2011-03 Northern Colorado Medical & Wellness

MARCH 2011

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Welcomes Natalie Phillips, Au. D.

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w w w. s t y l e m a g a z i n e c o l o r a d o . c o m w w w. m e d i c a l a n d w e l l n e s s . c o m Publisher Lydia Dody | lydia@stylemedia.com Editor Angeline Grenz | angie@stylemedia.com creative director Scott Prosser Senior Designer Lisa Gould digital director Austin Lamb | austin@stylemedia.com Advertising Sales EXECUTIVES Jon Ainslie (970) 219-9226 Karen Christensen (970) 679-7593 Lydia Dody (970) 227-6400 Saundra Skrove (970) 217-9932 Office Manager/About Town Editor Ina Szwec | ina@stylemedia.com Accounting Manager Karla Vigil Editorial Assistant Audrey Springer Office Assistants Ronda Huser, Trisha Milton Contributing Writers Connie Hein, Heidi Kerr-Schlaefer, Marty Metzger, Corey Radman, Kay Rios, Laura Sebastian, Tracee Sioux Photographer Marcus Edwards CONTRIBUTING Photographer Brent Yoder Affiliations Fort Collins Area Chamber of Commerce Loveland Chamber of Commerce & Visitors Center 2011 Style Magazines January-Loveland/Greeley Medical & Wellness Magazine and Directory February-Style March-Northern Colorado Medical & Wellness April-Style May-Northern Colorado Medical & Wellness June-Style July-Northern Colorado Medical & Wellness Magazine and Poudre Valley Health System Physician Directory August-Style September-Women’s Health & Breast Cancer October-Northern Colorado Medical & Wellness November/December-Holiday Style 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 $25/year and a two year subscription is $45/year. Free magazines are available at over 150 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) 2266400. Fax (970) 226-6427. E-Mail: ronda@StyleMedia.com ©2011 Style Media and Design Inc. All rights reserved. The entire contents of Style Magazine are 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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CONTENTS

Northern Colorado Medical & Wellness

M A RCH 2 0 1 1

22 Do You Hear That Ringing in My Ears?

34 Nothing to sneeze at

56 Denkai Saves Animals

58 spotlight: Temple Grandin – Breaking All the Boundaries 10

28 Weak in the Knees: Total Knee Replacement Surgery

40 Botox Solutions – Medical & Cosmetic

12 14 16 18 19 20 22 24 28 34 36 40 44 46 47 48 52 56 58

Publisher’s Letter Health News Navigating Health Insurance Enhancing the Human-Pet Bond Pet Insurance Eat, Play, Love Do You Hear That Ringing in My Ears?

Managing Your Anxiety Weak in the Knees: Total Knee Replacement Surgery Nothing to Sneeze At Disease Detection with Saliva Testing Botox Solutions – Medical & Cosmetic Lunchtime Face Lift Mega Nutrient: Omega-3/ Walk to Better Health Get Fit, Give Back Calendar Innovative, Integrated Treatment Benefits Patients Guide Dogs for the Blind Denkai Saves Animals Spotlight: Temple Grandin – Breaking All the Boundaries

on the cover: Robin Downing, DVM, posing with her paralyzed cat Pearl, deciphers the importance of the human-animal bond. Photography by Marcus Edwards. Make-up by April Chavez, leSalon, Fort Collins.

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 or healthcare provider.

Lydia’s STYLE Magazine

The art of heart.

Heart surgery is a delicate, precise procedure.

Experience and high-quality care are essential.

Our surgeons at Medical Center of the Rockies combine them all into the art of saving lives through great care .

More heart surgeries are performed at Medical Center of the Rockies than any northern Colorado hospital. And MCR is a Magnet hospital, which means our patients receive some of the nation's best nursing care .

For us, the art of heart care is all about you.

Learn more at pvhs.org/heart.

Source: www.hospitalcompare.hhs.gov

Dr. Mark Guadagnoli

Dr. Thomas Matthew

MEDICAL CENTER OF THE ROCKIES

HEART CENTER OF THE ROCKIES

POUDRE VALLEY HEALTH SYSTEM

POUDRE VALLEY MEDICAL GROUP

2500 Rocky Mountain Avenue

I

Loveland, CO

pvhs.org

1-25 and Highway 34

970.624.2500

Publisher’s Letter

I

People and Their Pets

t wasn’t easy trying to photograph my three furry pets, but my sister, Ina, kept making funny noises to capture their attention for the camera. They have become my buddies and an important part of my family. Daisy, my 12-year-old Lhasa Apso, is the queen of the household. Roo, my 8-year-old Pomeranian Pekinese and Japanese Chin mix, is my traveling lap dog. And Dyna is my affectionate 9-year-old white cat. They don’t see much of me weekdays, but every evening we take a walk in the neighborhood (even the cat). I truly enjoy and treasure the human-pet bond that Dr. Robin Downing speaks about in “Enhancing the

12

Human-Pet Bond.”

Meeting Dr. Downing was delightful. She is supremely passionate about animals and is drawn to take care of special needs pets. In fact, her entire menagerie of pets at Windsor Veterinary Clinic and The Downing Center for Animal Pain Management are rescued animals. Her four dogs and paralyzed cat are lovingly cared for, obedience trained, and responsive to commands – voice and hand signals. I was amazed at how responsive her brood of animals was to instructions when we were in her clinic to photograph. All it took was one or two commands and her pets responded immediately. Thank you, Robin, for the time you spent with us at Style and for opening our eyes to the precious value of each pet, no matter what handicaps they might have.

On the topic of pets, I hope you enjoy reading about how dogs are trained to become guide dogs and help the blind lead full, active lives in “Guide Dogs For the Blind.” Thank you Valerie and Kevin Utter for sharing a little about your lives.

Speaking of love for animals, you can’t overlook our celebrity profile article on Temple Grandin, Ph.D. and professor at Colorado State University.

We are honored to have had the opportunity to interview her. The demands on her time have grown exponentially since the movie about her life recently won seven Emmy Awards. Her life story is truly an inspirational testament to overcoming tremendous personal challenges and blazing a trail in an arena she loved. We salute Temple Grandin for her amazing contributions to society.

In Northern Colorado we are especially fortunate to have an exceptionally high quality of life

that is repeatedly demonstrated with the quality of healthcare in our region. This issue of Northern Colorado Medical & Wellness highlights some of the remarkable expertise we have available. I was impressed with the success Gene Haffner, public relations director for North Colorado Medical Center in Greeley, had with a recent knee replacement. Just look at the photo of him dancing with his wife, Julie, and you wouldn’t guess that just a few months ago he was in surgery. Read “Weak in the Knees: Total Knee Replacement” to learn about this life-enhancing procedure.

Another innovative procedure now available in our area is in the treatment of tinnitus, referred to as ringing in the ears. I can’t begin to imagine how difficult it must be for the millions suffering from this affliction. Read “Do You Hear That Ringing in My Ears?” and learn how Dr. Natalie Phillips, at Advanced Otolaryngology, is bringing compassion and hope to those who had given up.

This is just a sampling of the many interesting and informative articles in this issue. Other important topics on allergy treatment, anxiety management and much more fill our pages.

We celebrate the high quality lifestyle we have collectively developed here in our Northern Colorado oasis and are proud to highlight our healthcare professionals and the exceptional work they do.

Enjoy the blessings of spring!

lydia@stylemedia.com

Lydia’s STYLE Magazine

Northern Colorado Medical & Wellness 2010

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health news Congratulations and Spring Open House Rebecca de la Torre, M.D., medical director and owner of Allura Skin & Laser Clinic, has been nationally recognized by Dr. Gino Tutera as a SottoPelle Pellet Bio-Identical Hormone Replacement Provider.

Allura Skin & Laser Clinic will be celebrating two years in the Johnstown and Loveland areas at their Spring Open House on Thursday, April 7 from 5 p.m. to 8 p.m. Join Allura for refreshments and special offers on the latest in skin rejuvenation. Call for details: (970) 223-0193.

Loveland Community Health Fair The 31st Loveland Community Health Fair will be 8 a.m. to 1 p.m., Saturday, April 23 at the McKee Conference and Wellness Center, 2000 Boise Avenue, Loveland. Registration for blood screenings and memory screenings begins March 7.

Participants can receive a blood chemistry screening for $30, a complete blood count blood screening for $15, prostate specific antigen blood screening for $30, a high sensitivity C-Reactive Protein blood screening for $15, and a screening for hemoglobin A1c for $25. Blood draw appointments can be made by calling (970) 635-4181.

Specialist in Care of Children and Sports Injuries Joins Orthopaedic & Spine Center of the Rockies Dr. Ryan Hartman has joined the Orthopaedic & Spine Center of the Rockies as an orthopaedic surgeon who will focus on the care of children, from newborn through the teen years, and patients of all ages with sports and recreational injuries.

Appointments with Dr. Hartman may be made at the Orthopaedic & Spine Center’s offices in Fort Collins and Loveland. Call 970-419-7050 or 1-800-722-7441.

PVH and MCR Receive National Nursing Awards The American Nurses Association announced in January that Medical Center of the Rockies and Poudre Valley Hospital were among five U.S. hospitals receiving a national award for achieving and sustaining outstanding nursing quality that improves patient care and safety.

The awards are based on nursing performance measures reported to ANA’s National Database of Nursing Quality Indicators. NDNQI is the healthcare industry’s only comparative database used to make improvements in nursing services, patient safety and other areas of care.

14

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Comprehensive, Compassionate Care For The Whole Family According t~ quality oflif~ of allergies

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Northern Colorado Medical & Wellness 2011

15

MEDICAL

Insurance • Stay In Network – These providers have already negotiated rates with your insurance company.

Going outside the network will likely result in exorbitantly higher medical costs.

• Cost Comparison – “The cost of care in the Northern Colorado area is twice as high as the cost of care in Denver,” Lacy says. “The competition between hospitals and providers drives the price down in Denver. If you’re concerned about the escalating cost of healthcare the best thing you can do is a cost comparison.” One patient Lacy has worked with needed an MRI. She called around and found the price of an MRI in Broomfield or Denver was half the price.

Patients should care how much medical services cost to get the best bang for their medical buck.

If you’re paying 20 percent of a procedure, full price against a deductible, or an Health Savings Account (HSA), the difference can add up to hundreds, or hundreds of thousands, of dollars.

• Grants – Many surgeons and oncologists have grants to help patients pay for expensive services.

Pharmaceutical companies also have assistance programs. Ask. • Get Organized – Many insurance plans are online. Patients can check coverage, policy benefits, providers, track billing and pending claims. Make a spreadsheet to keep track of all the different providers, tests and prescriptions.

N a v igating

Health Insurance

By Tracee Sioux

I

s there anything more mind-boggling than health insurance? Faced with a diagnosis, who wants to add to the frustration of decoding the insurance industry?

Mary Lacy, Claims Advocate for Volk and Bell Benefits, has advice about navigating the maze of insurance:

• Know Your Policy – Go through your insurance policy handbook to know what your policy covers, what the co-pays and deductibles are, how they are applied and what the policy excludes. Familiarity prevents sticker shock and you will spot billing mistakes quickly.

• Use Preventative Benefits – Take advantage of the annual mammograms and physicals covered by most policies.

• Maintain Continual Coverage – Many insurance problems occur when patients go uninsured for over 90 days. A patient’s diagnosis can be deemed “a pre-existing condition” and coverage could be denied without a Certificate of Continual Coverage from a previous insurance company.

• Make Phone Calls – As soon as you notice a

16

discrepancy in a claim, call the insurance company. “Nine times out of 10 they’ll say they are very sorry and they’ll fix the error. Many people end up in collections, which could have been avoided with one phone call. Call the insurance company directly: don’t wait for your healthcare provider to do it.”

• Get Assistance from Friends and Family – Take someone with you to doctors appointments to ask questions, retain information and take notes. If a spouse or other significant person in your life is willing and able, patients may consider asking them to handle the insurance hassle, allowing the patient to focus on their health and well-being. Some insurance brokers, like Volk and Bell Benefits, provide an advocacy service to their customers for that very reason.

Tracee Sioux is a Fort Collins writer. She can be found at www.TheGirlRevolution.com and www. linkedin.com/in/traceesioux.

• Predetermination of Benefits – If a provider suggests you do a test or procedure, ask them to run a “predetermination of benefits.” Where a “preauthorization of benefits” will verify coverage, a “predetermination of benefits” is a “dummy claim” in which providers will use the actual codes and diagnosis for the procedure.

Insurance companies can tell you exactly how they intend to cover it and how much it will ultimately cost. “This allows patients to make an educated decision about care. If it’s very expensive you can ask the physician if there are alternatives and decide if you really want to go forward.”

• Understand Deductibles – Patients should understand what items will be applied to deductibles.

If your employer switches insurance plans, make sure the deductible, which is almost always calculated in calendar years, gets rolled over to the new plan.

Mary Lacy, Claims Advocate for Volk and Bell Benefits

Lydia’s STYLE Magazine

Northern Colorado Medical & Wellness 2011

17

E nhancing

the Human-Pet Bond

By Angeline Grenz

T

he meaningful relationship between pet and owner enhances the quality of life for both. For our pets, we guarantee them quality care and loving, structured companionship.

Pets in return give us an unconditional love that results in healthier minds and bodies and even adds years onto our lives – an innumerable value on both sides when the relationship is a good one.

But pets lack the ability to tell us where the bond may become fractured, and human owners have the added responsibility of deciphering our pet’s clues about their well-being.

“Once we accept responsibility for the life of another,” explains Dr. Robin Downing, local veterinarian and internationally known expert on pain management for pets, “we have a moral and ethical obligation to have the means with which to fulfill that responsibility… to budget for food, care and

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upkeep, regular veterinary care, and planning, saving and budgeting for the unforseen.”

Dr. Downing advocates that responsibility in her practice, with a special focus on how a pet’s health – including unknown conditions that may be causing pain and discomfort – can negatively impact the human-pet bond. She is owner of Windsor Veterinary Clinic and The Downing Center for Animal Pain Management.

