis.
Trauma Care Team Stands Ready
Follow the process from ambulance to recovery in Northern Colorado.
Comfort, Convenience at the New Medical Clinic at Centerra One-stop location for healthcare in Northern Colorado.
Brain Integration for Learning Disabilities
Dr. Charles Krebs’ own struggles lead him to create a new modality for treating learning disabilities.
16
Faces of ms: finding peace in the now
20
26
Comfort, Convenience at the New Medical Clinic at Centerra
32
46
Perfect Vision With iLASIK
50
Paul Joncas prevails over his MS with the help of Fort Collins Neurology, P.C.
trauma care team stands ready
Follow the process from ambulance to recovery in Northern Colorado.
Maximizing Communication A Multi-Pronged Approach Speech & Language Stimulation Center, Inc.
New Approaches to Treat Learning Disabilities LearningRx
Chronic Kidney Disease On the Rise The Nephrology Clinic, P.C., shares important information on CKD.
Practice Directory
A cross-section of healthcare providers in Northern Colorado.
Perfect Vision With iLASIK
State-of-the-art eye surgery at Eye Center of Northern Colorado.
Orthodontic Team Uses Cutting-Edge i-CAT Imaging Orthodontic Associates of Greeley, P.C.
Non-Invasive Treatment for Scoliosis
One-stop location for healthcare in Northern Colorado.
Brain Integration for Learning Disabilities
Charles Krebs, Ph.D., is founder of the Learning Enhancement Acupressure Program designed to treat learning disabilities.
Spine Correction Center of the Rockies
24-Hour Pet Emergency Care
Signs to look for in an emergency and where to take your pet after hours.
Physician Profile; A Father’s Influence
Donn Turner, M.D., Front Range Center for Brain & Spine Surgery, P.C.
State-of-the-art eye surgery at Eye Center of Northern Colorado.
on the cover: Neurologists Michael Curiel, M.D., and Timothy Allen, M.D., of Fort Collins Neurology, P.C., outside their office in Fort Collins.
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Orthodontic Team Uses Cutting-Edge i-CAT Imaging
Orthodontic Associates of Greeley, P.C.
The articles in this issue of Northern Colorado Medical & Wellness are presented for your general knowledge and are not a substitute for medical advice or treatment. If you have any questions or concerns about your health, please contact your doctor of healthcare provider.
Lydia’s STYLE Magazine
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Northern Colorado Medical & Wellness 2009
Publisher’s Letter
Technology Advances in Healthcare
H
ealthcare in our region is expanding at such a phenomenal rate I am always intrigued and amazed at the breadth and depth of the professionals our region seems to attract. But, why not? We are living in one of the most desirable areas in the country. Enjoy reading this issue focusing on a few of the region’s exciting new advances in healthcare.
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Recently, Nancy and Robert Evans contacted me to let me know Charles Krebs, Ph.D., was coming to town and they wanted me to meet him. After learning a little about him and browsing his book, I was convinced we needed to interview him for our Northern Colorado Medical & Wellness issue. This brilliant yet affable man, through his education and his own traumatic personal experience, had developed an important treatment modality for learning disorders. Best of all, he is establishing the Learning Enhancement Acupressure Program (LEAP) certification in Fort Collins and working with Nancy and Robert to develop the Fort Collins office as a hub of brain integration education. Not only is this good news for many children and adults afflicted with weaknesses in learning and attention deficit disorder, it is another important addition to the overall healthcare in our area. In fact, I am going through the program to improve my left and right brain integration! More state-of-the-art developments in healthcare are featured in this issue. The Eye Center of Northern Colorado has teamed up with Poudre Valley Health System to form the Eye Laser Center of Northern Colorado, which now offers the newest technology in its iLasik procedure. This bladeless technology is safer, completely custom fit, and offers the surgeons exceptional accuracy for their procedure. I find it amazing that vision can be improved to 20/20 almost immediately! After raising two daughters, both of whom were patients of Dr. Burdett Edgren for their orthodontia, I was interested in the newest developments in their diagnostics and treatment. Orthodontic Associates of Greeley recently added new advancements with their i-CAT scanning equipment to provide three-di-
mensional images to help them diagnose facial and jaw problems, pinpoint issues with wisdom teeth, and offer soft and hard tissue images to make earlier treatment plans that are more effective. The summer is a time when we all are a little more relaxed as we enjoy outdoor activities and sports. It is also a time when we are more vulnerable to accidents and injuries. We felt it was important to bring mindful awareness to what can really happen when we are careless. We decided to look at trauma care in our region and were impressed with the exceptional care our area offers. Trauma is the leading cause of death for ages one to 44, so we are fortunate to have the Trauma Center of the Rockies as a Level II trauma center in Northern Colorado. The exceptional team, led by Chris Cribari, M.D., Medical Director of Trauma for MCR, and Timothy Wirt, M.D., Neurosurgeon with Front Range Center for Brain & Spine Surgery, P.C., have their hands full in the warm summer months. Emergency care also extends to pets. Pets often become ill at night or on the weekends. My Lhaso Apso, Daisy, gave me a scare this past year when she punctured her eye and I found myself in a vet’s office at midnight and Daisy in surgery at 3:00 a.m. to save her eye. After much anguish and lots of recovery time, she is fine and just as curious and mischievous as ever! Read up on pet emergency care and clip out our ER list of vets for your refrigerator in case you might need a quick reference in a time of need. Enjoy the sun as it peaks out between the summer showers. lydia@stylemedia.com
Lydia’s STYLE Magazine
27 POINT INSPECTION • OIL CHANGES • CLUTCHES BRAKES • TIMING BELTS • SHOCKS • TUNE UP
15
awareness
Multiple Sclerosis
“Multiple sclerosis is not a death sentence or a disability sentence like it used to be. With access to knowledge, better diagnostics, and better meds, it is very manageable.” Timothy Allen, M.D., Fort Collins Neurology, P.C.
Michael Curiel, M.D., and Timothy Allen, M.D., Fort Collins Neurology, P.C.
Faces of MS:
Finding Peace in the Now
by Corey radman photos by warren diggles
Multiple sclerosis (MS) is a disease that affects the central nervous system by disrupting the flow of information from the brain to the body. According to the National MS Society, “it is an elusive disease with no known cause and no known cure. Symptoms vary from person to person depending on where the central nervous system is affected, making it hard to diagnose.” MS generally strikes people in the prime of life between ages 20 to 50 years old. Of those diagnosed, 73 percent are women.
T
ori Case is mean as spit and crazy too – at least that’s how she describes herself. However, anyone who meets her isn’t fooled. Case lights up the room with her fiery spirit, warm and ready laugh, and twinkling blue eyes that seem to say, “I know.” She knows she defies the wheelchair-bound stereotype of someone with MS. “And I’m not going to use a cane, like some old lady,” she says. Case knows it is her unrepentant obstinacy that has kept her mobile through 31 years living with MS. Asked about the limitations that MS imposes on her lifestyle she says, “I don’t give a damn what I’m supposed to do! I’m going to do what I want.”
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Case’s nervous system began to show signs of the disease at age 16, before she was really aware of it. Her mother, a healthcare professional, noticed her daughter’s eyes had stopped tracking from left to right and she was turning her head to see her periphery. Walking had also become difficult; Case says, “I looked like I was always going up stairs because my feet were numb and I couldn’t feel where the floor was.” After a spinal tap diagnosed probable MS, Case’s mother chose not to tell her daughter, fearing her flighty, rebellious teenager wouldn’t handle it well. “She was probably right,” muses Case, “but I kept saying to myself, ‘Why is this happening?’” It took two years, and Case’s future husband, Terry, to finally break the news to her that she had
MS. “My mother told Terry about it when she could see we were getting serious so he would know what he was getting into,” she remembers. The young couple had moved to Vail to begin their life together when Case’s symptoms became debilitating. “It was horrible. My legs and hands didn’t work, I couldn’t hold things or walk the way I wanted to, and I still didn’t know why. I was really depressed.” They returned to Greeley to see her doctor and be closer to family. After yet another vague medical appointment with more questions than answers, Terry finally told Case that she had MS. “I remember screaming ‘No! They’re wrong!’ I thought the doctor was a liar,” says Case. It took her and her husband a long time to
Lydia’s STYLE Magazine
adjust to the diagnosis and its relapsing-remitting pattern. It hasn’t been easy, but 29 years and four children later, Terry and Tori Case are still working through it together. “We just celebrated our 27th anniversary,” she smiles.
In Her Case Case says, “MS has been like a roller coaster for me. Things will be really great for a while and then…” she pauses, sifting through the myriad examples, “one eye goes blind.” She cites the symptom with a shrugged shoulder. “Then I wear a patch for a while until it goes away.” “Tori has one of the most severe types of MS (Secondary-Progressive),” says her neurologist, Timothy Allen, M.D., of Fort Collins Neurology, P.C. “She has done extraordinarily well with the newest medications. They make a huge difference for prevention of disability.” Case injects herself with the medicines weekly. “Twenty-five years ago, most people diagnosed with MS would have been in a wheelchair within three or four years,” he says. “Attitude makes all the difference.” “I love Dr. Allen,” says Case. “We connect. He says my MRIs show so many brain lesions that I should be in a wheelchair, but I just refuse. I still don’t feel like I have MS. The symptoms come and go, but my frame of mind keeps me well. I just refuse to be told what I can do, even by my own body.”
Prognosis and treatment “Common symptoms of MS include numbness, tingling, and sensory problems like weakness, vertigo, or poor balance,” explains Dr. Allen. “However,” he cautions, “you can’t jump to conclusions with these symptoms. There are more common causes for numbness or tingling. But if they happen over a number of days or occur through half of the entire body, it may be MS,” he says. Dr. Allen, who did his undergraduate work at Colorado State University and medical education at University of Colorado, is certified by the American Board of Psychiatry and Neurology. He has been a partner at Fort Collins Neurology since 1997. Dr. Allen’s partner, Michael Curiel, M.D., elaborates further: “There are different levels of MS: possible, probable, and definite.” With a definite or probable diagnosis, treatment can begin. “It’s better to be proactive [with probable MS] and start treating to suppress,” he explains. Cases of possible MS are usually observed over time. Dr. Curiel is one of the founders of Fort Collins Neurology, which originated in 1984. He completed his graduate studies at the University of Arizona and is a Diplomate of The American Board of Psychiatry and Neurology. Drs. Curiel and Allen typically recommend one of five major disease suppression medications for MS treatment. Some of the medications can be injected by the patients; others are administered by IV infusion at their office. Diet, exercise, and stress control are also important to disease management. Dr. Allen says, “MS is not a death sentence or a disability sentence like it used to be. With access to knowledge, better diagnostics, and better meds, it’s very manageable.”
Northern Colorado Medical & Wellness 2009
Colorado Ranks High
A Patient With Patience
The local chapter of the National MS Society reports that Colorado has one of the highest incidences of MS in the nation; there are 9,000, or one in every 540, Coloradans living with MS. Allison Hines, Regional Development Manager for the Colorado Chapter of the National MS Society, explains why the numbers for Colorado may be so high: “Colorado has a very mild climate and people living with MS are adversely affected by the heat. Many people find the climate in Colorado more suitable.”
Paul Joncas, who has Relapsing-Remitting MS, thinks Colorado’s high incidence rate is primarily due to non-natives like him who moved here for the climate and excellent resources. “I can’t ask for a better place to have this disease,” he jokes, but continues seriously, “I’m utterly grateful to be in Fort Collins and to have had the good fortune to connect with Dr. Curiel.” Dr. Curiel notes 85 percent of people diagnosed with the disease have Relapsing-Remitting MS. Joncas has tried many medications in the five years since his diagnosis, but is currently holding most of his symptoms at bay with a monthly IV infusion of an immune-modulating drug. Joncas is like many people with MS. He spent much of his adulthood with symptoms that would come and go, but never last long enough to get a diagnosis until all of the niggling annoyances like blurred vision, fatigue, and numbness on his right side occurred at the same time and refused to disappear. At 52 years old, Joncas finally understood what had been going on all those years. “My wife, Debbie, and I felt very confident in our course of action because of Dr. Curiel’s patience and concern.” On the day he was di-
Tori Case was diagnosed with multiple sclerosis 31 years ago, when she was only 16.
Paul Joncas was diagnosed with multiple sclerosis in 2004.
17
agnosed, Joncas and his wife stood asking questions of Dr. Curiel for 45 minutes. “He never once looked at his watch,” says Joncas. Joncas tried to continue to work for another year as pastor at Shepherd of the Hills Lutheran Church in Fort Collins, but his relapses were too frequent. Eventually he retired from the pastorship, but has continued to serve others through the MS Society. His recumbent tricycle has become a familiar site in the Bike MS event that covers 150 miles each summer. This year, Joncas was honored by the Fort Collins MS Society office as the 2009 MS Champion. “Paul has demonstrated exemplary volunteer service by helping the newly diagnosed adjust. He maintains an extremely positive atti-
tude,” says Hines. Joncas, perhaps because his diagnosis came later in life, more easily accepts the changes that have transformed his world, like the two crutches he uses to walk. His jokes are quick and often self-deprecating. “Of all the things I lost because of MS, I miss my mind the most,” he quips about the difficulty in concentrating for long periods.
