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Nurturing the health of you and your family

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Fall 2011 | Volume 3, Issue 4

Expert Response Parker Hospital delivers trauma care to community

Chris Winter, MD Medical Director of Trauma Program Parker Adventist Hospital

$99 HEART SCAN 3

INSIDE Weight-loss surgery success

| Stopping diabetes in its tracks | Chest pain warnings

Photo by Michael Richmond

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Growing into a regional medical center Dear grow readers,

Morre Dean CEO and President Parker Adventist Hospital

Meet Morre at our free community concert. See the back cover for details.

It is such a pleasure to be writing this column. I recently joined Parker Adventist Hospital as the new chief executive officer and president. I am thrilled to be back home — I was born at Porter Adventist Hospital (Parker’s sister facility), grew up nearby, and got my first hospital job there. For the past five years, I’ve been CEO and president of Glendale Adventist Medical Center in northern Los Angeles. When I was asked to fill the tremendous shoes left by Terry Forde, I thought to myself that this was a job worth coming home for. This hospital is home to some extraordinarily gifted health care experts, bringing this community a level of care that far exceeds its community hospital status. In fact, it’s our specialty services such as neurosurgery, spine surgery, joint replacement, and cancer care that form the foundation of our future. Every day, we continue to evolve into a regional medical center—a center that draws people from throughout the metro area, Colorado, and even beyond while continuing to provide extraordinary care and outcomes to the people of Parker, Castle Rock, Aurora, Elizabeth, Franktown, Centennial, and all our neighbors. Along with my wife, Katrina, and my children, 14-year-old Tyler and 12-year-old Jill, I want to thank you for welcoming us into your community, your hospital, and your hearts. God bless you,

Morre Dean

Successful weight-loss surgery Although many people believe weight-loss surgery is a cure for obesity, it’s the lifestyle changes patients make after their surgery that determine their ultimate weight-loss success, says Allison Galloway, FNP, bariatric coordinator with The Bariatric & Metabolic Center of Colorado. “Your journey to weight loss does not stop the day you have surgery,” Galloway says. “It takes long-term commitment to achieve success.”

She offers these success tips:  Research the risks and benefits of surgery and ask questions  Involve your family in your lifestyle changes  Adopt dietary restrictions before surgery  Begin exercising before surgery to improve lung function and speed recovery  Participate in support groups before and after surgery The Bariatric & Metabolic Center, located at Parker Adventist Hospital, offers monthly support groups, and an in-house social worker, dietitian, and bariatric coordinator. The Center is headed by Matthew Metz, MD, a fellowship-trained bariatric surgeon who has been certified as a Bariatric Surgery Center of Excellence surgeon. Learn more at bariatriccenterco.com. 2 ■ Fall 2011 ■

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free seminar Join Matthew Metz, MD, medical director of The Bariatric & Metabolic Center of Colorado, to learn more about the different types of weight-loss surgery, whether you are a candidate, and how surgery can improve or even cure diabetes. Upcoming seminars will be held on Nov. 9, Dec. 7, and Jan. 11, from 6:30-8 p.m. in the Parker Hospital Conference Center. Seminars are FREE, but registration is required. For more information and to register, call 303-777-6877, option 1.


Stick it to the flu

Low-cost flu vaccines

16. Parker Hospital will offer flu vaccines on Nov. 2, 9, and tal’s hospi All clinics will be held from 3–6 p.m. in the main lobby. Cost is $25 and is covered by Medicare Part B (as primary insurance), United Healthcare Medicare Advantage (formerly Secure Horizons), Aetna, Humana Gold, and Rocky Mountain Health Plan. You must show a valid insurance card. Flumist (nasal spray vaccine) is available for $30 for people ages 2–49 while supplies last.

Head off diabetes Could you be one of the 79 million Americans on your way to diabetes without knowing it? If so, long-term damage to your heart and circulatory system is already taking place that could result in a heart attack or stroke.

Warning signs of diabetes include: Frequent urination Unusual thirst Fatigue Blurred vision Poor circulation, including limbs that “fall asleep” The good news is that you can stop the progression and avoid medications with lifestyle changes, says Christy Beyerly, a registered dietitian and certified diabetes educator at Parker Adventist Hospital. Parker Hospital offers a comprehensive diabetes education and treatment program, available to anyone in the community and covered by Medicare. For more information and a full list of diabetes classes, go to parkerhospital.org/diabetes.