Dr. Downing’s own menagerie of pets – four dogs and a paralyzed cat – are all rescue animals that have come from homes where the bond was not able to be maintained, either by the owner’s choice or by their inability to provide adequately for the pet’s needs. Consider Opus, a pure white deaf mutt who responds to hand signals from Dr. Downing or her partner, Sharon DeNayer. Or Pearl, the beautiful grey feline, who was born with a twisted back and paralyzed rear legs. Pearl takes the honorary place in the crook of Dr. Downing’s arm, carried lovingly down from the upstairs apartment

everyday to the veterinary practice below, located on Main Street in Windsor.

Dr. Downing’s animals have become quite the celebrities over the years. Like the Great Dane, Murphy, who was a two-time cancer survivor and who appeared in a fundraising commercial with retired General Norman Schwarzkopf for Colorado State University’s Animal Cancer Center. Gen. Schwarzkopf sent his own private Learjet for Murphy so she would not have to fly in a crate in the belly of a commercial airplane. At Murphy’s passing, Gen. Schwarkopf sent a letter of condolence to Dr. Downing.

There is also Frankie, a stray who had been run over by a car. His story was so inspiring, it found its way onto the Maury Povich Show. Frankie’s spine had been crushed and the damage had permanently paralyzed his rear legs. The family fostering him brought him to Dr. Downing for rehabilitation. Dr. Downing outfitted Frankie with a canine wheelchair that allowed him to be mobile. He could move around as quickly as if all four legs were operational, and his story garnered quite a bit of national attention.

It seems that Dr. Downing’s drive to provide care for even very damaged animals is inherited from her grandfather. She knew as young as six years old that she wanted to be a veterinarian and that the bond between humans and their pets was a very special one. She had the example of her grandfather’s dog, Danny. After Danny experienced a stroke,

Lydia’s STYLE Magazine

her grandfather taught his beloved pet to walk again using the wall to support his paralyzed side.

Even more amazingly, her grandfather taught Danny to wear a hearing aid in his ear when his hearing began to fail. Back then, the hearing aid was the type with a receiver, which Danny cleverly kept attached to his collar with the implant in his ear. Perhaps this was one of the experiences that taught Dr. Downing that physical limitation in a pet by no means meant a limited existence.

Dr. Downing also refers to her “animal karma” that gave her the ability to understand the cues the animal world gave her to decipher their needs. “By the time I went to school, I had a good understanding of how to place that bond in the middle of my veterinary care.” Today, Dr. Downing’s unique experience has lead her to take the position as president of the American Association of HumanAnimal Bond Veterinarians (AAH-ABV), a voluntary organization of veterinarians dedicated to nurturing human-animal interactions.

Behavioral Training for a Strong Bond

The first piece of the human-pet bond is responsibility. Dr. Downing emphasizes that the bond requires that pet owners be committed to the best interests of their pets, providing for them in all manners from physical to emotional needs.

These needs may be different based on a new pet’s breed, age, physical limitations and other traits. But there are some basics for all pet owners to consider. “It may sound simplistic, but basic obedience training is the very best way to lay a solid foundation upon which to build, reinforce, enhance and expand the precious human-animal bond,” explains Dr. Downing. She adds that the prime time to socialize dogs is from 6 to 16 weeks.

“After that time, it is like a door closes and it becomes harder for them to learn new things.”

Cats in particular suffer if they are removed from their mothers too early, she continues. “If a kitten is removed too early, they will never have normal behaviors. Once their eyes have opened, around four weeks, they are usually okay. But removed too early, they generally are not comfortable being handled.”

Dr. Downing stridently warns against following television personalities who offer up trendy training techniques with no science behind them.

“Dominance is not the foundation on which to base the human-animal bond,” she says. “That sort of training creates a situation where dogs do not know what is expected of them. They need consistency, regularity.”

Along those lines, Dr. Downing recommends, “Our animal companions need a job. Training provides us humans with a language in which to communicate with them what their job is. Training provides the structure through which we communicate with them – they actually have a strong drive to please us by giving us the behaviors we desire.”

Dominance training can actually undermine the relationship because our pets, canine in particular, will not trust us, she says. Dr. Downing recommends dog owners refer to experts such as Dr. Sofia Yin, whose book, How to Behave So Your Dog Behaves, is a great text for dog owners to have at their fingertips.

Dr. Downing also recommends “clicker training” when working with your dog. This sort of training begins with treat training, then intermittently add the sound of a clicker (a small noisemaker easily

Northern Colorado Medical & Wellness 2011

available at most pet stores) until the dog begins to view the click as the reward. “Our dogs can actually learn really complex behaviors if we use this training in stages.”

When a pet has to re-home, says Dr. Downing, bonding can sometimes be more difficult, especially with abused or neglected pets. Often, the key is patience. She cites a family that adopted a stray, but because the dog would not bond, they almost euthanized him. The owners, however, made the decision to stick with it; though it took a period of years, the dog can now interact normally with the family.

Dr. Downing also advises those looking for a pet to use a healthy dose of common sense. If you are gone 12 hours a day with a busy career, a pair of cats makes a wiser choice as pets than a needy puppy with bundles of energy.

Longer, Better Lives for Our Pets

While the behavior training needed to create a strong bond with your pet is of great importance, Dr. Downing has spent much of her career investigating an area of the human-pet bond that is sometimes unrecognized – chronic diseases and dementia in pets.

“In the mid-80s we started to see that pets were living longer,” explains Dr. Downing. Labrador retrievers, which generally live into their teens today, lived an average of 9 to 10 years just three decades ago. Along with a longer life span, there has been a cultural shift for the pet – Dr. Downing calls it the migration from the backyard to the bedroom to the pillow, where pets now sleep on their master’s beds. One consequence of a longer life expectancy is the appearance of senility in dogs and cats – “they are living long enough for us to see this condition occur.”

“Some anthropologists say that part of what makes us human is bringing animals into the family,” says Dr. Downing. “We now recognize that there are dogs who can detect colon cancer, prostate cancer, heart attacks, seizures and other conditions in humans.” The ability for veterinarians to treat animals with special needs has also increased.

Frankie, mentioned at the onset, was going to be put to sleep because he could no longer walk or go to the bathroom on his own. But, according to Dr. Downing, Frankie wasn’t experiencing pain, interacted with people and still had a long life ahead.

“He opened the door to a new part of my profession – he was my first special needs dog,” she recalls. “We as pet owners have the responsibility to allow animals to live in a way that maximizes their lives.”

Dr. Downing shares the story of a quadriplegic poodle she once treated. The family was ready to euthanize, but decided to hold off. Dr. Downing noticed that the poodle ate and drank everyday, and was interested in what was going on around her.

A custom box was built that allowed the family to carry her everywhere – even on the boat with her own flotation device. “She died at age 24 – five years of that as a quadriplegic!”

“There has been a cultural change,” says Dr. Downing. “Owning a pet is no longer like having a pair of shoes. We have a moral obligation to advocate in their behalf because they cannot advocate for themselves.”

The relationship is reciprocal, adds Dr. Downing.

“The bond goes both ways – if your dog is fat, it probably means you are not getting enough exercise, either.”

Pet Insurance Tips for choosing the correct coverage for your pet.

Pet insurance might have sounded like a gimmick even just 10 or 20 years ago. But with pets living longer, and a plethora of diseases now being diagnosed, pet insurance may actually be life saving to your pet.

“Pet insurance is something that is near and dear to my heart,” says Dr. Downing, owner of Windsor Veterinary Clinic and The Downing Center for Animal Pain Management.

“Pet insurance can help prevent economic euthanasia.”

As the quality of pet care has increased over the years, so has the cost, largely due to the fact that much of the medical equipment used to treat pets is the same technology as that used on humans, says Dr. Downing. “There are vets that provide care that rivals what is available for humans.”

At the same time, some care has become economical, as more pharmaceutical companies now offer many common pet medications in generic form.

When and why should you purchase pet insurance?

“Pet insurance is best purchased for accidents and illness,” advises Dr. Downing. “We should be able to take care of routine and day-to-day pet care ourselves.”

Pet insurance is structured much in the same way as auto insurance. Premiums are paid monthly, with a set deductible. Where it differs, says Dr. Downing, is that while we insure a car in case of an accident, “if you have a pet, they will reach an age when something is going to happen.”

Pet insurance also pays a percentage of care, generally around 80 percent of the total cost, after the deductable.

“Look for a company that is transparent,” she recommends.

“If they have a schedule of benefits – don’t do it. You don’t want a long list of exclusions, though exclusions for pre-existing conditions are reasonable.”

Other reasonable exclusions include congenital conditions, such as luxating patella issues and cleft palates birth defects, conditions in some dogs that are a result of over-breeding. Cancer should be covered by pet insurance.

Look for companies that offer large lifetime limits, in the neighborhood of around $100,000 total or $5,000 to $7,000 per event. Dr. Downing warns against fly-by-night operations that do not have proven track records – look for established companies who are underwritten by larger insurance firms, such as ETNA or even Geico. Beware of those found solely by searching the Internet.

Dr. Downing has seen firsthand how families have been saved huge veterinary bills by taking this proactive step: “I think pet insurance is indispensible. It allows for quality pet care to be affordable.”

Dr. Downing recommends the following pet insurance companies to her patients. Ask your veterinarian for his or her recommendation: • Pets Best Insurance, www.petsbest.com • Purina Care Pet Insurance, www.purinacare.com • Trupanion Pet Insurance, www.trupanionpetinsurance.com

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eat play

LOVE

Tips for Bonding with Your Pets from a Top Animal Behaviorist

B

By Laura Sebastian

onding with a companion animal is a huge topic, but there are some basic do’s and don’ts that can help make your relationship thrive, even if you’re experiencing some bumps on the road to love. In the vast majority of cases, what we call “behavior problems” are simply cases of our animals trying to tell us something and our ignoring it or just not understanding what they’re saying.

Terry Jester, a nationally recognized companion animal behaviorist and animal issues columnist for the Fort Collins Coloradoan, clears some of it up with tips on what we can do to understand our companion animals and foster ties that bind.

“If I could get one message through, it would be to tell people that animals aren’t people,” Jester says.

“They have their own needs, language and ways of behaving that we must learn and adapt to in order to have a happy, healthy bond with them. For instance, we’ve bred dogs to be infantile and dependant, yet we leave them alone for eight or 10 hours a day and get angry when we come home and find they’ve chewed the rug. Dogs become hyper from anxiety due to lack of training, attention, exercise and direction. They’re pack animals and they need to be with people.”

And if you think cats don’t need people, well, they sure do.

“Cats are not as independent as people think,” Jester says. “They don’t do well left alone all the time or outside roaming. With them too, we must learn their nature rather than judging it through the eyes of our own behaviors. So, just because your cat prefers to relax a few feet from you doesn’t mean he isn’t loving or social. For some cats, that is their way of being social. Other cats, like mine, are practically glued to you like an appendage.

“A cat issue I often hear about is scratching. I encourage people to understand that scratching is natural and necessary for a cat and declawing them can lead to many painful problems, as well as behavior issues like avoiding the litter box or biting. Taking their first defense away – their claws – leaves them feeling less secure and quicker to use the only other defense they have, their teeth. So, provide scratching posts, or try turning on a vacuum cleaner to shoo them from scratching furniture.”

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Basic Animal Do’s and Don’ts:

Do’s

• Learn their unique language, behaviors and needs.

(Research a specific breed before you adopt.)

• “Baby-proof” your house and yard for their safety and your peace of mind. If you don’t want it broken or chewed, put it away.

• Spend time brushing, talking to and playing with your pet.

• Provide loving structure, limitation, guidance and routine, especially to dogs.

• Provide regular veterinary care, train your dog, and have clean litter boxes for cats.

Don’ts

• Don’t leave your animal alone for long stretches. Consider Doggy Day Care or a companion animal for your dog, cat and small pets.

• Don’t declaw your cat. Websites such as pawproject.org offer information on its negative effects. Ask your vet or animal behaviorist for alternate solutions.

• Don’t forget to rule out medical issues when faced with behavior changes such as litter box issues, urine spraying, biting, excessive barking or whining. If you can’t afford a vet, you can’t afford a pet.

• Finally, don’t expect your pet to be what you want; respect them for what they are and you’ll both be happier.

“A flourishing bond starts with coming from a loving, accepting place,” Jester says. “For me, everything about animals is so extraordinary, so important. I wouldn’t have a life if I didn’t have my animals.”

For training and behavioral help with all creatures great and small, contact Terry Jester at: (970) 568-7585 or email: arriniranch@aol.com. On the Web: www.fortcollinsdogtraining.com Fort Collins-based assistance to support your animal bond: • Pets Forever: A Colorado State University-sponsored non-profit helping low-income elderly or disabled Larimer County residents maintain ownership of their pets by providing needed help and resources. Contact: (email) lori.kogan@colostate.edu, (on the Web) csuvets.colostate. edu/petsforever.html or call (970) 491-7984.

• Fort Collins Spay/Neuter Clinic (a division of Fort Collins Cat Rescue): Low-cost cat and dog spay and neuter clinic for low-income individuals, the elderly and students. Contact: fortcollinscatrescue.org or call (970) 484-1861.

• Northern Colorado Friends of Ferals: A non-profit volunteer organization offering humane help for feral (wild) cats and cat colonies. Contact: (email) Leslie Vogt at feralfriends@fortcollinscatrescue.org, (on the Web) nocoferals.org.

• The Ladybug Fund: Founded to help those facing financial hardship pay for emergency veterinary care.

Contact: jon@theladybugfund.org, (on the Web) theladybugfund.org or call (970) 484-8080.

• Safely There Animal Transportation: A pet-taxi service providing transportation to the vet or elsewhere.

Contact: Lorry Schmitz, www.safely-there.com or call (970) 556-8661.

Laura Sebastian, who lives in Fort Collins, has worked as a freelance writer for 11 years.

Pain Management Reinforces the Bond

Dr. Downing’s training took a specific turn in the mid-80s, when she began greater research into cancer treatment for pets. That focus evolved into an international recognition as a pain expert for animals. “Animals can feel pain, both acutely and chronically, and pain injures the human-animal bond,” she says.

She recalls a family who came to her because their normally gentle black Labrador unexpectedly bit their son when he had wrapped his arms around the dog and given him a hug. They were ready to put the dog down but hesitated, asking Dr. Downing to examine the canine.

She discovered the dog was suffering from a great deal of lower back pain (an eight out of a pain scale of 10). “With just firm pressure, the dog was ready to bite the veterinarian,” she recalls. “For the child to have hugged the dog must have been excruciating.”