MS Misperceptions
Dr. Michael Curiel works with MS patient Paul Joncas.
Joncas often speaks to groups and mentors others with the disease. Asked to help others understand more about MS, he says, “We all have symptoms in common but no one’s MS is exactly the same as another person’s.” Joncas answers blunt questions honestly for those who come to him through the MS Society. “Doctors can sometimes be evasive about the hard questions,” he says. “New patients want to know: ‘Will this shorten my life? Am I going to end up in a wheelchair?’” “While it’s true no one can ever know for sure, the vast majority of people never end up in a wheelchair. The fact that I use crutches is unusual. Most people with MS are able to continue their careers with some adjustments.” “I think of myself as lucky,” he says. “Twenty years ago the prognosis would have been different. Today, with new drugs, MS doesn’t necessarily shorten life expectancy. I see the changing symptoms as something I adjust to. I have good days and less good days. There is no point in having bad days. If all I get done in a day is reading a few pages in something [due to fatigue], I still got something done,” he says smiling. Joncas is hopeful about the future of MS: “The current research is remarkable. There are oral drugs coming. Lab tests have had good luck in getting myelin to grow back on mice, which may be the road to a cure. That course of treatment may not be able to repair damage for people like me, but those who come after me may benefit.”
Life Lessons Though their journeys with MS have been drastically different, Case and Joncas have arrived at many of the same conclusions: life is what it is. “There is no promise that life is going to be perfect,” says Joncas. Case agrees. “I figure life’s too short. There’s nothing I can do about this, so why wallow?” “My outlook has changed,” says Joncas. “MS keeps me in the present. I can only deal with what’s right now. I can’t worry about the past or the things I can no longer do. I can’t look too far ahead, because I don’t know what I will be able to do tomorrow.” Planning for the future with MS is tricky, however a few things are certain. Case and Joncas will continue to use their challenges to make the most of life, often through laughter. Both will keep trying to reach out to make others’ days brighter. Both plan to continue stepping forward each day with grace, strength, and dignity. + Dr. Timothy Allen performs an exercise with patient Tori Case. Corey Radman is a freelance writer and mother of two living in Fort Collins.
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Lydia’s STYLE Magazine
Want to Help? Bike MS is one of the MS Society’s signature events that raises money for research and support for those living with MS.
Paul Joncas rides his recumbent tricycle in last year’s Bike MS event.
Saturday, June 27 & Sunday, June 28 TWO days, 150-mile cycling ride
Start/Finish at Front Range Community College in Westminster, with an overnight event at Colorado State University. Register, donate, or find more information online at: www.bikeMScolorado.org Volunteers can call: Jaclyn Wilmot at 303-698-5444 or jaclyn.wilmot@nmss.org The National MS Society is the largest private MS research funder in the nation, providing support for 440 research projects worldwide. The Colorado Chapter contributes research funds each year to the National MS Society’s nearly $50 million annual research budget. There are eight nationallyfunded research projects in Colorado.
Northern Colorado Medical & Wellness 2009
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regional care
Trauma Response
“Before, we would all come in and parcel out our care. There was no coordinated effort. I don’t think there is any question that with this system in place there are improved outcomes.” Timothy Wirt, M.D., Neurosurgeon, Front Range Center for Brain & Spine Surgery, P.C.
Trauma Care Team
Stands Ready
by Lynn M. Dean
It is summer at last. In Colorado that means outdoor fun. It also means traumatic injuries. “We see an increase in the number and severity of injuries in the summer,” says Chris Cribari, M.D., Trauma Medical Director at the Trauma Center of the Rockies at Medical Center of the Rockies. “More people are out in the warm weather participating in recreational activities.”
T
rauma is the leading cause of death for ages one to 44 in Larimer County and in the United States. Trauma Center of the Rockies is a Level II trauma center that provides comprehensive care for critically injured patients in Northern Colorado, southern Wyoming, and western Nebraska. Motorcycle and automobile accidents accounted for 43 percent of the traumatic injuries treated at the Trauma Center at Medical Center of the Rockies (MCR) last year. Injuries from falls comprised another 32 percent. Most of these injuries are fairly innocuous, according to Rob Baer, M.D., orthopaedic trauma surgeon with the Orthopaedic Center of the Rockies. “The most common injury we see at the Orthopaedic Center is a wrist fracture caused by
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falling on an outstretched hand. Ankle and leg injuries are a close second. Unless, of course, you are talking about motorcycles; I think they are dangerous and anybody who decides to ride one has to understand, sooner or later, they’ll probably crash.” “During the summer months we see a life- or limb-threatening injury daily,” adds Dr. Baer. He notes that it is important to remember not all of these injuries occur in the immediate area. “We have a large catchment area. We get patients, by ambulance or helicopter, from northern Denver, Wyoming, Nebraska, and even South Dakota. Sometimes, life-threatening injuries are not caused by something as dramatic as a motor vehicle accident or a fall while rock climbing. Sometimes they are just due to an unlucky circumstance or a lapse in judgment. That is what happened to
Carlos Toca, a teenager from Loveland, in August 2008. “Carlos did what the majority of under-21year-olds with cervical spine injuries have done,” explains Dr. Timothy Wirt, M.D., a neurosurgeon with the Front Range Center for Brain & Spine Surgery, P.C. “He wasn’t drinking. He wasn’t doing anything any other normal 15-year-old boy wouldn’t do.” It all happened last summer on a sweltering hot day up the Big Thompson Canyon. Dripping with sweat, Carlos and his friends decided to take a dip in the river. One by one, they jumped into the cool mountain water. And one by one they surfaced, refreshed. All except Carlos. A local emergency medical services (EMS) team was called to the scene. The paramedics quickly assessed the situation and determined,
Lydia’s STYLE Magazine
Chris Cribari, M.D., Medical Director of Trauma for MCR’s Trauma Center of the Rockies
Rob Baer, M.D., and Orthopaedic Trauma Surgeon with the Orthopaedic Center of the Rockies
Timothy Wirt, M.D., Neurosurgeon with Front Range Center for Brain & Spine Surgery, P.C.
based on his injuries and lack of sensation in his legs, that Carlos needed to be transported to a Level II Trauma Center. He was airlifted to MCR. “He came within millimeters of being a quadriplegic,” says Dr. Wirt, the neurosurgeon on Carlos’ trauma team. “He got very lucky.” Luckier still, Carlos had his near-fatal mishap in an area with a regional, Level II trauma center. A hospital that was in constant communication with the ambulance crew and had already begun assembling a team of specialists and sub-specialists. A hospital that was already developing an action plan while Carlos was still en route. As the Trauma Surgeon, Dr. Cribari leads a team of specialists like Dr. Wirt and Dr. Baer that are all part of a coordinated on-call system. “We have to be available to be at the hospital within a half an hour,” adds Dr. Wirt. It is a system that works. “I think (Poudre Valley Health System’s Trauma Program) has unified what used to be a very
fragmented approach to treating multiple-injury patients,” says Dr. Wirt. “Before, we would all come in and parcel out our care. There was no coordinated effort. I don’t think there is any question that with this system in place there are improved outcomes.” Poudre Valley Health System (PVHS) began its trauma program at Poudre Valley Hospital in the early 1990s, building the PVH program into a Level II trauma center. “When we were considering building a new hospital, one of the driving decisions was being able to offer these top-level trauma services regionally,” explains Lori McDonald, a registered nurse and PVHS’s trauma program director. “We also realized that we couldn’t take trauma resources out of the city – we needed to make sure that PVH would still be capable of handling some trauma.” Ultimately, PVHS decided to move the Level II services to MCR, while maintaining basic essential services at PVH at a Level III designation. Dr. Cribari describes the process: “Upon arriv-
al, the patient is met by a team of specialists who work in concert to quickly identify and treat all of the injuries.” Trauma patients are whisked into a state-of-the-art emergency department (ED) with dedicated trauma rooms where the team’s first task is to stabilize the patient, getting blood pressure and bleeding under control, and resuscitating them if necessary. Once stabilized, the patient is evaluated from head to toe. “The trauma patient undergoes a rapid assessment and diagnostic workup while undergoing resuscitation,” says Dr. Cribari. “This begins in the ED trauma bay and continues in the adjacent CT scanner, the OR (operating room), or the surgical intensive care unit. When you have someone with multiple injuries, there may be injuries that are not as obvious as others, but equally important to identify immediately.” MCR’s trauma team works closely together, says McDonald, who describes the intricate dance that takes place in the trauma room. “Besides the trauma surgeon, anesthesiologist, and ED physician, there are two ED nurses,
Daniel Asadi, D.O., Medical Director of the Northern Colorado Long Term Acute Hospital
Joseph Jacob, M.D., Medical Director of the Northern Colorado Rehabilitation Hospital
Sam Laney, M.D., Associate Medical Director of the Northern Colorado Rehabilitation Hospital
The Process
Northern Colorado Medical & Wellness 2009
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Medical Center of the Rockies’ Trauma Center of the Rockies team works to stabilize a patient.
a critical care nurse, and an OR nurse. There’s also a phlebotomist from the lab, a radiology tech, and a respiratory therapist. We have a couple of other people who may respond, including a nursing supervisor, security, and a social worker who will notify and assist the family. So it’s a pretty big group of people in the room. Sometimes it may look like chaos, but it is organized chaos because everybody has a specific job to do.” Recent advances in technology have also enhanced the diagnostic and treatment process. “What is now a critical link is remote digital imaging,” explains Dr. Wirt. “I can read CT scans and X-rays from the office, home, or any of the hospitals. Within 60 seconds, I can tell the trauma surgeon at the other end of the phone whether the patient needs to go to the OR right away or whether it is something that can wait. We couldn’t do the coordination we do without the current technology and system in place.”
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According to McDonald, many people misconstrue trauma as ER care. “They don’t understand it is an entire continuum that includes prehospital care, in-hospital care, and post-hospital care.” After the trauma patient is stabilized and evaluated at MCR, he or she will either go to the operating room or to the surgical intensive care unit (SICU). In Carlos Toca’s case, the trauma team determined that he had broken his neck and bruised his spinal cord. He was taken into surgery where Dr. Wirt inserted a plate and fused his spine. Once patients get to the SICU, whether they come directly from the ED or from the OR, they are carefully followed by their trauma team. “Trauma patients have a potential for fragmented care,” says McDonald. This can happen, she explains, because of the different specialists who may be involved in their care. The trauma center employs trauma case man-
agers - nurses specially trained in the care of the injured patient - who work closely with the trauma surgeon. Case managers serve as a liaison for the patient, family, trauma team, and specialists, says McDonald. “We do multi-disciplinary rounds every morning where the trauma surgeons and care providers come to the patient room to review the plan of care with each other and the patient,” she says. Besides the trauma surgeons and case managers, the team includes primary care nurses, a physical therapist, pharmacist, and discharge planner. Once patients are ready to leave the SICU, they are moved to the post-trauma unit. “One of the scariest times for families is when the patient is ready to leave the ICU,” says McDonald. “Again, the case manager is available to the patient and family. Because they see the same person throughout, it reassures the patient and their family and provides continuity of care.”
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Northern Colorado Medical & Wellness
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MCR’s Trauma Center of the Rockies 2008 Trauma Accidents
20% Falls Motor Vehicle Crash Motorcycle Crash Bicycle Crash Other Various
32% 5% 15% 28%
Figures courtesy of Poudre Valley Health System
Friday, June 12, 2009
Dr. Timothy Wirt with Carlos Toca minutes before he removed the hardware from Carlos’ neck. Thanks to Dr. Wirt and the Trauma Center of the Rockies team, Carlos has recovered significantly from his accident in August 2008, where he broke his neck and bruised his spine.
Simultaneously, the team is getting the patient ready to leave the hospital. “Our rehabilitation therapists are integrated from the get-go,” says McDonald. “They’re already doing things while the patient is still in bed and do a lot of therapy with the patient in the room.”
