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Summer 2013 | Volume 5, Issue 3
The Art of Being
BIG&LOUD Restoring quality of life for patients with Parkinsonâ€™s disease, MS, and stroke Jolene Henderson-Carlson feels free after participating in a Parker Adventist Hospital therapy program.
Hearing loss in newborns
Keeping your heart healthy naturally
New help for overactive bladder
page 7 Photo by Ellen Jaskol
Moving Better Artificial ankle relieves pain and restores movement If severe ankle pain from arthritis is interfering with the activities you like to do, an ankle replacement may be just what you need. In ankle replacement surgery, the doctor removes the arthritic joint surfaces and replaces them with an artificial ankle implant. “This provides tremendous pain relief and maintains adequate motion to allow people to have a more active and normal lifestyle,” says Keith Jacobson, DPM, a podiatric surgeon at Parker Adventist Hospital. Better function for longer Ankle replacement surgery is becoming more common with the advent of more advanced implants, such as Scandinavian Total Ankle Replacement (STAR™ Ankle). The STAR Ankle has three components:
a metal part that covers the lower ankle bone, another metal part that covers the bottom of the shin bone, and a plastic moveable insert that is then placed between the two metal parts. It is the unique way the parts are arranged that allows the STAR implant to work more like a normal ankle than earlier implants. “The STAR implant more closely replicates normal ankle movement as compared to other available implants today,” Jacobson says. Ninety-five percent of all STAR implants last five years, compared with only 67 percent of older ankle implants. The best choice for most people Another way to relieve severe ankle pain is fusion, in which the arthritic joint surfaces are removed and the bones are fused together.
Unfortunately, fusion locks the ankle into one position, and people with an ankle fusion usually require shoe modifications and/or bracing. Before having a fusion, Jacobson recommends finding out if ankle replacement will work for you. Ankle replacement using STAR is appropriate for most people with severe ankle arthritis, he says.
To learn more, join Dr. Jacobson for a FREE community seminar on Sept. 18. See next page for more details. And to learn more about Parker Adventist Hospital’s comprehensive joint replacement program, go to parkerhospital.org/joint.
Sound of Silence
Hearing loss in babies fairly common; early testing important hearing tests. But parents shouldn’t be too concerned, as the problem typically resolves itself in a few short days or the first couple months. “Babies have fluid in their ears at the time of birth, just like they have fluid in their lungs,” explains James Jaskunas, MD, a pediatric ear, nose, and throat surgeon at Parker Adventist Hospital. “It generally comes out fairly quickly with vaginal delivery but not in C-section babies. We also see (the problem) in premature babies.” Newborn hearing screenings are required in Colorado and typically are done right after birth. If there is fluid in the ears, the baby may fail the screening if it is done in the first day or two. “It’s usually normal a few days later, so it’s nothing to be worried about,” Jaskunas says. About one in every 300 newborns is born with permanent hearing loss. “It’s fairly common, and half of those have no risk factors,” Jaskunas says. About 5 to 10 percent of newborns will fail the initial hearing screening and will need a second screening. Babies who fail the screening again will typically need a diagnostic test. “It’s important to get this sorted out as soon as possible because it’s easiest to test babies before 2 months,” Jaskunas says. He adds that diagnosing a hearing problem after the baby is 6 months old can lead to speech delays and language problems.
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Colorado ENT Specialists is hosting three FREE hearing screenings for adults and childre n.
Pediatric Screening (ages 2-17): Friday, Aug. 30, 1-4 p.m.
Adult Screenings (18 and over): Fridays, Sept. 13 and 27, 1-4 p.m .
Location: Sierra Medical Office Buil ding, 9399 Crown Crest Blvd., Suite 401 (at Parker Adventist Hospital) Registration is required as space is limited. Call 720-274-2544 to regi ster.
Photos: FEET ©iStockphoto.com/buzzanimation; BABY ©iStockphoto.com/ferrantraite
C-section and premature babies are three times as likely to fail newborn
Mending Hearts 3 simple steps to better heart health By now, most people know the basics about heart health — eat right, exercise, and don’t smoke. But there are other simple steps that people can take to help ward off heart problems. Joan Eldridge, MD, a cardiologist at Parker Adventist Hospital, offers up these three tips:
Milk your blood sugars
If diabetes runs in your family but you’re not diabetic, consider taking milk thistle. There are some indications that this natural remedy helps the liver produce the appropriate levels of insulin. “Two hundred milligrams twice a day is safe,” Eldridge says. (Check with your physician before starting any natural supplements.)