By recognizing that the animal was in pain, and treating that pain, the ending is a happy one. The son’s interaction with the pet was carefully monitored until the dog’s pain was greatly reduced. “Eventually the dog began to ask to play and interact with the son,” says Dr. Downing. The bond was restored.

Dr. Downing’s work with pet pain management was groundbreaking in the 90s, and she worked with the drug company that developed some of the first non-steroid pain killer for dogs. She has also trained in veterinary medical acupuncture, medical massage for dogs, chiropractic care for pets, and canine rehabilitation and physiotherapy therapy, and teaches regularly on pet pain management techniques.

Her expertise provides valuable insight to owners who notice a change in their own bond with their pet. “Anytime there is an alteration in the behavior of your pet, the first step that needs to be taken is to rule out an organic disease.” Behaviors as simple as a lack of interest in food or a noticeably increased appetite may be indicative of a medical condition. Lethargy, unwillingness to participate in activities that your pet previously enjoyed, a change in sleeping patterns, using the bathroom inside the home, refusing to use the litter box – all of these are signs that your pet may be suffering.

“What you may be witnessing is a behavioral manifestation of a physical ailment,” she says.

In addition, age in and of itself is not a cause for changes in a pet’s behavior. “Old age is not a disease. Pet behaviors generally don’t change just because of age.”

If a change takes place in a geriatric pet, the cause could be cognitive dysfunction syndrome – a potentially treatable form of senility in dogs and cats, and a direct result of our pets living longer lives. Dr. Downing advises pet owners to watch for a change in behaviors in older pets, such as less interaction, not eating well, walking into a room and seeming to not remember why, not enjoying activities.

The condition is treated with anti depressants that alter the pet’s brain chemistry and return them to normal behaviors. After other conditions are ruled out, your pet’s doctor will likely prescribe a 60-day drug trial. While not every animal responds to medication, Dr. Downing has had a 90 percent success rate at her practice.

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The Ultimate Gift to Your Pet

In more recent years, Dr. Downing has broken into the realm of palliative care and hospice for pets. Palliative care means providing for the care and comfort of a pet without the intention to cure the disease. Hospice is the practice of keeping a dying pet comfortable.

“We have translated palliative care and hospice principles from human medicine and applied them to our animal patients,” she explains. “We can help animals live well right up to the moment of their deaths.”

Pets can live for some time with incurable diseases, such as cancers, heart conditions, kidney failure and others. Dr. Downing says these animals can be kept comfortable and given compassionate care that sustains the relationship with the pet. This care, however, is not a substitute for euthanasia.

“Euthanasia is a gift we give our pets; it is the ultimate pain relief tactic for when we can no longer be successful in relieving their pain,” says Dr. Downing. It is a veterinarian’s responsibility to guide a pet owner in making this important decision, she says, but ultimately it is one that pet owners must make themselves.

She gives pet owners a Quality of Life scale developed by Dr. Alice Villalobos. The scale asks a series of questions with a numerical value. After tallying questions, pet owners can decide if the quality of life is acceptable for their pet. “It allows us to help you be objective on a subjective topic.”

Responsibility of Pet Owners

“I think the least known or appreciated fact about the human-animal bond is that science now informs us that pets do not just add life to our years – they actually add years to our lives,” says Dr. Downing.

To that end, Dr. Downing emphasizes that the decisions a pet owner makes with regard to the care of their pet must begin with the very basic consideration of how to respect and honor that bond. Often, that includes the ability to invest in professional care and treatment for our pets, and she is a keen proponent of animal insurance to help pet owners meet those needs (see “Pet Insurance” on page 19 for more information.).

Where once experts advised people to avoid attributing emotions to animals, Dr. Downing says there is new thinking that is a key component to the rich bond animals and humans can share.

“Animals live rich emotional lives, they can suffer and they do remember,” she says.

“As a pet owner, my animals have added a dimension to living that is absolutely unique,” she continues. “I know my days have been richer for their presence. I cannot comprehend life without animals in it.”

Angeline Grenz is editor for Style Magazine.

Northern Colorado Medical & Wellness 2011

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MEDICAL

Ti n n i t u s

d o y o u hear that

ringing in my ears?

By connie hein

T

here has been much speculation over the centuries that the famous painter, Vincent Van Gogh, suffered from severe tinnitus. Shortly before his death, Van Gogh cut off his ear and painted a self-portrait with the side of his head bandaged. Though his idea of treatment may be extreme, Van Gogh’s suffering may mirror that of many who live with the painful condition today.

Tinnitus is the perception of sound without an external cause, often described as ringing or whooshing in the ears, that affects as many as 50 million Americans. Within this number, 10 to 15 million sufferers seek medical treatment for severe, highly disturbing tinnitus. The Centers for Disease Control and Prevention reports that a million new cases of tinnitus are identified each year, 200,000 of which are considered severe. Tinnitus symptoms can negatively impact normal daily activities and

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can lead to additional medical conditions, such as anxiety, depression and sleep deprivation.

Many of the millions of Americans suffering with the condition believe there is nothing they can do for relief, because over the years it has been misunderstood, as it was in an earlier century by people like Van Gogh.

The good news is there exists a growing awareness of treating the condition, along with other sound sensitivity issues, which is much easier and more effective than cutting off an ear. It’s as simple as finding an audiologist like Natalie Phillips, AuD., who will be persistent in finding the treatment that works best for each and every patient.

S.A. Armijo is one of those patients. The tinnitus and hyperacusis (sensitivity to moderate level sounds) treatment she received last year from Dr. Phillips at Advanced Otolaryngology, in Fort Collins, was a miracle. “To be able to enjoy both music and absolute silence and also the soothing sounds of nature for the first time since I was

very young is a miracle that has made every day of my life happier.”

She remembers being able to sit and enjoy listening to her father play the violin as a little girl, then gradually the sound of even soft music became painful. She was not able to enjoy any kind of music or embrace the comfort of sitting in silence. There was never silence because of the ringing in her ears. There was no sanctuary for Armijo. After visiting several doctors and being told there was nothing they could do except sever the nerve in her ear and leave her completely deaf, she had almost given up hope of finding relief from the condition.

Armijo’s final attempt at relief was a visit to Advanced Otolaryngology for a second opinion.

She told her story to Dr. Phillips, who had recently joined the clinic.

Dr. Phillips, who says tinnitus is her passion, has studied, researched and treated the condition for many years, and offers what she believes is the most effective treatment for the condition. She says the FDA-approved Neuromonics Tinnitus Treatment (NTT) has a 96 percent success rate in treating the condition.

This treatment is proven to interact, interrupt and desensitize tinnitus by delivering a customized neural stimulus embedded in clinically modified music, all within a portable device to be used by the patient a few hours a day.

“Through many years of research it was found

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that disturbing tinnitus may be due to the fact that it lingers in certain areas of the brain,” Dr. Phillips says. “For people with mild cases of tinnitus, it does not negatively impact their lives because their brain detects it, realizes it is nothing it needs to pay attention to and then moves on.”

Patients who need treatment are those whose brain detects the noise in the subcortical level of the brain, then for some reason the noise goes beyond this level to the cortical level of the brain (affecting perception and evaluation), sometimes engaging the limbic system (which generates emotional association) and the autonomic nervous system (responsible for physiological responses).

NTT best addresses the neurological processes of tinnitus, specifically its auditory, attentional and emotional aspects.

“By targeting underlying neurological processes, the treatment is proven to offer long-lasting relief,” Dr. Phillips says. “The goal of tinnitus therapy is to reduce the awareness and disturbance of tinnitus by working on the brain’s perception of tinnitus. It is not a ‘cure’ as the goal is to reduce the occurrence at the cortical level of the brain along with the limbic system and autonomic nervous system from engaging, thereby reducing the tinnitus back to a ‘normal’ level where the subcortical level of the brain may detect it from time to time, but can filter it out and the patient does not experience the same reaction to tinnitus as when it was disturbing.”

Dr. Phillips has been providing tinnitus treatment to patients for over 10 years. “It can be an awful, debilitating condition with devastating impact on a patient’s quality of life.” She says that is why she is so pleased to be able to offer NTT, which represents a significant step forward for a condition

Northern Colorado Medical & Wellness 2011

with traditionally limited treatment options.

NTT is delivered through a compact, lightweight and uniquely designed medical device customized to the patient’s hearing, tinnitus and loudness discomfort level profile. When placed in the ear, it delivers a customized neural stimulus that promotes neural plastic changes, allowing the brain to filter out the tinnitus sounds.

This stimulus is clinically administered and monitored within spectrally modified, customized music, which engages the brain’s emotional response center (the limbic system) and thereby reduces tinnitus-related disturbance. The device also logs usage data for interpretation and assistance to modify therapy for the individual patient.

Dr. Phillips says treatment typically occurs over a six to eight-month period, with daily use recommended for two to four hours per day, especially when the tinnitus is most disturbing. The treatment can take place during regular activities such as reading, relaxing or computer work.

The treatment involves a multi-stage process.

In stage one, a continuous broadband frequency stimulus is embedded within spectrally modified music which provides a high degree of interaction and relief from the tinnitus. In stage two, intermittent interaction with tinnitus perception helps decrease the brain’s sensitivity to the tinnitus sound.

Advanced Otolaryngology is the only clinic in Northern Colorado to offer the therapy alongside other successful tinnitus and sound sensitivity treatments, including Tinnitus Retraining Therapy (TRT).

TRT incorporates protocols to treat tinnitus, hyperacusis, misophonia (dislike of a particular sound which may cause a physiological response), phonophobia, and selective sound sensitivity syndrome.

Treating tinnitus with TRT is using sound therapy through small ear-level devices to remove the perception of tinnitus from a patient’s consciousness through habituation. The success rate of TRT is over 80 percent in reducing the awareness and disturbance of tinnitus.

Dr. Phillips says they provide a complimentary and comprehensive consultation as part of the initial diagnosis process to determine if there are other conditions that need to be treated along with or before the tinnitus.

Armijo says for her the treatment was truly a gift. “The joy of being able to enjoy music again and meditate in pure silence can’t be measured.”

She encourages others who have been suffering in silence (or non-silence) that there is hope and that Dr. Phillips was devoted to making the treatment experience as pleasant as possible. “Her compassion for her patients showed in her dedication to her work and knowledge in this area. I hope to get the word out so she can help thousands of people like me.”

As for Van Gogh, through all the controversy that surrounded his mental illness and death, the accumulation of facts indicates there is a common denominator between his symptoms and the symptoms of typical tinnitus sufferers today. His decision to cut off his ear may likely have been an extreme attempt to treat his debilitating condition.

For the millions suffering with the condition today, there is a much more sensible solution.

Connie Hein is a freelance writer living in Windsor and the author of the Toliver in Time series of children’s books.

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MEDICAL

Mental Health

M anaging

Your Anxiety

I

f you’ve ever had an anxiety attack, you’re not alone. Approximately 2.4 million Americans have experienced an anxiety attack, according to the National Institute of Mental Health. That’s one in every 113 people in the U.S. Of those 18 to 54 years of age, about 1.7 percent of people in any given year have anxiety disorders.

“Anxiety disorders are the highest of the mental disorders, even higher than depressive disorders,” says Marvin A. Boeding, Ph.D., a licensed clinical psychologist with Psychological Associates in Loveland. “Part of it is the time in which we live. We also have a high incidence of Post Traumatic Stress Disorder (PTSD) because of returning vets.”

The most obvious signs are physical ones, says Robert Bein, M.D., board certified adult psychiatrist currently in private practice in Longmont and Boulder and on staff at Boulder Community Hospital. “There are different ways anxiety commonly manifests itself.

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By Kay Rios

Typically one may experience sudden tachycardia, which is a very rapid heart rate, and shortness of breath accompanied by a feeling of panic and fear.”

There may also be sweating, chest pain, nausea, vomiting, gagging, numbness and tingling, and a feeling of loss of control. The element of fear often causes people to believe they are not getting enough oxygen, so they breathe harder and faster and actually hyperventilate, which can cause light-headedness, and even possibly fainting, adds Dr. Bein.

“The component of apprehension or fear can give a real sense of feeling unsafe even in a familiar environment or with people you know,” adds Beth A. Firestein, Ph.D., licensed psychologist at Inner Source Psychotherapy and Consultation Services in Loveland.

Panic attacks and anxiety attacks are closely related, she adds. “A panic attack occurs when anxiety reaches an absolute peak of intensity and… there is a sense of a complete lack of control. It’s a very intense anxiety attack that crosses a threshold.”

Steven Gale, Ph.D., licensed psychologist practicing

in Fort Collins, says, “A panic attack is more welldefined and is a diagnosable episode that involves not only severe anxiety but a sense of doom or fear.

Anxiety attacks come on more gradually whereas a panic attack comes abruptly. People who have a panic attack may think they are having a heart attack and end up in the emergency room.”

It can become a cycle, Dr. Gale says. “Once someone has had one or two, they will start to worry that they will have more. You anticipate another anxiety attack before it happens. People can think they are losing their mind or they are dying.”

Treating Your Anxiety

“The best thing is to learn about the condition,” say Dr. Boeding. “Learning about panic and anxiety attacks allows you to label it. Being able to say ‘I’m experiencing anxiety or panic’ empowers us because we can name it and confront it.”

There are things people can do in the middle of

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an attack, adds Dr. Firestein. “It can be useful to tell yourself, ‘This is just an anxiety attack. It is time limited; I’m not in physical danger.’ Then it helps to take any action that helps you feel a greater sense of safety or comfort. That might be reaching out to a family member or friend or just wrapping a blanket around yourself.”

Dr. Bein cautions, “If you are having your first attack ever and experiencing chest pain, and have not been evaluated medically, it’s a good idea to go to the emergency room to be assessed for a cardiac problem, even calling 911. However, if you continue to have these episodes and you have a clean bill of health, self talk and breathing techniques are essential.

Typically a panic attack will last 10 to 20 minutes.

There may be some residual feelings of anxiety but the tachycardia, sweating and the panic will subside.

As scary as it feels it is important to remember that this will pass.”

It’s important to be as calm as possible, he says.

“The harder and faster you breathe, the worse the panic will seem.” He suggests using breathing to gain control. “Find a comfortable place to sit down or, as calmly as possible, pull off of the road, and despite the shortness of breath, slow your breathing down.