What Happens After the Hospital Trauma care doesn’t end when patients are ready to be discharged. The continuum of care includes making sure the patient gets the posthospital care they need. The trauma team works with the patient and family to find the best fit for their rehab needs, which may include the PVH Life Skills Rehab facility or one of the other local or regional rehabilitation facilities. Two other local options include The Northern Colorado Rehabilitation Hospital (NCRH) and the Northern Colorado Long Term Acute Hospital (NCLTAH), both of which share a campus not far from MCR. Decisions regarding post-hospital care are made based on the individual needs of the patient. For example, Carlos went to Craig Hospital in Englewood where he would meet and be treated with other young patients with spinal cord injuries. “If a patient has enough injuries that they can’t go home safely and they need a doctor to manage their medical issues, then such a patient is more appropriate for an acute rehabilitation hospital like NCRH,” says Sam Laney, M.D., Associate Medical Director of NCRH. “We actively look at patients who have multiple injuries and require multiple avenues of care to recover. The
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Lydia’s STYLE Magazine
goal, which is accomplished as a team, is to medically optimize them, make them stronger, and enable them to do more for themselves. We call that maximizing independence. We train them safely how to use devices like walkers, power wheelchairs, and even train the family to take care of their loved one in the home environment.” NCRH was recently rated in the 10 percent of inpatient rehabilitation facilities in the United States. “This hospital is the only freestanding rehabilitation hospital north of Denver and into Wyoming,” adds Joseph Jacob, M.D., NCRH’s Medical Director. “We provide physical rehabilitation for individuals with arthroscopic, neurologic, or musculoskeletal disease or trauma. In this hospital, we can admit patients over the age of 14 from a variety of settings.” For patients who are very sick, have a great preponderance of medical issues, and require constant monitoring, NCLTAH might be a more appropriate choice. “If a patient is too sick to actively participate in rehabilitation, the NCLTAH would be an option,” says Daniel Asadi, D.O., NCLTAH’s Medical Director. “At our facility, we have pulmonologists, nephrologists, and infectious disease doctors. It is a level of care that is more intense. All the rooms are able to have a cardiac monitor.” “NCLTAH is for patients who need an ICU level of care,” adds Dr. Laney, who often consults with Dr. Asadi on an as-needed basis. Such collaboration is one of the many positive aspects of a joint campus. “It’s just a wonderful situation because, even though we are two separate entities, the doctors at NCRH and NCLTAH can help each other,” explains Dr. Asadi. “The medical and therapy related strengths of each facility complements the other,” adds Dr. Laney, “It makes the medical campus better able to meet the needs of the complex patient.” Once NCLTAH patients are more stable, it also provides a continuity of care when they transfer to NCRH. “A good portion of our patients go to the rehabilitation facility,” agrees Dr. Asadi. Once patients are released from whatever rehabilitation setting deemed appropriate and go home or into a skilled nursing facility, the continuum of care goes on and the circle closes. Patients continue to meet, on an outpatient basis, with specialists like Dr. Wirt and Dr. Baer, who manage their care as long as such oversight is necessary. “It is a trauma system that works,” says Dr. Wirt, who thinks more communities need to adopt a similar model. “Nationally we need to have highly efficient, good trauma centers that work with trauma patients. If we don’t promote (our success) other systems will never evolve to where they need to be.” And in the end it will be the patients and their communities who are short-changed. For Carols Toca, the outcome is a happy one. This month, Dr. Wirt removed the hardware in Carlos’ neck. Besides some limitations in his hands, he is almost back to normal and, with a few restrictions, Carlos is able to participate in most activities with other teens his age. +
the five levels of trauma care: What they mean There are five levels of trauma care a hospital or other facility can choose to provide, according to Lori McDonald, Poudre Valley Health System’s Trauma Program Director. They are as follows:
Level V - Indicates a minimum level of care and is generally assigned to ski clinics.
Level IV - Indicates a small community hospital where physicians are available, but general surgeons may not be available 24/7. In a trauma situation, their role is to stabilize the patient and get him or her ready for transfer to a trauma center.
Level III - Indicates the hospital has a trauma center. In addition to the anesthesiologists, there are general, trauma, and orthopedic surgeons at the ready. Other sub-specialists, like neurosurgeons and facial-trauma surgical specialists, may not be available. Poudre Valley Hospital is a Level III trauma center. Level II & Level I - Indicates a hospital that offers what is considered upper-level care. This hospital can take care of the full spectrum of clinical needs. Subspecialists are on-call, ready to respond as needed. The only difference between a Level II and a Level I is that Level I is affiliated with post-graduate Residency programs and has a trauma research program. Medical Center of the Rockies is a Level II trauma center.
Lynn M. Dean is a Colorado writer and mother of three. She has written more than 500 articles which have appeared in over 100 different publications in 35 states.
Northern Colorado Medical & Wellness 2009
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regional care
Medical Clinic at Centerra, P.C. “It is a one-stop shop for world-class medical treatment. These are the only true medical office buildings on the campus of a hospital facility in this region. Patients don’t have to run all over town for tests or specialists, it’s all right here and they appreciate that.” Ron Kuehl, McWhinney Vice President of Real Estate. Steven Dubs, M.D., surgeon with Greeley Medical Clinic, P.C.
Comfort, Convenience at the
New Medical Clinic at Centerra
BY Julie Estlick
When Steven Dubs, M.D., is called to perform an emergency appendectomy on a day when he is seeing patients in the office, it’s no sweat. Dubs, a general surgeon with the Greeley Medical Clinic, P.C., (GMC) practices next door to Medical Center of the Rockies in the new Medical Clinic at Centerra.
C
onvenience for doctors and patients was the key factor in construction of the Centerra North and South medical office buildings adjacent to the Medical Center of the Rockies (MCR) in Loveland. Both buildings have covered walkways directly into the hospital and were developed by Loveland-based McWhinney. With the opening of the North building earlier this year, patients are now able to have labs or X-rays done minutes before seeing their family physician and meet with any number of specialists at GMC’s Medical Clinic at Centerra, P.C. The South building opened with MCR in 2007 and includes Heart Center of the Rockies, a pharmacy, and durable medical goods store, among others. “It’s a one-stop shop for world-class medi-
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cal treatment,” says Ron Kuehl, McWhinney Vice President of Real Estate. “It’s very common throughout the country to have on-campus medical offices, but unique to Northern Colorado. These are the only true medical office buildings on the campus of a hospital facility in this region. Patients don’t have to run all over town for tests or specialists, it’s all right here and they appreciate that.” The MCR campus master plan included two medical office buildings flanking the hospital as part of the 91-acre campus. Although no one expected the North building to go up so quickly, Greeley Medical Clinic was eager to move its doctors and services closer to MCR, Kuehl says. The Colorado Contemporary style of both buildings blends well with the look of MCR. Na-
tive buff sandstone quarried in Masonville was used on the exterior and continued in the interior common lobbies for a mountain feel. Brick and Centria, a sleek pre-finished metal panel system with concealed fasteners, were selected for the exterior to reflect the stature of the providers and level of care offered within, says Tim Stern, Project Manager for Delta Construction, Inc., who served as general contractor for the project. The little details like a covered patient dropoff area and clear signage take into account the patient experience as soon as you exit Interstate-25 and drive into the lot. Stepping inside the North building, patients are greeted by a warm, inviting color palette of muted tones and cheerful geometric rugs. Paintings by local Front Range artists dot the walls and modern yet com-
Lydia’s STYLE Magazine
fortable couches and chairs in the waiting areas create a sense of calm worlds away from the cold, clinical feel of most doctors’ offices. The Medical Clinic houses 27 physicians with specialties in family practice, internal medicine, gastroenterology, oncology, rheumatology, dermatology, and general surgeons. Blood and imaging labs that include ultrasound, X-ray, CT scans, and MRI bays are located on the first floor. The imaging department has comfortable changing rooms, each with its own small waiting area for privacy. Upstairs are minor surgical procedure rooms and infusion suites for cancer and arthritis patients with panoramic mountain views. Additional services are provided by Hanger Prosthetics and Orthotics, the Urology Center of the Rockies, and Caring Hearts Home Health Care, who all lease space from GMC. The layout is open rather than separate, walled-off offices filling the space. Everyone checks in at a central desk and finds their “storefront” within the long waiting room that is closest to their doctor’s door. The storefronts are divided by hanging glass panels stenciled with trees that were created so everyone is not bunched into one place. Phone calls and scheduling actually happen in the back of the building for both confidentiality and to keep the waiting area as calm and quiet as possible. “It feels like a good, soothing environment when you come here – truly a place to get better,” says Donna Lankford, Director of Operations for Greeley Medical Clinic. “We designed this building for medical purposes and we’ve had rave reviews. Many of our patients say they prefer to come here rather than other physician’s offices because there’s generally no wait and it’s not as chaotic.” GMC has an ownership share in the North building and also has sites near the North Colorado Medical Center in Greeley and Loveland’s McKee Medical Center. The Medical Clinic doctors have “work patterns” which are small offices 5 ½ feet by 6 ½ feet set behind a nurse’s station of the same dimensions. A door separates them for doctor-patient confidentiality during phone calls. The offices are shared with no one owning a particular area, allowing for maximum flexibility and use. “The physicians indicated the work pattern allows them to hand their nurses something rather than calling them or walking down the hall,” Lankford says. “Physicians can see patients more quickly and on time. There is more effective communication with nurses and assistants. If a physician is not working, another one can hold clinic utilizing the same work space.” Stern, a veteran of medical office building construction, was certainly impressed with GMC’s design concepts. “The Medical Clinic at Centerra space is really innovative. It’s the first time I’ve seen an office combine the doctors’ and nurses’ spaces in one little room,” says Stern. “It was also unusual to combine a bunch of different specialties in one space on each floor rather than their own distinct offices.” Denise Swingle, RN, and owner of Caring Hearts Home Health Care, was thrilled when GMC invited her agency to expand to the North
Northern Colorado Medical & Wellness 2009
The North Medical Office building opened in early 2009 and is home to the Medical Clinic at Centerra and Caring Hearts Home Health Care.
The South Medical Office building houses Heart Center of the Rockies and was completed in 2007.
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building. “Servicing the aging population is very important to us and this location is ideal,” Swingle said. “We can talk directly to the physicians, make eye contact, and discuss a patient’s problems. Then we speak to a patient before they are discharged about the care they need at home. Elderly folks feel more comfortable if they get to meet us beforehand.” Caring Hearts Home Health Care, ranked in the top 100 of Home Health Care agencies in the country, is working to raise awareness among doctors and the public about the range of services available for at-home care. Their office at the Medical Clinic is like an endorsement from a doctor and a platform to educate patients, medical assistants, and physicians about medical care in the home, Swingle added. If business in the South building is any indication, patients are certainly benefiting from the cost savings and convenience of having their health care needs taken care of in one location. As the region’s premier cardiac care center, many patients travel hundreds of miles to be treated at Heart Center of the Rockies. The Heart Center shares special diagnostic equipment for heart patients with the hospital and pulmonologists and cardiac rehabilitation specialists in the South building. The machines are housed in a first floor hospital room that adjoins the Heart Center’s offices for easy access. “We didn’t want to waste space or resources,” says Dr. Gary Luckasen, President of
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the Heart Center of the Rockies. “This saves on costs and staff can flex between inpatient and outpatient services. It is great to have everything right here.” Those patients undergoing cardiac rehabilitation are clearly safer because specialists are right on site if they should collapse on the treadmill or anything goes wrong, Luckasen adds. “It’s also convenient if a patient gets a test done and has abnormal results, we can put them in the hospital right away.” Heart Center doctors share work pods when they are in the office and have access to studies in the hospital as well as electronic records and testing results, a common move among hospitals and physicians to use less paper files to ensure accuracy and cut down on errors. The casual observer may not notice, but several green design features were included in the North and South buildings to save energy and electricity, says Dean Barber, McWhinney Vice President of Development for the Medical Group. A special building management system controls the HVAC unit and electrical can be fine-tuned for efficiency so lights shut off when rooms are unoccupied, motors can be phased up or down, and adjustments made to let in more fresh air. The silver sunscreens above the windows are adjusted in the winter months to provide passive solar heat for the building and deflect heat in the scorching summertime, Barber notes. A tan reflective roof was installed so heat is not absorbed into the building, and a whopping 75 percent of what left the site during construction – like cardboard, wood, and concrete – was reused or recycled and kept out of the landfill. The building is a success on many fronts, but efficiency in patient care stands at the forefront. “I’ve been developing medical buildings for over 15 years and you really see an improvement in the quality and efficiency of the patient care system when physicians, imaging, outpatient, and specialty physicians are represented in one location rather than in 40 clinics spread out all over the place,” Barber says. “It helps the patient and it’s a better solution than stand-alone medical offices, in my opinion.” + Julie Estlick is a freelance writer and editor living in Fort Collins with her husband and young son.
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Northern Colorado Medical & Wellness 2009
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learning disorders
new facility Brain Integration in greeley
“Any loss of integrated brain function results in the loss of a specific mental capacity and can result in learning disabilities.” Charles T. Krebs, Ph.D., co-author of A Revolutionary Way Of Thinking
Brain Integration for
learning disabilities
By kay rios photos by warren diggles
“Since the brain is unlike any other structure in the known universe, it seems reasonable to expect that our understanding of its functioning - if it can ever be achieved – will require approaches that are drastically different from the way we understand other physical systems.” – Richard M. Restak, The Brain, The Last Frontier, 1979
T
o meet Charles T. Krebs, Ph.D., is to know you have met a brain science virtuoso. He has a unique gift for explaining complex brain functions, how learning disorders occur, and cuttingedge treatment strategies in a vernacular that regularly surprises lay people with how much they are able to learn from him. It is a gift Dr. Krebs has honed in 25 years as a teacher, research scientist, clinician, and inventor of acclaimed treatment techniques. So it is not entirely surprising it was standing room only when Dr. Krebs recently held a lecture at
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Fort Collins’ Bas Bleu Theater. “Brain integration,” he explains, “involves maintaining precise synchrony and timing of all brain functions to effectively process information and make timely decisions.” That is the basis for the Learning Enhancement Acupressure Program (LEAP), which Dr. Krebs co-created with Susan McCrossin, a health practitioner in Boulder. LEAP, which Dr. Krebs has taught in ten countries around the world, is aimed at correcting learning problems such as attention deficit disorder (ADD), attention deficit/hyperactivity disorder (ADHD), and dyslexia.