Learn how to prevent diabetes at Parker Hospital’s learn pre-diabetes class on Saturday, Nov. 12, from 1:15-4:15 p.m. Cost is $30 and seating is limited. For more information and registration, call 303-269-4500.

Scanning for deadly plaque One of the main culprits of heart disease is the buildup of plaque in your coronary arteries. This buildup narrows the arteries and prevents oxygen-laden blood from circulating, which can lead to a complete blockage that can cause a heart attack or stroke. A special scan called a coronary artery calcium scoring can determine how much hardened plaque has built up in the arteries, says Dietrich Schultze, MD, an interventional radiologist at Parker Adventist Hospital. “We know that the amount of calcified plaque can be an accurate predictor of future cardiac events like heart attacks,” Schultze says. The quick scan is painless and uses very low doses of radiation. It is recommended for both women and men who have risk factors for cardiac disease, including a family history, obesity, diabetes, or high cholesterol. Many doctors also recommend the screening at least once for all patients over the age of 50.

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Photo: VACCINE ©iStockphoto.com/ bmcent1 ILLUSTRATION: ARTERY ©iStockphoto.com/ alex-mit

are hospitalized with More than 200,000 people in the United States each year flu is to be vaccinated. flu-related complications. The easiest way to prevent the Here are some things to keep in mind: > The flu shot can’t give you the flu > One flu shot protects against both seasonal flu and H1N1 > Anyone over 6 months old should get the vaccine ve¸ but Flumist > The flu shot and the nasal spray Flumist are equally effecti ying is available only for those 2-49 years old who have no underl health conditions because “Our bodies can’t build up long-term immunity to the flu virus g and spreading it is constantly changing, so the best way to prevent catchin gton, MD, a the flu is to get vaccinated every year,” says Christian Whittin family practice physician at Parker Adventist Hospital.

Get a coronary artery calcium screening for $99 (normally $333) Nov. 7–Dec. 5 at Parker Adventist Hospital. A physician’s referral is not needed but is recommended. Results will be sent to your doctor. To schedule your scan, call 303-269-4500.

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Heart Scan

9395 Crown Crest Blvd., Parker, CO 80138 grow is published quarterly by Parker Adventist Hospital as part of our mission to nurture the health of the people in our community. To comment or unsubscribe, please email grow@centura.org. Executive Editor: Rachel Robinson

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Riding High Parker trauma surgeon puts local equestrian back on her horse

Trauma surgeon Chris Winter, MD, was called to the emergency room at Parker Adventist Hospital last February to treat a woman who had been thrown from her horse.

Military training

Photo by Michael Richmond

As a retired U.S. Army Reserve surgeon, Winter has seen his fair share of war injuries. He was deployed three times during his 18 years in the Reserve. His latest deployment was in Iraq in 2008 as part of a Forward Surgical Team Dr. Chris Winter near the front lines. “Working in the military gives you exposure to a wide variety of injuries,” Winter says. “You are part of a small team that is dedicated to one goal, which is to serve the soldier who is injured. I can’t think of a greater honor.”

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Sandy Marsik is back riding Desi after surgery at Parker Adventist Hospital. Photo courtesy of Larry Larson Photography, Rapid City, SD

Emergency Care at Parker Hospital > Ranked in the 99th percentile nationally for ER patient satisfaction > 15 minutes or less average patient wait time > 24/7 medical specialists in trauma, neurosurgery, spine, and orthopedic surgery > Nationally certified Advanced Primary Stroke Center

Find out Parker Hospital’s approximate ER waiting time at parkerhospital.org/ER.

Photo: Stopwatch ©iStockphoto.com/ adventtr

Not an unusual call at Parker Hospital, where equestrian injuries are the second leading cause for trauma visits. What was unexpected, however, was the extent of the patient’s injuries. Sandy Marsik, 63, had been thrown by her horse into a metal pole. She was knocked unconscious and brought by ambulance to Parker Hospital. Her injuries included not just one or two broken ribs, but multiple ribs that had been splintered and shattered in several places. “This type of injury is most commonly seen in severe blunt force trauma, including battlefield injuries such as explosions,” explains Winter, a general surgeon and medical director of the trauma program at Parker Hospital.