The more you can accept the panic, even welcome it, the less it will control you. It’s not intuitive at the moment but it works. Freaking out only makes the panic worse. With practice breathing, you begin to achieve more and more control over the attacks.”

Dr. Firestein says that yoga and meditation can also be helpful in reducing anxiety. “They give you specific things you can do to calm the body. Guided relaxation also helps.” Another proactive step can be keeping a journal. “Journaling can serve a valuable purpose in helping you pinpoint the reasons for the anxiety,” she says. “And it can actually help you work through the anxiety and resolve the issues.”

When a Professional is Necessary

When should a professional be contacted? “Panic attacks can occur out of the blue and may occur only once or they may occur one to ten times a day,” Dr. Bein says. “If it happens once or very rarely, it is probably not essential to see a professional. But if they are occurring regularly and having a negative impact on your life, then it is important to get help.”

He continues, “Though panic attacks can be treated with breathing techniques and self talk, sometimes we need some coaching and therapy to gain control over them. Sometimes we need medications to get them under control. Sometimes they are indicative of stress, or a more complicated problem, such as a mood disorder. And obviously, you should see your doctor to make sure you don’t have a medical problem that’s causing or complicating the multiple attacks.”

Anxiety attacks can be triggered both physiologically and psychologically, says Dr. Firestein. “Psychologically, they can be triggered by sudden life changes, stress, severe illness or having a family member die. Physically, an imbalance in the brain chemistry can cause them.

Brain chemistry can be determined through a clinical interview and a verbal symptom base assessment by a physician, counselor or psychologist.”

Some people have a genetic or hereditary predisposition to imbalances in the brain chemistry that might lead to depression or anxiety or both, she says. “But having a panic attack or anxiety attack doesn’t mean you will have more.”

Many treatment approaches exist. One of Dr. Gale’s preferred approaches is cognitive behavioral therapy, but he adds, “It’s very important to make it individual for each patient.”

Northern Colorado Medical & Wellness 2011

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Steven Gale, Psychologist, Fort Collins

Beth A. Firestein, Psychologist, Inner Source Psycotherapy and Consultation Services

Robert Bein, Psychiatrist, Boulder Community Hospital

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Lydia’s STYLE Magazine

Cognitive behavioral therapy addresses ways to change the physiological response of the body. The behavioral part is learning skills to calm or relax the body through meditation and breathing techniques.

On the cognitive side, we identify thoughts that are distorted or exaggerated and, once aware, change them before they trigger a panic or anxiety attack.

An anxious person is prone to predicting the future in a catastrophic way and to focusing on physiological symptoms associated with a panic attack so he or she will notice every flutter of the heart or twinge in the stomach, which can then trigger the attack.

Dr. Boeding adds that biofeedback is also effective because it teaches people they can control their physical responses – I can make my heart rate slow; I can bring my blood pressure down.

Dr. Gale also uses eye movement desensitization and reprocessing (EMDR), as does Dr. Firestein. “It’s a technique for helping people overcome PTSD and often anxiety is part of that,” says Dr. Firestein. “I’ve used EMDR for people who have been in car accidents, who have been sexually assaulted, or physically or emotionally abused.”

With EMDR, the therapist applies alternative bilateral stimulus of the left and right hemisphere of the brain to increase communication between left and right brain, explains Dr. Firestein. This “allows memory to move from the primitive right brain memory to narrative left brain memory. For most people, when they remember falling off their bike as a kid, it’s in the past. When you have PTSD, it’s like it happened yesterday and you feel all the pain you felt at the time. EMDR helps the brain process the event and provides the conduit for the brain to complete the natural healing processes.

It is a very rapid and gentle intervention backed by empirical evidence. With anxiety, you can do EMDR on the event causing the attack or on the anxiety itself.”

Medication might also be a consideration, Dr. Bein says. “If therapy and other interventions are not adequately beneficial, combining them with medications can be very helpful. In a crisis, a benzodiazepine such as Valium, Xanax, or Lorazepam can help.” But, he cautions, “This is only a band-aid and does not get at the cause of the attacks, so it should not be used long term unless nothing else is working. These medicines can be addictive and may not work over the long haul as a person may develop a tolerance to them.”

Most commonly, antidepressants such as Prozac, Celexa, Zoloft, and Effexor are used. “These do not work immediately, but given time, they can help change one’s chemistry, and eliminate or significantly reduce the attacks,” says Dr. Bein. “Other types of antidepressants or mood stabilizers can alternatively be used.

These medications can be used over a longer period of time without the risk of developing a dependence or tolerance.”

Medications work best when combined with therapy, he says. “You can correct the chemistry with medication, but there’s a lot of stresses and learned responses that combine with the chemistry. We’re not only chemistry, we are a bundle of learned behaviors and strategies that may not be productive.”

Dr. Gale has found there are times when it’s helpful to have medications early on. “It can give a patient a safety net and a sense that it’s under control. For the short term, you can use the medications to abort that feeling of fear but, for long term effect, you gain the skills through therapy.”

Kay Rios, Ph.D., is a freelance writer in Fort Collins. She writes for a variety of publications and is at work on a collection of creative non-fiction and a mystery novel.

Northern Colorado Medical & Wellness 2011

27

MEDICAL

Orthopedics

Dr. Kelly Sanderford reviews X-rays of a total knee replacement with patient Gene Haffner.

Weak in the Knees:

Total Knee Replacement Surgery

By Corey Radman

T

he pain keeps you up at night.

Every time you roll over it wakes you. You’ve about decided to give up exercise, even walking, because the retribution your knee metes out is unbearable. Yet, you haven’t consulted the orthopedic surgeon because a replacement seems completely out of the question for you.

Sound familiar?

Total knee replacement surgery (TKR) isn’t inevitable for every achy knee, even if you have arthritis, explains Dana Clark, M.D., with Orthopaedic & Spine Center (OCR) of the Rockies. Some people can manage knee pain through more conservative measures. “We exhaust all forms of non-operative treatment,” he says.

Dr. Clark continues: “If a person has mild to moderate arthritis, we have a number of options to employ first.”

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Conservative Measures

distribution of force across a knee, making exercise easier for some people with arthritic knees.

Typically physicians suggest these measures:

•

Lose weight, if your physician recommends it.

•

Try non-steroidal anti-inflammatory medications – like Aleve, Advil, or prescriptions.

•

Modify your activity – stop running and start swimming or biking.

•

•

•

Take cortisone shots. Injected directly behind the patella, they bring inflammation under control and can provide relief for up to a year.

Most physicians suggest that patients should receive no more than two or three per year.

• Consider glucosamine or chondroiton sulfate.

Evidence on these supplements is mixed.

Some studies suggest it builds cartilage.

Some say it makes for expensive pee. All three surgeons interviewed here suggested buying a small bottle and trying it for a month. If it helps, keep taking it. If not, discontinue.

Hyaluronic acid joint injections – jokingly called “chicken shots” because the first ones were derived from rooster combs – are a last stop before surgery, says Dr. Clark. The exact reason these work is unknown, but in theory, the shots serve as a supplemental lubricant for the joint and act as a nutrient to the cartilage cells.

Wear unloader braces – they can even out the

If these less invasive measures still don’t relieve

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Kelly Sanderford, M.D., Mountain Vista Orthopaedics, Greeley

the pain, then you may be a candidate for replacement, like Gene Haffner was.

Haffner, public relations director for North Colorado Medical Center, was a lifelong tennis enthusiast, reining as champion in USTA singles and doubles tournaments in Northern Colorado for years. It was the twisting and sudden direction changes that ultimately tore his right meniscus.

Haffner had arthroscopic surgery in ’95, and continued to play tennis for 12 more years. He explains, however, that arthritis developed and it became too difficult to play tennis any longer.

“I have a pretty high tolerance for pain, but eventually it got to where I couldn’t do most of the things I used to enjoy,” he says. “I began to walk differently, my muscles compensated for the change in posture and then I would get huge cramps at night because of it. That was in addition to the bone-on-bone grinding in my knee; it was more than I could tolerate.”

Haffner’s situation is very common. Post-traumatic arthritis in injured knees is the second most common reason patients seek a surgical consultation, behind osteoarthritis.

It’s Time

Once imaging studies and physical exam have shown that a knee is ripe for surgery, the question becomes, “When should I have it done?” Haffner’s surgeon, Kelly Sanderford, M.D., from Mountain Vista Orthopaedics, answers succinctly, “You’ll know when it’s time.”

He elaborates: “Think of your favorite five things to do in life. If you aren’t doing two or more of them due to the pain in your knee, then it’s probably time for surgery.”

Another factor to consider in timing is the patient’s age. The best information on new prostheses indicates that the components will likely last 15-20 years. For a patient under 55 years old, the path to surgery is thus a bit slower than a typical patient in their late 60s or early 70s.

Dr. Sanderford explains his process: “For younger patients, I work really hard to avoid surgery, because revising a knee later in life has less reliable outcomes. However, quality of life is a factor. If all other conservative measures have not helped, then I would [offer a replacement].”

Kirk Kindsfater, M.D., also with OCR, concurs.

“If somebody young comes in that truly has no other choice… I fix them. I can make their lifestyle better. We know that knee will not last the rest of their life – we’ll have to revise it later, but we can

Northern Colorado Medical & Wellness 2011

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Dana Clark, M.D., Orthopaedic & Spine Center of the Rockies

Patient Gene Haffner, who had a knee relacement last summer, returns for an X-ray. Haffner says his knee is healing and he has already returned to many of the activities he previously enjoyed.

Kirk Kindsfater, M.D., Orthopaedic & Spine Center of the Rockies

do that. I would rather give the patient a good, active lifestyle now.”

Dr. Kindsfater, who estimates that he has performed more than 5,000 knee replacements in his career, cautions against waiting too long to get surgery if you have severe arthritis. “The longer you wait, the more deformity, stiffness and bone loss there is. I can still help those people, but their outcomes would have been better if they had come in five years earlier.”

A University of Delaware study shows that women in particular put off knee replacement surgery too long. It was not known exactly why, but the majority of women studied scheduled their knee replacements at a much more debilitating stage of arthritis than the men in the study.

This waiting has a profound impact on quality of life before surgery, as well as recovery time after surgery.

made, cobalt components are cemented to the newly shaped bone ends. A polyethylene insert is attached to the tibial component, which acts as new cartilage, supporting the body’s weight and allowing the piece to glide as the knee bends.

Finally, the backside of the patella is resurfaced and capped with a polyethylene button-like component that moves freely over the bending knee. Before closing, the surgeon bends the knee back and forth to check for proper mobility.

Partial knee replacement surgery is similar to a total replacement, but less invasive. Dr. Sanderson explains, “Think of the knee in three compartments: medial (inside), lateral (outside), and patella (anterior). We can replace any of those compartments alone if there is arthritis in one location only.” Partials are far less common than total replacements because most patients have arthritis throughout their knee.

says Dr. Kindsfater, though he prescribes crutches or walkers until patient confidence and strength returns.

Pete Kranske, a two-year graduate from Dr. Kindsfater’s surgery suite, couldn’t be happier with his experience. He credits both Dr. Kindsfater’s surgical skills as well as his own devotion to the rehab exercises. “The key to success is doing all the therapy exercises religiously,” he says. Take the time to rehab it properly, “because you want to be walking properly in the long run.”

The Operation

Recovery

According to OCR materials: “A total knee replacement removes the damaged and painful areas of the femur (thigh bone) and tibia (lower leg bone). These areas are then replaced with specially designed metal and polyethylene plastic parts.”

During surgery, the doctor uses a saw to reshape the tips of the adjoining bones, thus removing damaged cartilage and worn-down bone. The patella (knee cap) slides to the side during this process. After the cuts have been

30

After surgery, a TKR patient can expect to be up and walking almost immediately. Most people can expect to be out of the hospital within two to three days and headed home if they are healthy and there is good patient support in place. Sometimes patients who have health complications or live alone first make a stop at a rehabilitation center.

Expect to be walking on your new knee the day after your surgery. “Most people can fully bear weight on their knee right after the procedure,”

Reality

Drs. Clark and Kindsfater both caution their patients to expect a year for a full recovery. Dr. Clark adds: “Most people have much less pain between six to 12 weeks,” but, he cautions, “five to ten percent of people take a full year to reach that point. It is difficult to predict who will heal quickly, and pain is complex. That’s not being a wimp; it’s just the way you’re wired.”

Haffner has experienced a fairly typical rehabilitation. “I was off work completely for five weeks. Then, I worked part time from home, and then at the office for a few weeks. I was back at work full time at week eight.”

Haffner reports that at six months post-surgery he is back to most of the activities he had given up on: doubles tennis, country dancing with his wife, Julie, and walking. “I still have days with some pain or swelling, but I have to remember that it is still healing… and it is a lot better than

Lydia’s STYLE Magazine

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it was before,” he says, as a grin springs from beneath his moustache.

Long-term, most patients will see their surgeon for up to a year post-surgery. However, Dr. Kindsfater likes to follow up with X-rays every two years for up to 10 years or longer. “The only way to follow the performance of these [prostheses] is

by X-ray and physical exam. If I see wear or other problems, I can follow the patient closely to see if the problem is progressing or I can fix the problem before it causes additional damage and requires more extensive surgery. ” With a total knee replacement, you can expect to curtail your running and jumping. However, for most patients, the increased mobility is such an improvement over life with arthritis, they don’t mind. The doctors also suggest to their patients that they use prophylactic antibiotics in advance of all invasive procedures that could potentially expose the blood stream to bacteria. This includes dental procedures (even cleanings) and colonoscopies.

Prevention

If you have arthritis in your knees, the best advice from these physicians is probably what your mother would tell you. Eat healthful foods.

Maintain a reasonable body weight. Be smart about your activities and exercise – especially heavy lifting or deep squats that can overload the knee cap (like baseball catchers and weight lifters do). And learn from the experience of both Gene Haffner and Pete Kranske – don’t grit your teeth through the pain for years when this reliable surgery can provide relief much sooner.

Corey Radman is a writer who lives in Northern Colorado. Dr. Kindsfater has served as knee surgeon to two members of her family.

Haffner dances with his wife, Julie, at the NCMC Foundation gala in January.

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Northern Colorado Medical & Wellness 2011

33

MEDICAL

Allergies

nothing to sneeze at

A

pril showers may bring the May flowers that we all love, but along with those flowers, May brings with it the misery of tree pollen allergies.

