Strokes in teens
Timeout from osteo meds
Shoulder Solace Keep your shoulders in working order Plus! How your personality impacts weight loss
Splitting pills to save money
FREE Sleep Quiz Find out if your sleep habits could be causing health problems. Take a FREE online quiz and hear back from a sleep specialist at penrosestfrancis.org/sleep. OR Download a FREE QR code scanner at your smartphone app store and then scan this code TO GET THE QUIZ.
Not Enough Zzzs
Strokes Striking Younger Moms may be surprised to learn that when it comes to strokes, they need to worry just as much about their kids and husbands as their elderly parents. The number of strokes among children ages 5 to 14, while a very small number, went up more than 30 percent between 1994 and 2007, according to data reported in February at an American Stroke Association conference. During that same time, the number of people aged 15 to 44 hospitalized for stroke also increased 30 percent, including a 51 percent jump among 15- to 34-year-old men. “The overwhelming majority of strokes still occur in adults over the age of 65, but we’re seeing an alarming trend among teens and early adults,” says Heidi Stouffer, RN, MA, stroke program coordinator with Penrose-St. Francis Health Services. “They eat terribly, and they’re not exercising. We’re also worried about the use of street drugs, such as marijuana.” Marijuana has been linked to increased risk of ischemic strokes within 24 hours of use, Stouffer says. “Not many people are aware of this outcome,” she adds. But the bigger problem is poor diet and lack of exercise. More than half of Coloradans — including 26 percent of children ages 2 to 14 – are overweight or obese. And close to 19 percent of young people ages 24 to 32 have high blood pressure, one of the biggest risk factors for stroke. High blood pressure, smoking, diabetes, obesity, and high cholesterol are all risk factors for stroke.
Cover Photo: Ellen Jaskol
When daylight savings hit a month ago, did you sleep in an extra hour or simply kiss it goodbye forever? “If you’re on vacation and you miss a few hours of sleep, it’s probably not a big deal,” says Alain Eid, MD, a pulmonologist with Penrose-St. Francis Sleep Disorders Center. “The problems start when it becomes chronic — the woman who goes to bed at midnight and gets up every day at 5 a.m. Chronic sleep deprivation has a lot of side effects, ranging from irritability and attention deficit to major health problems, such as heart disease and diabetes.” Consider this: • People who miss a few hours of sleep perform like people with a blood alcohol level of 0.05 percent, putting them at increased risk of accidents. • Losing even small amounts of sleep leads to a spike in the stress hormone cortisol, which lowers your ability to deal with stress. It also is linked with depression. • Shorter snoozing lowers your immune cell activity and raises your blood pressure. • Not getting enough sleep decreases your ability to lose weight. bloom is published four times annually by Penrose-St. Francis Health Services. As part of Centura Health, our mission is to nurture the health of the people in our community. The information herein is meant to complement and not replace advice provided by a licensed health care professional. For comments or to unsubscribe to this publication, please email us at email@example.com. Bloom is produced by Clementine LLC of Denver, Colo. Executive Editor is Jill Woodford. 2222 North Nevada Avenue Colorado Springs, CO 80907
2 Spring 2012
Decrease your family’s risk of stroke DOWNLOAD A FREE QR CODE READER TO your smartphone and SCAN this code for more!
by becoming a SALT SLEUTH at penrosestfrancis.org/salt. Learn why chicken breasts may not be the healthiest choice when eating out, test your salt IQ, and discover five easy ways to cut out salt. Penrose-St. Francis Health Services
Photos left to right: ©iStockphoto.com/BrianAJackson, ©iStockphoto.com/wpohldesign, ©iStockphoto.com/ImagePixel, ©iStockphoto.com/STEEX, steve bigley
Take a break from osteoporosis drugs Women at risk of osteoporosis who take bisphosphonates, such as Fosamax and Boniva, should consider taking a timeout if they have been on the medication for five years or more. Recent research shows that these drugs – used to prevent bone breakage – can actually increase a person’s risk of fractures and cancer if taken too long. These drugs help maintain bone strength by suppressing osteoclasts, the cells that break down bone. Over time, however, they can oversuppress these cells. This leads to lower bone “turnover” and increased
Test Your Bones
If you are over 60 or at risk of osteoporosis, schedule a DEXA bone scan at The Center for Women’s Imaging at the Penrose Pavilion by calling 719-776-8010. Win a FREE bone scan. See back cover for details.