The LEAP model involves an understanding of the latest scientific discoveries of how the brain functions. Popular models divide the brain into left and right brain, a concept that has been around since the 1960s when American psychobiologist Roger W. Sperry discovered the human brain has two very different ways of thinking. The right brain, he determined, is visual and processes information in an intuitive and simultaneous way, looking first at the whole picture then at the details. The left brain is verbal, processing information in an analytical and sequential way. This side first looks at the
Lydia’s STYLE Magazine
pieces and then puts them together to create the whole picture. Recent findings have shown that things aren’t quite that simple and the brain is not as split as the explanation would have it. Research has proven the human “bio-computer” is more complex than initially thought. Although specific areas of each hemisphere are responsible for initiating individual brain activities, such as math or reading, the reality is multiple areas of both hemispheres must be able to freely share information throughout the brain. That, says Dr. Krebs, is the definition of an integrated brain. This explains, according to Dr. Krebs, why many people have learning and behavior disorders. “Any loss of integrated brain function results in the loss of a specific mental capacity and can result in learning disabilities.” He likens it to how a car’s spark plugs will misfire or sputter if the electrical timing is off. Similarly, if brain processing is not properly synchronized and free flowing, its ability to take in, process, and carry out critical information is compromised. Symptoms of learning difficulties include inability to concentrate, demonstrated hyperactivity, poor impulse control, limited understanding of cause and effect, displays of inappropriate social behaviors, problems with reading and reading comprehension, with abstraction and math, and with short term memory. Behavior problems also appear when the brain is not integrated. “Children who are integrated control their behavior,” Dr. Krebs says. Stress is a large contributor to the loss of brain integration, Dr. Krebs maintains. “Brain integration is a continuum.” He describes a spectrum running from “distressed” and zero percent integration at one end, where learning and mental tasks are difficult. The other end, at 100 percent integration, Dr. Krebs designates as “in the zone.” When people become stressed, loss of brain integration can be indicated by Dr. Krebs’ long list of symptoms: a sense of being overwhelmed, inappropriate anger, inability to focus, muddled thinking, feeling fearful, difficulty sleeping, difficulty or inability to listen to or understand what you are told, Freudian slips or inappropriate social responses, extreme fatigue, and the inability to make decisions. “These symptoms let you know you have lost brain integration,” Dr. Krebs says.
Dr. Krebs’ Story Dr. Krebs knows firsthand what it is not to function well. His personal history took him through a time when there was no integration of brain or body. Dr. Krebs completed his Ph.D. at the Marine Biological Laboratory in Massachusetts and ended up in Australia in the 1980s. He was 35, physically fit, and the picture of health. He ran daily, played volleyball and basketball, was a strong downhill skier, and practiced karate two to three times a week. An invitation to spend a week diving off a national park called Wilson’s Promontory seemed perfect. Dr. Krebs, a professional diver, and his friends began working to build up to a dive searching for the wreck of an old ship about 60 meters deep, the limit for scuba divers using compressed air. He had been that deep on several dives before, but this time something happened. He became anxious on the dive and, back on the boat, he began to lose control of his motor coordination. He realized he
Northern Colorado Medical & Wellness 2009
Dr. Ann Pendley shows a patient how the brain processes information.
Maximizing Communication
A Multi-Pronged Approach
W
ith the goal of maximizing communication, the Speech and Language Stimulation Center, Inc., offers a variety of services. “We focus on pretty much everything in the communication field,” says Ann Pendley, Ph.D., and owner/director. It is a large menu for a small operation, but “one that works well.” The Center helps patients who may have difficulty with articulation, voice-vocal fold problems (literacy), pediatric feeding and swallowing, cleft palate, cognitive-language difficulties, brain injury, autism, stuttering, and more. In July 2009, they will begin seeing stroke patients and accepting Medicare. “It’s pretty eclectic. There are four therapists and we each bring our own brand of training and, by cross training, we’ve created a system that comes together.” One common influence is the Lindamood approach. “Most of us came from her perspective in literacy and we base our process on that.” She refers to the Lindamood Phoneme Sequencing (LiPS®) Program, which stimulates phonemic awareness: making individuals aware of mouth actions that produce speech sounds. The awareness becomes the means for verifying sounds within words, enabling individuals to become self-correcting in reading, spelling, and speech. The technique is catered to the client’s needs with Pendley’s unique approaches incorporated. “We determine the learning style of our client and then incorporate the parts of their brain that they may not have used before. For example, when you first look at the print on a piece of paper, the information goes to the occipital lobe (back of the brain), where you see the letters. Then it goes to the temporal lobe, where you interpret language. Then, if you read out loud, you bring it up front to the parietal lobe. The frontal lobe helps you monitor yourself, make corrections, and get the bigger picture. That is also part of the right hemisphere of the brain. So while most functions may happen on the left side of the brain, you also need the right side to grasp the bigger picture of what’s occurring.” There are many methods of incorporating other areas of the brain. “The motor component is not
By kay rios | photos by warren diggles typically used in reading. But, by crossing your legs at the ankle or sitting on an exercise ball, or even walking when you read, you might stimulate something that will help with learning. When we work with sensory-based colleagues, occupational therapists for example, they might suggest using exercise before a particular client sits down to read or write or concentrate on something. We take those suggestions and we integrate them into what we need to do and that’s the nice tie in between the disciplines.” It is within this area that brain integration might be useful, says Pendley. “If I’m working with a client and something just isn’t clicking – maybe they’re very distracted or frustrated or there’s a whole history we don’t know about – we may not be able to get through to the patient. That’s where I see something like Dr. Charles Krebs’ idea of opening pathways might work. It might be appropriate for some people to take a break from what we do, work with someone who does brain integration, and then come back. They may then be in a better place to add on this next layer.” Pendley says there is, of course, a full spectrum of approaches in the speech and language field as in any health-related area. “When you go to one end of the spectrum, it’s all evidence-based, and then at the other end of the spectrum are those non-scientifically demonstrated techniques. I put us in the middle. We like to base our work on what has been shown to be good and then we integrate some things that are a little less traditional. We need to be flexible and let it depend on the needs of the individual clients. If they need more evidence-based therapies, we can do that. If they come from a more non-traditional, holistic approach, we also try to incorporate that as much as we can.” It’s all about outcome, she says. “The point is to get them to learn to their full potential and it may take several different styles to do that.” For additional information on the Speech and Language Stimulation Center, check their Website at www.speech-language-voice.com Kay Rios, Ph.D., is a freelance writer based in Fort Collins.
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Certified brain integration technique professional and founder of Open Pathways to Learning, Nancy Evans works on reading skills with a child at her office.
Evans has been invited to join Dr. Krebs in incorporating and leading his USA brain integration certification program.
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was experiencing type two bends. One after another, portions of his body became paralyzed. After ten days of treatment in a decompression chamber he made some progress, but doctors thought he would never walk again since the nerves in his legs had been badly damaged. A month after his accident, he began to work out for seven hours a day, trying to build up strength and muscle tone. He made slow progress, finally moving from a wheelchair to a walker. He had to practice balancing and had to remember how to walk. By the sixth month of rehabilitation, Dr. Krebs had moved to two walking canes. However, even getting dressed was a major effort and he had to catheterize himself four and five times a day. Despite this, he returned to work at the Victorian Marine Science Laboratory where he transferred to a desk job. He soon realized something was wrong with the way his brain functioned. Work became increasingly difficult and he was required to have a neuropsychological assessment. The test showed that as well as spinal damage, he had suffered brain damage. He spent the next few years searching for a means to heal himself, to make progress back into a body and brain in which he felt comfortable. Through a series of events, he came in contact with a kinesiologist. What he heard made sense and he became convinced about the effectiveness of kinesiology. After two hours of acupressure and applied physiology techniques, 80 percent of the chronic back pain he had been suffering for several years was eliminated and he experienced dramatic improvement. As he continued to work with the kinesiologist, he began to believe his muscles didnâ&#x20AC;&#x2122;t work
Lydiaâ&#x20AC;&#x2122;s STYLE Magazine
I ADD/ADHD • Dyslexia • Reading Problems • Math Difficulties • Poor Handwriting Attention & Focusing Issues • Extreme Anger • Depression • Poor Self-Esteem Memory Problems • Hyperactivity • Muddled Thinking • Poor Social Skills Traumatic Brain Injury • Mood Swings • Eye Strain • Test & Stress Anxiety Brain Integrati on Treatment can successfully resolve these and many other symptoms of improper neuro- pathway functi oning. Non-invasively and without drugs, this gentle therapeutic process restores the brain 's ability to successfully process and integrate inform ati on. Call today or visit our website to discover why Brain Integrati on Treatment is popul ar in many count ries around the world.
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Northern Colorado Medical & Wellness 2009
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Dr. Krebs (center) pictured with Robert Evans and Nancy Evans of Open Pathways to Learning, LLC.
because a “circuit breaker” had switched off in his nervous system. Those observations led to more work and more investigation into the reaction of his neurons in response to the stress of hypoxia. They didn’t die, says Dr. Krebs, but went on standby until the energetic system could be reactivated. After more work, he was able to regain full brain function and, though he still walks with difficulty, he is far from incapacitated.
Open Pathways to Learning That experience brought him to the concepts he incorporated into the LEAP approach. In the LEAP model, clients are assessed using two tools. The first is a means of accessing memory of past experience, traumas, or stress. “You can actually activate much of the same neurology that was activated by the original experience. For example, when you remember an argument, you often become angry again.” The second tool is direct muscle biofeedback with muscle monitoring or muscle testing. “Most of the muscle function is subconscious and it provides reliable subconscious feedback that can be consciously observed and felt,” he says. “Using muscle monitoring, we can assess brain integration and its functional consequences.” Once the assessment is done, acupressure techniques can be applied to re-synchronize brain functions, defuse the stressful emotional issues causing the dysfunction, and reopen neuro-pathways so learning can occur and mental tasks can be more easily performed, he says. Nancy Evans is one success story. Her daughter was diagnosed with ADHD. After trying medication, doctor visits, support therapy, and tutors, she came across brain integration treatment. Since treatment, according to Evans, her daughter is no longer on medication and has developed into a talented writer, where previously she had difficulty writing a single paragraph. A registered nurse, Evans became so convinced of the potential of brain integration, she became certified as a brain integration technique professional and, with her husband Robert, co-founded Open Pathways to Learning in Fort Collins. Christie Hoffer’s family is reflective of the kind of parent who seeks out Evans’ help. When Hoffer’s son was just five years old, he was diagnosed with ADHD and experienced trouble staying focused and being able to “just go with the flow” while in the classroom. A friend of Hoffer’s, whose son was also diagnosed with ADHD and had found help at Open Pathways, invited her to attend one of Dr. Krebs’
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lectures. Hoffer was intrigued by what she learned and immediately had Open Pathways evaluate her son. “What convinced me to try Open Pathways more than anything was Nancy’s honesty. She said, ‘I don’t know if I can help your son, but I can try.’ We decided to do three to four sessions to see.” Two sessions later, Hoffer and her husband saw a dramatic change in their son. “Especially with his reading. He went from reading at a normal kindergarten level to reading complete sentences.” A year later, she reports, “This has been life-changing. He has calmed down, has more focus, more interests, and is more able to just go with the flow, a 180-degree change.” His teachers have since recommended him for gifted and talented programs and Hoffer says she cannot thank Open Pathways enough. “This has been a bigger help than just medication and it is permanent,” she says. “The biggest thing I tell people [who ask about Open Pathways] is to be open-minded. We tend to have a fear of Eastern medicine, thinking it is mumbo jumbo. This is much more than that.”
The Future of Brain Integration Therapy Dr. Krebs recently invited Nancy and Robert Evans to join him in incorporating and leading his USA brain integration certification program. “We were honored that Dr. Krebs invited us to join with him,” says Evans. She will take on the role of Admissions Coordinator and Robert as Business Director. “He has been impressed with our practice and leadership in creating the Learning Solutions Network of Northern Colorado. The good news for Northern Colorado is that we’re now positioned to become the national hub of brain integration. National and international learning disorder experts and teachers will be heading our way and families and health professionals in our area will definitely benefit!” Dr. Krebs says his plans for the future involve getting his work to people in the mainstream. He does, however, caution that this is not a fix-all. “If it is organic damage, like extreme autism, this may not be able to correct it. Brain integration is like a software fix, but it can’t fix a hardware program.” He also says it is not a stand-alone approach. “I’ve worked with speech pathologists and other health professionals for years. My technique prepares people for learning and for functioning. After their brain is integrated and they’re not working with faulty pathways, then other professionals can work with them more effectively.” Scientific research of why and how brain integration achieves its results hinges on future funding. Currently, complementary and alternative medicine modalities are largely overlooked in research. However, Dr. Krebs has succeeded in attracting the attention of learning disorder medical specialists in several areas of the world. A recent Haifa University control group study of learning disabled children in Israel produced impressive data on the success of brain integration. The study can be reviewed on Open Pathways’ Website, www. openpathways.org. +
Kay Rios, Ph.D., is a freelance writer based in Fort Collins.
Northern Colorado Medical & Wellness 2009
Mike Winchell, co-owner of LearningRx Fort Collins, working with a student.