This is why we hear so many warnings about allergy season, along with commercials and advertisements for medications to alleviate symptoms.

So how do the almost 30 percent of adults who suffer with allergy symptoms know what triggers to avoid and what treatments might be affective?

Style decided to do a little investigating on the subject, hoping to make spring and summer more enjoyable for our readers who suffer with allergies.

We talked to Krishna Murthy, M.D., the senior physician at the Northern Colorado Allergy and Asthma Clinic (NCAAC) in Fort Collins, to get answers about causes of allergy symptoms and advice about what sufferers can do to prevent or treat the symptoms.

34

The Cause Dr. Murthy says genetics plays a big role for the millions suffering with allergies. “We can’t do anything to change that. This just means those ‘lucky’ people inherited sensitivity to some otherwise harmless substance.”

He says the body’s immune system normally defends individuals from harmful substances such as viruses and bacteria. In the genetically predisposed individuals, the immune system identifies harmless substances such as pollen, foods, or animal dander as dangerous and mounts an inflammatory reaction to rid the body of these invaders or allergens. This inflammatory reaction produces the symptoms of sneezing, nasal stuffiness, watery nasal discharge and eye irritation.

Dr. Murthy says different parts of the country have unique conditions that cause allergic reactions at certain times of the year. “For the population of allergy sufferers in the Rocky Mountain region, it can be a year round battle,” he says.

By connie hein

In early spring, allergies are brought on by the pollination of the huge variety of native trees.

In late spring and summer, the grass and flower pollen is carried by bees and blown around by the summer breezes. In fall, allergies are most often triggered by the pollen from weeds and drying leaves. In winter, allergies can be caused by dust, our dry Colorado air, secondhand smoke, and pet dander inside our homes.

Controlling the Symptoms

Dr. Murthy says since these seasonal related conditions cannot be changed, allergy sufferers must do what is necessary to control the symptoms.

“Strictly speaking, allergy is not ‘cured’ but only kept under control so that it does not produce symptoms,” Dr. Murthy says.

He has given us several suggestions to relieve and control symptoms, but says avoidance or prevention should always come first. This means identifying triggers for allergic reactions, then avoiding these

Lydia’s STYLE Magazine

triggers and conditions. Following these tips could alleviate many allergy symptoms: •

Avoid combing animals inside the house and keep them out of the bedroom.

•

Use air conditioning in the summer and keep doors and windows closed.

•

Do not do yard work early in the morning in spring, summer or fall, because the pollen count is higher during these times.

•

Keep a good quality HEPA filter on both furnaces and air conditioners.

•

Keep home humidity at 35 to 40 percent in the winter with the use of humidifiers.

•

Avoid secondhand smoke at home or in enclosed areas.

He says although prevention should always come first, medication or other treatments may be necessary if symptoms persist or allergen exposure is unavoidable.

Treatments

Allergies are most commonly treated with antihistamines, decongestants and nasal sprays.

Dr. Murthy says over the counter medications may be tried first, and if they are not affective doctors can prescribe stronger medications.

Nasal saline irrigation is an important aspect of treatment of allergies. Use a solution of 8 oz. of warm water, ½ teaspoon of sea salt or noniodized salt and a pinch of baking soda in a bulb syringe.

Leaning over the sink, spray little puffs in each direction, hitting every aspect of the nose. Use all of the solution in the bulb syringe. Repeat on the other side of the nose. When finished with the washes, gently blow your nose.

For patients that are having little relief with medication or treatments, allergy shots, or immunotherapy, is a vaccination program that can reduce an individual’s reactions to an allergic substance.

Immunotherapy works like a vaccination. By injecting small amounts of a purified allergen, the body produces protective antibodies and prevents or reduces the allergic response. Beginning with small doses, the body gradually builds up immunity until a maintenance dose is reached. Immunotherapy generally lasts three to five years or longer and may greatly reduce or eliminate symptoms.

To determine which treatment is most affective and what type of allergens a patient may be reacting to, the staff at NCAAC takes a comprehensive history along with a nose and eye examination and skin testing to decide on treatment options.

Even though allergic reactions are seldom life threatening, says Dr. Murthy, they can have a negative effect on a person’s quality of life that could lead to more serious conditions such as sinusitis, nasal polyps or asthma. “Our goal is to help our patients enjoy active lives with as few symptoms as possible, indoors and out.”

So bring on the spring in Colorado with all the budding trees and flowers. Allergy sufferers now have the tools to enjoy every warm, sunny moment and that’s nothing to sneeze at.

Connie Hein is a freelance writer living in Windsor and enjoying everything that spring in Colorado brings!

Northern Colorado Medical & Wellness 2011

35

MEDICAL

New Frontiers

D isease D etecti o n

with Saliva Testing

By Kay Rios

T

he mouth holds many secrets, both figuratively and literally. With recent research on saliva testing, medical professionals are encouraged to probe deeper into those secrets and the mouth/body connection.

It’s now common knowledge that oral health can impact the health of the body. Periodontal disease, a chronic inflammatory disease, has been linked to other serious health risks such as osteoporosis, heart disease, stroke, diabetes, pregnancy problems and respiratory disease.

Both clinicians and researchers have used saliva testing in assessing digitalis toxicity, celiac disease, liver function and immunodeficiency, and that has and continues to be the predominate use. Saliva as a diagnostic tool and predictor of health risks is not widely used throughout the medical community at this point. However, with growing favorable research, it’s just a matter

36

of time, says Shelby L. Kahl, registered dental hygienist in Windsor.

“Our traditional oral medicine is so accustomed to diagnosing symptoms, we rarely look at the causal effects,” says Kahl. “We are just beginning to look at that bigger picture and rely on other diagnostic methods to help us understand why a patient presents in a particular way.”

Saliva testing is a means for understanding a number of things that occur in the body, she says. “Having detailed information about the bacteria present in someone’s mouth and the genetic risks can provide valuable information about that person’s oral health, and we know that oral health can impact overall health.”

Saliva plays a critical role in maintaining optimal oral health and creating an appropriate ecologic balance. Saliva’s function includes lubrication and protection of oral tissues, buffering action, maintenance of tooth integrity,

With periodontal disease linked to other serious health risks such as osteoporosis, heart disease, stroke, diabetes, pregnancy problems and respiratory disease, saliva testing may become a valuable tool to diagnose and predict these risks.

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Shelby L. Kahl offers saliva testing at her Windsor practice.

antibacterial activity, and taste and digestion.

And there are many ways to use saliva for understanding a patient’s state of health. A saliva test developed in 2005 by a University of Southern California School of Dentistry team can predict whether children will get cavities, the number of cavities and which teeth are most vulnerable. The Caries Assessment and Risk Evaluation (CARE) test measures the relative proportions of oligosaccharides (sugar chains) in saliva; these are the same sugar chains present on tooth surfaces. The USC test suggests that genes may play a greater role in tooth decay than in the past since malnutrition and negligent oral health are more rare in developed countries. That suggests that the gene is the prime determinant of future dental health.

Today, Caries Management by Risk Assessment (CAMBRA) protocol is commonly used and includes pH and bacteria testing, which helps to establish the risk factors for cavities. The saliva provides the information that can be assessed through this protocol.

Tests that are currently available help the dental professional determine viscosity, flow rate, resting pH, stimulated pH, and buffering capacity of a patient’s saliva. With that information, an individualized treatment plan can be created,

38

Lydia’s STYLE Magazine

ensuring more successful caries (cavity) prevention.

“Saliva testing is not new, and we are entering into our second decade of it,” Kahl says. “In the mid 80s, Joyce Jenzano, a dental hygienist working on her masters at the University of North Carolina, Chapel Hill, figured out how to determine breast cancer risk by testing saliva. She used saliva to detect tumors that were remote from the oral cavity and she discovered there were many cancer antigens that could be found in saliva.”

There are several tests available, Kahl says.

“There’s a pathogen test, an oral HPV test, and a test for genetic inflammatory markers. There is a genetic code for inflammatory markers and pathogens in your body. The genetic test identifies individual genetic susceptibility to periodontal disease and that then establishes the patient’s increased risk for an exaggerated immune response.”

Saliva testing is patient-friendly. It is non-invasive, Kahl says. “You don’t need a needle, tube, or scope to collect the sample. It’s easy to store and ship. You can actually store samples for up to a week before the genetic coding starts changing.”

There’s a lot to be learned from saliva’s properties. Aside from the caries detection potential, saliva can be used to determine if oral HPV infection is present. There are many different strains of HPV and the health risk depends on the type of virus.

While low risk viruses may cause skin lesions such as warts, high-risk types may cause an infection that could lead to cancer. For example, medical research shows that certain of the high-risk types are linked to approximately 90 percent of cervical cancers. Along with smoking and alcohol consumption, specific types of oral HPV are considered to be serious risk factors for developing cancer in the head and neck.

Testing can also be used to determine adrenal stress. Saliva samples can evaluate stress response, blood sugar control, stress adaptation, toll on immunity, adrenal reserve and grain intolerance. Salivary cortisol measurement is a practical approach to assessing pituitary adrenal function, according to studies reviewed by Diagnos-Techs, Inc out of Kent, Washington. The review also says that saliva is a useful diagnostic tool for measuring steroid hormones.

Kahl, who provides oral cancer screenings at the 9Health Fair each year and has run a school based program in Weld County, District 6 for 10 years, believes that saliva’s many possibilities will be used more in the future. “The technology is there, but it needs to become more mainstream.

It’s really just a matter of using the information with individual patients.”

Kay Rios, Ph.D., is a freelance writer in Fort Collins.

She writes for a variety of publications and is at work on a collection of creative non-fiction and a mystery novel.

Northern Colorado Medical & Wellness 2011

39

MEDICAL

New Frontiers

B o tox

S o luti o ns

Medical & Cosmetic

M

any of us have preconceived notions about Botox. It represents the new fountain of youth, and while some are still skeptical, others have made it part of their beauty regimen. The uses for Botox go far beyond cosmetic, however, and people are finding relief from many different ailments that are far more serious than wrinkles.

The medical community has been using Botox in 80 countries for over 20 years, and the active ingredient in Botox, the botulinum toxin, has been studied for over 100 years. The drug works by blocking the release of neurotransmitters from the nerve to the muscle. It takes several days to start working, and in most applications, both medical and cosmetic, it lasts approximately three to four months.

In Northern Colorado the drug is being used for cosmetic purposes as well as the various Federal and Drug Administration (FDA) approved medical treatments. Chet E. Reistad, M.D., of Eye Center of Northern

40

Colorado, performs plastic and reconstructive surgery of the eyelids, orbit and lacrimal system. After Dr. Reistad completed his residency, he went on to complete a two-year specialized training program approved by the American Society of Ophthalmic Plastic and Reconstructive Surgery.

Dr. Reistad had been using Botox since his residency at Yale University. “Botox was first used by an ophthalmologist in the 80s,” he explains. “It was used for eye muscle imbalances that caused double vision.

Physicians then started using it for muscle spasms, and then it was eventually approved for cosmetic use.”

In the 1950s, scientists discovered that botulinum toxin could reduce muscle spasms, and for the next two decades scientists studied the toxin as a treatment for strabismus, or crossed-eyes. In the late 1980s, Allergan, Inc., a multi-specialty healthcare and pharmaceutical company, began researching other medical uses for the toxin.

Botox is Allergan’s commercial name for botulinum toxin. In 1989, the FDA approved Botox as a treatment for blepharospasm (eye spasms) and strabismus. Eleven

Dr. Timothy Allen treats a variety of medical conditions with Botox including migraines.

By Heidi Kerr-Schlaefer

years later the FDA approved the drug for the treatment of cervical dystonia, a neurological movement disorder of the neck muscles.

“Some people have an uncontrollable squeezing or blinking of both eyes simultaneously,” says Dr. Reistad.

“That’s a condition called blepharospasm.” The cause of this disorder is unknown, but it is debilitating for the chronic sufferer. Neurologic medicine sometimes relieves these spasms, but Botox can also be used to ameliorate or alleviate the spasms.

Dr. Reistad also uses Botox for those who suffer from hemifacial spasms. These occur on either the left or right side of the face and involve spasms of the eyebrow, eyelid, and even the cheek and nose.

“Patients with hemifacial spasm need to be evaluated with imaging studies of the brain to make sure there’s not a tumor or vascular lesion causing irritation of the facial nerve, causing it to fire abnormally – which can be a cause of hemifacial spasm,” advises Dr. Reistad.

“After those diagnoses are ruled out, patients can either use oral medications prescribed by a neurologist or they can choose to have Botox injections to reduce

Lydia’s STYLE Magazine

Dr. Warren Schutte uses Botox at his practice for cosmetic purposes and chronic underarm sweating.

these spasms.”

The results have been good, as evidenced by Dr. Reistad’s patients returning again and again to receive these medical Botox injections. Unlike cosmetic Botox, insurance companies may cover these types of injections for spasm disorders.

In 2002, Botox was approved for what became the most well known use for the drug, cosmetic applications to smooth wrinkles. Two years later, a lesserknown use for the drug was approved when Botox became an option for those who suffer from chronic underarm sweating.

Warren Schutte, M.D., from Front Range Plastic & Reconstructive Surgery, finds many uses for Botox in his Loveland clinic. Hyperhidrosis is a medical condition causing a person to sweat excessively, even in cool temperatures. The sweating can occur all over their body, but mostly under arms and palms, and it can be an embarrassing condition.

“I don’t particularly like using it for hand sweating because I don’t think it is as effective, but for hyperhidrosis of the axilla, or armpit, it works fantastic,”

Northern Colorado Medical & Wellness 2011

41

says Dr. Schutte.

The office-based procedure is relatively fast and easy.

The Botox is injected directly into the sweat glands under the arms and stops the glands from overproduction.

The number of injections is patient dependent, and the drug prevents over sweating for approximately three to four months.

Dr. Schutte performs this procedure on patients who wish to prevent sweating for a special occasion – for instance, a woman who doesn’t want to sweat in her wedding dress.

Recently, Botox was approved as a therapy for increased muscle stiffness in elbow, wrist and finger muscles with upper limb spasticity. This past fall, the FDA approved Botox for use on people who endure severe migraines.