Flex your ankles
health seminars Join Parker Adventist Hospital for a series of FREE health seminars. All seminars are held in the Parker Hospital Conference Center, located on the Garden Level at the west entrance. A light lunch is served during daytime programs, and light snacks are served during evening programs. Registration is required for all seminars by calling 303-777-6877, option 1.
Joint Replacement Surgery
Dr. Joan Eldridge
If you have low blood pressure and momentarily black out when standing, try flexing your ankles 10 times while sitting. “You need to move the muscles in your legs to get the veins to pump the blood back to the heart,” Eldridge says. “The more fidgety you are, the better for your heart.” The bonus is that fidgeting also burns an extra 300 calories a day.
Photos: PLANT ©iStockphoto.com/PicturePartners; SLEEP ©iStockphoto.com/STEFANOLUNARDI; LAB & DoCTOR by 360 Media
Watch your waist Watching your weight and BMI are good, but the best predictor of heart health is waist circumference. Waists larger than 40 inches for men and 35 inches for women double the risk of premature death — regardless of a person’s overall weight. “Belly fat is nearly as detrimental as smoking,” Eldridge says. If you need to lose a few inches, try the Mediterranean diet. In a study published earlier this year in the New England Journal of Medicine, this diet reduced the risk of heart attacks and strokes by 30 percent in people who had any type of heart disease risk factor. Eldridge recommends the Flat Belly Diet book to her patients.
Expanded Heart Care Parker Adventist Hospital has renovated its cardiac catheterization lab and added advanced technology. The new cath lab houses the latest GE Innova IGS (image guided system) and Mac-Lab® Hemodynamic Recording System, which provides pictures of the heart and arteries on a 56-inch monitor with real-time documentation of the procedure. The system, the first in Colorado, gives physicians a better view of the heart, allowing them to perform more delicate procedures with greater accuracy.
$99 Heart Scan If you have one or more risk factors for heart disease, you may want to consider a coronary artery calcium screening. This noninvasive CT scan measures the level of calcified plaque buildup in your arteries. Normally $333, Parker Adventist Hospital is offering this scan for $99 from Aug. 26-Sept. 30. A physician’s referral is not required, but results must be sent to a doctor. To schedule a scan, call 303-269-4500.
Thu, Sep 5 | Noon-1:30 p.m. Join Dr. Derek Johnson, orthopedic medical director, to learn about computer-navigated knee replacement, patient-specific knee replacement, and minimally invasive anterior hip replacement surgery.
Overactive Bladder Tue, Sep 10 | Noon-1:30 p.m. More than 33 million people suffer from an overactive bladder. Dr. Damian Sorce, urologist, will discuss some of the most common causes of overactive bladder, along with symptoms and treatment options.
Weight-Loss Surgery Wed, Sep 11 | 6:30-8 p.m. Join bariatric surgeon Dr. Josh Long for a look at various surgical weight-loss options. Learn more about the LAP-BAND®, gastric bypass, and sleeve surgical procedures, and whether you’re a candidate for surgery.
Ankle Arthritis Wed, Sep 18 | 6:30-8 p.m. Ankle pain caused by arthritis no longer needs to limit your lifestyle. Join podiatric surgeon Dr. Keith Jacobson to learn about the latest treatments, including ankle replacement surgery and whether you’re a candidate.
Sleep Disorders Thu, Sep 26 | 6:30-8 p.m. Do you feel tired even after a full night of sleep? You may have a sleep disorder that could be harming the quality of your life and your health. Join Dr. Neale Lange, sleep medicine specialist, to learn more and to receive a free sleep assessment.
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Get BIG… Get LOUD Therapy program at Parker Adventist Hospital helps relieve symptoms for patients with Parkinson’s disease, MS, and other disorders
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expressions, pronouncing vowels and consonants loudly, and repeating everyday expressions. “It’s an incredibly simple program with amazing results,” says June Hartmann, MS, an occupational therapist at Parker Adventist Hospital who works with patients on the program. Parker Adventist Hospital is the only hospital in Colorado that offers the physical, occupational, and speech portions of the LSVT program. LSVT is an approved therapy program that is covered by most insurance plans with a physician referral.