For the man in your life
fragility, says Thomas Bartlett, MD, an internal medicine physician with Penrose-St. Francis Health Services who specializes in the treatment of osteoporosis. “It’s reasonable that you consider a holiday after five years,” Bartlett says. Women who discontinue use of the medication should have a test to measure bone turnover every six months. As the medication “clears” out of the body, bone turnover will resume and the medication can be restarted. The test is performed through a urine sample. “It’s important that the medication is not restarted arbitrarily but based on an objective measure,” Bartlett says. Women also need to be diligent about taking calcium and vitamin D supplements and getting regular exercise that puts stress on their spine, hips, and legs. “If women are not stimulating their osteoblasts (cells that build bones) through weight-bearing exercise, medications will not be effective,” he warns.
Protect His Skin
Get a FREE SKIN CANCER SCREENING on Saturday, May 5, from 8-11:30 a.m. at Peak Vista Community Health Center, 225 South Union Boulevard. Appointments are required and can be scheduled by calling 719-444-2273.
You look deeply into his eyes, but when’s the last time you took a thorough look at your guy? His skin, that is. Go on, take a look. Be sure to pay close attention to his face, ears, neck, and back — the areas most likely to develop skin cancer. Men have nearly double the rate of skin cancer than women, and they are more likely to die from it. In fact, men over 65 are twice as likely to die from melanoma, the deadliest form of skin cancer, than women, of the same age, according to the National Cancer Institute. “Men are less likely to use sunscreen, more likely to get sunburned, and less likely to pay attention to their skin,” says Elizabeth W. Piantanida, MD, a dermatologist with Penrose-St. Francis Health Services. “Men also tend to delay seeking medical attention for suspicious skin lesions.” Thankfully, the vast majority of skin cancers are curable if caught early. So at least once a year, encourage the man in your life to get a thorough skin check by a professional. penrosestfrancis.org
Michael Force, RPh Director of Pharmacy Services Penrose-St. Francis Health Services
Can I split my pills to save money? In general, most pharmacists are opposed to this practice, as it can lead to inaccurate doses and potential overdosing. But after consulting with your doctor or pharmacist, some pills may be split safely. Here are some tips: • Use a tablet splitter rather than a knife. • Some tablets have a special coating to delay absorption until the drug is in the intestine. Cutting through this may affect absorption or cause stomach irritation. • In general, delayed-release tablets (suffixes with XR, CR, SR, XL) should NOT be split or crushed because absorption is hastened, leading to a problem known as “dose dumping.” • Tablets should not be split ahead of time.
Get a FREE pill splitter by stopping by Penrose Professional Pharmacy at Penrose Hospital, 2222 North Nevada Avenue, while supplies last. (PSF associates and volunteers are not eligible.)
Shouldering the Maybe it’s OK not to put your shoulder into it. After all, more than 9 million people will see a doctor this year for shoulder pain, with another 1 million hitting emergency rooms for urgent problems. “A lot of people tend to ignore shoulder problems until they become so severe that the pain limits even their daily living,” says Richard Stockelman, MD, an orthopaedic surgeon with Penrose-St. Francis Health Services. “But most problems are easy to fix if they are seen early on.” Stockelman recommends rest, ice, and nonsteroidal anti-inflammatory medications, such as ibuprofen, when you initially experience pain. If the pain is not gone within two to three weeks, see a physician.
Give It a Rest Your shoulder is the most complicated joint in the body, actually consisting of two joints. The more well-known is the ball-and-cup socket between the upper arm and shoulder. The second joint is located where the collarbone meets the tip of the shoulder bone. These joints are supported by numerous muscles, tendons, and ligaments. The shoulder also moves in many different directions, making it vulnerable to injury. Most shoulder pain in people under the age of 50 is due to inflammation of either the rotator cuff tendon or the bursa, the small sac of fluid
Big purses may be this season’s fashion trend, but they’re not good for your shoulders. Here are some tips for shouldering the load.
4 Spring 2012
• Don’t carry more than 10 pounds • Weigh the purse empty before you buy – some purses weigh as much as 8 pounds before you add a single lipstick
• Alternate carrying your purse on both shoulders
• Choose purses with wide straps that help distribute the weight
• Alternate purses so you’re not carrying a large bag every day
• Use a backpack-style purse if you’re walking a lot
Penrose-St. Francis Health Services
Photos left to right: ©iStockphoto.com/jklune, Ellen Jaskol, ©iStockphoto.com/jklune, STEVE BIGLEY
The shoulder is often the forgotten workhorse until trouble hits. Learn how to protect this precious part.
Load Richard Stockelman, MD
that covers the rotator cuff. This inflammation is caused by overuse or injury, and is easy to treat with rest, anti-inflammatory medications, and ice. The problem, however, comes when people don’t treat the initial inflammation and use the rotator cuff improperly to work around the pain.