Care close to home

Before Parker Hospital opened seven years ago, many area residents had to travel a half hour or more for emergency care. Although the state doesn’t require hospital ERs to be trauma centers, Parker Hospital chose to become a Level III trauma center after hearing the community’s concerns and needs. As a Level III trauma center, Parker Hospital offers 24/7 surgical specialists, including trauma, neurosurgery, spine, and orthopedics. In addition, specially trained clinical teams are available to initiate immediate advanced care for trauma, stroke, and cardiac patients. After Marsik was stabilized and moved to the intensive care unit, Winter met with her to explain the serious extent of her injuries. “Dr. Winter kept telling me I had a flail chest,” says Marsik, a nurse at the Arapahoe County Jail. “I kept saying, ‘No, I just have broken ribs,’ because I knew that a flail chest was serious and survivability is not good.”

Complex surgery

Marsik spent nearly a week in the ICU, but her injuries prevented her from fully recovering. Some ribs were broken in two and had shifted so that even the smallest movement, including breathing, was debilitating. It was then that Winter determined that Marsik would need a complex surgery called a “rib lock” if she was to improve. Winter’s trauma experience, along with the specialized training of the hospital’s surgery and intensive care team, meant he could perform the procedure Marsik needed at Parker Hospital. “You implant a bracket over the ribs that stabilizes the chest wall so that the patient can move without pain,” Winter explains. “She got better pretty quickly.” “I tell everyone I have bionic ribs,” Marsik says. Marsik is back at work and once again riding Desi, her beloved Andalusian horse. Riding is an interest Marsik shares with her surgeon. Winter, who lives near the hospital with his wife, breast surgeon Christine Rogness, MD, and their 11-year-old twin sons, grew up in Nebraska riding horses. “Some of the most severe trauma cases we see are experienced riders who have been thrown by spooked horses,” Winter says. “The first question most of these patients ask is, ‘When can I ride again?’”

Learn more about equestrian safety and Parker Hospital’s free helmet program at parkerhospital.org/equestriansafety.

Heart attacks don’t wait Heart disease is the second leading killer of men and women in Colorado, yet people ignore the symptoms of a heart attack every day. “Most people aren’t sure if they’re having a heart attack, so they think they should wait until they know for sure. Unfortunately, that can be too late,” says Phil Mitchell, MD, medical director of emergency services at Parker Adventist Hospital. Heart attacks can have many different symptoms. If you or someone else is experiencing one or more of the following symptoms, you should call 911 immediately.

Warning signs of a heart attack Chest or upper body pain Can be a shooting pain or feel more like achiness, tightness, or squeezing in the center of the chest. Pain or discomfort can spread to the shoulders, arms, back, neck, teeth, or jaw — with or without chest pain. Usually lasts more than a few minutes, but can come and go. Trouble breathing Panting or difficulty drawing a breath. Often occurs before chest pain. Sweating and lightheadedness Sudden sweating but with cold, clammy skin. Dizziness or feeling like you’re going to pass out. Stomachache Can feel like heartburn or nausea. Special symptoms Women often don’t have chest or upper body pain but may experience the other listed symptoms. They also may feel unusually fatigued.

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PhotoS: ©iStockphoto.com/ CHEST: fatihhoca, HEADACHE: nuno, STOMACH: fotandy

During his residency for general surgery, Winter worked at Denver Health, the state’s largest Level I trauma center. He followed that up with five years as a trauma surgeon at the Level I trauma center at St. Anthony Central Hospital, Parker Hospital’s sister facility. After working at Denver’s two largest trauma centers, he joined Parker Hospital as medical director of the hospital’s Level III trauma center, which opened in 2004. “The difference between a Level I, Level II, or Level III trauma center is generally not the severity of a single injury, but whether the patient has multiple injuries,” Winter says. “We can handle pretty much any level of severity here, and we use our Centura trauma network to transfer patients who have multiple injuries. The key is understanding what the entire hospital, not just the surgeon, can safely handle.”