“We use Botox for everything from what it was originally approved for, which is eyelid and facial tics and spasms, dystonia and excessive sweating, to limb spasticity occurring from MS or traumatic brain injuries, and intractable migraine,” says Timothy Allen, M.D., at Fort Collins Neurology.

The relief from the injections lasts approximately the same length of time as other medical and cosmetic uses of Botox, although Dr. Allen has some patients who only have to be injected once a year. “I have one patient I only see about once every two years.”

He has found Botox to be effective in managing painful back spasms and preventing muscle contractures.

The longer a patient suffers from a spastic limb, as in the case of a stroke or brain injury, the more likely it will be that they develop muscle contractures that prevent them from using the limb at all. Nearly every Botox procedure in Dr. Allen’s office is covered by insurance.

Today, patients who suffer from severe migraine headaches can find relief from Botox. “It works well in certain patients, but it’s not for every single migraine,” explains Dr. Allen. “Right now it’s a very, very small part of our practice.” In fact, in order for a patient to be a candidate for these injections, they must have 15 or more migraine headaches per month lasting more than four hours and must have failed other, more conservative treatments.

Today, Botox represents $1.3 billion in sales for

42

Lydia’s STYLE Magazine

Dr. Chet Reistad uses Botox for a variety of medical and cosmetic applications including eyelid spasms.

Allergan, a company that made $4.4 billion in 2009.

Half of the $1.3 billion in Botox sales comes from the cosmetic industry. Younger and younger women are opting to use the drug to smooth their faces and to prevent wrinkles from occurring.

Dr. Reistad, who performs both medical and cosmetic Botox injections, explains there are two types of wrinkles – dynamic and static. Dynamic wrinkles are formed when the muscles move during facial expressions, and they tend to form around the mouth and between the eyes. Botox treats this by blocking the action of the muscle. Static wrinkles are the deeper creases and lines present when the face is at rest.

“In younger people who are just starting to notice fine lines, when Botox is placed appropriately, we can prevent those fine lines from becoming so deep,” says Dr. Schutte. “My goal with Botox is to soften deep lines and wrinkles while preserving my patients’ ability to express normal facial animation.”

There are still misperceptions about Botox, mostly fueled by horror stories in the media, but much of the bad press surrounding the drug often involves knock-off products being used by nonprofessionals. The consensus among Northern Colorado doctors using Botox in their practices is that the drug, when used properly, is safe.

In a recent New York Times interview of Dr. Scott M. Whitecup, executive vice president for research and development at Allergan, the doctor predicted that in the next five years the therapeutic uses of Botox will surpass its cosmetic uses.

While the drug was recently approved for migraine headaches, research on the use of Botox for headaches continues. It’s also being studied for managing overactive bladder. It is reportedly one of the most widely researched medications in the world, and there are approximately 2,100 publications on the drug with many more to come.

As long as Allergan can smooth out any potential wrinkles through careful research, it looks like Botox has a bright future.

Heidi Kerr-Schlaefer is a journalist and freelance writer from Northern Colorado. She is also the Mayor of www.HeidiTown.com, a blog about Colorado events and festivals.

Northern Colorado Medical & Wellness 2011

43

wellness

Med Spa

Lunchtime Face Lift

By ANGELINE GRENZ

W

ant that fresh, youthful look without the investment – both monetarily and timewise – of a traditional face lift? Got an hour or two over lunch? Then a liquid face lift might just be what you are looking for.

Liquid face lifts are non-invasive procedures that are optimal for people who don’t want to go through a face lift surgery, but are looking for wrinkle reduction and a more rested look.

Liquid face lifts work by using a derma filler such as Juvederm, Restylane or Perlane to fill in and contour areas of the face where the skin may have lost some of its collagen and elastin, and therefore some of its fullness, from the natural aging process.

“A liquid face lift can give you a rested, softer look,” says Jeannie Gordon, RN, who performs liquid face lifts at Xanadu Med Spa in Fort Collins. Gordon says the most common features

44

that are requested are the nasal labial fold (our “laugh lines”), around the corners of the mouth, and around the chin.

“As you age, you lose volume in the face,” explains Jeffery Raval, M.D., owner of Raval Facial Aesthetics in Cherry Creek, who trained Gordon on the procedure. “Liquid face lifts can add volume back into the face, enabling you to hold off on a traditional face lift.” He adds that the median age for a surgical face lift used to be around 50 years old. With preventative techniques from liquid face lifts, that age can be pushed back as much as 10 years.

The derma filler gel used is made from hyaluronic acid, a natural substance found in the skin that helps aid in skin volume and hydration.

Lidocaine is added to the filler to minimize pain.

The procedure also works well when combined with Botox. Botox numbs muscles and reduces the appearance of lines. “Botox works well for the upper third of the face, but it doesn’t always work well alone in one area,”

says Dr. Raval. Derma filler can be used along with Botox to smooth out the deeper wrinkles near the eyes.

Botox can also work to extend the life of a liquid face lift, says Dr. Raval. “Filler decreases over time because of movement in the face.”

Botox can arrest some of this movement.

Most liquid face lift procedures last about an hour, says Dr. Raval, but duration generally depends on the individual. Those with a higher pain tolerance can have their procedure completed in 30 minutes, using only the numbing solution found in the derma filler. For those with a weaker pain tolerance, a localized anesthetic gel is applied to the face to numb the area, adding an hour onto the procedure time.

Once the procedure is complete, you can return to work with little side effects beyond some bruising and swelling. Swelling will disappear over the first two weeks. Recovery, says Gordon, depends on the person, but most can see the results immediately; Botox generally takes two weeks before it takes effect. Occasionally, the solution can settle and cause bumps under the skin. However, it is moldable for up to two weeks, according to Gordon, and bumps can be smoothed out with simple pressure from the fingertips.

The results from a liquid face lift last for up to one year or even a year and a half, says Dr. Raval, though the effect diminishes over time and you may want to come in for additional filler sometime before the year is up. Botox generally lasts for about three to four months.

Liquid face lifts work well for women in their mid-30s and older, and Gordon sees a variety of ages at Xanadu. Dr. Raval recommends the liquid face lift as a great preventative that can hold off more invasive procedures. However, he says that there are certain things only a surgical face lift can accomplish, such as getting rid of jowls and sagging neck skin.

The procedure also works well to contour and balance out certain facial features, such as one Xanadu client who had a natural indentation in her forehead and another who wanted her pointy chin rounded. It does not, however, work well over tough scar tissue.

Dr. Raval encourages women to consider the liquid face lift as part of an overall beauty regimen that includes other techniques, such as lasers and skin peels. But he cautions that women must also have realistic expectations.

“Do not expect to look 30 when you are 45.

But we can make you look really good at 45,” he says, adding that a realistic expectation is a look that is five to eight years younger than your natural age.

Xanadu is currently the only med spa in Northern Colorado that specializes in the liquid face lift, according to Christian Noni, marketing coordinator at Xanadu. In addition to a wide range of cosmetic procedures, skin care and massage, Xanadu now offers spa parties, where you can receive up to 50 percent off of products and services. For more information about Xanadu, call (970) 482-1889 or visit www.xanadumedspa.com.

Angeline Grenz is editor for Style Magazine.

Lydia’s STYLE Magazine

Christopher Bee, MD

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We are medical directors & pathologists of the clinical laboratories at Poudre Valley Hospital, Medical Center of the Rockies, McKee Medical Center and North Colorado Medical Center.

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walk to better health

Hey, can you keep a secret? Regular, brisk walking can be just as effective exercise as running or lifting weights. Walking helps people lose weight, reduce their risk of heart attacks and improve cardiac health, increase bone strength, and lift their moods.

It’s accessible to almost everyone – and if the weather’s good, the only investment you need is a decent pair of shoes.

Walking can help you lower bad cholesterol, raise good cholesterol, lower blood pressure, reduce your risk of or help manage type 2 diabetes, manage your weight, and help you stay strong and fit. Walking can even help reduce the risk of heart attack by the same amount as vigorous exercise, such as jogging, according to the Mayo Clinic.

Other studies have found that walking can reduce body fat, strengthen the immune system, prevent colon cancer – all without the stress on your joints that high impact exercise may cause.

How to Get Started • Start your walking workout with comfortable walking shoes with arch support, thick soles and a firm heel. Try them out in the store before you buy to make sure they fit well. Dress in loose, breathable fabrics and during cooler weather dress in layers for protection and comfort.

• Warm up your walking routine with about five minutes of slow walking that will wake up your muscles. Gradually increase your pace until you begin to feel your body heat rise. A good rule of thumb – you should be able to carry on a conversation while you are walking; if you cannot, you are walking too fast.

• When walking, keep your shoulders back and engage your abdominal muscles – in

46

other words, walk tall. Swing your arms loosely at your sides. Land on you heel then roll off the ball of your foot. Take long, easy strides and deep breaths, especially as your pace quickens. Add hills or weights for an additional challenge.

• Repeat the five minutes of slow walking at the end of your brisk walk as a cool down.

Stretch your calves, hamstrings and do a good side stretch.

• If you are taking up a walking routine for the first time, start slowly. Gradually build up to between 30 to 60 minutes of brisk walking at least five days a week. A rough guide is that walking one mile can burn about 100 calories (based on a 150-pound male). That translates into 10 pounds of weight loss per year for a simple 15-minute walk every day.

• If you are having difficulty finding the time to walk for a solid 30 minutes, invest in a pedometer that can track your steps.

Roughly speaking, 10,000 steps a day equals 30 minutes of walking. If you are walking indoors on a treadmill, set the elevation to one percent to best mimic outdoor walking.

• Vary your routine to stay interested and engaged. Try one of the great trails through the towns of Loveland and Fort Collins or venture out onto groomed open space trails and enjoy the natural beauty of Northern Colorado.

M ega N utrient :

Omega 3 Under the sea may not be a land of musical mermaids and crustaceans, but there are a few creatures that can make our bodies sing. Fatty fish contain omega-3, a nutrient that has become increasingly popular in recent years. Set aside a minute to dive into this trend.

According to a 2010 ConsumerLab.com survey, fish oil is the most popular supplement in the U.S. And with good cause – omega-3 fatty acids found in fish oil promote brain and heart health, and may have general anti-inflammatory properties that help joints and the immune system.

While the American Heart Association and other health organizations recommend that Americans increase their intake of omega-3s, they recommend avoiding supplements and eating foods high in unsaturated fats (which includes omega-3s).

The best foods for omega-3 intake are fatty fish, especially salmon, herring, and tuna, but there are also good non-meat sources like flaxseed, walnuts and soybeans. Sardines, anchovies, and avocadoes also have some omega-3. If you eat canned tuna, choose water-packed rather than oil-packed, as oil can absorb omega-3s, which are then drained away.

Another major benefit of omega-3s is their ability to balance with omega-6, a group of fatty acids that helps blood clot and lowers cholesterol.

However, omega-6 may also promote inflammation, which omega-3 is needed to counteract.

According to experts, a ratio of 4 parts omega-3 to 1 part omega-6 is optimal. Omega-6 is found in foods such as eggs, poultry, cereals, and margarine.

The American Heart Association also recommends eating two servings of fish high in omega-3s every week. If you’ve stayed away from fish for fear of mercury poisoning, not to worry – a serving of fish is 4 ounces, and the FDA says 12 ounces a week is safe for everyone, even small children and pregnant women.

The primary benefit of omega-3 comes from DHA, also found in eggs and organ meats like liver.

DHA is an important pre- and post-natal nutrient for babies’ brain development, and it may also help protect the brains of older people from age-related dementia. The role it plays in heart health is helping to raise HDL – the good cholesterol – and lower blood pressure. EPA, another omega-3, is also found in fish and aids DHA. However, ALA, the omega-3 found in vegetarian sources, is not as helpful. Our bodies don’t use AHA as efficiently as DHA or EPA, which may put people who don’t eat fish at a nutritional disadvantage. In this case, fish oil supplements may provide some benefit. Daily supplements of 1 gram of omega-3s may also help those suffering with heart disease.

But, for the general population, food should come before supplements.

The next time you’re planning a meal, consider the underwater delight of fish and the omega-3s they provide. They’ll help you move through life swimmingly.

If you have health concerns, consult your doctor about your routine and buy a heart rate monitor to track the intensity of your workout. Walking can be a great, simple way to invest in your health and ease you into the multitude of health benefits that a regular exercise routine provides.

Lydia’s STYLE Magazine

Get Fit, Give Back Calendar Many of these great events donate a portion of their proceeds to local and national non-profits. So get off the couch, strap on your tennis shoes and get out there for a worthy cause.

March 5 – Tubbs Romp to Stomp Out Breast Cancer Snowshoe Series, 7:30 a.m., Frisco Nordic Center, Frisco, benefitting Susan G. Komen for the Cure, www.tubbsromptostomp.com

Don’t just sign up for a walk. Join a movement.

Medical research, community services, health education, advocacy. March for Babies funds great March of Dimes programs in our community that serve all babies, like those who need help to survive and thrive. It’s easy, fun and rewarding to participate. Join with the March of Dimes and let’s walk together for stronger, healthier babies.

The March of Dimes’ March for Babies is an annual event taking place across the U.S. The march is a one-day, 5-mile course along trails and sidewalks. Help babies and their moms by walking in support of programs and research to save pre-term babies and prevent pre-term births.

12 – Sharin’ O’ the Green 5k Run/Walk, 8 a.m., Library Park, Fort Collins, benefitting Partners Mentoring Youth, www.partnersmentoringyouth. org/Events.aspx

April 2 – Poudre River 5k Classic, 9:30 a.m., Cache La Poudre Middle School, La Porte, www.poudreriverrun.com 9 – Third Annual Journey Quest 5k Run/Walk, 7 a.m., Fort Collins Club, Fort Collins, benefitting the Shared Journeys Brain Injury Foundation, www.sharedjourneysfoundation.org/events.htm 10 – Flying Pig 5k Charity Walk/Run, 8:30 a.m., Spring Canyon Park, Fort Collins, benefitting families in the Family Support Service Program at Foothills Gateway, www.runningguru.com 16 – Arbor Day 5k Run/Walk, 7 a.m., Boardwalk Park, Windsor, proceeds will go to planting trees in the city, www.ci.windsor.co.us/CurrentEvents. aspx 17 – Horsetooth Half Marathon, 8:30 a.m., Hughes Stadium, Fort Collins, www.horsetoothhalfmarathon.com

Saturday, April 30

Greeley – Bittersweet Park, 8:30 a.m. registration, 9 a.m. start Larimer County – Edora Park in Fort Collins, 8 a.m. registration, 9 a.m. start Sign up early online at www.marchforbabies.org or call (303) 692-0011 to learn more.