New shoulder replacement surgery
Rotator Cuff Tears The rotator cuff, which is made up of four muscles that hold the upper arm bone in the shoulder socket, helps you lift and rotate your arm. While inflammation is common in people of all ages, rotator cuff tears become more common with age. “By the time you’re 70, you’ve got up to a 60 percent chance of one or both of your rotator cuffs being partially or fully torn,” Stockelman says. Injury occurs for two main reasons: 1. People tend to overuse the supraspinatus muscle, just one of the four muscles making up the rotator cuff. 2. As we age, our muscles become shorter and tighter. The rotator cuff muscles, which often don’t get stretched, are vulnerable. Even just reaching for something can cause injury. Rotator cuff tears can range in severity from mildly annoying to extremely painful. You’ll typically experience pain when you try to lift or rotate your arm. But a rotator cuff tear also causes pain when resting.
Repairing the Damage About half of all rotator cuff injuries can be treated with rest, anti-inflammatory medications, steroidal injections, and physical therapy. The other half will require surgery to reattach the tendon. A partial tear may need a procedure only to trim or smooth it, while a complete tear requires stitching the two sides of the torn tendon together. Surgery often can be done arthroscopically through tiny incisions. A recent development is the use of the patient’s own blood platelets, which are thought penrosestfrancis.org
to increase the blood flow and promote faster healing. The problem, Stockelman says, is that when used with a rotator cuff, it may help repair the tear. But the area where the tendon attaches to the bone may remain too stiff. “You’re left with a rotator cuff that is stiff, so it won’t reattach to the bone,” he says. “My concern is that this is already being marketed to patients, but the technique is still being developed and has not yet been proven to be effective. It’s also expensive and not covered by insurance. Orthopedic biologics hold promise, but we’re not quite there yet.”
FREE Seminar Sore shoulders?
Learn what’s causing your problem and what can be done at a FREE community seminar with Richard Stockelman, MD, and Vicki Lieber, physical therapist. Dress comfortably, as you’ll get the chance to learn some exercises to maintain shoulder health.
Enter to win A cross-body summer purse! Date: Thursday, May 3 Time: 6-8 p.m. Location: St. Francis Medical Center NorthCare Building Registration is required by calling 719-776-5052.
A beautiful fall day of raking leaves quickly turned into tragedy for 82-year-old Anna Dow when she missed a step and fell several feet onto her shoulder. “No sooner had I stepped into the (raised flower) bed and my ankle twisted and threw me down to the sidewalk,” says Dow, of Colorado Springs. She called 911, and paramedics rushed her to the Penrose Hospital emergency room. It was clear to orthopaedic surgeon Richard Stockelman, MD, that she would need a complex surgery called a “reverse total shoulder replacement” to repair a severe fracture of her humeral head. This type of fracture does not heal well in the elderly, and the rotator cuff cannot be reattached. In this relatively new surgery, the surgeon replaces the natural ball-and-socket shoulder joint with an artificial joint. But instead of replacing it in the same position, the joint is reversed so that the artificial socket, or “cup,” is attached to the top of the arm bone. “With a chronic tear of the rotator cuff, the tendon stiffens and retracts,” Stockelman explains. “If we try to reattach the rotator cuff to hold the artificial shoulder joint in place, it won’t attach. By reversing the joint, the joint becomes more stable and function is restored.” The surgery, which is beneficial for patients who have no remaining rotator cuff function, is commonly used in patients older than 70. Patients are able to drive within four to six weeks and are typically 90 percent recovered within three months, Stockelman says. “I had very little pain after the surgery,” Dow says. “I’m faithfully doing my (physical therapy) exercises, and my arm is getting stronger. And I’m getting more range of motion all the time, so I feel most fortunate.”
Weighing In What you can gain from weight-loss research Watching your weight is a numbers game. Numbers on the scale. Dress size. Calories. But if your weight-loss efforts aren’t adding up, take a break from math and dig into the science behind these three recent studies.
“Eat ‘near to nature,’” Weatherly says. “When you pick up a food item, the ingredient list is as important to read as the nutrition label.”
Fighting fat with fat – and muscle
Your personality is another important part of the weight-loss equation. How do you handle stress? Do you take yourself too seriously? Do you multitask? Researchers at the National Institute on Aging found a link to higher body mass index (BMI) in people who were impulsive or had a tendency to experience negative emotions, as well as those who were perfectionists or scored low on conscientiousness. Weatherly says identifying how stress affects you is key. “If you tend to eat a bowl of ice cream when you’re stressed, you need to explore realistic alternatives,” she says.