Minimal Downtime

Minimally invasive hysterectomy reaps big benefits ore than 500,000 hysterectomies are performed every year in the United States, making it the second most common surgery in reproductiveaged women after cesarean sections, according to the Centers for Disease Control and Prevention. Unlike their mothers, however, women today Incisions for no longer have to undergo traditional “open” minimally invasive hysterectomies that require a large abdominal hysterectomies are just incision, a multiday hospital stay, and six 1/2-inch long. The surgery requires weeks of recovery. Today, most women are just one night stay in the hospital, candidates for noninvasive treatments (see and women resume normal accompanying story) or minimally invasive activities within two weeks. surgery. These procedures typically require just an overnight stay in the hospital, and most women resume normal activities within two weeks, sometimes even faster. “Ninety percent of women who need a hysterectomy qualify for a minimally invasive procedure,” says Erica Drennen, MD, an obstetrician and gynecologist at Parker Adventist Hospital. “The only time women may still require traditional surgery

Surgery-free fibroid fix

ery to treat fibroids also should look into Women considering hysterectomy surg ne fibroid embolization. a surgery-free treatment known as uteri ional radiologist threads a thin In this painless procedure, an intervent y in the groin. Small “beads” are then catheter into the uterus through an arter ne arteries to cut off the blood supply, inserted through the catheter into uteri s. which kills the fibroids but spares the uteru t women and relieves symptoms mos for n “This procedure is a great optio l Dietrich Schultze, MD, an interventiona in more than 85 percent of cases,” says . e at Parker Adventist Hospital radiologist who performs this procedur United States are performed to es Nearly one-third of hysterectomi in the tion has been available for 15 years and treat fibroids. Although fibroid emboliza countries, many women do not know is used much more frequently in other about it, Schultze says. ital and takes less than two hours. The procedure is performed in the hosp n ital overnight to receive pain medicatio The patient generally stays in the hosp to work in a week. to relieve cramping. Most women are back

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is to remove cancerous tumors or if they have extremely complex fibroids.” A hysterectomy is a surgery to remove the uterus. It is most commonly used to treat benign fibroid tumors, abnormal bleeding, and endometriosis. There are two types of minimally invasive hysterectomy surgeries described by the National Institutes of Health. Vaginal hysterectomy, performed through a small incision in the vaginal wall, is used in about 22 Dr. Erica Drennen percent of all cases. Surgeons may use a laparoscope, a narrow tube with a tiny camera on the end, to guide this procedure. “This is really the first choice, particularly for women who have delivered babies vaginally because the tissue is more lax,” Drennen says. “It’s less painful than abdominal surgery, and the vaginal wall heals well.” The second and most recent evolution in minimally invasive hystrectomy surgery is laparoscopic abdominal surgery. This surgery, which is being used in an increasing number of cases, is performed using laparoscopic tools that are inserted through three to five small abdominal incisions, usually one-half inch or smaller. In all hysterectomies, the uterus is removed, making it impossible for the woman to have biological children following surgery. However, removal of the cervix, fallopian tubes, and/or an ovary depends on the type of surgery used and each woman’s individual situation.

Lunch ‘n’ Learn Join Dr. Dietrich Schultze, interventional radiologist at Parker Hospital, to learn more about fibroid embolization and whether you can avoid hysterectomy surgery. This FREE program will be held Tuesday, Nov. 15, from noon-1:30 p.m. in the Parker Hospital Conference Center. Lunch will be served so women can attend on their lunch hour. Park on the west side of the hospital for direct access or use free valet parking at the main entrance. Registration is required by calling 303-777-6877, option 1.

Photo: RULER: ©iStockphoto.com/ CDH_Design

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On the road again A

computer game helps stroke patients at Parker Adventist Hospital prepare to get back safely on the road. The game, called SmartDriver, is used as part of a patient’s occupational therapy to help assess response speed, visual perceptual skills, and physical ability. Occupational therapist June Hartmann, MS, says while the game is far less sophisticated than a driver simulator, it’s a helpful screening tool. Hartmann doesn’t decide whether patients can drive again. “But the game is a good indicator of whether patients need to work on certain skills, or maybe they can take a road test to see if they’re ready,” she says. The game includes a steering wheel along with accelerator and brake pedals and runs through levels that include changes in speed, sudden turns, hazards like potholes and even other cars bumping into the driver. Hartmann works with four or five patients a month on the game. More and more of her patients are in their 40s and 50s. “They have to get back to work. They work downtown and they have to drive,” she says.

Photo by Toby Fike

Q&A Neale Lange, MD Medical Director Sleep Disorder Center at Parker Adventist Hospital

Sandra Greene, 69, worked on the driving game last year after she had a stroke following back surgery. “I was not severely June Hartmann impaired, but I was concerned that my stroke had affected my abilities like reaction time and whether I could drive in traffic,” Greene says. “The game gave me confidence. I always wanted to go back to driving. It’s part of my way of life.” SmartDriver is just one of many tools the rehab specialists use to help stroke patients regain as much function as possible. Parker Hospital’s rehab program offers the most comprehensive adult rehabilitation services available in Parker.