New Approaches to
Treat Learning Disabilities
A
brain that performs slowly and inefficiently can be the underlying cause of learning disabilities. But that can often be remedied, say Mike Winchell and Don Cassidy, co-owners and co-directors of the LearningRx Fort Collins brain training center. “It is widely assumed you are born with a fixed amount of intelligence you carry with you the rest of your life,” Winchell says. “However, the things we do every day modify and improve the factors that make up IQ: how fast you think; your processing speed; how well your memory works, including short and long term memory; your attention skills, including the ability to focus for sustained periods and block out distractions; the ability to multitask; auditory processing, including key reading skills; visual processing; and logic and reasoning, which are important for math and arithmetic.” Cassidy equates LearningRx techniques to the approach a physical trainer might use, pushing the client to go faster and become stronger. “We don’t accommodate weaknesses; we fix them and turn them into strengths. For example, we have a student who was diagnosed with ADD and learning disabilities. His mother used to have to sit at the table with him to get homework done. After brain training, she now enjoys an hour and a half of ‘me’ time while he completes homework on his own without distraction. Where accommodation of his weaknesses and modification of his learning environment were previously necessary, we have turned his attention weakness into a strength.” LearningRx students work five days a week at the center and their skills translate into academic achievement and life skills, Winchell says. “Brain training is synergistic with what schools do; we work on strengthening cognitive skills and they work on teaching academic content. It makes a great partnership.” “The LearningRx approach takes the struggle out of learning,” Winchell continues. “We work at a more fundamental level than schools and tutoring to fix the underlying problems. Most people don’t realize you can change basic cognitive skills,
By kay rios photos by warren diggles so when others talk about ‘underlying problems’ they don’t know what that truly means. Study skills, for example, are a second level skill, not an underlying problem.” Discussion around gains differs as well. “When we talk about years of gain, we talk about cognitive gain and the ability to think faster and remember better. When others talk about years of gain, it’s typically about current academic gain and not if the brain can function better or if there is the ability to retain content after the test.” The results of the LearningRx approach register cognitive gains, he adds. “We get between two and six years of gain per cognitive skill. For instance, if a 13-year-old is processing at the speed of an 11-year-old when she starts the program, six months later we can have her processing at the level of a 15-year-old. We have a recent student who gained even more than that.” The training is not for everyone, Winchell admits. “We have turned people away, but,” he clarifies, “almost everyone can benefit from cognitive skill training no matter their age. For seniors it can mean getting their youthful feeling back with improved processing speed and better memory. For working adults is can mean faster, better work and more billable hours or more time with their family. For the unemployed it can mean a hiring edge. And for the struggling student it means faster homework and easier A’s.” Winchell says LearningRx has improved the brains of over 20,000 students of all ages in its 57 centers across the country. “These techniques were developed over the last 30 years using the most advanced brain research. For families who struggle, this program can be an incredible gift. At the end of the day, the most important thing is how we have changed the lives of the families we touch. That is why we brought this program to Northern Colorado.”
Kay Rios, Ph.D., is a freelance writer based in Fort Collins.
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awareness
Chronic Kidney Disease
“Now there are specific levels of disease and also a corresponding action. In the first two stages, we focus on diagnosing the cause and limiting its progression. When it gets to stage three, we look at treating complications.” Jason Merritt, M.D., The Nephrology Clinic, P.C.
Chronic Kidney Disease
on the rise
By kay rios Photos by warren diggles
More than 20 million Americans have chronic kidney disease (CKD) and 20 million more are at increased risk for developing it, according to National Institutes of Health (NIH) estimates. Many of those people are not aware of the risk. “Kidney disease is often asymptomatic until the organs are functioning at less than 30 percent,” says Jason Merritt, M.D., at The Nephrology Clinic, P.C., in Fort Collins. “That’s why it can develop into a chronic disease before it’s diagnosed and treated.”
K
idney disease, or the increased risk of CKD, is not something to ignore, says Dr. Merritt, since kidneys are vital to good health. The kidneys are hard working organs. They balance body fluids, filtering excesses out of the blood through urination. They regulate body water and minerals in the blood such as sodium, potassium, phosphorus, and calcium. They remove waste products from the blood, help expel drugs and toxins from the body, release hormones that control blood pressure, make red blood cells, and keep bones healthy. The two most common causes of CKD are
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diabetes and high blood pressure, and CKD is a condition that increases the chance of premature death. “People with CKD are more likely to develop heart disease,” Dr. Merritt says, “and this is the number one cause of death among kidney patients.” The good news is that early detection and treatment can keep kidney disease from worsening and can prevent life-threatening complications such as kidney failure and heart disease. But, because symptoms may not show up until late in the game, CKD often goes undiagnosed. In the past, early diagnosis was inhibited by the lack of a universal definition and classification sys-
tem for the stages of CKD. In 2002, the National Kidney Foundation created definitions and guidelines that would help doctors make appropriate diagnosis in its Kidney Disease Outcomes Quality Initiative (KDOQI). “Before the National Kidney Foundation came out with its guidelines and stages of CKD, it was just classified as renal insufficiency,” Dr. Merritt says. “Now there are specific levels of disease and also a corresponding action. For example, in the first two stages, we focus on diagnosing the cause and limiting its progression. When it gets to stage three, or less than 60% of normal function, we look at treating the complications.”
Lydia’s STYLE Magazine
Early diagnosis is essential, he says. “The sooner diagnosis is made, the less likely it will progress to the need for dialysis.” While most people don’t experience severe symptoms until kidney disease is in the last stages, there are some symptoms that might cause concern. Those include feeling more tired than usual, having trouble concentrating or thinking clearly, or poor appetite. Other indicators can be nighttime muscle cramps, swollen feet and legs, or a foamy quality to the urine. Even without symptoms, it is wise to get a check-up. “Get your annual physical and blood work,” Dr. Merritt says. “That will typically include a creatinine level, which is a marker of kidney function.” Creatinine is a waste product created through muscle activity and then eliminated through urination. The results of the blood creatinine test are used to estimate the glomerular filtration rate, or GFR, which indicates the level of kidney function. A low GFR may mean that the kidneys are not working as well as they should to remove wastes. Analysis of the urine can also detect whether protein in being excreted, which if present can indicate compromised kidney function. Using the GFR as a standard, the National Kidney Foundation established five stages of chronic kidney disease. In stage one, there is some kidney damage (for example, protein in the urine) but GFR is normal (more than 90 mL/min). Stage two indicates kidney damage with a mild decrease in GFR (60 to 89). Stage three reflects a moderate decrease in GFR (30 to 59). Stage four indicates a severe decrease in GFR (15 to 29) and stage five is considered kidney failure when dialysis or a kidney transplant is needed. There is more to the interpretation of GFR results than just the number, however. “The problem is that the lab has to account for everyone from a 25-year-old male bodybuilder to a 95-yearold female with no muscle mass. So the range of creatinine values is large,” Dr. Merritt says. “Creatinine has to be interpreted based on age and muscle mass. In other words, the interpretation has to be individualized.” That’s what nephrologists do, he explains. That and education. “We do our best to educate other physicians as to what chronic kidney disease is and when patients should be referred to a nephrologist.” Patients also have to be educated. “Initially, a lot of patients do not see their diabetes and hypertension as systemic diseases capable of damaging other organs, such as the kidneys. However, after being diagnosed with chronic kidney disease, these patients tend to pay more attention to their blood sugar and blood pressure. Their primary care doctor may have already told them that poor blood sugar or blood pressure control could result in kidney damage. But until they hear the CKD diagnosis, they are often not as vigilant or compliant as they need to be.” Diagnosis is half the battle. Action is the other half. “You can slow the progression of chronic kidney disease,” Dr. Merritt says. “This can be done through tighter blood sugar and blood pressure control, use of specific medications to decrease the protein in the urine, and avoidance of a few over-the-counter medications which can be harmful to the kidneys.”
Northern Colorado Medical & Wellness 2009
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The National Kidney Foundation lists several ways to lower the chances of developing kidney disease. First, patients must carefully follow prescribed treatments to control diabetes and/or high blood pressure. Losing excess weight with a healthy diet and regular exercise program is also a must. Smoking is a major contributor. So, if you’re a smoker, stop. Other ways to lower chances include avoiding use of large amounts of over-thecounter pain relievers and limiting the intake of alcohol. Even with a diagnosis of CKD, early detection and treatment can often stop or slow the progression of the disease. Treatment depends on the stage of CKD and other concurrent health problems, but some common efforts that doctors may recommend include: • Control of high blood pressure. That may require medication such as an angiotensin converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB). Limiting the amount of salt in your diet also helps. • Control of blood sugar if diabetic. • Following a special diet that controls the amount of protein and saturated fat consumed. Registered dietitians can help plan meals that include appropriate quantities and are aimed at weight control. • Treatment of anemia with iron supplements and erythropoietin (EPO). EPO stimulates red blood cell production.
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Dr. Jason Merritt examines a patient. More than 20 million Americans have been diagnosed with chronic kidney disease. • Preventing bone disease with balanced phosphorus and calcium levels. The kidneys normally remove excess amounts of phosphorus, but when they aren’t working well it can build up, ultimately leading to a loss of calcium from the bones. Doctors may recommend dietary restrictions or may prescribe medication. • Following a doctor-recommended exercise program. • Taking steps to prevent heart problems, including treatment of diabetes, high blood pressure, anemia, and high cholesterol levels. • Smoking cessation. How well the treatment achieves its goal depends on several things. The earlier treatment is started, the better. Results also depend heavily on how carefully the treatment plan is followed. Dr. Merritt encourages anyone at risk or with CKD to talk to his/her primary care doctor. “Primary care physicians in this area really do a good job trying to get people more involved in their own health care. And they can also tell you when it’s time to see a nephrologist. The main thing is to get educated and get active.” + Kay Rios, Ph.D., is a freelance writer based in Fort Collins. She writes for a variety of regional and national publications and is currently at work on a collection of creative non-fiction and a mystery novel.
Northern Colorado Medical & Wellness 2009
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physician and dentistry practice
Directory
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P R A C T I C E D I R E C T O RY
cardiology
Heart Center of the Rockies 2121 East Harmony Road, Suite 100 & 200 Fort Collins 80528 P: 970.221.1000 1.800.459.4241 Monday - Friday: 8:00 - 5:00 www.heartcenteroftherockies.com
A cross-section of the finest healthcare providers in Nor thern Colorado.
dentistry
Overton Center for Dental Arts, P.C. 1220 Oak Park Drive Fort Collins 80525 P: 970. 223.6677 Monday - Thursday: 7:00 - 5:00 www.overtoncenter.com
other Locations: 2500 Rocky Mountain Ave., Suite 100 Loveland, CO 80538 P: 970.624.1800 Estes Park Medical Center 555 Prospect Avenue Estes Park 80517 P: 970.577.4478
Heart Center of the Rockies, in partnership with Poudre Valley Health System, has 18 cardiologists, two cardiovascular surgeons, and over 180 clinical support specialists. They are considered a leader in all medical matters of the heart.
Hematology/Oncology
In practice for 15 years, Dr. Tom Overton is a general dentist with a special focus on cosmetic and neuro-muscular dentistry. He creates beautiful smiles by utilizing his artistic talent and staying on the cutting-edge of technology.
Cancer Center of the Rockies 2121 E. Harmony Road, Suite 150 Fort Collins 80528 P: 970.493.6337 | F: 970.493.3528 Monday - Friday: 10:00 - 6:00 Saturday: 9:00 - 12:00 www.cancerhealth.com Cancer Center of the Rockies is an independent group of physicians and professionals devoted to the diagnosis, care, and treatment of patients with malignancies (oncology) and blood disorders (hematology).
other Locations: 2500 Rocky Mountain Avenue Suite 350 Loveland 80538 P: 970.493.6337 F: 970.493.3528
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Multi-Specialty
other Locations:
Medical Clinic at Centerra, P.C. 2500 Rocky Mountain Avenue North Medical Office Building Loveland 80538 P: 970.203.7000 Monday - Friday: 8:00 - 5:00 www.greeleymedclinic.com www.medicalclinicatcenterra.com
Greeley Medical Clinic, P.C. 1900 16th Street Greeley 80631 P: 970.353.1551 Peakview Medical Center 5881 West 16th Street Greeley 80634 P: 970.313.2700 Urgent Care West 2001 70th Avenue, Suite 100 Greeley 80634 P: 970.378.4155
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Nephrology
The Nephrology Clinic, P.C. 1600 Specht Point Rd., Suite 127 Fort Collins 80525 P: 970.493.7733 | F: 970.493.8745 Monday - Friday: 8:30 - 5:00 www.thenephrologyclinic.com
The Nephrology Clinic has been providing the highest level of care for patients with kidney problems and hypertension in Northern Colorado since 1980. Their nephrologists have medical staff privileges at five Northern Colorado hospitals and can provide hemodialysis, peritoneal dialysis, and therapeutic plasmapheresis.
Greeley Medical Clinic has served Northern Colorado for over 75 years and is one of the oldest continuously physicianowned multi-specialty medical practices in Colorado.
neurology
Fort Collins Neurology, P.C. 2121 East Harmony Road, Suite 270 Fort Collins 80528 P: 970.221.1993 | F: 970.221.9170 Monday - Thursday: 8:00 - 5:00 Friday: 8:00 - 2:00
Neurosurgery
Fort Collins Neurology’s physicians are Diplomates of the American Board of Psychiatry and Neurology. They specialize in assessing and treating neurological disorders such as multiple sclerosis, Alzheimer’s Disease, pain management, head injury, seizure, stroke, Parkinson’s Disease, and more.