Making the right choices While weight loss seems like simple math, studies show that it’s where you get your calories that counts. Harvard researchers found that subjects eating the same number of calories gained more weight when they ate certain foods, including refined grains and sugary drinks. Others lost weight by consuming fruits, vegetables, whole grains, and, surprisingly, dairy products. People often drop dairy from their diet, thinking it will help them shed pounds. But Weatherly says it’s about making wise choices like low-fat, no-sugar-added yogurt and skim milk, both of which are rich in calcium and vitamin D.
6 Spring 2012
Is surgery right for me? When weight-loss efforts have failed, it might be time to consider bariatric surgery. Today, multiple procedures offer more options for more people. While results vary, patients can expect to start shedding pounds, and their associated health problems, immediately. In the first year, gastric bypass patients can lose up to 120 pounds; up to 60 pounds for Lap-Band® patients; and around 90 pounds for sleeve gastrectomy patients – if they follow the prescribed healthy eating and exercise plan from their doctor. Gastric bypass surgery has been found to reduce cholesterol levels and blood pressure rates and improve or even cure diabetes. “After gastric bypass, it’s amazing how quickly patients can lose their co-morbidities (related health problems),” says Fran Jackson, RN, CBN, bariatric program coordinator with Penrose-St. Francis Health Services. “For the majority of patients, these conditions will be gone within six months.”
Visit penrosestfrancis.org/weightloss to request a FREE private consultation about weight-loss surgery options.
Penrose-St. Francis Health Services
Photos left to right: ©iStockphoto.com/daneger, ©iStockphoto.com/sjlocke
Most of your body fat is white, but a specialized type of brown fat, found in very small amounts in humans, can actually burn other fat. The Journal of Clinical Investigation reported that when triggered by cold or exercise, brown fat increases metabolic rate. Although applications of these findings are a ways off, you can fuel your metabolism today by building muscle. Sandra Weatherly, a registered dietitian with Penrose-St. Francis Health Services, says, “More muscle mass makes your body burn calories more efficiently – even when you’re at rest. That means you’ll be more successful losing weight by including strength training in your exercise plan.”
Pounds for personality?
calendarspring Penrose-St. Francis Health Services encourages you to experience the wide variety of health programs, screenings, and fitness classes that we offer throughout the Colorado Springs area. This calendar briefly highlights some of our beneficial programs and classes, many of which are ongoing throughout the year. See the key below for location information, and visit penrosestfrancis.org/wellness for a complete listing. Registration is required for all programs and can be made by calling the number listed.
Location key: CSSCA – CSSC Aquatics Center, 1625 Medical Center Point, No.160 PCC – Penrose Cancer Center, 2222 North Nevada Avenue
Photos left to right: Jill Woodford, ©iStockphoto.com/amygdala_imagery, ©iStockphoto.com/H-Gall
PH – Penrose Hospital, 2222 North Nevada Avenue PHLCG – Penrose-St. Francis Health Learning Center Gym, 1644 Medical Center Point PHWC – Penrose Hospital, Wellness Center, 2222 North Nevada Avenue PVCHC – Peak Vista Community Health Center, 225 South Union Boulevard SFMC – St. Francis Medical Center, 6001 East Woodmen Road SFMC-NCB – St. Francis Medical Center NorthCare Building, 6075 East Woodmen Road
*Penrose-St. Francis Health Services employees are eligible for discounts on these classes.
Aquatics Classes | CSSCA Call for fee Warm water exercise classes that are good for cardiovascular conditioning. Call for dates and times. 719-776-4780
Oral, Head & Neck Cancer Screening PCC | FREE Receive a noninvasive and painless head and neck cancer screening. Appointment needed. Wed, Apr 25, 4-6 p.m., 719-776-6918
8th Annual First & Main Town Center Summer Concert Series | FREE Food, drink, music, and fun for the whole family. Sponsored by Penrose-St. Francis Health Services. Fris, Jun 1-Jul 27, 5-7 p.m.