To learn more about SmartDriver or other rehabilitation services, call the Parker Adventist Center for Rehabilitation & Sports Medicine at 303-269-4590 or go to parkerhospital.org/rehab.

Sleepy Brain

Q. How does sleep affect my brain function? A. Sleep is an active state that affects both your physical and mental well-being, allowing your body to restore its energy levels. A good night’s sleep is the best way to help you manage stress. It also improves concentration, allows your brain to process information, and aids in memory retention. One of the most common sleep disorders is sleep apnea, which has recently been linked to dementia in older women, raising the relative risk of developing this disease by 85 percent.

Q. W  hat happens if I don’t get enough sleep? A. Your body will not adapt to getting less sleep than it needs. While most people who don’t get enough sleep are unaware of the toll it takes on their health, sleep deprivation can cause depression, decrease immune responses, and impair your memory and thought processes. Metabolic processes like glucose control and appetite also can be adversely impacted by sleep loss.

Q. H  ow much sleep do I need? A. Your sleep needs are based on various factors, including age. Some people need 10 hours of sleep nightly while others require only five. The following are general daily guidelines: Infants: 16-18 hours Teenagers: 9 hours Adults: 7-8 hours Pregnant women: In the first trimester, they often need more sleep than usual

We’ve doubled the size of our Sleep Disorder Center! Go to parkerhospital.org/sleep to take a free sleep quiz or call us at 303-269-4188 to schedule a sleep assessment.

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Photo by Toby Fike

Computer game helps stroke victims prepare to drive


Portercare Adventist Health System

A caring community concert

Non-Profit Organization U.S. Postage

Paid

Denver, CO Permit No. 4773

9395 Crown Crest Blvd. Parker, CO 80138

Parker Adventist Hospital is pleased to invite the community to its fifth annual Concert of ThanksCaring. The free musical event once again will feature the sounds of The Denver Brass and Celtic Colorado along with the Young Voices of Colorado, a teen girls’ choir. The concert is free, but a donation to the Women’s Crisis & Family Outreach Center in Douglas County is welcome.

“Our annual concert is a way to thank the community for its support and also show our support of local organizations who share our mission to improve the health of the people of our community,” says Morre Dean, the new president and CEO of Parker Hospital.

Concert of ThanksCaring

Saturday, Nov. 5 • 2:30-4 p.m. Parker Evangelical Presbyterian Church 9100 E. Parker Road • Parker, CO 80138

Shoulders require ongoing care

Patients typically require two rehab sessions weekly for six weeks while practicing the exercises almost every day for 20 minutes. Other nonsurgical measures that may help relieve the pain include: > Rest >N  onsteroidal anti-inflammatory drugs (such as ibuprofen) > Cortisol injections

“The key to avoiding pain is to practice shoulder hygiene just like you practice dental hygiene,” Alijani says. “If therapy is not effective, shoulder surgeries for rotator cuff injuries have an outstanding track record of producing excellent results.” To learn more about shoulder rehabilitation, go to parkerhospital.org/rehab.

Centura Health complies with the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973, and no person shall be excluded from participation in, be denied benefits of, or otherwise be subjected to discrimination in the provision of any care or service on the grounds of race, religion, color, sex, national origin, sexual preference, ancestry, age, familial status, disability, or handicap.

Photo: MAN: ©iStockphoto.com/ LattaPictures ILLUSTRATION: NOTES: ©iStockphoto.com/ mattasbestos

Half of Americans over the age of 65 will experience a rotator cuff injury at some point, mostly due to aging and improper use. While most people think of this as a devastating injury, more than 80 percent of patients can be helped with some simple measures and will never need surgery, says Todd Alijani, MD, an orthopedic surgeon at Parker Adventist Hospital. “Rehabilitation is extraordinarily effective at keeping people active, fit, and free of pain,” he says. The rotator cuff is made up of four tendons. The supraspinatus tendon most often gets injured because the other three are underused. The easiest way to prevent rotator cuff injury also happens to be the easiest way to fix a rotator cuff: Perform specific exercises that help balance the workload. Dr. Todd Alijani “These are not exercises you see in a gym. That’s why you need to visit a physical therapist,” Alijani says. “If you develop a dynamic balanced shoulder, you’ll be less prone to injury and you’ll increase your overall performance.”


Grow Fall 2011