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 2009
Front Range Center for Brain & Spine Surgery, P.C. 1313 Riverside Avenue Fort Collins 80524 P: 970.493.1292 | F: 970.493.1210 Monday - Friday: 8:00 - 5:00 www.brain-spine.com Front Range Center for Brain & Spine Surgery is the regional expert in non-surgical and surgical treatments of spinal and intracranial pathology and treatment of problems concerning the peripheral nerves. The addition of an orthopedic surgeon has further enhanced the scope of spine procedures they offer.
other Locations: 2500 Rocky Mountain Avenue Suite 360 Loveland 80538 P: 970.669.0470 2001 70th Avenue, Suite 300 Greeley, CO 80634 P: 970.356.4488 800 E. 20th Street, Suite 320 Cheyenne, WY 82001 P: 307.635.8388
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Ophthalmology
Eye Center of Northern Colorado, P.C. 1725 East Prospect Road Fort Collins 80525 P: 970.221.2222 | F: 970.221.4286 Monday - Thursday: 7:00 - 6:00 Friday: 7:00 - 5:00 www.eyecenternoco.com
other Locations: Skyline Center for Health 2555 13th Street, Suite 225 Loveland 80537 P: 970.679.0000 Windsor Medical Center 1455 West Main Street Windsor 80550 P: 970.686.7171
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Orthodontics
Orthodontic Associates of Greeley, P.C. 3400 West 16th Street, Building 4-V Greeley 80634 P: 970.356.5900 | F: 970.356.2418 Monday - Friday: 7:30 - 5:00 www.dredgren.com
Orthodontic Associates of Greeley are specialists in orthodontics and dentofacial orthopedics for adults and children. At their initial visit, each patient receives a detailed treatment consultation with complete clinical diagnosis, written summary of their findings, and detailed plan of treatment.
The Eye Center of Northern Colorado has been located in Fort Collins for over three decades. They provide the most complete medical and surgical eye care in the region. The Eye Center is the only provider in Northern Colorado to offer the most advanced LASIK technology, iLASIK.
Orthopedic
Orthopaedic Center of the Rockies 2500 E. Prospect Road Fort Collins 80525 P: 970.493.0112 | F: 970.493.0521
pathology
Loveland office: 2923 Ginnala Drive Loveland 80538 P: 970.663.3975 F: 970.663.2235
Summit Pathology
(in Skyline Center for Health building)
2555 E. 13th Street, Suite 120 Loveland 80538 P: 970.353.5136 | F: 970.353.5614
Monday - Friday: 8:00 - 5:00 Call to check holiday hours. www.orthohealth.com
Monday - Friday: 8:00 - 5:30
Orthopaedic Center of the Rockies provides expert care in orthopaedics, podiatry, and sports medicine. Their 23 physicians have board certification and/or specialized fellowship training.
Summit Pathology is a locally physician-owned and -operated clinical and anatomic pathology clinic with specialties that include breast pathology, cytology, blood banking and transfusion medicine, gastrointestinal pathology, genitourinary pathology, surgical pathology, hematopathology, and dermatopathology.
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www.summitpathology.com
other Locations: Cytology Laboratory 2918 West 10th Street Greeley 80634 Summit Pathology has offices in the Estes Park Medical Center, McKee Medical Center, Medical Center of the Rockies in Loveland, Northern Colorado Medical Center in Greeley, and Poudre Valley Hospital in Fort Collins.
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Pulmonary
Poudre Valley Hospital Sleep Disorders Center 1107 South Lemay Avenue, Suite 260 Fort Collins 80524 P: 970.495.8670 Monday - Friday: 8:00 - 5:00 www.sleepcenteroftherockies.com Sleep Disorders Center of the Rockies is a comprehensive sleep facility with Diplomats of the American Board of Sleep Medicine physicians who diagnose and design treatment plans for common sleep problems like snoring and apnea. They have additional sleep testing facilities in Loveland and Estes Park.
2127 East Harmony Road, Suite 130 Fort Collins 80528 P: 970.282.2900 | F: 970.282.9800 8:00 a.m. to 9:00 p.m. Sunday through Saturday for X-ray, 8:00 a.m. to 9:00 p.m. Monday through Friday and 8:00 a.m. to 1:00 p.m. on Saturdays for Ultrasound, CT and MRI.
P R A C T I C E D I R E C T O RY
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Radiology
office Locations: Sleep Disorder Centers of the Rockies 2121 East Harmony Road, Suite 300 Fort Collins 80528 P: 970.663.3377 or 970.619.6105 2500 Rocky Mountain Avenue, Suite 300 Loveland 80538 P: 970.663.3377 or 970.619.6105
Radiology
The Imaging Center at Harmony
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Advanced Medical Imaging Consultants, P.C. Corporate Office: 2008 Caribou Drive Fort Collins 80525 P: 970.484.4757 | F: 970.377.3386
other Locations: All of Advanced Medical Imaging Consultants’ doctors are hospital-based and serve Western Nebraska, Northern Colorado and Southern Wyoming.
www.AdvMedImaging.com
The AMIC team consists of over 20 board-certified, subspecialty-trained radiologists. They use today’s most advanced technologies in the areas of Women’s Imaging, Cardiac Imaging, Interventional Radiology, Neuroradiology, Musculoskeletal Imaging, and Oncologic Imaging.
sports medicine
other Locations: The Imaging Center at Centerra 2500 Rocky Mountain Avenue, Suite 150 Loveland 80538 P: 970.282.2900
www.the-imaging-centers.com The Imaging Center offers convenient, easy access to radiology services for the residents of Northern Colorado, Southern Wyoming, and Western Nebraska. The Imaging Centers are staffed by board-certified radiologists and equipped with state-of-the-art imaging technology.
Northern Colorado Medical & Wellness 2009
Colorado Spine, Pain & Sports Medicine, P.C. 1301 Riverside Avenue, Suite 2 Fort Collins 80524 P: 970.692.5550 | F: 970.692.5561 Monday - Friday: 9:00 - 5:00 Website coming soon
Colorado Spine, Pain and Sports Medicine provides non-surgical treatment of low back, neck, and other orthopaedic conditions. They also specialize in sports medicine, electrodiagnostic medicine, and spine intervention procedures under fluoroscopic guidance by a fellowship-trained and board-certified physician.
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|
vision
iLASIK
“The iLASIK procedure is a marriage of the accuracy of a custom fit and the safety of bladeless surgery.” Gary Foster, M.D., Eye Center of Northern Colorado
perfect vision with
ilasik
By Angeline Grenz Photos by warren diggles
Our eyesight is one of our most cherished senses. A weakness in our sight can easily be improved with eyeglasses or contact lenses, but they still hold many back from the active lifestyle they desire.
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aking back their precious sight through LASIK eye surgery, millions today have been able to gain perfect or near-perfect vision. The Eye Center of Northern Colorado has teamed up with Poudre Valley Health System to form the Eye Laser Center of Northern Colorado. Together they have taken LASIK surgery to the next level with a new technology, iLASIK. This technology makes LASIK bladeless, safer, and completely custom-fit to your eyes’ specifications. “The procedure is a marriage of the accuracy of a custom fit and the safety of bladeless surgery,” according to Gary Foster, M.D. Foster is one of the four doctors at The Eye Center of Northern Colorado who perform the iLASIK procedure. He is passionate about the advantages of the new
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technology. “The iLASIK procedure offers a higher standard and level of care,” says Dr. Foster. In fact, the iLASIK procedure is so effective that it has been approved for NASA astronauts. According to clinical trials, 98 percent of patients who undergo the procedure can see 20/20 or better after the treatment. Doctors Matthew Robinson, Randall Smith, and Karl Olsen also perform iLASIK at the Eye Laser Center of Northern Colorado. The iLASIK vision correction procedure specifically refers to a three-fold technology. The first step is a machine that creates a custom map of the eye, the next is the bladeless creation of a treatment flap, and the final step is a laser that reshapes the cornea to correct the imperfections in the eye, fixing those defects that make you nearsighted or farsighted.
The process begins with a complete diagnosis of the eye. The Wavefront machine bounces light through the eye, measuring the eye in a hundred different ways. This technology creates a “blueprint” of the eye, determining what is wrong and enabling the LASIK laser to make a custom focusing correction for the eye. Traditional LASIK procedures use a general eye glass machine to create the treatment. Though great for glasses, the machine does not have the precision of the Wavefront machine. “Sometimes we will use this Wavefront machine to measure patients that are hard to fit with glasses, who aren’t even planning laser correction, because it is so accurate. They end up with an amazingly refined glasses prescription,” says Dr. Foster. This extensive examination is the first step
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in the iLASIK process. Next is the Intralase laser, which creates a thin flap in the cornea that enables the doctor to make corrections to the vision. To ensure accuracy, the room that houses the laser is given very careful attention. The air is scrubbed clean of any particles and the temperature and humidity are monitored and kept steady. Both actions ensure that nothing disturbs the laser as it works. Two battery packs in the room and another backup generator outside the building ensure that if the power does go down for any reason the delicate process with the laser is uninterrupted. “Everything is done for the greatest laser precision,” says Dr. Foster. What a laser can accomplish over bladed surgery, says Dr. Foster, is to create a better flap. “The laser creates a thinner, smaller flap that is more consistent and the procedure is overall safer.” Another benefit is that the flap fits more tightly over the eye, creating greater security and strength during the healing phase. “The flap is much more secure to trauma and, because it is thinner, the procedure leaves more of the natural strength and resilience of the eye.” The final step, laser vision correction, is driven by the blueprint made by the Wavefront machine. The iLASIK procedure is quick, as little as ten minutes per eye. During the procedure patients are awake, but are given medication to help them relax and feel only a slight pressure during the surgery. After the procedure, it is not uncommon for patients to have 20/20 vision almost immediately. While there is a little sensitivity immediately following the procedure, the discomfort generally disappears within a few hours. Bladeless LASIK takes longer than the standard LASIK procedure, “but one of the beauties of the Intralase is that if you don’t believe you have the ideal flap, you
Dr. Gary Foster takes a scan of patient Dr. Peter Smith’s eyes.
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can recreate it with the laser. It is a very forgiving process with a high safety profile.” Both the bladeless and bladed procedures have quick recovery times for patients. Dr. Foster recommends a patient wear a protective eye covering while sleeping for the first week after surgery, but they can resume normal activities and exercise. Almost immediately, most are free to enjoy the benefits of better vision. Regular checkups are scheduled the first week after the procedure, a month after, three months after, then nine months after to monitor the health of the eyes with the patient’s preferred eye doctor. One such patient who has been enjoying greatly enhanced vision since his procedure is Peter Smith, M.D., a doctor of internal medicine
with Big Thompson Internal Medicine in Loveland. Dr. Smith’s eyesight before the procedure was not good. “I couldn’t read my digital clock in the mornings,” he says. Dr. Foster adds, “Smith’s preoperative vision was 20/400 without his glasses, twice as bad as legally blind.” As Smith’s children reached an age where they could participate in sports activities and outdoor recreation, Smith made the decision to look into LASIK vision correction. “The kids got old enough to do beach vacations and we started to spend a lot of time in the water. It was hard to be in the water with my kids and not be able to see well. For me, it was a lifestyle quality issue.” Dr. Smith contacted The Eye Center of Northern Colorado and came into contact with Dr.
Foster, who recommended the iLASIK procedure. Smith says the entire process was surprisingly simple. “I had to do eye drops a couple weeks before the procedure to prepare my eyes, but the procedure itself seemed to take less than ten minutes per eye.” After the surgery, which occurred in February, recovery was pleasantly hassle-free for Smith. “I was a little uncomfortable for a couple hours after the procedure. The feeling was something like getting soap in the eye, but I went home and went to sleep and was fine.” After a week with an eye protector worn at night, Smith was fully recovered. “I was a little nervous before the procedure, but the doctor did a great job of talking me through it. My vision now is spectacular. It is slightly better than what I had with glasses. The visual acuity is impressive.” Smith officially “tested” his new eyesight during spring break when he took his two children, ages six and eight, to the ocean. “I couldn’t be happier with the outcome.” There are patients who do not qualify for LASIK procedures. Generally, these are persons who have a naturally weak cornea or who have a prescription too big to allow for an elective procedure. However, some patients who could not have the bladed LASIK do qualify for iLASIK because the Intralase laser can make a much thinner flap. “The Eye Center of Northern Colorado and Poudre Valley Health System are pleased to be able to work together to provide the latest, safest, and best technology available,” says Dr. Fos-
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Lydia’s STYLE Magazine
Dr. Gary Foster works with the Interlase laser to create a custom-fit flap over the cornea.
ter. “We are the only organization to offer the iLASIK procedure, with the Wavefront blueprinting system and the Intralase laser, in Northern Colorado.” “If you love high tech toys, then you would love being an eye doctor,” jokes Dr. Foster. One very special machine used by Dr. Foster in a recent clinical study gives “CAT scan type” images of the cornea. They also have two different types of machines that can give topographical maps of the cornea prior to iLASIK. “Patients often have no idea how much effort we are putting into their safety,” he adds. The next frontier in optical health, predicts Dr. Foster, will be using a laser to correct the vision of those who need reading glasses. The Eye Center of Northern Colorado is home to a large staff of eye experts and specialists. “The collegial, teamwork approach that comes from having specialists for each area of the eye under one roof allows us to provide the best possible service to the community. Our practice in Northern Colorado has roots that go back to 1935. We have been here and will be here for our patients throughout their lives. They are our neighbors. We are the largest eye center in the region and provide the best LASIK technology available. We are proud of what we do here,” concludes Dr. Foster. + Angeline Grenz is Contributing Editor for Style Magazine.