Overriding the Disease
Parkinson’s disease impairs neural pathways in the brain. This, in turn, causes patients to curtail their movements, resulting in a shuffling gait and constricted movements. The disease also often impacts breathing, speech, and even swallowing. “They get smaller,” Hartmann explains. “They take smaller steps and stop trying to reach overhead for things in the cabinet. Their voice turns into almost a whisper.” After practicing the exercises provided through the BIG program, patients typically will see at least a 25 percent improvement in: Increased range of motion Improved balance Stronger and longer gait Jolene Henderson-Carlson saw almost immediate results after going through the BIG portion of the program in January at Parker Adventist Hospital. Diagnosed
PHOTOS: ELLEN JASKOL
bout 60,000 Americans this year will be diagnosed with Parkinson’s disease — many of them in the prime of their lives and peak of their careers. Once hit, most people will experience tremors, rigidity, slow and restricted movement, and loss of voice control. Rapid advancements in treatment — from medications to surgery — are making effective inroads into controlling the symptoms of Parkinson’s disease. Now, a surprisingly simple technique is changing the lives of patients with Parkinson’s disease, as well as patients who have suffered a stroke or have multiple sclerosis. This technique combines physical, occupational, and speech therapy exercises to help these patients regain speech, facial expressions, and more normal gait and movements. The program is called LSVT, which is an acronym for Lee Silverman, the founder, Voice Treatment. It’s often called BIG and LOUD because it stresses exaggeration of movements, facial expressions, and voice volume and inflections to help patients improve. Patients go through a month of near-daily sessions with a physical, occupational, or speech therapist — depending on their needs — and then practice the exercises daily at home after that. The exercises Jorge Yordan include simple movements, practices his facial and speech exercises for 30 such as swinging their arms minutes every morning. in wide circles, taking very “When I wake up, I can’t large steps, or walking talk,” he says. “It makes a backward. Speech exercises huge difference.” include exaggerated facial
Parkinson’s disease fast facts Motor system disorder, caused by loss of dopamine-producing brain cells 1 percent of people over age 60 have Parkinson’s disease 60,000 Americans diagnosed annually Four most common symptoms: – Tremors – Rigidity of limbs –S lowness of movement (bradykinesia) – Impaired balance and coordination Parker Adventist Hospital partners with its sister hospital, Littleton Adventist Hospital, to also offer the new “asleep” deep brain stimulation surgery for patients with Parkinson’s disease, dystonia, essential tremor, and other conditions. To learn more, go to mylittletonhospital.org/ neuro-treatments.
last September with Parkinsonism, a disease with symptoms similar to those of Parkinson’s disease, Henderson-Carlson saw rapid deterioration in her ability to walk and stand. By December, she was close to using a wheelchair. But after four weeks of BIG training, her balance, coordination, and gait all improved to the point where she could get in and out of chairs or go up and down stairs unassisted. “I saw improvement both physically and mentally,” says Henderson-Carlson, who lives in Elizabeth with her husband, dog, a wild fox, and two miniature donkeys. “I can go into the yard with my animals, and I’m no longer afraid of falling.”
A Proven Program
LSVT first started about a decade ago as a speech program, which has now been taught to 30,000 patients in 54 countries, according to LSVT Global, the training organization for the program. Similar to BIG, patients go through an intense four-week training program with a speech
therapist, and then are given exercises to do on their own at home. The exercises take 30-60 minutes and must be practiced daily for the rest of their lives. Despite the intensity, Ravi Shah, MD, a neurologist at Parker Adventist Hospital is a big fan. “It’s pretty rigorous at first,” Shah says. “For the people who keep on it, you really see the improvement. You can see a difference in their gait and their movements. These are patients where nothing else has changed, just the therapy was added.” Jorge Yordan, 57, was diagnosed with Parkinson’s disease in 2005. The disease, which Jorge Yordan affects every person differently, made it difficult for him to swallow, breathe, and talk, although he didn’t experience the typical tremors associated with Parkinson’s disease. Within three years, he had started losing his voice and turned to voice therapies such as LSVT for help. “It makes a huge difference,” says Yordan, a former minerals research scientist who lives in Parker. “I do it every day. Without it, I can’t talk.” Yordan doesn’t go a day without doing his exercises. Upon wakening, Yordan
Jolene Henderson-Carlson works through a BIG session with occupational therapist June Hartmann at Parker Adventist Hospital.
drinks a smoothie, takes his medications, and gets to work. First comes a half hour of facial and speech exercises, followed by stretches and aerobics, and then on to puzzles such as Sudoku and word scrabble. “I call my program the total package because I do a little bit of everything,” Yordan says. “I talk to a lot of people with this disease and I tell them that the key is to never give up and keep a positive attitude. Never feel sorry for yourself and make your disability into an ability. Otherwise, if you give up and sit down, you’re going to freeze.”