Infant/Child CPR | SFMC | $20 This two-hour course teaches you to administer CPR to babies and children, and how to relieve an obstructed airway. Ongoing evening and weekend classes. 719-571-3101
Power Up | PHWC | $60* Feel great through cardiovascular conditioning, muscle toning, balance, agility training, and flexibility. Sats, through Apr 28, 9-10:30 a.m., 719-776-7494
Skin Cancer Screening PVCHC | FREE FREE skin cancer screening. Sat, May 5, 8-11:30 a.m., 719-444-2273
Breast Cancer Support Group PCC | FREE Support and encouragement for women with breast cancer. 2nd Mon of the month, 5:307 p.m., 719-776-5311
T’ai Chi | PHLCG | $40/month (for 8 classes) A gentle, relaxing workout that improves body awareness, strength, and coordination. Tues & Thurs, 9-10 a.m., 719-776-4780
Bariatric Weight-Loss Surgery PH | FREE Learn if you are a candidate, your surgical options, and what to expect following surgery. Sat, Jul 28, 9-11 a.m., 719-776-5359
Fresh Start Smoking Cessation | CPCC | FREE A four-week education program to help you quit smoking. Mons, 5:30-6:30 p.m., 719-776-6048
Yoga | SFMC | Call for fee Join this therapeutic, breathinspired style of flow yoga, for all fitness levels! Mons, May 7-Jun 25, 5-6 p.m., 719-776-7494
Infant Massage | SFMC | $30 This two-part class teaches strokes that will relax your baby, encourage restful sleep, and more. Baby should be at least 3 weeks old when class begins. Couples welcome for one price. Tue, May 15 & 22, 10-11 a.m., 719-571-3101
WomenHeart Support Group PH | FREE Providing encouragement and strategies to cope with a heart condition. 2nd Wed of month, 11:30 a.m.1 p.m., 719-200-2645
May 3 Conversations with Women: Soothing Your Shoulder Pain
SFMC-NCB | FREE Sore shoulders? Learn what’s causing your problem and what can be done at a FREE community seminar with Richard Stockelman, MD. Then join Vicki Lieber, PT, to learn some exercises to maintain shoulder health. Thu, May 3, 6-8 p.m., 719-776-5052
Enjoy FREE refreshments and enter to win this FREE cross-body purse!
Catholic Health Initiatives Colorado
Ee! E R F packag
Mother, Daughter, Sister, Friend, and You!
Non-Profit Org. U.S. Postage
2222 North Nevada Avenue Colorado Springs, CO 80907
Colorado Springs, CO Permit No. 14
Invite the women in your life to the Penrose Women’s Pavilion Open House Saturday, May 12 9 a.m. -12:30 p.m. Penrose Pavilion, 2312 North Nevada Avenue (on the Penrose Hospital campus)
• Savor healthy superfood refreshments • Get a professional bra fitting from Dillard’s Chapel Hills • Shop in the new Mother Daughter Sister Friend women’s boutique • Attend fun, educational seminars • Enjoy a relaxing chair massage
• Get a full cholesterol screening for just $10 (fasting is required) • Register to win a FREE screening mammogram or bone density scan • Meet the staff, and schedule a future screening mammogram or bone density screening (or you can call now to schedule an appointment: 719-776-8010)
Penrose Women’s Services is located on the second floor of the Penrose Pavilion and includes The Center for Women’s Imaging, the Penrose-St. Francis Breast Care Center, and the Penrose Vein Center. Also located in the Pavilion is the Mother Daughter Sister Friend women’s boutique, offering health products and unique gift ideas.
Good Health Seminars At the May 12 Open House, each of these seminars will run twice. Please join us from 9:30 to 10:30 a.m. and from 10:45 to 11:45 a.m.
Hot Legs: Steps Toward Healthier Veins Remember when your legs used to turn heads? At the Penrose Vein Center, minimally invasive treatment options for varicose and spider veins can produce knockout results and you’ll feel much better, too. Learn steps you can take to reduce your risk for varicose or spider veins and what you can do if you have them.
Giveaways Galore! Come early – the first 250 women through the door will get a free tote bag! Plus, every woman can enter to win a Salon and Spa Package ($275 value) from A Total New You Salon and Spa!
Save the TaTas!
When was the last time you did a breast self-exam or got a mammogram? Learn the latest screening guidelines, the correct way to do a BSE, and when you need to talk to your doctor.
Strong Women, Strong Bones Half of all women will suffer an osteoporosis-related fracture – often much younger than anticipated. Learn how to prevent osteoporosis with nutrition and exercise as well as understand the risks and benefits of medications and treatment options. Plus, learn about medical conditions and medicines that can cause bone loss.
Super Foods for Super Health Shape up your plate with all the colors of the rainbow. Learn from a registered dietitian the top 14 foods you should eat every day. Practical solutions and recipes will be shared.
Want a BONUS chance to win a $275 spa package? Bring this coupon to the Women’s Pavilion Open House when you check in, and we’ll give you a bonus entry into the drawing for a FREE spa day!
Name: ________________ Phone: ________________
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.
Learn how to protect your shoulders, the most complicated joint in the body in this quarterly magazine nurturing women's health in CO. Writ...
Published on Apr 2, 2012
Learn how to protect your shoulders, the most complicated joint in the body in this quarterly magazine nurturing women's health in CO. Writ...