Northern Colorado Medical & Wellness 2009
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Orthodontia
new technology
“People just want the best care possible and that is where we stand. More and more today, doctors are handing off the treatment to other staff with less and less training. Those doctors are taking an ancillary approach to treating the patient. That is not how we operate.” Burdett Edgren, DDS, MS, Orthodontic Associates of Greeley, P.C.
Orthodontic Team Uses
Cutting-Edge i-CAT Imaging
By Angeline Grenz Photos by warren diggles
The doctors Edgren, patriarch Burdett and son Bradford, encapsulate the best of a successfully functioning team. Dedicated to running the highest quality orthodontic office, the path has taken them to a new frontier of technology: a scan that provides advanced imaging to facilitate a more accurate diagnosis and treatment for their patients. The i-CAT scanner has even enabled the doctors to detect potential health problems that the patient was unaware of or was not clearly visable on a routine dental radiograph.
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he Edgren duo may be soft-spoken, but underneath the quiet manner is a firm commitment to their field. Dr. Burdett Edgren, DDS, moved to Greeley in 1971 and began his first Colorado practice. He opened Orthodontic Associates of Greeley, P.C., at its current location in 1986, designing it with the expectation of his son joining him in the practice. Dr. Bradford Edgren, DDS, joined him in 1993, after finishing school. Despite familial ties, their 16-year partnership has been much more than a matter of convenience. Dr. Burdett describes their practice as “handson” with a focus on quality care. “People just want the best care possible and that is where we stand,” he says. “More and more today, doctors are handing off the treatment to other staff with less and less training. Those doctors are taking an ancillary approach to treating the patient. That is not how we operate.” “Some people just want us to straighten the
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Social Six,” says Dr. Burdett, referring to the six front teeth that appear when we smile. At Orthodontic Associates of Greeley, Drs. Edgren refuse to sacrifice function for the sake of looking good. “We strive for function first, then work on the aesthetic result,” adds Dr. Bradford. “In general, if the patient has good, proper function, then it will be aesthetic.” Their quest to provide the highest quality orthodontic care has led them to cutting-edge technology, the i-CAT imaging system. Dr. Bradford is a proponent of the system, having done beta testing on the imaging software and lecturing other orthodontists about the system. “These scans are more diagnostic, convenient, and efficient,” he says. The advantages of the i-CAT scanner over other technology are impressive. The i-CAT needs only seconds to take and download a scan. Digital files are downloaded quickly and easily shared or transferred. There is significantly less exposure to radiation for the patient than other computed
tomography. The scan captures three-dimensional images that aid in implant planning, extractions, impactions, airway assessment, panoramic images, and much, much more. “The images we make are far superior to traditional dental radiography,” says Dr. Bradford. “We are finding all sorts of things that patients may not have known about. We have been able to find previously undiagnosed facial and jaw problems.” The scans are so clear and can be examined from so many different angles that they have detected jaw fractures in accident victims. The doctors have also found enlarged adenoids and polyps in patients’ sinuses. These patients were then refered to the appropriate physician for further diagnosis. Traditional radiographic images are twodimensional, such as the panoramic X-ray taken before a patient has their wisdom teeth removed. With one i-CAT three-dimensional scan, the doctors can evaluate views from the front, axial, and lateral sides of the head. The additional views al-
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Burdett R. Edgren, DDS, MS, is the founder of Orthodontic Associates of Greeley, P.C.
Bradford N. Edgren, DDS, MS, joined his father Dr. Burdett Edgren in the family practice in 1993.
low them to easily see the nerve canals that run along the roots of the wisdom teeth before they are removed or the anatomy surrounding an extra tooth (a supernumerary) that was not visible on a traditional X-ray. “You can’t diagnose what you don’t know and you can’t treat what you aren’t able to diagnose. If we are unsure of something, there are several ways to look at the patient’s scan,” explains Dr. Bradford. The images can be adjusted to show soft tissue. Or if the concern is about hard tissue, the image can be changed to show only bone. “The machine enables us to evaluate what the problem is and treat it accordingly, or when necessary, refer the patient to a specialist,” says Dr. Bradford. Images can be compared to visual norms based on age, sex, and race to determine dental versus skeletal problems. One special feature is the ability to diagnose airway problems. Airway obstructions can be directly related to dental-facial development, according to Dr. Burdett. “This is useful for all our orthodontic patients,” he adds. It is also useful in helping other physicians assess health problems such as sleep apnea, upper airway obstruction, and mouth breathing. Drs. Edgren have had other dentists as well as other dental specialists refer patients in to have scans made. Adolescents, in particular, benefit from the new technology. Because they are still developing, potential airway and dental-facial problems can lead to larger problems if they are not treated at a young age. With the iCAT scanner, the doctors can
compare scans of a growing child through their adolescence. Even before the iCAT technology was available, Drs. Edgren made it their practice to provide the most complete care possible. “We saw one child with a cleft palate from six weeks to 18 years old,” recalls Dr. Burdett. By age seven, a child has completed 75 percent of their total growth with regards to dental-facial development, he continues. “Why wait until a child is 15 or 16 years old, when they have finished growing, to treat? We can find significant dentofacial problems, treat them, and prevent them from getting any worse.” “This is becoming the gold standard in care,” says Dr. Bradford. “We feel it is the right thing to do for our patients and it is important in the way we want to run our practice,” adds Dr. Burdett. Though the i-CAT images are more expensive to create than traditional 2-D dental radiographs, the doctors absorb some of that expense themselves and patients win out in the long run with better imaging, less time invested, and overall better treatment. “A wise consumer realizes that when it comes to healthcare, your first shot is your best shot for treatment,” says Dr. Burdett. “After that comes repair,” concludes Dr. Bradford, “and there are no bargains in healthcare.” + Angeline Grenz is Contributing Editor for Style Magazine.
The i-CAT imaging system enables Drs. Edgren to create more accurate scans for better diagnosis and treatment at their practice, Orthodontic Associates of Greeley, P.C.
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Spine Correction Center of the Rockies
chiropractic
“In addition to keeping people out of surgery, we are helping people that have already had surgery and are still suffering with chronic pain. It is fulfilling as a doctor to see lives changed and get them back to the life they want to live.” April Cardwell, D.C.,
Spine Correction Center of the Rockies
Non-invasive treatment
for Scoliosis
By Laura lee carter
The Spine Correction Center of the Rockies represents the very best in non-invasive, non-surgical treatment for scoliosis and disc disorders. Michael Farrell, D.C., and April Cardwell, D.C., are among the less than two percent of doctors who have received advanced training and certification from the CLEAR Institute, a non-profit organization formed to empower the chiropractic and medical community with the mission of implementing an effective system of scoliosis treatment.
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coliosis is a condition affecting 4.5 percent of the population that causes curvature of the spine greater than 10 degrees when viewed from the front. It can cause symptoms of back pain, headaches, fatigue, and in severe cases, digestive symptoms and breathing difficulties. The condition affects women more often than men and is generally diagnosed during the teen years. The disease can be progressive, with curves continuing to advance even after the patient has finished growing. There is a misconception that scoliosis will stop once a person has finished puberty, yet the latest research has shown curves can continue to progress at a rate of one to three degrees per year after growth has ended. It has been shown that scoliosis may decrease a person’s lifespan by up to 14 years if not treated. Dr. Farrell and Dr. Cardwell have been able to treat and successfully reduce the curvature of the spine in patients ranging in age from preteen to those in their 80s. “While catching scoliosis earlier in life may allow for easier correction,” notes Dr. Farrell, “fantastic results can be obtained by patients into their 70s and 80s. The effectiveness of this new procedure is profound. To date, there has not been a scoliosis patient that we have not been able to make a positive impact on their ability to function.” Linda Williams, a patient with adult onset scoliosis, first came to the Spine Correction Center of the Rockies in July 2008. She began treatment when
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she learned they offered non-invasive methods. Previously, Williams had been told by several doctors there was no treatment for her painful condition. She had reached a point where she could no longer enjoy her day-to-day activities. “I feel great now,” Williams says, “My spine curvature has been reduced by 60 percent. I could not have imagined I would have these kinds of results. I love the atmosphere at the clinic and plan to keep coming here because I’ve seen so much improvement.” She continues, “I even went for a walk a few weeks ago without the use of my trekking poles for support. I didn’t believe I would be able to do that again. I walked for 20 minutes without pain, now that’s improvement!” Williams can now get back to her yard work and daily walks, thanks to Dr. Cardwell. Statistics show that back pain accounts for almost 80 percent of doctors’ visits each year in the United States. There are many causes for back pain, including osteoporosis, spinal stenosis, scoliosis, disc herniation, buldging discs, muscle spasms, and arthritis. Spine Correction Center of the Rockies has been able to relieve and eliminate pain for patients suffering from all of these conditions. Along with their CLEAR certification training in scoliosis, they also specialize in decompression treatment, which allows them to help disc disorders. Decompression therapy, discovered by NASA, is FDA-approved for the treatment of disc disorders. Decompression allows the spine to alleviate the
pressure on the discs, helping them regenerate and heal during treatment. Patients usually see a significant decrease in pain levels within just two weeks of treatments. Decompression is also extremely effective for other conditions such as carpal tunnel syndrome, migraine or severe headaches, and tingling and numbness in limbs. “Patients’ symptoms differ greatly,” Dr. Cardwell explains, “but the most common we see are electric shock pain that typically goes into the arms when the disc issue is in the neck and into the legs when the issue is in the lower back. Along with pain, there can be muscle weakness from the lack of nerve energy to that muscle or surrounding areas. Most patients can avoid surgery, prolonged use of medications, and a lifetime of pain with spinal decompression therapy.” Medical journal research has placed the effectiveness of spinal disc decompression therapy at 75 to 92 percent with a relapse rate of two percent. “In addition to keeping people out of surgery, we are helping people that have already had surgery and are still suffering with chronic pain. It is fulfilling as a doctor to see lives changed and get them back to the life they want to live. It makes me feel good when I go home to know that what we do is helping so many people.” says Dr. Cardwell. Patient Lou Hall was treated at Spine Correction Center of the Rockies for scoliosis and says, “When I began treatment with Dr. Farrell I was hoping to straighten and strengthen my spine and reduce the chronic pain that comes with scoliosis. Along with achieving these goals came an unexpected added bonus - a new lease on life. I was unaware how many aspects of my life were affected by the pain of my scoliosis. My treatment not only helped my scoliosis but it significantly improved the quality of my life.” “The ability to provide this new treatment for scoliosis and disc disorders has a very significant meaning to me as a physician. It is fantastic to see patients able to resolve their conditions without the invasiveness of surgery or bracing, which can sometimes result in severe disability. I love what we are able to accomplish and hope to be able to continue healing and restoring the quality of my patients’ lives,” Dr. Farrell says. For more information on the innovative, noninvasive treatments provided at Spine Correction Center of the Rockies visit their Website at: www. spinecorrectioncenter.com. Laura Lee Carter is a freelance writer and author of the new book Midlife Magic: Becoming The Person You Are Inside! Please check out her blog at www. MidlifeCrisisQueen.com.
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Coloradoâ&#x20AC;&#x2122;s Premier Clinic Specializing in Non-Invasive, Non-Surgical, Non-Bracing Treatment of Scoliosis & Disc Disorders
SPINE CORRECTION CENTER OF THE ROCKIES
JUNE IS SCOLIOSIS MONTH
Complimentary Scoliosis Screening Tuesday, June 30th, 2pm-7pm Free refreshments and 1/2 hour presentation given by doctors at 3pm and 6pm
Scoliosis Bulging & Herniated Discs
Dr. Michael Farrell, DC
Dr. April Cardwell, DC
CLEAR Institute Certified
CLEAR Institute Certified
Carpal Tunnel Dizziness Headaches/Migraines Chronic Back/Neck Pain Call to schedule a FREE consultation by phone, email or in person
970.226.1117 frontdesk@spinecorrection.com
1101 Oakridge Dr. Ste. A | Fort Collins, CO 80525 | www.spinecorrectioncenter.com
Northern Colorado Medical & Wellness 2009
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24-hour care
Emergency Veterinary Care “Emergency clinics allow vets to avoid being on call 24/7, which makes for more consistent quality care for pets and peace of mind for pet owners. When there are veterinarians dedicated solely to emergency care, there is always someone rested, ready, and available to help.” Ted Mika, DVM, Fort Collins Veterinary Emergency Hospital and P.E.T.S. of Northern Colorado Jon Geller, DVM, co-owner of Fort Collins Veterinary Emergency Hospital and P.E.T.S. of Northern Colorado, with technician Corina Herron holding a couple of very cute patients.
24-Hour
Pet Emergency Care
By Allie Comeau
If you’ve ever had a pet get sick or hurt, you know it rarely happens during office hours. Call it Murphy’s Law or just plain bad luck, but pets often become ill at night or on the weekends. So what is a pet owner to do with an ill or injured pet if their usual veterinarian is unavailable?