To learn more about the BIG and LOUD programs at Parker Adventist Hospital, go online to parkerhospital.org/lsvt. And be sure to join Dr. Shah and Parker Adventist Hospital therapists on Oct. 3 for a FREE seminar about the program. See back cover for details.
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LivingVIBRANTLY Your key to a better, healthier life
A Women’s Wellness Expo, hosted by Castle Rock, Littleton, Parker, and Porter Adventist Hospitals Join us for a day to celebrate women, their courage and their zest for life. This FREE event will be filled with tips for maintaining good health — giving you tools to live, love, and play at your best!
FREE chair massages
The day will get a laughter-filled start with keynote speaker Nancy Sharp. Sharp, author, Huffington Post Exclusive giveaways and drawings blogger, and nationally known speaker, draws from her own transformative story of courage and Health advice from leading experts renewal to inspire women around the country to harness their courage and live boldly. “Courage enables us to keep showing up and push beyond our limitations, even in the face of loss, disappointment, and change,” says Sharp.
Spa-la-la! Win a FREE spa gift certificate! Register by Aug. 31 to be entered in a drawing for a day at the spa. Call 303-777-6877 or visit southdenverhealth.org/ expo-registration.
Nancy Sharp, Keynote Speaker
Women’s Wellness DATE | Sat, Sep 7 TIME | 9 a.m.-2 p.m. LOCATION | The Newman Center for the Performing Arts, University of Denver, 2344 E. Iliff Ave. COST | FREE (free parking available in the garage)
Reserve your space today for this special event online at southdenverhealth.org/womens-expo.
expo schedule 9 a.m. Doors open 10 a.m. Kick off the day with keynote speaker
University of Denver New man Center
Nancy Sharp who will present: Living Vibrantly— Your Key to a Healthier, Better Life
9 a.m.- 2 p.m. Visit with experts throughout the day to learn about sleeping better, stress relief, bone and joint health, and much more! Then pick from these talks: ormones: What You Need to Know to Stay Balanced; 11 a.m. H Dr. Vandna Jerath, OB/GYN 11:30 a.m. Top Tips to Keep Your Heart Healthy; Dr. Cinthia Bateman, cardiologist
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Noon Gurgles, Grumbles, and Growls — What Is Your Stomach Trying to Tell You?; Dr. Patrice Michaletz-Onody, gastroenterologist
1 p.m. Lose Your Belly Fat and Help Your Heart — Cooking Demonstration; Dr. Richard Collins, The Cooking Cardiologist
1 p.m. Yoga—Learn How to Strengthen Your Mind, Body, and Spirit
PhotoS: NANCY SHARP by ELLEN JASKoL; FLOWER ©iStockphoto.com/felinda; SPOON ©iStockphoto.com/alphacat
Lifestyle choices can help reduce risk of breast cancer recurrence
Fighting Strong Up to 20 percent of women who have beat breast cancer will have a recurrence within 10 years of their first diagnosis, according to the American Cancer Society. The risk of breast cancer recurrence depends on a variety of factors, including patient age, inherited susceptibility, stage and grade of the original tumor, and type of treatment for the original tumor. But women can help lower the odds of recurrence through lifestyle choices, says Nadine Mikhaeel, MD, a medical oncologist at Parker Dr. Nadine Mikhaeel Adventist Hospital.
Three things she recommends: Maintain a healthy weight through diet and exercise. Fat allows the buildup of estrogen in the body, which increases the risk of recurrence.
Limit alcohol. Although small amounts of alcohol may have a beneficial effect on the heart, significant daily alcohol intake has been linked to increased risk of recurrence. This may be related to its high sugar content, which may allow cancer cells to grow, Mikhaeel says.
Watch your vitamin D levels. “In at least three studies, maintaining a level of 40 or above decreased the chances of recurrence,” Mikhaeel says. Every woman should have her vitamin D level checked to determine if she needs supplements.