23 – Fast and the Furriest 5k, 9 a.m., CSU Oval Fort Collins, benefitting the CSU Veterinary Teaching Hospital’s Companion Care Fund 30 – Sierra’s Race Against Meningitis, 9 a.m., Crossroads Church, Loveland, benefitting Sierra’s Race Against Meningitis, www.sierrasraceagainstmeningitis.com 30 - March for Babies, 9 a.m., Edora Park, Fort Collins, www.marchforbabies.org 30 - March for Babies, 9 a.m., Bittersweet Park, Greeley, www.marchforbabies.org

May 1 – Colorado Marathon, 6:15 a.m., Poudre Canyon, Fort Collins, benefitting a number of charities including Friends of the Poudre and Larimer County Boys and Girls Club, www.thecoloradomarathon.com 7 – Cinco-Cinco 5k Run/Walk, 8:30 a.m., CSU Oval, Fort Collins, benefitting The Gil Gutierrez Memorial Scholarship, www.cincocinco.colostate.edu

Northern Colorado Medical & Wellness 2011

7 – Walk MS, 7:30 a.m., Edora Park, Fort Collins, benefitting the Colorado-Wyoming Chapter of the Multiple Sclerosis Society, www.walkmscolorado.org 7 – Walk MS, 7:30 a.m., Chapungu Sculpture Park, Loveland, benefitting the Colorado-Wyoming Chapter of the Multiple Sclerosis Society, www.walkmscolorado.org 8 – Crazy Leg’s 10k and Trail Run, 7 a.m., Devil’s Backbone Open Space, west of Loveland, www. paulstofko.com 15 – Community Classic Bike Tour, 6:30 a.m., McKee Medical Center, Loveland, benefitting the Stepping Stones Adult Day Program at McKee, www.mckeefoundation.com

15 – FC Triathlon/Duathlon, 7 a.m., EPIC, Fort Collins, www.timberlinetiming.com 21 – Family Medical Clinic Fit Family 5 Mile, 8:30 a.m., Stanley Park, Estes Park, benefitting Families for Estes and Lifelong Learning of Estes Valley, www.fitfamily5mile.org 22 – Lory State Park Trail Race, 9 a.m., Lory State Park, Fort Collins, www.runnersroostfortcollins. com 22 – RAM Bicycle Classic, 6:30 a.m., CSU, Fort Collins, benefitting CSU’s Global Social & Sustainable Enterprise Master’s Program, www. rambicycleclassic.org 28 – Pelican Fest Triathlon, 8 a.m., Windsor Lake, Windsor, www.pelicanfesttriathlon.com

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wellness

Chiropractic

I nn ovati ve , I ntegrated T reatment

Benefits Patients

O

nce upon a time, not so long gone, medical doctors and chiropractors were often conflicted about treatment types.

That adversarial mindset is changing. Michael Farrell, D.C., says that members of both are willing to join forces.

That’s good news for patients.

When Dr. Farrell and April Cardwell, D.C., founded Spine Correction Center of the Rockies in July 2007, it was a typical chiropractic and physical therapy office. But in October 2010, the facility became fully integrated when Tamara Johnson, M.D., and Jean H. Fitch, F.N.P., joined the practice. These new team members bring diverse backgrounds to the enhanced model.

Fitch, for example, has worked in clinical situations ranging from Vietnam to college campuses.

The innovative D.C. and M.D. combination

48

By Marty Metzger

provides patients a broad scope of care options not generally offered together in Northern Colorado. The consolidated office’s workings are convenient and beneficial for people battling a plethora of musculoskeletal disorders including carpal tunnel syndrome, disc dysfunctions, scoliosis, migraine headaches, dizziness and low back pain.

Spine Correction Center of the Rockies uses a global approach in looking at the patient’s overall condition. Traditional diagnostic tools are utilized to identify the cause of the patient’s presenting medical condition. Once identified, a specific program is prescribed and a clinical team approach is used to ensure the resolution of the patient’s condition. It is a functional medicine approach to musculoskeletal disorders that is bringing about long term change beyond just pain reduction.

Spine Correction Center of the Rockies is

certified by the CLEAR Institute as a Scoliosis Regional Treatment Center. This designation draws patients from Arizona, New Mexico, Utah, California, Idaho, Wyoming, Kansas, Nebraska and South Dakota. The clinic is also reaching patients from across the world, ranging from the Middle East to Australia. These patients receive intense therapies over a 1-2 week period.

“Clinically, results since last October are better than before the integration,” Dr. Farrell says.

Katrina Brossia thoroughly agrees with his favorable assessment. The 41-year-old sales representative was initially diagnosed with scoliosis at age 13. Her spinal curve at the time was 23 degrees and wasn’t then severe enough to warrant surgery or use of a brace, the only viable remedies in that era.

Over the years, Brossia’s curve worsened by 10 degrees. Pregnancy and job duties (16 hours of travel per week and carrying heavy samples)

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49

had taken their toll. Research shows that adolescent idiopathic scoliosis like Brossia’s increases on average 3-5 degrees per year after skeletal maturity.

About 1.5 years ago, after reading a Northern Colorado Medical & Wellness Magazine article (May 2009) about non-invasive scoliosis treatment available at Spine Correction Center, Brossia sought their help. Even though Brossia had few options when diagnosed over 20 years ago, she was very excited to learn of the new options for treating her scoliosis and for dealing with her pain. She never knew this type of treatment existed until she contacted Spine Correction Center.

Since November 2010, eight injections administered by Fitch, coupled with CLEAR protocol treatments by Dr. Cardwell and the spinal technicians have produced excellent results. Brossia explains injections decrease the inflammation in and around muscles, also called trigger points, and allow the doctors to make more changes around the spine before setting the spine into a more desirable position.

The curve in Brossia’s spine has lessened from 33 degrees to the low 20s in a mere two months.

Delighted by her rapid progress, she credits integrated care for improvement in all aspects of her life. Brossia previously had believed that the pain she suffered for two days following sales trips was just a normal, to-be-expected

50

Lydia’s STYLE Magazine

Drs. April Cardwell and Michael Farrell have integrated a medical approach into their chiropractic and physical therapy practice.

occupational hazard. But now she realizes that this doesn’t have to be a part of her life and she doesn’t have to live in pain. She experiences more energy, greater flexibility and an improvement in personal relationships, such as with her husband, and says that with pain greatly diminished, she now enjoys a renewed, overall sense of well-being.

“The whole experience has been wonderful,” says Brossia. “The integrated approach to treatment is fabulous. I most definitely recommend Spine Correction Center of the Rockies. Their staff is professional, friendly and easy to get along with. They’ve truly changed my life. I really want people to know that even though they may not have had options years ago, now they have an option for treating their condition as well as getting out of pain.”

Spine Correction Center of the Rockies is located at 1101 Oakridge Dr., Ste. A, in Fort Collins. They are welcoming new patients at this time and have set aside time to consult with inquiring patients about this new integrative approach. Call (970) 226-1117 for more information or visit their website at www.spinecorrectioncenter.com.

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Northern Colorado Medical & Wellness 2011

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veterinary

guide

Service Dogs

d o gs

f o r the blind

By Heidi Kerr-Schlaefer

H

aving sight is something we take for granted, but for the 25.2 million Americans who are visually impaired, sight is a precious gift.

With a guide dog beside them, they are able to “see” the world like never before. These amazing dogs help a person lead a full and active life, and it all starts with a special puppy.

Lois Merrihew and Don Donaldson of California formed Guide Dogs for the Blind in 1942. The two saw a need to help wounded servicemen who had been blinded during World War II. One of the first guide dogs they trained was a German Shepherd that had been rescued from the pound. The organization is now located in California and Oregon, and has a specialized breeding program in place to breed dogs with the right temperament and intelligence to be a guide dog. Today, they only use Labrador Retrievers and occasionally Labrador

52

and Golden Retriever mixes.

When the puppies are eight to 12 weeks old they are shipped to various raisers around the western part of the United States, including Northern Colorado. The dogs stay with the raisers for the first year and then return to Oregon for what could be called a college for dogs.

In October 2010, a black Lab puppy named Prima arrived in Colorado. She came with a 250-page manual and high expectations. She was delivered via truck to Sam Cluett, age 13, and his mother Jennifer. While the Cluetts met Prima, other raisers were dropping off their one-year-old dogs to be returned to the West Coast.

The Fort Collins family made the decision to become raisers for Guide Dogs for the Blind after having spent time with a guide dog owned by a family friend. Jennifer Cluett thought it would be a good activity for her son, and the program encourages children to be raisers.

The family started attending The Larimer Club,

led by Guide Dogs for the Blind volunteer Fred Sprague. The club is comprised of the 12 raisers.

The Cluetts submitted to a home check, and they had to dog sit for a raiser several times in order to see if raising a guide dog puppy was right for them.

Today, Prima attends school with Jennifer, who teaches at Berthoud High School, and with Sam, who attends Polaris Expeditionary Learning School in Fort Collins. “His principal was absolutely fantastic.

As long as Prima was potty trained and wouldn’t be too much of a distraction, the school was okay with it,” said Jennifer. By spring, Prima will be with Sam at Polaris ELS every day.

The Cluett family already had three dogs, something the program prefers, but Prima can’t be treated like just another pet. She must be raised in a specific manner using regulated methods, and she can only play with approved toys. The raiser’s job is to socialize the puppy and to teach it a variety of orders, including urinating on command. There are specific reasons for each and every command,

Lydia’s STYLE Magazine

however odd it may seem to a sighted dog owner.

Next fall, Sam and his family will have to say goodbye to Prima. “It will be hard, there’s no doubt about that,” says Jennifer. “But on the day we got Prima, Sam saw people putting dogs back on the truck, so he knows what is coming.”

The family considers Prima a project, not a pet, although attachment is inevitable. Ultimately, the Cluetts find inspiration in the knowledge that they are part of something bigger than them; someday, the dog they helped train will be the eyes for someone who is visually impaired.

When Prima returns to the West Coast, she will enter an intense training regimen before being paired with a visually impaired person. The two will train together for another four weeks before graduation.

Eventually Prima will end up with a family like the Utters of Fort Collins. Kevin and Valerie Utter met as teenagers while attending a camp for the blind in Wyoming. “Of course, we like to tell people we met on a blind date,” jokes Valerie, sitting in her home with her guide dog, Fathom, curled at her feet.

The two kept in touch through college, and in 1989 they married. Kevin and Valerie’s blindness hasn’t held them back from living full lives. Kevin, who has a M.A. in music, is a church organist, while Valerie is a homemaker running a home-based health and wellness business. They have three children and four dogs, including two from Guide Dogs for the Blind.

Valerie got her first guide dog while attending college in Seattle, Washington, but the couple lived without them for a long time. Around nine years ago, frustrated with constantly changing bus schedules and continuous construction around their neighborhood, they felt having a guide dog would make it easier to work around these obstacles.

Kevin was nervous; after all, he’d lived his entire life with only a cane and his own good instincts. “I was always a little leery about trusting myself to a dog or any living creature other than a person,” says Kevin. “When I got my dog, that first day walking with the dog was just incredible.”

Kevin describes life with a guide dog as “less awkward.” He recalls walking through the mall and hitting kiosks or other objects with his cane as he walked. “Now with my dog, I don’t even know they are there; I just waltz around them.”

Before getting his first dog, Kevin was reluctant to go out on a windy day. He explains that walking in the wind for a blind person is like a sighted person walking in a thick fog. “It messes up our hearing,” he says. Today, thanks to his dog, Kevin has no difficulty navigating in the wind.

While Kevin found he was faster and more confident with a guide dog, Valerie found walking with canine assistance to be less stressful. “There was always that question and anticipating of what your cane was going to hit,” explains Valerie. For her, having the dog has made walking smoother and less nerve-racking.

The couple’s first two guide dogs have since retired, and they now have Fathom, a male black Lab belonging to Valerie, and Bingo, a yellow male Lab who works for Kevin.

Valerie describes her dog as the icebreaker between the public and her blindness. While a cane causes anxiety in the public, a dog has the opposite effect. “When people see you using a cane, they either hopscotch over it or they run from it,” says Valerie. “Having a dog actually draws people in.”

Some guide dog owners do not like the public

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53

dogs with

jobs

By Heidi Kerr-Schlaefer

Kevin and Valerie Utter are out for a stroll with their guide dogs, Bingo and Fathom.

to pet or interact with their dogs, but Kevin and Valerie don’t mind letting people meet and pet their dogs as long as they ask first. ”I love walking in the mall and hearing all the kids saying, ‘Doggie!

Doggie!’” says Kevin. The two know their interaction with children and the public alleviates some of the discomfort people may have around the blind.

While a guide dog receives lots of training before they come to live with their owners, new situations always arise. For instance, Valerie had to train Fathom to walk her around low hanging tree limbs so she wouldn’t get hit in the face when walking by. When the tree limbs were eventually cut back, Valerie had to retrain Fathom, who had decided he would always walk Valerie around that area.

“The training is an ongoing process,” she says.

Guide Dogs for the Blind isn’t the only organization providing guide dogs for the visually impaired, but it is one of the oldest. All services provided to the blind are free, including the dogs. The organization also provides free long-term services for the people who receive their dogs, even flying in a trainer when necessary.

Barb Deevers, canine community field

54

representative for Guide Dogs for the Blind in Denver, explains that the organization is one hundred percent nonprofit and does not receive government money or grants. They receive donations from individual and corporate donors. “We even have people leave money to us in their estate,” says Deevers.

The program is always in need of donations and volunteers, such as puppy raisers and puppy sitters.

For more information, visit www.guidedogs.com.

Note: If you see a working dog in a vest, please avoid petting the dog. You can chat with the owner and ask if they mind – many will not – but it’s important never to interrupt a working dog.

Also, it’s important for sighted people to follow all leash laws. Guide dogs have been attacked by off leash dogs, and this can also be a safety issue for the dog’s owner.