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hankfully, pet owners in Northern Colorado have access to emergency veterinary care. Emergency veterinarians are dedicated emergency professionals who treat acutely ill or injured pets. They typically work in clinics that are either open 24 hours a day or open on nights and weekends when traditional veterinary practices are not. They are there when your pet gets sick or hurt – no matter what time of day it happens. Pet owners can visit Ted Mika, DVM, or his partner Jon Geller, DVM, and their staff of emergency vets, assistants, and interns at the Fort Collins Veterinary Emergency Hospital (FCVEH) or at Pet Emergency Treatment Services of Northern Colorado (PETSNC), in Greeley. “There has been a shift in veterinary medicine towards supple-
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menting traditional veterinary practices with afterhours emergency clinics,” says Dr. Mika. “It gives veterinarians their lives back. Emergency clinics allow vets to avoid being on-call 24/7, which makes for more consistent quality care for pets and peace of mind for pet owners. When there are veterinarians dedicated solely to emergency care, there’s always someone rested, ready, and available to help.” Susan Wight, DVM, an emergency veterinarian with VCA Veterinary Specialists of Northern Colorado, echoes these sentiments. “Vets can refer their after-hours emergencies to us and rest assured their patients will be taken care of,” she says. “We try to communicate with our patients’ regular doctors, and keep them apprised of the situation. We handle crises and keep them from
escalating further. We provide 24-hour care for patients that need it, with access to specialists if the situation requires it.” Both FCVEH and VCA are open 24 hours a day, seven days a week, 365 days a year. “As of November of last year, we’re always open,” says Dr. Mika. “Our referring veterinarians around town were getting so busy they needed the option of daytime emergency care as well. Now trauma victims and severely ill pets can receive treatment right away, rather than making an appointment or waiting to see a doctor who’s booked up with surgeries or vaccinations. We’re also able to provide long-term critical care at the clinic in addition to emergency care.” Emergency and Critical Care has been a specialty of veterinary medicine since 1989. Residen-
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DOES YOUR PET NEED
EMERGENCY CARE? Dr. Susan Wight, DVM, with VCA Veterinary Specialists of Northern Colorado recommends pet owners seek medical attention when their pets exhibit the following signs: Difficulty breathing • Vomiting or diarrhea • Pain Extreme lethargy • Pale gums • Lack of appetite Difficulty walking • Snakebite in any pet Bleeding • A pregnant pet in prolonged labor
Fort Collins Veterinary Emergency Hospital OPEN 24 HOURS • (970) 484-8080 816 S. Lemay Ave. • Fort Collins, CO 80524 www.veterinaryemergencyhospital.net
VCA Veterinary Specialists of Northern Colorado OPEN 24 HOURS • (970) 278-0668 201 W. 67th Ct. • Loveland, CO 80538 www.vcavsnc.com
P.E.T.S. of Northern Colorado
Emergency Hospital
OPEN NIGHTS & WEEKENDS • (970) 339-8700 3629 23rd Ave. • Evans, CO 80620 www.petsemergency.com
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cies and board certification are available, but are not prerequisites to the specialty. Many emergency vets are traditionally trained veterinarians who were drawn to emergency care. Long-time practicing veterinarians, Dr. Mika and Dr. Geller, founded PNC in 2001 after noting the need for such services in the Greeley area. FCVEH followed closely, along with a third clinic in Grand Junction. Dr. Wight has been practicing veterinary medicine for 20 years but calls emergency care “her niche in veterinary medicine.” Dr. Wight was a traditional vet in Estes Park for eight years before coming on board with VCA in 1996. Dr. Wight works with one other full-time ER doctor, a part-time ER doctor, and two rotating interns. FCVEH works closely with the CSU Vet Hospital to offer internships and education and remain up-to-date with the latest veterinary medicine advances. “We have continuing education allowances for our technicians and staff and we’re one of the only emergency clinics that has a board-certified anesthesiologist,” says Dr. Mika. “Dr. Bonnie Wright manages protocols for anesthesiology and also runs a pain-management clinic here. We have excellent pain-management protocols, including acupuncture.” Emergency veterinarians deal with everything from vomiting and diarrhea, to pet poisonings, trauma, snakebites, and more. “We see about 4,000 to 5,000 cases a year, everything from lacerations to gunshot wounds to car accidents to intoxication from anti-freeze, rat poison, and chocolate,” says Dr. Mika. “We’ve had
six snakebite cases so far this season.” “There really isn’t a most common illness or injury we see,” says Dr. Wight. “I’ve seen just about everything in the past 20 years; it’s about equal between illness and injury. This time of year, we see an increase in snakebites (five so far), lacerations, animal bite trauma, and automobile trauma.” What can pet owners do to prevent accidents from happening? Dr. Wight warns pet owners not to let dogs ride in the back of trucks, to remove metal lawn edging due to risk of laceration, to use mouse traps instead of rat poison, to keep current on all vaccinations, to keep all medication, foreign objects, and people food away from animals, and never to selfprescribe medication (even aspirin) to your pet. “Most of it is common sense,” says Dr. Wight. “But seemingly harmless things, like chocolate, candy, gum (Xylitol can be fatal to dogs), string, small kids’ toys, and bones can cause major problems.” Dr. Wight stresses the need to bring your pet to an emergency clinic if they are displaying any of the following symptoms: difficulty breathing, vomiting or diarrhea, pale gums, bleeding, pain, lack of appetite (which often indicates pain), difficulty walking, or extreme lethargy (which indicates pain or illness). A bloated abdomen in a dog, or a snakebite in any pet, warrants an immediate trip to the ER because both can be fatal if not treated immediately. A pregnant pet in labor but progressing slowly should also see an emergency veterinarian. “The best way to avoid snakebites is to keep
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pets leashed when walking or hiking, although dogs have been bitten on leashes and in backyards,” says Dr. Wight. “It was a mild winter and their food supply is abundant, so snakes will probably thrive this year.” If your dog is bitten, it will most likely need antivenin from an emergency veterinarian, who should have it on hand at the clinic. “Snakebites are treatable and we have a supply of antivenin, but fatalities do happen – we saw several last year unfortunately.” In the summer, heat stroke is also a real threat for many pets, especially dogs. Never leave a dog in a parked car in the summer and limit exercise in the afternoon. “Avoid any kind of over-exertion (hiking or running; walking is okay with ample water) if the outside temperature is more than 75 degrees; keep bull dogs and other ‘short nosed, smashed face type’ dogs in air conditioning when it’s warm outside,” says Dr. Wight. “Dogs don’t sweat. They cool themselves by panting. That only goes so far before their compensatory mechanism is overwhelmed and their body temperature increases rapidly.” “You should always call and ask if you have a question about a symptom or if you’re unsure whether or not a trip to the vet is warranted,” says Dr. Mika. “Something that may seem minor, like vomiting, could turn out to be a poisoning but we won’t know that unless you bring the pet in. Better safe than sorry – that’s what we’re here for.” Allie Comeau is a freelance writer, copywriter, and blogger living in Fort Collins, CO. Email her at alliecomeau@gmail.com
Northern Colorado Medical & Wellness 2009
Pet ER:
Cooperative Veterinary Care
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he Fort Collins Veterinary Emergency Hospital (FCVEH) supplements traditional veterinary service by providing after-hours emergency care for pets. Inspired by a spirit of cooperation and a need to relieve veterinarians of around-the-clock duty, FCVEH “gives vets their lives back” by caring for pets who become ill or injured during nights and over weekends. FCVEH, a cooperative emergency clinic, works closely with local veterinarians who refer patients for emergency care. The 21 veterinary members/owners of FCVEH treat the emergency clinic as an extension of their own practices. “These partnerships allow for a higher level of consistent care and let local veterinarians enjoy their time off without having to take emergency calls,” according to owner Ted Mika, DVM. Now that FCVEH is open 24 hours a day, seven days a week, and is able to provide critical care in addition to emergency care, these partnerships are evolving even further. FCVEH is now able to see emergency cases during the day, which makes it easier on both the patient and the referring veterinarian. (Because FCVEH is dedicated solely to emergency and critical care, they’re ready to treat an ill or injured pet at a moment’s notice.) The other benefit to the clinic being open 24 hours is that sick pets no
by Allie Comeau
longer have to leave the clinic in the morning. “This way, a critically ill or injured pet doesn’t have to be transported back and forth between the emergency clinic and the veterinarian’s office. We keep the vet apprised of the patient’s condition at all times,” says Dr. Mika. FCVEH is a fully staffed and equipped clinic, complete with a broad range of diagnostic services, a well-stocked pharmacy, in-hospital surgery suite, in-house digital X-ray capabilities, and closely supervised hospitalization area. The sister clinic of FCVEH, P.E.T.S. of Northern Colorado, was the first cooperative emergency clinic in Northern Colorado. Founded by Dr. Mika’s partner, Jon Geller, DVM, in 2001, PETS operates in the Greeley area and is similar to FCVEH. The only difference is that P.E.T.S. is only open on nights and weekends. P.E.T.S. of Northern Colorado has 12 veterinary owners. Both FCVEH and P.E.T.S. provide an invaluable service to pet owners and veterinarians alike. “Before we had the emergency clinic, vets would be on call nights and weekends,” says Dr. Mika. “Having trusted emergency veterinarians to take those calls and see patients during the night has not only enhanced the quality of life for local vets but also the quality of care for local pets. It’s a win-win situation for everyone.”
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physician profile
donn turner, M.D. “There is something fantastic about being able to fix a patient’s health problem with one’s hands.” Donn Turner, M.D., Front Range Center for Brain & Spine Surgery, P.C.
A Father’s
Influence
By Connie Hein
Donn Turner, M.D., was sure he would grow up to be an airplane pilot, until a discussion with his father changed his plans and his life. “My father was a World War II Navy carrier fighter pilot and, throughout my life, a United Airlines pilot. I admire him more than anyone.”
W
hile growing up, “my intention and desire was to be a professional pilot, just like my father was,” Turner relates. Dr. Turner, neurosurgeon with Front Range Center for Brain and Spine Surgery, P.C., is a secondgeneration Colorado native born in Denver. He and his twin brother, Bruce, both applied and were accepted to the Air Force Academy with the intention to fly. “My brother was the first to change his mind and accepted admittance to Colorado College in Colorado Springs. I also turned down the Air Force Academy after a last minute talk with my dad. He said he thought I would be bored with flying. He felt I could do something more important with my life and encouraged me to go to Colorado College with my brother.” Dr. Turner’s father had much to do with what he became and the career he chose, but his brother was also a great influence on him. “We were always very competitive and there’s no doubt he influenced
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me greatly to work hard and excel.” It is interesting, he adds, that both brothers changed careers and did not grow up to become what they thought they would. “My brother always wanted to be a doctor, but turned down medical school to eventually become a diplomat for the U.S. State Department. I always wanted to be a pilot, but turned down pilot training to become a doctor.” Dr. Turner received his doctorate of medicine in 1978 from Washington University School of Medicine in St. Louis. During medical school, Dr. Turner started thinking about a specialty in neurology but realized he enjoyed surgery even more. “I had two surgical procedures done on my neck during medical school by neurosurgeons and admired them. I decided I wanted to be like them and do that kind of work.” He completed his neurosurgical residency at the University of Iowa in 1984, then moved to Fort Collins and joined Front Range Center for Brain and Spine Surgery later that year. Dr. Turner was certified by the American Board of Neurological Surgery in
1986 and became a Fellow of the American College of Surgeons in 1988. What he loves most about his career is “figuring out each patient’s individual puzzle, looking at lots of cool images, and then planning the best way to get them back to their life,” he says. Dr. Turner enjoys the act of performing surgery because it requires knowledge, discipline, exactness, and artistic talent, blending these qualities together to obtain an excellent result. “There is real beauty in an operating room,” he adds, with the efficiencies and camaraderie among the entire crew of nurses, orderlies, technicians, and partners all working together to get the best outcome for the patient. “There is something fantastic about being able to fix a patient’s health problem with one’s hands.” Even though he loves his career, Dr. Turner says his great passion is his family. “My first passion is truly my wife and children. Though I love neurosurgery and it has shaped me, I try to spend every spare second I have with my family. Skiing has been a great family pastime as was camping and fishing when the kids were younger. As my kids leave the nest, my wife and I are trying golf and a little tennis.” Dr. Turner met his wife, Mary Kay, while she was a manager for Poudre Valley Health System. Because they were both in their mid-thirties, Dr. Turner says they decided to start a family right away and feels very fortunate to have had kids without difficulty before it was too late. “I truly made the best decision ever with my wife, and I absolutely adore my kids and am extremely proud of each of them. I don’t have many outside interests unless it somehow involves them.” Dr. Turner and his wife have been married for 22 years and have three children: Kyle, age 20, attending Colorado College in Colorado Springs; Leah, 18, attending University of Denver; and Kara, 16, a Junior at Fossil Ridge High School. “My wife became a stay-at-home mom after our third child was born and is very involved in their schools, the National Charity League, and several other charities. She helps me get involved in the community outside of medicine.” Dr. Turner says he and his family love Fort Collins and are passionate about giving back to the wonderful community that has given them so much. Connie Hein is a freelance writer living in Windsor and the author of the Toliver in Time series of children’s books.
Lydia’s STYLE Magazine
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