Photo: WOMAN ©iStockphoto.com/Urilux
Reduce Your Risk Are you a breast cancer survivor interested in learning how you can reduce your risk of recurrence? Join Dr. Mikhaeel for a special session of Trio Breast Center’s breast cancer support group to learn more, ask questions, and share your experience with others. This support group is open to everyone, regardless of where you received treatment. Date Tuesday, Oct. 15 Time 11:30 a.m.-1 p.m. Location Parker Adventist Hospital Conference Center Cost FREE Information 303-269-4155
Treating Overactive Bladder New treatments avoid side effects Forget about dry mouth and constipation, the common side effects of traditional medications to treat overactive bladder (OAB). New alternatives offer relief without the baggage. “With a lineup of options, 99 percent of people with overactive bladder can now be helped,” says Damian Sorce, MD, a urologist at Parker Adventist Hospital. OAB results from the bladder squeezing too often or without warning. This condition affects an estimated 33 million Americans, the majority of whom are older women, according to the Food and Drug The FDA recently Administration. approved the Introduced in l medication Oxytro 2012, the medication as n) ni (oxybuty mirabegron lacks the first over-the the side effects t en tm ea tr counter associated with B. for women with OA anticholinergics h tc pa l ro The Oxyt (the class of drugs helps relax the used to treat OAB). bladder muscle to “I’ve seen great prevent spasms. results, particularly in patients where other medications didn’t work,” Sorce says. When medicines fail, physicians may recommend InterStim® Therapy. InterStim is a pacemaker-like device that enhances communication between the brain and the nerves that control the bladder. This minimally invasive therapy has few side effects.
No prescr iption needed
Join Dr. Sorce on Sept. 10 at a FREE seminar to learn the pros and cons of these new treatments. Details on Page 3.
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OCTOBER FREE health seminars
Portercare Adventist Health System
Non-Profit Organization U.S. Postage
9395 Crown Crest Blvd. Parker, CO 80138
Become more body-wise with the experts at Parker Adventist Hospital. All seminars are FREE but require registration by calling 303-777-6877, option 1. Seminars are held in the Parker Hospital Conference Center at the west entrance. A light lunch is served during noon seminars, and light snacks are served during evening programs.
Denver, CO Permit No. 4773
Spine Surgery Tue, Oct 1 | Noon-1:30 p.m. Join Dr. Zak Ibrahim, orthopedic spine surgeon, to learn about treatment options for low back pain, including minimally invasive surgery, and how to know when it’s the right time for surgery.
The Nasty Norovirus
New Therapy for Parkinson’s Disease Thu, Oct 3 | 6:30-8 p.m. Join neurologist Dr. Ravi Shah and rehab therapists to learn about Lee Silverman Voice Treatment (LSVT), and recent advances in therapy treatments for patients with Parkinson’s disease and other neurological disorders.
What every parent needs to know Although norovirus might look like plain old food poisoning
Weight-Loss Surgery Wed, Oct 9 | 6:30-8 p.m. Join bariatric surgeon Dr. Josh Long for a look at various surgical weight-loss options. Learn more about the LAP-BAND®, gastric bypass, and sleeve surgical procedures, and whether you’re a candidate for surgery.
Joint Replacement Surgery
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 email@example.com. grow is produced by Clementine LLC. Executive Editor: Rachel Robinson 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. Copyright © Centura Health, 2013.
PhotoS: VIRUS ©iStockphoto.com/sitox; Boy ©iStockphoto.com/vitapix
Tue, Oct 22 | 6:30-8 p.m. Join Dr. Derek Johnson, orthopedic medical director, to learn about computer-navigated knee replacement, patient-specific knee replacement, and minimally invasive anterior hip replacement surgery.
Dehydration Check The easiest way to check if your child is properly hydrated is to push on the tip of his finger. If the white spot doesn’t regain color within a few seconds, he needs fluids.
or the flu, the highly contagious “winter vomiting disease” is responsible for nearly 1 million pediatric visits to the ER Other signs: each year. Everyone is susceptible to the A dry, rather than virus, but the delicate immune systems and moist, mouth fickle hygiene habits of infants and young children Low urine output make them particularly vulnerable. Failure to keep any type of Norovirus spreads through contact with an infected fluid down person, a contaminated surface, or contaminated Inability to regain energy food. Symptoms appear quickly, typically within 12-14 hours, and include severe vomiting or diarrhea, stomach cramping, a low-grade fever, and lethargy that can last up to three days. The best way to prevent norovirus is good old hand-washing, particularly after being in community play areas such as playgrounds, mall play areas, or community toy areas in day care centers and schools. Train your toddlers and children to wash their hands before and after play, and you’ll reduce their risks of contracting the disease. One in 14 children will wind up in the ER from norovirus, and one in six will need a doctor’s care due to dehydration caused by the vomiting and diarrhea, so be sure your child is getting lots of fluids, but do it gently. “When kids are dehydrated, they tend to guzzle fluids, but oftentimes this leads to persistent vomiting,” says Karen Gavigan, MD, a pediatrician at Centura Health at Southlands. “Gentle rehydration by taking a few sips at a time is a better way to get fluids back into your child.” Call your doctor if symptoms last more than 48 hours or if your child remains dehydrated.