Heidi Kerr-Schlaefer is a journalist and freelance writer from Northern Colorado. She is also the Mayor of HeidiTown.com, a blog about Colorado events and festivals.

Dogs have been living and working alongside humans for thousands of years and it’s little wonder why the species is called “Man’s Best Friend.” Throughout history dogs have been used for hunting, herding and protection. Today working dogs can still be found across the globe; they sniff for bombs, they rescue lost hikers, they guide the blind.

A working dog that guides the blind is a called a service dog. The Americans with Disabilities Act broadly defines a service dog as any guide dog, signal dog, or other animal individually trained to provide assistance to an individual with a disability.

Therapy dogs are not service dogs, although the two terms are often confused. A therapy dog is a family pet that has been trained to provide comfort and reduce stress. They visit nursing homes, hospitals and schools. These dogs are not recognized as service dogs under the ADA. Service dogs have been helping people since seeing-eye dogs were first trained in the United States in the 1930s. Hearing-dog training programs were established in the mid-1970s. Today, service dogs help people with many types of

Lydia’s STYLE Magazine

disabilities, both mental and physical. Dogs assist people suffering from diabetes, epilepsy, and psychiatric disorders.

There are a number of organizations in Colorado that provide service dogs. These groups are nonprofit and work to help individuals lead confident and full lives by providing dogs to assist them with daily activities that most of us take for granted. Here are some of the organizations in our state.

Freedom Service Dogs, located in Englewood, was established in 1987. They have received national attention in the past several years for their work with military veterans. Their mission is to train dogs to aid disabled military veterans. All dogs in the program are rescued from shelters.

These amazing dogs assist veterans who have become disabled during service, who have developed PTSD or other psychological trauma, or who have developed medical problems later in life after their service. Find Freedom Service Dogs online at www.freedomservicedogs.org and learn about the program from veterans whose lives have been transformed by their service dog.

Canine Partners of the Rockies is located in Denver. Their mission is to place service dogs with Coloradoans who have mobility limiting conditions. They also place therapy dogs with those individuals who work with Coloradoans with disabilities. To learn more and read stories written by recipients of service dogs from Canine Partners of the Rockies, go to www.caninepartnersoftherockies.org.

International Hearing Dogs was established in 1979, and has placed over 1,100 dogs with the hearing impaired, both nationally and internationally. Located in Henderson, Colorado, IHD obtains all their dogs from shelters and rescues.

The dogs are trained to respond to the many sounds in a home, such as the doorbell, a knock, a ringing telephone, an alarm clock, a smoke alarm, a baby crying and much more. Visit them online at www.ihdi.org.

Colorado Service Dogs is another organization training service dogs to help the disabled.

Located in Elizabeth, Colorado, their newest service is providing dogs for individuals with autism. An autism assistance dog can act as a guide, an anchor and continuous focus for a child with autism. Autistic children with an assistance dog often show greater focus and have the potential for improved learning and communication. For more information on this and other services provided by Colorado Service Dogs visit www.coservicedogs.com.

Guide Dogs of America is located in California, but provide guide dogs to the visually impaired across the country, including Colorado.

For more information on this guide dog program go to www.guidedogsofamerica.org.

Heidi Kerr-Schlaefer is a journalist and freelance writer from Northern Colorado.

Northern Colorado Medical & Wellness 2011

55

veterinary

Animal Rescue

Denkai Saves Animals

By Marty Metzger

L

ittle Sweet Pea slowly and painfully hobbled along. Neglect had caused a crippling deformity to her tiny hooves, which resembled elf feet.

X-rays would later reveal that, over time, bones had fused together inside the malformed hooves that curled up and back into ghastly, 4-inch-long curved horns. The 7-year-old, 32-inch tall miniature horse was in dire condition.

Enter Floss Blackburn, who explained to Sweet Pea’s owner the necessity of ongoing hoof care and that Sweet Pea’s need was urgent – before the damage permanently crippled the horse. At Blackburn’s urging, the diminutive sorrel’s owner surrendered the mare to her.

Restorative farrier work gradually transformed Sweet Pea from a forlorn, rocking chair-footed creature into a comfortable, happy pony – the first resident of Blackburn’s Denkai Animal Sanctuary.

56

Named for her sons Denali and Kaia, Blackburn’s fledgling facility soon housed more animals. Four months later, in May 2004, Blackburn received 501(c)(3) non-profit status. The same month, Denkai relocated from west of Ault to just outside Windsor. Subsequent moves to Nunn, then in May 2006 to Carr, eased space limitations and rental woes.

Thanks to grants and hard work by Blackburn and Denkai’s supporters, a 640-acre Grover property became the facility’s home in May 2008. No longer bursting at the seams as at previous locations, Denkai’s new digs provided room to grow. The needs were as boundless as the rescue group’s zeal.

Rejected animals of many species came in from manifold situations. Dogs and cats had been neglected, abandoned or abused. Fad animals, like pot-bellied pigs, were out-of-vogue castoffs. Some horses were saved from dreadful living conditions or starvation. Others were snatched by winning bids at auctions from kill buyers eager to add them to the more than 100,000 U.S. equines annually

slaughtered for human consumption by Europeans.

Denkai’s achievements are remarkable, its expansions impressive. The original 15 animals gained plenty of company in Grover. Then, in February 2010, the sanctuary took over a defunct Greeley dog boarding facility. An L-shaped building shares six acres with two houses, one home to a constant caretaker. Denkai is seeking to purchase the entire property, although currently using only one house and half of the kennel building. Between that space, called Denkai Adoption Center, and the Grover acreage, 250 large and small animals at any given time are safe and well-cared for.

Volunteer ranks have also swelled, from an original handful to now upwards of 1,000 spread across the U.S. (as are adopters). These charitable folks give of their time and talents in roles varying from board members to marketing personnel to elbow-greased cage and pen cleaners. Individuals volunteer, as do groups including Turning Point, Reflections for Youth and the Weld County PLIGHT Team.

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Service is a two-way street for Denkai. This reciprocation extends to Loveland area’s Reflections for Youth, where therapy includes an equine program for youth in crisis. Children learn to do ground work with, and care for, two Denkai horses stabled on-site. Blackburn heartily applauds the results.

“This program is successful in so many ways,” she says. “Boys exhibit far less violence at home since interacting with the horses. It’s a great motivation for girls, too. Some were ‘cutters,’ self-mutilating to vent fear and frustration. That destructive behavior is now curbed.”

Denkai’s agenda is adding new projects to ongoing ones, “some big ones!” Blackburn enthusiastically reports.

A positive reinforcement training program for dogs is designed to amend antisocial behaviors. This gentle attitude adjustment will increase chances for adoption or ensure an animal can successfully stay with its owner. Because of a grant from The Colorado Pet Over-Population Fund, subsidized spay or neuter surgeries are available. Denkai also offers micro chipping and low-cost vaccination clinics. And a pet food bank assists owners who’ve lost jobs or suffered other financial setbacks.

Revenue is a constant priority for all non-profits.

Blackburn reports that new, innovative funding ideas include a future thrift store at the Greeley location. In Grover, an annual wheat crop is sold, as is compost, coveted by ardent gardeners. A monthly minimum combined Grover-Greeley budget of $24,000 necessitates grants, private and corporate donations, municipal funding, fundraisers and adoption fees to help keep the ark afloat. That ark’s passenger list continues to grow.

In early February 2011, seven 5-week-old Heeler puppies were abandoned in frigid temperatures outside a Briggsdale residence when owners moved.

Denkai took the pups for future adoptions.

Five new horses also climbed aboard in February.

Denkai and other rescue groups came to the aid of these refugees from a 45-horse stable when their owner lost his lease at Cherry Creek State Park.

Denkai’s belief is that there’s always potential and room for one more needy creature.

On October 7, 2009, Blackburn received a desperate call from a Fort Collins-based horse rescuer.

Among dozens of equines destined for slaughter via an auction she was attending were seven youngsters: five yearlings, a weanling and a foal no more than two months of age (far too young to be without its dam). Could Denkai take some of the young horses if the woman bought them? Even though they were hard-pressed for space, the image of the tiny, terrified, sickly baby being trampled and crushed during a 1,000 mile overcrowded semitrailer ride to slaughter overwhelmed Blackburn.

Although two of the yearlings ultimately took that last, tragic ride, the rescuer bought the weak, liver chestnut baby colt, the beautiful Palomino weanling, a lovely chestnut yearling filly with a blaze and four high stockings, and a similarly marked, handsome yearling colt. The total price for the four, a mere $145, transformed “What might have been” into “Great potential!” Thanks to Denkai’s excellent care, even the sickly foal fully recovered from multiple problems. Each member of that once discarded “baby herd” became a star in a loving, new home and is ready to shine on for many years to come.

Blackburn sums up Denkai’s agenda: “We provide a unique range of services for various animal species, as well as for youth in crisis. Also, we offer

Northern Colorado Medical & Wellness 2011

resources in a down economy for pet owners through our food and subsidized spay/neuter programs. We look forward to many years serving and supporting both our local and national communities.”

Sweet Pea, the baby herd and other animals, many yet to come, say, “Thank you, Denkai.”

Website: www.denkaianimalsanctuary.org To volunteer, email: volunteer@denkaisanctuary.org or call Volunteer Coordinator Peggy Bush at (970) 352-5330.

To donate: For in-kind donations (i.e. dog food), contact: info@denkaisanctuary.org.

Online donations available through PayPal on their website.

Send cash or check to Denkai Animal Sanctuary, 36710 WCR 126, Grover, CO 80729.

Marty Metzger, who lives in Fort Collins, has worked as a freelance writer for 23 years.

57

spotlight

Temple Grandin, Ph.D.

T emple G randin Breaking All the Boundaries

By Angeline grenz

S

ome of us are visual learners, some audio. Most of us, however, utilize all the senses freely, intermingling their input for a collective conclusion that helps us to learn, grow, form relationships.

Because of her autism, Temple Grandin did not get the “normal” experience. “I think in pictures,” she says, actually considering the spoken word to be a secondary language. Because of this lifelong challenge, Grandin proved tenacious in her quest for a career and used a singular ingenuity to achieve her goals.

Today, she is called a true-life hero and an inspiration for her work in animal behavior and autism education.

Last year, her inspiring story, adapted into an HBO movie featuring actress Claire Daines, garnered the praise of Hollywood when the Temple Grandin movie walked away with seven Emmy Awards, including Outstanding Lead Actress and Outstanding Director for a miniseries or movie.

“They did a great job with the movie,” says Grandin. Though some scenes were abbreviated for time and others heightened to add drama, she says the portrayal of her autism and the challenges she faced with sensory problems and anxiety issues were spot-on

58

and gave a very truthful glimpse into her early life. She adds that some of the drawings used throughout the movie were her original project sketches.

Grandin was born in 1947 and didn’t speak until she was almost four years old. At that time, children diagnosed with autism were recommended to an institution and their condition was often blamed on the neglect or cruelty of the mother. But Grandin’s mother, Eustacia Cutler, refused to listen to those “experts” and instead advocated for her daughter through education.

The road wasn’t an easy one for Grandin. As a young child, she exhibited the classic autistic behaviors: fixating, heightened anxiety, emotional distance and a dislike of being touched. School was difficult for Grandin, with peers who had little interest in understanding her odd behaviors.

The difficulty was mutual, however. “People have subtle social signs that I just couldn’t pick up,” recalls Grandin. “I didn’t know they even existed.” But a fortuitous move to a boarding school in her high school years introduced Grandin to two important catalysts: a science teacher, Mr. Carlock, who recognized Grandin’s unique abilities, and, with several farm animals living on the grounds, the world of animals.

Mr. Carlock challenged Grandin to learn and excel,

and her affinity for animals opened up a new world in which she could communicate freely. “Animals in some ways are simpler,” says Grandin. “They are like me – they are visual thinkers.” Her ability to understand the animal kingdom and her exposure to cattle on her aunt’s Arizona ranch led her to a career in animal sciences. The livestock systems Grandin created for cattle handling are now used for more than half the cattle in the U.S. These systems include design features, such as curved shoots, that feel more natural to cattle and reduce anxiety-causing distractions like flickering lights.

While completing research for her master’s in animal science at the University of Phoenix in the early 70s, Grandin not only overcame the challenges of helping others understand the controversial concepts for livestock handling that she was presenting, she had to overcome the bias of an all-male world. “It was a man’s field,” she explains, remembering many situations where she had to “sneak” onto feedlots and other locations where women were banned to complete her research work. Today, many of her students are female and she is a recognized trailblazer into the industry for women.

After completing her Ph.D. in animal science from the University of Illinois at Urbana-Champaign, Grandin says her desire was to teach, and she ended up at Colorado State University as a professor in 1990. She has worked on a variety of projects with her students, including groundbreaking research into the relationship between “when cattle are excited and scared and how that is related to weight gain and meat quality.”

Among the accomplishments she counts as most personally satisfying is her audit system for cattle processing plants. Her system is a simple scoring system that helps plants to evaluate themselves and operate in an efficient, humane way and is based on her research into the mooing behaviors of cattle and the stress-free handling techniques she developed.

In addition to teaching at CSU and guest lecturing at other universities about animal behavior, Grandin speaks worldwide on autism and the intricacies of the autistic mind. In fact, “my work in the autism world would take over if I let it. But I like the animal behavior stuff.”

She enjoys her many speaking engagements, and is gratified to hear students, parents of autistic children, and many others tell her how she has been an inspiration to them. She has written several books on both animal behavior and autism, often linking her insight into the former on the challenges of the latter.

Grandin is dedicated to both passions and finds her work keeps her happily busy. At age 63, she is content to live alone; her family – including two sisters and one brother – live in other states. When she has free time, she enjoys watching movies such as Avatar that are highly visual; she does not care for relationship-based movies, calling them “boring.”

For Grandin, life has been a series of transformations: from the revelation of how a cow’s moos are indicative of its stress level to the recognition of her own challenges in both handling anxiety and learning to communicate comfortably with her peers.

Today, Grandin navigates successfully in a world in which she will always stand just a little bit apart.

Through her experiences, she has abandoned the “squeeze machine” that she employed in her youth to simulate a hug and de-stress a situation. “It broke and I haven’t gotten around to fixing it,” she admits.

“Today I imagine a virtual squeeze machine when I need to. And also – I hug for real now.”

Angeline Grenz is editor for Style Magazine.

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